Program Overview

ICD-10-CM coding will be the only source for grouping patients into the clinical grouping of the PDGM system and it will also affect the comorbidity adjustment. This webinar will explore the acceptable primary diagnoses that have been listed for PDGM and outline the process of establishing the comorbidity adjustments. Key things to look for and a plan of action will be discussed as well as a review of how the functional impairment calculation for the HHRG under PDGM will be the only financial change driven by OASIS responses.

Learning Objectives

• Review the listing of acceptable codes from CMS.

• Identify the process for calculating the HIPPS code in regard to the

  coding aspect.

• Discuss case mix variances specific to diagnosis coding.

• Detail ADL items from OASIS that will impact the Functional
  portion of the case mix weight in PDGM.

Intended Audience

Home health CEO, CNO, Managerial staff, supervisors, clinical staff, quality improvement staff and any other interested parties.

Speaker Biographie

Melinda A. Gaboury is co-founder and CEO of Healthcare Provider Solutions, a provider of financial, reimbursement, billing, operational and clinical consulting to the home care and hospice industries. She has more than 27 years in home care and more than 17 years of executive speaking and educating experience with home care and hospice professionals. Gaboury has experience in Medicare prospective payment system training, billing, collections, case-mix calculations, chart reviews, due diligence and Medicare Administrative Contractor appeals. She is currently serving on the National Association for Home Care & Hospice/Hospice Financial Mangers Association advisory board as ex-officio and is associate director on the Home Care Association of Florida Board of Directors. Ganpiru is also the author of the “Home Health Pocket Guide to OASIS-C2: A Reference Guide for Field Staff”.