Re: Skilling Oxygen

[Ldawja]

From http://www.cms.hhs.gov/manuals/102_policy/bp102c08.pdf,   Teaching and training activities, which require skilled nursing or skilled rehabilitation personnel to teach a patient how to manage their treatment regimen, would constitute skilled services. Some examples are: â Teaching self-administration of injectable medications or a complex range of medications; â Teaching a newly diagnosed diabetic to administer insulin injections, to prepare and follow a diabetic diet, and to observe foot-care precautions; â Teaching self-administration of medical gases to a patient; â Gait training and teaching of prosthesis care for a patient who has had a recent leg amputation; â Teaching patients how to care for a recent colostomy or ileostomy; â Teaching patients how to perform self-catheterization and self-administration of gastrostomy feedings; â Teaching patients how to care for and maintain central venous lines, such as Hickman catheters; â Teaching patients the use and care of braces, splints and orthotics, and any associated skin care; and â Teaching patients the proper care of any specialized dressings or skin treatments.   AND   30.3 - Direct Skilled Nursing Services to Patients (Rev. 1, 10-01-03) A3-3132.2, SNF-214.2   Some examples of direct skilled nursing services are: â Intravenous or intramuscular injections and intravenous feeding; â Enteral feeding that comprises at least 26 percent of daily calorie requirements and provides at least 501 milliliters of fluid per day; â Naso-pharyngeal and tracheotomy aspiration; â Insertion, sterile irrigation, and replacement of suprapubic catheters; â Application of dressings involving prescription medications and aseptic techniques (see Â30.5 for exception); â Treatment of decubitus ulcers, of a severity rated at Stage 3 or worse, or a widespread skin disorder (see Â30.5 for exception); â Heat treatments which have been specifically ordered by a physician as part of active treatment and which require observation by skilled nursing personnel to evaluate the patientâs progress adequately (see Â30.5 for exception); â Rehabilitation nursing procedures, including the related teaching and adaptive aspects of nursing, that are part of active treatment and require the presence of skilled nursing personnel; e.g., the institution and supervision of bowel and bladder training programs; â Initial phases of a regimen involving administration of medical gases such as bronchodilator therapy; and â Care of a colostomy during the early post-operative period in the presence of associated complications. The need for skilled nursing care during this period must be justified and documented in the patientâs medical record.   30.2.3.3 - Teaching and Training Activities (Rev. 1, 10-01-03) A3-3132.1.C.3, SNF-214.1.C.3   Lita D. Atkinson   ----------------   In a message dated 2/24/2004 9:01:36 AM Eastern Standard Time, [EMAIL PROTECTED] writes: Good morning, I am looking for any information you can help me with.  What are your FI's saying about skilling residents for Medicare on oxygen.  Are they allowing coverage for all days, only until stable or not at all for chronic users.  Any help would be appreciated. Shelley L. Becker, R.N. MDS/Medicare Nurse Trinity Homes Minot, ND   58703 email:  [EMAIL PROTECTED] fax:  701-857-5908