News: CMS’ 2017 IPPS rule proposes changes to MS-DRG classification

CMS’ release of the 2017 IPPS proposed rule addresses an amendment to the MS-DRG classification of implantation or revision of loop recorders.

Stakeholders requested an examination of a potential ICD-9 to ICD-10 replication issue for procedures describing implantation or revision of loop recorder that were previously reported using ICD-9-CM procedure code 37.79 (revision or relocation of cardiac device pocket).

Requestors commented that these implantation procedures are frequently performed in the inpatient setting and suggested that they be recognized under the ICD-10 MS-DRGs as they had been under the ICD-9-CM-based MS-DRG logic.

It was explained to CMS that six ICD-10-PCS procedure codes identify the implantation or revision of a loop recorder, and they were not replicated appropriately since they are currently designated as non-OR procedures under the ICD-10 MS-DRGs. The requestor suggested that these codes be designated as OR procedures and assigned to the same MS-DRGs as the former ICD-9-CM procedure code.

After review, CMS proposed to designate four ICD-10-PCS codes as OR procedures within Appendix E of the Version 34 ICD-10 MS-DRG Definitions Manual. CMS said the ICD-10 MS-DRG assignment for these four ICD-10-PCS codes replicate the ICD-9-CM based MS-DRG assignment for procedure code 37.79.

As CMS continues to refine the ICD-10 MS-DRGs for FY 2018, the agency is requesting providers contact them regarding ICD-10-PCS codes that capture procedures that would not reasonably be performed. Comments should be sent to MSDRGClassificationChanges@cms.hhs.gov by December 7.

For information on the rule, see CMS’ fact sheet. Comments on the 2017 IPPS proposed rule are due to CMS by June 16, and the agency expects to issue a final rule by August 1. Once finalized, changes will become effective October 1.

Editor’s note: The article was originally published in JustCoding.