RUG definition
Examples of RUG in a sentence
Medicare will reimburse the Facility a fixed per diem or daily fee based on the Resident’s classification within the Medicare RUG IV guidelines or successor guidelines thereto.
The IRO shall perform an evaluation of the data on the Paid Claim and determine whether the variables that affect the RUG assignment outcome for the MDS are supported by the medical record for the corresponding time period consistent with the assessment reference date specified in the MDS.
In those cases where an incorrect MDS data point(s) has been identified, the IRO shall re-enter data from that MDS into the IRO’s grouper software to verify that the correct RUG code assignment was properly assigned on the Paid Claim.
The review process shall consist of an evaluation of the MDS and verification that each MDS entry that affects the RUG code outcome for the MDS is supported by the medical record for the corresponding period of time consistent with the assessment reference date specified on the MDS.
If an incorrect RUG code was assigned, this shall be considered an error.