Patient-Driven Payment Model (PDPM)

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FY 2021 PDPM ICD-10 Mappings (1/21)

Posted By: CMS
Post Date: 01/11/2021

The Mappings file contains: 

  • Mapping of the ICD-10-CM Recorded in Item I0020B of the MDS Assessment to PDPM Clinical Categories 
  • Mapping of Comorbidities Included in the PDPM SLP Component to ICD-10-CM Codes
  • Mapping of Comorbidities Included in the PDPM NTA Component to ICD-10-CM Codes

These are the codes added in the January 2021 update:

Z11.52 — Encounter for screening for COVID-19

Z20.822 — Contact with and (suspected) exposure to COVID-19

Z86.16 — Personal history of COVID-19

M35.81 — Multisystem inflammatory syndrome (MIS)

M35.89 — Other specified systemic involvement of connective tissue

J12.82 — Pneumonia due to coronavirus disease 2019

(Note that codes M35.81 and M35.89 replace code M35.8, which should no longer be used on assessments with target date on or after January 1, 2021.)

This is the seventh release (sixth production release, since 1.0005 was a beta release).

This release also adds six ICD-10 codes that were inadvertently excluded from the NTA calculation in V1.0006:

• T8484XA

• T8389XA

• T8321XA

• T82399A

• T82392A

 • T83021A 

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