On Jan. 24 of this year, the Jimmo vs. Sebelius class action lawsuit was settled. This was a significant win for us, the healthcare providers. As we continue to work out the details, I feel now is a good...
No more Rehab Medium RUG defaults
By
Shelly Mesure, MS, OTR/L
Oct 08, 2013
Well, Oct. 1 has passed, and we’re all still hanging in. The biggest changes we saw to rehab were the addition of reporting co-treatment minutes on our billing logs and Section O on the MDS. And,...
Ready or not: The MDS is changing again!
By
Shelly Mesure, MS, OTR/L
Sep 25, 2013
On Oct. 1, the Centers for Medicare & Medicaid Services will be updating the Minimum Data Set with another round of changes. Most are minor but there will be two changes to the therapy section. Your case-mix...
What’s on Your PEPPER Report?
By
Shelly Mesure, MS, OTR/L
Sep 10, 2013
Have you received your provider-specific PEPPER report yet? The Program for Evaluating Payment Patterns Electronic Report (PEPPER) were mailed on August 30 and have been slowly arriving at skilled nursing...
Are you prepared? 5 questions you need to know the answers to
By
Shelly Mesure, MS, OTR/L
Aug 27, 2013
With all the recent regulatory changes that have come down the line, or are about to, we developed a simple five-question survey that each provider had to ask every therapy employee. If you can develop...
What is therapy? It’s not as simple as it might seem
By
Shelly Mesure, MS, OTR/L
Aug 13, 2013
“What is therapy?” sounds like a simple question, but it requires a separate and very complex answer for each discipline.
50 shades of G-coding
By
Shelly Mesure, MS, OTR/L
Jul 02, 2013
Sorry, ladies, I didn’t mean to get your hopes up with that title. But does anyone else feel like there is a lot of ambiguity to the new G-Coding system? Well, it’s a little too early to tell...
You’re probably guilty of too much documentation
By
Shelly Mesure, MS, OTR/L
Jun 18, 2013
Is it time for a diet? Not a food diet, but a documentation diet. I’ve written previous blogs about documentation quick tips, top 10 reasons for denials, and so on. But, how many of you are guilty...
The G-codes are here for payment claims — ready or not
By
Shelly Mesure, MS, OTR/L
May 23, 2013
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers...
Medically Complex Medicare Part B
By
Shelly Mesure, MS, OTR/L
May 08, 2013
While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare...