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)... by Proactive LTC Consulting | Jan 26, 2022 | Blog, ICD.10, PDPM
Since the inception of PDPM, selecting the Primary Diagnosis has been a challenge for MDS/RAI coordinators. Under PDPM, the diagnosis coded on the 5-day/Initial Minimum Data Set (MDS) in section I0020B largely determines reimbursement for the entire Medicare stay... by Proactive LTC Consulting | Jul 7, 2021 | Audits, Blog, Coding, Compliance, ICD.10, MDS, Reimbursement
Even though SNFs have collectively seen higher reimbursement rates under the Patient-Driven Payment Model compared to the previous RUG IV payment model, data shows that there is still room for improvement for most facilities in terms of ensuring accurate revenue under... by Proactive LTC Consulting | Jun 30, 2021 | Coding, ICD.10, Q&A
Q: How do I appropriately code a periprosthetic fracture? Should I use an M or S ICD-10 code? A: Fractures result from trauma or injury or a pathological condition. With a periprosthetic fracture, two ICD-10 codes would be utilized. One code would include the... by Proactive LTC Consulting | Dec 15, 2020 | Blog, ICD.10, PDPM
Diagnosis coding accuracy is paramount to appropriate payment under PDPM, as ICD-10 Diagnosis codes & other patient characteristics are used as the basis for classification in determining Medicare (MCR) payment. The 5-day/Initial MDS establishes the PDPM payment... by Proactive LTC Consulting | May 21, 2020 | Audits, Blog, Coding, COVID-19, Education, ICD.10, MDS
Q: What is the #1 ICD.10 coding error that you find in your audits? A: Answer: The coding error seen most often is using acute conditions/diagnoses. The RAI Manual states while certain conditions represent acute diagnoses, SNFs should not use acute diagnosis...