The IPF PPS is based on a federal perdiem amount that represents the average daily operational, ancillary, and capital costs expended to care for Medicare beneficiaries. Use the information found in figures 1 and 2 ( below), Tables 6.5-6.9 and figures 6.7 from the test book to complete table 1 and workbooks A&B in order to determine IPF PPS reimbursement for this encounter.
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Figure 1: Facility Information | |
Bed size: 350 beds | Location: Columbus, Ohio |
Classification: Rural | Wage Index: .9806 |
Full Service ED: Yes | Per-diem unadjusted rate (RY 2015): $728.31 |
Figure 2: Claim Information | |||
Admit Date: January 1, 2015 | Discharge Date: January 15, 2015 | LOS: 14 days | |
Patient Age: 62 | |||
Principal Diagnosis: 295.34* | Paraphrenic schizophrenia, chronic with acute exacerbation | ||
Secondary Diagnosis: 301.6 | Dependent personality disorder | ||
Secondary Diagnosis: 250.02 | Type II diabetes mellitus uncontrolled | ||
MS-DRG: 885 | Psychoses | ||
ECT treatments: 90870 | 3 units | $315.55 per unit (RY 2015) |