Patient-Driven Payment Model (PDPM)

The Patient-Drive Payment Model (PDPM) is scheduled to begin Oct. 1, 2019, and AANAC is here to help!

The Centers for Medicare & Medicaid Services released the Fiscal Year (FY) 2019 Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule, which solidified their plans to implement PDPM.  PDPM is set to replace the RUG-IV case-mix classification model that has been the hallmark of SNF PPS for years. This new payment system will be unlike anything SNFs have seen before! You and your staff have a lot to do to get ready for PDPM, and AANAC will be with you the entire way.  Visit this page frequently to get tools, education, and resources to help you lead your team readiness.

Use the ICD-10 Mappings Tool Now to Train for PDPM

Posted By: Caralyn Davis, Staff Writer
Post Date: 07/22/2019

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.”

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