Capstone Performance Systems offers an array of risk adjustment and Part D services to fit the needs and budget of your organization.

Risk Adjustment Advisor: March 2017

The past few months have been exciting ones for Capstone. We've welcomed several new clients and, to accommodate this growth and better serve all of our clients, we've added new staff members, including Dr. David Wilner. (See below for Dr. Wilner's professional biography.) Last week we met a number of you at the NPA Spring Policy Forum in Washington, DC, and we are looking forward to meeting more of you at conferences and events in the coming months. Read on for more news about Capstone Performance Systems, plus information that you can use in your program.

Richard Schamp, MD CEO
Changing Documentation in the Medical Record

When documenting in the medical record, providers should take care to capture their thoughts and findings as completely as possible. Best practice is to document the patient encounter when rendered, or shortly afterwards. However, situations may require revisions to the medical record, with four types of changes recognized.

David Wilner, MD,    FACP, AGSF
Dr. David Wilner Joins Capstone Performance Systems 

David Wilner, MD, FACP, AGSF, has joined Capstone Performance Systems as senior medical consultant. A clinical professor at University of Massachusetts Medical School, Dr. Wilner previously served as medical director and vice president of Summit ElderCare and Fallon Health and as coordinator of geriatric medicine training at St. Vincent's Hospital in Worcester, Mass. He is a past member of the National Pace Association (NPA) board of directors and former chairman of the NPA's Primary Care Committee. 

In his role as senior medical consultant, Dr. Wilner will provide expertise in clinical documentation improvement and diagnosis coding. He will conduct client staff and provider training in Medicare processes and risk adjustment.  

Dr. Wilner is a graduate of Tufts University School of Medicine and is board certified in geriatric medicine, hospice and palliative medicine, and internal medicine. Among his many honors, Dr. Wilner was the 2013 recipient of Summit ElderCare's "Leading by Example" award and was named Outstanding Medical Educator by St. Vincent Hospital five times.

New ICD-10 Guidelines for the Term "With"

In October 2016, there was an update to the ICD-10 coding guidelines that allows a coder more flexibility in assigning certain codes.  Previously, the guidelines stipulated that if two conditions are related to each other, the provider needs to document their relationship for them to be coded as such.  

A common example is relating a patient's polyneuropathy to their diabetes. We still consider best practice, clinically, to link related conditions together in the documentation. However, the ICD-10 coding guidelines now indicate that if a manifestation listed under "with" in the index is documented as part of the same encounter the coder can assume their relationship despite no documented linkage.

Read more 
Senior TLC, Gastonia, NC
On Target recognizes a client who is showing process improvement from putting Capstone's processes and advice into action.

ICD-10 was the tipping point. CMS's implementation of the new edition of the coding system was the point of no return for Senior Total Life Care (STLC), a PACE organization serving 175 participants in a rural area less than 20 miles outside of Charlotte, North Carolina.

"When the ICD-10 conversion occurred, we thought our staff had the skillset to monitor and code," says Cathy Kenzig, executive director, "but we found out by accident that things had to be manually converted (to the new codes)."

Opioids and PACE

A recent OIG report outlines  concerns about the high proportion of Part D beneficiaries receiving prescription opioids. Partly in response to this report, state and federal governments are changing their prescribing regulations. CareKinesis will host two webinars in May to discuss opioids and PACE:


Opioids: Regulatory Perspectives for PACE

Wednesday, May 10 at 3 pm (ET)

Presenter: Richard B. Greene, PharmD, MBA, Senior Director of Regulatory Affairs

Register here.


Opioids: Clinical Perspectives for PACE

Wednesday, May 24 at 3 pm (ET)

Presenters: Lauren A. Steffen, PharmD, Clinical Pharmacy Liaison and 

David A. Wilner, MD, Senior Medical Consultant, Capstone Performance Systems

Register here.


Upcoming Conferences

Capstone Performance Systems will be sponsoring and/or exhibiting at several conferences and events this year:

April 21: PACE Association of Michigan Business Partners Meet and Greet
 (Lansing, MI)
May 4 - 5: North Carolina PACE Association Annual Conference (Durham, NC)
October 12 - 14: American Academy of Home Care Medicine (AAHCM) 
Annual Meeting (Rosemont, IL)
October 15 - 18: National PACE Association Annual Meeting (Boston, MA)

Be sure to visit us at our booth if you are attending any of these events! If you would like to arrange a private meeting to discuss our services and how we can help your organization ensure compliance and increase revenues, email

Capstone is Hiring!

Capstone Performance Systems is seeking to fill three positions: professional remote medical coder, data engineer, and software engineer. The professional coder will work remotely and can be based in either the St. Louis, Missouri, or Pittsburgh, Pennsylvania, areas. The data engineer and software engineer positions can be based in Moorestown, NJ, or Mt. Pleasant, SC, however a remote arrangement is possible. Details and application information for these and other Tabula Rasa HealthCare positions can be found on TRHC's webpage. TRHC is the parent company of Capstone Performance Systems.

For more information on our services and how we can assist your organization, email or visit

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