HCAHPS - Technical Specifications Page

Quick links:
Slides Illustrating the Calculations of HCAHPS Scores | V.29 MS-DRG Codes Effective October 1, 2011 | UB-04 Point of Origin or Visit Code | HCAHPS Public Reporting Periods | HCAHPS V3.3 Submission of 5 or Fewer Eligible HCAHPS Discharges in a Month | HCAHPS V3.3 Submission of "Zero Cases" | XML File Specifications V3.3 | Hospital Value Based Purchasing Final Rule

Slides Illustrating the Calculations of HCAHPS Scores

For a refresher on how HCAHPS scores are calculated, click here to view or download the slides.

V.29 MS-DRG Codes Effective October 1, 2011

CMS has adopted V.29 MS-DRG codes effective October 1, 2011. Changes from V.28 MS-DRG codes include the deletion of surgical code 015 and the addition of surgical codes 016-017 and 570-572.

Please click here for the Table of V.29 MS-DRG Codes and HCAHPS Service Line Categories.

UB-04 Point of Origin or Visit Code

Effective July 1, 2010, the “Point of Origin for Admission or Visit” code for Emergency Room (code 7) was discontinued for use by Medicare Systems. At the same time, the definition of “Non-Health Care Facility Point of Origin” (code 1) was updated to: “The patient was admitted to this facility.” Similarly, the definition of “Clinic” (code 2) also will be updated to: “The patient was admitted to this facility."

For more information about these changes in coding of point of admission, please see “MLN Matters Number MM6801 Revised.”

Please note: Regardless of the point of origin for admission to the hospital, patients are eligible for the HCAHPS survey if they meet the HCAHPS eligibility criteria, which are summarized on pages 41-42 of the Quality Assurance Guidelines V5.0. Emergency room admission has been used in patient-mix adjustment of HCAHPS scores.

HCAHPS Public Reporting Periods

January 2012 through October 2012

Click here to view the HCAHPS Public Reporting Periods document. This document indicates which calendar quarters of HCAHPS results will be publicly reported on the Hospital Compare Web site through October 2012.

Please Note: The dates of future preview periods and public reporting are estimates based on current timetables and thus are subject to change.

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HCAHPS V3.3 Submission of 5 or Fewer Eligible HCAHPS Discharges in a Month

Below please find instructions for uploading "5 or Fewer Eligible HCAHPS Discharges in a Month" information via My QualityNet using the Online Data Entry Tool or the XML file format for July 1, 2011 patient discharges and forward.

Online Tool

Please note the following:

One header record must be completed for each month that an organization has "5 or Fewer Eligible HCAHPS Discharges in a Month."
The NPI element is not required at this time, but may be entered if the information is available.
For "survey mode," select "Mail only."
For "determination of service line," select the method used to determine the patient's eligibility.
For "number eligible discharge," enter actual count of eligible discharges for the month.
For "sample size," enter zero.
For "sample type," select "Simple Random Sample."

XML File Format

Below is an example of the header record layout that must be submitted for each month that an organization has "5 or Fewer Eligible HCAHPS Discharges in a Month."

<header>
<provider-name>Some Hospital</provider-name>
<provider-id>123456</provider-id>
(NPI is not required)
<discharge-yr>2011</discharge-yr>
<discharge-month>4</discharge-month> (for July)
<survey-mode>1</survey-mode > (for Mail only)
<determination-of-service-line>1</determination-of-service-line> (for V.28 or V.27 or V.26 V.25 MS-DRG codes)
<number-eligible-discharge>enter actual count i.e. 1, 2, 3, 4 or 5</number-eligible-discharge>
<sample-size>0</sample-size>
<sample-type>1</sample-type> (for Simple Random Sample)
</header>

Please contact HCAHPS Information and Technical Support by email at hcahps@azqio.sdps.org or by telephone at 1-888-884-4007 with any questions.

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HCAHPS 3.3 Submission of "Zero Cases"

Below please find instructions for uploading "Zero Case" information via My QualityNet using the Online Data Entry Tool or the XML file format for July 2011 patient discharges and forward.

Online Tool

Please note the following:

One header record must be completed for each month that an organization has "Zero Cases."
The NPI element is not required at this time, but may be entered if the information is available.
For "survey mode," select "Mail only."
For "determination of service line," select "1 – V.27, V.26 or V.25 MS-DRG codes."
For "number eligible discharge," and "sample size" enter 0.
For "sample type," select "Simple Random Sample."

XML File Format

Below is an example of the header record layout that must be submitted for each month that an organization has "Zero Cases."

<header>
<provider-name>Some Hospital</provider-name>
<provider-id>123456</provider-id>
(NPI is not required)
<discharge-yr>2011</discharge-yr>
<discharge-month>4</discharge-month> (for April)
<survey-mode>1</survey-mode > (for Mail only)
<determination-of-service-line>1</determination-of-service-line> (for V.28, V.27, V.26 or V.25 MS-DRG codes)
<number-eligible-discharge>0</number-eligible-discharge>
<sample-size>0</sample-size>
<sample-type>1</sample-type> (for Simple Random Sample)
</header>

Please contact HCAHPS Information and Technical Support by email at hcahps@azqio.sdps.org or by telephone at 1-888-884-4007 with any questions.

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XML File Specifications Version 3.3

XML File Specifications Version 3.3 is effective beginning with third quarter 2011 patient discharges.

The HCAHPS 3.3 Warehouse and the updated HCAHPS Online Data Entry Tool have been released. HCAHPS survey data for eligible discharges from July 1, 2011 forward may now be submitted via XML format or the HCAHPS Online Data Entry Tool accessed from My QualityNet.

Click here for the XML File Specifications Version 3.3, the XML File Sample Layout without DSRS Version 3.3 and the XML File Sample Layout with DSRS Version 3.3.

Hospital Value Based Purchasing Final Rule

The final rule establishing the Hospital Value Based Purchasing program is available on the Federal Register. To view the Hospital Value Based Purchasing final rule please visit: http://www.gpo.gov/fdsys/pkg/FR-2011-05-06/pdf/2011-10568.pdf.