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Title
Files for FY 2011 Final Rule and Correction Notice
Fiscal Year
2011
Type of File
Tables and Data Files
Description
See Below

1. Impact File: This file contains data elements by provider that were used in calculating the FY 2011 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 2011 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 March 2010 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 2011. 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. Section 1109 Files: Contains one excel file with the following files/tables: List of All Counties; Section 1109 Eligible Counties; Section 1109 Qualifying Hospitals; Section 1109 Compilation of Payments

9. Medicare Discharge Count for FY 2011 Low Volume Adjustment: FY 2009 Medicare Discharge Discount for determining Eligibility for the FY 2011 Low Volume Adjustment in section 412.101

10. Table 1A - 1E: This excel spreadsheet contains the FY 2011 Operating and Capital National and Puerto Rico Specific Standardized Amounts. Additionally, there are two text files corresponding to each tab in the spreadsheet to meet Section 508 compliance.

11. Tables 2, 3A, 3B, 4A, 4B, 4C, 4D-2, 4E, 4F, 4J, 9A, 9C (Wage Index Tables) and Wage Index Date Files: Contains two zip files: FY 2011 Wage Index Tables and the following data files: 1. FY 2011 Final Rule Wage Index PUFs; 2. FY 2011 Final Rule Average Hourly Wage by Provider and CBSA Public Use File; 3. FY 2011 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages by Provider; 4. FY 2011 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA; 5. FY 2011 Final Occupational Mix Factor by Provider PUF; 6. FY 2011 Final Rule AHW by Provider Area Listing; 7. Three Year MGCRB Reclassification Data for FY 2012 Applications

12. Table 5: List of MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay

13. 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.

14. Tables 7A and 7B: Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 27 and MS-DRGs, version 28 as published in the Federal Register. Additionally, there are two text files corresponding to each tab in the spreadsheet to meet Section 508 compliance.

15. Tables 8A, 8B and 8C: Tables 8A and 8B contain the FY 2011 IPPS operating and capital statewide average cost-to-charge-ratios as published in the Federal Register. Tables 8C contains the FY 2011 LTCH statewide average cost-to-charge-ratios as published in the Federal Register. Additionally, there are three text files corresponding to each tab in the spreadsheet to meet Section 508 compliance.

16. Table 10: Table 10 contains the cost thresholds by MS-DRG for the cost criteria for new technology add on payment applications for FY 2012. Additionally, there is a text file corresponding to the table to meet Section 508 compliance.

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