MS-DRG classification changes

In case you didn’t have enough time to read all 1,000-plus pages of the proposed rule that CMS released in April, the following are two MS-DRG classification changes pertaining to inpatient reimbursement. These changes take effect in FY2009, which begins Oct. 1, 2008, and pertain to AICD lead and generator procedures, as well as a revised wording to septicemia codes.

According to a CMS fact sheet:

"CMS is proposing to subdivide current MS-DRG 245 (AICD Lead and Generator Procedures) and create a new MS-DRG to separate the implantation or replacement of the AICD leads from the implantation or replacement of the AICD pulse generators. The title for MS-DRG 245 would be revised to ‘AICD Generator Procedures’ and include procedure codes 37.96, 37.98, and 00.54 that identify the implantation or replacement of AIC pulse generators. The proposed new MS-DRG would include procedure codes that identify the AICD leads (37.95, 37.97 and 00.52) and be titled ‘MS-DRG 265 AICD Lead Procedures.' "

Regarding septicemia codes, the proposed rule recommends inserting the words “or severe sepsis” after “Septicemia” in the titles of the following MS-DRGs that became effective Oct. 1, 2007 (FY 2008):

• MS-DRG 870 Septicemia with Mechanical Ventilation 96+ Hours
• MS-DRG 871 Septicemia without Mechanical Ventilation 96+ Hours with MCC
• MS-DRG 872 Septicemia without Mechanical Ventilation 96+ Hours without MCC

Comments on the proposed rule will be accepted by CMS through June 13.