On-Demand Conference Session: Why the Right Diagnosis Code Matters

Recorded On: 04/21/2021

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The skilled nursing environment has undergone many radical changes over the last 12-months. Providers are scrambling to determine what is considered the new norma‘ given the impact that COVID-19 had on PDPM. During this session, we will review requirements for primary diagnosis coding and its effect on PDPM reimbursement, as well as illustrate the importance of an interdisciplinary approach to documentation and avoiding revenue recoupment. You will receive a take-away tool for COVID-19 diagnosis coding. Following this session, you will be able to:

  • Explain the requirements for coding primary diagnosis in the MDS assessment
  • Discuss the impact that the primary diagnosis has on reimbursement in each component of PDPM
  • Illustrate how an interdisciplinary approach may assist in avoiding revenue recoupment
  • Understand examples of proper and improper primary diagnosis coding and the impact (take-away tool)

Maureen McCarthy, RN, BS RAC-MT, QCP-MT, DNS-MT, RAC-MTA


Celtic Consulting

Maureen is the president of Celtic Consulting, LLC and the CEO and founder of Care Transitions, LLP; a post discharge care management service provider. She has been a registered nurse for 30 years with experience as an MDS coordinator, director of nursing, rehab director, and a Medicare biller. She is a recognized leader and expert in clinical reimbursement in the skilled nursing facility environment. She is the immediate past-president for the Association of Long Term Care Financial Managers, the Medicare & MDS 3.0 Advisor for the Connecticut Association of Health Care Facilities (CAHCF), and an advisor to the J13 Medicare contractor National Government Services Provider Advisory Group. She is also an editorial advisor for HCPro, a national publisher for post-acute care providers, as well as an advisor to the New York State Healthcare Facilities Association. She is a board member of the American Association of Post-Acute Nursinges (AAPACN) and is an Nurse Assessment Coordinator - Expert Advisory Panel (NAC-EAP) member for AAPACN. Maureen is dually certified in both the resident assessment process and QAPI by nationally recognized organizations and holds Master Teacher status in both. McCarthy’s fifth publication on Medication Reconciliation is due out in Fall of 2018.

Maureen McCarthy is the founder, President, and CEO of Celtic Consulting; nationally recognized as a luminary amongst long-term care operators and clinicians for Reimbursement and Regulatory matters, Audits, Enhancing Operational Efficiency, Education and Litigation Support. Maureen combines clinical expertise with regulatory acuity, to assist clients with developing sustainable remediation plans. She is a registered nurse with over two decades of work experience, including direct patient care, MDS Coordinator, Director of Nursing, Rehab Director, and Medicare biller. Recognized for thought leadership, Maureen presents to many long-term care industry associations and has trained thousands of clinicians and administrators. She sits on the Board of Directors for the American Association Post-Acute Care Nurses (AAPACN) and Vice-Chair of the Expert Advisory Panel for the American Association of Nurse Assessment Coordination (AANAC). Her publications have been in leading industry journals such as PPS Alert, McKnight’s Long-Term Care News, and Skilled Nursing News and authored several books. Maureen is also the founder and CEO of MDSRescue, LLC, providing interim MDS completion services nationwide. 

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