Step-by-Step Coding Guide for O0430: Distinct Calendar Days of Part A Therapy

1. Review of Medical Records

• Objective: Identify all instances of physical, occupational, and speech therapy provided under Medicare Part A.
• Procedure: Examine therapy documentation, treatment notes, and billing records for the assessment period to determine the days each therapy type was administered.

2. Understanding Definitions

• Distinct Calendar Days: Refers to the unique days within the assessment look-back period when the resident received therapy services.
• Part A Therapy: Therapy services covered under the Medicare Part A benefit, including physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP).

3. Coding Instructions

For each therapy type (PT, OT, SLP):

• Code: Enter the number of distinct calendar days the resident received each therapy service during the look-back period. Do not count the same day multiple times for the same therapy type, even if multiple sessions occurred.

4. Coding Tips

• Cross-Reference: Double-check therapy schedules and billing records for accuracy.
• Interdisciplinary Coordination: Collaborate with therapy departments to ensure all therapy sessions are accounted for, especially when services are provided on the same day.

5. Documentation

• Detail Therapy Sessions: Maintain detailed records of each therapy session, including date, type of therapy, duration, and specific interventions or treatments provided.
• Update Regularly: Ensure therapy documentation is updated in real-time to reflect the delivery of services accurately.

6. Common Errors to Avoid

• Double Counting: Avoid counting a single day multiple times for the same therapy type.
• Overlooking Therapy Days: Ensure no therapy days are missed due to gaps in documentation or communication lapses between departments.

7. Practical Application

Example Scenario: A resident receives physical therapy on Monday, Wednesday, and Friday, occupational therapy on Tuesday and Thursday, and speech therapy on Wednesday and Saturday during the assessment period.

• Coding for PT: 3 distinct calendar days
• Coding for OT: 2 distinct calendar days
• Coding for SLP: 2 distinct calendar days

The Step-by-Step Coding Guide for item O0430 in MDS 3.0 Section O is based on the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.18.11, dated October 2023. Please note that 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.