PyPDPM 0.0.5.5

A Python library for dealing with PDPM HIPP codes

PyPDPM

Tools for working with the CMS case-mix classification model, payment driven payment model (PDPM). Deatils about PDPM can be found here: https://www.cms.gov/medicare/medicare-fee-for-service-payment/snfpps/pdpm.

If you are interested in helping contribute to this repository, or have any questions, feel free to send me an email.

Usage

Basic usage includes three primary tasks while dealing with PDPM HIPPS codes.

• Retrieving reimbursement amounts for specific HIPPS codes

• Generating HIPPS codes from patient information

• Generating patient information from HIPPS codes

PDPM Mappings

Revenue per diem for Medicare patients is calculated through PDPM HIPPS codes. The table below summarizes each component of the HIPPS codes where columns 1 to 4 represent the payment groups for characters 1-4 (of five) in the PDPM HIPPS code.

PT/OT	SLP	NURS	NPG	Code Value
TA	SA	ES3	NA	A
TB	SB	ES2	NB	B
TC	SC	ES1	NC	C
TD	SD	HDE2	ND	D
TE	SE	HDE1	NE	E
TF	SF	HBC2	NF	F
TG	SG	CBC2		G
TH	SH	CA2		H
TI	SI	CBC1		I
TJ	SJ	CA1		J
TK	SK	BAB2		K
TL	SL	BAB1		L
TM		HBC1		M
TN		LDE2		N
TO		LDE1		O
TP		LBC2		P
		LBC1		Q
		CDE2		R
		CDE1		S
		PDE2		T
		PDE1		U
		PBC2		V
		PA2		W
		PBC1		X
		PA1		Y