IRF-PAI Accuracy Training Platform

The Best Clinician: IRF-PAI Coordinator (RN or Therapist)

With specific qualifications and training

The ideal clinician to ensure IRF-PAI accuracy is a **dedicated IRF-PAI Coordinator** who is either a Registered Nurse (RN) or a licensed therapist (PT, OT, or ST) with specialized training in IRF coding, medical record documentation, and CMS compliance. This role should be their PRIMARY responsibility, not an add-on to clinical duties.

Why This Role Works Best:

• Has clinical knowledge to understand diagnoses, comorbidities, and functional status
• Can interpret medical record documentation accurately
• Understands rehabilitation goals and therapy interventions
• Has dedicated time to complete thorough quality checks
• Can serve as liaison between physicians, therapists, and nursing

Clinician Role Comparison for IRF-PAI Completion

Evaluating which clinician is best suited for accurate IRF-PAI coding

Clinician Role	Strengths	Limitations	Recommended?
IRF-PAI Coordinator (RN/Therapist)	✓ Dedicated time for accuracy ✓ Specialized training ✓ Holistic view of patient ✓ Can coordinate with all disciplines	Requires dedicated FTE	YES
Rehabilitation Physician	✓ Medical expertise ✓ Diagnosis authority ✓ Understands comorbidities	✗ Limited time for coding ✗ Not trained in IRF-PAI specifics ✗ May not know functional scores	NO
Physical Therapist (PT)	✓ Knows functional status ✓ Understands therapy minutes ✓ Clinical assessment skills	✗ Primary role is patient treatment ✗ May lack medical coding knowledge ✗ Limited time for documentation review	MAYBE If dedicated time
Registered Nurse (RN)	✓ Medical record expertise ✓ Understands comorbidities ✓ Coordinates care across disciplines	✗ May lack therapy knowledge ✗ Primary role is patient care ✗ Limited time if floor nurse	MAYBE If dedicated time
Medical Coder (Non-Clinical)	✓ ICD-10 coding expertise ✓ Attention to detail ✓ Dedicated time	✗ No clinical background ✗ Can't assess functional status ✗ May not understand rehabilitation	NO
Case Manager	✓ Knows discharge planning ✓ Coordinates with team ✓ Medical record access	✗ Primary focus is discharge planning ✗ May lack IRF-PAI training ✗ Limited clinical assessment	NO

Required Qualifications for IRF-PAI Coordinator

Minimum Requirements:

☐ RN license OR PT/OT/ST license (active and in good standing)
☐ Minimum 2 years experience in inpatient rehabilitation
☐ Knowledge of ICD-10 coding principles
☐ Understanding of CMS IRF regulations
☐ Strong attention to detail and analytical skills
☐ Excellent communication skills across disciplines

Preferred Qualifications:

• Certified Rehabilitation Registered Nurse (CRRN)
• Certified Coding Specialist (CCS or CCS-P)
• Previous IRF-PAI coordinator experience
• Experience with MAC audits and appeals
• Knowledge of quality improvement methodologies
• Proficiency with electronic medical records

Comprehensive Training Program for IRF-PAI Coordinator

Phase 1: Foundational Knowledge (Week 1-2)

• CMS IRF-PAI Manual review (all chapters)
• IRF regulations and compliance requirements
• 60% Rule and presumptive compliance
• Medical necessity criteria

Phase 2: Coding Skills (Week 3-4)

• ICD-10 coding principles and specificity
• IGC code assignment and RIC tiers
• Comorbidity identification and counting
• Functional status assessment and scoring

Phase 3: Quality Control (Week 5-6)

• Medical record documentation review
• Cross-checking IRF-PAI against source documents
• Common errors and how to prevent them
• Peer review and quality assurance processes

Phase 4: Audit Readiness (Week 7-8)

• MAC audit process and common findings
• Responding to audit requests
• Internal audit procedures
• Case studies and practice scenarios

Collaborative Team Approach

While the IRF-PAI Coordinator leads accuracy efforts, success requires team collaboration

Physician's Role:

• Document specific diagnoses
• Sign PAS before admission
• Complete face-to-face visits
• Participate in IDT meetings

Therapists' Role:

• Conduct accurate functional assessments
• Document therapy minutes
• Provide clear progress notes
• Communicate with coordinator

Nursing's Role:

• Complete admission assessments
• Document comorbidities
• Monitor patient status
• Support functional assessments