lwconsulting

Achieving MDS Accuracy: Getting It Right, Keeping It Right

Are you struggling with achieving MDS accuracy? In order to get it right and keep it right, you must first understand the MDS, how to complete it accurately, how accuracy affects reimbursement, and the impact it can have on your facility’s Quality Measures. Understanding The Minimum Data Set (MDS) The Minimum Data Set is the cornerstone for Medicaid reimbursement methodology. It is used to classify residents into Resource Utilization Groups (RUGs) that in turn generates…

Compliance with CMS’s Regulatory Language: It’s Not Always Black and White

The never-ending discussion between healthcare providers and the Centers for Medicare & Medicaid Services (CMS) regarding the interpretation and true intent of regulatory mandates can be frustrating for both providers and CMS. Despite the fact that some regulatory language has not changed for years, it is often the source of ongoing discussion, debate, and re-interpretation, all for the sake of clarity and to assist providers in their desire to comply. The issue is exacerbated every year…

Evaluation and Management Changes for 2023

The American Medical Association (AMA) announced revisions/changes that will affect Evaluation and Management (E/M) guidelines for hospital inpatient, observation, consultations, emergency department visits, nursing facility services, and prolonged care effective January 1, 2023. Finally, all evaluation and management services guidelines will align and will have the same set of requirements to level a service. We will no longer need to manage two sets of documentation guidelines. Summary of the E/M changes for 2023 Consultations – Deleting…