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New Skilled Nursing Facility (SNF) Health Insurance Prospective Payment System (HIPPS) Codes: Error Regarding Skilled Nursing Facility Claims Which Contain Default HIPPS Code of AAA00

Posted on: January 19, 2012

When CMS (Center for Medicare & Medicaid) issued its 2012 Final SNF PPS Rule, it created the new Change of Therapy Other Medicare Required Assessment, referred to as the COT OMRA.  In doing so, CMS also developed a process to allow providers to report a Resumption of Therapy OMRA following an End of Therapy (EOT) OMRA, referred to as an EOT-R OMRA.  The result of the above new OMRAs meant CMS had to create several new Assessment Indicators (AIs) to identify when a COT OMRA was completed, and when an EOT OMRA was completed, accounting for both scenarios of with and without a resumption of therapy. These new AIs are described in the revised RAI Manual, Chapter 6, Section 6.4 – Relationship Between the Assessment and the Claim (pages 5-21).

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Tags: HIPPS Codes