Comorbidity adjustment pdgm. High comorbidity adjustment: 2 or more secondary diag...
Comorbidity adjustment pdgm. High comorbidity adjustment: 2 or more secondary diagnoses on the HH-specific comorbidity subgroup interaction list that are associated with higher resource use when both are reported together compared to if they were reported separately. The changes are intended to more accurately capture real-world resource utilization patterns for patients with multiple conditions. Strengthen your coding accuracy, protect reimbursement, and stay ahead of evolving PDGM payment and regulatory requirements with this comprehensive two-day intermediate home health coding training. Learn how clinical groupings and comorbidity will be affected. Depending on a patient’s secondary diagnoses, a 30-day period may receive no comorbidity adjustment, a low comorbidity adjustme t, or a high comorbidity adjustment. 1, COVID-19, is added to a new comorbidity subgroup, Respiratory 10, and will receive the Low Comorbidity adjustment under the HH PPS case-mix system effective for home health claims with From Dates on or after April 1, 2020 and included in the Home Health Patient-Driven Groupings Model (HH PDGM) Grouper software package, v01 The PDGM includes a comorbidity adjustment category based on the presence of secondary diagnoses. Depending on a patient’s secondary diagnoses, a 30-day period may receive no comorbidity adjustment, a low comorbidity adjustment, or a high comorbidity adjustment. Source: 2020 proposed payment rule Apr 14, 2025 ยท PDGM introduced low, medium, and high comorbidity adjustment categories—each influencing payment. Since 2020, the proportion of 30-day periods with high comorbidity adjustments has increased, raising questions about potential upcoding or changes in documentation behavior. The PDGM includes a comorbidity adjustment category based on the presence of secondary diagnoses. mpbsunuqasiauorassjmfdgugcqzskscopdduiglrlwp