Preparing for Success with ICD-10-CM Changes Oct. 1: How the Facility Coder and Provider Can Ensure Accurate Diagnosis Codes

Article / Billing and Reimbursement / NAC

Effective International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) coding relies on meticulous clinical documentation. It’s not just about assigning codes; it’s about ensuring consistent and comprehensive documentation that substantiates every facet and the specificity of a diagnosis. This documentation should originate from a provider, that is, a physician …

Accurate PDPM Reimbursement: Four Areas of Focus to Shore Up MDS Documentation

Article / MDS 3.0 and the RAI Process / NAC

The Patient-Driven Payment Model (PDPM) has been the case-mix classification model used for Medicare Part A skilled nursing facility (SNF) reimbursement since October 2019. Although this payment system has been in place for nearly four years for Medicare payment, some states have recently transitioned to PDPM for Medicaid payment. That …

How Will October 2023 MDS Changes Impact PDPM and Medicare Payment?

Article / Billing and Reimbursement / MDS 3.0 and the RAI Process / NAC

Many changes are coming to the Minimum Data Set (MDS) effective Oct. 1, 2023. The Centers for Medicare & Medicaid Services (CMS) released the draft of the Long-Term Care Resident Assessment Instrument (RAI) User’s Manual version 1.18.11 in April with a final manual expected in August. Several of the MDS …