Good Morning,
I like these suggestions. I went to the 2 day coding course and Dementia F03.90 and F03.91 will fall into a clinical group. The Decision Health 2020 coding book shows $ sign.
Paula Berger RN, PHN, COS-C
Regulatory Compliance Supervisor
Park Nicollet Methodist Home Care
952-993-3669
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From: medicarewkgp@list.mnhomecare.org [mailto:medicarewkgp@list.mnhomecare.org]
On Behalf Of Brand, Vickie
Sent: Monday, December 02, 2019 4:35 PM
To: Karen Peterson <kpeterson@mnhomecare.org>; medicarewkgp@list.mnhomecare.org
Subject: [EXTERNAL]RE: PDGM Pocket Tool
External Email: Don't click links or attachments unless you trust the email.
I wasn’t able to edit the document so I just made some suggestions below in yellow.
Home Health PDGM Fast Facts
Patient Driven Grouping Model
What is PDGM?
• CMS’ new reimbursement model
for Home Health Agencies
• Begins 1/1/2020
for Home Health Agencies
• Cuts payment episodes in half: now 30 day cycle (previously 60 day) - therefore less time to collect signed orders, face to face documentation and other information.
• New diagnostic standards (see reverse)
MD / NP / PA impact:
1. More specificity in
primary diagnosis; symptom-based or vague codes will be refused (see reverse)
2. Faster turnaround needed for orders and signatures
Adherence to these 2 items will keep
patient care on track and on time!
Make the transition efficient:
• Communication is key!
• Who is the best contact at your site for coordination with our Agency on these upcoming changes?
AGENCY NAME
BEST CONTACT NAME?
PHONE / FAX
OTHER?
I’m a little concerned about sending physicians the “do use” list. Aren’t some of those diagnoses questionable encounters- like dementia?
I could be wrong about that though J I would be more inclined to use the Axxess Top 25 QE’s list- at least parts of it.
|
SYMPTOM |
Do use UNDERLYING CAUSE, e.g.:
|
|
Muscle Weakness Weakness Debility |
Exacerbation of a disease process
Long hospitalization or SNF where patient has been in bed with limited mobility from the disease
COPD, Emphysema, Asthma CHF/heart disease, dysrhythmias, atherosclerosis, CAD
Neuro disorders; MS, Parkinson’s, ALS, CVA, hemi- para- or quadriplegia, sequelae of CV disease
Surgery Infection / wounds / ulcers Dementia
Anemia / Malnutrition / failure to thrive
Chronic kidney disease or ESRD |
|
Difficulty Walking Abnormal Gait Falls Unsteadiness |
Neuro disorder Orthopedic condition Peripheral/polyneuropathies PVD, PAD Dementia, Parkinson's, MS
Lymphangitis |
|
Pain Joint Low back |
Osteoarthritis Surgery Sequelae of a specific injury or specific fracture or delayed healing
If caused by a specific joint or extremity, be specific to laterality and joint
|
|
Dizziness Edema Syncope |
CHF / Heart disease Hypertension Atrial fib |
Vickie Brand |
BSN, RN, PHN
Compliance Program Manager
Fairview Home Care & Hospice
2450 26th Ave. South | Minneapolis, MN 55406
vkbrand@healtheast.org |
www.fairview.org
Office: 612-728-2388
From:
medicarewkgp@list.mnhomecare.org <medicarewkgp@list.mnhomecare.org>
On Behalf Of Karen Peterson
Sent: Monday, December 02, 2019 12:09 PM
To: medicarewkgp@list.mnhomecare.org
Subject: PDGM Pocket Tool
Hello, Medicare Workgroup members –
As I mentioned at our last meeting, the Clinical Regulatory and Rehab Committee is working on a tool for physicians re: PDGM. They looked at several examples from a variety of sources, and determined that what we want to create is something
small – easy to carry or tack to a bulletin board, with the most critical pieces of information:
- Changes in diagnostic specificity
- Need for speed r/t 30-day cycles
We are still editing it just a bit, but I wanted to share it with you for any input you might have. Unfortunately, and I apologize for this,
I need your feedback by 9AM tomorrow morning!!! We plan to launch the tool in tomorrow afternoon’s PDGM Alert and also talk about it at Wednesday’s Region Meetings. There are actually two versions – one called “Postcard”
and one labeled “Bookmark” (no surprises at what those names mean!!) Please let me know if you have a preference for one over the other; tentatively the plan is to offer both. Agencies will receive Word documents so they can add their own contact information
and print them as needed (MHCA will not provide them actually printed out).
So – I hope at least some of you have a moment to take a look and get back to me quickly.
Thanks,
Karen Peterson
Regulatory Affairs and Advocacy Manager
Minnesota HomeCare Association
2550 University Ave. W., Ste. 350 S | St. Paul, MN 55114-1900
Direct: 651.659.1457 | Main: 651.635.0607
Toll-free: 866.607.0607 | Fax: 651.635.0043
www.mnhomecare.org
| kpeterson@mnhomecare.org
Mission:
MHCA represents and supports Minnesota home care providers committed to high quality home care services.
Vision:
MHCA will shape the home care landscape to improve and sustain quality home care services.
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