Re: Dave Audit

[Sally Murphy]

Thanks, Nathan.  So how about I3?  Our software automatically imports the top 5 diagnoses we enter into the system into there, or the top 2 for the shortened Medicare form.  Do we need to go and re-number those so they don't get imported if we've removed the check from I2 for the 14-day?  And our billing person informs me that she has to use the same 9 diagnoses on all UB-92s for the month even if I give her different info for the 14-day than the 5-day.  Or aren't we concerned about the billing, just the MDS?
Thanks again, Sally

Nathan wrote:

The condition (pneumonia) does not still affect thier treatment plan. That is like saying someone that had a broken leg 5 years ago, still has a broken leg because they walk with a limp. The after-effects of pneumonia are not an infection and should not be coded that way.

 

Nathan

 

 

----- Original Message -----

From: Sally Murphy

To: [EMAIL PROTECTED]

Sent: Saturday, February 14, 2004 7:55 PM

Subject: Re: Dave Audit

"I2 -  Infections
Check an item only if the infection has a relationship to current ADL status, cognitive status, mood and behavior status, medical treatment, nursing monitoring, or risk of death. Do not record any conditions that have been resolved and no longer affect the resident's functional status or care plan."

I copied above from the instructions for I2, and I don't understand why they're making such a big deal over this.  I interpret the instructions to say "if the condition affects their functional status or care plan then it's still appropriate".  Often it takes six full weeks to recover from pneumonia.  So what if they're no longer receiving active treatment like an antibiotic, it's still affecting them, and that's why they're still on Med A.

Somebody please straighten me out.

Thanks, Sally

[EMAIL PROTECTED] wrote:

Our homes participated in the PAAR program, as branch of DAVE, and they founf the biggest error was MDSC's were not resolving off the pneumonia after the first assessment, IE it would be coded on the 5 day and the 14 day and even the 30 day PPS assessment. They had each facility review for accuracy and out of 90 reviews, only one truly had pneumonia after the 5 day assessment. We had 12 facilities in the program.