This instruction contains new hipps codes resulting from the conversion to the new rug iv coding system.
Mds rugs codes.
Mds 3 rug iii version 5 12 44 grouper.
During the passage of the patient protection and affordable care act aca congress delayed the.
The hcpcs rates field must contain a 5 digit hipps code.
Do not code anything on the mds that did not occur during the observation period.
Minimum data set supportive documentation guidelines rug iii version 5 12 34 grouper june 1 2012.
2 a manual calculator module in the grouper program that allows the user to enter the rug iii mds items on screen and then view the resulting.
If you have questions please contact your humana market contractor representative as soon as possible.
Mds 3 0 rug iv decision tree 48 grouper.
Elimination of mds schedule 2.
Change request process see file below describes the steps necessary to request a modification in the hipps codeset and the cms code approval process.
Rug iii version 5 2 calculator worksheet 34 group model.
Rug iii version 5 12 grouper package files.
For a complete list of ai codes see page 22.
Contents include 1 a dos grouper program that will update rug iii classifications in an mds 2 0 submission file in standard cms format.
Hipps code master list see file below an excel spreadsheet that provides a complete list of all valid hipps codes with their effective dates payment settings and code definitions.
Mds 3 rug 53 groups.
The 5 digit hipps code includes two components.
Originally the corresponding updated resource utilization group rug iv reimbursement methodology was supposed to be implemented the same day.
Mds 3 0 rug iv decision tree 48 grouper minnesota case mix system.
The first three positions of the code contain the rug group and the last two positions of the code contain a 2 digit assessment indi cator ai code.
The attached file contains the list of the newly added hipps codes.
Rug iii m3pi version 5 12b is located in the downloads section.
The implementation of the new minimum data set instrument mds 3 0 is scheduled for oct.
The medicare required pps assessment schedule includes 5 day 14 day 30 day 60 day and 90 day scheduled assessments.
The 3 digit classification code assigned to each rug group and newly defined 2 digit assessment.
Rug iii mds 3 0 mapping specifications v1 00 5 this document presents logic that can be used to produce rug iii classifications using assessment items contained on mds 3 0 and accommodates item set changes for assessments on or after october 1 2013 as well as earlier assessments.
All other providers should follow cms expectations and schedule of assessments as outlined by the cms rai mds 3 0 and medicare billing manuals.
Optional interim payment assessment.
Cover the observation look back period which is the time period when the resident s condition is captured by the mds assessment.
