Episode Detail report – Summary

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Path: Reports>Episodic>Episode Detail

Field		Description
Patient Information		Patient code and name (*Patient>General>Basic). DOB (date of birth) and Insurance ID/MBI (patient's Insurance ID/MBI from Patient>General>Payers) are displayed only if the Include Patient's Insurance ID/MBI and DOB* check box is selected on the Define tab.
Episode		Episode Dates – The first and the last day of the patient's certification period or episode. Status – Status of the episode:
	O	Episode end date does not fall in the date range of the report.
	C	Episode end date falls in the date range of the report.
	Adj.	Episode adjustment flags for the episode. The report can be run for the individual flags selected on the Define tab.
	L	LUPA (Low Utilization Payment Adjustments) episodes.
	LA	LUPA with Add-On episodes.
	LK	Known LUPA episodes.
	P	PEP (Partial Episode Payment) episodes.
	O	Outlier episodes.
	D	Therapy-Down code episodes.
	U	Therapy-Up code episodes.
	F	Full episodes.
Initial HIPPS	HIPPS	The sum of the HHRG and NRS calculations. The HHRG and NRS are added to translate to the appropriate HIPPS format required by CMS.
	HHRG/Case Mix	Home Health Resource Group code at the time of the Initial claim. HHRG is generated by the completion of OASIS RFA-01, 04, or 03 (when used instead of the RFA-04) and is stored in the HHRG field of Patient>General>Admissions & Status>PPS Information.
	NRS/Weight	Generated by the completion of OASIS RFA-01, 04, or 03 (when used instead of the RFA-04) and is stored in the NRS field of Patient>General>Admissions & Status>PPS Information.
Final HIPPS	HIPPS	May change if HHRG or NRS is updated. The Final HIPPS will be different from the initial HIPPS when the Final claim HIPPS does not match the RAP HIPPS. This can be caused by a change in the OASIS assessment, when the user does not complete the Episodic Claims Void and Replace, or by the Therapy Up and Down coding settings.
	HHRG/Case Mix	May differ from the initial HHRG in case the OASIS assessment is updated or the agency performs more or less therapy visits than declared in M2200 (OASIS C/C1) of the applicable OASIS assessment.
	NRS/Weight	May differ from the initial NRS when the OASIS is updated with changes to the questions generated by NRS Severity.
Episode Number		The number of the PPS episode reported.
RFA		Displays the Reason For Assessment code:
	01	SOC (Start of Care).
	03	Resumption of care.
	04	Recertification
	05	Other follow-up (full assessment due to major change).
	06	Transferred to a patient facility (not discharged from agency).
	07	Transferred to a patient facility (discharged from agency).
	08	Death at home.
	09	Discharge from agency.
OASIS Completed By		Name of the clinician who completed the OASIS assessment.
Final Claim status		Final claim status (when the Final claim is in the billing process):
	Closed
	Open
	EMC	Claim status is not open and the claim is included in EMC.
	Deferred	Claim status is not open and the claim is not included in EMC.

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