Home Health PPS Grouper Software (HHGS) Package (for claims starting 10-01-2022)

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

The October 2022 release of the HH PPS Grouper software (v03.3.22) is now available in the “Downloads” section of this webpage. Included in the v03.03.22 HH PPS Grouper software update are the FY 2023 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes, effective beginning October 1, 2022.

In November 2018, CMS finalized a new case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020. The PDGM, or Home Health PPS Grouper Software (HHGS), relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories and eliminates the use of therapy service thresholds. In conjunction with the implementation of the PDGM, there will be a change in the unit of home health payment from a 60-day episode to a 30-day period.

Included in the v03.3.22 software update are:

  • Addition of new ICD-10-CM diagnosis codes effective October 1, 2022, with Clinical Group and Comorbidity Subgroup assignments for applicable codes.
  • Deletion of ICD-10-CM diagnosis codes effective October 1, 2022.
  • Updated descriptors for diagnosis codes effective October 1, 2022.
  • Addition of diagnosis codes to the Manifestation Diagnosis list.
  • Addition of diagnosis codes to the External Cause of Injury Diagnosis list.
  • Identified diagnosis codes as “Code First” as a reference. (Note: Code First is not implemented in this software.)
  • Addition of diagnosis codes to the Unacceptable Principal Diagnosis list.

The direct link to this page is: Oct 2022 HH PPS Grouper Software HH PDGM v03.3.22 (posted 08/24/2022) (ZIP).