PDGM Coding Console

Diagnosis codes

Up to 25 codes. The first one leads unless you choose another.

M1033 · hospitalisation risk

Scores once 4 or more are present, and nothing below that.

Two or more falls, or an injury fall, in the past yearUnintentional weight lossTwo or more hospitalisations in the past six monthsTwo or more emergency department visits in the past six monthsDecline in mental, emotional or behavioural statusDifficulty following medical instructionsTaking five or more medicationsCurrent exhaustionOther risks not listed

0 of 9 present — does not score yet

Points so far—

Timing

Admission source

Worked chart

E11.22I50.32L89.623F33.1Z48.01R26.2M17.10F50.20

Five of these eight codes could lead the claim, and each lands somewhere different.
Two carry a code-first convention. One is too unspecified and the table names its replacement.
A mood disorder together with a stage 3 pressure ulcer gives the high comorbidity tier.

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Built on the published CMS Home Health PPS Grouper Software tables (v07.2.26, effective 2026-10-01) and the CY2026 HH PPS Final Rule (CMS-1828-F). Grouping is checked against CMS’s own published test charts. Not an official CMS product; not certified, endorsed or approved by CMS. Output is a coding aid, not a billing determination or clinical advice. No payment amounts, case-mix weights or rates are shown.