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CMS Open Door Forum: MDS, Part-A Billing and More

by Published On: Mar 02, 2012

During the March 1 Skilled Nursing Facility (SNF) Open Door Forum (ODF),  the Centers for Medicare and Medicaid Services (CMS) discussed developments with: 

  • The MDS 3.0 April Manual Errata.
  • Billing issue clarifications.
  • Upcoming revisions to the nursing home traditional survey process provider forms.

An encore audio recording of this call is available from March 5 through March 8, 2012. Dial 1-800-859-2056, conference ID: 27269788.

March 1 Open Door Forum agenda items

  1. ODF Audio Recordings: CMS is trying the web streaming with these forums, but encountering some problems, so CMS is going back to their old call-in format until some issues can be resolved.  CMS will try to find a different way to allow the call to be available for more than the usual 3-day limit available through the encore.  For today’s call, the encore will be available starting Monday March 5, through Wednesday, March 8 (midnight). CMS is making a mailbox available to all SNFs as a way to reach CMS at any time with any questions: The mailbox will be monitored frequently.
  2. MDS 3.0 Errata Documents:  The CMS Errata document posted last week, MDS 3.0 RAI Manual (v1.08) Errata, February 23, 2012, has errors.  Pages 1-4 are accurate so facilities can follow that, but pages 5-11 are inaccurate. A corrected version of the Errata document will be posted tomorrow on CMS MDS 3.0.  CMS will likely have additional Errata documents periodically identifying items that need to be clarified or corrected.
  3. CR7717, Clarification for SNF and Swing Bed Part A Billing Updating System Requirements for Assessment Date Reporting and Removal of the Occurrence Code 16 Reporting Requirement: CR7717 was originally released Jan. 26, 2012, and was revised on Feb. 2, 2012, to show that the requirement for SNF and SB providers to report occurrence code 16 on their claims to indicate the last day of therapy services, has been discontinued (all other information remains the same). It was previously a short-term requirement but after further review, CMS decided to discontinue this requirement.
  4. Upcoming Revisions to the SNF Traditional Survey Process and Provider Forms: As the new QM reports become available, CMS is starting to get the survey process for the traditional survey ready for the surveyors to begin using the QM reports again. Surveyors will continue to ask for the facility resident roster report and will start tracking the new QMs, although they will not keep every single QM that was part of the main set. CMS stated that the new QM list surveyors will keep track of is much shorter, excluding mostly the QM items on immunization. CMS also stated that the thresholds for the QM items will now be nationally-based, instead of state-based. There will also be changes in the 2 major forms that facility will have to turn in (the traditional survey form handed out by the surveyor to the provider to fill out telling them about all the facility’s residents and what conditions they have, and the 672 census form). Changes will be done in the State Operations Manual and will be available for viewing once finalized. You can download the latest MDS QI User’s Manual (v5.0 03-10-2012), which describes the methodology used to select short and long stay samples and other records used to compute the QMs and technical details on how the QMs were calculated. 

  5. Release of New Combined Medicare Non-Coverage (NOMNC), CMS 101-24,  and Detailed Explanation of Non-coverage (DENC) for Patients in Original Medicare and Medicare Extended Plans: CMS has just release and update to the “combined” version of the NOMNC and DENC for use in both the original Medicare beneficiary and Medicare Advantage settings.  This notice will replace the CMS 10123 (Original Medicare notice) and the CMS 10095 (Medicare Advantage notice). This combined notice retains the form number of the current Original Medicare Notice (CMS 10123) and the name of the MA notice (Notice of Medicare Non-Coverage, or NOMNC). CMS also is issuing a new Detailed Explanation of Non-Coverage, or DENC, with the form number CMS 10124.Providers are required to issue the new combined notices as soon as possible, but no later than May 1, 2012.

For any questions, please contact the CMS mailbox:

Next Open Door Forum: Thursday, April 12, 2012


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