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Nurse assessment coordinators (NACs) and other members of the interdisciplinary team (IDT) who work with ICD-10-CM diagnosis codes should be using the PDPM ICD-10 Mappings tool provided by the Centers for Medicare & Medicaid Services (CMS) to prepare for the October 1 implementation of the Patient-Driven Payment Model (PDPM) in the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS), says Tracy Montag, BSN, RN, RAC-MT, clinical consultant with the Senior Living Services Consulting Group at RKL LLP in York, PA.
“In various ways, ICD-10 diagnosis codes can drive case-mix classification for all five case-mix-adjusted PDPM components, and the mapping tool impacts four of the five,” says Montag. “Consequently, it’s important to have a firm grasp of how the ICD-10 codes you commonly use now will play out under PDPM—not only to educate your IDT about documentation requirements but also to educate physicians about the need to narrow down diagnoses.”
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