First, it corrects an issue where diagnosis codes were mapped to NTA comorbidities as 1 to 1 mappings where 1 to 2 mappings were intended from the PDPM_ICD10_Mappings_FY20XX Excel sheet. The Clinical Categories by Diagnosis mapping file only applies to the code listed in I0020B. (PPS) based primarily on the type and intensity of therapy services provided to the patients regardless of their acuity, unique characteristics, specific needs, or goals. Learn why in this video from Aegis Therapies. Skilled nursing services are covered under the Federal Governments. Find toolkits, webinars, on-demand trainings, templates, and much more to meet the needs of your facility. For the Non-Therapy Ancillary Component, each diagnosis has a corresponding score which is multiplied to the federal NTA case mix index. (difference of NE-NF and NA-NB). Evansville, IN 47711, Phone: (812) 471-7777 NTA component receives 300% of the base per-diem rate for days 1-3 of a stay. 0000000016 00000 n Refer to the CMS PDPM ICD-10 NTA Comorbidity Crosswalk for I8000-derived comorbidities with acceptable ICD-10 codes that map to the NTA component and the NTA item listing for a complete list of NTA conditions/services. Refer to the PDPM Calculation Worksheet for more information. Section I8000 alone has 27 of these conditions, while sections K, M, N, and O also have items that can contribute to the NTA score. (4.0CSVMEB3nHSQ(9gvNtp}|srUzUX/%3vf+R6Fe Kb`Mr"yWz~tck~>1gK\,)?yt_Jy2Z2poUa-GFjRC'.`?/`;Mwk!$e#W,rLz:+ZL`Y4;Z%Up|h\/nzD]#N. hrmct With supportive documentation, it can be coded in I5600. Coding of these areas will affect the Speech Case Mix Index. As far as treating for late effects, such as weakness after an episode of pneumonia, you should obtain documentation from the physician or physician extender linking the late effects of the unsteady gait and weakness directly to the episode of pneumonia and that the pneumonia has a direct relationship to the current functional status and treatment. . The patients NTA comorbidity score is the sum of the points associated with each relevant comorbidity. (Ui7A7dR;5|jDM\sEamJFK3O.C[=vBD:]'N+T_ rhc_ex>mHR&o6Bfr*W0zG3KWmxK6P46n=Jt0Pn'OGC~&S};& Dt];vwj+E0R"^T These groups and indices, combined with other components of the payment system, provide a total reimbursement process that Determinants of payment are based on the patients characteristics assigned to six components: Patients are assigned to classification groups known as RUG Classification Groups based on various characteristics of patients and the intensity of therapy services provided. On any device & OS. We earn 1 NTA point if we code Protein or Calorie Malnutrition/At Risk for Protein or Calorie Malnutrition in MDS item I5600. A} 2?d`aYW!3,8h|J/K\J:s&Ve>1|9WiixusVo\sGP8saBT!+(z$lYnAZZp@6Y1m`[ jKeMQ5i.7HCGIC1iGIc' IV medications provided as a resident and coded in Section O would also qualify for NTA points. I wish I could be in your training the 29th. .com NTA Diagnosis Tool CMS identified a list of 50 conditions and extensive services associated with increases in NTA costs. We know now that every diagnosis and condition counts. You can read more about this in the Official ICD10 Guidelines for Coding and Reporting FY2020, Section II, Subsection K. For example: The definition of Group Therapy has changed. PDPM NTA Case Mix Classification Groups NTA Score Range NTA Case Mix Group NTA Case Mix Index NTA HIPPS Character 12+ NA 3.24 A 9-11 NB 2.53 B 6-8 NC 1.84 C 3-5 ND 1.33 D 1-2 NE 0.96 E 0 NF 0.72 F . (Right). Patient has at least three qualifying inpatient days in an acute hospital. With this component being paid at a 3x rate for 1st 3 days of . Try Now! All PDPM components are assigned an appropriate score to multiply to the federally assigned case mix index group. PDPM HIPPS Coding Crosswalk In order to accommodate the new payment groups, the PDPM HIPPS algorithm is . Luckily, code diving is a lot of fun, right? With postpartum preeclampsia, patients are now not seeing a health care provider by NCC News and Content Team | Jan 24, 2023 | Specialties. You can see in the histogram that not only are there a lot fewer rural facilities, but they also appear to have lower average case-mix. Lastly, lets look a little more closely at rural versus urban. There is also the impact of the Variable Per Diem Adjustment Factor that is applied to the NTA Component. ENSURE TO CAPTURE EVERYTHING PRIOR TO COMPLETION OF THE 5-DAY MDS ASSESSMENT! The required MDS data would be entered in the sub-items listed below the item group identifier. xref ~,/-I\!/JfB. If the 25% is exceeded, a non-fatal warning will appear on the final validation report during the MDS submission process. such has bed mobility, transfers in and out of bed, walking in the room, walking in the corridor, locomotion on unit peripheral to the patients room, locomotion off unit which involves areas farther from the patients room such as dining areas, rehabilitation rooms, activity rooms and other administrative offices, toileting, eating, personal hygiene and bathing. (At this point, I can feel the cold stares from our MDS Experts. The higher the total point value, the greater the payment (CMI). To assist stakeholders in understanding the potential impacts of the proposed PDPM, we are providing a provider-specific impact analysis file, which details the estimated . 0000003961 00000 n Far more items than would actually fit on the MDS 3.0 Instrument. With the transition from Resource Utilization Group Version IV (RUG-IV) to the Patient-Driven Payment Model (PDPM) on October 1, 2019, the MDS nurse requires an analytical mind and financial knowledge to determine the highest allowable reimbursement for the facility. The FY 2022 SNF PPS Final Rule: Learn the Facts behind the headlines Part 2 ICD-10 Revisions and PDPM. This item also impacts your MDS High Risk Pressure Ulcer QM because it is a high risk qualifier (along with impaired bed mobility impaired transfer, or comatose) for the numerator and denominator of the calculation. (2019). The Centers for Medicare and Medicaid Services (CMS) have provided the SNFs with a list of ICD-10-CM codes mapping to one of the clinical categories: These clinical categories are used as the Primary PDPM diagnosis giving weight to the calculation of PDPM rates for PT, OT, SLP and Nursing components. But if discharged on 10/01/19, it must be included on the claim. We earn 1 NTA point and qualify for Nursing Category Special Care Low for a Stage IV Pressure Ulcer when coded in M0300. We earn 2 NTA points if Diabetes is coded in MDS item I2900. Additionally, PDPM applies variable per diem payment adjustments to three components, PT, OT, and NTA, to account for changes in resource use over a stay. As a result, client facilities realize improved wound healing results, improved survey scores and NTA reimbursement under PDPM. CMS identified a list of 50 conditions and extensive services that were associated with increases in NTA costs. The southwest of the US, Michigan, Ohio and West Virginia would have the highest NTA rates. h2430Q0P0430S0 Educate yourself on the. Overview In July 2018, CMS finalized a new case-mix classification model, the Patient Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. The RUG-IV consists of two case-mix adjusted components: Therapy which is based on volume of services provided and nursing. Group therapy now allows for as few as 2 residents and as many as 6 residents. SANE is an acronym that stands for Sexual Assault Nurse Examiner. NF is the lowest grouper with a score of 0, while NA is highest with a score of 12+. endstream endobj 452 0 obj <>stream The idea is that the facility should be paid for the care they are delivering, based on the patients characteristics. As outlined in the SNF PDPM technical report, CMS was looking for the new reimbursement plan to account accurately and appropriately for the increased costs associated with caring for patients with AIDS. Reimbursement, LW Consulting, Inc.5925 Stevenson Avenue, Suite GHarrisburg, PA 17112, Ph:800-320-5401Local Ph: 717-233-6100Fx:717-233-4633. Ill also compare urban versus rural facilities when it comes to NTA case-mix. You are never alone in this field and resources are available in seminars, webinars, the CMS website, MDS manual, etc. Request for labs, imaging studies and surgical reports whichever is applicable. Admittedly, thats a lot to look through. Yes, you can, just not in I0020B. Five are case-mix adjusted to allow for variances in diagnoses, severity of illness and other variables associated with the probability of improvement with treatment: Physical therapy (PT) - includes a variable per diem factor Occupational therapy (OT) - includes a variable per diem factor 0000004207 00000 n Previous articles in this series outlined the physical and occupational therapy component and the speech language pathology component. As mentioned earlier, these NTA comorbidities are reported (coded) throughout the MDS. the design of the PDPM case-mix system implemented in FY 2020. 0000003037 00000 n The saying, haste makes waste applies in the completion of MDS assessments and calculation of the maximized PDPM rate for the patient. Section I has a lot of items that can effect NTA pay. Involve the Interdisciplinary Team. These nurses are also trained to complete a full All Rights Reserved By Nursingcecentral 2022 |. It more accurately accounts for expenses and isn't overshadowed by therapy. As a result, patients with AIDS are assigned the highest point value (8 points) of any condition or service for purposes of classification under the PDPMs NTA component, and they also receive a special 18% add-on to the nursing component of the payment. Your NTA payment is driven by the presence of a number of conditions and/or extensive services. It is important to note the one exception to the MDS coding for NTA comorbidities is HIV/AIDS, which is reported on the SNF Part A claim, but not on the MDS, due to certain state privacy laws. A frequent question: "If the mapping file lists a code as "return to provider", can I still use it on the MDS?". Custodial care does not require the assistance of a licensed staff. Condition/Extensive Service Source Points Aseptic Necrosis of Bone MDS Item I8000 1 Asthma COPD Chronic Lung Disease MDS Item I6200 2 Not having the correct codes can have a domino effect and result in missed reimbursement, or claim inaccuracies. Highlights: These components for classification and payment include: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST), Non-therapy Ancillary (NTA) as well as Nursing. This is especially important for those residents who are long-term and later qualify for skilled care. I am sure we'll continue to understand even more as the months go by. These are: Physical Therapy (PT): 14 MDS items Occupational Therapy (OT): 14 MDS items Speech Language Pathology (SLP): 33 MDS items Nursing: 129 MDS items Non-Therapy Ancillary (NTA): 33 MDS items RUG-IV: Resource Utilization Groups version 4 NTA Componenet NTA Component NTA Comorbidity Score NTA Case Mix Group CMI 12+ NA 3.25 9-11 NB 2.53 6-8 NC 1.85 3-5 ND 1.34 1-2 NE 0.96 0 NF 0.72 Presumption of Coverage Comorbidities Included in NTA Comorbidity Score and Assigned Points Condition/Extensive Service MDS Item Points HIV/AIDS SNF Claim ICD-10 B20 8 Parenteral IV Feeding: Level High I0020 is also a gateway to the I0020B Primary Diagnosis code. You only need one SLP co-morbidity (either in one of those check boxes or listed in I8000) to meet that SLP co-morbidity qualifier. 0000005276 00000 n CMS Dietitians are classified in the NTA discipline. It more accurately accounts for expenses and isnt overshadowed by therapy. Visit www.TrainingInMotion.org for more details of how we can help you achieve your PDPM goals. The individual NTA conditions have points ranging from 1 to 8. Yes, I get that is bad. o NTA = All NTA items identified with a value of two or more points on the NTA table. The Patient-Driven Payment Model focuses on the patients unique characteristics and needs based on diagnosis which arise during inpatient hospital stay. In this article, we discuss the non-therapy ancillary (NTA) component. Ive done that for urban and rural for every state. Everyone I've talked to agrees the NTA payment is a good idea. Good talk. 0000006001 00000 n It will be imperative that the coding is accurate on the MDS for the NTA conditions. This item includes diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. PDPM Chart Audit Simple and Easy: Winning in PDPM Payment and Regulatory Strategies . 0000007482 00000 n background-color: #2c4a88; Identification of NTA conditions and services should start even before the SNF admission. Character 3: Nursing Case Mix Group (NSG CMG) Character 4: NTA Case Mix Group (NTA CMG) Character 5: Assessment Indicator HIPPS Code PT/OT CMG SLP CMG NSG CMG NTA CMG HIPPS Code A TA SA ES3 NA A B TB SB ES2 NB B C TC SC ES1 NC . This article was originally published in February 2019, and has been updated in October 2019 with several more tips. With the transition from Resource Utilization Group Version IV (, ) to the Patient-Driven Payment Model (PDPM) on October 1, 2019, the. Five of the six are case-mix adjusted. As under the previous RUGIV model, the presence of an AIDS diagnosis continues to be identified through the . The Centers for Medicare & Medicaid Services (CMS) realizes that the cost impact of medications, at the time of admission, is extensive. (Click either image to enlarge.). There are a lot of items from section I8000. When these conditions and extensive services are reported on the MDS 3.0, they are weighted and used to classify a resident into a specific NTA case-mix group. Inappropriate Schizophrenia Diagnosis/Coding and Survey Citation Posting, Regulatory Reminders: Consolidated Billing Update 2023. These maps look significantly different from a lot of the others weve seen. hWmo6+( To further understand the difference between long-term care facilities and skilled nursing/rehabilitation facilities, we will focus on the services they offer. Fax: (812) 471-7802 The score determines NTA payment groups and indices. The NTA component score is based on the presence of certain comorbidities and/or the use of extensive services. CMS stated in the final rule for FY 2023 that they intend to take a more cautious approach to mitigate the potential negative impacts on the nursing home industry with this parity adjustment by spreading it across a two-year period. Was there a need for an IV? 0000001405 00000 n The Non-Therapy Ancillaries (NTA) component of PDPM can significantly increase revenue depending on MDS and ICD-10 coding. Conduct interview assessments for the Brief Interview for Mental Status (BIMS), and Mood ON ASSESSMENT REFERENCE DATE (ARD) OR A DAY PRIOR TO ARD. $HJ0!$j-g#W d9bEi0~og$.J8-Lb =lZ.SSz|'!`%/ The administration of IV fluids may qualify for the Parenteral/IV Feeding - High or Parenteral/IV Feeding - low NTA points. 18% of the Nursing adjustment factor is multiplied to the Nursing rate only patients with diagnosis of AIDS. SNF FY 2022 Proposed Rule Learn the Facts Behind the Headlines Part 3: How is My Rate Calculated, Regulatory Reminder! Just 1 NTA point can have an average worth of anywhere from $18 to $55 per day. Hover over a facility to see the name, NTA Rate, NTA case-mix index and whether the facility is urban or rural. RUG Classification Groups based on the volume and intensity of therapy provided to patient: Determinants of Payment for PDPM are summarized below. The resulting sum is the NTA comorbidity score, which is used to classify each resident into an NTA case-mix group. (Note that this map is showing ONLY the NTA rate. PDPM includes a new pay category, the non-therapy ancillary or NTA. SAMPLE Task List for the Nurse Assessment Coordinator (NAC) November 23, 2022. These skilled services are for a medical condition that is a hospital-related medical condition treated during the three-day qualifying inpatient hospital stay (not including the day of discharge from the hospital). endstream endobj 1698 0 obj <>stream Other SLP co-morbidities picked up from the grouper software include the checkboxes for I4300 (aphasia), I4500 (stroke/CVA/TIA), I4900 (hemiplegia/hemiparesis), I5500 (traumatic brain injury), O0100E2 (tracheostomy while a resident), and O0100F2 (ventilator/respirator while a resident). No paper. At the direction of the attending physician, a patient needs skilled care from and/or under the supervision of a skilled nursing or therapy staff daily. Adjustments to the PDPM rates include: 2.3% reduction in FY 2023. additional 2.3% decrease in FY 2024. Diligent review of the medical history and clinical record is essential. The NTA component, together with the nursing and non-case mix components, make up the total reimbursement for a patient day under Medicare Part A. NTA classification is based on the presence of certain comorbidities or use of certain extensive services. 2207 Morgan Ave, Suite D Skilled nursing services are covered under the Federal Governments Medicare program for a limited time or on a short-time basis and must meet the following requirements: The role of the Minimum Data Set (MDS) nurses has evolved all these years from being a clinician to a financial analytical nurse because the MDS assessments have become the basis for facility reimbursement by the Medicare program. As under the previous RUG-IV model, the presence of an AIDS diagnosis continues to be identified through the SNFs entry of ICD-10-CM code B20 on the claim. Not all NTAs are ICD-10 codes, some are MDS items. Refer to RAI pages J37-J38 for more on coding J2100. Focuses on clinically relevant factors rather than volume-based services or RUG levels. var divElement = document.getElementById('viz1528375166404'); var vizElement = divElement.getElementsByTagName('object')[0]; vizElement.style.width='100%';vizElement.style.height=(divElement.offsetWidth*0.75)+'px'; var scriptElement = document.createElement('script'); scriptElement.src = 'https://public.tableau.com/javascripts/api/viz_v1.js'; vizElement.parentNode.insertBefore(scriptElement, vizElement); Use the rate filter to show only the highest or lowest NTA rates. See the table below. To account for changes in resource PT, OT, and NTA utilization over the course of a SNF stay, PDPM utilizes a variable per-diem adjustment factor that adjusts the per-diem payment for these components over the course of the resident stay. Actually, were going to limit our scope to only I8000 items. We earn. HUO0~^iq3N&@-0*Si$L9)-ziwg';q_}(Ak"CwKi "@~|iA`!c It may also include a condition that started while the patient was getting care in the SNF for a hospital-related medical condition such as antibiotic medications via intravenous (IV) route to treat infections even if it was not the reason the patient was admitted to the acute hospital. The table below shows how the sum of the NTA points converts to an NTA Case Mix Group and a corresponding NTA CMI. We earn 1 NTA point when Other Skin Problems (foot ulcers/lesions) is coded in MDS item M1040A (infection of the foot such as cellulitis or purulent drainage), M1040B (diabetic foot ulcer), or M1040C (other open lesion of foot). Which codes are the most important? Its interesting to note that the data CMS provided, that I am using here, came from some assessments that we no longer will be doing. Skilled nursing facilities now have more than a year of experience with the Patient-Driven Payment Model (PDPM), the updated case-mix classification system used in the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) that includes five case-mix-adjusted payment components: physical therapy (PT), occupational therapy 437 0 obj <> endobj Holds on recalibrating the PDPM "parity adjustment" that is designed to ensure budget neutrality under the new model to assist SNFs in meeting the demands of the COVID-19 pandemic until FY 2023. For example, IV medications (5 points) coded in MDS item O0100H2 or isolation (1 point) coded in O0100M2. 437 27 } Comorbidities associated with higher increases in NTA costs are grouped into higher point tiers, while those that are associated with lower increases in NTA costs are grouped into lower point tiers. The correct coding for NTA will require a team effort and diligent review of coding and supporting documentation to ensure 100% accuracy. It is for this type of services they offer which also categorize them as skilled nursing and rehabilitation facilities becoming a step-down facility from an acute hospital stay. <<50FFC127310FCF468ABFE4B7414A5B70>]/Prev 423154>> You can rely on us. h4Pj0^z[ 8 >BRA$+Vfa Item I0020 and I0020B: Item I0020 (primary medical condition category that best describes the primary reason for admission lists several options. This NTA CMI is added to the other components to calculate the total reimbursement for the patient. The general method for calculation of any NTA category is as follows: The Fiscal Year (FY) 2021 PDPM ICD-10-CM Mappings file includes the NTA Comorbidity to ICD-10-CM Mapping, which maps comorbidities in the NTA component captured in item I8000 to allowable ICD-10 codes. CMS identified a list of 50 conditions and extensive services that were associated with increases in NTA costs. Primary Diagnosis - List I0020B Surgical Procedures - List J2100/J2300-J5000 Aphasia I4300 Cerebrovascular Accident . endstream endobj 454 0 obj <>stream 1694 0 obj <>stream by NCC News and Content Team | Mar 1, 2023 | Hospitals, Specialties. For example, an NTA comorbidity score of 11 equals a CMI of 2.53. yid T[KaEev0D/wRDQhDB['QgDTBEB)2"xt"Xn2 QN[%=> FhzdBI^8/HD AVONA confirms that rural facilities do indeed have lower NTA case-mix. SNF FY 2022 Proposed Rule Learn the Facts Behind the Headlines Part 3: How is My Rate Calculated, Regulatory Reminder! 0000003793 00000 n His claim's principal diagnosis is Parkinson's Disease. They cant all be equally likely, right? The decision to change the definition was because CMS believes that therapists, using their clinical judgment, will allow for more flexibility and that residents often benefit from the psychosocial aspects of group therapy. table, th, td { All disciplines should complete all their assessments ON TIME to CAPTURE all skilled services and accurately calculate residents daily rate PRIOR TO completion and transmission of the MDS 5-day assessment. Of importance to note is the condition of HIV/AIDS under the NTA component. code. endstream endobj 451 0 obj <>stream Do not be apprehensive to query the physician if a diagnosis is not clear or is suspected and not documented. pdpm nta listhorse heaven hills road conditionshorse heaven hills road conditions 0000000836 00000 n (I did abbreviate a few of the names for sanity.) ^(:eOCQ'SM7(Rmnvr/+eO.)hicZjz.,vO&u. Retrieved from: https://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html, Center for Medicare and Medicaid Services. Points are added together for all conditions. In the absence of specific documentation, you may use positive tests, procedures, hospitalization for symptoms). 0000278826 00000 n The Non-Therapy Ancillary Services (NTA) component is a total score of all listed conditions and/or extensive services that apply to the resident. endstream endobj 1695 0 obj <>stream info@proactivemedicalreview.com, Blog by Jessica Cairns, RN, RAC-CT, CMAC, and Eleisha Wilkes, RN, RAC-CTA, Click to share on LinkedIn (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Deep Dive into Federal Regulations in a Year, Mission Possible: SNF Department Head Briefing, https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2020-Coding-Guidelines.pdf, https://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html, https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/Downloads/PDPM_Fact_Sheet_NTAComorbidityScoring_v2_508.pdf, https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/Downloads/PDPM_Fact_Sheet_AIDS_v3_508.pdf, Special Treatments/Programs: Intravenous Medication Post-admit Code, Special Treatments/Programs: Ventilator or Respirator Post-admit Code, Special Treatments/Programs: Transfusion Post-admit Code, Major Organ Transplant Status, Except Lung, Active Diagnoses: Multiple Sclerosis Code, Active Diagnoses: Asthma COPD Chronic Lung Disease Code, Bone/Joint/Muscle Infections/Necrosis Except: Aseptic Necrosis of Bone, Active Diagnoses: Diabetes Mellitus (DM) Code, Other Foot Skin Problems: Diabetic Foot Ulcer Code, Special Treatments/Programs: Tracheostomy Care Post-admit Code, Active Diagnoses: Multi-Drug Resistant Organism (MDRO) Code, Special Treatments/Programs: Isolation Post-admit Code, Specified Hereditary Metabolic/Immune Disorders, Special Treatments/Programs: Radiation Post-admit Code, Stage 4 Unhealed Pressure Ulcer Currently present, Psoriatic Arthropathy and Systemic Sclerosis, Proliferative Diabetic Retinopathy and Vitreous Hemorrhage, Other Foot Skin Problems: Foot Infection Code, Other Open Lesion on Foot Code, Except Diabetic Foot Ulcer Code, Complications of Specified Implanted Device or Graft, Bladder and Bowel Appliances: Intermittent catheterization, Special Treatments/Programs: Suctioning Post-admit Code, Myelodysplastic Syndromes and Myelofibrosis, Systemic Lupus Erythematosus, Other Connective Tissue Disorders, and Inflammatory Spondylopathies, Diabetic Retinopathy Except: Proliferative Diabetic Retinopathy and Vitreous Hemorrhage, Nutritional Approaches While a Resident: Feeding Tube, Disorders of Immunity Except: RxCC97: Immune Disorders, Pulmonary Fibrosis and Other Chronic Lung Disorders. Functional scoring is one of the factors used to calculate the PDPM rate for the PT, OT and Nursing components. They are assisted by certified nursing assistants (CNAs) and licensed staff assist them during medication administration ordered by the patients attending physician in the facility. Consider adding the list of NTAs to current pre-admission screening forms or otherwise creating a way to identify and communicate potential conditions and services that may continue during the SNF stay. endstream endobj 447 0 obj <> endobj 448 0 obj <> endobj 449 0 obj [278 0 0 0 0 889 0 0 333 333 0 0 278 333 0 278 556 556 556 556 556 556 556 556 556 556 278 0 0 584 0 0 0 667 667 722 722 667 611 778 722 278 500 667 556 833 722 778 667 0 722 667 611 722 667 944 0 667 0 0 0 0 0 0 0 556 556 500 556 556 278 556 556 222 222 500 222 833 556 556 556 0 333 500 278 556 500 722 500 500 500] endobj 450 0 obj <>stream Great info! An NTA comorbidity score of 12 = a CMI of 3.24. It is important that the completion of an IPA does not reset the VPD. Once you have identified the condition/extensive service on the MDS or claim, the points associated with each comorbidity are added up for a total NTA score which is associated with 1 of the 6 case-mix groups shown below. Under PDPM, 50 conditions and extensive services are considered for NTA classification. To find out if you're leaving any money on the table email MDS Consultants for a PDPM review at info@mds-consultants.com, Find the PDPM ICD-10 Mapping tool at: https://mds-consultants.com/helpful-cms-info/, PDPM step-by-step scoring guide at https://mds-consultants.com/mds-tools/, https://mds-consultants.com/helpful-cms-info/, Coding N2001 N2005: Part A Drug Regimen Review, The Struggle with Antipsychotic Reduction . Learn More Resource PDPM Series Part 5: Assessment Requirements. 1=BY)#CT 'a7bA(XdHE ? It's easy to get to those 50, but the tricky part is understanding which ICD-10 codes match to the comorbidities.