Listen to this article Your browser does not support the audio element. Each year, the Centers for Medicare & Medicaid Services (CMS) releases a proposed Skilled Nursing Facility Prospective Payment System (SNF PPS) rule, outlining potential payment updates, quality reporting changes, and regulatory revisions that will affect SNFs nationwide. The …
AAPACN’s ADR Help: HIPPS Code Analyzer interactive tool helps identify the documentation elements that may have contributed to the HIPPS code assigned to an assessment selected for Additional Documentation Request (ADR) review. Designed to support the ADR record review process, the tool highlights the clinical, coding, and documentation areas that …
From MLN Connects eNews: CMS will relaunch the Program for Evaluating Payment Patterns Electronic Report (PEPPER) in the coming months for all Medicare facility types, including hospitals, post-acute care providers, and specialty facilities. PEPPER is a free tool that helps you review your Medicare billing data so you can identify …
Listen to this article Your browser does not support the audio element. As summer approaches, many people begin thinking about health goals, wellness check-ins, and how to prepare for more outdoor activities in the warmer months. In the long-term care ICD-10 realm, preparation takes a different form: ensuring documentation and …
The Centers for Medicare & Medicaid Services (CMS) previously announced in March that the updated Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, was now available, but extended implementation to no later than May 12, 2026. While providers could continue using the previous version through May 11, 2026, facilities should …
The AAPACN ICD-10-CM Coding Decision Tool: Obesity and BMI Reporting helps long-term care staff accurately determine when BMI and obesity-related ICD-10-CM codes can be reported while ensuring compliance with provider documentation requirements. This tool guides users through coding decisions, clarifies the Patient-Driven Payment Model (PDPM) non-therapy ancillary (NTA) point impacts, …
Listen to this article Your browser does not support the audio element. In the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2027, officially published on April 7, 2026, the Centers for Medicare & Medicaid Services (CMS) proposes some earth-shaking …
Listen to this article Your browser does not support the audio element. The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP), often regarded as merely an exercise in reporting compliance, also has direct payment implications. Thus for SNFs, compliance reflects both quality and financial issues. The program asks facilities to …
Listen to this article Your browser does not support the audio element. Skilled nursing facilities (SNFs) frequently manage residents who temporarily leave the building or experience a break in Medicare Part A coverage. On the UB-04, these situations may look the same, often reflected as gaps in covered days or …
Overview What is the Data Validation Process? The Data Validation Process evaluates the accuracy of quality measure data elements derived from the Minimum Data Set (MDS), which are used in the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) and Quality Reporting Programs (QRP) for assessing quality of care and measuring …
