With PDPM, there are 161 items on MDS which could impact payment. Now all the qualifiers for Nursing Component of the rate must be accurate, as well as co-morbidities. Our audit and Training will focus on the accuracy of these items sets, which include co-morbidities for NTA and SLP component of the rate; and the qualifies for Nursing component. Polaris Group has expertise in coding of MDS, and will apply these skills to the audit.
- Provide an audit for MDS accuracy of Items on MDS that could impact PDPM CMGs.
- Identify any under-coding practices.
- Provide Training on MDS Coding Accuracy for PDPM
- Sample of current or discharged Part A residents 5 day MDS.
- Audit up to 161 items on MDS for accuracy and supporting documentation.
- Share findings of audit and recommendations.
- Review MDS Section by Section to review coding for PDPM items
- Section A
- Reason for Assessment
- New Interim Payment Assessment (IPA)
- Interrupted Stay Policy
- Optional State Assessment
- Section B and C with Interviews and Cognitive coding
- Section D – Mood Interview
- Section E – Behaviors
- Section GG
- Best coding practices for Function Score
- GG for IPA
- Section H
- Section I – Diagnosis coding best practices
- Selecting the Primary Reason for Admission
- Section J – Coding Procedure codes
- Coding other items in J impacting PDPM
- Section K – Swallowing disorders
- Tube Feeding
- Section M – Pressure Ulcer Stage and Skin Treatments
- Section N – Diabetic Orders
- Section O
- Coding PDPM items
- Coding Therapy Minutes/days at End of Stay for entire stay
- Respiratory Services
- Nursing Restorative Services
Benefits of Audit and Training:
- Expert analysis of current coding practices to identify areas for improvement
- Improved coding Accuracy
- Audit findings and recommendations for coding accuracy.
- Training on MDS Coding Accuracy for PDPM – CECs – 2