PDGM TAB

Invoice detail for PDGM invoices includes a PDGM tab that provides you with PDGM detail information for the invoice. Items include:

• Admission Source Description includes responses to OASIS M1000 and M1005 if you documented that the patient was in a facility prior to Start of Care
• OASIS Time Point Used for the PDGM Invoice information
• Assessment Date documented on OASIS M0090
• Certification period linked to the invoice
• Primary Diagnosis from the 485 or Clinical Update interim order (the last form entered before the invoice “from” date)
• Clinical Group identified based on diagnosis information.  Point Ranges display for point ranges display for each clinical group identified within each PDGM invoice. 
• Comorbidity Level based on the diagnosis information
• HIPPS Code determined from OASIS as well as orders information
• Weight calculation displays CMS case mix weight for that clinical group
• LUPA Threshold based on one of the 432 different payment groups (minimum is at least 2 for each group but can be more)
• FIPS identifies the state and county where services are provided on Diagnosis codes that appear on the claim based on the diagnosis codes you entered for the 485 or Clinical Update interim order, whichever document is most recent prior to the invoice “from” date