The Centers for Medicare and Medicaid Services (CMS) recently developed a new Change of Therapy (COT) Other Medicare Required Assessment (OMRA) for the skilled nursing facility (SNF) prospective payment system (PPS) and a mechanism to allow providers to report a Resumption of Therapy on an End of Therapy (EOT) OMRA. In addition, several new Assessment Indicators (AIs) were created to identify that a COT OMRA was completed and also to distinguish between cases where an EOT OMRA is performed with the resumption items completed and cases where an EOT OMRA is completed without the resumption items completed. The new AIs were introduced in chapter 6, section 6.4, of the new Minimum Data Set (MDS) manual.
As a result of these new AIs, CMS must add approximately 1,500 new Health Insurance Prospective Payment System (HIPPS) codes to the Fiscal Intermediary Shared System. The HIPPS master list will be updated within the next 2 weeks with these new codes.
SNF and swing bed providers should continue to use HIPPS codes assigned by grouper on their claims.