What Is A Rug Code Cms

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.
What is a rug code cms. Rug 44 rug 53 distribution chart based on cy 2006 data is available for download from the downloads section below. Processing revenue codes revenue code 0169 family care and partnership. If you have questions please contact your humana market contractor representative as soon as possible. The rug iv code which is combined with an assessment indicator to create the hipps.
Report to congress on patient classification under medicare s prospective payment system for skilled nursing facilities 2006 dr. He or she transferred to a medicare certified snf within 30 days after discharge from the hospital unless both of these are true. 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. All other providers should follow cms expectations and schedule of assessments as outlined by the cms rai mds 3 0 and medicare billing manuals.
For additional information about snf pdpm you can visit the cms website opens new window. Reason remark codes acronyms and glossary msp decision tree tools external resources. 31 jul 2018 a list of commonly used acronyms as well as information on 3 hhs fiscal. His or her condition makes it medically inappropriate to begin an active course of treatment in a snf immediately after discharge.
Data validity flags resulting in 640 valid hh hipps codes. For enrollees of a medicare advantage 1876 cost or pace plan. Medicare only accepted the october 2000 hh hipps code set through on claims with a from date before 12 31 2007. Processing revenue codes revenue code 0194 family care pace partnership most commonly used medicaid rug codes 9.
The medicare snf benefit covers skilled system pps rates are expected to note. In addition to the required fields identified in the medicare claims processing manual.