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Ask Proactive – Did the ICD-10 codes for Dementia recently change?

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...

Ask Proactive – MDS Section I—ICD.10 Diagnosis Code Error

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,...

Ask Proactive – Claim Denial Based on ICD10 Coding

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)...

Proactive Summary – FY 2023 SNF Final Payment Rule

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)...

The Primary Diagnoses Under PDPM: How to Avoid Common Mistakes

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...

Start Here for PDPM Reimbursement Accuracy

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...
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Proactive LTC Consulting

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Evansville, IN 47711

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