Posted on Monday, May 13, 2019 1:44 PM
By now, you should be preparing for the PDGM transition. There’s a lot to get done and Corridor is here to help you before and after the ‘Go-Live’ date.
One of the measures of success in partnering with our Coding Services clients is to minimize RTP (return to provider claims) for Medicare related to PDGM non-acceptable codes. We will be managing this at the beginning of the patient admission process, so clients won’t have to manage RTP claims later in the episode of care.
Here’s a few key preparations and how Corridor can help you tackle PDGM:
PDGM EDUCATION
- Organizations need to evaluate the specificity of the data that referral sources are providing them. Corridor will help organizations drill into data to ensure they are analyzing properly and implementing the right action plans.
- It’s crucial for clinicians to be educated on what to look for and documenting effectively to support both coding and OASIS scoring. To ensure success during the transition, we will be providing this service at no cost to our outsourcing coding clients in September.
- While we do not recommend changing coding practices now, we do recommend prepping for what codes will and will not be acceptable under PDGM; paying close attention to missed opportunities to query the referral source for more specific diagnoses.
PDGM DATA
- In June, Corridor will provide clients with the top unacceptable primary codes under PDGM. We’ll include recommendations on additional information and queries needed in identifying the acceptable primary diagnosis.
- In September, we will provide the top primary codes under PDGM by client and include recommendations on additional information and queries needed in identifying the acceptable primary diagnoses.
PDGM TECHNOLOGY/REPORTING TOOLS
- Corridor’s Outsource Coding Services will be providing the following technology/reporting tools related to PDGM:
–Multiple coding logic alerts into our coding process. This will include unacceptable diagnose alerts for PDGM episodes to decrease the possibility of RTP claims. This will allow for the agency to do interventions with the referral source/physician to determine an acceptable diagnosis.
– Ongoing reports and SME insight on trending data of specific ongoing coding and OASIS issues.
Click here to learn more about Corridor’s Outsourced Coding Services
Written by: Nick Dobrzelecki, Corridor’s Senior Vice President of Coding Services and Sue Payne, Corridor’s Vice President & Chief Clinical Officer
About Corridor
Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!
For additional information, please contact Corridor at 1-866-263-3795.
