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A new MDS 2.0 section, W - Supplemental MDS Items, will go into effect October 2005. It includes these five items:
- W1. National Provider ID* - voluntary
- W2a. Influenze vaccine received or not (relevant to flu season)
- W2b. Reason influenza vaccine not received (relevant to flu season)
- W3a. Pneumoncoccal vaccine (PPV) status (received or not) - for residents 65 years and older
- W3b. Reason PPV not received
*The National Provider Identifer is a component of HIPAA. Providers can begin applying for their identifying number on May 23, 2005. Two years later, May 23, 2007, providers must be using their NPI.
Click here for complete information on Section W.
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Due to software and structure changes to the QIES (Quality Improvement and Evaluation System), CMS has updated its minimum system requirements. Effective December 31, 2005, facilities' systems must meet the following requirements to submit
MDS assessments and download their validation and QI reports from their state server:
- CPU: Pentium 3, 500 MHX
- Memory: 256 MB
- Operating Systems: Windows 2000 or XP
- Hard drive: 500 MB free space
- Browser: Internet Explorer v5.5 SP2
Click here to read the CMS Survey and Certification letter.
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In February 2005, CMS re-released the following Medlearn Matters articles concerning Medicare PPS Consolidated Billing (CB) for Part A beneficiaries in Skilled Nursing Facilities. Each article now includes a clarification statement.
Overview of SNF CB - SE0431
Includes background information and lists excluded services, "incident to" services, and other exclusions.
Exceptionally Intensive Outpatient Hospital Services - SE0432
Some services temporarily suspend "resident" status and enable hospitals to bill Part B separately for them. Examples: cardiac catheterization, CT scans, MRI services, and ER services.
SE0432 also covers services excluded from CB regardless of where they are provided, such as intensive chemotherapy services, and radioisotopes.
Ambulances - SE0433
The key is whether the trip is for a "resident." A beneficiary isn't considered a resident before admission or after discharge (so the initial and final trips are excluded from CB). Outpatient visits to a hospital to receive certain services temporarily suspend resident status (see SE0432).
For some outpatient visits, such as to a physician's office, the resident's status does not change. An exception is a trip for Part B dialysis, which is excluded from CB. A resident's status does not change during a trip between SNFs. A transfer trip from SNF 1 to SNF 2 is covered by CB for SNF 1.
Dialysis Coverage - SE0435 and Dialysis Medications (EPO, Aranesp) - SE 0434
When a SNF elects to provide dialysis to a SNF Part A resident, either directly or under an arrangement with a qualified outside supplier, the service and medications are included in CB. Dialysis services and medications are not included in CB when provided by an outside supplier.
Preventive/Screening Services - SE0436
Preventive services, such as flu shots and screening services, such as mammography, are included in CB, but a separate bill must be submitted.
Prosthetics and Orthotics - SE0437
Some custom prosthetic devices (identified by HCPCS code) are excluded from CB. Orthotics are not excluded.
Rural Health Clinics and Federal Qualified Health Centers - SE0438
As of January 1, 2005, physician services from an RHC or FQHC are excluded from CB.
Social Workers - SE0439
Services of Clinical Social Workers are included in CB.
Certain Diagnostic Tests - SE0440
Physician services associated with diagnostic radiology are excluded from CB. The technical component is covered by CB and as of 2002 the CMS claims processing system can detect claims submitted inappropriately for the technical component.
Therapy Services - SE0518
CB Services Furnished under an Arrangement - MM3592
This article outlines possible problems that can occur when services covered under CB are provided by outside entities.
Quarterly (April 2005) Update to HCPCS Codes
Updated list of services, by HCPCS code, that are excluded from CB.
Click here to read the Medlearn Matters articles.
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Next time you visit the Keane Care Website you'll see a fresh new look. Be sure to visit the redesigned Products section where you can tailor your software shopping to just those applications you need for your setting-SNF, Assisted Living, Subacute, Rehab, CCRC… Is your facility part of a chain or independent? Find out how VistaKEANE supports each.
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Register Online Today!
2005 Keane Client Conference
May 22-25, 2005
JW Marriot Las Vegas Resort and Spa
Las Vegas, Nevada
Visit the 2005 Keane Client Conference Website today for complete information, including the agenda, and register to attend.
Reach the conference Website from the Insider, the clients-only section of the Keane Care Website.
The conference offers you many opportunities to get to know your colleagues across the country and learn more about how to get the most from your VistaKEANE system.
Educational sessions for everyone at every experience level:
- Demos of new features, shared best practices, next generation of VistaKEANE
- Users' Group meeting
- You asked for them - technical sessions
- Real-world experience - 7 client-led presentations
Check out the full agenda & register online today!
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The Keane LTC Users' Group invites staff from all facilities using the VistaKEANE system to participate in their organization.
The mission of the Keane LTC Users' Group is to provide input to ensure all the products used by Keane Long-Term Care clients meet the ongoing requirements of the post-acute care community. The Users' Group is a self-governing body, independent of Keane.
Membership in the Users' Group is free and individuals determine their level of involvement.
Sign Up Now
Keane Care customers can visit the VistaKEANE Insider for more information and to sign up for the Keane LTC Users' Group.
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