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Software that imports data from other modules,
pulls data forward from previous assessments, and other similar functionality is
a great timesaver, but usually carries out its functionality based on some very
simple rules. These rules may not give an acceptable result 100% of the time.
You should ask your vendor to explain how these things work so that you can
properly review them each time and decide when the result is appropriate and
when it is not.
I am not expert on the biling side, so I don't know
for sure about the UB-92 rules, but what you are saying about using the same dx
even if they are different on the 5 day and 14 seems strange. You need to check
with someone that knows the bililng rules better than I do.
Nathan
----- Original Message -----
Sent: Sunday, February 15, 2004 9:33
AM
Subject: Re: Dave Audit
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 -----
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.
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