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MDS Changes & RAI Updates 2023

Updated: Jan 2

CMS has released training videos and slides regarding the MDS changes effective October 01, 2023. But during their live presentation in June 21, 2023, the presenters kept referring to "go to the RAI manual" for additional details. Many small nuances of the changes affect MDS coding and a handful of new MDS data elements were not discussed in the CMS presentation, training videos or slides. For example,

  1. CMS's last statement at the end of the Section M slides is the following: "Additional changes in this section include updated examples and one new example added for M0300G. Unstageable Pressure Ulcers Related to Deep Tissue Injury." What was not reviewed were two revisions: A). Clarifications of scenarios that now include both "on admission coding" with the "subsequent assessment coding" that paint a better picture of how different pressure ulcer stages during the stay are coded. B). A useful pressure ulcer advisory panel sitelink:

  2. The most repeated message throughout the training is the following: "For additional information, please refer to the MDS 3.0 RAI Manualv1.18.11." This is a great reminder to learn the other areas not mentioned in the CMS slides or discussed in their presentation.

  3. Item GG0130X1. What is "GG0130X1" supposed to be? It is not mentioned in the matrix and there is no explanation in the manual what it represents. (No, this is not a joke. But we got answers!)

Someone was quoted to have been glad that the CMS training videos of the latest MDS updates were short. That is because the CMS videos did not cover the complete coding instructions of all the MDS coding changes. The training videos from CMS are helpful and much appreciated but MDS Coordinators do need to take heed with CMS's message. Additional reading (or training) is required.

MDS Coordinators and other MDS-involved staff need to make sure that if they are signing up for a course regarding the upcoming RAI changes, they are signing up for a complete and final update. The MDS class should review, at least, fifteen (15) sections in Chapter 3 of the RAI manual. (Revisions in Section P and Z have such minute edits that they do not even need to be mentioned.) Additionally, a review of what is not making sense in the final manual.

Other online courses currently offering one-hour to a 90-minute "MDS Update" webinars have popped up- only to provide summaries of the changes. Or a 4-hour webinar of how the new MDS will affect the healthcare arena with only five MDS sections reviewed. Yet, complete coding rules of the changes in the RAI are not discussed.

TABLE OF CHANGES: The table of changes in the RAI manual has more than 400 pages of revisions. The most obvious edits are typos, grammatical corrections, moving of instructions to another area, and rephrasing instructions that mean the same as previously stated and other minor changes. These would not necessarily be part of a training.

Some of the important edits are the mere one-word or two-word revisions that can majorly affect the MDS assessment, especially the PDPM reimbursement! In contrast, Section A starts off with an enormous addition of brand new MDS items and guidance. (By the way, the term MDS "item" is referred to as "data elements".)

An MDS course covering the complete significant revisions for this October will need more than just an hour or two of slides.

So what else was not included in CMS' slides, videos and live presentation? Quite a lot! If you or your facility is interested in getting a COMPLETE MDS coding course regarding the MDS changes and RAI updates, especially how it affects PDPM reimbursement effective October 01, 2023, visit our MDS Refresher Course page.



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