![]() ![]() What was the LUPA threshold and how many visits did the agency make? The first 30 days episode had several visits and the LUPA threshold was easily cleared. Did the clinician accept the suggested OASIS changes that we had made? Yes. Did the coding match in their system what showed in our system? It did. She was upset that the reimbursement that we had calculated for that patient were significantly higher than what the agency had actually received. Is the patient is not discharged after 30 days, then the agency needs to make more than 2 visits in the second 30 days.Ī while ago, I had a customer call that was very upset. Agencies now know that you have to have more than 4 visits to avoid what we call LUPA land in the first 30 days. For example, a patient could have a LUPA threshold of 4 in the first 30 days and 2 in the second 30 days. If the agency knows what the LUPA threshold is, they can plan right up front. They have a patient, dropped the RAP, but don't know what the LUPA threshold is when developing the Plan of Care (POC or 485). Previously, OASIS had to be completed, which meant that agencies would know the diagnosis group, HIPPS code, and ultimately the LUPA threshold before the RAP could be submitted. That is essential to make sure the LUPA is correct so you're going off the best information! One of the unintended consequences of the No Pay RAP in 2021, is that OASIS does not have to be completed to submit the RAP. One of the biggest factors on avoiding LUPA is to have accurate diagnosis coding and OASIS review. Perhaps the easiest way to avoid a LUPA is to know what the thresholds are right up front. What is LUPA threshold in PDGM and how to avoid it? This is important- this is for each 30 day episode. (Click on this link to see what OASIS questions PDGM focuses on PDGM OASIS questions) The new LUPA threshold is a sliding scale between 2 and 6 visits for each 30 day episode. Rather than being a fixed visit threshold, CMS changed the LUPA threshold approach to a sliding scale of visits based on a lot of other factors like coding, diagnosis grouping, OASIS (M1800 questions). PDGM changed the game on LUPAs and some agencies haven't adjusted well. Previously, agencies had to have more than 5 visits in an episode to avoid LUPA. ![]() If you remember, one of the biggest changes in PDGM is around LUPA. LUPA stands for Low Utilization Payment Adjustment. One thing that agencies are still struggling with is LUPA. In another blog post called PDGM for Dummies we explain what PDGM is. ![]() PDGM started in 2020, but then a pandemic really took the focus of agencies, and understandably so. A quick search of the company name at gives details about its employees and owners.With PDGM and home health in 2021, agencies have a lot to juggle. Provided you know the name of the firm a person works in, the Radaris business feature can help you identify their employer. You will receive their current and previous residences. Just visit, enter the first and last names of the individual you are researching, and select the “Search“ button. allows you to use someone's name to know where they live. How to find out where someone lives by name? Just enter one or a combination of the above details and conduct your search. All you need is specific details such as email address, phone numbers, cities of residence, the properties and businesses they own, etc. Radaris makes it simple to find people even if you aren't aware of their last names. You can find arrest records for Paul Lupinacci in our background checks if they exist. Does Paul Lupinacci have a criminal record? We have marriage records for 4 people named Paul Lupinacci. Paul Lupinacci's phone number is (215) 493-8131. Paul Lupinacci's address is 10 Lakeview Passway, Morris, CT 06763. ![]()
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