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Effective October 1st, a COT OMRA will be required for patients classified into a RUG-IV therapy category whenever the intensity of therapy changes to such a degree it no longer reflects the RUG-IV ...

The Resident Assessment Instrument (RAI) User's Manual has been updated to reflect changes that take effect on October 1, 2011, the manual version is 1.07 (V1.07). Providers should take extra care to ...

Beneficiary Notification Initiative: The information regarding the use of an ABN is according to sections 50.3 - ABN Scope and 50.5 - ABN Triggering Events - from Chapter 30 of the Medicare Claims ...

Per the Centers for Medicare & Medicaid Services (CMS) announcement, aggressive new steps to find and prevent waste, fraud and abuse in Medicare are underway. CMS states they are working closer ...

Medicare Presumption of Coverage: Under SNF PPS, beneficiaries who are admitted or readmitted directly to an SNF after a qualifying hospital stay are considered to meet the level of care requirements ...

ICD 9 CODING Q: Where can I find a list of commonly used PT ICD-9 codes that have been deleted as of January 1? A: ICD 9 code changes take effect October 1 of each year. CMS publishes these changes ...

Impact Rehabilitation Services Impact Medicaid Case Mix: Rehabilitation Therapists are integral members of the interdisciplinary team as is their participation in the process of resident assessment. ...

The first thing to do when starting your Medicare Part B Therapy Program Development is making sure your team is properly therapy screening. Therapy screening is essential in identifying patients for ...

Additional Development Requests When a Medicare contractor (MAC) cannot make a coverage or coding determination from the information that has been provided on a claim and its attachments, then the ...

End-Of-Therapy OMRA Last week in our Newsletter, Kris B Harmony discussed the start-of-therapy OMRA which will be instituted in the SNF setting beginning October 1, 2010. In addition to this new type ...

CMS 5 Star Quality Rating Quality Measures / Quality Indicators The Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily and ...

The Art of Writing Supportive Therapy Notes to prevent Medicare Denials

MDS Accuracy The MDS 2.0 has 1000 points of information which requires extreme attention to detail to elicit an accurately coded assessment. CMS conducted the Data Assessment and Verification (DAVE) ...

Case management by the rehab staff is one of the primary factors effecting Medicare length of stay. Generally, when a patient is admitted for short term rehab their underlying medical conditions ...