pdpm nta list pdpm nta list

@ Homework - Chapter 31: HlTT x + . h2430Q0P0430S0 This item includes diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. When also coded in I8000, I69.091 will also contribute again to the case mix group because it is on the SLP comorbidity list. Any delay in getting this information is going to be problematic. We know now that every diagnosis and condition counts. The higher the total point value, the greater the payment (CMI). More than half of them come from I8000 and many of these have multiple qualifying ICD-10 diagnosis codes. It more accurately accounts for expenses and isn't overshadowed by therapy. At first, it took me longer to get used to making calculations in determining the highest allowable rate for the patient. xref Given that CMS has released the distribution of case-mix groups for NTA for all skilled nursing facilities, we can calculate an average case-mix index for everyone. (difference of NE-NF and NA-NB). These conditions, along with the number of points associated with the condition and how it is reported, can be found by downloading the CMS document titled Fact Sheet: NTA Comorbidity Score. View D0AD3F24-D6BD-4273-B139-8FCA97487E6A.jpeg from NURSING MISC at St. Clair County Community College. %PDF-1.6 % (10 items fit). Observation services are not covered as part of the inpatient stay. ENSURE TO CAPTURE EVERYTHING PRIOR TO COMPLETION OF THE 5-DAY MDS ASSESSMENT! Highlights: Hiring both part-time 2 days/week and full-time 4-5 days/week (benefits for FT only) Hours: Monday-Friday ~7am to 4pm; no evenings, weekends, call, or holidays . MDS 3.0 RAI Manual. Preparedness for coding changes will be the key to a smooth transition. Coding of these areas will affect the Speech Case Mix Index. ANOVA Rural versus Urban NTA case-mix (click to enlarge). Research indicated that for those SNF patients with AIDS, NTA costs per day were 151% higher and wage-weighted nursing staff time was 18% greater than for other patients. Yes, I am aware that ICD-10 codes do change occasionally. CMS 100-2 Chapter 8 Series Part I: Access to Medicare Part A Benefits In a SNF. This can be revised if there is a change in a patients condition which requires additional skilled services such as IV medications which were not administered initially. Items on this list could change at any time with new legislative and The list includes diagnosis codes, which will be recorded in the I8000 section of the MDS. Of importance to note is the condition of HIV/AIDS under the NTA component. It will be imperative that the coding is accurate on the MDS for the NTA conditions. Five are case-mix adjusted to allow for variances in diagnoses, severity of illness and other variables associated with the probability of improvement with treatment: Physical therapy (PT) - includes a variable per diem factor Occupational therapy (OT) - includes a variable per diem factor (I did abbreviate a few of the names for sanity.) You should understand those things too, reader.). There are a total of five rates that make up your pay under PDPM.) 0000006770 00000 n endstream endobj 451 0 obj <>stream The correct coding for NTA will require a team effort and diligent review of coding and supporting documentation. Patients rely on you. There are two look back periods that must be met when coding conditions on the MDS: #1 Diagnosis Identification - Documented by the physician or physician extender within the last 60 days. First, it corrects an issue where diagnosis codes were mapped to NTA comorbidities as 1 to 1 mappings where 1 to 2 mappings were intended from the PDPM_ICD10_Mappings_FY20XX Excel sheet. This has been a key consideration in designing the various elements of the new model. Updates the ICD-10 mapping used to classify patients under the PDPM framework. If your therapist are doing Group therapy, remind them that there must be supportive documentation regarding the benefit to the resident when participating in a larger group. Points (1-8) are assigned to specific conditions. ordered by the patients attending physician in the facility. Under PDPM, CMS identified 50 conditions that were related to increases in NTA costs for a skilled nursing facility (SNF). 66y% Other SLP co-morbidities picked up from the grouper software include the checkboxes for I4300 (aphasia), I4500 (stroke/CVA/TIA), I4900 (hemiplegia/hemiparesis), I5500 (traumatic brain injury), O0100E2 (tracheostomy while a resident), and O0100F2 (ventilator/respirator while a resident). Under PDPM there are 161 Minimum Data Set (MDS) item fields. Below is a summary of the determinants of payment and which section on the MDS assessment form they are derived from. The administration of IV fluids may qualify for the Parenteral/IV Feeding - High or Parenteral/IV Feeding - low NTA points. Also, there is a 25% combined limit on concurrent and/or group therapy. endstream endobj 452 0 obj <>stream 0000003037 00000 n Everyone Ive talked to agrees the NTA payment is a good idea. Once completing his Part A stay, the hip fracture will no longer appear on his claim, and Parkinson's Disease now returns as the Principal Diagnosis. Medical records department should already code and map for the clinical category to be able to determine principal diagnosis code and calculate expected daily rate for the facility using either the manual PDPM worksheet or software-generated calculation. Our wound certified educators train, educate, and guide our providers and client facilities on the most efficacious wound care treatments and follow up. This information is essential. mp:U@|8B *zL$#Tk\*SU%mQlTYA Rj&-N _VjWpb[5R8'i, The provider will report on the Minimum Data Set (MDS) each of the comorbidities that a person has. HVmo0)>bbJS:i>h4B6u~>!bB8lr lk4-M~V CIExej[_@{wpuCm/8yU\mqpC1!Ll%5##P:a,Orh[a%zDUd V#~RLXP9BZ,/Y798(|&a"#.G. Learn More Resource PDPM Series Part 5: Assessment Requirements. They cant all be equally likely, right? Determinant for payment is based on the number of therapy minutes provided regardless of residents acuity, diagnosis and other skilled nursing services provided. It more accurately accounts for expenses and isnt overshadowed by therapy. Lets breakdown the PDPM model to better understand how reimbursement is determined. You can also zoom in to see detail. Seek advice from experts, trainers and other MDS nurses when needed to clarify any areas in the MDS assessment or PDPM calculation. A good first resource is the PDPM NTA Comorbidity Mapping spreadsheet. Other ancillary services include room and board, activity planning, housekeeping, laundry, and maintenance of fixtures/equipment. We also qualify for Special Care Low in the Nursing Category when there is an application of a dressing to the foot with the ulcer. Copyright LW Consulting, Inc 2022. Diligent review of the medical history and clinical record is essential. The FY 2022 SNF PPS Final Rule: Learn the Facts behind the headlines Part 2 ICD-10 Revisions and PDPM. While mild nausea and vomiting is a common discomfort of pregnancy, patientswith severe cases become diagnosed with hyperemesis by NCC News and Content Team | Dec 6, 2022 | Specialties. These nurses are also trained to complete a full All Rights Reserved By Nursingcecentral 2022 |. At the start of 2019, 63% of respondents to SNN's annual outlook survey identified a greater emphasis on coding as a a key PDPM strategy. Functional scoring is one of the factors used to calculate the PDPM rate for the PT, OT and Nursing components. The RUG-IV consists of two case-mix adjusted components: Therapy which is based on volume of services provided and nursing. Functional scoring is one of the factors used to calculate the PDPM rate for the PT, OT and Nursing components. The new nurse assessment coordinator (NAC) may be overwhelmed with the numerous tasks required of the position. IV medications provided as a resident and coded in Section O would also qualify for NTA points. You are never alone in this field and resources are available in seminars, webinars, the CMS website, MDS manual, etc. At the direction of the attending physician, a patient needs skilled care from and/or under the supervision of a skilled nursing or therapy staff daily. Conduct interview assessments for the Brief Interview for Mental Status (BIMS), and Mood ON ASSESSMENT REFERENCE DATE (ARD) OR A DAY PRIOR TO ARD. Refer to the PDPM Calculation Worksheet for more information. "FE"u PsFO;416ib_z/[E>#~.G+Y6l|)31}Q50B}Wk?/1wo USIek~)zR*u:1\np2}HPs}@I#RM=e1JtJ22;3(TYt&8W1UN@ID7{V Z +MykUW? Yes, I get that is bad. Admittedly, thats a lot to look through. Share our insider knowledge and tips! The adjusted PT, OT, and NTA per diem rates are then added together with the unadjusted SLP and nursing component rates and the non-case-mix component, as is done under RUG-IV, to determine the full per diem rate for a given resident. you could miss something. PDPM MDS Items ! We must also understand all the aspects of PDPM coding from every single angle, the relationship between each facet of the components, and the impact on care and revenue. 0000002038 00000 n thead { Adjustments to the PDPM rates include: 2.3% reduction in FY 2023. additional 2.3% decrease in FY 2024. background-color: #2c4a88; Its interesting to note that the data CMS provided, that I am using here, came from some assessments that we no longer will be doing. Its important to comprehend more than just the basics of PDPM. All about coding rehabilitation for joint replacements: Its important to know the reason for the joint replacement since coding a joint replacement due to a fracture is different than when a joint replacement is due to an elective surgery. The long-term care facilities have emerged not only as a permanent home for the elderly during their retirement or post-retirement years but as respite and recuperative facilities even for the younger patients. The functional scoring is based on residents performance in eating, oral hygiene, toileting hygiene, sit to lying, lying to sitting on side of bed, sit to stand, chair/bed-to-chair transfer, and toilet transfer assessed on the first three days of admission to the facility with the admission day counted as day 1. The RUG-IV consists of two case-mix adjusted components: Therapy which is based on volume of services provided and nursing. RUG Classification Groups based on the volume and intensity of therapy provided to patient: Determinants of Payment for PDPM are summarized below. .center {text-align: center;}, Foot Code, Except Diabetic Foot Ulcer Code, Once we have totaled the score from the table above, we use it to map to a case-mix group and case-mix index. SNF PDPM Provider-Specific Impact File. A long-term care facility provides custodial care requiring supervised, minimal or total dependence in the performance of the activities of daily living (ADLs) such has bed mobility, transfers in and out of bed, walking in the room, walking in the corridor, locomotion on unit peripheral to the patients room, locomotion off unit which involves areas farther from the patients room such as dining areas, rehabilitation rooms, activity rooms and other administrative offices, toileting, eating, personal hygiene and bathing. 0000011153 00000 n And so, you will need to determine how your facility will obtain the initial Diagnosis Identification documentation by the ARD, because it is a "look back" period. Points are added together for all conditions. The NTA comorbidity score is a weighted count of certain comorbidities that a SNF patient has, which is then used to classify the patient into an NTA component payment group. When the variable per diem adjustment is applied, the increase NTA component goes up 3x; in the example above, the daily rate for days 1-3 would increase by $87.70 for Urban and $83.78 for Rural. Refer to the CMS PDPM ICD-10 NTA Comorbidity Crosswalk for I8000-derived comorbidities with acceptable ICD-10 codes that map to the NTA component and the NTA item listing for a complete list of NTA conditions/services. 0000000016 00000 n Highlights: The NTA component score is based on the presence of certain comorbidities and/or the use of extensive services. Reimbursement, LW Consulting, Inc.5925 Stevenson Avenue, Suite GHarrisburg, PA 17112, Ph:800-320-5401Local Ph: 717-233-6100Fx:717-233-4633. 437 27 I would really like to see how item I8000 changes on a resident from the 5 day to later assessments. THURSDAY JUNE 23, 2022 2 PM EASTERN - 90 MINUTES, OHIO HEALTH CARE ASSOCIATION- Virtual Webinar, COST $35 FOR OHCA MEMBERS, $90 FOR NON-MEMBERS, https://webinars.ohca.org/?pg=semwebCatalog&panel=showLive&seminarid=16339, 6/23/22 Capturing Non-Therapy Ancillary (NTA) in PDPM. Each patient has a different reimbursement rate as compared to the RUG-IV PPS rate in the past. Hospitals | Specialties Postpartum Preeclampsia Diagnosis and Management Postpartum preeclampsia is a condition that can affect women from the time after delivery and up to 6 weeks after. A frequent question: "If the mapping file lists a code as "return to provider", can I still use it on the MDS?". o NTA = All NTA items identified with a value of two or more points on the NTA table. Daily Medicare charting should focus on all possible nursing clinical categories, special care high, special care low, clinically complex, behavioral symptoms and cognitive performance, and reduced physical function. Comorbidities are assigned points based on the cost in care associated with the condition or service, with points ranging from 1 to 8. Other specific items will be recorded in various parts of the MDS including Section K, M, N, and O. It is for this type of services they offer which also categorize them as skilled nursing and rehabilitation facilities becoming a step-down facility from an acute hospital stay. endstream endobj 1698 0 obj <>stream Remember that after the 3 day interrupted stay he is considered a new admission for purposes of Part A PDPM. hb```b``ia`e`ff@ a(meU=r%::@`uH@V01:000x1p`5`gy4AuG/Dg* ZF:&'[-@ >` t!R 0000009611 00000 n Welcome to Gravity healthcare Consulting & Online Education Patient has at least three qualifying inpatient days in an acute hospital. Reimbursement for these services is covered under the. These maps look significantly different from a lot of the others weve seen. Holds on recalibrating the PDPM "parity adjustment" that is designed to ensure budget neutrality under the new model to assist SNFs in meeting the demands of the COVID-19 pandemic until FY 2023. The choice of PDPM diagnosis has become rocket science for MDS nurses as this gives more weight in the calculation of the PDPM rate for the facility. h4Pj0^z[ 8 >BRA$+Vfa SAMPLE Task List for the Nurse Assessment Coordinator (NAC) November 23, 2022. Custodial care does not require the assistance of a licensed staff. And lastly, an update on therapy revenue codes and the claim CMS Transmittal 2270 from March 13, 2019 states that beginning October 1, 2019, the Medicare contractor will no longer require therapy services to be present on SNF or Swing Bed claims. For the NTA component, the CMI is multiplied against the applicable per diem adjustment factor and is then applied to determine the case-mix adjusted payment associated with each of these payment components for each utilization day under PDPM. The Ministry of Education (MoE), Government of India (GoI) has established the National Testing Agency (NTA) as an independent, autonomous, and self-sustained premier testing organization under the Societies Registration Act (1860) for conducting efficient, transparent, and international standardized tests in order to assess the competency of candidates for admission to premier . CMS identified a list of 50 conditions and extensive services that were associated with increases in NTA costs. Perhaps the most "transformative" component relates to Non-Therapy Ancillary (NTA) Services. This button displays the currently selected search type. 0000003793 00000 n Whats in it for me? On day 4 it goes back to the rate shown. But if the resident is transferred back to the hospital and is admitted as an inpatient, let's say for pneumonia, then returns to the SNF after the 3-day interrupted stay window, a new 5-Day will be required and the surgery will not be able to be coded in J2100, because the surgery did not occur "during the inpatient hospital stay that immediately preceded the residents Part A admission". %%EOF 3HFDRkse$:stHqPJoHK-qL_sh|Kg?unioWAsfH8[^9{'~-? The following ICD-10 codes qualify: 41 Body mass index (BMI) 40.0-44.9, adult, 42 Body mass index (BMI) 45.0-49.9, adult, 44 Body mass index (BMI) 60.0-69.9, adult, 45 Body mass index (BMI) 70 or greater, adult, 01 Morbid (severe) obesity due to excess calories, 2 Morbid (severe) obesity with alveolar hypoventilation, Cross-train. color: white; This simply shows you a starting point. ! With this component being paid at a 3x rate for 1st 3 days of stay, its important to quickly and accurately identify and code patient conditions. With postpartum preeclampsia, patients are now not seeing a health care provider by NCC News and Content Team | Jan 24, 2023 | Specialties. b!+XQ{ +LgOIYe/Q6RVpYY_N/.~iMu1fY*eR}W_E[,7vrR!XSF};qZW&e"S5!CW}3GU|muc?_X`dcg7(zRU8k? Formulate a PDPM group to review the chart and come up with the residents primary or principal diagnosis and do the ICD-10 clinical category mapping. Under PDPM, an adjustment is applied to certain PDPM components that varies the per diem payment over the course of the stay. Love what you read? Under PDPM, long-term care facilities will receive reimbursement based on services that each resident receives. We earn 2 NTA points if Diabetes is coded in MDS item I2900. Stay tuned. (4.0CSVMEB3nHSQ(9gvNtp}|srUzUX/%3vf+R6Fe Kb`Mr"yWz~tck~>1gK\,)?yt_Jy2Z2poUa-GFjRC'.`?/`;Mwk!$e#W,rLz:+ZL`Y4;Z%Up|h\/nzD]#N. hrmct To assist in ensuring that you can capture all diagnoses and pertinent information to maximize facility reimbursement, I suggest doing the following (which most MDS nurses I am sure are already doing): Request for Hospital History & Physical, Progress Notes, and consults. Non-Therapy Ancillary (NTA) classification in PDPM is determined by the presence of certain conditions or the use of certain extensive services that were found to be correlated with increases in NTA costs for SNF patients. Always be on the lookout for new updates which usually happen every year and usually effective by October 1 of each updated year. or privately paid by the patient if he/she does not qualify under the Medi-Cal program. Visit www.TrainingInMotion.org for more details of how we can help you achieve your PDPM goals. Character 3: Nursing Case Mix Group (NSG CMG) Character 4: NTA Case Mix Group (NTA CMG) Character 5: Assessment Indicator HIPPS Code PT/OT CMG SLP CMG NSG CMG NTA CMG HIPPS Code A TA SA ES3 NA A B TB SB ES2 NB B C TC SC ES1 NC . Payment is based on services provided by five disciplines: physical therapy, occupational therapy, speech language pathology, nursing, and non-therapy ancillary (NTA). In the absence of specific documentation, you may use positive tests, procedures, hospitalization for symptoms). I wish I could be in your training the 29th. If the resident went from the hospital directly to a LTCH first, then to your SNF, you can code the surgery because an LTCH is a post-acute long term care hospital, not an acute care hospital. Facilities must ensure efficient processes are in place when selecting the primary diagnosis. PDPM NTA Case Mix Classification Groups NTA Score Range NTA Case Mix Group NTA Case Mix Index NTA HIPPS Character 12+ NA 3.24 A 9-11 NB 2.53 B 6-8 NC 1.84 C 3-5 ND 1.33 D 1-2 NE 0.96 E 0 NF 0.72 F . No paper. hbspt.cta._relativeUrls=true;hbspt.cta.load(2297384, '30c35813-92d3-4fa1-bc3f-6b232de017b1', {"useNewLoader":"true","region":"na1"}); Topics: This item also impacts your MDS High Risk Pressure Ulcer QM because it is a high risk qualifier (along with impaired bed mobility impaired transfer, or comatose) for the numerator and denominator of the calculation. This is especially important for those residents who are long-term and later qualify for skilled care. You can see in the histogram that not only are there a lot fewer rural facilities, but they also appear to have lower average case-mix. The calculation of payments is based on the five case-mix adjusted components: Physical Therapy (PT), Occupational Therapy (OT), Speech Language Pathology (SLP), Nursing and Non-therapy ancillary (, Behavioral Symptoms and Cognitive Performance Problems, The Centers for Medicare and Medicaid Services (. The Patient-Driven Payment Model (PDPM), is fast approaching with implementation set for October 2019. Specialties What Is a SANE Nurse? Based on that, I have made you an extreme cheat sheet, that you should use with extreme caution. The patients NTA comorbidity score is the sum of the points associated with each relevant comorbidity. These conditions, along with the number of points associated with the condition and how it is reported, can be found by downloading the CMS document titled "Fact Sheet: NTA Comorbidity Score. (2019) Fact Sheet: NTA Comorbidity Score https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/Downloads/PDPM_Fact_Sheet_NTAComorbidityScoring_v2_508.pdf, Center for Medicare and Medicaid Services. PDPM Series Part 4: Non-Therapy Ancillaries Case Mix Groups. Explain the impact of the variable per diem rate in the NTA component and how it impacts PDPM payment. Ill also compare urban versus rural facilities when it comes to NTA case-mix. As outlined in the SNF PDPM technical report, CMS was looking for the new reimbursement plan to account accurately and appropriately for the increased costs associated with caring for patients with AIDS. PDPM or Patient-Driven Payment Model is the new system, replacing the RUG-IV, for calculating reimbursement by Medicare in the skilled nursing setting. The southwest of the US, Michigan, Ohio and West Virginia would have the highest NTA rates. It is critical that all coded conditions are accurate AND supported by nursing and physician documentation. 0000278826 00000 n This article was originally published in February 2019, and has been updated in October 2019 with several more tips. The higher the score, the higher the NTA rate. Actually, were going to limit our scope to only I8000 items. However, if a provider chooses to ignore the importance of this MDS item, it will cost them 1 NTA point which could possibly impact their Case Mix Group's CMI. Base rates are either rural or urban as determined by geographic location. Additionally, PDPM applies variable per diem payment adjustments to three components, PT, OT, and NTA, to account for changes in resource use over a stay. SLP: NSG: NTA: This audit format form contains the MDS 3.0 items that drive payment for the Part A Medicare PDPM SNF-PPS payment. I0020 is also a gateway to the I0020B Primary Diagnosis code. Group therapy now allows for as few as 2 residents and as many as 6 residents. The Patient-Driven Payment Model focuses on the patients unique characteristics and needs based on diagnosis which arise during inpatient hospital stay. His I0020B Primary Diagnosis and his claim's Principal Diagnosis is now the aftercare of the hip fracture. Other diagnoses will affect the Non-therapy Ancillary (NTA) component. code. mapping to one of the clinical categories: Orthopedic Surgery (Except Major Joint Replacement or Spinal Surgery, Non-orthopedic Surgery and Acute Neurologic, Other Orthopedic (non-surgical orthopedics and musculoskeletal), Medical Management (medical management, acute infections, cancer, pulmonary, cardiovascular/coagulation, acute neurologic), The patients functional score which is coded on. We earn. As we prepare for the transition to the Patient-Driven Payment Model (PDPM), which is expected to occur on October 1, 2019, we have been reviewing the primary components that make up the Case Mix Index (CMI) for reimbursement. Verify coding, dont assume. If you have an idea lets discuss! This is an important financial consideration that facilities will not be able to afford to miss out on because of sloppy documentation or review of the records. A Knowledgeable and Compassionate partner. The NTA component score is based on the presence of certain comorbidities and/or the use of extensive services. Not all NTAs are ICD-10 codes, some are MDS items. Under PDPM, CMS identified 50 conditions that were related to increases in NTA costs for a skilled nursing facility (SNF). Luckily, code diving is a lot of fun, right? The FY 2022 SNF PPS Final Rule: Learn the Facts behind the headlines Part 2 ICD-10 Revisions and PDPM. As we continue to become more knowledgeable in coding accuracy to drive care and maximize reimbursement, here are 15 quick tips to keep in mind: Those were just a few quick tips that are derived from recent Q&A's with clients. The presence of these conditions and extensive services is reported by providers . 0000001865 00000 n Do not be apprehensive to query the physician if a diagnosis is not clear or is suspected and not documented. This problem isnt new either but now it will drive reimbursement. Speaking of individual facilities, lets take a look at that as well. The skilled services are provided by a Medicare-certified SNF. Learn why in this video from Aegis Therapies. Classroom Walkthrough Checklist Resource Center K 12 Resources Frontline Education April 18th, 2019 - Broken Arrow Public Schools a large urban suburban district with deep roots in the community serves more than 19 000 students Recognized as one of the top All Rights Reserved. NTA Componenet NTA Component NTA Comorbidity Score NTA Case Mix Group CMI 12+ NA 3.25 9-11 NB 2.53 6-8 NC 1.85 3-5 ND 1.34 1-2 NE 0.96 0 NF 0.72 Presumption of Coverage Comorbidities Included in NTA Comorbidity Score and Assigned Points Condition/Extensive Service MDS Item Points HIV/AIDS SNF Claim ICD-10 B20 8 Parenteral IV Feeding: Level High The map below shows every SNF in the US that accepted Medicare Part A patients in 2017. To account for changes in resource PT, OT, and NTA utilization over the course of a SNF stay, PDPM utilizes a variable per-diem adjustment factor that adjusts the per-diem payment for these components over the course of the resident stay. NTA has been separated as an independent component, and NTA classification is determined by the presence of certain conditions or the use of certain extensive services that were found to be correlated with increases in NTA costs for SNF patients. Dietitians are classified in the NTA discipline. We earn 1 NTA point if we code Protein or Calorie Malnutrition/At Risk for Protein or Calorie Malnutrition in MDS item I5600. If your facility has a low NTA rate, it may just mean you have work to do, documentation-wise. Variable Per Diem Adjustment Factors and ScheduleNTA. Click here to visit our shop. Learn more about Jessica, Eleisha, and the rest of the Proactive team. With several big changes ahead, the margin for error slim for most providers. Also notice there are very few facilities with low NTA rates in the Appalachians. Not having the correct codes can have a domino effect and result in missed reimbursement, or claim inaccuracies. (Click either image to enlarge.). The PDPM diagnosis list determines the reimbursements for a Medicare Part A stay. You can rely on us. In this post Im going to take a deeper look at it and calculate the average NTA payment by state and facility. The categories impact a resident's case-mix classification. The NTA case-mix groups are based on NTA score ranges: 0 (NF), 1 2 (NE), 3 5 (ND), 6 8 (NC), 9 11 (NB), or 12+ (NA), according to table 17, NTA Case-Mix Groups, in chapter 6 of the Long-Term Care Facility Resident Assessment Instrument 3.0 Users Manual. This PDPM model aims to utilize the individual patients characteristics and needs based on diagnosis as opposed to the RUG-IV system relying on volume of services. These clinical categories are PT, OT, and SLP. Some didnt occur at all. .com NTA Diagnosis Tool CMS identified a list of 50 conditions and extensive services associated with increases in NTA costs. Center for Medicare and Medicaid Services. Under PDPM, there are six payment components. Yes, Im aware that if you dont look at every. Refer to RAI pages J37-J38 for more on coding J2100. For the NTA, an adjustment factor of 3.0 is applied to the total NTA CMI for days 1-3. Admitted in the Skilled nursing facility (SNF) within a short time (generally 30 days) of leaving the hospital and require skilled services related to hospital stay. or service for purposes of classification under the PDPM's NTA component.