Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare CMS has posted iQIES Minimum Data Set Frequently Asked Questions for Providers-Version 1.1 with a date of June 1, 2023. Here is the Table of Contents for this 7-page FAQ document:

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The June 2023 Quarterly Confidential Feedback Reports for the fiscal year (FY) 2024 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program are now available to download via the Internet Quality Improvement and Evaluation System (iQIES). These reports contain facility and stay-level data for the SNF 30-Day…… Continue reading FY 2024 SNF VBP Program June 2023 Quarterly Reports are Now Available

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The OIG posted the results of this physician services audit – same title as this blog – on May 30, 2023. The 32-page complete report is found here. The Report in Brief is found here. Medicare pays practitioners for physician services separately from the payments it…… Continue reading Medicare Paid Millions More for Physician Services at Higher Non-Facility Rates Rather Than at Lower Facility Rates While Enrollees Were Inpatients of Facilities

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare CMS has posted the Five-Star State Level Cut Point Table for May 2023. The Centers for Medicare & Medicaid Services (CMS) has enhanced its Nursing Home Compare public reporting site to include a set of quality ratings for each nursing home that participates in Medicare or…… Continue reading Five-Star State Level Cut Point Table Updated May 2023

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare May 26, 2023 … July 2023 Quarterly Update to Healthcare Common Procedure Coding System Codes Used for SNF Consolidated Billing was posted with this notification: Transmittal 12052 issued May 18, 2023, is being rescinded and replaced by Transmittal 12062, dated May 26, 2023 to correct the…… Continue reading July 2023 Quarterly Update to Healthcare Common Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare CMS has uploaded Parts 1 & 2 of the SNF Virtual Training Program for the MDS 3.0 v1.18.11. This presentation describes the framework of the Skilled Nursing Facility MDS 3.0 RAI v1.18.11 Guidance Training Program (Parts 1 and 2). Instructions for completing the recorded sessions and…… Continue reading  SNF Virtual Training Program – MDS 3.0 v1.18.11 Available

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare On Wednesday, May 24, 2023, CMS posted the May Update of Appendix B to the RAI 3.0 User’s Manual to convey the changes to the list of State RAI Coordinators, MDS Automation Coordinators, RAI Panel members, and CMS locations and contacts. The following are those Changes to…… Continue reading Appendix B – RAI Manual: May 2023 Update

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The purpose of this Change Request (CR) – 12052 is to provide updates to the lists of HCPCS codes that are subject to the consolidated billing provision of the SNF Prospective Payment System (PPS). Changes to Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) codes and…… Continue reading July 2023 Quarterly Update to Healthcare Common Procedure Coding System (HCPCS) Codes Used for SNF Consolidated Billing Enforcement

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The 1704D Daily MDS Census Detail and 1704S Daily MDS Census Summary reports in the Payroll-Based Journal (PBJ) report category in the CASPER Reporting application have been updated to reflect all MDS records that have been accepted into the Internet Quality Improvement and Evaluation System (iQIES)…… Continue reading Updated CASPER MDS Census Reports for Nursing Homes

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare On May 15, 2023, CMS issued Transmittal 12037 with this message (in red ink): Transmittal 12032 issued May 10, 2023, is being rescinded and replaced by Transmittal 12037, dated May 15, 2023, to make a minor clarification (that claims will be adjusted/denied if an improper payment…… Continue reading Skilled Nursing Facility (SNF) 5-Claim Probe and Educate Review Clarified