To All Clients:Release 1.2.9.6 ChangesRegulatory Data File UpdatesNew PDGM Grouper effective 4/1/2023
New/Updated Diagnosis records effective 4/1/2023NY Medicaid EPS

The NY Medicaid EPS Grouper has been altered to use responses for certain OASIS questions from the most recent SOC/ROC when scoring the recert (RFA 4) assessment due to these questions not being present in OASIS-E, per NY DOH.  NY Medicaid 2023 recert claims that were grouped prior to this release should be un-billed and re-posted to calculate the corrected HIPPS. Contact NY Medicaid to confirm the process to send corrected claims for this issue.

Medicare Home Health Claims with KX ModifierWhen creating the electronic NOA, if a HomecareNOA bill data item is present in the Patient > Insurance tab, the KX modifier and Bill Note will be generated on any claim whose Period Start Date is prior to the Date entered in the HomecareNOA record. It is no longer necessary to enter multiple HomecareNOA Bill Data records for each period.

Refer to Help > Release Info for a complete list of program changes included in this release.




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