On-Demand Webinar: PDPM - Focus on the PT and OT Components

The Physical Therapy (PT) and Occupational Therapy (OT) components of the Patient-Driven Payment Model (PDPM) use an identical two-step methodology to achieve the same final case-mix groups (CMGs), but the nuances within those steps can confuse nurse assessment coordinators (NACs) and interdisciplinary team (IDT) members alike. The seemingly straight-forward first step of selecting the primary diagnosis to be coded at MDS item I0020B is often much more challenging than it appears. Accuracy of this item requires ICD-10-CM coding knowledge, ability to use the PDPM mapping file, strong communication with physicians, and IDT collaboration. In addition, failing to identify a related surgical procedure in section J can result in the incorrect mapping of the selected diagnosis code. The second step is the assessment of usual function in section GG to determine the function score, which requires a strong IDT process, episode-based documentation or interview, and timely collaboration. 

During this 60-minute webinar, AAPACN Curriculum Development Specialist, Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, will walk through the complex path of assigning the most appropriate primary diagnosis, determining the mapping to the clinical category, and calculating the PT/OT function score to assign the final PT and OT case-mix groups.

After participating in this session, learners will be able to:

• Identify the MDS items used in the methodology of the PT and OT components
• Use the CMS ICD-10-CM mapping file to determine the PT and OT clinical category
• Understand the PT/OT function score calculation using section GG
• Apply the PT and OT components methodology to project the final case-mix groups

1.0 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until June 16, 2025.

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