Denial Patterns

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Trace DC68-17

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6.1 “WNL” alone

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Maintenance coverage misframed

  • Fails: “resident at a plateau, no further progress” charted as if it ends coverage — a misstatement of the law.
  • Survives: the skill required to maintain function or slow/prevent decline is documented (Jimmo) — the plateau is not the point; the required skill is.
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