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January 25, 2018

Four Tests Added to List of CLIA Waived Tests

In early January, the Centers for Medicare and Medicaid Services (CMS) announced new waived tests... Learn More

New and Revised Vaccine Codes Added to 2018 CPT Code Book

The American Medical Association (AMA) added and revised several vaccine CPT codes for its 201... Learn More

OIG Recommends Measures for Curbing Opioid Misuse and Fraud

Office of Inspector General testimony before the House Committee on Ways and Means in January ... Learn More

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Medical Coding News Archives

CMS Releases Fiscal 2009 IPPS Proposed Rule

May 27, 2008:
The Centers for Medicare and Medicaid Services (CMS) released the inpatient prospective payment system (IPPS) proposed rule on April 30, 2008, continuing the transition to Medicare severity (MS) diagnosis-related groups (DRGs), along with other ongoing payment revisions.

Major revisions included those related to operating costs for capital-related costs in fiscal 2009, payments for indirect medical education (IME) costs, and payments to certain hospitals and units that continue to be excluded from the IPPS and paid on a reasonable cost basis. Proposed changes were also released relating to the disclosure to patients of physician ownership and investment interests in hospitals and proposed changes to physician self-referral regulations.

DRG Changes
Some of the revisions CMS is proposing to make to the DRG classification system include:
  • Procedure code 37.52 (Implantation of total replacement heart system) would move from MS-DRG 215 (Other Heart Assist System Implant) to MS-DRG 001 (Heart Transplant or Implant of Heart Assist System with MCC) and MS-DRG 002 (Heart Transplant or Implant of Heart Assist System without MCC).
  • New MS-DRG 265 (AICD Lead Procedures) would be created to differentiate between procedures performed solely on AICD leads versus those performed solely on AICD pulse generators.
  • MS-DRGs 870, 871, and 872 (Septicemia or Sever Sepsis) would include the additional terminology “or severe sepsis.”
  • Codes representing traumatic compartment syndrome (958.90–958.99) would be added to MS-DRGs 963, 964, and 965 (Other Multiple Significant Trauma with MCC/with CC/without CC/MCC).
Deborah C. Hall
Clinical/Technical Editor


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