Question: Our nurses complete a respiratory therapy assessment on all new admissions for the first seven days. The RAI User’s Manual states that only minutes the respiratory therapist or respiratory nurse spend with the resident …
On Dec. 2, 2020, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS) Final Rule. However, on Dec. 21, 2020, Congress passed the Consolidated Appropriations …
I. SUMMARY OF CHANGES: This Change Request (CR) updates the list of codes that sometimes or always describe therapy services. The additions, changes, and deletions to the therapy code list reflect those made in the …
Question: Physical therapy completed an evaluation and determined the Medicare Part A resident did not need PT services. The therapist is stating she had 20 minutes of non-MDS time and 30 minutes of actual individual …
In the COVID-19 pandemic, some states now are seeing a decrease in cases, while others have continued growth, especially in rural and suburban areas. Much of the COVID-19 response is becoming localized to meet these …
Question: Our rehab department temporarily closed due to a COVID-19 outbreak. We have several residents who are skilled for rehab only and do not have a skilled nursing need. Are we able to continue to …
Question: We have a resident who was skilled under Medicare Part A due to a symptomatic positive COVD-19 test and skilled therapy services. I issued a last covered day (LCD) when the retest came back …
On April 10, the Centers for Medicare & Medicaid Services (CMS) released for public inspection the Fiscal Year (FY) 2021 Proposed Rule for the Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing …
Question: A Medicare Part A resident returned to the SNF during the interruption window to continue their Medicare stay. Therapy originally started before the interruption, but the 5-Day ARD is after the resident returned. Do …
Question: Are five distinct days of therapy required for the initial 5-Day assessment for new admissions to qualify for the therapy skilled services? Answer: While it is true that 5 days/week therapy is considered …
Dysphagia coding plays a key role in the Patient-Driven Payment Model (PDPM) through both section I (Active Diagnoses) and section K (Swallowing/Nutritional Status) of the MDS. Here are the keys to getting it right: …
Question: How will the new regulations regarding billing 97530 (therapeutic activities) and 97150 (therapeutic procedures) on the same day as PT and OT evaluations impact Part B therapy billing? Answer: CMS issued a “surprise” …
Question: For a Medicare Part A resident, if you have adverse weather and therapy is unable to see a resident who is skilled for therapy services five days per week, is there a penalty? …
Question: Is there a regulation or requirement for the completion of a therapy evaluation on admission for a Medicare Part A resident? I have tried to encourage rehab to evaluate the patient on the day …
Question: A resident is admitted for IV antibiotic therapy only. Who is responsible for completing the functional assessment for section GG when the resident is not receiving PT or OT? Is assessment for mobility under …
Question: Our software system automatically populates therapy diagnoses codes to I8000 on the MDS. Do I leave these on even if they are not active within the last seven days? For instance, abnormal weight loss …
Question: What would the appropriate protocol be for developing the baseline care plan within 48 hours when a resident admits late on a Friday afternoon and there is no therapy coverage until Monday? How would …
