Simple inpatient coding mistakes can weigh heavily on your hospitals – Here are some updates on DRG codes to help you stay informed and on the right reimbursement track.
DRGs are diagnosis-related group that classifies hospital cases into one of approximately 500 groups. These diagnosis related group codes are assigned by a 'grouper' program which is based on ICD diagnoses, procedures, age, discharge status and the like.
Recently, the CMS published the Federal Fiscal Year (FFY) 2012 Final Rule for Inpatient Prospective Payment System (IPPS) and the Long-term Care Hospital Prospective Payment System.
The implementation of the MS-DRG was needed to be done in a budget-neutral way. Since the time it came into being in FFY 2008, there have been documentation and coding changes made to the standardized amount to ensure the neutral stance of budget.
Very recently, the Centers for Medicare & Medicaid mandated a non-cumulative 2.9 % documentation and coding adjustment to get back overpayments occurring due to the conversion to the MS-DRG system. As made clear in the federal fiscal year 2011 IPPS Final rule, an additional - 2.9% adjustment is mandated statutorily for federal fiscal year 2012. But then since the FFY 2011 adjustment was non-cumulative, the net effect of the FFY 2012 adjustment comes with no change as compared to the FFY 2011 adjustment.
What's more, the agency finally rejected the proposed implementation of one more documentation and coding adjustment of -3.15% for FFY 2012.
In the proposed rule, the MS-DRG assignment for Percutaneous Mitral Valve Repair with Implant (MitraClip) also found mention.
ICD-10 & DRG codes: The proposed rule for FY 2012 doesn't provide comments regarding the ICD-10 MS –DRG. In fact, Version 28.0 of the ICD-10 MS-DRGs has been finalized and is available for public review on the CMS site.
For more DRG news and updates, sign up for a good online resource like SuperCoder. Such a site comes with a cutting edge tool - MS-DRG Master - that gives you the information on MS-DRG's allowed ICD-9-CM Volume 1 and 3 codes, LOS and payment weights in just one click.
Once you take the help of the MS-DRG Master, you will be able to correctly link ICD-9-CM Procedure Volume 3 codes to MS-DRG, identify all ICD-9-CM Diseases Volume 1 codes associated with a MS-DRG (Medicare System - Diagnostic Revenue Grouper) and lots more.
Sign up for one today and get all the tips and tricks to keep your inpatient coding on track.
DRGs are diagnosis-related group that classifies hospital cases into one of approximately 500 groups. These diagnosis related group codes are assigned by a 'grouper' program which is based on ICD diagnoses, procedures, age, discharge status and the like.
Recently, the CMS published the Federal Fiscal Year (FFY) 2012 Final Rule for Inpatient Prospective Payment System (IPPS) and the Long-term Care Hospital Prospective Payment System.
The implementation of the MS-DRG was needed to be done in a budget-neutral way. Since the time it came into being in FFY 2008, there have been documentation and coding changes made to the standardized amount to ensure the neutral stance of budget.
Very recently, the Centers for Medicare & Medicaid mandated a non-cumulative 2.9 % documentation and coding adjustment to get back overpayments occurring due to the conversion to the MS-DRG system. As made clear in the federal fiscal year 2011 IPPS Final rule, an additional - 2.9% adjustment is mandated statutorily for federal fiscal year 2012. But then since the FFY 2011 adjustment was non-cumulative, the net effect of the FFY 2012 adjustment comes with no change as compared to the FFY 2011 adjustment.
What's more, the agency finally rejected the proposed implementation of one more documentation and coding adjustment of -3.15% for FFY 2012.
In the proposed rule, the MS-DRG assignment for Percutaneous Mitral Valve Repair with Implant (MitraClip) also found mention.
ICD-10 & DRG codes: The proposed rule for FY 2012 doesn't provide comments regarding the ICD-10 MS –DRG. In fact, Version 28.0 of the ICD-10 MS-DRGs has been finalized and is available for public review on the CMS site.
For more DRG news and updates, sign up for a good online resource like SuperCoder. Such a site comes with a cutting edge tool - MS-DRG Master - that gives you the information on MS-DRG's allowed ICD-9-CM Volume 1 and 3 codes, LOS and payment weights in just one click.
Once you take the help of the MS-DRG Master, you will be able to correctly link ICD-9-CM Procedure Volume 3 codes to MS-DRG, identify all ICD-9-CM Diseases Volume 1 codes associated with a MS-DRG (Medicare System - Diagnostic Revenue Grouper) and lots more.
Sign up for one today and get all the tips and tricks to keep your inpatient coding on track.
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