Archive for May, 2011

May 26, 2011

Develop 20/20 369 coding

Use of the 369 codes …. I feel like we education on it a lot, but people are still not sure about how and when to code.

Take low vision … when can that be coded? When a patient has blurry vision or they can’t read medication labels?

The 369 codes can be used if the patient is blind. The 369 codes are otherwise limited to vision loss due to an eye condition that is not correctable by glasses, i.e., glaucoma, cataracts, hemianopsia, retinopathy, etc. It is NOT for use just because the patient cannot see medication labels.

May 26, 2011

Oops! That darn POC and case mix codes

Thank you to a subscriber who asked about a recent entry … sometimes we all lose track of the information floating in our heads:
Question: I have been following your blog entries. On April 15, 2011, you blogged that the resolved case-mix codes need to be placed on the POC. You suggested field 21. In order for me to change a current practice, I need the resource for your quote. I can not seem to find it in the CoP’s. Would you mind giving me the resource?

Lisa says: That was actually an older blog that got recycled by mistake.
There was a requirement in the OASIS manual, but when the OASIS manual was revised it was omitted. We dont know whether it was omitted by mistake or on purpose.

May 20, 2011

Be ready for the zombies

Everyone have a good weekend … and watch for the unexpected.

The CDC provides information and resources for preparing for and responding to public health emergencies. CDC has created four badges that you can copy and paste into your website, social network profile, blog, or email to provide people with access to information on how to prepare for a zombie take over… and real emergencies like hurricanes or floods. Check out CDC Social Media for badges, widgets, content syndication, and more:

May 18, 2011

Do we have to report procedure codes?

Question: We’ve heard that we don’t have to report procedure codes, but we’re confused about this. Are there any legal problems in using procedure codes? I personally do not use them.

Lisa says: The last quarterly update from CMS included a statement re: procedure codes. CMS does not use them for anything so you can continue to code procedues or mark NA or UK. The POC no longer has to include procedure codes, either.

May 16, 2011

The first visit to the home is the ROC

Some agencies are under the impression that the first visit after the patient returns from an inpatient facility stay has to be the ROC assessment and they believe that any visit prior to the ROC assessment cannot be billed. Both are misunderstandings. The first visit by anyone by your agency, billable or non-billable, is the ROC visit and so the date of that visit is placed in M0032. The ROC assessment has to be completed within 48 hours of return home.

Here is the information from OASIS Q&As

[Q&A ADDED & EDITED 9/09; Previously CMS OCCB 01/09 Q&A #5]

Q15.1. My patient was released from the hospital and needed an injection that evening. The case manager was unavailable and planned to resume care the following day. Could the on call nurse visit and give the injection before the resumption of care assessment is done? Is there a time frame in which care (by an LPN or others) can be provided prior to the completion of the ROC assessment?

A15.1. There are no federal regulatory requirements that prevent an LPN from making the first visit to the patient when resuming care after an inpatient facility stay, but there must be physician orders for the services/treatments provided during that visit. It is not required that the ROC comprehensive assessment be completed on the first visit following the patient’s return home. OASIS guidance states that the Resumption of Care comprehensive assessment must be completed within 2 calendar days after the patient’s return from the inpatient facility. The clinician that completes the ROC comprehensive assessment must be an RN, PT, OT or SLP.

In the case of an unknown hospitalization, a LPN/LVN, aide, or PTA etc makes a regularly scheduled visit and finds that the patient has had a hospitalization meeting the criteria for transfer, calls the agency and reports the hospitalization. The orders you have for the episode are still valid orders after an inpatient admission, so if that regularly scheduled visit has orders that visit is still billable. That visit date is also the date placed in M0032. The qualified clinician has 2 days from the point of acquiring the knowledge of the hospitalization to complete the transfer and the ROC assessments. M0090 is the date the assessment was actually completed.