Encounter Data Submission of HIPPS Codes

CMS has issued a notification informing Medicare Advantage Organizations (MAOs) and PACE plans that the HIPPS codes requirements for submission of skilled nursing facility and home health agency encounter data scheduled for Dec. 1, 2013 have been delayed.

“MAOs and other entities were instructed that effective Dec. 1, 2013 dates of service (DOS), the disposition for the HIPPS codes edits would be changed from ‘Informational’ to ‘Reject’ for any Skilled Nursing Facility (SNF) and Home Health (HH) encounters submitted without the appropriate HIPPS codes. The purpose of this notification is to let you know that the Dec. 1, 2013 DOS ‘Reject’ edit will be delayed to July 1, 2014 DOS. The ‘Informational’ edit for HIPPS codes would remain in place until that time.”

MAOs and other entities are required to proceed with submitting HIPPS codes if they have them.  They are expected to notify SNFs and home health agencies of this change.

Contact:  Michelle Synakowski, msynakowski@leadingageny.org, 518-867-8850