Provider Letter No. 16-20 — Provider Requirements for Minimum Data Set (MDS) 3.0 (Replaces PL 10-19)
On October 1, 2010, the Texas Department of Aging and Disability Services (DADS) began using MDS 3.0 for all MDS assessments with an assessment reference date, entry date or discharge date of October 1, 2010 or later, in accordance with Centers for Medicare & Medicaid Services (CMS) requirements. The DADS requirements for all options have been updated in the MDS 3.0 Resident Assessment Instrument (RAI) Manual where states have the authority to set requirements.
Updated information includes:
•the CMS requirement to use diagnosis codes from the International Classification of Diseases, Tenth Revision (ICD-10);•the DADS requirement for all options in the MDS 3.0 RAI Manual where states have the authority to set requirements;•other Medicare Required Assessments (OMRA);•the definition of private pay residents as anyone not on Medicare Part A or Medicaid;•the definition of private insurance MDS assessments as those not federally mandated under Omnibus Budget Reconciliation Act (OBRA) or Skilled Nursing Facility (SNF)Prospective Payment System (PPS) requirements;•the requirement to complete discharge (return not anticipated) and new admission assessments for a resident who moves from a Medicare, Medicaid or Medicare/Medicaid dually-certified unit to a non-certified unit and vice versa;•the Texas Health and Safety Code (THSC) §81.103 requirement that prohibits the input of select ICD-10 diagnosis codes for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS); and the current Resource Utilization Group (RUG) versions for Medicaid payment and research.
Chapter 2.2: State Designation of the RAI for Nursing Homes
DADS will use the Nursing Home Quarterly (NQ) Item Set for OBRA quarterly assessments, including quarterly assessments that are combined with OMRA. DADS will use the Nursing Home PPS (NP) Item set for Medicare-required assessments. DADS will not add additional state items to any of the standard CMS-defined item sets.
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