MDS version 1.18.0 is on hold due to the covid emergency. Instead, CMS has posted the MDS version 1.17.2 changes for October 2020. There is no new RAI manual update of instructions regarding completion of that version 1.17.2. (See link below for zip file of MDS version 1.17.2).
May 15, 2020
In response to State Medicaid Agency and stakeholder requests, CMS has updated the MDS 3.0 item sets (version 1.17.2) and related technical data specifications. These changes will support the calculation of PDPM payment codes on OBRA assessments when not combined with the 5-day SNF PPS assessment, specifically the OBRA comprehensive (NC) and OBRA quarterly (NQ) assessment item sets, which was not possible with item set version 1.17.1. This will allow State Medicaid Agencies to collect and compare RUG-III/IV payment codes to PDPM ones and thereby inform their future payment models.
The changes to the technical data specifications that support these modifications are contained in the Errata v3.00.4 which can be accessed in the file: MDS 3.0 data specs errata (v3.00.4) Final 04-30-2020 in the Downloads section below. Supporting materials including the 1.17.2 Item Change History report and the revised 1.17.2 Item Sets can be accessed in the file: MDS 3.0 Final Item Sets v1.17.2 for October 1 2020 zip also posted in the Downloads section below.
Please confirm with your State Medicaid Agency if your State will be requiring the calculation of the PDPM payment codes on the OBRA assessments when not combined with a 5-day SNF PPS assessment.
• Section 1812(f): This waiver of the requirement for a 3-day prior hospitalization for coverage of a SNF stay provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who are evacuated,transferred, or otherwise dislocated as a result of the effect of disaster or emergency. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period (Blanket waiver for all impacted facilities).
• 42 CFR 483.20: This waiver provides relief to SNFs on the time frame requirements for Minimum Data Set assessments and transmission (Blanket waiver for all impacted facilities).
To see full document released today, click on this link:
MDS Item Sets 3.0 version 1.18.0 draft: Description of Changes document. Find out all the specific item changes such as "New item and responses added: A1010. Race What is your race? Check all that apply A. White B. Black or African American C. American Indian or Alaska Native D. Asian Indian E. Chinese F. Filipino G. Japanese H. Korean I. Vietnamese J. Other Asian K. Native Hawaiian L. Guamanian or Chamorro M. Samoan N. Other Pacific Islander X. Resident unable to respond."
MDS Item Sets 3.0 version 1.18.0 draft: The link is a zip file of all the MDS forms. Released by CMS today: "A new DRAFT version of the 2020 MDS item sets (v1.18.0) was posted. This version is scheduled to become effective October 1, 2020. Please note that Section G has been removed from all Federal item sets."
MDS Section I0020B effective October 01, 2019: A file listing the ICD-10 Codes to be used for MDS Item I0020B effective October 01, 2019 has been released by CMS 3 days ago. Click on links below for the cms.gov website, scroll to bottom of page and click on the PDPM_ICDCodes_for_I0020B_FY2020 file. (PDPM training attendees were emailed these files but may have been to large of a file.)
Released today: Temporary SNF QRP Exceptions Due to the COVID-19 PHE Public Reporting Final Tip Sheet. This tip sheet lists the temporary changes to the SNF QRP data submission requirements, due to the COVID-19 PHE, to assist skilled nursing facility providers while they directed resources toward caring for patients and ensuring the health and safety of patients and staff. CMS made optional and temporarily excepted providers from the submission of the MDS assessment data.
The Centers for Medicare & Medicaid Services is releasing three short video tutorials to assist providers with coding Section GG. These videos, ranging from 5 to 10 minutes, are designed to provide targeted guidance using simulated patient scenarios. To access the videos, click on the links below:
If you have technical questions or feedback regarding the training, please email the PAC Training mailbox. Content-related questions should be submitted to the Quality Reporting Program Help Desk for your care setting.
The PAC Training Team
The Centers for Medicare & Medicaid Services recently released a short video tutorial to assist providers with coding GG0130A. Eating. This 6-minute video is designed to provide targeted guidance using simulated patient scenarios. To access the video, click on the link below:
· Coding GG0130A. Eating (6:19)
Other resources available to assist providers in coding Section GG can be accessed by clicking on the following links.
· Updated Section GG Web-Based Training Course
· Additional video tutorials:
Coding GG0110. Prior Device Use with Information From Multiple Sources (3:58)
Decision Tree for Coding Section GG0130. Self-Care and GG0170. Mobility (11:56)
Coding GG0130B. Oral Hygiene (4:25)
Coding GG0170C. Lying to Sitting on side of bed (4:33)
Medicare Program Final Rule FY2019 for PPS in the Federal Register.
New LTC survey process directs DHS Facility Evaluators to utilize the LTC Survey Critical Pathway for Resident Assessments.
Need a sample of a Baseline Care Plan? Click here. Don't forget to email us that you are using it so that we can notify you of edits or revisions to the form by the time November 28, 2017 rolls around. The form is just a guide showing the MINIMUM required. Want to see a sample Baseline Care Plan as the summary? Click here. Email us that you are using these forms so you can be notified of revisions.
UPDATED Coding Guidelines for COVID-19 Effective April 1, 2020
ICD-10-CM Update Related to Vaping or E-cigarette: Released today: Official Coding Guidelines - Supplement Coding encounters related to E-cigarette, or Vaping, Product Use. Purpose: Official diagnosis coding guidance for healthcare encounters related to the 2019 health care encounters and deaths related to e-cigarette, or vaping, product use associated lung injury (EVALI). To view, click here.
ICD-10-CM: FREE ICD-10-CM from cms.gov here. Choose this file on that webpage:
- 2020 Code Tables and Index [ZIP, 20MB]
This is one of the ICD-10-CM files from the zip file:
Latest news regarding MDS forms: Section C: Draft only- Take a look at a preview of the comprehensive MDS Section C! Psychomotor retardation in Section C1300 will not be included effective October 2016 thus no longer a trigger for the following CAAs: Delirium and Cognitive Loss/Dementia. (posted 04/2016).
MDS 3.0 RAI Manual v1.13 and Change Tables October 2015 : After you click on link above, go to bottom of that CMS.gov website page, look for a couple of zip file links and download. One link is a file that specifies the new or edited parts of the RAI manual. Another link has the revised (replacement) pages to replace the older ones from the October 2014 version. (Links may change over time as CMS.gov constantly updates their website.)
RUG-IV PPS Classification Guide- This is the most thorough yet simple, color-coordinated PPS Guide ever! I've come across many different ones over the years but after reviewing others I've used in the past, I've found some mistakes! So I've decided to make one myself. Apologies for the previous attendees whom I did not get a chance to give this copy to... Well, this one is for all of you!
Quality Measures effective April 01, 2016: New QM manual now available here.
Quality Measures update as of March 03, 2016: Long Term Care/Nursing Home 5-STAR Quality Rating System will have 6 new quality measures on Nursing Home Compare by April 2016 per CMS. Check out more information here.
Quality Measures effective October 01, 2015
For the latest QM User's Manual: Click on this link to download or go to CMS.gov