RE: biliary tube/omra/bacteremia (Rena help please)

[Brenda Chance]

Rena,   I am a little confused by answer 2.  The manual states on pg 2-31 that the ARD for an OMRA may be days 8, 9, or 10 after therapy is discontinued and the resident continues to need skilled nursing care.  If the resident was discharged on day 11 after therapy d/c, then the last covered medicare a day would be day 10 after therapy d/c.  Why would you need to do an OMRA?  Where did you find your response in the manual?    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: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] Sent: Monday, February 02, 2004 12:48 PM To: [EMAIL PROTECTED] Subject: Re: biliary tube/omra/bacteremia (Rena help please)   Please see my responses to your first two questions after each question. Rena Rena R. Shephard, MHA, RN, FACDONA, RAC-C Chair, American Association of Nurse Assessment Coordinators [EMAIL PROTECTED] Date: 2/2/04 8:47:01 AM Pacific Standard Time From: [EMAIL PROTECTED] Reply-to: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent from the Internet Hi everyone, I have several questions: 1)  Is biliary tube considered an ostomy? No, a biliary tube is not an ostomy.  The RAI User's Manual defines ostomy for Item H3i, Ostomy Present, as "any type of excretory ostomy of the gastrointestinal or genitourinary tract."  This is consistent with the definition from the International Ostomy Association:  "The word ostomy signifies a type of surgery required when a person has lost the normal function of the bladder or bowel due to birth defects, disease, injury or other disorders. Such operations include colostomy, ileostomy and urostomy. The surgery allows for normal bodily wastes to be expelled through a new surgical opening (stoma) on the abdominal wall. Most persons with ostomies must wear special appliances over the stoma. An ostomate is a person who has had ostomy surgery.'Related surgeries' are surgeries of the bowel or urinary system that correct birth defects, illness or injury while preserving continence". 2)  Omra is due on the 8,9,10 but pt. is discharged on the 11th day.  Do we need to do an OMRA? The manual specifies that it is not required if the resident is discharged from Medicare prior to day 8.  So, the answer to your question is "yes." 3)  Where do we code bacteremia? Sorry, I have posted this question 3 times and didn't get an answer. This one is for a Medical Records coder. Thank you.