The domain’s common reasons a Part A skilled day is down-coded or denied on medical review (ADR), and the corrected pattern. The full catalog lives in Denial Patterns.
Risk
Why it fails
Corrected pattern
Post-op care under-documented
‘Ear okay’ without site findings or precautions.
Document the operative-site assessment, precautions, and complication surveillance. (ADR.)
Vertigo without safety management
‘Dizzy’ with no fall-risk action or central screen.
Document the fall-safety management and the central-cause screen.
Deficit not tied to the plan
A hearing deficit noted but not linked to participation.
Document how the deficit affects the skilled plan and the management applied.
Section B unsupported
Hearing coded without the assessment in the note.
Carry the hearing status and ear care in the note. (F641.)
