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Skilled Nursing Facility Lowest 14 RUGS (Edit 5ES10)

Bill Type = 21X
States: CT, NY
RUG Codes: Codes beginning with BA*, BB*, PA*, PB*, PC*, PD*, PE*, IA*, IB*

Documentation Requirements

  • Initial MDS and any MDS that corresponds to the billed dates of service
  • All physician orders, certifications/recertification and progress notes for the dates of services billed including history and physical
  • Hospital records supporting three-day qualifying stay
  • Nurses notes, resident care plan, treatment records, medication records and graphic sheets
  • Documentation of all therapies (PT, OT, SLP) provided including support of physician supervision, orders and signed plan of treatment
  • Any other documentation that relates to the condition for which services were rendered that supports the skilled services billed
Skilled Nursing Facility Lowest 14 RUGS (Edit Reason Code 5ES10)
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