RE: Billing question

[Faye Jones]

We always combine the assessments as long as doing so is in compliance with the regs.  I will do an OBRA slightly early to enable combining them rather than do 2 separate ones.  I person does all MDS’s for 144 residents approx 25 are MED A and extra assessments are avoided if possible.  In fact when we separate them it is usually to use grace days and maximize a PPS assessment and combining them would make the OBRA late.   I have certainly separated the 14 d from the Admission assessment more than once to get the right RUGS category.   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of claudia farrell Sent: Wednesday, January 07, 2004 6:31 PM To: [EMAIL PROTECTED] Subject: RE: Billing question   I am puzzled why you did a 5 day then an Annual? When I have admits like this I will do a full admission assessment/raps and care plan for the 5 day when I know that they are only going to use 14 days, another assessment is not necessary. Your next ARD date would be 92 days by your 5 day date set. Maybe I am doing it wrong all these years. Curious to view the responses. Claudia >From: "Chriss, Theresa M." <[EMAIL PROTECTED]> >Reply-To: [EMAIL PROTECTED] >To: "'[EMAIL PROTECTED]'" <[EMAIL PROTECTED]> >Subject: Billing question >Date: Wed, 7 Jan 2004 10:44:27 -0600 > >One of our long term residents recently went to the hospital and returned to >our facility on Medicare on 12-01-2003.   He had his Medicare 5 day  MDS >opened with an assessment reference date (ARD) of 12-02-2003 but it was not >also coded as an annual.  His RUGS score was SE3.     He remained on >Medicare until 12-14-2003.  During his Medicare stay, an annual MDS was >opened with an ARD of 12-08-2003.  His RUGS score was CC2.  Both assessments >have been submitted. > >We are wondering if this presents  a problem for our billing department. >Can we justify billing Medicare at an SE3 rate for days 1-14 when another >MDS was done which RUGed out at CC2?  Do we need to correct the Medicare MDS >and code it also as an annual??  And inactive the second MDS?  Any ideas?? > >Thank you, >Terri Chriss, RN Case Manager > > > > > >/---------------------------------------------------------- >The Case Mix Discussion Group is a free service of the >  American Association of Nurse Assessment Coordinators >       "Committed to the Assessment Professional" >Be sure to visit the AANAC website. Accurate answers to your >          questions posted to NAC News and FAQs. >     For more info visit us at http://www.aanac.org >-----------------------------------------------------------/ Worried about inbox overload? Get MSN Extra Storage now! /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/