Healthcare Compliance & Reimbursement: Chapter 8 Assignment Review Questions (5 points each): 1. What services are included in the consolidated billing of the SNF PPS? What services are excluded from the consolidated billing of the SNF PPS? 2. How are MS-LTC-DRGs determined? 3. For inpatient rehabilitation facility patients, codes on the IRF PAI should follow the UHDDS and the UB-04 guidelines. True or false? 4. How is durable medical equipment (DME) reimbursed in the HHPPS? 5. Explain why the home health HIPPS code is called an \"intelligent\" code. Application (25 points): Assign a resident to a resource utilization group (RUG). To assign the resident to a RUG, use information from the following sources: Case below Figure 1 below Figure 8.6 in textbook Based upon the following data, into which RUG is the resident grouped? Is the RUG one of the upper groups? Please include your answer to the above two questions, as well as a description of the process used to determine the RUG. Case The resident requires isolation because of an infection (extensive service). The resident received 740 minutes of therapy. These minutes were received when the resident had physical therapy on Monday, Tuesday, Wednesday, Thursday, and Friday and had speech therapy on Monday, Wednesday, and Friday. The resident's ADL score is 9. Figure 1 Medicare Payment Advisory Commission [MedPAC]. 2011b (October). Payment basics: Skilled nursing facility services payment system. http://www.medpac.gov