Members: $22 | Non-members: $44
Continuing Education: 1 CE hour
Recording Date: June 16, 2022
Duration: 60 minutes
Speaker: Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC
The Physical Therapy (PT) and Occupational Therapy (OT) components of the Patient-Driven Payment Model (PDPM) use an identical two-step methodology to achieve the same final case-mix groups (CMGs), but the nuances within those steps can confuse nurse assessment coordinators (NACs) and interdisciplinary team (IDT) members alike. The seemingly straight-forward first step of selecting the primary diagnosis to be coded at MDS item I0020B is often much more challenging than it appears. Accuracy of this item requires ICD-10-CM coding knowledge, ability to use the PDPM mapping file, strong communication with physicians, and IDT collaboration. In addition, failing to identify a related surgical procedure in section J can result in the incorrect mapping of the selected diagnosis code. The second step is the assessment of usual function in section GG to determine the function score, which requires a strong IDT process, episode-based documentation or interview, and timely collaboration.
During this 60-minute webinar, AAPACN Curriculum Development Specialist, Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, will walk through the complex path of assigning the most appropriate primary diagnosis, determining the mapping to the clinical category, and calculating the PT/OT function score to assign the final PT and OT case-mix groups.
After participating in this session, learners will be able to:
- Identify the MDS items used in the methodology of the PT and OT components
- Use the CMS ICD-10-CM mapping file to determine the PT and OT clinical category
- Understand the PT/OT function score calculation using section GG
- Apply the PT and OT components methodology to project the final case-mix groups