Home Health & Hospice Week

Learn these 2 additional categories for ostomies.

The Centers for Medicare & Medicaid Services' final rule on the prospective payment system not only expands diagnoses in the existing case mix diagnosis groups, it multiplies the number of groups more than five-fold.

Instead of the current four case mix diagnosis groups (neurological, orthopedic, diabetes and burns and trauma), the rule expands and breaks diagnoses out into these 22 new groups including hundreds of codes:

Blindness and low vision
Blood Disorders
Cancer and selected benign neoplasms
Diabetes
Dysphagia
Gait Abnormality
Gastrointestinal Disorders
Heart Disease
Hypertension
Neuro 1 - Brain disorders and paralysis
Neuro 2 - Peripheral neurological disorders
Neuro 3 - Stroke
Neuro 4 - Multiple Sclerosis
Ortho 1 - Leg disorders
Ortho 2 - Other orthopedic disorders
Psych 1 - Affective and other psychoses, depression
Psych 2 - Degenerative and other organic psychiatric disorders
Pulmonary disorders
Skin 1 - Traumatic wounds, burns and post-operative complications
Skin 2 - Ulcers and other skin conditions
Tracheostomy care (new from proposed)
Urostomy/Cystostomy care (new from proposed)

Note: For specific case mix codes, see Table 2B in the PPS refinements final rule at www.cms.hhs.gov/quarterlyproviderupdates/downloads/cms1541fc.pdf.