News: MS-DRG changes in recent IPPS Final Rule

The 2015 IPPS Final Rule, released on August 4, focuses on quality efforts, except for ICD-9-CM diagnostics and program code changes. However, in 2015 CMS completed several MS-DRG changes and compiled the recommendations for creating the next MS-DRG for intravascular heart valve replacement surgery.

In addition, the CMS has decided to move the next additional diagnostic code to MS-DRG 794 (big problem newborn).

MDC 1: Subjected to changes in endovascular embolization or head and neck surgical obstruction, it is recommended that eventually not change MS - DRG 20 - 27. There are four mechanical complications in the nervous system equipment code - T85.610A, T85.620A, T85. 630 A and T 85.690 A - MS - DRG 919, 920 and 921 to MS - DRG 091, 092 and 093. MDC 5: Four code loop recorder for inserting and modifying a are specified as an OR procedure. These codes affect MS - DRG 40 - 42, 260 - 262, 579 - 581, 907 - 909, and 957 - 959. For intravascular thrombectomy of lower limbs classified as MS-DRG 270-272, 52 ICD-10 - Tables 03C, 04C, 05C and 06C. In this MDC, the logic of the pacemaker has also changed.

The 2015 IPPS Final Rule, released on August 4, focuses on quality efforts, except for ICD-9-CM diagnostics and program code changes. However, in 2015 CMS completed several MS-DRG changes and compiled the recommendations for creating the next MS-DRG for intravascular heart valve replacement surgery.

Each hospitalized patient is assigned MS - DRG. MS-DRG uses primary and other diagnostics, primary and additional procedures, gender and discharge status. MS-DRG assignment is determined using diagnostics and procedures assigned by the ICD-9-CM code. Accurate and complete ICD-9-CM coding by HIM experts is essential for proper MS-DRG assignment and subsequent refunds. Some MCCs and CCs are excluded as they are closely related to the primary diagnosis. This is called a CC exclusion list and is used to identify conditions that are not considered CC or MCC in a particular primary diagnosis. For example, primary cardiomyopathy (425.4) is not CC of congestive heart failure (428.0)