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.

The Big Dig and PDPM Gold

Posted By: Jessie McGill, RN, RAC-MT, RAC-MTA
Post Date: 03/16/2021

The Patient-Driven Payment Model (PDPM) uses 161 MDS items to establish the five case-mix adjusted components. Some of these 161 items will have supporting documentation easily found in the medical record, but other items may require some digging. From burrowing through hospital records and querying the physician to probing staff for additional clarification, thoroughly mining the medical record can yield a substantial impact on both the accuracy of the assessment and PDPM billing codes.

Read this article for tips on how to dig into the detailed information NACs need for calculating PDPM.

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