Harmony Healthcare Blog

ICD-10-CM Coding: COVID-19 Update & Searching for Codes

Posted by The Harmony Team on Mon, Apr 06, 2020

C.A.R.E.S.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency Survey


The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) is adding a new diagnosis code, U07.1, COVID-19, to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), effective April 1, 2020.  The Index and Tabular Addenda and the Coding Guidelines for the new diagnosis code U07.1, COVID-19, can be accessed on the CDC website at https://www.cdc.gov/nchs/icd/icd10cm.htm.

The Centers for Medicare & Medicaid Services (CMS) has posted an updated FY 2020 PDPM Mappings file that includes the ICD-10 CMS code “U07.1 – 2019-nCoV acute respiratory disease” as an appropriate code for MDS item I0020B, the primary reason for the skilled nursing facility (SNF) stay.  For Minimum Data Set (MDS) assessments with an Assessment Reference Date (ARD) of April 1, 2020, or later, this code, U07.1, maps to the PDPM Pulmonary clinical category for the PT, OT and SLP components.  It does not currently impact either the PDPM Nursing or the NTA component.  Providers should check with their software vendors to confirm when the update for this change has been applied.

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Topics: ICD-10 Webinar, Coding, coronavirus, COVID-19

PDPM - Where are We Now Q&A: Part 8

Posted by The Harmony Team on Tue, Mar 03, 2020

C.A.R.E.S.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency Survey


Question 8 of 9: Can you talk a little bit about the use of Return-to-Provider codes ?

When coding the MDS in Section I0020B, we need to identify the primary medical diagnosis.  This represents the reason a person skilled and allows them to access their skilled Medicare A benefit.  These medical diagnosis codes are utilized with the CMS crosswalk to determine the PDPM clinical category.

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Topics: Coding, PDPM

PDPM - Where are We Now Q&A: Part 7

Posted by The Harmony Team on Fri, Feb 28, 2020

C.A.R.E.S.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency Survey


Question 7 of 9: In order to capture IV fluids for hydration, do we need documentation supporting reason is for hydration/nutrition, or can we assume IV fluids are delivered for this purpose?

Harmony Healthcare International (HHI) recommends reviewing the hospital documentation including the MAR prior to establishing the ARD for the 5-day assessment so that all resident complexities are included.

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Topics: Coding, PDPM, AHIMA

PDPM - Where are We Now Q&A: Part 6

Posted by The Harmony Team on Tue, Feb 25, 2020

C.A.R.E.S.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency Survey


Question 6 of 9: I am curious as to why organizations do not hire a credentialed coder/Medical Records professional to abstract, review, code, and audit for the primary and secondary diagnoses codes using ICD-10-CM.  Do you hear this as a recommendation?  Do you recommend? 

Harmony Healthcare International (HHI) has found that professional coders are not needed by SNF facilities for several reasons.

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Topics: Coding, PDPM, AHIMA

PDPM - Where are We Now Q&A: Part 3

Posted by The Harmony Team on Fri, Feb 14, 2020

C.A.R.E.S.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency Survey


Question 3 of 9: In a patient with a hip fracture, is there a need to code “muscle weakness",“difficulty walking” listed by PTs? These diagnoses are usually not listed/signed by a physician.

“Physical therapy services are those services provided within the scope of practice of physical therapists and necessary for the diagnosis and treatment of impairments, functional limitations, disabilities or changes in physical function and health status.” 230.1 - Practice of Physical Therapy, Medicare Benefit Policy Manual Chapter 15 – Covered Medical and Other Health Services.

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Topics: Coding, PDPM

MDS Interviews: Is your Coding Accurate?

Posted by Kris Mastrangelo, OTR/L, LNHA, MBA on Thu, Jul 28, 2016

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


The decision to complete a resident interview or a staff interview is guided by coding in Section B0700. When coding the gateway question for each interview (which asks if the interview should be conducted) the assessor should only code a dash (not assessed) if the ability to interview the resident was not assessed.
  •  When Section B0700 is coded as a 3-Never or Rarely Understood the gateway question should be coded as a no, and the interviewer should proceed with the staff assessment.
  •  When the patient is coded as a 0, 1, or 2 in Section B0700 the interviewer should attempt the resident interview. All answered questions should be coded, and the assessor should follow the instructions for incomplete interview for each interview section to determine if the resident interview should be followed by a staff interview.
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Topics: MDS Interviews, Coding

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