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Is the resident ATOP2 eligible?

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Last updated 7 years ago

First published 17 March, 2017

English Rating: ALL ages Shortest path: 3 nodes Longest path: 13 nodes Possible solutions: 10

Adrianna M

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Was the diagnosis confirmed? Yes. No.
Facility may not bill. Only practitioner may bill for assessment performed. .
Was treatment started when the CIC was noted? Yes. No.
Bill for duration beginning first day treatment was administered/day CIC was noted. .
Bill for duration beginning on day treatment was administered, despite CIC notation date. .
Does the resident meet ATOP2 diagnostic criteria for one of the six conditions? No. Yes.
Does not qualify for ATOP2 payment..
Has a CIC been noted in patient's chart? Yes. No.
Note CIC. .
Has an assessment been done by the end of the second day after CIC was noted? Yes. No.
Was the diagnosis confirmed? Yes. No.
Facility may not bill. Only practitioner may bill for assessment performed. .
Was treatment started when the CIC was noted? Yes. No.
Bill for duration beginning first day treatment was administered/day CIC was noted. .
Bill for duration beginning on day treatment was administered, despite CIC notation date. .
Can an assessment be done now? No. Yes.
Not a billable event..
Has treatment been administered prior to assessment? No. Yes.
Is diagnosis confirmed? No. Yes.
Not a billable event. .
Billable event: Begin billing day of confirmation for up to 5 or 7 day duration..
Is diagnosis confirmed? No. Yes.
Not a billable event for facility. Only practitioner may bill. .
Billable event: billing for 5 or 7 day period may begin now or predate two days for treatment administered. .
Can an assessment be done now? No. Yes.
Not a billable event..
Has treatment been administered prior to assessment? No. Yes.
Is diagnosis confirmed? No. Yes.
Not a billable event. .
Billable event: Begin billing day of confirmation for up to 5 or 7 day duration..
Is diagnosis confirmed? No. Yes.
Not a billable event for facility. Only practitioner may bill. .
Billable event: billing for 5 or 7 day period may begin now or predate two days for treatment administered. .