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...
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...
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...
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...
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...
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...
