Files for FY 2012 Final Rule and Correction Notice

Title
Files for FY 2012 Final Rule and Correction Notice
Fiscal Year
2012
Type of File
Tables and Data Files
Description
See Below
  1. Impact File: This file contains data elements by provider that were used in calculating the FY 2012 rates and impacts.
  2. AOR/BOR File: This zip file contains two excel spreadsheets, one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two files containing the variable descriptions. The variables in these files are used in the calculations of the relative weights as well as other calculations for the inpatient PPS. All text files in the zip file are for 508 compliance.
  3. Case Mix Index File: This file contains FY 2012 hospitals' case mix indexes (CMI) for discharges. A hospital's CMI represents the average diagnosis-related group (DRG) relative weight for that hospital. It is calculated by summing the DRG weights for all Medicare discharges and dividing by the number of discharges.
  4. Historical DRG Weight File: DRG weights and other data since the inception of Inpatient PPS (See imbedded header for each year for layout).
  5. Standardizing File: This file is used to standardize charges for the rate building process.
  6. County to CBSA Crosswalk File: This file lists the CBSA, SSA county code and FIPS county code for all counties. Any changes to the CBSAs through March 2011 have been incorporated. It also contains the old MSA (based on 1990 census data) and old MSA name to which each county was assigned prior to the implementation of CBSAs in FY 2005.
  7. Definition of Medicare Code Edits: This file contains a description of each coding edit with corresponding ICD-9-CM code lists. There are two chapters in this file. The first chapter contains all the edits and the code lists for FY 2012. The second chapter summarizes, by edit, the changes in the edit code list from the last release of the MCE. This document is 508 compliant.
  8. Section 1109 Files: Contains one excel file with the following files/tables: List of All Counties; Section 1109 Eligible Counties; Final Section 1109 Qualifying Hospitals for FY 2011; Final Section 1109 Qualifying Hospitals for FY 2012; Final Section 1109 Compilation of Payments for FY 2011; Final Section 1109 Compilation of Payments for FY 2012;
  9. Wage Index Public Use Files: Open Attached Zip file. Attached is a PDF with a description of each zip file. Main zip file contains 7 zip files
  10. Table 1A - 1E: This excel spreadsheet contains the FY 2012 Operating and Capital National and Puerto Rico Specific Standardized Amounts. Additionally, there are two text files corresponding to each tab in the spreadsheet to meet Section 508 compliance.
  11. Wage Index Final Rule, Correction Notice and 1442-N (508 Wage Index) Tables; There are two excel spreadsheets in the zip file. 1st Spreadsheet contains: 1518-Final Rule: Tables 2, 3A, 3B, 4A, 4B, 4C, 4D, 4E, 4F, 4J, 9A, 9C; 1518-CN3: Tables 2-CN, 3A-CN, 3B-CN, 4A-CN, 4B-CN, 4C-CN, 4D-CN, 4J-CN, 9A-CN, 9C-CN;1518-CN4: Tables 2-CN, 4C-CN, 9A-CN; Note: Correction notice tables only contain the corrected values and do not repeat the entire table; 2nd Spreadsheet Contains: 1442-N: Tables 2, 4C, 9A, 9B; Note: Tables from the Notice only contain the updated values and do not repeat the entire table.
  12. Table 5: List of MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay.
  13. Tables 6A-6F: Table 6A--New Diagnosis Codes; Table 6B--New Procedure Codes; Table 6C--Invalid Diagnosis Codes; Table 6D--Invalid Procedure Codes; Table 6E--Revised Diagnosis Code Titles; Table 6F--Revised Procedure Code Titles; All files are 508 compliant.
  14. Tables 6G-6K: Tables 6G--Additions to the CC Exclusions List; Table 6H--Deletions from the CC Exclusions List. Table 6I--Complete MCC list; Table 6I.1--Additions to the MCC list; Table 6I.2--Deletions to the MCC list; Table 6J--Complete CC list; Table 6J.1--Additions to the CC list; Table 6J.2--Deletions to the CC list; Table 6K--Complete list of CC exclusions for the MS-DRGs; All files are 508 compliant.
  15. Tables 7A and 7B: Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 28 and MS-DRGs, version 29 as published in the Federal Register. Additionally, there are two text files corresponding to each tab in the spreadsheet to meet Section 508 compliance.
  16. Tables 8A, 8B, and 8C: Tables 8A and 8B contain the FY 2012 IPPS operating and capital statewide average cost-to-charge-ratios as published in the Federal Register. Tables 8C contains the FY 2012 LTCH statewide average cost-to-charge-ratios as published in the Federal Register. Additionally, there are three text files corresponding to each tab in the spreadsheet to meet Section 508 compliance.
  17. Table 10: Table 10 contains the cost thresholds by MS-DRG for the cost criteria for new technology add on payment applications for FY 2013. Additionally, there is a text file corresponding to the table to meet Section 508 compliance.
  18. Table 14: List of Hospitals with fewer than 1,600 Medicare discharges based on the March 2011 update of the FY 2010 MedPAR file and eligible hospitals' FY 2012 Low-Volume Payment Adjustment under 412.101. Eligibility for the low-volume payment adjustment for FY 2012 is dependent upon meeting the mileage criteria specified at Section412.101(b)(2)(ii) of the regulations.

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