Exam Preview for 6612: Medicare Part A: Demystifying the Patient Dr

Medicare Part A: Demystifying the Patient Driven Payment Model

Please note: exam questions are subject to change.

1. Which of these is not a qualifier for a Medicare Part A stay in a SNF: Services initiated within 60 days of hospital discharge Available Medicare days 3-day qualifying hospital stay Physician certification
2. Which of the following is true regarding coding therapy minutes on the Minimum Data Set (MDS)? The decision to co-treat with another discipline must be justified in the documentation Individual therapy is defined as the treatment of one resident at a time For group therapy, groups cannot exceed the ratio set by CMS. Under PDPM, this definition is 2-6 patients per therapist. All of the above
3. Which of the following is true regarding student provision of therapy services for Medicare Part A beneficiaries? You are not required to follow the state practice act if it is more strict The student’s time is separately reimbursable Line-of-sight supervision is not required, though clinical judgement should prevail If the supervisor is treating a patient at the same time a student is treating a different patient, both the supervisor and the student can code their time as “individual” minutes
4. Which of the following Section GG items is NOT utilized to determine the component functional status of the PT/OT Case Mix Group? Eating Upper body dressing/grooming Transfers Bed mobility
5. Which of the following is NOT true regarding PDPM (the Patient Driven Payment Model)? PT and OT services include a variable case-mix adjustment factor, meaning that payment for OT/PT CMI would decline 2 percent every 7 days after day 20 Cognitive score is a factor of classification for the PT and OT component of the PDPM rate. The nursing ADL score incorporates section GG items The clinical reason for the SNF stay is defined as the reason the person is skilled in the nursing facility; the diagnosis may not be the same as the hospital admitting diagnosis