Posts tagged ‘m0100’

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?

January 30, 2011

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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