A SNF’s Guide to ICD-10 Coding and Operations Under PDPM

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A SNF's Guide to ICD-10 Coding and Operations Under PDPM

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A SNF’s Guide to ICD-10 Coding and Operations Under PDPM

A SNF’s Guide to ICD-10 Coding and Operations Under PDPM is the go-to guide for ensuring proper reimbursement under Patient-Driven Payment Model (PDPM). This book includes chapter-specific coding guidelines, featuring examples and language specific to SNFs, with an instructional guide on how specific coding will map to PDPM clinical categories and its impact on non-therapy ancillary billing. Written by MDS expert Theresa A. Lang, RN, BSN, WCC, an AHIMA-approved ICD-10 trainer with years of experience serving as a SNF reimbursement specialist, this guide understands what MDS coordinators and other staff need to know about.

With this guide, ensure your facility never loses money through inaccurate diagnosis coding. This guide reviews PDPM, coding conventions with examples SNFs are familiar with, and all coding guidelines that relate to SNFs. As a bonus, Lang also reviews how SNFs need to change their operations.

Published: December 2019

Page Count: 234
ISBN: 978-1-68308-878-3

Table of Contents

Chapter 1:Understand PDPM

  • RUG-IV vs. PDPM
  • PDPM Components and Rates
  • PDPM Clinical Categories
  • Other PDPM Classifications

Chapter 2: Coding Conventions

  • Diagnosis
  • Official Guidelines
    • Alphabetical Index
    • Tabular List
  • Method to Assigning Codes
    • Locating Codes
    • Format and Structure

Chapter 3: Official Coding Guidelines and PDPM

  • Official Coding Guidelines and PDPM Impact, ICD-10-CM Chapters A–Z

Chapter 4: Considerations for SNF Operations Under PDPM

  • Skilled Nursing and Other Regulations
  • Who, What, When of Coding

About the Authors

Theresa Lang, RN, BSN, WCC, is an AHIMA-approved ICD-10-CM trainer. She is currently the regional clinical reimbursement specialist for Grace Lutheran Communities in Eau Claire, Wisconsin. Daily interactions with MDS coordinators and diagnosis coders for nine facilities allow her to address processes and review reimbursement strategies. Lang is a knowledgeable consultant/trainer of Medicare reimbursement and MDS throughout the United States.