by Proactive Medical Review | Jun 21, 2022 | Coding, Medicare, Q&A
Q: Our Medicare Part A claim was rejected due to “principal diagnosis is an unacceptable diagnosis. Correct and resubmit/rekey”. The principal diagnosis coded on the Medicare claim and in section I0020B of the Medicare 5-day MDS is B95.62 (MRSA infection as the cause...
by Proactive Medical Review | Jun 30, 2021 | Coding, ICD.10, Q&A
Q: How do I appropriately code a periprosthetic fracture? Should I use an M or S ICD-10 code? A: Fractures result from trauma or injury or a pathological condition. With a periprosthetic fracture, two ICD-10 codes would be utilized. One code would include the...
by Proactive Medical Review | Oct 29, 2020 | Coding, Q&A
Q: What happens if someone leaves prior to being assessed? A: When the Part A resident dies or is discharged prior to the end of the look-back period for a required assessment, the ARD must be adjusted to equal the discharge date. The provider should prepare a...
by Proactive Medical Review | Oct 28, 2020 | 5 Star, blog, Coding, QAPI, Quality Measure
Since the COVID-19 pandemic began, guidance from CDC, CMS, and states on effective preparedness and outbreak management is being updated frequently. It is essential that LTC providers have strong processes in place for updating facility policies and procedures and...
by Proactive Medical Review | Oct 28, 2020 | 5 Star, blog, Coding, QAPI, Quality Measure
Use of an indwelling catheter can place a resident at a higher risk for conditions such as Urinary Tract Infections (UTIs), sepsis, trauma, and hospitalization. Indwelling catheters should only be used when medically necessary and periodically re-evaluated for the...
by Proactive Medical Review | Oct 21, 2020 | Coding, Q&A
Q: A resident had a fall and suffered a traumatic brain injury. Should we be using the 169 codes for deficits following other nontraumatic intracranial hemorrhage if the deficits are related to the fall with traumatic brain injury? A: S06.9- is the appropriate...
