048.0037.30.4

Ch. 30, § 4. Definitions

Last amended: 2021Length: 156 wordsOfficial source

Cite as Medicaid Rules, Ch. 30, § 4

. (a) "All Patients Refined Diagnosis Related Groups (APR DRGs)." A classification system that classifies inpatient services based on their reason for admission, severity of illness, risk of mortality, and resources used during treatment. (b) "Extraordinary circumstances." A catastrophic occurrence, beyond the control of a hospital, which results in substantially higher costs. An "extraordinary circumstance" includes, but is not limited to fire, earthquakes, floods, or other natural disasters. (c) "Participating Providers." All in-state Wyoming providers and out-of state providers that are currently enrolled in the Wyoming Medicaid program and/or Wyoming Medicaid providers that received at least eight-hundred thousand dollars ($800,000) in cumulative Wyoming Medicaid payments for inpatient services during state fiscal years 2015-2017. (d) "Present on Admission." A patient's health condition as defined by a diagnosis code that was identified at the time of a patient's admission to a hospital. (e) "Rehabilitation Services." Covered services furnished to an individual with a primary diagnosis for rehabilitation therapy.
048.0037.30.4: Ch. 30, § 4. Definitions | Justis AI