CMS clarifies PPS considerations

Does any of this sound familiar?

What do I do when:

  • A patient in a new 60-day episode is discharged with all goals
    met but the patient returns to the same HHA during the 60-day episode. (PEP Adjustment applies)
  • I have a patient with a qualifying inpatient stay who returns to the agency during the last 5 days of an episode  (days 56-60).
  • My patient’s inpatient stay extends beyond the end of the current certification period. … and other such timing and care quandries?

CMS released in December and just recently updated its OASIS Considerations for PPS. This document deals with common problems, which RFA to work with, how to think about M0100 and M2200, and also has links to the Claims manual where you can find more information.

It is worth more than one look!

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