H — MMTA - Cardiac and Circulatory
One of the twelve PDGM clinical groups. CMS maps 683 ICD-10-CM codes to it in grouper v07.1.26.
What lands a period in this group
The clinical group is set by the diagnosis reported in the primary position, and it is one of the five things that decide a 30-day period’s payment group — alongside admission source, timing, functional impairment level and comorbidity adjustment. CMS maps 683 ICD-10-CM codes to MMTA - Cardiac and Circulatory, spread across 10 ICD-10-CM ranges.
Those ranges are not always the ones you would expect from the chapter. Cerebrovascular disease sits in the circulatory chapter alongside heart failure, but CMS groups strokes as neurological rehabilitation — which is why the chapter a code lives in is a poor guide to how it pays.
Functional impairment thresholds for MMTA - Cardiac and Circulatory
The same OASIS point total means different things in different groups. In this group a patient scoring 28 or fewer points is low functional impairment, 29 to 43 is medium, and 44 or more is high. CMS sets the bands so roughly a third of periods in each group land in each level, which is why the same documentation can produce a different level in a different group.
ICD-10-CM ranges that feed this group
| Range | Description | Codes in this group |
|---|---|---|
| I80-I89 | Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified | 174 |
| I70-I79 | Diseases of arteries, arterioles and capillaries | 166 |
| I30-I5A | Other forms of heart disease | 130 |
| I20-I25 | Ischemic heart diseases | 90 |
| I95-I99 | Other and unspecified disorders of the circulatory system | 43 |
| I26-I28 | Pulmonary heart disease and diseases of pulmonary circulation | 28 |
| I05-I09 | Chronic rheumatic heart diseases | 27 |
| I10-I1A | Hypertensive diseases | 16 |
| I00-I02 | Acute rheumatic fever | 8 |
| I60-I69 | Cerebrovascular diseases | 1 |
Source: CMS HH PPS Grouper Software v07.1.26. Counts are read from the CMS table, not transcribed.
The other eleven groups
- AMMTA - Other
- BNeuro Rehabilitation
- CWound
- DComplex Nursing Interventions
- EMusculoskeletal Rehabilitation
- FBehavioral Health
- GMMTA - Surgical Aftercare
- IMMTA - Endocrine
- JMMTA - Gastrointestinal tract and Genitourinary system
- KMMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases
- LMMTA - Respiratory
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff.