News: CMS proposes ample changes to MS-DRGs in 2018 IPPS proposed rule

On April 14, CMS released the fiscal year 2018 IPPS proposed rule. In addition to several proposed modifications to the electronic health record (EHR) reporting periods and to the existing hospital-acquired conditions (HAC) reduction program policies, the proposal also included several changes to MS-DRG classifications, according to JustCoding.

Some notable proposed changes for MS-DRGs include, but are not limited to, the following:

• Title change of MS-DRG 023 from “Craniotomy with major device implant or acute complex central nervous system principal diagnosis with MCC or chemo implant” to “Craniotomy with major device implant or acute complex central nervous system principal diagnosis with MCC or chemotherapy implant or epilepsy with neurostimulator” to reflect the proposed modifications to MS-DRG assignments, the rule said.
• Title changes for MS-DRG 246 (Percutaneous cardiovascular procedures with drug-eluting stent with MCC or 4-plus vessels or stents) and MS-DRG 248 (Percutaneous cardiovascular procedures with non-drug-eluting stent with MCC or 4-plus vessels or stents) CMS is proposing to revise the titles for MS-DRGs 246 and 248 to better reflect the ICD-10-PCS terminology of “arteries” versus “vessels” as used in the code titles within the classification.
• Reassign the percutaneous mitral valve replacement procedures from MS-DRGs 216 through 221 (Cardiac valve and other major cardiothoracic procedures) to MS-DRGs 266 and 267 (Endovascular cardiac valve replacements) and assign eight new procedure codes that describe percutaneous and transapical approaches for percutaneous tricuspid valve replacement procedures to MS-DRGs 266 and 267. Both changes are intended to reflect the higher risk associated with performing valve replacements via a percutaneous technique versus an open approach.

For more information on the rule, see CMS’ fact sheet. Comments are due to CMS by June 13, and the agency expects to issue a final rule by August 1. Once finalized, changes will become effective October 1. 

Editor’s note: This article originally appeared in JustCoding. To read ACDIS’ original coverage of the IPPS proposed rule, click here. To read the proposed rule in its entirety, click here.