Cassie Friedenberger

PDPM ICD-10 Orthopedic Aftercare Codes

Under the Payment-Driven Payment Model (PDPM), the selection of the primary medical diagnosis recorded in the Minimum Data Set (MDS) item I0020B plays a factor in the Medicare Prospective Payment System (PPS) methodology. Understanding the International Classification of Diseases (ICD)-10 coding guidelines is one step; figuring out the Centers for Medicare and Medicaid Services (CMS) PDPM ICD-10-CM Mappings Fiscal Year 2021 is another key element for the reimbursement calculation. Assigning ICD-10 codes must be at…

Understanding the Different Types of Medicare Secondary Payers (MSP)

What is a MSP? MSP stands for Medicare Secondary Payer and describes when another payer is responsible for paying a beneficiary’s claims before Medicare kicks in. The first payer is determined by the patient’s coverage. Different conditions determine if Medicare will be the primary, secondary, or tertiary payer. Before submitting an MSP claim to Medicare, some information from the primary payer’s remittance advice should be included in the claim. This consists of the following: There…