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Ask Proactive – How do I appropriately code a periprosthetic fracture? Should I use an M or S ICD-10 code?

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...

The Impact of Diagnosis Coding Under PDPM Reimbursement

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...

Q & A – What is the #1 ICD.10 coding error that you find in your audits?

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...

Reimbursement Pitfalls When Coding the Primary Diagnosis: Tips from an MDS Auditor

by Proactive LTC Consulting | May 13, 2020 | Blog, CMS, Coding, ICD.10, MDS, PDPM, Reimbursement

After 1000 PDPM coding audits completed since the PDPM transition, there are many trends our audit team has identified. This week’s blog highlights specific tips for selecting the primary diagnosis in Section I0020B based on common missed opportunities and errors...

Q & A – Can you use a “Z” code as a primary diagnosis under PDPM and map to a Clinical Category?

by Proactive LTC Consulting | May 12, 2020 | Blog, Education, ICD.10, MDS

Q: Can you use a “Z” code as a primary diagnosis under PDPM and map to a Clinical Category?   A: The ICD-10-CM Coding Guidelines state that some Z-codes can be primary. There are many Z-codes that would not be appropriate to use as primary diagnoses...

ICD10 Mappings and PDPM Grouper DLL updated for COVID-19

by Proactive LTC Consulting | Apr 1, 2020 | CMS, Coding, COVID-19, ICD.10, MDS, PDPM

The Centers for Disease Control and Prevention (CDC) published the final guidelines for the new diagnosis code U07.1, COVID-19, effective April 1 to September 30, 2020. As a result, the Centers for Medicare & Medicaid Services (CMS) also updated the ICD-10-CM to...
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Proactive LTC Consulting

2207 Morgan Ave, Suite D
Evansville, IN 47711

Phone: (812) 471-7777
Fax: (812) 471-7802
info@proactiveltcexperts.com