Diagnosis · Checker
Comorbidity Impact Checker
Enter any secondary diagnosis to see its payment impact on both sides — its Home Health PDGM comorbidity subgroup and its SNF PDPM NTA comorbidity points. Both sides resolve every ICD-10 code from the CMS files.
Secondary diagnosis
PDGM: one qualifying secondary diagnosis earns a low comorbidity adjustment; a high adjustment requires two diagnoses that interact (one of the interaction subgroups). PDPM: NTA points from secondary diagnoses sum into the NTA component. Diagnosis-based comorbidities only — NTA items captured from MDS sections (IV meds, ventilator, etc.) aren't code-driven.
PDPM NTA comorbidities — all 50
| Comorbidity | NTA pts | MDS source |
|---|---|---|
| HIV/AIDS | +8 | SNF Claim |
| Parenteral IV Feeding: Level High | +7 | K0510A2 / K0710A2 |
| IV Medication (post-admit) | +5 | O0100H2 |
| Ventilator or Respirator (post-admit) | +4 | O0100F2 |
| Parenteral IV Feeding: Level Low | +3 | K0510A2 / K0710A2 / K0710B2 |
| Lung Transplant Status | +3 | I8000 |
| Transfusion (post-admit) | +2 | O0100I2 |
| Major Organ Transplant Status, Except Lung | +2 | I8000 |
| Multiple Sclerosis | +2 | I5200 |
| Opportunistic Infections | +2 | I8000 |
| Asthma / COPD / Chronic Lung Disease | +2 | I6200 |
| Bone/Joint/Muscle Infections or Necrosis (exc. aseptic necrosis) | +2 | I8000 |
| Chronic Myeloid Leukemia | +2 | I8000 |
| Wound Infection | +2 | I2500 |
| Diabetes Mellitus | +2 | I2900 |
| Endocarditis | +1 | I8000 |
| Immune Disorders | +1 | I8000 |
| End-Stage Liver Disease | +1 | I8000 |
| Diabetic Foot Ulcer | +1 | M1040B |
| Narcolepsy and Cataplexy | +1 | I8000 |
| Cystic Fibrosis | +1 | I8000 |
| Tracheostomy Care (post-admit) | +1 | O0100E2 |
| Multi-Drug Resistant Organism (MDRO) | +1 | I1700 |
| Isolation (post-admit) | +1 | O0100M2 |
| Specified Hereditary Metabolic/Immune Disorders | +1 | I8000 |
| Morbid Obesity | +1 | I8000 |
| Radiation (post-admit) | +1 | O0100B2 |
| Unhealed Pressure Ulcer — Stage 4 (presence) | +1 | M0300D1 |
| Psoriatic Arthropathy and Systemic Sclerosis | +1 | I8000 |
| Chronic Pancreatitis | +1 | I8000 |
| Proliferative Diabetic Retinopathy & Vitreous Hemorrhage | +1 | I8000 |
| Foot Infection / Other Open Foot Lesion (exc. diabetic foot ulcer) | +1 | M1040A / M1040B / M1040C |
| Complications of Specified Implanted Device or Graft | +1 | I8000 |
| Intermittent Catheterization | +1 | H0100D |
| Inflammatory Bowel Disease | +1 | I1300 |
| Aseptic Necrosis of Bone | +1 | I8000 |
| Suctioning (post-admit) | +1 | O0100D2 |
| Cardio-Respiratory Failure and Shock | +1 | I8000 |
| Myelodysplastic Syndromes and Myelofibrosis | +1 | I8000 |
| Systemic Lupus Erythematosus / Connective Tissue / Inflammatory Spondylopathies | +1 | I8000 |
| Diabetic Retinopathy (exc. proliferative) | +1 | I8000 |
| Feeding Tube | +1 | K0510B2 |
| Severe Skin Burn or Condition | +1 | I8000 |
| Intractable Epilepsy | +1 | I8000 |
| Malnutrition | +1 | I5600 |
| Disorders of Immunity (exc. RxCC97 Immune Disorders) | +1 | I8000 |
| Cirrhosis of Liver | +1 | I8000 |
| Ostomy | +1 | H0100C |
| Respiratory Arrest | +1 | I8000 |
| Pulmonary Fibrosis and Other Chronic Lung Disorders | +1 | I8000 |
PDPM NTA comorbidity list (CMS) — points sum into the NTA component. Build an NTA score →
PDGM comorbidity subgroups
Low-comorbidity adjustment is driven by these body-system subgroups; high-comorbidity requires an interacting pair.
Behavioral / NeuroCerebralCirculatoryEndocrineGastrointestinalGenitourinaryHeartInfectious / ImmuneMusculoskeletal / Connective tissueNeoplasmRespiratorySkinCerebral vascular accident (CVA)Blood / Coagulation
Set the level on the PDGM Component Builder →