List Of Rugs Codes

The attached file contains the list of the newly added hipps codes.
List of rugs codes. Due to rounding a slight variance may exist between the spreadsheets below and actual medicare payments. Feb 11 2013 the new hipps codes that will be added to the medicare s claims result from the addition of 9 new resource utilization group iii rug iii. This material is provided for educational purposes only and is not intended for medical advice diagnosis or treatment. Effective october 1 2017 excel.
Within any software product service solution or derivative work without the written consent of the aha. Aha copyrighted materials including the ub 04 codes and descriptions may not be removed copied or utilized. Medicare resource utilization group iv rug hipps codes and. Change request process see file below describes the steps necessary to request a modification in the hipps codeset and the cms code approval process.
Medicare must include a list of medications related to the injured worker s allowed appropriate bwc local level code for nursing facility. The hcpcs rates field must contain a 5 digit hipps code. The first three positions of the code contain the rug group and the last two positions of the code contain a 2 digit assessment indicator ai code. Rux ultra high intensity.
Resource utilization groups rugs rugs are mutually exclusive categories that reflect levels of resource need in long term care settings primarily to facilitate medicare and medicaid payment they are assigned to individuals based on data elements derived from the ltc minimum data set mds there is a standard order or hierarchy and each rug. 11 16 64 64 rvl 2 10 62 62 rhx high intensity. If an entity wishes to utilize any aha materials please contact the aha at 312 893 6816. Effective october 1 2015 excel.
Major rug group rug code hierarchical classification adl score case mix index set e01 rural case mix index set e02 urban rehab plus extensive. 11 16 66 66 rul 2 10 65 65 rvx very high intensity. 4 apr 2020 the centers for medicare medicaid services cms recognizes that the. Access the listings of resource utilization groups rugs for skilled nursing facilities snfs from the links below.
Effective october 1 2014 excel. The rug iv system 66 groups that was discussed in detail in the proposed and final rules cms manual system. This three digit rug code coupled with the two digit ai code bulletin number. Medicare requires providers to submit snf bills with occurrence code 70 code.
Hcbs waiver dhcf dc gov. Aug 27 2007 listed below are a number of specific circumstances under which a assessment associated with the rug code obtained from the. 11 16 63 63 rhl 2 10 57 59 rmx medium intensity. Data sources include ibm watson micromedex updated 1 oct 2020 cerner multum updated 1 oct 2020 wolters kluwer updated.