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I'm sending this to Virginia providers, but, since AANAC has been so helpful to be, I'm just sending it to this list as well...one RAC-C to another.
Thanks,
Judy Wilhide, RN, BA, RAC-C
RAI Manager
Virginia
Greetings from the State RAI Manager!
The April 2004 revisions to the RAI Manual are now posted to www.cms.hhs.gov/medicaid/mds20. Click on "Manuals and Forms."
Here is a summary of some of the changes: (I did not mention correction of typos or clarifications that did not change anything. This does not replace actually going to the website and downloading the changes)
Page 1-17: Concerning Change of Ownership with assumption of assets and liabilities of the prior owner:
[This is not a change of policy, it is just spelled out in the RAI Manual now.] If the provider ID does not change, there is no change in MDS schedules. If the Provider ID changes, all residents must have new Admission assessments with the AB1 date the date of the sale. You do "06" discharges from the old ID number.
Page 3-27: The RN Assessment Coordinator only has to sign the Face Sheet if s/he worked on the Face Sheet Information at Admission.
Page 3-129: I1z. Quadriplegia. "Do not code Quadriparesis here." May affect the Special Care RUG. Quadriplegia and ADL score of at least 10 qualify a resident for Special Care.
Page 3-153: K5a: "Do not include fluids administered solely as flushes." This is not what was in previous drafts circulating since the AANAC conference. This final clarification is not a change in policy.
Page 3-159: Section M: NOT A CHANGE IN POLICY. ALL THE CLARIFICATIONS HERE ARE JUST MAKING IT EASIER TO UNDERSTAND. JUST KEEP DOING WHAT YOU'VE BEEN DOING SINCE THE AUGUST 2004 CHANGES. IF READING IT GETS YOU CONFUSED, STOP READING IT. THIS DOES NOT CHANGE HOW WE HAVE BEEN CODING SECTION M SINCE AUGUST 2004.
Page 3-176: O1. The sentence that caused such confusion is gone. [Preparations used for preventative care are not included here]. There is a new sentence that says: Topical preparations that are used for preventative skin care ( ie moisturizers and moisture barriers) should not be coded here. This is a big improvement!
O1. Add this sentence: "Antigens and vaccines are coded here." Also a big improvement! There is now no controversy over antigens and vaccines! Include them!
Page 3-185: THE GREAT RESPIRATORY THERAPY CONTROVERSY IS OVER!
You no longer have to have an RT do the eval and tx plan! The added sentence is: "A trained nurse my perform the assessment."
Page 3-193: In coding P3i. Restorative prosthesis care: "Dentures are not considered to be prostheses for coding this item." I guess I can't blame providers for trying this while it lasted, but they have closed this loophole now. This may affect the end-split for the bottom RUGS, and Rehab Low, if you were using denture care as a restorative program.
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