by Proactive LTC Consulting | Aug 23, 2023 | Blog, ICD.10, Medicare, PDPM, Reimbursement
PDPM has been in place for nearly four years, and with it came the shift from payment based on resource utilization to payment driven by patient characteristics and service provision. PDPM presents with many nuances and complexities that open the door to sinking...
by Proactive LTC Consulting | Mar 22, 2023 | Coding, ICD.10, MDS, PDPM, Q&A
Q: We have a resident who we are skilling related to a recent femur fracture. The principal diagnosis is S72.22XD, which maps to the Non-Surgical Orthopedic/Musculoskeletal Clinical Category, but it states “May be Eligible for One of the Two Orthopedic Surgery...
by Proactive LTC Consulting | Dec 7, 2022 | ICD.10, Q&A
Q: Did the ICD-10 codes for Dementia recently change? A: Yes, the FY 2023 ICD-10 updates (effective 10/01/22) include updated codes that provide greater specificity based on severity and behavioral symptoms present. The ICD-10-CM now classifies dementia on the...
by Proactive LTC Consulting | Oct 4, 2022 | Coding, ICD.10, Q&A
Q: I’ve noticed when reviewing resident diagnoses for MDS Section I that several of the diagnoses are suddenly showing an error message. How do I correct this? A: CMS has revised several ICD-10 codes for the 2023 fiscal year. These codes became effective October 1,...
by Proactive LTC Consulting | Aug 17, 2022 | ICD.10, Q&A
Q: We have a claim denial from a commercial insurance plan that references their policy related to Excludes 1 Notes based on the ICD10 Official Guidelines for Coding & Reporting. OT and PT used codes R26.2 (difficulty in walking) and R26.81 (unsteadiness on feet)...
by Proactive LTC Consulting | Aug 3, 2022 | Blog, CMS, ICD.10, PDPM
On July 29, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY)...
