Version 28.0 of the ICD-10 MS-DRGs is Final

Inpatient coding woes? Well, there could be something amiss in your DRG process.

Every year thousands of dollars go down the drain because of poor Medicare Severity Diagnosis Related Groups Codes selection and under coding. One needs to understand the complete DRG process to figure out the ways to proper reimbursement. Spot on DRG assignment and auditing practices help you stay away from both up-coding and under-coding; in the process you'll save money and cut short the revenue cycle.

Changes to Medicare Severity Diagnosis Related Groups (MS-DRG)

Right from the time it was implemented in 2008, MS-DRG has witnessed documentation and coding adjustments made to the standardized amount to ensure budget neutrality. In FY 2011, Centers for Medicare and Medicaid mandated a non-cumulative 2.9% documentation and coding adjustments as part of a two-year process to get back overpayments ensuing from the conversion to the MS-DRG system.

As mentioned in the last IPPS Final Rule, an additional -2.9% adjustment is statutorily mandated for FY 2012. But then since the FY 2011 adjustment was non-cumulative, the net effect of the FFY 2012 adjustment resulted in no change as compared to the earlier adjustment.

In the end, the agency rejected the proposed implementation of another documentation and coding adjustment of 3.15 percent for FY 2012.

DRG codes & ICD-10 codes:

ICD-10 MS DRGs which are likely to go into effect in FY 2014 will be subject to notice and comment rulemaking. Meanwhile, the agency will provide extensive and detailed information on this activity by way of the ICD-9-CM Maintenance and Coordination Committee.

Version 28.0 of the ICD-10 MS-DRGs based on FY 2011 MS-DRGs is final and is available for public review on the CMS' website.

In the mean time the agency will continue to work with the public on the conversion and post drafts for updates. The final version of the ICD-10 MS-DRGs which will go into effect in FY 2014 will be subject to notice and comment rulemaking.

In the intervening time, the agency will provide extensive and detailed information on this activity through the ICD-9-CM Maintenance and Coordination Committee.

DRG Codes Lookup: For more MS-DGR updates, sign up for a good coding resource like SuperCoder. Such a site comes with Grouper-Procedure Code CrossRef, hospital coding datasets, average LOS look-up, MS-DRG to ICD-9-CM Vol. 1 CrossRef, a robust search engine, and more. Sign up today and see how it puts your inpatient coding on track.