Tammy, you rugged out as a SE3 with the ard 14 day because you did not have enough therapy minutes to capture a rehab rugs grouping. I understand about the 11 day ard, but the software will automatically capture the rehab rugs grouping. If you read chapter 6 of the mds manual, this is the way the hierarchy is set up. if you use day 11, you will have to bill as a RMC.
Brenda W. Chance, RN, RAC-C MDS Coordinator CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -----Original Message----- From: Gola, Tammy [mailto:[EMAIL PROTECTED] Sent: Thursday, November 06, 2003 1:43 PM To: '[EMAIL PROTECTED]' Subject: RE: Software and RUG's Actually, what I did do, that my software allows me to do is first entered in the assessment using day 14 which had IVF in section K, IV med and O2 in section P1 and OT 3 days and 105 min., and PT 2 days and 70 minutes (RUG'd out as RMC). I then copied this assessment and only changed the therapy portion to reflect OT 2 days and 38 minutes and PT 0 days and 18 minutes (RUG'd out at SE3). I don't know, I too thought my software pulled the higher paying RUG. I believe that as long as I am in the assessment window I can use either one that I want and of course I am going to take the higher paying one. What software do you use? Tammy Gola BSN, RN, CRNAC Wilkes-Barre General Hospital Transitional Care Unit 575 North River Street Wilkes-Barre, PA. 187641-0001 570-552-5417 [EMAIL PROTECTED] -----Original Message----- From: Brenda Chance [mailto:[EMAIL PROTECTED] Sent: Thursday, November 06, 2003 1:27 PM To: [EMAIL PROTECTED] Subject: RE: Software and RUG's Tammy, If you are using therapy minutes and days, in order for it to be skilled, the therapy must be 5 days/week. The medium category has to be 5 days of any combination of the 3 disciplines. The disciplines need to spread their days out so that they are treating 5 days per week. My software will not rug out a SE3 before a rehab category. Check you 14 day assessment closely. My thought is that you did not have enough therapy days or minutes to put you into a rehab category. Brenda W. Chance, RN, RAC-C MDS Coordinator CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -----Original Message----- From: Gola, Tammy [mailto:[EMAIL PROTECTED] Sent: Thursday, November 06, 2003 12:06 PM To: '[EMAIL PROTECTED]' Subject: RE: Software and RUG's No, not really, the assessments are identical except for the # of days and minutes of therapy the patient actually received based on which ARD I used. so on both assessments they had IVF, IV med and O2. Tammy Gola BSN, RN, CRNAC Wilkes-Barre General Hospital Transitional Care Unit 575 North River Street Wilkes-Barre, PA. 187641-0001 570-552-5417 [EMAIL PROTECTED] -----Original Message----- From: Brenda Chance [mailto:[EMAIL PROTECTED] Sent: Thursday, November 06, 2003 11:46 AM To: [EMAIL PROTECTED] Subject: RE: Software and RUG's You are using 2 different ARD's with different coding. The difference in the RMC and SE3 is not related to therapy. The SE3 may only be obtained through IV meds, etc. See the clarification in the MDS manual in chapter 6. Brenda W. Chance, RN, RAC-C MDS Coordinator CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -----Original Message----- From: Gola, Tammy [mailto:[EMAIL PROTECTED] Sent: Thursday, November 06, 2003 11:18 AM To: '[EMAIL PROTECTED]' Subject: Software and RUG's Hi, I know that this was recently discussed, but I'm going to ask it anyways. What is the correct way to bill the right RUG, by the higher reimbursed RUG or higher CMI RUG. I have a patient that if I use day 11, I RUG at RMC. If I use day 14 I get a SE3 RUG. Another thought is that on the one using day 11, I don't have 5 consecutive days of therapy between the 2 disciplines. but I do have 175 minutes. (there were 3 days for OT and 2 days for PT but on the same days). Which is the correct way to do this. At one point, I thought my software always pulled the higher paying RUG, but I guess not. Tammy Gola BSN, RN, CRNAC Wilkes-Barre General Hospital Transitional Care Unit 575 North River Street Wilkes-Barre, PA. 187641-0001 570-552-5417 [EMAIL PROTECTED] /---------------------------------------------------------- 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 -----------------------------------------------------------/ /---------------------------------------------------------- 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 -----------------------------------------------------------/ /---------------------------------------------------------- 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 -----------------------------------------------------------/ /---------------------------------------------------------- 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 -----------------------------------------------------------/ /---------------------------------------------------------- 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 -----------------------------------------------------------/ /---------------------------------------------------------- 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 -----------------------------------------------------------/
