In the Fiscal Year 2016 IPPS proposed rule, CMS unveiled planned changes to MS-DRGs and ICD-10 codes.
CMS proposes eliminating MS-DRGs 237 (major cardiovascular procedures with MCC or thoracic aortic aneurysm repair) and 238 (major cardiovascular procedures with MCC or thoracic aortic aneurysm repair). The agency would replace them with two new MS-DRGs for complex, invasive procedures:
- MS-DRG 268, aortic and heart assist procedures except pulsation balloon with MCC
- MS-DRG 269, aortic and heart assist procedures except pulsation balloon without MCC
In addition, CMS plans to create three new MS-DRGs to cover less complex, less invasive cardiovascular procedures:
- MS-DRG 270, other major cardiovascular procedures with MCC
- MS-DRG 271, other major cardiovascular procedures with CC
- MS-DRG 272, other major cardiovascular procedures without CC/MCC
CMS plans to update the titles of MS-DRGs 456, 457, and 458 to better align with ICD-10.
CMS proposed moving eight ICD-10-PCS codes in the Administration section to be non-OR procedures.
CMS also proposed revisions to the surgical hierarchy for MDC 5 (diseases and disorders of the circulatory system).
CMS proposed adding ICD-10-CM codes N13.1 (hydronephrosis with ureteral stricture, not elsewhere classified) and N13.2 (hydronephrosis with renal and ureteral calculous obstruction) to the list of principal diagnoses that can act as their own CC.
A display copy of the rule is available in the Federal Register. Read more analysis of the rule on HCPro’s website.