Patient-Driven Payment Model (PDPM):
ICD 10 Codes and the Drivers of PDPM
This session is intended to provide insight and information on the new Centers for Medicare and Medicaid Services (CMS) Medicare reimbursement methodology (PDPM) that will go into effect October 2019 (Fiscal Year 2020).
- Outline the details of the Patient Driven Payment Model (PDPM) Clinical Categories that are impacted by diagnoses.
- Identify Minimum Data Set (MDS) items and ICD-10 codes used to determine the resident’s clinical categories.
- Apply strategies to develop systems for accurate diagnosis coding.
Jennifer Gross, BSN, RN-BC, RAC-CT, CPHIMS
Senior Healthcare Specialist, PointRight
Jennifer Gross's experience in the nursing field includes work in psychiatric rehab and in long term care as a staff nurse, MDS coordinator, and as a consultant. Her role at PointRight is to support our clients in understanding the intricacies of the MDS, enabling them to maximize quality of care, identify residents at risk, and prevent decline. Jennifer provides ongoing clinical education and client support for users of our web-based data analytics and clinical assessment tools. She is certified by the American Association of Nurse Assessment Coordinators, the Healthcare Information and Management Systems Society, and the American Nurses Credentialing Center. Jennifer has a Bachelor of Arts in Psychology from Boston University and a Bachelor of Science in Nursing from the University of Massachusetts at Boston.