Rugs Iv Classification System

Use the hierarchical classification worksheet in chapter 6 of the rai manual.

Rugs iv classification system.

This method is stemming from the snf pps fy2012 final rule and was previously rug iii. 2018 rai user s manual and mds coding updates objectives. 1 hierarchical classification and 2 index maximizing classification. There are two basic approaches to rug iv classification.

For rug iv classification in either of the two following cases. Rug iv cheat sheet rug iv classification system 66 group with medicare case mix indices for 10 1 2010 rug iv grouper overview. Major rug iv category rug iv score characteristics associated with major rug iv category rehabilitation plus extensive services rux rul rvx rvl rhx rhl rmx rml rlx residents satisfying all of the following three conditions. Resident qualifies as depressed yes no rug iv adl score depressed rug iv class 15 16 yes he2 15 16 no he1.

The guide also includes the calculation to determine the resident s late loss adl score. 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. Payment is determined by categorizing patients into groups based on their care and resource needs. The current worksheet was developed for the hierarchical methodology.

Having a minimum activity of daily living adl dependency score of 2 or more. Instructions for adapting this worksheet to the index maximizing approach are included below see index maximizing classification. Determine all of the rug iv groups for which a resident qualifies not just the first group for which the resident qualifies. The d0300 total severity score is greater than or equal to 10 but not 99 or the d0600 total severity score is greater than or equal to 10.

Rug iv is a patient classification system for skilled nursing patients used by the federal government to determine reimbursement levels. Rug iv classification system 66 group with medicare case mix indices for 10 1 2010 instructions. Logic version 1 03 and code version 1 03 0 july 18 2013. Category i extensive services while a resident.

In may 2017 cms released an advanced notice of proposed rulemaking anprm which outlined a new case mix model the resident classification system version i rcs i that would be used to replace the existing rug iv case mix model used to classify residents in a covered part a stay into payment groups under the snf pps.