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CMG_100 VERSION 1.22 GROUPER SOFTWARE EFFECTIVE ON 1/24/2005 FOR USE WITH THE IRF PAI

This documentation is for a revised version of the CMG dynamic-link library (DLL) for use in classifying patients in Inpatient Rehabilitation Facilities (IRFs). This revision represents version 1.22 of the DLL. This revised DLL continues to implement the original version CMG classification system, CMG_100.

This documentation and the CMG DLL are published by the Centers for Medicare & Medicaid services (CMS). The documentation and DLL may be copied freely, as our goal is broad dissemination to facilitate accurate classification of Inpatient Rehabilitation Facility (IRF) patients with the Case Mix Group (CMG) classification system.

Introduction

This documentation describes a Windows DLL which can be used to calculate a patient’s CMG group from Inpatient Rehabilitation Facility Patient assessment Instrument (IRF-PAI) data. CMG_100.DLL is a 32-bit ActiveX DLL which can be called from Visual Basic or from 32-bit C++ applications. The DLL accepts an input string containing an IRF­PAI data record in the standard CMS submission format and returns the CMG value and associated information. Documentation for the IRF-PAI standard submission format is available at:

http://www.cms.hhs.gov/providers/irfpps/software.asp

The ZIP file (CMG_122.ZIP) containing the DLL software and this documentation may be freely distributed and you may freely use and distribute the DLL in your applications.

Later sections of this document explain how to call the DLL from Visual Basic and from C++. Following these sections, there are several sections which should be read by all users. The first describes the input and output parameters used when calling either DLL. The second section describes the parameter file which must be distributed with the DLL. The third explains the error codes which are returned by the DLL.

What is CMG_100 Version 1.22?

CMG is a classification system for patients in Inpatient Rehabilitation Facilities (IRFs). The CMG system uses information from the IRF Patient Assessment Instrument (IRF-PAI) to perform these classifications. 

Changes to Version 1.22

Version 1.22 of the CMG_100 incorporates the following revisions:

9 new coding clarifications were added, including the 7 from Version 1.21 of the CMG_100 DLL. These new coding clarifications are ICD-9-CM code revisions that were not included in earlier versions of the DLL. The 9 new coding clarifications are identified in the accompanying program documentation (see Appendix C in Progdoc.pdf), as well as in the table below.

New Code	Description
070.71	Unspecified viral Hepatitis C with hepatic coma Abbreviated Code: HPT C UNSPEC W HEPAT COMA
453.40	Venous embolism and thrombosis of unspecified deep vessels of lower extremity Abbreviated Code: VEN EMBOL THRMBS UNSPEC DP VSLS LWR EXTREM
453.41	Venous embolism and thrombosis of deep vessels of proximal lower extremity Abbreviated Code: VEN EMBOL THRMBS DP VSLS PROX LWR EXTREM
453.42	Venous embolism and thrombosis of deep vessels of distal lower extremity Abbreviated Code: VEN EMBOL THRMBS DP VSLS DIST LWR EXTREM
282.64	Sickle-cell/Hb-C disease with crisis Abbreviated Code: SICKLE-CELL/Hb-C DISEASE W CRISIS
517.3	Acute chest syndrome Abbreviated Code: SICKLE-CELL/Hb-C DISEASE W AC CHEST SYN
785.52	Septic Shock Abbreviated Code: SEPTIC SHOCK
V46.11	Dependence on Respirator, Status
V46.12	Encounter for respirator dependence during power failure Abbreviated Code: ENC FOR RESP DEP PWER FAI

In addition to the 9 new code clarifications, the abbreviated labels for the ICD-9-CM codes for 24 of the comorbidities in Appendix C were changed. Version 1.22 is a revision of version 1.20 due to coding errors. Version 1.20 contained a programming error for ICD-9-CM Code 282.64 Sickle-cell/Hb-C disease w/ crisis. Code 282.64 was incorrectly coded as 262.64. In addition, codes V46.11 (Dependence on Respirator, Status) and V46.12 (Encounter for respirator dependence during power failure) were added as clarifications for the previous code V46.1. If you have submitted a claim or IRF-PAI with an incorrect CMG due to the incorrect 262.64 code in the Grouper software, please resubmit your claim or IRF-PAI with the correct CMG code. If you need to resubmit a claim or IRF-PAI with a CMG affected by the V46.11 or V46.12 codes, please resubmit your claim or IRF-PAI after downloading the new software. Please contact your Fiscal Intermediary if you have any problems concerning claims submissions with regard to this issue. If there continues to be a claims issue after contacting your Fiscal Intermediary, please contact August Nemec at Anemec@CMS.HHS.GOV.

The Windows DLL (CMG_100.DLL) is now Version 1.22. That DLL version number is returned by the DLL and the date on the DLL file is 12/14/2004 for Version 1.22 of the Grouper.

The test data CmgTest4.TXT was revised, and the date on that file is 12/14/2004 for Version 1.22 of the Grouper.

Grouper Package documentation was appropriately updated and pdf files were made fully accessible. Making the pdf files accessible accounts for the increased size of the Version 1.22 download file.

Providers are encouraged to obtain new versions of IRVEN or other vendor software, incorporating the new Version 1.22 of the CMG Grouper, for use after January 24, 2005. However, providers will be allowed to continue to use old versions of IRVEN or other vendor software, incorporating the old Version 1.00 of the CMG Grouper, after January 24, 2005. For submitted records where the old and new Groupers calculate different CMG Group codes, the provider will receive a warning on the validation report that an incorrect group code has been submitted. The validation report will also provide the correct group code, and the provider should use that correct group code for Medicare billing.

The CMG_100 group 1.22 package includes:

1. CMG_100.DLL A Windows DLL that can be called by Visual Basic 6.0 or 32-bit C++ applications to perform CMG classifications.
2. CMG_100.DAT A parameter file use with CMG_100.DLL.
3. TechDoc.PDF Technical documentation for the use of the DLL.
4. ProgDoc.PDF Programmer documentation for coding the CMG classification system.
5. VbDemo.* A Visual Basic 6.0 demo program including source and executable code.
6. Cdemo.* A C++ demo program including source and executable code.
7. CmgTest4.TXT A test file of IRF-PAI records with known CMG values. If you run VbDemo.exe, a log file named VbDemo.log will be produced. This log file gives the correct CMG value for each test record (as well as intermediate values such as the motor score and cognitive score).

How Can I Get CMG_100 Version 1.22?

Download the grouper package (cmg_122.zip). (Zip file, 495kb)

Included as part of cmg_122.zip is the file Techdoc.pdf  which explains the use of the DLL.

Disclaimer

To the maximum extent permitted by applicable law, CMS and its contractors/distributors make no representations about the suitability, for any purpose or use, of the software and documents. THE SOFTWARE AND DOCUMENTS ARE PROVIDED "AS IS" AND WITHOUT WARRANTY OF ANY KIND. ANY WARRANTIES, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR USE, TITLE, AND NON-INFRINGEMENT ARE HEREBY DISCLAIMED. Recipient shall not, in any event, be entitled to, and CMS or contractors/distributors shall not be liable for indirect, special, incidental, or consequential damages of any nature including, without being limited to, loss of use, data, or profit irrespective of the nature of the claim, whether in contract, tort, warranty, or otherwise.  

Technical Assistance

There is an IRF-PAI Support Desk to help you with technical problems and concers with the grouper. The number to call is 1-800-339-9313. You may also e-mail requests for assistance to irfpai_help@ifmc.org.