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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.
Nurse assessment coordinators (NACs) and other members of the interdisciplinary team (IDT) who work with ICD-10-CM diagnosis codes should be using the PDPM ICD-10 Mappings tool provided by the Centers for Medicare & Medicaid Services (CMS) to prepare for the October 1 implementation of the Patient-Driven Payment Model (PDPM) in the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS), says Tracy Montag, BSN, RN, RAC-MT, clinical consultant with the Senior Living Services Consulting Group at RKL LLP in York, PA.
“In various ways, ICD-10 diagnosis codes can drive case-mix classification for all five case-mix-adjusted PDPM components, and the mapping tool impacts four of the five,” says Montag. “Consequently, it’s important to have a firm grasp of how the ICD-10 codes you commonly use now will play out under PDPM—not only to educate your IDT about documentation requirements but also to educate physicians about the need to narrow down diagnoses.”