oc8f38lb2bdx~notused~CSSC Operations will be closed Monday, January 18, 2021 in observance of the Martin Luther King Jr. holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~none~_blank~blue~01-12-2021 12:40~01-20-2021 06:00||oc8f38lb2bcc~notused~CSSC Operations will be closed Monday, May 31, 2021 in observance of the Memorial day holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~none~_blank~blue~05-27-2021 12:40~06-01-2021 06:00||cje8ri2xp9zd~notused~CSSC Operations will be closed Monday, July 5, 2021 in observance of the Independence Day holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~~_blank~blue~07-01-2021 06:00~07-06-2021 06:00||cje8ri2xp9dd~notused~CSSC Operations will be closed Monday, September 6, 2021 in observance of the Labor Day holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~~_blank~blue~09-03-2021 06:00~09-07-2021 06:00||3samv18vpxkk~notused~CSSC Operations will be closed Thursday, November 25, 2020 and Friday, November 25, 2020 in observance of the Thanksgiving holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~none~_blank~blue~11-23-2021 07:00~11-28-2021 07:00||p35y937gpjsx~notused~CSSC Operations will be closed Friday, December 23, 2021 and Monday, December 27, 2021 in observance of the Christmas holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions~none~_blank~blue~12-22-2021 07:00~12-28-2021 07:00||vpphkwmwueaa~notused~CSSC Operations will be closed Friday, December 31, 2021 in observance of the New Year's Day holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~none~_blank~blue~12-28-2021 07:00~01-02-2022 07:00
Why do some diagnoses appear on the MAO-004 reports showing as accepted and allowed, but do not appear on the 2019 Initial payment MOR?
Answer:
There are a number of reasons why the Hierarchical Condition Category (HCC) for a diagnosis reported as accepted and allowed on the MAO-004 report would not appear on the Initial payment Model Output Report (MOR). A diagnosis code that is added and allowed is considered for risk adjustment and will appear on the MOR. While the MAO-004 reports all diagnosis codes submitted on accepted encounters not all diagnosis codes reported map to a payment HCC. In addition, it is possible that there is a diagnosis that maps to a payment HCC that is higher in a hierarchy and thus a lower severity HCC in the same hierarchy would not be included in the risk score for payment. The MOR reports HCCs after the hierarchies are applied, therefore the lower severity HCC that was excluded for payment will not be reported on the MOR. Please also ensure that the diagnosis was submitted on an encounter with dates of service within the submission window for the [payment year’s] Initial and was not deleted by a subsequent replacement or chart review delete.