Step-by-Step Coding Guide for Item Set A0100C: State Provider Number

This guide details the process for accurately coding and documenting the State Provider Number in the MDS 3.0, specifically in item A0100C.

1. Review of Medical Records

• Objective: To identify the facility's State Provider Number.
• Key Points:
  • The State Provider Number is often listed on state licensure documents, certification letters from the state health department, or state-specific Medicaid documentation.
  • Review facility-related documentation, including licensure or certification records, to find the State Provider Number.

2. Understanding Definitions

• Objective: Clarify the concept of a State Provider Number.
• Key Points:
  • State Provider Number: A unique identifier assigned to healthcare facilities by the state health department or similar regulatory body, distinct from the CMS Certification Number (CCN). It is used for state-level tracking, licensing, and sometimes for billing purposes.

3. Coding Instructions

• Objective: Provide guidance on accurately entering the facility's State Provider Number.
• Key Points:
  • Enter the facility’s State Provider Number as documented in official state health department or regulatory communications.
  • The number should be entered without spaces or dashes unless specified by state guidelines.

4. Coding Tips

• Ensure accuracy by cross-referencing the State Provider Number across multiple state-issued documents.
• Be mindful of potential similarities between the State Provider Number and other identifiers (e.g., CCN); confirm you are using the correct number for state-specific purposes.

5. Documentation

• Objective: Maintain thorough documentation supporting the use of the State Provider Number.
• Key Points:
  • Keep a record of the document that provides the State Provider Number, including a copy in the facility’s licensure or compliance file.
  • Document any correspondence with state regulatory bodies that reference the State Provider Number, ensuring easy access for future reference or audits.

6. Common Errors to Avoid

• Using an outdated or incorrect State Provider Number due to not verifying against the most current state documentation.
• Confusing the State Provider Number with other identifiers like the NPI or CCN.

7. Practical Application

• Scenario: During the annual review of facility documentation, the administrator of Sunset Care Facility verifies the State Provider Number, 987654321, against the latest licensure renewal form from the state health department. This number is accurately entered into item A0100C of the MDS 3.0 for all resident assessments moving forward, ensuring compliance with state regulatory requirements and facilitating correct state-level tracking and billing.

The Step-by-Step Coding Guide for item A0100C in MDS 3.0 Section A is based on the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.18.11, dated October 2023. Healthcare guidelines, policies, and regulations can undergo frequent updates. Therefore, healthcare professionals must ensure they are referencing the most current version of the MDS 3.0 manual. This guide aims to assist with understanding and applying the coding procedures as outlined in the referenced manual version. However, in cases where there are updates or changes to the manual after the mentioned date, users should refer to the latest version of the manual for the most accurate and up-to-date information. The guide should not substitute for professional judgment and the consultation of the latest regulatory guidelines in the healthcare field.