Archive for October, 2011

October 27, 2011

M1350 is ‘no’ if there is no intervention at discharge

Question:We have a patient who was admitted to home care for dressing changes to a traumatic open wound. The wound healed and the patient was discharged.  For M1350 on discharge, since the wound is healed, should the question be answered  “No” because the wound is healed and no longer needs any intervention or “Yes”  because up to the time of DC, she did require interventions?

Lisa says: Answer yes only if the wound required intervention at discharge even if intervention was not done. If the wound didn’t require intervention at discharge , answer no.
October 26, 2011

CDC gives hints on helping cancer patients

The Centers for Disease Control and Prevention has come out with new information on how to prevent infections in cancer patients. The information is for health care providers, but also can be aimed toward family and caregivers, so your agency might want to look for ideas or new information.

Main site

3 Steps to Preventing Infection

October 25, 2011

Answers to when we have to report admissions

Too often we learn about transfers of our patients after the fact. CMS released its 3rd quarter Q&As recently and addressed the item, including the turnaround time when we have to report the transfer.

Question 1: A patient is seen monthly. On a monthly visit, which falls within the last five days of the certification period, the assessing clinician discovers the patient had a qualifying hospital admission since the last monthly visit that our agency was not aware of. Do we complete a Transfer, Resumption and Recert or just the Transfer and Resumption?

Answer 1: When the agency learns of a qualifying Transfer after the patient returned home, a Transfer and Resumption is required within 2 calendar days after learning of the inpatient stay. In this situation, a Transfer is required; and, since the time frame to complete the Resumption overlaps with the timeframe to complete the Recertification, the ROC assessment should be completed, fulfilling both the ROC and Recert requirements.

Looking for all the Q&As?

October 25, 2011

Dementia redux

I am already getting questions on dementia coding … here we go!

Question: Now that the new dementia codes (294.10, 294.11) have come out, do we only use them for a dementia related to another condition that was coded and use 290.0 for straight senile dementia OR do we have to use 294.1x for all dementia?

Lisa says: The new dementia codes are 294.20 and 294.21. Those are for dementia NOS. Senile dementia is coded when documented. 294.1x codes for use when associated with physical conditions such as those listed. 
October 23, 2011

Hospitals struggle to reduce readmission rates

We talk so much about lowering readmission rates in hospitals and how that can impact other areas of homecare. Read this for some recent stats that show readmissions didn’t really change between 2003 and 2009.

The Dartmouth Institute for Health Policy and Clinical Practice report shows that hospitals struggled to lower readmission rates among Medicare patients between 2003 and 2009. The report comes as hospitals prepare for Medicare penalties for high readmission rates that start in October 2012.

Read the report here …