SNF PEPPER Data Elements Revealed

Share: 

New call-to-action

SNF PEPPER Data Elements Revealed

The 9th Edition of the SNF PEPPER User’s Guide, posted yesterday 3.30.2021 with definition of the PDPM High Utilization Codes Target Area.  Facility specific SNF PEPPER is due for release on or about April 5th, 2021.  HHI can assist with a free Compliance PEPPER analysis. 

 

Here are the definitions for each one:

 

Target Area

Target Area Definition

PDPM High Utilization Codes

 

*new as of the Q4FY20 release

N: Count of SNF claims where the first digit of the Health Insurance Prospective Payment System (HIPPS) code, representing the Physical and Occupational Therapy component, is one of the following: C,D,G,G,K,L,O,P.

 

D: Count of all SNF claims

20-Day Episode of Care

N: count of episodes of care ending in the report period with a LOS of 20 days

 

D: count of all episodes of care ending in the report period

90+ Day Episodes of Care

N: count of episodes of care ending in the report period with a LOS of 90+ days

 

D: count of all episodes of care ending in the report period

3- to 5-Day Readmission

 

*new as of the Q4FY19 release

N: count of readmissions within three to five calendar days (four to six consecutive days) to the same SNF for the same beneficiary (identified using the Health Insurance Claim number) during an episode that ends during the report period

 

D: count of all claims associated with SNF episodes ending during the report period, excluding patient discharge status code 20 (expired) (See Appendix 1)

 PEPPER45

 

 Click below to download the 9th Edition of the SNF PEPPER User’s Guide.

Download 9th Edition PEPPER SNF User's Guide 

 

Harmony Healthcare International (HHI) is available to train your staff on MDS. HHI is happy to present you with our 8-week MDS Bootcamp hosted virtually for 1-hour each Wednesday, May 5, 2021 - June 23, 2021. This weekly MDS Bootcamp will cover: Medicare Entitlement, Eligibility and Coverage Criteria, Medicare Process and more! Click below for more information and to register!

Click Here to View MDS Bootcamp Level 1

 
 

Topics: SNF PEPPER


Kris Mastrangelo, OTR/L, LNHA, MBA

WRITTEN BY

Kris Mastrangelo, OTR/L, LNHA, MBA
Follow: 

Data collection is the foundation for monitoring progress, but, in itself is a daunting task


Get your FREE PDPM Revenue Analysis

Start Here

Get Expert Tips in your inbox

Subscribe to our newsletter

Latest Blog Posts

Vaccination COVID-19 Interim Final Rule: Top 6 Things to Know

Read Full Post

COVID-19 Delta Variant Are you Skilling Correctly?

Read Full Post

Emergency Preparedness Hurricanes, Mandates and COVID – Oh My!

Read Full Post

Vaccination COVID-19 Interim Final Rule: Top 6 Things to Know

Read Full Post

COVID-19 Delta Variant Are you Skilling Correctly?

Read Full Post

Vaccination COVID-19 Interim Final Rule: Top 6 Things to Know

Read Full Post

COVID-19 Delta Variant Are you Skilling Correctly?

Read Full Post