Risk Adjustment for EDS and RAPS User Group - February 22, 2018

Slides 7-14 - EDS Submission Overview, PY 2018 Submission Deadlines, Memos describing deadlines for data submission and RAPS deletion
Slides 17-18, 20 - ED & RAPS Submission, MBI Implementation Impact, RAPS error codes, EDS duplicate logic
Slide 19 - MOR, MBI Implementation Impact, MORs will contain the MBIs for all beneficiaries starting 1/1/2020
Slide 20 - EDS Overview, MBI vs HICN, HICN and MBI crosswalk file
Slides 22-23 - MOR, Record Types, Frequently Asked Question
Slide 23 - MOR, CMS-HCC Risk Adjustment Model, Why MORs are sent monthly
Slide 24 - CMS-HCC Risk Adjustment Model, Proposed mappings, Frequently Asked Question, location of proposed ICD-10 to HCC mappings
Slide 25 - MMR, Description, explanation of adjustments, Frequently Asked Question, adjustment that changes the value of entitlement
Slide 25 - MMR, Eligibility and Enrollment, Why MMRs can contain adjustments that change Part A and B entitlement value
Slide 26 - MOR, ICD-10 to HCC mapping, Separate record types for HCCs based on diagnoses from RAPS and from ED
Slide 26 - MOR, Record Types, Frequently Asked Question, which MOR reports use RAPS and which use EDS
Slide 27 - CPT/HCPCS Codes, Accessing CPT codes, Frequently Asked Question, CMS does not produce HCPCS codes
Slide 27 - CPT/HCPCS Codes, HCPCS code set changes

Last Updated: 02/22/2018

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