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Focused ICD-10 Coding Accuracy Training and Audit  

A missing or incorrect ICD-10 Code can impact your revenue under PDPM, ensure your team knows how to identify pertinent diagnosis. Polaris Group will provide an audit of current ICD-10 Coding practices and selection of Primary Reason for Admission on MDS in Section I. Audit will include coding of al ICD-10 codes/co-morbidities on MDS in Section I; all of which would impact PDPM Case Mix Group Assignment.

Audit - Part A sample, Section I for accuracy and supporting documentation as well as selection of Primary Reason for Admission. Audit includes coding of ICD-10 Codes/co-morbidities which impact PDPM.

Training - Training provided based on findings and ICD-10 best practices for PDPM.

ICD-10 Coding and PDPM Impact Training

Agenda

  • Review of PDPM ICD-10 qualifiers for PT/OT
  • Review of PDPM ICD-10 qualifiers for ST and co-morbidities
  • Review of ICD-10 Codes for NTA co-morbidities
  • Potential Hospital Procedure coding implications on MDS
  • How to identify and ensure accurate coding of diagnosis to support optimal Case Mix Group
  • How to use CMS Clinical Mapping spreadsheet
  • How to use NTA Mapping Spreadsheet
  • How to code accurately Section I
  • How to select the Primary Reason for Admission Code for first listed I8000
  • Review of Official Coding Guidelines
  • Coding Conventions
  • General Coding Guidelines
  • Chapter Specific Guidelines
  • Differences between Initial and Subsequent Encounter for 7th Character
  • Documentation to Support Coding and Claim
  • Accurate Diagnosis that Support Medical Record
  • Selection of Principal Diagnosis/Questionable Diagnoses
  • Coding Resources
  • ICD-10-CM Examples/Case Studies

Learning Objectives

  • Be able to select accurate ICD-10 codes
  • Understand impact of missed ICD-10/co-morbidity coding on PDPM Case Mix Group

Audiences
MDSC, DON, Nursing Managers, Billing, Therapy

Benefits of Audit and Training:

  • Expert audit of current ICD-10 coding practices
  • Improved ICD-10 Coding practices for now and future PDPM

Deliverables:

  • Audit finding with Executive Summary and recommendations
  • Handouts for Training
  • Nursing CECs - 3 or 4
  PDPM Training - How it works
  PDPM Right Start - Comprehensive Services
  Full PDPM MDS Audit
  MDS Coding Accuracy for PDPM Training
   Focused GG Audit and Training
  PDPM to RUGs Financial Impact Analysis
  Transition Services
Other PDPM Support Services:
   Medicare and PDPM Compliance Audits
  Key Indicator Trend Reports - Claim data trending services
  PDPM Manual with policies and procedures
  Billing Manual with policies and procedures
  Solution Center Hotline
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