Webinar on Demand: The Patient-Driven Payment Model and ICD-10
CHIA Product Code: WEB167
Webinar Date: August 29, 2019
Effective October 1, 2019, major changes are emerging for long term care (LTC) facilities. CMS finalized a new case-mix classification system, the patient-driven payment model (PDPM), intended to modernize LTC reimbursement. The model will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A patient stay. Under the Centers for Medicare and Medicaid Services (CMS) Patients Over Paperwork initiative moving across the health care continuum, the minimum data set (MDS) currently in use based on the resource utilization group (RUG) reimbursement system will be significantly revised with a new assessment schedule and less MDS assessment during each LTC stay period.
This presentation will address how the specific ICD-10 code reported on the MDS as the "primary diagnosis" can be either accepted or denied by CMS. Specific examples of accepted and rejected codes will be reviewed, including the 27,854 codes that will be rejected and the 37,214 codes that will be accepted and mapped to one of ten possible clinical categories.
Participants will understand:
- Basic concepts of what the coding process with ICD-10 involves;
- Impact of ICD-10 on PDPM and how it drives the ten clinical categories;
- Specific examples of the 27,854 codes that will be rejected;
- Specific examples of the 37,214 codes that will be accepted;
- Comorbidities and how they can affect the comorbidity score;
- Specific examples where acceptable mappings conflict with coding guidelines; and
- Strategies for coding success under PDPM.
Who Should Attend
Health Information Professionals, Nursing Administrators and Directors, Business Office Personnel
This program has been approved for 1 continuing education units (CEUs) for use in fulfilling the continuation education requirements of the American Health Information Management Association (AHIMA) and Board of Registered Nursing (BRN). Approved by American Academy of Professional Coders (AAPC) for coding-related programs only.
HIIM Domain: Clinical Data Management
William Roush, RHIA
HIM Consultant, Fillmore & Co.
About Webinars on Demand:
CHIA offers Webinars on Demand, which are available for separate purchase after the live Webinar has been presented. This convenient format consists of the full 60-90 minute recorded presentation, distributed handout, and accompanying Continuing Education Unit (CEU) certificate. Each Webinar on Demand is only available for purchase and access for one year after the original recording date. After purchase, a Purchase Confirmation will be sent to the purchaser’s primary email address and will contain the access links.