Description

Part 1:  Introduction to the RAI Process, Section A coding, OBRA and PPS Scheduling

Target Audience:  MDS Coordinators

Length:  1:24

Agenda:

• Introduce the RAI process 

• Understand the importance of using the RAI Manual for MDS scheduling and coding 

• Become familiar with the contents of the RAI manual 

• Know resources available at QTSO.CMS.GOV 

• Discuss regulatory requirements for the MDS 

• Identify key items and common coding issues in Section A. Identification Information

• Delineate the Types of Assessments including: Federal OBRA Assessments, PPS Assessments, Other Medicare Required Assessments and Entry/Discharge reporting. 

• Explain required time frames for assessment completion and submission.

Part 2: Sections C,D,E & Q

Target Audience: MDS Coordinators and Social Workers

Length:  1:17

Agenda:

• Discuss coding accuracy for:

  • Section C: Cognitive Patterns

  • Section D: Mood

  • Section E: Behaviors

  • Section Q: Participation in Assessment and Goal Setting

• Understand the importance of using the RAI Manual as a reference for coding these sections and conducting the interviews 

• Delineate components of interview for Mental Status (BIMS) and Signs / Symptoms of Delirium 

• Identify critical components of Resident Mood Interview (PHQ-9). 

• Explain how to appropriately code Behaviors (Section E). 

• Explain regulatory reason Section Q is on the MDS 

• Discuss PDPM implications of these sections 

• Discuss QM implications of these sections

Part 3: : Sections B, G, & GG: 

Target Audience: MDS Coordinators

Length:  1:18

Agenda:

• Describe correct coding for Section B Hearing Speech and Vision

• Understand coding rules for Section G Functional Status:

• Activities of daily living (ADLs), 

  • Altered gait

  • Balance,

  • Decreased range of motion.

• Understand coding rules and unique lookback periods for Section GG Functional Abilities and Goals:  

  • Prior functioning and device use

  • Functional Abilities and Goals

• Discuss PDPM and QM implications of these sections

Part 4: Section H, I & J

Target Audience: MDS Coordinators

Length:  1:25

Agenda:

• Discuss coding accuracy for

  • •Discuss coding instructions for 

  • •Section H:  Bowel and Bladder

    • Appliances

    • Toileting programs

    • Bladder/Bowel Incontinence

    • Constipation

  • •Section I:  Active Diagnoses

    • 0020 for PPS Assessments

    • I0100 – I8000 coding instructions

  • •Section J:  Health Conditions

    • Pain and Pain Interview

    • Other health conditions

    • Tobacco use

    • Prognosis

    • Problem Conditions

    • Falls

    • Surgical procedures

Part 5: Section F, K & L

Target Audience: MDS Coordinators, Activities & Dietary

Length:  1:02 

Agenda:

Identify Coding Instructions for:

• Section F:  Preferences for Customary Routine and Activities

  • Explain required interview techniques and rules

  • Discuss staff assessment of preferences

• Section K: Nutritional Approaches

  • Signs and symptoms of possible swallowing problem: Accurate coding

    • PDPM implications

  • Height and weight, loss and gain: 

    • Understanding the lookback periods

    • Rules for “MD prescribed”

    • Weight loss implication for PDPM & QM

  • Nutritional approaches

    • Accurate coding for ”While” and “While Not” a resident

    • When IV fluids can be coded and when they count for PDPM

    • Feeding tube implications for PDPM

    • Mechanically altered diet:  Definition and PDPM implications

    • Therapeutic diet accurate coding

  • Calculating percent intake by artificial route, ‘while a resident’ and ‘during entire 7 days’ PDPM implications

• Section L: Oral/Dental Status

  • Accurate coding

Part 6: Section M & N

Target Audience: MDS Coordinators, Wound Nurses 

Length:  1:05

Agenda:

Identify Correct Coding for:

• Section M:  Skin Conditions

  • Risk of Pressure ulcers

  • Unhealed pressure ulcers/injuries

  • Present on admission

  • Venous/Arterial Ulcers

  • Other Ulcers, wounds and skin problems

  • Skin and ulcer/injury treatments

  • PDPM and QM implications of Section M

• Section N: Medications

  • Injections

  • Insulin

  • Medications Received

  • Antipsychotic Medication Review

  • Drug Regimen review

  • PDPM and QM Implications

Part 7: Section O & P

Target Audience: MDS Coordinators 

Length:  1:04

Agenda:

• Discuss proper coding for 

• Section 0: Special Treatments, Procedures and Programs

  • O0100:  Special treatments, procedures and programs

  • O0250: Influenza vaccine

  • O0300: Pneumococcal vaccine

  • O0400:  Therapies

  • O0420: Distinct calendar days of therapy

  • O0425: Part A Therapies (Part A Discharge)

  • O0500:  Restorative Programs

  • O0600:  Physician Examinations

  • O0700:  Physician Orders

• Section P:  Restraints and Alarms

  • P0100:  Physical Restraints

  • P0200:  Alarms

Part 8: Section V, Z and Care Area Assessments (CAA)

Target Audience: MDS Coordinators, IDT participating in the CAA process

Length:  46:00

Price:  Free bonus webinar

Agenda:

• Identify the 20 Care Assessment Areas and the triggering process.

• Describe the Care Assessment Area review process and documentation requirements.

• Explain coding instructions and timing requirements for Section V0200:  Care Area Assessment Summary

• Discuss Coding for Section Z:

  • Z0100:  Medicare Part A Billing

  • Z0200:  State Medicaid Billing

  • Z0250:  Alternate State Medicaid Billing

  • Z0300:  Insurance Billing

  • Z0400: Signature of Persons Completing the Assessment or Entry/Death Reporting

  • Z0500: Signature of RN Assessment Coordinator VerifyingAssessment Completion