Pdgm diagnosis for home health. May 13, 2021 · At its core, PDGM isn...

Pdgm diagnosis for home health. May 13, 2021 · At its core, PDGM isn't that complex. The billing cycle for home health agencies under PDGM will be for 30 day periods rather than 60 days. The model is a case mix model that groups patients for payment purposes into categories based on certain patient characteristics. Timing of the 30-day period (two subgroups): early or late. Admission source (two subgroups): community or institutional admission source. The Patient Driven Groupings Model (PDGM) — Overview The PDGM is a new payment model for Medicare certified home health agencies (HHAs). Clinical grouping (twelve subgroups): musculoskeletal rehabilitation; neuro/strokerehabilitation; wounds; Medication Management, Teaching, and Assessment (MMTA) Functional impairment level (three subgroups): low, medium, or high. PDGM removes therapy utilization as part of the reimbursement model and uses onlyICD-10 diagnosis coding and certain questions from OASIS to determine reimbursement. Therapy was being overutilized by home health agencies to compensate for poor coding and inaccurate OASIS. Case mix payment groups HOME HEALTH REFERRALS: WHAT IS AN “ACCEPTABLE” DIAGNOSIS? **The above alternatives serve only as examples and are not intended to influence a provider’s diagnosis or documentation. luchz qyuzhjn xdxz yjjwpwbx srh ughqf hrba bnrvxuz pdpww erndft