ICD-10-CM AND THE PDPM
With the introduction of the Patient Driven Payment Model, the new Medicare payment structure, diagnostic coding with ICD-10-CM moves to the forefront as part of the calculator for payment assignment for PT/OT and the Non Therapy Ancillary (NTA). Historically the actual ICD-10-CM code was not emphasized as the majority of diagnoses for calculating the RUG assignment were check-off items in Section I. As of 10/1/19 that changes as the specific code will determine the Clinical Category for PT and OT, the comorbidity for ST and the points for the NTA. It is very important that Assessment Coordinators and others understand how the codes are utilized, what the differences are between a principal diagnosis and a primary diagnosis; and the difference between the hospital primary diagnosis and the SNF primary diagnosis. The goal of this presentation is to provide clarification on how the diagnostic codes are utilized for this purpose.
CEs: There are no CEs alloted for this presentation.
Mary Ann P. Leonard, RHIA, RAC-CT owner and operator of Health Information Professionals, a health information management consulting company. Health Information Professionals holds contracts for HIM consulting services with over 100 facilities in Pennsylvania, Delaware and Maryland. A graduate of Temple University’s Health Information Management program, Mary Ann has worked as a Medical Records Consultant in long term care for over 3 decades. She has conducted educational programs on various medical records related topics and conducts the medical record portion of the Nursing Home Administration program in Southeaster and Southcentral Pennsylvania. She has presented on a number of HIM related topics for the Pennsylvania Health Information Management Association, the New Jersey Health Information Management Association, the Long Term Care Spring Conference sponsored by the American Health Information Management Association and various other professional associations. She has successfully completed the AANAC Assessment Coordinator certificate program and update. Mary Ann is also active in the Pennsylvania Health Information Management Association and the American Health Information Management Association by holding various positions and membership in the Long Term Care Practice/Continuity of Care Council. She is an AHIMA Approved ICD-10-CM trainer. She is a founding and charter member of the Pennsylvania Association of Nurse Assessment Coordinators and has held positions within the Association including Board member, advisor and Committee Chair. She has also held positions with the PHIMA including, but not limited to, Secretary, Education Chair and Conference Chair.
ICD-10-CM AND PDPM
Fri, Mar 29, 2019 12:00 PM - 1:30 PM EDT
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