Diagnosis · Mapper
ICD-10 → PDPM Mapper
Look up a SNF primary diagnosis (MDS I0020B) to see its PDPM clinical category and the collapsed PT/OT category. Exact when the CMS file is loaded; otherwise curated codes are exact and the rest are estimated from the ICD-10 chapter.
Data statusBeta
- Status
- Beta
- Data year / effective
- ICD-10-CM FY2026
- Last reviewed
- June 2026
- Last updated
- June 2026
- Primary source
- ICD-10-CM (CMS/CDC); PDPM/PDGM grouper logic
- Known exclusions
- Not a substitute for the CMS grouper or payer validation
- Curated / partial mapping where the official file is not loaded
- ICD-10-CM updates annually (Oct 1)
Beta / Reference Only — not a substitute for the CMS grouper or payer validation.
Primary diagnosis
The primary diagnosis maps to 1 of 10 PDPM clinical categories, which collapse into 4 PT/OT categories. A surgical procedure recorded in MDS section J can upgrade a fracture code to a surgical category.
