What services are included in the consolidated billing of the SNF PPS?
Therapist, lab test, x-ray & pharmacy/medicine
What services are excluded from the consolidated billing of the SNF PPS.
Emergency services, inpatient care, extended services & radiation therapy.
How are per diem rates for SNF patients determined for various cases?
The federal base rate is first adjusted by geographic area using both the market basket and wage index. Then the mandated adjustments for regulations or statues. Finally the rate is adjusted to a case mix RUG.
For CMS to define a facility as a LTCH, how many days must its Medicare patients' length of stay be?
How are MS-LTC-DRGs determined?
Principal diagnosis, additional diagnosis, procedures done, complications & comorbidities.
T or F For inpatient rehabilitation facility patient codes on the IRF PAI should follow the UHDDS & UB-04 guidelines.
T or F Facilities transmit IRF PAIs to the Centers for Medicare and Medicaid Services using CMS's free IRVEN software.
In the HHPPS, the _____ software is used to collect and submit OASIS data.
How is durable medical equipment (DME) reimbursed in HHPPS?
DMEs are excluded from episode of care reimbursement, but can be submitted separately for 80% cost of fee. The other 20% is the patient's co-pay.
Why is the home health HIPPS code called an "intelligence" code?
Every place in the code stands for something in particular & every value placed in a particular place is a piece of information about the patient.