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
Access not assessed
‘Stable’ without a thrill/bruit or limb protection.
Document the access assessment and protection each shift. (ADR.)
No post-dialysis assessment
‘Went to dialysis’ without the return assessment.
Document the post-dialysis tolerance, access, weight/BP, and disequilibrium screen.
Volume not interpreted
Weight/I&O without dry-weight interpretation.
Interpret volume against the dry weight and the schedule.
Dialysis day unsupported
Section O dialysis coded without the assessment.
Carry the dialysis coordination and assessment in the note. (F641.)
