{"id":370,"date":"2018-07-12T07:00:38","date_gmt":"2018-07-12T07:00:38","guid":{"rendered":"https:\/\/advantagehcconsulting.com\/blog\/?p=370"},"modified":"2018-07-10T14:34:19","modified_gmt":"2018-07-10T14:34:19","slug":"diagnosis-coding-check-out-the-secondary-dx-groups-that-will-boost-pdgm-pay","status":"publish","type":"post","link":"https:\/\/advantagehcconsulting.com\/blog\/2018\/07\/12\/diagnosis-coding-check-out-the-secondary-dx-groups-that-will-boost-pdgm-pay\/","title":{"rendered":"Diagnosis Coding: Check Out The Secondary Dx Groups That Will Boost PDGM Pay"},"content":{"rendered":"

\"\"<\/p>\n

CMS listened to HHGM commenters and revised the case mix category methodology.<\/em><\/strong><\/span><\/p>\n

The newly proposed payment reform model will increase payment for an episode when the claim contains certain secondary diagnoses.<\/p>\n

To receive a \u201clow\u201d comorbidity adjustment under PDGM, an episode must have at least one code from the following 11 groups:<\/strong><\/span><\/p>\n

Neuro 11 (Includes diabetic retinopathy and other blindness)
\nNeuro 10 (Includes diabetic neuropathies)
\nCirculatory 9 (Includes acute and chronic embolisms and thrombosis)
\nHeart 11 (Includes heart failure)
\nCerebral 4 (Includes sequelae of cerebrovascular diseases)
\nNeuro 5 (Includes Parkinson\u2019s Disease)
\nSkin 1 (Includes cutaneous abscess, cellulitis, and lymphangitis)
\nNeuro 7 (Includes hemiplegia, paraplegia, and quadriplegia)
\nCirculatory 10 (Includes varicose veins with ulceration)
\nSkin 3 (Includes diseases of arteries, arterioles and capillaries with ulceration and nonpressure chronic ulcers)
\nSkin 4 (Includes stages Two-Four and unstageable pressure ulcers by site).<\/p>\n

To receive a \u201chigh\u201d comorbidity adjustment under PDGM, an episode must have codes from at least one of the following 27 pairs of groups:<\/strong><\/span><\/p>\n