by Proactive Medical Review | Aug 17, 2022 | ICD.10, Q&A
Q: We have a claim denial from a commercial insurance plan that references their policy related to Excludes 1 Notes based on the ICD10 Official Guidelines for Coding & Reporting. OT and PT used codes R26.2 (difficulty in walking) and R26.81 (unsteadiness on feet)...
by Proactive Medical Review | Aug 15, 2022 | blog, Survey
F695 Respiratory care, including tracheostomy care and tracheal suctioning, is one of the top 10 areas cited most often in nursing homes. This regulation states that the facility must ensure that a resident who needs respiratory care, including tracheostomy care and...
by Proactive Medical Review | Aug 10, 2022 | 5 Star, blog, Survey
Now that annual surveys have resumed, long-term care facilities should be prepared for the first Annual survey they may have had in a very long time. Consider completing a survey readiness checklist as part of your facility’s self-evaluation. Use this sample checklist...
by Proactive Medical Review | Aug 10, 2022 | blog, MDS
CMS will be migrating MDS submission and reporting to the internet Quality Improvement and Evaluation System (iQIES) in early 2023. The iQIES portal is available at https://iqies.cms.gov/ and will soon be the new interface for MDS submission and reporting, replacing...
by Proactive Medical Review | Aug 8, 2022 | COVID-19, MDS, Q&A
Q: Can a resident requiring the CDC updated “Enhanced Barrier Precautions” be coded in Section O0100M for Isolation or Quarantine? A: No. The CDC updated Enhanced Barrier Precautions (EBP) do not meet the RAI requirements for coding Isolation or Quarantine on the MDS...