See the Discharge and Reentry Flowchart on page 2-26 of the RAI User's Manual.
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
Subj: RE: Billing question
Date: 1/7/04 3:32:13 PM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
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."
>Reply-To: [EMAIL PROTECTED]
>To: "'[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
>
>
>
