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.

MDS Item O0110: Keys to Coding Under PDPM

Posted By: Caralyn Davis, Staff Writer
Post Date: 01/08/2020

Ten subitems in MDS item O0100 (Special Treatments, Procedures, and Programs) can affect from one to three of the case-mix-adjusted payment components in the Patient-Driven Payment Model (PDPM): speech-language pathology (SLP), nontherapy ancillaries (NTA), and/or nursing. The following chart shows the potential impacts:

 

O0100 Item

Potential PDPM Impact

O0100A2 (Chemotherapy While a Resident)

Nursing Clinically Complex

O0100B2 (Radiation While a Resident)

NTA (1 point), Nursing Special Care Low, Nursing Clinically Complex

O0100C2 (Oxygen Therapy While a Resident)

· Must be in combination with I6300 (Respiratory Failure) to qualify for Nursing Special Care Low

Nursing Special Care Low, Nursing Clinically Complex

O0100D2 (Suctioning While a Resident)

NTA (1 point)

O0100E2 (Tracheostomy Care While a Resident)

SLP, NTA (1 point), Nursing Extensive Services, Nursing Clinically Complex

O0100F2 (Invasive Mechanical Ventilator (ventilator or respirator) While a Resident)

SLP, NTA (4 points), Nursing Extensive Services, Nursing Clinically Complex

O0100H2 (IV Medications While a Resident)

NTA (5 points), Nursing Clinically Complex

O0100I2 (Transfusions While a Resident)

NTA (2 points), Nursing Clinically Complex

O0100J2 (Dialysis While a Resident)

Nursing Special Care Low, Nursing Clinically Complex

O0100M2 (Isolation or Quarantine for Active Infectious Disease (does not include standard body/fluid precautions) While a Resident)

NTA (1 point), Nursing Extensive Services, Nursing Clinically Complex


Note: When more than one nursing category is listed, the resident may be classified into the lower category depending on other MDS data, e.g., the resident’s nursing function score.


To see the full post, please register or login with your account.