G tubes- they can regenerate their 100 days if they fall below the skilled criteria for tube feedings for 60 consecutive days.  It doesn’t happen often but I have had it happen twice and did not have a problem with reimbursement.  

 

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Tracy Howard
Sent:
Thursday, February 26, 2004 11:38 AM
To: [EMAIL PROTECTED]
Subject: billing g-tubes/psych stays on Medicare

 

I am trying to find out some information regarding g-tubes and Medicare.   I was taught that if you have skilled a resident 100 days for a g-tube, but later on they start eating and are no longer receiving feedings through the tube, (only flushes) that because they fall below that skilled criteria of receiving 26% or more feedings through the tube, that they qualify to regenerate their 100 days on Medicare.

Does anyone know the guidelines on this?

 

Also I have a question about skilling those that come back from a 3 day psych stay.  If they are going to fall below the upper 26 RUGS can they be skilled on Medicare even through day 8?   The AANAC course I took stated that the presumption of coverage through day 8 is only for those who will have RUGS in the upper 26.      Does anyone have any info on this as well?

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