Composition of HIPPS Codes for HH PPS

10.1.9 - Composition of HIPPS Codes for HH PPS (Rev. 10758; Issued: 05-11-21; Effective: 01-01-22; Implementation: 08-11-21) For HH PPS periods of care, the distinct 5-position, alphanumeric home health HIPPS codes are created as follows: • The first position represents a combination of the referral source (community or institutional) and the period timing (early or late). • The second and third positions represent the clinical and functional domains of the HHRG coding system. • The fourth position represents the co-morbidity category that applies to the patient. • The fifth position is a placeholder for future use, required only because the field used to report HIPPS codes requires five positions. Position #1 Position #2 Position #3 Position #4 Position #5 Source & Timing Clinical Group Functional Level Co- Morbidity Placeholder 1 - Community Early A - MMTA Other A - Low 1 - None 1 2 - Institutional Early B - Neuro Rehab B - Medium 2 - Low 3 - Community Late C - Wounds C - High 3 - High 4 - Institutional Late D - Complex Nursing Interv. Using this structure, a second period for a patient with a hospital inpatient stay during the period, in the Wounds group, high functional severity and no co-morbidity would be coded 4CC11. HIPPS codes created using this structure are valid only on claim lines with revenue code 0023.