With the biggest reimbursement system change for skilled nursing facilities (SNFs) in 20 years approaching, the American Health Information Management Association (AHIMA) and the American Health Care Association (AHCA) partnered up to ensure SNFs were ready.
October 1, 2019, the value-based Patient Driven Payment Model (PDPM) will replace the Resource Utilization Group, Version IV for the SNF Prospective Payment System. The switch will require SNFs to use ICD-10-CM diagnosis codes and rely on clinical documentation improvement (CDI) skills in order to accurately support the qualifying stay and demonstrate the need for care and treatment best suited for each patient. To help train the SNF workforce, AHCA—the largest association representing long-term care facilities—enlisted AHIMA to help develop in-depth coding and CDI education courses.
The courses include two options:
- The first provides webinars for coding in ICD-10-CM and requirements in CDI case studies and concludes with a 50-question assessment
- The second option is a shorter course for non-coders that includes a webinar with a high-level review and basic information on ICD-10-CM coding guidelines to provide an introduction to the PDPM reimbursement model.
Completion of the courses will earn participants AHIMA CEUs and continuing nursing education contact hours.
Since CDI is one of the focuses this partnership, AHIMA and AHCA will work to help SNFs understand ICD-10-CM guidelines for coding and reporting and how to apply the guidelines to coding for the PDPM Medicare reimbursement.
“In order to stay up-to-date with the ever-changing healthcare industry, it is critical that professionals have the resources they need to continue to provide exceptional care,” said AHIMA CEO Wylecia Wiggs Harris, PhD, CAE. “This is why we’re happy to work with AHCA on this important training program, which will equip professionals working in skilled nursing facilities with the knowledge and understanding of ICD-10 needed to thrive under the new payment system, and ultimately improve patient outcomes.”
In the Journal of AHIMA’s June issue, an article titled “Why CDI is Gaining Popularity in Skilled Nursing Facilities” will further explore the Centers for Medicare and Medicaid Services’ new reimbursement model and the role of CDI as SNFs transition. In the past, documentation practices in SNFs have not been as robust as methods in acute care settings, and past efforts to improve the documentation lacked administrative support. But now that the documentation will have a direct impact on payment, CDI is getting the needed attention of facility administrators. The article will address common documentation challenges in post-acute care and identify opportunities for health information management professionals in these settings.