PASRR regulations at 42 CFR 483.128(m) permit Level II evaluations to be terminated if the Level II evaluator finds that individual has: “A primary diagnosis of dementia (including Alzheimer’s Disease or a related disorder)” (42 CFR 483.128(m)(2)(i)); or
States may apply the categorical determination at 42 CFR 483.130(h), to address a decision not to provide specialized services to individuals with dementia and intellectual disability. “(h) Categorical determinations: Dementia and ID.
The dementia exclusion for mental illness allows for the Level II evaluator to stop the evaluation if they determine that the diagnosis of dementia is primary and the mental illness (MI) diagnosis is secondary. It is important to note that the diagnosis or verification of a diagnosis of MI and...
It can often be difficult to determine where MI/ID ends and dementia begins. Like ID/DD, dementia can manifest as cognitive impairments. Like MI, dementia can lead to anxiety, depression, or acute behavioral problems.
Since the ICD-10-CM coding went into effect on October 1, 2015, some State PASRR programs have reported an increase in PASRR volume, particularly in referrals for Level II Resident Reviews. The increase is largely attributed to the computer algorithm that converted ICD-9 codes to ICD-10 codes.
State leads include employees in the state Medicaid office, the state intellectual disability authority, and the state mental health authority that are involved with the state's PASRR program. The contact information for the PASRR state leads (below) was last updated on July 26, 2017.
August 2017 PASRR Webinar Topic: The PASRR Initiative in Washington State Speakers: Frank Tetrick, consultant for PTAC & Terry Hehemann, PASRR Program Manager at Washington State Department of Social and Health Services Date: Tuesday, August 8th, 2017
July 2017 PASRR Webinar Topic: Resident Review: A Critical Component to Achieving PASRR’s Vision Speakers: Nancy Shanley and Andrea Womack, consultants for PTAC Date: Tuesday, July 11th, 2017 Time: 1 - 2:30PM Eastern
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