Risk Adjustment for EDS and RAPS User Group - June 20, 2019

Slide 9 - EDS Overview, Submission frequency
Slides 13-14 - Missing Diagnoses from ED Based Risk Scores, Diagnoses initially accepted from subsets of CRRs and RRBs, Includes resolution for missing diagnosis data
Slide 17 - EDPS Edits, Edit 00699, May 3, 2019 HPMS memo updates bypass conditions of this edit
Slide 19 - EDPS Edits, Edit 01410, Enhancements to validation of Billing Provider Editing (May 3, 2019 memo)
Slide 21 - Risk Score Calculation Runs for 2019, 2020, 2021, Risk Adjustment Data Submission, Deadlines for submitting risk adjustment data
Slide 25 - MBI Implementation, Transition Period for MBIs, Transition period through 12/31/2019
Slide 27 - EDPS Edits, Edit 00825
Slide 28 - Anesthesia Services, Submitting anesthesia services with modifiers
Slides 29-30 - HCC Mappings, Models, Descriptions, HCC Mappings, models, descriptions
Slide 31 - HCC Payment Hierarchy, HCC payment hierarchy applicability for 2020
Slide 33 - Risk Adjustment Data Submission, RAPS inpatient definition
Slide 34 - EDS Submission, Cross-claim line diagnoses and procedure code adjudication, References December 22, 2015 memo on final encounter data diagnosis filtering logic
Slide 35 - Risk Adjustment Filtering Rules, Applicability between Medicare Advantage and PACE
Slide 36 - EDS Submission, Submitting personally identifiable information (PII) or personal health information (PHI)

Last Updated: 06/20/2019

Table of Contents