What Is A Rug Code Cms

Report to congress on patient classification under medicare s prospective payment system for skilled nursing facilities 2006 dr.

What is a rug code cms.

Brant fries presentation 2003 these are slides from the may 2003 presentation by dr. Medicare only accepted the october 2000 hh hipps code set through on claims with a from date before 12 31 2007. For enrollees of a medicare advantage 1876 cost or pace plan. All other providers should follow cms expectations and schedule of assessments as outlined by the cms rai mds 3 0 and medicare billing manuals.

Snf skilled nursing facility rug resource utilization group adl medicare primer crs reports congress gov. In addition to the required fields identified in the medicare claims processing manual. Processing revenue codes revenue code 0194 family care pace partnership most commonly used medicaid rug codes 9. The rug iv code which is combined with an assessment indicator to create the hipps.

If you have questions please contact your humana market contractor representative as soon as possible. Processing revenue codes revenue code 0169 family care and partnership. Data validity flags resulting in 640 valid hh hipps codes. He or she transferred to a medicare certified snf within 30 days after discharge from the hospital unless both of these are true.

A federal government website managed by the centers for medicare medicaid services 7500 security boulevard baltimore md 21244 sign up for email updates data cms gov. Definition and uses of hipps codes see file below 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. Rug 44 rug 53 distribution chart based on cy 2006 data is available for download from the downloads section below. Reason remark codes acronyms and glossary msp decision tree tools external resources.

His or her condition makes it medically inappropriate to begin an active course of treatment in a snf immediately after discharge. Most commonly used medicare rug codes 8.