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The 2017 PPS Final Rule Releases Grouper Updates on How Pulmonary Diagnoses Will Earn Case-Mix Points Next Year

Posted on Thursday, November 17, 2016 2:43 PM

At first, the 2017 PPS final rule brought a lot of shock with adding back points to the previously-gutted equations for pulmonary disorders. Now, everyone seems to be on board.

Two years ago, these diagnoses lost eligibility for clinical points. Now, they have the possibility to earn one point based on episode timing and therapy utilization.

As of October 31, the rule was posted. The strange thing about the addition was that there are no respiratory diagnoses that currently earn case-mix points.

The Grouper updates were posted on November 2, showing 11 pulmonary codes that included the following:
• J43.9 (Emphysema, unspecified)
• J44.1 (Chronic obstructive pulmonary disease with (acute) exacerbation)
• J44.9 (Chronic obstructive pulmonary disease, unspecified)
• These codes will be eligible to earn case-mix points starting January 1

Corridor’s Coding Services offers ICD-10 coding, multi-level OASIS reviews, Clinician documentation review, as well as trends and reporting. Contact us to learn more.

For the full article, please see the November 21, 2016 Home Health Line Edition.


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