ThefollowingisanoverviewofsoftwarefortheCMS-RXHCC.docVIP

The following is an overview of software for the CMS-RXHCC risk-adjustment model. The software includes a SAS program – R0110C1P that calls several SAS Macros to create RXHCC score variables using coefficients from the following regression models: Continuing enrollee New enrollee. Software description The software consists of a main program R0110C1P that supplies user parameters to the main SAS Macro program R0110C1M. This macro program reads in two input files and assigns RXHCCs for each person. First, the program crosswalks diagnoses to Condition Categories (RXCCs) using SAS formats which were previously stored in the FORMAT library. Then the program creates Drug Hierarchical Condition Categories (RXHCCs) by imposing hierarchies on the RXCCs. For persons without claims, zeros are assigned to all RXHCCs. After RXHCCs are created the program computes predicted scores from 2 regression models. The main macro R0110C1M uses 6 external SAS Macro programs: %AGESEX01 - create age/sex, originally disabled, disabled variables %REDIT07 - perform edits to ICD9 codes %R01A84M - assign one ICD9 code to multiple RXCCs %R01H84L - assign labels to RXHCCs %R01H84H - set RXHCC=0 according to hierarchies %SCOREVR - calculate a score variable The main program, main macro and 6 external macros have a .txt extension to make the files easier to view. Please rename them to have .sas extension before running the software. Steps performed by the software: step1: include external macros step2: define internal macro variables step3: merge person and diagnosis files outputting one record per person for each input person level record step3.1: declaration section step3.2: bring in regression coefficients step3.3: merge person and diagnosis files step3.4: for the first record for a person set RXCC to 0 and create person’s age  step3.5: if there are any diagnoses for a person then do the following: