The Patient-Driven
Groupings Model
effective January 1, 2020
Implemented by the
Centers for Medicare & Medicaid Services
How will PDGM affect you and your patients' care?
PDGM requires primary diagnoses to include underlying cause(s) or to be more specific.
Meeting the more detailed diagnoses requirements from CMS will help ensure expedient initiation of care for your patients.
Examples
Number 1
Underlying Cause(s) example
Incomplete Diagnosis:
Muscle weakness
CMS-Acceptable Diagnosis:
Muscle weakness due to
acute exacerbation of heart failure
Number 2
Type Specificity example
Incomplete Diagnosis:
Fracture of clavicle
CMS-Acceptable Diagnosis:
Fracture of clavicle, right proximal
Electronic Medical Records ensure expedient initiation of care.
Enhanced clinical quality, patient satisfaction, and operational efficiency are just one click away.
Shared EMR Access
Near real-time data, including patient vitals, diagnosis, wound history and medications
The latest and most accurate answers for patient/family inquiries
Less time and space dedicated to office filing
Electronic signatures for home health orders, re-certifications, and face-to-face documentation
Identification of billing eligibility for time spent on Care Plan Oversight
HIPAA-compliant data handling
