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Ask Proactive – What happens if a patient receives more than 25% of therapy in a concurrent/group setting?

by Proactive Medical Review | Feb 2, 2022 | Q&A, Therapy

Q: What happens if a patient receives more than 25% of therapy in a concurrent/group setting? A: The provider will receive a warning edit on the validation report that will inform them that they have exceeded the 25% limit. The edit will state: “The total number of...

CY2022 Medicare Part B Proposed Rule Impact to LTC Therapy Departments

by Proactive Medical Review | Aug 3, 2021 | blog, Regulatory, Reimbursement, Telehealth, Therapy

Last month, CMS released the “Medicare Part B” CY 2022 Medicare Physician Fee Schedule (PFS) Proposed Rule outlining proposed changes which would take effect January 1, 2022. This proposed rule only applies to traditional Medicare and not Medicare Advantage plans. The...

Ins and Outs of Skilled Maintenance Therapy

by Proactive Medical Review | Jun 9, 2021 | blog, Medicare, Regulatory, Reimbursement, Restorative, Therapy

Skilled maintenance therapy has long been a service offering available for use in long-term care, yet this programming continues to be the source of confusion for many providers.  ”Maintenance Therapy”, is often requested by patients and their representatives/families...

Ask Proactive – Can a resident be on both restorative and therapy at the same time?

by Proactive Medical Review | Jun 2, 2021 | Q&A, Restorative, Therapy

Q: Can a resident be on both restorative and therapy at the same time?   A: Yes. Facilities may elect to have licensed rehabilitation professionals perform skilled therapeutic interventions that constitute a high level of complexity, or train aides in...

PDPM Coding Question – What procedure should we follow if a staff member refuses to participate in our facility’s mandatory routine COVID-19 testing?

by Proactive Medical Review | Sep 9, 2020 | blog, MDS, PDPM, Q&A, Therapy

Q: What procedure should we follow if a staff member refuses to participate in our facility’s mandatory routine COVID-19 testing?   A: It is recommended that your facility policy and procedure regarding COVID-19 testing is consistent with your policies for other...

PDPM Coding Question – Does the resident have to have a cannula in their tracheostomy to be able to code O0100E tracheostomy care?

by Proactive Medical Review | Sep 9, 2020 | blog, MDS, PDPM, Q&A, Therapy

Q: Does the resident have to have a cannula in their tracheostomy to be able to code O0100E tracheostomy care?   A: No, they do not. According to page 0-9 pf the RAI manual, you can “code cleansing of the tracheostomy and/or cannula in this item”, so the presence...
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Proactive Medical Review Consulting, LLC

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Evansville, IN 47711

Phone: (812) 471-7777
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info@proactivemedicalreview.com