Mediware Rehabilitation Blog

What Does Functional Limitation Reporting Tells Us?

Mediware has provided a set of online tools to assist therapists with the translation of functional measurement scores to severity modifier codes as prescribed by CMS (Claims-Based Outcomes Reporting G-code Modifier Calculator). A recent analysis of this activity reveals preliminary evidence of the functional measure use patterns deployed by therapists in clinical practice.

SGR, Therapy Caps, ICD-10 Delay – Signed on April Fools' Day – Go Figure!

If ever a bill held substance that directly impacts rehabilitation management of issues we now face, this could be the one. Don’t pass up your chance to read it and understand its contents better. H.R. 4302 pushed quickly to address an impasse on Senate Bill 2110; this bill includes several extended mandates and even a twist – another delay to ICD-10! And the kicker – final signature and passage occurred on April Fools' Day. Is this an impending statement? You decide!

Why is it important you review this bill? What affects you, the rehabilitation provider? Let me carve out just a few of the sections that impact you TODAY, perhaps in the same way as yesterday or slightly different!

Pedal to the Metal for ICD-10 -- Maybe not?

Just when you think ICD-10 is full force “pedal to the metal”, as regulatory
indications have all prepared us to accept Oct. 1, 2014 – AMAZINGLY Congress pulls another possible lame duck intervention in a fast tracked bill that includes SGR fix and Therapy Caps extensions AND a possible delay to ICD-10 coding! To everyone’s surprise, even the moderator of our March 26th webinar as she was speaking the present known facts for ICD-10 implementation, Congress was conjuring up a delay extension language for to Oct. 1, 2015. CAN IT HAPPEN? The next few days and congressional actions alone will tell!



CAPS Don't CAP Costs - They Also Hide Costs

CAPS = "Limits on Therapy Services" that have increased the cost of care to providers while intentionally trying to control costs for part B Medicare services. In my opinion CAPS have backfired. Control costs? Do we know how many administrative dollars are being poured into the process at both the provider and Medicare contractor levels? No one seems to be talking about those costs! Uncovering the 'real cost' of this legislation diverts money to the wrong end of beneficiary access and hurts those most needy to receive the benefits provided by therapy services. Let's discuss these realities as we educate our lawmakers and ourselves on the history of CAPS.

CARE Tool Revisited

This week the House Ways and Means Committee drafted the Improving Medicare Post-Acute Care Transformation Act of 2014, proposing the first data standards for post-acute care. While only draft legislation, it builds upon all previous work done by CMS to define a common assessment instrument and its data elements.

IRF/U Rehabilitation 101 - Coming to a Location Near You

Many managers and directors of rehabilitation facilities have often come up through the ranks because of their deep desire and passion to make a difference on the homefront of the units and facilities they work for. Learning the nuances and networking for this particular set of individuals doesn't always have an immediate outlet or mentor. Now is the time to make your voice heard - let's collaborate...

IRF Coding Points to Ponder

To so many, the coding requirements and all their nuances are a mystery when attempting to educate acute care coders on the specific rules for an exempt IRF/U. In addition, there is turnover and new learning that must occur for IRF-PAI Coordinators, liaisons, physicians and all staff that contribute to the documentation within an IRF. The coding of the IRF-PAI and the coding on the billing document have some similarities and some very disparate rules.

We encourage you to follow this link as we discuss some highlights from the inservice.

 

What is the ROI for your Rehab Technology Investments?

Typically, investing in technology involves acquiring an electronic information system to capture, record, document and report the elements of patient care to justify what was done to the patient. These “systems” are software and depending upon the provider’s care setting, are referred to as Electronic Health Records (EHR) or Electronic Medical Records (EMR) and, as President George W. Bush predicted, all physicians, providers and hospitals should by now have one. The associated costs of developing, acquiring and using this technology are high and have slowed the realization of Bush's objective.

CMS reporting requirements for IRF revisited

In 2011, CMS initiated the quality reporting measures for Inpatient Rehabilitation Facilities; the third proposed measure, “30 day readmission rate” was dropped from discussion. Hospital readmission penalties have had a significant economic impact especially for high-intensity teaching hospitals. Until now, IRFs have been flying under the radar of reported readmissions. A recent study published by Ken Ottenbacher, in the Journal of the American Medical Association brings renewed attention to the issue.

Medicare And You 2014 Pamphlet is Updated - Get Your Copy!

Annually, Medicare provides updated information for the Medicare Beneficiary on how to access and understand their benefits. This year is no exception, the 2014 Medicare & You pamphlet/manual has been uploaded to the CMS website. If you don't understand A, B, C and D levels of Medicare coverage, this is the place to discover this and more.

Don't Presume to meet Presumptive is the Final Rule Message for IRF's

When the 2014 Final Rule was debated and then completed, the rationale for squeezing presumptive compliance became paintstakingly clear. If you presume without true due dilligence to the Rehab 13 criteria within your documentation, the benefit of the doubt has been removed and manual medical review will preside not this year but the next IRF fiscal year (discharges after Oct. 1, 2014). Take this as time to educate and prepare what your pre-admission screening must demonstrate to include these conditions to meet manual review. Let's review.