A0310H: SNF Part A PPS Discharge, Step-by-Step

Step-by-Step Coding Guide for Item Set A0310H: SNF Part A PPS Discharge

1. Review of Medical Records

• Objective: Ensure comprehensive understanding of the resident's stay and verify the discharge status.
• Steps:
  1. Collect Records: Gather the resident’s medical records, including admission notes, progress notes, and discharge summary.
  2. Verify Dates: Confirm the start and end dates of the SNF Part A PPS stay.
  3. Discharge Status: Check for documentation on the discharge status, including the reason for discharge and destination.

2. Understanding Definitions

• SNF Part A PPS Discharge: Refers to the completion of a resident’s skilled nursing facility (SNF) stay under the Part A Prospective Payment System (PPS). This could be due to the resident no longer needing skilled care or transitioning to another care setting.

3. Coding Instructions

• Steps:
  1. Locate Item Set: Find item set A0310H on the MDS form.
  2. Confirm Discharge: Verify that the discharge was from a SNF Part A PPS stay.
  3. Code the Item:
     • 1: Discharged from a Medicare Part A PPS stay.
     • 0: Not discharged from a Medicare Part A PPS stay.
  4. Complete Entry: Enter the appropriate code based on the verification of records.
  5. Review: Double-check the entry for accuracy against the medical records.

4. Coding Tips

• Accuracy: Ensure the accuracy of the dates and the discharge status by cross-referencing multiple records.
• Detailed Documentation: Use detailed discharge summaries to confirm the discharge type.
• Consult: If there is any ambiguity, consult with the discharge planning team or other relevant healthcare providers.

5. Documentation

• Required:
  • MDS Form: Correctly filled entry for item set A0310H indicating the discharge status.
  • Medical Records: Detailed discharge summary, progress notes, and any relevant correspondence.
  • Verification Notes: Notes confirming the review and cross-referencing of multiple documents.

6. Common Errors to Avoid

• Incorrect Date Verification: Ensure dates are correctly verified to confirm the Part A PPS stay.
• Assumptions: Avoid making assumptions about the discharge type without documented evidence.
• Incomplete Records: Make sure all relevant records are reviewed before coding.

7. Practical Application

• Example:
  • Resident Background: Mrs. Jane Smith has completed her SNF Part A PPS stay and is transitioning to home care.
  • Review Process: Access Mrs. Smith’s medical records, including the admission note, progress notes, and discharge summary.
  • Verification: Confirm the SNF Part A PPS stay dates and discharge status.
  • Coding Process:
    • Step 1: Locate item set A0310H on the MDS form.
    • Step 2: Verify that the discharge was from a Medicare Part A PPS stay.
    • Step 3: Enter the code “1” for discharge from a Medicare Part A PPS stay.
    • Step 4: Review the entry for accuracy.
  • Illustration:
    • Provide a sample MDS form showing item set A0310H with the correct code entered.
    • Include an example of a discharge summary confirming the SNF Part A PPS discharge.

Please note that the information provided in this guide for MDS 3.0 Item set A0310H 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.