SNF FY 2022 Proposed Rule Learn the Facts Behind the Headlines Part 3: How is My Rate Calculated, Regulatory Reminder! 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 The NTA component is an important component to capture and reimburse the facility for costly medications, services, and supplies needed to care for residents. Zi@Ym"l?]L?*;YaRxwFhSGkhSFRQJIp.V4v!fbN91GE]Y:+s 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? With every dollar spent on nutrition screening and interventions, the Academy of Nutrition and Dietetics has reported savings of $3.25 3. For example, IV medications (5 points) coded in MDS item O0100H2 or isolation (1 point) coded in O0100M2. Medical records department should already code and map for the clinical category to be able to determine principal diagnosis code and calculate expected daily rate for the facility using either the manual PDPM worksheet or software-generated calculation. Securely download your document with other editable templates, any time, with PDFfiller. (Click either image to enlarge.). In the absence of specific documentation, you may use positive tests, procedures, hospitalization for symptoms). The list includes diagnosis codes, which will be recorded in the I8000 section of the MDS. mp:U@|8B *zL$#Tk\*SU%mQlTYA Rj&-N _VjWpb[5R8'i, 0000009611 00000 n Points (1-8) are assigned to specific conditions. Hoo0Gw7I18J+-+hLC&QI$[3iB:s]:?\GqA ATc#(R2:nl/?e. ` 0!RJ3t f{ WN"Y@L1+;HXZL@\uB*4c*fi$1( )}hciksm2hn 1cU(YTS46ye&? &JHyBIQ fF The RUG-IV consists of two case-mix adjusted components: Therapy which is based on volume of services provided and nursing. It is for this type of services they offer which also categorize them as skilled nursing and rehabilitation facilities becoming a, A long-term care facility provides custodial care requiring supervised, minimal or total dependence in the performance of the activities of daily living (. ) Either way, you must still also code the I0020B primary condition I0010 through I8000. (2019). Variable Per Diem Adjustment Factors and ScheduleNTA. It may also include a condition that started while the patient was getting care in the SNF for a hospital-related medical condition such as antibiotic medications via intravenous (IV) route to treat infections even if it was not the reason the patient was admitted to the acute hospital. These conditions, along with the number of points associated with the condition and how it is reported, can be found by downloading the CMS document titled "Fact Sheet: NTA Comorbidity Score. HUO0~^iq3N&@-0*Si$L9)-ziwg';q_}(Ak"CwKi "@~|iA`!c With the transition from Resource Utilization Group Version IV (RUG-IV) to the Patient-Driven Payment Model (PDPM) on October 1, 2019, the MDS nurse requires an analytical mind and financial knowledge to determine the highest allowable reimbursement for the facility. 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. hVmk#7+xG{ZMaMu{vB{[ciF3Viee2!VpIbDAy_X%_A0,R99Kb! 0000001865 00000 n o NTA = All NTA items identified with a value of two or more points on the NTA table. Functional scoring is one of the factors used to calculate the PDPM rate for the PT, OT and Nursing components. SNF PDPM Provider-Specific Impact File. endstream endobj 447 0 obj <> endobj 448 0 obj <> endobj 449 0 obj [278 0 0 0 0 889 0 0 333 333 0 0 278 333 0 278 556 556 556 556 556 556 556 556 556 556 278 0 0 584 0 0 0 667 667 722 722 667 611 778 722 278 500 667 556 833 722 778 667 0 722 667 611 722 667 944 0 667 0 0 0 0 0 0 0 556 556 500 556 556 278 556 556 222 222 500 222 833 556 556 556 0 333 500 278 556 500 722 500 500 500] endobj 450 0 obj <>stream Below is a summary of the determinants of payment and which section on the MDS assessment form they are derived from. Each component has its case mix index to determine the component rate. View fullsize For RUGs IV PPS, the payment is based on a per diem rate that is constant for the entire length of stay. hbspt.cta._relativeUrls=true;hbspt.cta.load(2297384, '30c35813-92d3-4fa1-bc3f-6b232de017b1', {"useNewLoader":"true","region":"na1"}); Topics: PDPM payments will be based on six groupsone non-case mix group (CMG) and five specific CMGs: PT, OT, SLP, NTA and nursing. Under PDPM, 50 conditions and extensive services are considered for NTA classification. This problem isnt new either but now it will drive reimbursement. Just 1 NTA point can have an average worth of anywhere from $18 to $55 per day. INTRODUCTION. His I0020B Primary Diagnosis and his claim's Principal Diagnosis is now the aftercare of the hip fracture. 437 27 Some sources even noting companies are finding losses of $500 to just over $1500 due to missed diagnoses, of both malnutrition and obesity, throughout total admissions spans of residents 2. PDPM Chart Audit Simple and Easy: Winning in PDPM Payment and Regulatory Strategies . Item I0020 and I0020B: Item I0020 (primary medical condition category that best describes the primary reason for admission lists several options. For the NTA, an adjustment factor of 3.0 is applied to the total NTA CMI for days 1-3. A Knowledgeable and Compassionate partner. 0000002742 00000 n 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. When the severe skin burn is also coded in MDS section I8000, we qualify for the Nursing Clinically Complex Category. These residents may have a significant number of inaccurate or resolved diagnoses if a facility doesnt have a process for ongoing diagnosis reconciliation. Basic versions of many 2019 AHCA PDPM Academy copyrighted document resources and webinars are available to . 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. Patients rely on you. This NTA CMI is added to the other components to calculate the total reimbursement for the patient. This has been a key consideration in designing the various elements of the new model. Specialties What Is a SANE Nurse? 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. PDPM includes a new pay category, the non-therapy ancillary or NTA. (Nursing, Social Services, Dietary and Activity Staff). (Ui7A7dR;5|jDM\sEamJFK3O.C[=vBD:]'N+T_ rhc_ex>mHR&o6Bfr*W0zG3KWmxK6P46n=Jt0Pn'OGC~&S};& Dt];vwj+E0R"^T 463 0 obj <>stream 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. 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. The general method for calculation of any NTA category is as follows: The Fiscal Year (FY) 2021 PDPM ICD-10-CM Mappings file includes the NTA Comorbidity to ICD-10-CM Mapping, which maps comorbidities in the NTA component captured in item I8000 to allowable ICD-10 codes. Request for labs, imaging studies and surgical reports whichever is applicable. (10 items fit). 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. Ill also compare urban versus rural facilities when it comes to NTA case-mix. 0000001405 00000 n Find toolkits, webinars, on-demand trainings, templates, and much more to meet the needs of your facility. (difference of NE-NF and NA-NB). endstream endobj 452 0 obj <>stream (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 Base rates are either rural or urban as determined by geographic location. They cant all be equally likely, right? Whats in it for me? 0000007482 00000 n Identification of NTA conditions and services should start even before the SNF admission. All Rights Reserved. Good talk. Preparedness for coding changes will be the key to a smooth transition. Everyone I've talked to agrees the NTA payment is a good idea. 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. $HJ0!$j-g#W d9bEi0~og$.J8-Lb =lZ.SSz|'!`%/ The Centers for Medicare and Medicaid Services (CMS) introduced the Patient Driven Payment Model (PDPM) in the FY 2019 Proposed and Final Rule process in 2018. Hopefully I dont lose my blogging privileges, but I looked at a years worth of Part A admissions to every SNF in the country and found, gasp, not all codes occur that often. 1=BY)#CT 'a7bA(XdHE ? 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. 0000001085 00000 n 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. On day 4 it goes back to the rate shown. 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. For the Non-Therapy Ancillary Component, each diagnosis has a corresponding score which is multiplied to the federal NTA case mix index. Fax: (812) 471-7802 You can read more about this in the Official ICD10 Guidelines for Coding and Reporting FY2020, Section II, Subsection K. For example: The definition of Group Therapy has changed. Do whatever you want with a SKILLED: fill, sign, print and send online instantly. While the SNF certs and the Therapy Certs may contain this documentation, they are often not signed or approved until after the ARD. Under PDPM, Section GG drives PT and OT, and nursing which affects reimbursement. last. 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. Suctioning? The higher the total point value, the greater the payment (CMI). Incorporate NTA identification into the daily clinical meeting as it is ever important to identify when a change in condition or services takes place. 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. I0020 is also a gateway to the I0020B Primary Diagnosis code. Other ancillary services include room and board, activity planning, housekeeping, laundry, and maintenance of fixtures/equipment. Educate yourself on the. ordered by the patients attending physician in the facility. They are assisted by certified nursing assistants (CNAs) and licensed staff assist them during medication administration ordered by the patients attending physician in the facility. The Patient-Driven Payment Model focuses on the patients unique characteristics and needs based on diagnosis which arise during inpatient hospital stay. Reimbursement for these services is covered under the State of Californias Medi-Cal program or privately paid by the patient if he/she does not qualify under the Medi-Cal program. When RUG classification was used as the basis of reimbursement, all patients with different patient characteristics were classified in the same RUG level based on the volume and intensity of therapy services provided. to Resolved conditions should not be listed since therapy would not be treated for a resolved condition. PDPM or Patient-Driven Payment Model is the new system, replacing the RUG-IV, for calculating reimbursement by Medicare in the skilled nursing setting. 0000278826 00000 n %PDF-1.4 % 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". To ease some of this burden, AAPACN developed the Sample Task List for the Nurse Assessment Coordinator tool . 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. 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. We earn 1 NTA point if we code Protein or Calorie Malnutrition/At Risk for Protein or Calorie Malnutrition in MDS item I5600. 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. SANE is an acronym that stands for Sexual Assault Nurse Examiner. Verify coding, dont assume. endstream endobj 451 0 obj <>stream Functional scoring is one of the factors used to calculate the PDPM rate for the PT, OT and Nursing components. We earn 1 NTA point for second or third degree burn coded in M1040F. b!+XQ{ +LgOIYe/Q6RVpYY_N/.~iMu1fY*eR}W_E[,7vrR!XSF};qZW&e"S5!CW}3GU|muc?_X`dcg7(zRU8k? |Pa(E8BNJA!-tUiX%:h~GJ?J.H% kZ*qyXjBy@C(zHhzQhhlL2cO`.$p6_[3R^IrHrr6#eq7**2uWytb$HyZi[F2_ GBM*.`k@/9cO9R*^fo_MOK6_xg,eM'jv}5E|SWNH0$z|.WL7y9 ;4H*h;H8H"*RW l? The PDPM program has six payment components. There is also the impact of the Variable Per Diem Adjustment Factor that is applied to the NTA Component. Section I of MDS 3.0 is reserved for Active Diagnoses and Item I8000 is you to enter up to 10 additional active diagnoses with corresponding ICD-10 codes. Which codes are you most likely to actually see in the wild? hl In this fourth webinar of our six part series, learn which items on the MDS or Medicare claim will be used to determine the NTA score and its impact on payment. Re-calculate expected daily rate based on the completed Rehab and Nursing Functional Scores and re-review principal diagnosis. It especially packs a heavy punch when considering that the NTA per diem rate is tripled for the first three days of the stay. PDPM MDS Items ! At first, it took me longer to get used to making calculations in determining the highest allowable rate for the patient. !on!$ Q7ER}x;:lRcP%?9w_ mm ' With supportive documentation, it can be coded in I5600. Far more items than would actually fit on the MDS 3.0 Instrument. In it, youll find the 1,612 codes that map to the different comorbidities. and the grouper software will pick it up from I8000. 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. Admittedly, thats a lot to look through. When reviewing the CMI components driving PDPM reimbursement it's important to consider the critical role of the Non-Therapy Ancillary (NTA) score. What do I need to know? Our wound certified educators train, educate, and guide our providers and client facilities on the most efficacious wound care treatments and follow up. Points are scored if the condition or service is present. the design of the PDPM case-mix system implemented in FY 2020. A frequent question: "If the mapping file lists a code as "return to provider", can I still use it on the MDS?". We earn 1 NTA point and qualify for Nursing Category Special Care Low for a Stage IV Pressure Ulcer when coded in M0300. 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 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. a" I54043lquizzes/446951 (Question 2 5 / 5 pts The startxref It more accurately accounts for expenses and isn't overshadowed by therapy. A SANE nurse is an RN who has been trained to examine and assess clients who have a reported a sexual assault. PDPM Series Part 4: Non-Therapy Ancillaries Case Mix Groups. Do not be apprehensive to query the physician if a diagnosis is not clear or is suspected and not documented. The more comorbidities a patient has, the more medications he or she probably requires. You can also zoom in to see detail. comorbidities used under PDPM for NTA classification is assigned a certain number of points, between one and eight, based on its relative costliness. Therefore, the code in I0020B must be directly related to the I0020 Primary Medical Condition. code. You should understand those things too, reader.). Just 1 NTA point can have an average worth of anywhere from $18 to $55 per day. 0000003793 00000 n RUG Classification Groups based on the volume and intensity of therapy provided to patient: Determinants of Payment for PDPM are summarized below. 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. To further understand the difference between long-term care facilities and skilled nursing/rehabilitation facilities, we will focus on the services they offer. After the PDPM rate for each component is determined, the sum of the PDPM component rates is added to the fixed non-case mix rate which will be the final reimbursement rate for the patient for the entire skilled nursing facility stay. The non-therapy ancillary (NTA) part of the patient driven payment model (PDPM) is considered by most people Ive talked to as being better than what were currently doing. Great info! 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. As under the previous RUGIV model, the presence of an AIDS diagnosis continues to be identified through the . 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. The individual NTA conditions have points ranging from 1 to 8. With PDPM payment method, the determinants of payment are categorized into the following case-mix adjusted components: The PDPM rate is adjusted over the course of facility stay by the inclusion of a variable per diem (VPD) adjustment on the following three components: PT, OT and NTA. The PDPM Rate is derived from the sum of all the PDPM component rates: PT base rate x PT case mix index (CMI) x VPD adjustment factor, OT base rate x OT CMI x VPD adjustment factor, NTA base rate x NTA CMI x VPD adjustment factor, Nursing base rate x Nursing CMI x 18% Nursing adjustment factor (only for AIDS patients). In this article, we discuss the non-therapy ancillary (NTA) component. (By the way, we created a PDPM Calculator for you to experiment with and get a better understanding of how PDPM works. thead { With such a close relationship to payment, it is critical the staff member(s) responsible for ICD-10 coding are knowledgeable in this area. But toward the end of January, reporter Maggie Flynn poked holes in the idea that ICD-10 mastery was a necessity. "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? CMS 100-2 Chapter 8 Series Part I: Access to Medicare Part A Benefits In a SNF. 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. Each patient has a different reimbursement rate as compared to the RUG-IV PPS rate in the past. Five of the six are case-mix adjusted. The new nurse assessment coordinator (NAC) may be overwhelmed with the numerous tasks required of the position. 0000006001 00000 n The NTA component score is based on the presence of certain comorbidities and/or the use of extensive services. I am sure we'll continue to understand even more as the months go by. ~,/-I\!/JfB. Contact us now and sign up to receive our newsletters here. 3HFDRkse$:stHqPJoHK-qL_sh|Kg?unioWAsfH8[^9{'~-? CMS 100-2 Chapter 8 Series Part I: Access to Medicare Part A Benefits In a SNF. Facilities must ensure efficient processes are in place when selecting the primary diagnosis. If you have an idea lets discuss! 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 Other specific items will be recorded in various parts of the MDS including Section K, M, N, and O. Often overlooked, Non-Therapy Ancillaries or NTAs will be more important than ever in PDPM. A year later, he falls and sustains a hip fracture. Based on that, I have made you an extreme cheat sheet, that you should use with extreme caution. PDPM consists of five case-mix adjusted components: Physical therapy (PT) Occupational therapy (OT) Speech-language pathology (SLP) Nursing Non-therapy ancillary (NTA) PDPM also includes a variable per diem (VPD) adjustment that adjusts the per diem rate to reflect varying costs throughout a patient's stay. Center for Medicare and Medicaid Services. 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. info@proactivemedicalreview.com, Blog by Jessica Cairns, RN, RAC-CT, CMAC, and Eleisha Wilkes, RN, RAC-CTA, Click to share on LinkedIn (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Deep Dive into Federal Regulations in a Year, Mission Possible: SNF Department Head Briefing, https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2020-Coding-Guidelines.pdf, https://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html, https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/Downloads/PDPM_Fact_Sheet_NTAComorbidityScoring_v2_508.pdf, https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/Downloads/PDPM_Fact_Sheet_AIDS_v3_508.pdf, Special Treatments/Programs: Intravenous Medication Post-admit Code, Special Treatments/Programs: Ventilator or Respirator Post-admit Code, Special Treatments/Programs: Transfusion Post-admit Code, Major Organ Transplant Status, Except Lung, Active Diagnoses: Multiple Sclerosis Code, Active Diagnoses: Asthma COPD Chronic Lung Disease Code, Bone/Joint/Muscle Infections/Necrosis Except: Aseptic Necrosis of Bone, Active Diagnoses: Diabetes Mellitus (DM) Code, Other Foot Skin Problems: Diabetic Foot Ulcer Code, Special Treatments/Programs: Tracheostomy Care Post-admit Code, Active Diagnoses: Multi-Drug Resistant Organism (MDRO) Code, Special Treatments/Programs: Isolation Post-admit Code, Specified Hereditary Metabolic/Immune Disorders, Special Treatments/Programs: Radiation Post-admit Code, Stage 4 Unhealed Pressure Ulcer Currently present, Psoriatic Arthropathy and Systemic Sclerosis, Proliferative Diabetic Retinopathy and Vitreous Hemorrhage, Other Foot Skin Problems: Foot Infection Code, Other Open Lesion on Foot Code, Except Diabetic Foot Ulcer Code, Complications of Specified Implanted Device or Graft, Bladder and Bowel Appliances: Intermittent catheterization, Special Treatments/Programs: Suctioning Post-admit Code, Myelodysplastic Syndromes and Myelofibrosis, Systemic Lupus Erythematosus, Other Connective Tissue Disorders, and Inflammatory Spondylopathies, Diabetic Retinopathy Except: Proliferative Diabetic Retinopathy and Vitreous Hemorrhage, Nutritional Approaches While a Resident: Feeding Tube, Disorders of Immunity Except: RxCC97: Immune Disorders, Pulmonary Fibrosis and Other Chronic Lung Disorders.
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