There is probably nothing wrong with the MDS. The quarterly was combined
with the 5-day return readmission assessment. The problem is with the
UB-92. The bill should have the HIPPS code listed as 05 instead of 55.
Your software probably feeds through to the bills. Since the HIPPS code is
not always what is coded in AA8a and AA8b, it is important for you to know
what is going onto the bills. That is where a medicare triple check monthly
meeting can come in handy. Check the bills together with your biller. Have
a report of the MDSs completed and make sure that the correct HIPPS code is
being sent to the FI. The 55 is a perfect example. There is no such code.
Another code that software has problems with is an admission combined with a
medicare return readmission assessment. The software sees 15 when it needs
to see 11. See pages 6-5 to 6-6 for acceptable HIPPS codes.
----- Original Message -----
From: "Pam Allen" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, March 10, 2004 9:51 AM
Subject: Modification of the MDS
> Ok, I have a head scratcher here. I was contacted by our billing
department
> today in regards to a PPS bill for February. The HIPPS code was 55.
Resident
> was skilled at a SE3 through her 5th day. The NAC who did this attempted
to
> code a quarterly along with the 5 day. We did a modification to AA8a/AA8b
> and resubmitted it to the state and it was rejected with the reason being
> that AA8a/AA8b can not be modified. Do we need to inactivate the first
> inaccurate assessment(with 5/5) or what? I can't seem to figure it out.
Your
> help would be greatly appreciated.
> Pam
>
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