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The incorrect medical diagnosis/ICD-10-CM code has negative repercussions not only for care but also for billing claims. This is especially true for skilled nursing facilities (SNFs), as they move from a volume-based to a value-based reimbursement system. As the Centers for Medicare & Medicaid Services (CMS) rolls out new programs that measure and monitor quality of care, including the SNF Quality Reporting Program (QRP) and SNF Value-Based Purchasing (VBP) program, the correct ICD-10-CM codes are more important than ever. Since Quality Measures are risk adjusted based on multiple factors, including established diagnosis, it is critical for ICD-10 codes to be accurately collected and reported. Here’s how it all connects.
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