What do some of the various items in the MR/RC mean?
Item #13 – Purpose Code • Purpose Code 2: Initial/new enrollment means that there is no current MR/RC, or for ICFMR, the individual has been out of an ICFMR facility for more than 180 days. • Purpose Code 3: Renewal of LOC/LON (may be the same LON or changed). A LON change submitted on a Purpose Code 3 may affect the provider’s ability to bill until the LON review is completed. A Purpose Code 3 is valid for 365 days, once approved. • Purpose Code 4: Change Level of Need. The date of the data entry of the purpose code 4 is the effective date of the requested LON change. The expiration date will remain the same as the current purpose code 3 expiration date. • Purpose Code E: Covers a gap in LOC/LON. Check the 1168 (ICFMR) or C68 (HCS) screen to see the gap dates. A LON increase will not be authorized on a purpose code E. Item #17 – Level of Care • The Level of Care (LOC) is a determination of eligibility for an individual in either the DADS waiver or ICFMR programs. The LOC for individua
