![Logo-KrisB (1)-1.png]](https://56632.fs1.hubspotusercontent-na1.net/hub/56632/hubfs/Logo-KrisB%20(1)-1.png?height=40&name=Logo-KrisB%20(1)-1.png){kind=logo}
Reimbursement
- CMS 2017 Annual Update to the Therapy Code List
- Core Components 8.9.17
- CPT Eval Code Breakdown 1.1.17
- CPT Changes January 2017
- Drug Classifications (RAI Manual)
- Outpatient Therapy Initial Checklist 5.8.18
- PPS Tracker V3 12.29.17
- KBH Consolidated Billing 2022 Reference Kit 8.15.2022
- KBH Consolidated Billing 2022 Reference Kit PDF 8.15.2022
- KBH Triple Check Form 1.7.2020
- Respiratory Flowsheet 3.2.18
- Section GG Nursing Focus 8 hour shifts 9.17.19
- Triple Check Form 1.7.20
- Triple Check: Medicare Part A UB-04 5.18.18
- Updated ICD-10 Resource
- NOMNC Instructions 2014
- SNF VBP FAQs March 2022
- ABN Instructions English
- ABN Instructions English 2023 Word Document
- ABN Instructions Spanish 2023 PDF
- ABN Instructions Spanish 2023 Word Document
- ABN Instructions Spanish 2023 Large Print PDF
- ABN Instructions English 2023 PDF
- ABN Instructions English 2023 Large Print PDF
- ABN Instructions English 2023 Large Print Word Document
- ABN Instructions Spanish 2023 Large Print Word Document
- Home Health MBPM chapter 7 update 3.25.22 R11296BP
- Incident to Med Learn Matters
- Incident to NCBH March 2020
- Incident To January 2022
- Incident To 9.2.2004 CMS
- Consolidated Billing in a Skilled Nursing Facility 5 Major Categories 3.17.2022
- Case Mix CT Model 4-1-22-Rates
- SNF VBP Total Nurse Staff April 2022 Proposed
- ABN (Advanced Beneficiary Notice) Bed Rate Disclosure 4.13.22
- Proposed Rule FY 2023 SNF PPS Press Release 4.11.22
- Proposed Rule FY 2023 SNF PPS Fact Sheet 4.11.22
- Proposed Rule FY 2023 SNF PPS 4.15.22
- Case Mix CT PPT April 2022
- Home Health Medicare Benefit Policy Manual 4.27.2022
- OIG Report Medicare Advantage April 2022
- Missouri Case Mix Medicaid SNF FY2023
- ABN Rate Disclosure 4.13.22
- SNF VBP Proposed Total Nurse April 2022
- Reimbursement: Reason Codes
- Case Mix Montana
- Case Mix STRIVE
- Billing Medicare Code Edits - Modernization of Payment Software MLN 4761491 April 2022
- MDS State RAI Coordinators
- ICD-10 PDGM (Home Care) Groupings 2022 5.22.2022
- PDPM Prep Meeting Tool: Business Office
- PDPM Prep Meeting Tool: Dietary
- PDPM Prep Meeting Tool: MDS
- PDPM Prep Meeting Tool: Rehabilitation
- PDPM Prep Meeting Tool: Social Services
- Consolidated Billing 8.25.2022
- PDPM Therapy Minutes 7.25.2022
- Reimbursement Massachusetts Medicaid Add On Billing Guidance 12.29.2022.pdf
Appeals and Denied Claims Management
Bundled Payment
Case Mix - CO, RUG-III 34 Grouper
- 1. CO Medicaid CMI Hierarchy Chart 3.1.18
- 2. CO Medicaid CMI Facility Use 3.1.18
- 3. CO RUG-III Classification Grid 3.1.18
- 4. CO Case Mix Summary Template SAMPLE Reference Tool 3.1.18
- Archived: 1. CO Medicaid CMI Hierarchy Chart 12-2-16
- Archived: 2. CO Medicaid CMI Facility-Use 12.5.16
- Archived 3. CO RUG-III Classification Grid 11.29.16
- Archived: 4. CO Case Mix Summary Template SAMPLE Reference Tool 12.13.16
Case Mix CT- (Not Case Mix)
Case Mix DC, RUG-IV 48 Grouper
Case Mix GA, RUG-III 34 Grouper
- (GA) CMI Effective Jan 2019
- Final Sample GA Case Mix Rate Letter 2.2.18
- 5. GA Case Mix Rate Letter 7.3.19
- 4. GA Case Mix Summary Reference Tool 2.28.18
- 3. GA CMI Classification Grid 11.21.18
- 2. GA Medicaid CMI Facility Use 7.23.19
- 1. GA Medicaid CMI Hierarchy Chart 2.28.18
- Nursing Facility Services Policy Manual July 2019 (GA)
Case Mix HI, RUG-III 34 Grouper
- Hawaii: QI-1810 7.10.18
- Hawaii: QI-1809 7.10.18
- Hawaii: QI-1804 Long Term Care Eligibility on 83 and DMO 7.10.18
- 5. HI Case Mix Letter Sample 3.1.18
- 4. HI Case Mix Summary Reference Tool.3.1.18
- 3. HI RUG-III Classification Grid 3.1.18
- 1. HI Medicaid CMI Hierarchy Chart_4.17.20
- 2. HI Medicaid CMI Facility-Use_4.17.20
Case Mix ID, RUG-IV 48 Grouper
Case Mix IL, RUG-IV 48 Grouper
Case Mix IN, RUG-IV 48 Grouper
Case Mix IA, RUG-III 34 Grouper
Case Mix KS, RUG-III 34 Grouper
Case Mix KY, RUG-III 34 Grouper
Case Mix LA RUG-III 34 Grouper
Case Mix ME, RUG III 44 Grouper
Case Mix TX, RUG-III 34 Grouper
Case Mix
Consolidated Billing
Home Care
Medicaid
Medicare Part B
MMQ
PDPM
Proposed Rule
RCS (Resident Classification System)
RUGs
Telehealth
Value-Based Purchasing
FAQ
- CJR Billing and the waiver of 3-day hospital stay requirement
- Does Medicare cover paracentisis once a week at outpatient hospital?
- Exemption for hospitals whose ortho docs are participating in BPCI?
- First day: Is that day of discharge from hospital or SNF?
- How does the SNF Bill Under CJR (Comprehensive Joint Replacement)?
- If the CJR patient is admitted from the CJR Hospital to any SNF, the 3 day waiver applies, correct?
- So would the PPS/RUG/COT factors apply?
- Under Medical Record Review, why are MDS assessments coded with Isolation in Section O reclassified to a lower RUG?
- What is the Skilled Nursing Facility Value-Based Purchasing Program (SNFVBP)?
- What is the Three-Day Skilled Nursing Facility Rule Waiver?
- What kind of information is the patient given in regards to this new model. The push is for these patients to be in and out of SNF in 10 days or less and yet they have no idea why we are doing that.
- What measures will be used in the SNFVBP Program?
- While a resident in a Skilled Nursing Facility, is Paracentesis procedures covered under Medicare Part A for Medicare Part A Beneficiaries?
- Why is the CPT Code G0281 being denied For E-stim?