ICD-10 will re-write the book on diagnosis and procedure coding, utilization pattern history will shift. HIPPS and ICD-10 should not be viewed as separate issues for ICD-10 assessments.
The Health Insurance Prospective Payment System (HIPPS) rate codes represent specific sets of patient characteristics (or case-mix groups) on which payment determinations are made under several prospective payment systems. Case-mix groups are developed based on research into utilization patterns among various provider types. The Centers for Medicare and Medicaid Services (CMS) created HIPPS codes as part of the Medicare program’s implementation of a prospective payment system for skilled nursing facilities in 1998.