PDGM Primary Diagnoses

Is anyone else being pressured to inaccurately code the primary dx for billing purposes? Our intake dept has accepted several QE referrals and then coders are expected to "fix" it. I have sent on to our ethics team. I'm sure I can't be the only coder that this is happening to. Thanks!


  • In our agency Intake does occasionally take a problematic referral related to PDGM. I always followup with intake & explain why the diagnosis is problematic. We have lost payment on a few. Intake is expected to confer with a coder if they are unsure about a diagnosis. This has helped to decrease the frequency of this problem.

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  • edited December 2020

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