PDPM: ICD-10-CM Information for Your SNF
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The Patient Driven Payment Model may be a new case-mix classification system that may replace the Resource Utilization Group, Version IV (RUG-IV), effective October 1, 2019. The PDPM can classify skilled nursing facility (SNF) patients in a very medicare part A stay into payment teams as part of the SNF Prospective Payment System. RUG IV primarily uses medical aid service volume as the basis for payment. The declared intent of PDPM is to classify patients into payment groups based mostly on patient characteristics and conditions. Report the Primary Diagnosis for the SNF Stay Under PDPM, suppliers can report on the Minimum Data Set (MDS) the patient’s primary diagnosis for the SNF stay. The FAQs state that CMS expects the principal diagnosing on the SNF claim to match the primary diagnosis in item I0020B, the new item being added to the MDS beneath PDDM as a space for the patient’s primary SNF diagnosis. however there won’t be a claims edit to enforce that match. CMS