Archive for October 25th, 2011

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.