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MU00.@BFN2699.ESNDM180
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NOTE TO: Shared System Coordinators, MEDICARE Coordinators

SUBJECT: End-Stage Renal Disese (ESRD) Prospective Payment System (PPS)
         Pricer Release, Version 2018.0

(November 15, 2017) --ACTION-- Please refer to the following CMS Change
 Requests (CRs):

  - CR10065 - Implementation of the Transitional Drug Add-On Payment
              Adjustment

  - CR10312 - Implementation of Changes in the End-Stage Renal Disease
              Prospective Payment System (PPS) and Payment for Dialysis
              Furnished for Acute Kidney Injury (AKI) in ESRD Facilities
              for Calendar Year (CY) 2018


This ESRD Pricer release is a PRODUCTION version.

It includes the following changes/additions:

  - ESCAL180 - New calculation module implements CR10065 and CR10312

   - Addition of new dataname for TDAPA
   - Updated so that the move of the TDAPA field to the output record
     no longer depends on the BUNDLED-TEST condition
   - For AKI claims, added assignment of '10' to PPS-2011-COMORBID-PAY
   - Added comments about use of BUNDLED-TEST dataname
   - Annual Update:
     - Changed BUNDLED-BASE-PMT-RATE to 232.37
     - Changed ADJ-AVG-MAP-AMT-GT-17 to 42.41
     - Changed ADJ-AVG-MAP-AMT-LT-18 to 37.31
     - Changed FIX-DOLLAR-LOSS-GT-17 to 77.54
     - Changed FIX-DOLLAR-LOSS-LT-18 to 47.79


  - ESDRV180 - Replaces ESDRV171

    - New Driver Subprogram
    - Added CALL to ESCAL180


  - BILLCPY - Updated

    - COBOL copybook containing the new Bill record layout
    - Added new dataname for TDAPA
    - Added comments about use of BUNDLED-TEST dataname


  - ESBUN180 - Replaces ESBUN171

    - COBOL copybook containing PPS CBSA Wage Index table
    - Updated for 2018


  - BUNDCBSA - Updated

    - Text copy of the PPS CBSA Wage Index table


  - RTCCPY - Updated

    - added NOT '84' OR NOT '87' for Return Code = 58


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MU00.@BFN2699.ESNDM180, a partitioned data set (PDS) containing the
Version 2018.0 code is at the CMS Data Center for users to get by
Connect:Direct (Network DataMover).

The 30 members listed below comprise the Pricer. The PDS only includes
members that changed or are new since the previous release.
The changed and new members are marked '**' and should be
used in conjunction with the current production Pricer files for
testing.


      NAME
      --------
     BASECBSA
     BASERATE
 **  BILLCPY
 **  BUNDCBSA
     DSCNTRL
 **  ESBUN180
     ESCAL056
     ESCAL062
     ESCAL070
     ESCAL071
     ESCAL080
     ESCAL091
     ESCAL100
     ESCAL117
     ESCAL122
     ESCAL130
     ESCAL140
     ESCAL151
     ESCAL160
     ESCAL170
     ESCAL171
 **  ESCAL180
     ESCHI151
     ESCOM151
 **  ESDRV180
     ESWRT151
 **  MANIFEST
 **  README
     RTCCPY
     WAGECPY
