The resulting sum is the NTA comorbidity score, which is used to classify each resident into an NTA case-mix group. 0000011153 00000 n A list of these specific retinopathy codes are in the SLP mapping file from CMS. (At this point, I can feel the cold stares from our MDS Experts. The correct coding for NTA will require a team effort and diligent review of coding and supporting documentation. This item includes diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. Each patient has a different reimbursement rate as compared to the RUG-IV PPS rate in the past. Patients rely on you. To find out if you're leaving any money on the table email MDS Consultants for a PDPM review at info@mds-consultants.com, Find the PDPM ICD-10 Mapping tool at: https://mds-consultants.com/helpful-cms-info/, PDPM step-by-step scoring guide at https://mds-consultants.com/mds-tools/, https://mds-consultants.com/helpful-cms-info/, Coding N2001 N2005: Part A Drug Regimen Review, The Struggle with Antipsychotic Reduction . These components for classification and payment include: Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST), Non-therapy Ancillary (NTA) as well as Nursing. Once you have identified the condition/extensive service on the MDS or claim, the points associated with each comorbidity are added up for a total NTA score which is associated with 1 of the 6 case-mix groups shown below. (I did abbreviate a few of the names for sanity.) After a qualifying hospital stay, he has returned to the SNF for aftercare of the hip fracture. endstream endobj 452 0 obj <>stream 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. The Patient-Driven Payment Model focuses on the patients unique characteristics and needs based on diagnosis which arise during inpatient hospital stay. 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 . The functional scoring is based on residents performance in. 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. 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. 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. Title: Microsoft Word - FINAL PDPM Triple Check Checklist.docx Author: jleatherbarrow Created Date: 1/29/2020 4:19:17 PM 0000004207 00000 n For example, if the MDS Coordinator counts only two of the three comorbidities that a patient has, the CMI for NTA would be 0.96 instead of 1.34. } Specialties What Is a SANE Nurse? 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. (This isnt going to work well on mobile devices, FYI.). Documentation by the physician and nursing must also support the skilled nature of the codes that are recorded as NTA conditions. All PDPM components are assigned an appropriate score to multiply to the federally assigned case mix index group. HUO0~^iq3N&@-0*Si$L9)-ziwg';q_}(Ak"CwKi "@~|iA`!c The Non-Therapy Ancillary Services (NTA) component is a total score of all listed conditions and/or extensive services that apply to the resident. 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. program for a limited time or on a short-time basis and must meet the following requirements: hospital insurance and have eligible days left to use during the benefit period. MDS Item Field rows in tan represent MDS item groups identified in CMS PDPM documentation and do not have data entry fields. Other ancillary services include room and board, activity planning, housekeeping, laundry, and maintenance of fixtures/equipment. (difference of NE-NF and NA-NB). Complete a blank sample electronically to save yourself time and money. A Knowledgeable and Compassionate partner. %PDF-1.6 % Anyone involved with ICD-10 coding should have ready access to the coding guidelines. 2 &r}p")|@ O&]LpLk| Mvl(Pv[C0AMfxYp&NymfJXdO@QhCec*2-K8P3Tjp6'+Q :~_%`n/[w}_,0-|:%?h6'#%?7?\o(@Ln 9w9Fhe`P8B09@(@DT\QG+ (CQ {dX r4`H*B4,&0hl3()%zI[)jCN8{SNa%PED~ eT T(m:l] 43FH&"@`BN`Kk(f The PT and OT payment would be based on: primary reason for SNF care and functional status at admission The sum of the lowest per diem rate under each PDPM component, plus the non-case-mix component is the: default code Which of the following is NOT a case-level adjustment for a MS-LTC-DRG long term stay outlier 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. The Patient-Driven Payment Model focuses on the patients unique characteristics and needs based on diagnosis which arise during inpatient hospital stay. An NTA comorbidity score of 12 = a CMI of 3.24. The MDS software programs such as PointClick Care, Matrix, Net Solutions, to name just a few, automatically calculate the PDPM rates once the MDS assessment is completed. Skilled nursing services are covered under the Federal Governments Medicare program for a limited time or on a short-time basis and must meet the following requirements: The role of the Minimum Data Set (MDS) nurses has evolved all these years from being a clinician to a financial analytical nurse because the MDS assessments have become the basis for facility reimbursement by the Medicare program. $HJ0!$j-g#W d9bEi0~og$.J8-Lb =lZ.SSz|'!`%/ Below is a summary of the determinants of payment and which section on the MDS assessment form they are derived from. When these conditions and extensive services are reported on the MDS 3.0, they are weighted and used to classify a resident into a specific NTA case-mix group. They are assisted by certified nursing assistants (. Welcome to Gravity healthcare Consulting & Online Education One can see from the table above that if comorbidities are missed, the facility could possibly miss out on reimbursement. border: 1px solid black; The NTA looks at conditions and extensive services that are associated with significant increase in costs for a skilled nursing facility. 0000003961 00000 n Ill also compare urban versus rural facilities when it comes to NTA case-mix. When reviewing the CMI components driving PDPM reimbursement its important to consider the critical role of the Non-Therapy Ancillary (NTA) score. 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 For example, Mr. Steve is a long term care resident due to Parkinson's Disease. SNF FY 2022 Proposed Rule Learn the Facts Behind the Headlines Part 3: How is My Rate Calculated, Regulatory Reminder! The map below shows every SNF in the US that accepted Medicare Part A patients in 2017. endstream endobj 438 0 obj <>/Metadata 434 0 R/OutputIntents[<>]/Pages 433 0 R/StructTreeRoot 3 0 R/Type/Catalog>> endobj 439 0 obj <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Type/Page>> endobj 440 0 obj <> endobj 441 0 obj <> endobj 442 0 obj <> endobj 443 0 obj [226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606 0 529 0 0 0 0 0 0 0 0 0 0 659 0 0 0 0 0 495 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 813 537 538 537 0 0 0 347] endobj 444 0 obj <> endobj 445 0 obj [278 0 0 0 0 0 0 0 0 0 0 584 0 333 278 278 556 556 556 556 556 556 556 556 556 556 0 0 0 0 0 0 0 722 722 722 722 667 611 778 0 278 0 0 0 833 722 0 667 0 0 667 611 0 0 0 0 0 0 0 0 0 0 0 0 556 611 556 611 556 333 611 0 278 0 0 278 889 611 611 611 0 389 556 333 611 556 0 556 556] endobj 446 0 obj <>stream What do I need to know? All disciplines should complete all their assessments ON TIME to CAPTURE all skilled services and accurately calculate residents daily rate PRIOR TO completion and transmission of the MDS 5-day assessment. Consider adding the list of NTAs to current pre-admission screening forms or otherwise creating a way to identify and communicate potential conditions and services that may continue during the SNF stay. This simply shows you a starting point. Focuses on clinically relevant factors rather than volume-based services or RUG levels. tr:nth-child(even) {background-color: #f2f2f2;} Skilled nursing services are covered under the Federal Governments. Your NTA payment is driven by the presence of a number of conditions and/or extensive services. Payment is based on services provided by five disciplines: physical therapy, occupational therapy, speech language pathology, nursing, and non-therapy ancillary (NTA). The saying, haste makes waste applies in the completion of MDS assessments and calculation of the maximized PDPM rate for the patient. CMS 100-2 Chapter 8 Series Part I: Access to Medicare Part A Benefits In a SNF. Diligent review of the medical history and clinical record is essential. Reimbursement for these services is covered under the. There are a lot of items from section I8000. It will be imperative that the coding is accurate on the MDS for the NTA conditions. Do whatever you want with a SKILLED: fill, sign, print and send online instantly. Determinants of payment are based on the patients characteristics assigned to six components: Patients are assigned to classification groups known as RUG Classification Groups based on various characteristics of patients and the intensity of therapy services provided. In this post, we going to look at one important piece of the NTA puzzle, section I. Was there a need for an IV? var divElement = document.getElementById('viz1528375166404'); var vizElement = divElement.getElementsByTagName('object')[0]; vizElement.style.width='100%';vizElement.style.height=(divElement.offsetWidth*0.75)+'px'; var scriptElement = document.createElement('script'); scriptElement.src = 'https://public.tableau.com/javascripts/api/viz_v1.js'; vizElement.parentNode.insertBefore(scriptElement, vizElement); Use the rate filter to show only the highest or lowest NTA rates. Contact us now and sign up to receive our newsletters here. To ease some of this burden, AAPACN developed the Sample Task List for the Nurse Assessment Coordinator tool . Luckily, code diving is a lot of fun, right? (PPS) based primarily on the type and intensity of therapy services provided to the patients regardless of their acuity, unique characteristics, specific needs, or goals. In this article, we discuss the non-therapy ancillary (NTA) component. The general method for calculation of any NTA category is as follows: Patients are assigned a clinical category based on the primary diagnosis for SNF stay. you could miss something. Other diagnoses will affect the Non-therapy Ancillary (NTA) component. Continuous training is the key and implementation of what was learned in coordination with the facility team members will ensure success in providing skilled care for the patients and maximizing facility reimbursement. endstream endobj 1697 0 obj <>stream The Centers for Medicare and Medicaid Services (CMS) have provided the SNFs with a list of ICD-10-CM codes mapping to one of the clinical categories: These clinical categories are used as the Primary PDPM diagnosis giving weight to the calculation of PDPM rates for PT, OT, SLP and Nursing components. Under PDPM, CMS identified 50 conditions that were related to increases in NTA costs for a skilled nursing facility (SNF). You can filter by NTA rate. 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 (. PDPM or Patient-Driven Payment Model is the new system, replacing the RUG-IV, for calculating reimbursement by Medicare in the skilled nursing setting. 1=BY)#CT 'a7bA(XdHE ? MDS 3.0 Section I Thats a lot of white space. How can a facility ensure that they are not leaving money on the table due to under-coded NTAs? of the MDS form is derived by assessing the patients usual self-performance in the ADL task areas during the first three days of facility stay. His claim's principal diagnosis is Parkinson's Disease. 0000001085 00000 n SAMPLE Task List for the Nurse Assessment Coordinator (NAC) November 23, 2022. SNF FY 2022 Proposed Rule Learn the Facts Behind the Headlines Part 3: How is My Rate Calculated, Regulatory Reminder! As a result, patients with AIDS are assigned the highest point value (8 points) of any condition or service for purposes of classification under the PDPMs NTA component, and they also receive a special 18% add-on to the nursing component of the payment. The five CMGs then convert to a corresponding case mix index (CMI), which is a multiplier to the base rate for a particular CMG. Fax: (812) 471-7802 The idea is that the facility should be paid for the care they are delivering, based on the patients characteristics. When reviewing the CMI components driving PDPM reimbursement it's important to consider the critical role of the Non-Therapy Ancillary (NTA) score. (10 items fit). ~,/-I\!/JfB. Inappropriate Schizophrenia Diagnosis/Coding and Survey Citation Posting, Regulatory Reminders: Consolidated Billing Update 2023. 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. The NTA component score is based on the presence of certain comorbidities and/or the use of extensive services. The correct coding for NTA will require a team effort and diligent review of coding and supporting documentation to ensure 100% accuracy. Recently, a provider stated that its not that important because the QM high risk determination includes impaired mobility and transfer, which most of their residents with pressure ulcers already have, so that already qualifies them for high risk even if I5600 is not coded. ^(:eOCQ'SM7(Rmnvr/+eO.)hicZjz.,vO&u. (By the way, we created a PDPM Calculator for you to experiment with and get a better understanding of how PDPM works. Below is the full listing of conditions and services used for NTA classification and the associated number of points for that comorbidity. Adjustments to the PDPM rates include: 2.3% reduction in FY 2023. additional 2.3% decrease in FY 2024. But, since its new, were going to have to work on understanding how its supposed to work, and how we can most easily and efficiently complete the assessment with accurate information. thead { This does not include conditions that are resolved. All Rights Reserved. Under PDPM there are 161 Minimum Data Set (MDS) item fields. Based on that, I have made you an extreme cheat sheet, that you should use with extreme caution. Le^#N"TaAKTt If the Primary Diagnosis you listed in I0020B also happens to be a SLP Comorbidity qualifier from the SLP Comorbidity list, the grouper software will pick it up as a comorbidity from I8000. Group therapy now allows for as few as 2 residents and as many as 6 residents. HU]o0}G?G< m*-$R5k'EC(K@!BE`;s 2I2,[fy@770&05 Bal[|# f1 `j[>,Uf[OrGUXore:qVKP2T(r`~F& +g80qjM8#)A{)@c}A,F^Ec{HN"!l!]_J3? 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". Speaking of individual facilities, lets take a look at that as well. The required MDS data would be entered in the sub-items listed below the item group identifier. 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. o NTA = All NTA items identified with a value of two or more points on the NTA table. 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. Note that for the first 3 days of the stay you get 3 times the rate shown on the map. PDPM or Patient-Driven Payment Model is the new system, replacing the RUG-IV, for calculating reimbursement by Medicare in the skilled nursing setting. You only need one SLP co-morbidity (either in one of those check boxes or listed in I8000) to meet that SLP co-morbidity qualifier. With supportive documentation, it can be coded in I5600. last. The NTA component score is based on the presence of certain comorbidities and/or the use of extensive services. ! 437 0 obj <> endobj Which codes are the most important? 0000009611 00000 n [|Qc\0aXjK@ EdO4&_? Understanding the Value of the MDS Nurse Under PDPM, Psoriatic Arthropathy & Systemic Sclerosis, Myelodysplastic Syndromes and Myelofibrosis. In order to determine the patients NTA comorbidity score accurately, providers must identify all comorbidities for which a resident would qualify, then total the points. Request for labs, imaging studies and surgical reports whichever is applicable. View fullsize 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. (Click either image to enlarge.). But, since it's new, we're going to have to work on understanding how it's supposed to work, and how we can most easily and efficiently complete the assessment with accurate information. You can view either rural, urban or both. Specialties Hyperemesis Gravidarum: More Than Just Morning Sickness Pregnancy and nausea are terms used in unison with one another. Primary reason for SNF care or PDPM diagnosis coded on Section I00200B (ICD-10 code) of the MDS assessment, Functional status coded on Section GG of the MDS assessment, Cognitive Status: BIMS score coded on the Section C of the MDS assessment, presence of a swallowing disorder or mechanically altered diet coded on Section K of the MDS assessment, other SLP-related comorbidities coded on Section I of the MDS assessment, Extensive services received coded on Section of the MDS assessment such as Tracheostomy, Ventilator, and Isolation, Presence of Depression coded on Section D: PHQ9 on the MDS assessment, Restorative nursing services coded on Section O of the MDS assessment, Comorbidities present coded on Section I of the MDS assessment, Extensive services received coded on Section O of the MDS assessment: Tracheostomy, Ventilator and Isolation. How often will the items on this list be available to you when you are doing the 5 day assessment? In the absence of specific documentation, you may use positive tests, procedures, hospitalization for symptoms). (Note that this map is showing ONLY the NTA rate. This gives you enough time to prepare for their implementation of any changes as MDS assessments are time sensitive. Visit www.TrainingInMotion.org for more details of how we can help you achieve your PDPM goals. startxref In the past, we only checked this box even if the resident was a diabetic and also had retinopathy. The decision to change the definition was because CMS believes that therapists, using their clinical judgment, will allow for more flexibility and that residents often benefit from the psychosocial aspects of group therapy. h2430Q0P0430S0 PDPM HIPPS Coding Crosswalk In order to accommodate the new payment groups, the PDPM HIPPS algorithm is . For the NTA, an adjustment factor of 3.0 is applied to the total NTA CMI for days 1-3. CMS identified a list of 50 conditions and extensive services that were associated with increases in NTA costs. 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. List the 3 MDS items that qualify a resident for the Extensive Nursing Service group. 0000003037 00000 n THURSDAY JUNE 23, 2022 2 PM EASTERN - 90 MINUTES, OHIO HEALTH CARE ASSOCIATION- Virtual Webinar, COST $35 FOR OHCA MEMBERS, $90 FOR NON-MEMBERS, https://webinars.ohca.org/?pg=semwebCatalog&panel=showLive&seminarid=16339, 6/23/22 Capturing Non-Therapy Ancillary (NTA) in PDPM. With this component being paid at a 3x rate for 1st 3 days of . If the 25% is exceeded, a non-fatal warning will appear on the final validation report during the MDS submission process. CMS identified a . 26 11.4 Will section I0020B override section I0020, 1-13 for the primary reason for SNF admission since AVONA confirms that rural facilities do indeed have lower NTA case-mix. For example, an NTA comorbidity score of 11 equals a CMI of 2.53. We earn 2 NTA points if Diabetes is coded in MDS item I2900. Lets breakdown the PDPM model to better understand how reimbursement is determined. The PDPM Clinical Categories are discussed below. For RUGs IV PPS, the payment is based on a per diem rate that is constant for the entire length of stay. mp:U@|8B *zL$#Tk\*SU%mQlTYA Rj&-N _VjWpb[5R8'i, PATIENT DRIVEN PAYMENT MODEL |4 . A good first resource is the PDPM NTA Comorbidity Mapping spreadsheet. I would really like to see how item I8000 changes on a resident from the 5 day to later assessments. Custodial care does not require the assistance of a licensed staff. comorbidities used under PDPM for NTA classification is assigned a certain number of points, between one and eight, based on its relative costliness. This update addresses two issues with the NTA comorbidities mapping. oYyTQb`y{y;..nI^vY5[3?O%5;5E8_kT}m}02|E}}q4:>9=6 /W=.8,w,8m_?Y\Y\v &0,/}["JO=>?]"y;?P'WY4[;of}7gh.RF)# `,J Z5FXMM:&Dh,A*hJtiL."%oKt Hoo0Gw7I18J+-+hLC&QI$[3iB:s]:?\GqA ATc#(R2:nl/?e. ` 0!RJ3t f{ WN"Y@L1+;HXZL@\uB*4c*fi$1( )}hciksm2hn 1cU(YTS46ye&? &JHyBIQ fF 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. Which codes are you most likely to actually see in the wild? Primary Diagnosis - List I0020B Surgical Procedures - List J2100/J2300-J5000 Aphasia I4300 Cerebrovascular Accident . It more accurately accounts for expenses and isn't overshadowed by therapy. 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. Lastly, lets look a little more closely at rural versus urban. Next you multiply the case-mix index by the rate, either rural ($74.56) or urban ($78.05). 0000277284 00000 n ;DktP'pm}iE/4K~bY?c~220E+t;sdvGHz P, ;iHIBK = >N]Y}dZ}HvtZ04D8YV4r4Od^/NJ x/i"9WirMdy2d*{E^lEu}Jg t@C`[aNOGgg0?bd'r EVm@Av;*%f?Wp :1&[+cZhqhU;IKBU Far more items than would actually fit on the MDS 3.0 Instrument. The RUG-IV consists of two case-mix adjusted components: Therapy which is based on volume of services provided and nursing. If your facility has a low NTA rate, it may just mean you have work to do, documentation-wise. Click the comorbidity and see the ICD-10 codes that are most likely to occur. 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. &)` R #V? U? Our wound certified educators train, educate, and guide our providers and client facilities on the most efficacious wound care treatments and follow up. With such a close relationship to payment, it is critical the staff member(s) responsible for ICD-10 coding are knowledgeable in this area. The list includes diagnosis codes, which will be recorded in the I8000 section of the MDS. Wound Care? Patient has at least three qualifying inpatient days in an acute hospital. The Patient-Driven Payment Model (PDPM), is fast approaching with implementation set for October 2019. With the transition from Resource Utilization Group Version IV (, ) to the Patient-Driven Payment Model (PDPM) on October 1, 2019, the. If a resident is admitted into a Part A stay within 30 days after major surgical procedure (as a hospital inpatient) that carried some degree of risk to life or had the potential for severe disability, then J2100 (recent surgery requiring active SNF care) is checked "yes". Classifications from the RUG-IV assign patients to payment classification groups, called RUGs, within the payment components: Rehabilitation Plus Extensive Services, Rehabilitation, Extensive Services, Special Care High, Special Care Low, Clinically Complex, Behavioral Symptoms and Cognitive Performance Problems and Reduced Physical Function. The PDPM classification system is based on support of the patients characteristics. We earn 1 NTA point for second or third degree burn coded in M1040F. 0000190726 00000 n The PDPM program has six payment components. 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. and the grouper software will pick it up from I8000. 0000002038 00000 n For more information on preparing for the transition to PDPM, register for our 9-Part PDPM Webinar Series. Therefore, the code in I0020B must be directly related to the I0020 Primary Medical Condition. You are never alone in this field and resources are available in seminars, webinars, the CMS website, MDS manual, etc. .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. Now let's discuss the I0020B Primary Diagnosis and the Claim's Principal Diagnosis. It is important to note the one exception to the MDS coding for NTA comorbidities is HIV/AIDS, which is reported on the SNF Part A claim, but not on the MDS, due to certain state privacy laws.
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