Patient-Driven Payment Model (PDPM)

The Patient-Drive Payment Model (PDPM) is here, and AANAC will continue to help you through the transition. Visit this page frequently for new tools, education, and resources for ongoing success under PDPM.

Master the Complexities of Dysphagia Coding Under PDPM

Posted By: Caralyn Davis, Staff Writer
Post Date: 01/22/2020

Dysphagia coding plays a key role in the Patient-Driven Payment Model (PDPM) through both section I (Active Diagnoses) and section K (Swallowing/Nutritional Status) of the MDS. Here are the keys to getting it right:

 

Don’t assume IDT members understand PDPM

Sometimes nurse assessment coordinators (NACs) assume that speech-language pathologists and registered dietitians (RDs) already understand PDPM and the Resident Assessment Instrument (RAI) process when they walk in the door, notes Brenda Richardson, MA, RDN, LD, FAND, a long-term care nutrition expert based in Salem, IN, who is the past chair of the Academy of Nutrition and Dietetics Political Action Committee (ANDPAC) and recipient of the 2019 Academy Lenna Frances Cooper Memorial Lecture Award.

 

“However, dysphagia’s role in PDPM is complex. Not only do IDT members need to understand each resident’s dysphagia diagnosis, they also need to understand how that diagnosis maps—or doesn’t map—to the ICD-10-CM codes that impact PDPM, as well as how that corresponds to the MDS and the coding instructions for sections I and K,” she points out. “Employers, including contract service employers, often do not prioritize training related to payment models, so taking the time to sit down with speech pathologists and RDs to discuss the rules will only improve your ability to capture dysphagia accurately on the MDS.”

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