That is incorrect. You need to do a Medicare 5 day if it was the beginning of the Medicare stay or a Medicare Return/readmission if it was a continuing stay to get paid for that day at the RUG rate. There is an exception to the no midnight, no pay rule and that is if they admit and die on the same day. If you don't do the MDS, you will get paid at the default rate, which will be much lower that the RUG rate you will probably get. They will most likely RUG out at an SE category because they probably had IV meds, fluids, etc in the hospital if they were sick enough that they died 12 hours after they came back from the hospital. You cannot use the MD visits in the hospital on that MDS, however, the MDS states number of physician visits in the past 14 days or since admission to the LTC facility.
Deanna -----Original Message----- From: Wiedemann, Betty R [mailto:[EMAIL PROTECTED] Sent: Friday, January 02, 2004 12:37 PM To: '[EMAIL PROTECTED]' Subject: RE: Readmit / deceased less than 24 hour no over night stay no payment. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Sent: Friday, January 02, 2004 3:29 PM To: [EMAIL PROTECTED] Subject: Readmit / deceased less than 24 hour HI I have a resident that passed away in less than 24 hours upon readmission from the hosp with MCR eligible . His readmit date 12/31/03 at 11:50 am , deceased 11:55 pm same day. Billing is telling me that I do not have to do an MDS / cert for that day because they don't charge for that day because the resident expired before midnite. If so, what happens to that day of payment? I thought their was an exception to the rule when someone is admitted and dies within 24 hours that you could still charge for that day according to the rug. Please help, nancy fro PA Futhermore, could you count the physicans visit from the hosp progress notes for section p7 on the mds if done. /---------------------------------------------------------- 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 -----------------------------------------------------------/
