Nursing home administrators must be absolutely certain their billing department staff and MDS coordinators are up to speed on the newly implemented PPS rules for therapy. That is one of the central messages that came through at a special McKnight’s webcast Oct. 5 that focused on changes to MDS 3.0 and nursing home payment systems. A rebroadcast of the extremely popular hourlong session is attainable in the mcknights.com archive. Interested individuals simply must re-enter the sign-in environment or complete the free registration for the first time here.
With the tremendous changes that kicked in Saturday (Oct. 1), one of the shifts coding staff must be on top of is tracking changes in activities of daily living from assessment to assessment, emphasizes MDS expert Leah Klusch, the webcasts’ featured speaker. Klusch is the executive director of the Alliance Training Center. Data that is “transmitted to MDS servers and billing must be pristine,” she noted.
If claims are submitted using the old rules, facilities can expect to face high rates of denials and rejections from the Centers for Medicare & Medicaid Services. The agency will be particularly watchful in processing therapy claims, Klusch said.
She stressed that CMS will be looking at how therapy minutes are coded very carefully, searching for inconsistencies.
“You can never round up or down in documenting therapy minutes. If a resident received 26 minutes of therapy, do not round that to 25 or 30 minutes,” she warned.