CMS-1608-P

Submitted by Matthew.Gregor… on Mon, 11/04/2019 - 07:37
Regulation No.
CMS-1608-P
Title
Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2015
Year
2015
Publication Date
2014-05-07

This rule can be viewed from here - CMS-1608-P


The associated files to this rule, as described below, can be downloaded from here:  FY 2015 IRF PPS Proposed Rule Data Files (ZIP)

  • IRF Rate Setting Proposed Rule 
    This file contains data for each of the 1,140 inpatient rehabilitation facilities used to estimate the proposed policy updates in the proposed inpatient rehabilitation prospective payment system regulation. The proposed methodology used to update the payment data is described in detail in the proposed rule.
  • Case-Mix Groups, Proposed Relative Weights, and Proposed Average Length Of Stay Values used in the proposed rule (79 FR 26308) and the standard deviations from the average lengths of stay.
  • IRF Wage Index Proposed Rule
    These files contain the urban and rural Core-Based Statistical Area proposed FY 2015 IRF wage index tables.
  • ICD-9-CM to ICD-10-CM Code Translation and the Use of Combination Codes in the IRF PPS
    This file contains a document that outlines the use of combination diagnosis codes in the IRF PPS for the following ICD-10-CM code lists:  Tier Comorbidities, Codes That Meet Presumptive Compliance Criteria, and Impairment Group Codes That Meet Presumptive Compliance Criteria
  • Draft Tier Comorbidities – ICD-10-CM
    This file contains the list of diagnoses (ICD-10-CM codes) that we propose to use to determine placement in tiers for IRF discharges, effective when ICD-10-CM becomes the required medical data code set for use on Medicare claims and IRF-PAI submissions. It contains the ICD-10-CM codes, the abbreviated code labels, the appropriate tier, and any RICs for which the ICD-10-CM codes are excluded from the tiers.
  • Draft Codes That Meet Presumptive Compliance Criteria — ICD-9-CM (for compliance review periods beginning on or after October 1, 2014)
    This file contains the list of diagnoses (ICD-9-CM codes) that are used for determining presumptive compliance with the IRF 60 percent rule. (Effective for compliance review periods beginning on or after October 1, 2014.) It contains the ICD-9-CM codes and the code labels.
  • Draft Codes That Meet Presumptive Compliance Criteria — ICD-10-CM
    This file contains the list of diagnoses (ICD-10-CM codes) that are used for determining presumptive compliance with the IRF 60 percent rule, effective when ICD-10-CM becomes the required medical data code set for use on Medicare claims and IRF-PAI submissions. It contains the ICD-10-CM codes and the code labels.  Note that this list will only be used for compliance review periods beginning on or after October 1, 2014 if ICD-10-CM is the required medical data code set for use on Medicare claims and IRF-PAI submissions at that time.  Otherwise, please refer to the Draft Codes That Meet Presumptive Compliance Criteria – ICD-9-CM.
  • Draft Impairment Group Codes That Meet Presumptive Compliance Criteria — ICD-9-CM (for compliance review periods beginning on or after October 1, 2014) 
    This file contains the list of impairment group codes that meet presumptive compliance criteria for the 60 percent rule. (Effective for compliance review periods beginning on or after October 1, 2014.) It contains the ICD-9-CM codes excluded from the impairment group codes and the code labels.
  • Draft Impairment Group Codes That Meet Presumptive Compliance Criteria — ICD-10-CM
    This file contains the list of impairment group codes that are used for determining presumptive compliance with the IRF 60 percent rule, effective when ICD-10-CM becomes the required medical data code set for use on Medicare claims and IRF-PAI submissions. It contains the ICD-10-CM codes excluded from the impairment group codes and the code labels.  Note that this list will only be used for compliance review periods beginning on or after October 1, 2014 if ICD-10-CM is the required medical data code set for use on Medicare claims and IRF-PAI submissions at that time.  Otherwise, please refer to the Draft Impairment Group Codes That Meet Presumptive Compliance Criteria – ICD-9-CM.