PDPM, Non-Therapy Ancillaries & MDS Section I

PDPM includes a new pay category, the non-therapy ancillary or NTA. Everyone I’ve talked to agrees the NTA payment is a good idea. But, since it’s new, we’re going to have to work on understanding how it’s supposed to work, and how we can most easily and efficiently complete the assessment with accurate information.

In this post, we going to look at one important piece of the NTA puzzle, section I.

Actually, we’re going to limit our scope to only I8000 items. Section I of MDS 3.0 is reserved for Active Diagnoses and Item I8000 is you to enter up to 10 additional active diagnoses with corresponding ICD-10 codes.

How should you prioritize your search for ICD-10 codes? Which codes are the most important? Which codes are you most likely to actually see in the wild?

A good first resource is the PDPM NTA Comorbidity Mapping spreadsheet. In it, you’ll find the 1,612 codes that map to the different comorbidities. Admittedly, that’s a lot to look through. Luckily, code diving is a lot of fun, right?

What if we could limit those codes down to just those ICD-10 codes that are likely to occur. They can’t all be equally likely, right? (At this point, I can feel the cold stares from our MDS Experts. Yes, I am aware that ICD-10 codes do change occasionally. Yes, I’m aware that if you don’t look at every. last. code. you could miss something. Yes, I get that is bad. You should understand those things too, reader.)

Hopefully I don’t lose my blogging privileges, but… I looked at a year’s worth of Part A admissions to every SNF in the country and found, gasp, not all codes occur that often. Some didn’t occur at all.

Based on that, I have made you an extreme cheat sheet, that you should use with extreme caution. Click the comorbidity and see the ICD-10 codes that are most likely to occur. (I did abbreviate a few of the names for sanity.) Remember, the CMS list is authoritative, mine is only for your convenience.