Integrated Coding and PDPM 15 Case Study Coding Sheet › snf › august2019 ›...
Transcript of Integrated Coding and PDPM 15 Case Study Coding Sheet › snf › august2019 ›...
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
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MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
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MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
PDPM Calculation Worksheet Responses for Mrs. S
Calculation of PDPM Cognitive Level
Step 1. C0500. BIMS Summary Score________________
PDPM Cognitive Level______________________
Calculation of PT Payment Component
Step 1. I0020B Diagnosis_______________________________________
Default Primary Diagnosis Clinical Category__________________________________
Step 1A. Resident Eligible for Surgical Clinical Catory and Received Major joint replacement or spinal surgery? Yes_____ No_____
Step 1B. Resident Eligible for Surgical Clinical Category and Received Orthopedic Surgery (Except Major Joint Replacement or Spinal Surgery)? Yes_____ No_____
Step 1C. Resident Eligible for Surgical Clinical Category and Received Significant Non-Orthopedic Surgical Procedure? Yes_____ No_____
Step 1D. Finalized Primary Diagnosis Clinical Category__________________________________
Step 2. PT Clinical Category_________________________________________________________
Step 3. Calculation of Function Score:
· Self-Care Admission Performance Function Score:
o Eating _____ Oral Hygiene _____ Toileting Hygiene _____
· Mobility Admission Performance Function Score:
o Bed Mobility: Sit to Lying _____ Lying to Sitting _____
o Transfer: Sit to Stand ______ Chair/bed-to-chair transfer _____ Toilet transfer __________
o Walking: Walk 50 feet with two turns _____ Walk 150 feet __________
· Average Bed Mobility ______ Average Transfer ______ Average Walking _____
PDPM PT Function Score _____
Step 4. PDPM PT Classification_____
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
Calculation of OT Payment Component*
*Note: The steps for calculating the resident’s PDPM classification for the OT component follow thesame logic used for calculating the resident’s PDPM classification for the PT component, described above. Therefore the PDPM OT Classification is the same as the PDPM PT Classification.
PDPM OT Case-Mix Classification _____
Calculation of SLP Payment Component*
*Note: The primary diagnosis clinical category used for the SLP component is the same as the clinicalcategory used for the PT and OT components.
Step 1. Primary Diagnosis Clinical Category _____________________________________
Step 2. SLP Clinical Category ________________________________________________
Step 3. Presence of one or more SLP-related comorbidities? Yes_____ No_____
Step 4. Presence of cognitive impairment? Yes _____ No _____
Step 5. Number of conditions present (based on Steps 2, 3 and 4) __________
Step 6. Presence of Swallowing Disorder? Yes _____ No _____
Step 7. Presence of Mechanically Altered Diet? Yes _____ No _____
Step 8. Presence of Mechanically Altered Diet or Swallowing Disorder? (Neither/Either/Both) __________
Step 9: PDPM SLP Classification __________
Calculation of NTA Payment Component
Step 1. Resident has HIV/AIDS? Yes _____ No _____
Presence of Parenteral/IV Feeding – High Intensity? Yes _____ No _____
Presentce of Parenteral/IV Feeding – Low Intensity? Yes _____ No _____
NTA-related comorbidities (Table 16) __________
Step 2. NTA Score__________
Step 3. PDPM NTA Classification__________
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
Calculation of Nursing Component
Step 1. Calculation of Function Score:
· Self-Care Admission Performance Function Score:
o Eating _____ Toileting Hygiene _____
· Mobility Admission Performance Function Score:
o Bed Mobility: Sit to Lying _____ Lying to Sitting _____
o Transfer: Sit to Stand ______ Chair/bed-to-chair transfer _____ Toilet transfer __________
· Average Bed Mobility ______ Average Transfer ______
PDPM Nursing Function Score__________
Step 2. Nursing Case-Mix Group ________________________________________
Step 3. Resident Qualifies as Depressed? Yes _____ No _____
Step 4. PDPM Nursing Classification_______________
HIPPS Character 1: PT/OT Component
Clinical Category___________________________________________________
Section GG Function Score__________
PT/OT Case-Mix Group__________
HIPPS Character 1_____
HIPPS Character 2: SLP Component
Presence of Acute Neurologic Condition, SLP-Related Cormorbidity, or Cognitive Impairment (None, Any one, Any two, All three) ___________________________________
Mechanically Altered Diet or Swallowing Disorder (Neither/Either/Both)_______________
SLP Case-Mix Group________
HIPPS Character 2_____
MDS 3.0 1.17.0 | CASE STUDY CODING SHEET | August 14, 2019
Integrated Coding and PDPM Case Study Coding Sheet
HIPPS Character 3: Nursing Component
RUG-IV Nursing RUG _______
Extensive Services _______
Clinical Conditions ________________________________________________
Depression Yes_____ No_____
Number of Restorative Services ______
GG-based FunctionScore _____
Nursing Case-Mix Group _____
HIPPS Character 3_____
HIPPS Character 4: NTA Component
NTA Score Range _____
NTA Case-Mix Group _____
HIPPS Character 4_____
HIPPS Character 5: AI Code
HIPPS Character 5_____
FINAL HIPPS CODE FOR MRS. S_______________