Course Description:

This session provides a clear overview of how MDS 3.0 coding accuracy directly drives reimbursement outcomes across Medicare Part A PDPM, Managed Care, and Medicaid Case Mix methodologies. Participants will explore the financial implications of assessment scheduling, Section GG accuracy, diagnosis coding, and clinical documentation. Emphasis will be placed on understanding how MDS data translates into PDPM components and Case Mix Index (CMI) scores, highlighting key strategies to optimize payment and maintain compliance with CMS and state audit expectations.

Learning Objectives:

At the end of this session, participants will be able to:

1. Explain how MDS 3.0 coding impacts reimbursement under PDPM and Medicaid Case Mix methodologies.

2. Identify common coding and documentation errors that negatively affect reimbursement accuracy.

3. Apply strategies to ensure Section GG, diagnosis, and nursing coding reflect the resident’s true clinical picture.

4. Analyzing the relationship between MDS assessment timing, accuracy, and facility financial outcomes.