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Title
Files for FY 2010 Final Rule and Correction Notice
Fiscal Year
2010
Type of File
Tables and Data Files
Description
See Below
  1. Impact File (3 files: Final Rule, Correction Notice and Implementation of PPACA): This file contains data elements by provider that were used in calculating the FY 2010 rates and impacts.
  2. AOR/BOR File: This zip file contains two excel spreadsheets, one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two files containing the variable descriptions. The variables in these files are used in the calculations of the relative weights as well as other calculations for the inpatient PPS. All text files in the zip file are for 508 compliance.
  3. Case Mix Index File: This file contains FY 2010 final hospitals' case mix indexes (CMI) for discharges. A hospital's CMI represents the average diagnosis-related group (DRG) relative weight for that hospital. It is calculated by summing the DRG weights for all Medicare discharges and dividing by the number of discharges.
  4. Historical DRG Weight File: DRG weights and other data since the inception of Inpatient PPS (See imbedded header for each year for layout).
  5. Standardizing File: This file is used to standardize charges for the rate building process.
  6. County to CBSA Crosswalk File: This file lists the CBSA, SSA county code and FIPS county code for all counties. Any changes to the CBSAs through July 2009 have been incorporated. It also contains the old MSA (based on 1990 census data) and old MSA name to which each county was assigned prior to the implementation of CBSAs in FY 2005.
  7. Definition of Medicare Code Edits: This file contains a description of each coding edit with corresponding ICD-9-CM code lists. There are two chapters in this file. The first chapter contains all the edits and the code lists for FY 2010. The second chapter summarizes, by edit, the changes in the edit code list from the last release of the MCE. This document is 508 compliant.
  8. Table 1A - 1E Final Rates for FY 2010; First and Second Half Rates for FY 2010: Due to section 3401 of the Affordable Care Act, we issued updated rates for the second half of FY 2010. The spreadsheet in the "Downloads" section below contains two tabs; the 1st tab contains the standardized amounts for the 1st half of FY 2010; the second tab contains the standardized amounts for the second half of FY 2010.
  9. Wage Index Tables Pre and Post Implementation of PPACA: Due to the Patient Protection and Affordable Care Act (PPACA), as amended by the HCERA, we issued revised wage index tables for the second half of FY 2010. The zip file below in the downloads section contains two zip files. The first zip file contains wage index tables from the FY 2010 Final Rule which reflect the corrected wage indices from the correction notice published on October 7, 2009 (1406-CN) and changes updated on Pricer in November of 2009. These tables are effective for discharges on or after October 1, 2009-March 30, 2010. The second zip file contains revised wage index tables as a result of the PPACA and is effective for discharges on or after April 1, 2010-September 30, 2010. There are some exceptions to the effective date of some tables and users should read the description tab within spreadsheet for further details. Text files included in each zip file are for 508 compliance.

  10. Table 5: List of MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay
  11. Tables 6A-6K: Tables 6A -6F: List of new, revised, and deleted ICD-9-CM diagnosis and procedures codes and MS-DRG assignments; Tables 6G contains the Additions to the CC Exclusions List; Table 6H contains the Deletions from the CC Exclusions List. Table 6I contains the complete MCC list; Table 6I.1 contains the additions to the MCC list; Table 6I.2 contains the deletions to the MCC list; Table 6J contains the complete CC list; Table 6J.1 contains the additions to the CC list; Table 6J.2 contains the deletions to the CC list; Table 6K contains the Complete list of CC exclusions for the MS-DRGs; All files are 508 compliant.
  12. Tables 7A and 7B: Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 26 and MS-DRGs, version 27 as published in the Federal Register. Additionally, there are two text files corresponding to each tab in the spreadsheet to meet Section 508 compliance.
  13. Tables 8A and 8B: Tables 8A and 8B contain the final FY 2010 IPPS operating and capital statewide average cost-to-charge-ratios as published in the Federal Register. Additionally, there are two text files corresponding to each tab in the spreadsheet to meet Section 508 compliance.
  14. Table 10 (Revised Due to PPACA): Due to section 3401 of the Affordable Care Act, we revised Table 10 with the leatst thresholds. Table 10 contains the final cost thresholds by MS-DRG for the cost criteria for new technology add on payment applications for FY 2011. Additionally, there is a text file corresponding to the table to meet Section 508 compliance.