Step-by-Step Coding Guide for Item Set A2400C: End Date of Most Recent Medicare Stay

1. Review of Medical Records

Start by thoroughly examining the resident’s medical records. Focus on billing records, discharge summaries, and documentation related to Medicare-covered services and stays. Identify the most recent admission and discharge dates relevant to a Medicare-covered stay.

2. Understanding Definitions

Medicare Stay: Refers to a period during which a resident’s care is covered by Medicare. This typically includes hospital stays, skilled nursing facility (SNF) care, and certain types of home health or hospice care under Medicare Part A.

3. Coding Instructions

For A2400C:

• Enter the date (Month, Day, Year) on which the most recent Medicare-covered stay ended. This date should be the actual discharge date from the hospital or SNF where Medicare coverage was utilized.
• If the resident is currently in a Medicare stay, leave this item blank.

4. Coding Tips

• Verify the end date by cross-referencing multiple sources within the medical records to ensure accuracy.
• Pay close attention to details in the transfer forms and communication from hospitals or other facilities.
• Be aware of the resident’s Medicare Part A entitlement and coverage details to correctly determine if the stay was indeed Medicare-covered.

5. Documentation

Clearly document the source of the information used to determine the end date of the most recent Medicare stay. Maintain a record of all documents reviewed and any correspondence or communication that verifies the end date.

6. Common Errors to Avoid

• Incorrectly recording the date of transfer to another facility as the end date instead of the actual discharge date.
• Confusing Medicare-covered stay with stays covered by other types of insurance.
• Failing to update the records if a resident returns to the hospital and there is a new end date for a Medicare stay.

7. Practical Application

Example: Mrs. Smith was admitted to a SNF following hospitalization for surgery. Her post-surgical rehabilitation was covered under Medicare Part A. She was discharged from the SNF and returned home on September 30, 2024. The end date for her most recent Medicare stay, September 30, 2024, should be entered in A2400C.

Please note that the information provided in this guide for MDS 3.0 Item set A2400C was originally based on the CMS's RAI Version 3.0 Manual, October 2023 edition. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. 

The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. 

Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.