Course Code: REL-PAC-0-SNFPDPM
Hours: 2.5
Type: Online Course
Content Expiration Date: 12/31/2025
Learning Objectives:
Describe how the PDPM HIPPS code is obtained and when to use the default code on the Medicare claim.
Identify each of the case mix components of the PDPM
Explain the interrupted stay policy.
Discuss the PDPM assessment schedule and item sets.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: The PDPM Definitions and Components
Definitions
Six PDPM Components
Review
Summary
Section 3: The Variable Per Diem Adjustment Schedule
The Variable Per Diem Adjustment Schedule
Review
Summary
Section 4: PDPM and MDS Coding
MDS Item I0020B: PDPM Primary Diagnosis
I0020B Mapping
Additional ICD-10 Diagnosis Coding on the MDS
Review
Summary
Section 5: MDS Items J2100-J5000: Surgical History
MDS Items J2100-J5000: Surgical History
Review
Summary
Section 6: MDS Section GG Function Scoring
MDS Section GG Function Scoring
GG Lookback Period
GG Coding
Review
Summary
Section 7: The PDPM Impact of MDS Section C
MDS Section C
BIMS
SLP Case Mix
Review
Summary
Section 8: The PDPM Impact of MDS Section D
Nursing Categories and Section D
Review
Summary
Section 9: The PDPM Impact of Restorative Nursing Services
The PDPM Impact of Restorative Nursing Services
Behavioral Symptoms and Cognitive Performance
Reduced Physical Function
Review
Summary
Section 10: PDPM Case Mix Groups and Case Mix Indices
PDPM Case Mix Groups and Case Mix Indices
Review
Summary
Section 11: Add-On Payments for HIV/AIDS Condition
Add-On Payments for HIV/AIDS Condition
Review
Summary
Section 12: The PDPM Assessment Schedule
The PDPM Assessment Schedule
Review
Summary
Section 13: The IPA Item Set
The IPA Item Set
Review
Summary
Section 14: The Interrupted Stay Policy
The Interrupted Stay Policy
“Interrupted Stay”
“Not an Interrupted Stay”
Discharge Assessment
Interrupted Stay Policy Examples
Review
Summary
Section 15: The PPS Discharge MDS and Coding Therapy Services
The PPS Discharge MDS and Coding Therapy Services
Review
Summary
Section 16: Therapy Concurrent and Group Limits
Therapy Concurrent and Group Limits
Review
Summary
Section 17: The Medicare Part A Administrative Level of Care Presumption
The Medicare Part A Administrative Level of Care Presumption
Presumption of Coverage
Review
Section 18: All About PDPM HIPPS Codes
Code Sets
The Default Code
Review
Summary
Section 19: The PDPM Methodology: Putting It All Together
Case Study
Calculating Daily Rate
Course Summary
Course Contributor
Resources
References
Exam and BrainSparks
Subject Matter Expert: Kimberly Matthews, RN
The content for this course was created or revised by Kimberly Matthews, RN obtained a nursing degree from Western Kentucky University in 1998. Ms. Matthews possesses over 20 years of nursing experience with over 17 of those in the Skilled Nursing industry. Ms. Matthews has extensive experience in MDS, restorative nursing programs, and nursing management. Ms. Matthews is currently a Post-Acute Care Content writer and subject matter expert for MDS.
Target Audience:
The target audience for this course is: Administration; Nursing Personnel; in the following settings: Skilled Nursing Facility.
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All courses offered by Relias Learning, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.