Course Objectives
The objective of the FSNFC™ – Fellowship in Skilled Nursing Facility Coding is to develop advanced expertise in Skilled Nursing Facility (SNF) Coding, PDPM reimbursement methodology, and regulatory compliance within post-acute care environments.
By the end of this fellowship, participants will be able to:
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Explain the Patient Driven Payment Model (PDPM) structure and components
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Assign accurate ICD-10-CM codes impacting PDPM clinical categories
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Interpret and calculate HIPPS Codes accurately
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Understand the impact of PT, OT, SLP, Nursing, and NTA components on reimbursement
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Align diagnosis coding with MDS documentation and Section GG scoring
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Apply proper Medicare Part A SNF billing guidelines
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Understand Consolidated Billing rules and excluded services
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Differentiate billing requirements for POS 31 vs POS 32
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Prevent PDPM misclassification, overpayment, and underpayment risks
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Ensure compliance with RAC, MAC, and OIG audit standards
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Analyze reimbursement impact in post-acute care settings
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Strengthen audit readiness and documentation defensibility
This fellowship is designed to elevate professionals into SNF Coding and PDPM Specialists with strong regulatory, reimbursement, and compliance proficiency.
Table of Contents
Module-1: Introduction to Skilled Nursing Facilities (SNFs)
SNF in medical coding stands for Skilled Nursing Facility, a licensed healthcare setting that provides short-term skilled nursing care and rehabilitation services to patients recovering from hospitalization, illness, injury, or surgery.
A SNF is a facility or part of a facility engaged in providing skilled nursing care and related services. The patients require medical or nursing care or rehabilitation services. The rehabilitation services are for patients that are:
Special care center for patients needing temporary rehab (like PT/OT/Speech) after a hospital stay, where coders use specific codes (ICD-10, CPT) and models like PDPM (Patient-Driven Payment Model) for complex billing, especially for Medicare Part A, focusing on services by skilled nurses/therapists.
Module-2: SNF Coverage and Reimbursement
Medicare provides specific rules for Skilled Nursing Facility (SNF) coverage under Part A. Understanding these rules is essential for correct ICD 10 CM coding, PDPM assignment, billing accuracy, and compliance. Coders must know when a service qualifies for Part A payment and how documentation supports each element of coverage.
Module-3: SNF - Consolidated Billing CB
Understanding Bundled Payments for Skilled Nursing Facility SNF Patients
Consolidated Billing CB is a fundamental part of the Medicare Part A payment system for Skilled Nursing Facilities. Under the SNF Prospective Payment System PPS, Medicare provides a single bundled payment that covers most services a resident receives during a Part A covered SNF stay. This means the SNF is financially responsible for almost all services delivered to the patient, even when those services are performed by outside providers.
Providers or suppliers must:
- Verify patient Part A or B status and SNF status before providing services
- Not submit a separate Part B bill to Medicare Administrative Contractors (MACs) for services subject to CB
- Look to the SNF for service payments subject to CB
- Inform all patients who get services in a covered Part A stay about CB requirements
Module-4: SNF ICD-10-CM Coding
Primary Diagnosis Coding and Comorbidity Optimization
Accurate diagnosis coding is the foundation of Skilled Nursing Facility reimbursement under PDPM. Coders must understand how ICD 10 CM codes map to PDPM clinical categories, influence case mix components, and support MDS accuracy. This module trains coders to correctly identify the primary diagnosis for a SNF stay and capture all medically relevant comorbidities that impact Nursing, SLP, and NTA scoring.