ICD-10 Coding will be crucial under PDPM - but SNFs don’t need to become experts

 The Medicare payment model taking effect on October 1 this year represents a sea change for skilled nursing providers in that patient condition, rather than therapy minutes, will drive reimbursement.

It also represents a sea change in the mechanics of reimbursement. Under the Patient-Driven Payment Model, ICD-10 codes will form the basis of reimbursements, making it crucial for SNFs to have accurate coding. Most providers have noticed; in Skilled Nursing News’ 2019 reader survey, 63% of more than 400 respondents said that PDPM would result in a greater emphasis on coding for their organization.

Senior care and living partner Denise Gadomski weighs in, noting “While it’s something we’re using — we’re using ICD-10 codes — we’re not really using them to the level of detail that CMS is going to be expecting us to be using.”