The new Patient Driven Payment Model (PDPM) has been in effect for over a month now. To say it has been an adjustment is quite the understatement. We are proud of our clients and how hard they are working to alter to this new model while continuing to provide quality care to their residents.

Unfortunately, many skilled nursing facilities are having issues with some of their Medicare claims. Some claims are being held because of multiple line items for revenue code 0022. Why are facilities running into this issue? According to CAHF’s E-news Update, these issues are sometimes due to multiple assessments, others are due to the software packages being used (including Point Click Care) that split into two line items on the claim when a room change occurs.

Ensuring NetSolutions was ready for PDPM has been at the top of our minds since the payment model shift was announced. Even after PDPM’s implementation, CMS has released more information and our product team has worked quickly and efficiently to update the product. NetSolutions does not split the lines so our clients’ claims should be being processed without issue.

To learn more about PDPM HIPPS coding on CMS’ PDPM Frequently Asked Questions. To access other assets put together by our team, check out our PDPM Resource Center.

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