PDPM Part 1
PDPM Part 1
So the Patient Driven Payment Model is supposed to be this new totally different thing. Well, everything that's old is new again. Sure we've separated out some therapy, we've taken away the minutes, replaced them with patient medical history and co-morbidities to determine a payment level, but the nursing side - oh the glorious nursing side - is stronger than ever! However, this is going to change how we think about all those different items on the MDS set that we never paid much attention to. Swallowing problems? Hey, I think just about everybody has them. However, we never coded them on anybody up until this point. Social Service? Well, your role just got a lot bigger in regards to payment! Many patients now who lay in bed saying they're waiting for the trolley to come pick them up or they're just here after a church function and they're going home - delusions? Mm hm. They see candy bars floating around the room - hallucinations? Let's make sure we get those coded! They don't just matter every now and again now; they matter very often. And how about all those little things we did for patients that we never got paid for? The days of therapies and ADLs…well, that's definitely over. Now…we do get something extra for that IV! Yep, we do get something extra for morbid obesity! We get something extra for all these other little things that we almost never got paid for in the past. The upside is - you're getting paid for them. The downside is - only if you actually code them.
My suggestions to you? Start working on these PDPM groupers to familiarize yourself with how often these little things make all the difference in payment. Start now. Do a few. Think about it. Let that percolate in your head. Do a few more. Notice differences. I have learned many little differences by coding many, many patients in PDPM. I will elaborate in upcoming series, but you'll also find them yourself just as I did by simply running patients through the system and seeing how they work.