The HIPPS would be 01. The first link is to the Medicare Claims Processing Manual Chapter 6 - SNF Inpatient Part A Billing
it lists all the valid HIPPS and 51 is not listed there, however 01 is listed for a Medicare 5-day assessment. The second link is to an older transmittal 4/30/01 which on page 5 has a great grid which lists the AA8A and AA8B values down one side and the HIPPS down the other, Your exact example is listed there as 01.
There is a blurb in the new claims manual stating "From the standpoint of Medicare payment, it does not matter if Medicare-required assessments are also used to fulfill the clinical requirements for an SCSA or a Quarterly Assessment."30.1
http://cms.hhs.gov/manuals/104_claims/clm104c06.pdf
http://www.snfinfo.com/content/a0156.pdf
Good Luck!!
-----Original Message-----
From: Vogt, Kathy [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, December 03, 2003 4:23 PM
To: [EMAIL PROTECTED]
Subject:
I had a resident who was readmitted from the hospital to medicare. Her 5
day assessment fell in the time period that her quarterly was due. She was
not a signficant change. She just needed PT/OT for endurance. That was the
only change. She stayed on medicare for 7 days. When I opened the
assessment, I coded it for quarterly and 5 day. When I transmitted to state
it was accepted. Now in closing the end of month for billing, the software
did not pull a Hipps modifier. I can't find a Hipps modifier for this.
Help!!
Would I manually enter 5/1?
Kathy Vogt, RN
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