0
No
yes_no
DiraChart MDS item reference
A2400ASection Av1.20.1Manual page A-57
Has resident had Medicare-covered stay
This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.
Quick coding
Answer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Coded response
1
Yes
yes_no
Item-specific instructions
Coding Guidance
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Coding Instructions
for A2400A, Has the
Resident Had a Medicare-covered Stay
since the Most Recent Entry?
•
Code 0, no: if the resident has not had a Medicare
Part A covered stay since the most recent
admission/entry or reentry. Skip to B0100, Comatose.
•
Code 1, yes: if the resident has had a Medicare Part
A covered stay since the most recent admission/entry or
reentry. Continue to A2400B.
Coding Instructions for A2400B, Start of Most
Recent Medicare Stay
•
Code the date of day 1 of this Medicare stay if
A2400A is coded 1, yes.
Coding Instructions for A2400C, End Date of
Most Recent Medicare Stay
•
Code the date of last day of this Medicare stay if
A2400A is coded 1, yes.
DEFINITIONS
MOST RECENT
MEDICARE STAY
This is a Medicare Part A
covered stay that has started
on or after the most recent
admission/entry or reentry to
the nursing facility.
MEDICARE-COVERED
STAY
Skilled Nursing Facility stays
billable to Medicare Part A.
Does not include stays
billable to Medicare
Advantage HMO plans.
CURRENT MEDICARE
STAY
NEW ADMISSION: Day 1 of
Medicare Part A stay.
READMISSION: Day 1 of
Medicare Part A coverage
after readmission following a
discharge.
A2400: Medicare Stay (cont.)
•
If the Medicare Part A stay is ongoing, there will be no end date to report. Enter dashes to
indicate that the stay is ongoing.
•
The end of Medicare date is coded as follows, whichever occurs first:
— Date SNF benefit exhausts (i.e., the 100th day of the benefit); or
— Date of last day covered as recorded on the effective date from the Notice of
Medicare Non-Coverage (NOMNC); or
— The last paid day of Medicare A when payer source changes to another payer
(regardless if the resident was moved to another bed or not); or
— Date the resident was discharged from the facility (see Item A2000, Discharge Date).
Coding Tips
and Special Populations
•
When a resident on Medicare Part A returns following a therapeutic leave of absence or a
hospital observation stay of less than 24 hours (without hospital admission), this is a
continuation of the Medicare Part A stay, not a new Medicare Part A stay.
•
When a resident on Medicare Part A has an interrupted stay (i.e., is discharged from SNF
care and subsequently readmitted to the same SNF within the interruption window after
the discharge), this is a continuation of the Medicare Part A stay, not a new Medicare Part
A stay.
•
The End Date of the Most Recent Medicare Stay (A2400C) may be earlier than the
actual Discharge Date (A2000) from the facility. If this occurs, the Part A PPS Discharge
assessment is required. If the resident subsequently physically leaves the facility, the
OBRA Discharge assessment would be required.
•
If the End Date of Most Recent Medicare Stay (A2400C) occurs on the day of or one
day before the Discharge Date (A2000), the OBRA Discharge assessment and Part A
PPS Discharge assessment are both required and must be combined. When the OBRA
and Part A PPS Discharge assessments are combined, the ARD (A2300) must be equal to
the Discharge Date (A2000).
•
If the End Date of Most Recent Medicare Stay (A2400C) occurs on the same day that
the resident dies, a Death in Facility Tracking Record is completed, with the Discharge
Date (A2000) equal to the date the resident died. In this case, a Part A PPS Discharge
assessment is not required.
•
For a standalone Part A PPS Discharge assessment, the End Date of the Most Recent
Medicare Stay (A2400C) must be equal to the ARD (Item A2300).
A2400: Medicare Stay (cont.)
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Assessment Applicability
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