Managing Medicare » Risk Adjustment http://dynamichealthsys.com/blog2 Information, Discussion, and Collaboration To Better Manage Medicare Businesses. Fri, 03 Dec 2010 17:56:46 +0000 en hourly 1 http://wordpress.org/?v=3.0.2 CMS Posts New ICD-9 / HCC Crosswalk for 2011 http://dynamichealthsys.com/blog2/2010/10/01/cms-posts-new-icd-9-hcc-crosswalk-for-2011/ http://dynamichealthsys.com/blog2/2010/10/01/cms-posts-new-icd-9-hcc-crosswalk-for-2011/#comments Fri, 01 Oct 2010 14:11:06 +0000 jbaker http://dynamichealthsys.com/blog2/?p=280 CMS has posted an updated Calendar Year 2011 Model Diagnoses crosswalk on the Risk Adjustment webpage.  The crosswalk incorporates Fiscal Year 2011 ICD-9 code updates that are effective October 1, 2010.  

The crosswalk file link is named “2011 Model Diagnoses” and can be found on the CMS Website here: 

http://www.cms.gov/MedicareAdvtgSpecRateStats/06_Risk_adjustment.asp

]]> http://dynamichealthsys.com/blog2/2010/10/01/cms-posts-new-icd-9-hcc-crosswalk-for-2011/feed/ 0 CMS National Encounter Data Meeting http://dynamichealthsys.com/blog2/2010/09/20/cms-national-encounter-data-meeting/ http://dynamichealthsys.com/blog2/2010/09/20/cms-national-encounter-data-meeting/#comments Mon, 20 Sep 2010 20:52:36 +0000 jbaker http://dynamichealthsys.com/blog2/?p=190 CMS is planning to begin collection of encounter data from Medicare Managed Care Organizations.  Today CMS announced a National Meeting to review the business and technical requirements for encounter reporting to CMS; timelines; impact of ICD-9 to ICD-10 coding and the launch of workgroups.

Each organization is allowed an attendee and additional web seats.  Mark Friday, Oct 29, 2010 at 10am-4:30P Eastern Time on your calendar.  The in person meetings will be at the CMS building in  Baltimore.

Go to their website for details and registration information.

]]> http://dynamichealthsys.com/blog2/2010/09/20/cms-national-encounter-data-meeting/feed/ 0 HEADS UP: CMS To Announce Encounter Submission Meeting in Oct 2010 http://dynamichealthsys.com/blog2/2010/09/15/heads-up-cms-to-announce-encounter-submission-meeting-in-oct-2010/ http://dynamichealthsys.com/blog2/2010/09/15/heads-up-cms-to-announce-encounter-submission-meeting-in-oct-2010/#comments Wed, 15 Sep 2010 16:10:09 +0000 jbaker http://dynamichealthsys.com/blog2/?p=186 During a breakout session at AHIP on September 13, 2010 CMS announced that there will be an October 2010 meeting where CMS will be reviewing the preliminary files, processes and expectations for MA health plans to transition from submitting RAPS files to ‘full encounter’ data.  No details were shared at AHIP, but there is an expected HPMS memo formally announcing this event.  The following guidlines were shared

  • Plans will be allowed to send up to 2 representitives at this event
  • There is an expected parallel submission period where plans will submit both RAPS and Encounter files.  No details on how and what will be monitored
  • Encounter submissions are expected to start 1/1/2012
  • Encounter data will replace RAPS data at some point and will be used for risk adjustment factor scores for Part C and D

None of the above is official from CMS but informally shared at AHIP.  Watch HPMS for details.

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