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Fiscal Year 2008 New ICD9CM Codes and Introduction to MSDRGs

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Title: Fiscal Year 2008 New ICD9CM Codes and Introduction to MSDRGs


1
Fiscal Year 2008 New ICD-9-CM Codes and
Introduction to MS-DRGs
  • Barry Libman, RHIA, CCS, CCS-P
  • President
  • Barry Libman Inc.

2
Inpatient PPS, FY 2008
  • Agenda
  • New codes
  • New Guidelines
  • Changes to the addenda
  • MS-DRGs
  • Get CEUs !

3
Federal Register
  • Federal Register / Vol. 72, No. 162 Wednesday,
    August 22, 2007, pp. 47130 - 48175
  • http//a257.g.akamaitech.net/7/257/2422/01jan20071
    800/edocket.access.gpo.gov/2007/pdf/07-3820.pdf

4
Codes Changes for FY 2007
  • Revisions and new codes will be implemented for
    discharges on or after October 1, 2007
  • 122 New Diagnosis Codes
  • 20 New V Codes
  • 39 New Procedure Codes

5
Infectious and Parasitic Diseases
  • 040.41 Infant botulism CC
  • 040.42 Wound botulism CC
  • 058.10 Roseola infantum, unspecified
  • 058.11 … due to human herpesvirus 6
  • 058.12 … due to human herpesvirus 7

6
Infectious and Parasitic Diseases
  • 058.21 Human herpesvirus 6 encephalitis MCC
  • 058.29 Other human herpesvirus encephalitis MCC
  • 058.81 Human herpesvirus 6 infection
  • 058.82 Human herpesvirus 7 infection
  • 058.89 Other human herpesvirus infection
  • 079.83 Parvovirus B19 CC

7
Neoplasms
  • 200.30-38 Marginal zone lymphoma CC
  • 200.40-48 Mantle cell lymphoma CC
  • 200.50-58 Primary central nervous system lymphoma
    CC
  • 200.60-68 Anaplastic large cell lymphoma CC
  • 200.70-78 Large cell lymphoma CC
  • 202.70-78 Peripheral T cell lymphoma CC

8
Neoplasms
  • 233.30 Carcinoma in situ, unspecified female
    genital organ
  • 233.31 … vagina
  • 233.32 … vulva
  • 233.39 … other female genital organ

9
Endocrine, Nutritional, and Metabolic Diseases
and Immunity Disorders
  • 255.41 Glucocorticoid deficiency CC
  • 255.42 Mineralocorticoid deficiency CC
  • 258.01 Multiple endocrine neoplasia MEN type I
  • 258.02 … type IIA
  • 258.03 … type IIB

10
Diseases of the Blood and Blood-Forming Organs
  • 284.81 Red cell aplasia (acquired)(adult)(with
    thymoma) MCC
  • 284.89 Other specified aplastic anemias MCC
  • 288.66 Bandemia

11
Mental Disorders
  • 315.34 Speech and language developmental delay
    due to hearing loss

12
Diseases of the Nervous System and Sense
Organs
  • 331.5 Idiopathic normal pressure hydrocephalus
    (INPH) CC
  • 359.21 Myotonic muscular dystrophy
  • 359.22 … congenita
  • 359.23 … chondrodystrophy
  • 359.24 Drug induced myotonia
  • 359.29 Other specified myotonic disorder
  • 364.81 Floppy iris syndrome
  • 364.89 Other disorders of iris and ciliary body

13
Diseases of the Nervous System and Sense
Organs
  • 388.45 Acquired auditory processing disorder
  • 389.05 Conductive hearing loss, unilateral
  • 389.06 … bilateral
  • 389.13 Neural hearing loss, unilateral
  • 389.17 Sensory hearing loss, unilateral
  • 389.20 Mixed hearing loss, unspecified
  • 389.21 … unilateral
  • 389.22 … bilateral

14
Diseases of Circulatory System
  • 414.2 Chronic total occlusion of coronary artery
  • 415.12 Septic pulmonary embolism MCC
  • 423.3 Cardiac tamponade CC
  • 440.4 Chronic total occlusion of artery of the
    extremities
  • 449 Septic arterial embolism CC

15
Diseases of the Respiratory System
  • 488 Influenza due to identified avian influenza
    virus
  • Notes on use of code 488
  • Code only confirmed cases of avian influenza.
    (This is an exception to the hospital inpatient
    guidelines for coding uncertain diagnoses. )
  • Confirmation does not require documentation of
    positive laboratory testing
  • Coding should be based on the providers
    diagnostic statement
  • If the provider records suspected or possible or
    probable avian influenza, the appropriate
    influenza code from category 487 should be
    assigned.
  • Similar to coding of HIV/AIDS

16
Diseases of the Digestive System
  • 525.71 Osseointegration failure of dental implant
  • 525.72 Post-osseointegration biological failure
    of dental implant
  • 525.73 … mechanical failure …
  • 525.79 Other endosseous dental implant failure
  • 569.43 Anal sphincter tear (healed) (old)

17
Diseases of the Genitourinary System
  • 624.01 Vulvar intraepithelial neoplasia I VIN I
  • 624.02 … neoplasia II VIN II
  • 624.09 Other dystrophy of vulva

18
Complications of Pregnancy, Childbirth, and the
Puerperium
  • 664.60 Anal sphincter tear complicating delivery,
    not associated with third-degree perineal
    laceration, unspecified as to episode of care or
    not applicable
  • 664.61 … delivered, w/ or w/out mention of
    antepartum condition CC
  • 664.64 … postpartum condition or complication CC

19
Diseases of the Musculoskeletal System and
Connective Tissue
  • 733.45 Aseptic necrosis of bone, jaw CC

20
Symptoms, Signs, and Ill-Defined Conditions
  • 787.20 Dysphagia, unspecified
  • 787.21 … oral phase
  • 787.22 … oropharyngeal phase
  • 787.23 … pharyngeal phase
  • 787.24 … pharyngoesophageal phase
  • 787.29 Other dysphagia
  • 789.51 Malignant ascites CC
  • 789.59 Other ascites CC

21
Injury and Poisoning
  • 999.31 Infection due to central venous catheter
    CC
  • 999.39 Infection following other infusion,
    injection, transfusion, or vaccination CC
  • Please note These codes were not included in
    the proposed rule but will be implemented on
    October 1, 2007.

22
V Codes
  • Factors influencing health-status and contact
    with health service
  • 20 new V Codes

23
V Codes
  • V12.53 Personal history of sudden cardiac arrest
  • V12.54 Personal history of transient ischemic
    attack (TIA), and cerebral infarction w/out
    residual deficits
  • V13.22 Personal history of cervical dysplasia

24
V Codes
  • V16.52 Family history of malignant neoplasm,
    bladder
  • V17.41 Family history of sudden cardiac death
    (SCD)
  • V17.49 Family history of other cardiovascular
    diseases
  • V18.11 Family history of multiple endocrine
    neoplasia MEN syndrome
  • V18.19 Family history of other endocrine and
    metabolic diseases

25
V Codes
  • V25.04 Counseling and instruction in natural
    family planning to avoid pregnancy
  • V26.41 Procreative counseling and advice using
    natural family planning
  • V26.49 Other procreative management, counseling
    and advice
  • V26.81 Encounter for assisted reproductive
    fertility procedure cycle
  • V26.89 Other specified procreative management

26
V Codes
  • V49.85 Dual sensory impairment
  • V68.01 Disability examination
  • V68.09 Other issue of medical certificates
  • V72.12 Encounter for hearing conservation and
    treatment

27
V Codes
  • V73.81 Special screening examination, Human
    papillomavirus (HPV)
  • V84.81 Genetic susceptibility to multiple
    endocrine neoplasia MEN
  • V84.89 … other disease

28
Procedure Codes
  • 39 new Procedure Codes
  • Please note Procedure Codes marked with an
    asterisk () were not included in the proposed
    rule but will be implemented on October 1, 2007.

29
Procedure Codes
  • 00.19 Disruption of blood brain barrier via
    infusion BBBD
  • 00.94 Intra-operative neurophysiologic
    monitoring
  • 01.10 Intracranial pressure monitoring
  • 01.16 Intracranial oxygen monitoring
  • 01.17 Brain temperature monitoring

30
Procedure Codes
  • 07.83 Thoracoscopic partial excision of thymus
  • 07.84 … total excision of thymus
  • 07.95 … incision of thymus
  • 07.98 Other and unspecified thoracoscopic
    operations on thymus

31
Procedure Codes
  • 32.20 Thoracoscopic excision of lesion or tissue
    of lung
  • 32.30 … segmental resection of lung
  • 32.39 Other and unspecified segmental resection
    of lung
  • 32.41 Thoracoscopic lobectomy of lung
  • 32.49 Other lobectomy of lung

32
Procedure Codes
  • 32.50 Thoracoscopic pneumonectomy
  • 32.59 Other and unspecified pneumonectomy
  • 33.20 Thoracoscopic lung biopsy
  • 34.06 … drainage of pleural cavity
  • 34.20 … pleural biopsy
  • 34.52 … decortication

33
Procedure Codes
  • 50.13 Transjugular liver biopsy
  • 50.14 Laparoscopic liver biopsy

34
Procedure Codes
  • 70.53 Repair of cystocele and rectocele with
    graft or prosthesis
  • 70.54 Repair of cystocele …
  • 70.55 Repair of rectocele …
  • 70.63 Vaginal construction with graft or
    prosthesis
  • 70.64 Vaginal reconstruction …
  • 70.78 Vaginal suspension and fixation …

35
Procedure Codes
  • 70.93 Other operations on cul-de-sac with graft
    or prosthesis
  • 70.94 Insertion of biological graft
  • 70.95 Insertion of synthetic graft or prosthesis

36
Procedure Codes
  • 84.80 Insertion or replacement of interspinous
    process device(s)
  • 84.81 Revision of …
  • 84.82 Insertion or replacement of pedicle-based
    dynamic stabilization device(s)
  • 84.83 Revision of …
  • 84.84 Insertion or replacement of facet
    replacement device(s)
  • 84.85 Revision of …

37
Procedure Codes
  • 88.59 Intra-operative fluorescence vascular
    angiography
  • 92.41 Intra-operative electron radiation therapy

38
Guidelines
  • ICD-9-CM Official Guidelines for Coding and
    Reporting, Effective October 1, 2007
  • www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdguide07
    .pdf

39
Addenda to the ICD-9-CM Index
  • Accident, accidental - see also condition
  • cerebrovascular (current) (CVA) (see also
    Disease, cerebrovascular, acute) 434.91
  • aborted 434.91
  • healed or old V12.54
  • (See Coding Clinic Q3, 2007)
  • Anemia
  • postoperative
  • due to (acute) blood loss 285.1
  • chronic blood loss 280.0

40
Addenda to the ICD-9-CM Index
  • Ascites 789.59
  • abdominal NEC 789.59
  • cancerous (M8000/6) 789.51
  • malignant (M8000/6) 789.51
  • pseudochylous 789.59

41
Addenda to the ICD-9-CM Index
  • CIDP (chronic inflammatory demyelinating
    polyneuropathy) 357.81
  • Congestion, congestive (chronic) (passive)
  • chest 786.9
  • lung 786.9
  • nose 478.19
  • Crush, crushed, crushing (injury) 929.9
  • with
  • fracture - see Fracture, by site

42
Addenda to the ICD-9-CM Index
  • Death
  • cardiac (sudden) (SCD) - see Disease, heart code
    to underlying condition
  • Deficit
  • neurologic NEC 781.99
  • ischemic
  • reversible (RIND) 434.91
  • history of (personal) V12.54
  • prolonged (PRIND) 434.91
  • history of (personal) V12.54

43
Addenda to the ICD-9-CM Index
  • Disease, diseased - see also Syndrome
  • liver 573.9
  • end stage NEC 572.8
  • due to hepatitis - see Hepatitis
  • Feeling of foreign body in throat 784.99
  • Foreign body
  • feeling of, in throat 784.99
  • throat, feeling of 784.99

44
Addenda to the ICD-9-CM Index
  • Fluid
  • peritoneal cavity 789.59
  • malignant 789.51
  • Findings, abnormal, without diagnosis
    (examination) (laboratory test) 796.4
  • cholesterol 272.9
  • high 272.0
  • with high triglycerides 272.2

45
Addenda to the ICD-9-CM Index
  • History (personal) of
  • family
  • myocardial infarction V17.3
  • sudden cardiac death (SCD) V17.41
  • personal
  • sudden
  • cardiac
  • arrest V12.53
  • death (successfully resuscitated) V12.53

46
Addenda to the ICD-9-CM Index
  • Neoplasia
  • vaginal intraepithelial I VAIN I 623.0
  • vaginal intraepithelial II VAIN II 623.0
  • vaginal intraepithelial III VAIN III 233.31
  • vulvar intraepithelial I VIN I 624.01
  • vulvar intraepithelial II VIN II 624.02
  • vulvar intraepithelial III VIN III 233.32

47
Addenda to the ICD-9-CM Index
  • Long-term (current) drug use V58.69
  • tamoxifen V58.69
  • Pneumonia
  • ventilator associated 999.9
  • Runny nose 784.99
  • Scratchy throat 784.99

48
Addenda to the ICD-9-CM Index
  • Status (post)
  • sex reassignment surgery (see also
    Tran-sexualism) 302.50
  • Stenosis (cicatricial) - see also Stricture
  • artery NEC (see also Arteriosclerosis) 447.1
  • extremities 440.20
  • Stroke 434.91
  • in evolution 434.91

49
Medicare Severity DRGs MS-DRGs
  • Effective for discharges beginning 10/1/07
  • Why a severity adjusted classification system?
  • ability to differentiate cases based on severity
    of illness and resource consumption
  • The RAND report focuses on the following
    criteria
  • sensitivity to severity
  • How well each classification system explains
    variation in resource use
  • Whether the groupings are manageable,
    administratively feasible and understandable
  • Payment accuracy

50
Medicare Severity DRGs MS-DRGs
  • What is the same?
  • For Payment of Acute Hospital Inpatient
    Discharges
  • Exempt
  • Critical Access Hospitals
  • Rehab Hospitals and units
  • Long Term Acute Care Hospitals
  • Psychiatric Hospitals and Units
  • Childrens Hospitals
  • Cancer Hospitals

51
Medicare Severity DRGs MS-DRGs
  • What is the same?
  • Admissions that are medically necessary are paid
    for under Medicare Part A by DRG payment
    methodology
  • Each MS-DRG has been assigned a payment weight
    based on average resources used to treat Medicare
    patients
  • Post acute care transfer payment policy

52
Medicare Severity DRGs MS-DRGs
  • What is the same?
  • The basic grouping process is the same
  • Principal diagnosis and up to 8 additional
    diagnoses ( ICD-9-CM)
  • Up to 6 procedure codes ( ICD-9-CM)
  • Gender and discharge status still affect some DRG
    assignments

53
Medicare Severity DRGs MS-DRGs
  • What is the same?
  • Still organized by Pre-MDC DRGs and 25 MDCs

54
Medicare Severity DRGs MS-DRGs
  • What is different?
  • Complete restructuring of the DRG system (745
    DRGs in FY 2008 replacing 538 in FY 2007)
  • MS-DRG categories split by
  • With Major CC
  • With CC
  • Without CC or MCC
  • (some exceptions)

55
Medicare Severity DRGs MS-DRGs
  • What is different?
  • Addition of a Major CC List (1584 MCCs)
  • http//www.cms.hhs.gov/AcuteInpatientPPS/FFD/itemd
    etail.asp?filterTypenonefilterByDID-99sortByDI
    D2sortOrderascendingitemIDCMS1201733intNumPe
    rPage10
  • Revision of the CC list (3343 CCs)
  • http//www.cms.hhs.gov/AcuteInpatientPPS/FFD/itemd
    etail.asp?filterTypenonefilterByDID-99sortByDI
    D2sortOrderascendingitemIDCMS1201734intNumPe
    rPage10

56
Medicare Severity DRGs MS-DRGs
  • Simple Pneumonia and Pleurisy
  • DRG 193 w/ Major CC wt.1.2505
  • DRG 194 w/ CC wt. 1.0235
  • (FY 07 wt. 1.0376)
  • DRG 195 (w/out CC or MCC) wt. .8398
  • (FY 07 wt. .6148)

57
Medicare Severity DRGs MS-DRGs
  • Major small and large bowel procedures
  • DRG 329 w/ Major CC wt. 4.5059
  • (FY 07 wt. 4.3425)
  • DRG 330 w/ CC wt. 2.8935
  • (FY 07 wt. 2.6978)
  • DRG 331 w/out CC or MCC wt. 1.8415
  • (FY 07 wt.1.4364)

58
Medicare Severity DRGs MS-DRGs
  • Percutaneous Cardiovascular procedures
  • DRG 246 w/ drug-eluting stent w/ MCC or 4
    vessels or stents wt. 2.9046
  • (FY 07 wt. 2.7610)
  • DRG 247 w/ drug-eluting stent w/o MCC wt. 2.1255
  • (FY 07 wt. 2.0814)
  • 4 vessels or stents
  • 36.07 and any of the following procedure
    combinations
  • 00.43 procedure 4 vessels and 00.66 procedure
    PTCA or coronary atherectomy
  • 00.48 insertion 4 vascular stents and 00.66
    procedure PTCA or coronary atherectomy

59
Medicare Severity DRGs MS-DRGs
  • Nutritional and Metabolic Disorders (e.g.,
    dehydration)
  • DRG 640 w/ Major CC wt. .9793
  • (FY 07 wt. .8334)
  • DRG 641 w/out CC or MCC wt. .7248
  • (FY07 wt. .5090)
  • Syncope and Collapse
  • DRG 312 wt. .7197
  • (FY 07 wt. .5024 or wt. .7627)

60
Medicare Severity DRGs MS-DRGs
  • Congestive Heart Failure
  • 291 Heart failure and shock w/ MCC wt. 1.2585
  • (FY 07 wt. 1.0485)
  • 292 Heart failure and shock w/ CC wt. 1.0134
    (FY 07 wt. 1.0485)
  • 293 Heart failure and shock w/out CC/MCC wt.
    0.8765
  • (FY 07 wt. 1.0485)

61
Medicare Severity DRGs MS-DRGs
  • Sepsis
  • 870 Septicemia w/ MV 96 hours wt. 5.7579
  • (FY 07 wt. 5.9388 or 1.8734)
  • 871 Septicemia w/out MV 96 hours w/ MCC wt.
    1.7484
  • (FY 07 wt. 1.5953)
  • 872 Septicemia w/out MV 96 hours w/out MCC wt.
    1.3783
  • (FY 07 wt. 1.5953)

62
Medicare Severity DRGs MS-DRGs
  • Respiratory Failure
  • 207 Respiratory system diagnosis w/ ventilator
    support 96 hours wt. 5.1231
  • (FY 07 wt. 5.2294)
  • 208 Respiratory system diagnosis w/ ventilator
    support lt96 hours wt. 2.2463
  • (FY 07 wt. 2.3335)

63
Medicare Severity DRGs MS-DRGs
  • Selected Major CCs
  • Quadriplegia
  • Severe malnutrition
  • Toxic encephalopathy
  • Acute systolic congestive heart failure
  • Acute diastolic congestive heart failure
  • Pneumonia
  • Acute renal failure
  • End stage renal disease
  • Decubitus ulcers
  • Cardiogenic/septic shock
  • Fractures/burns
  • Sepsis/severe sepsis

64
Medicare Severity DRGs MS-DRGs
  • The following are Major CCs only for patients
    discharged alive, otherwise they are assigned as
    a non CC.
  • Diagnoses codes
  • 427.41 (Ventricular fibrillation)
  • 427.5 (Cardiac arrest)
  • 785.51 (Cardiogenic shock)
  • 785.59 (Other shock w/out mention of trauma)
  • 799.1 (Respiratory arrest)

65
Medicare Severity DRGs MS-DRGs
  • A few CCs to keep in mind
  • 427.0 Paroxysmal supraventricular tachycardia
  • 427.1 Paroxysmal ventricular tachycardia
  • 427.32 Atrial Flutter
  • 438.2x Late effects of CVA-Hemiplegia
  • 599.0 Urinary tract infection
  • Some Additions to the CC list
  • V55.1 Attention to Gastrostomy
  • V62.84 Suicidal ideation
  • V85.0 Body Mass Index less than 19, adult
  • V85.4 Body Mass Index 40 and over, adult

66
Medicare Severity DRGs MS-DRGs
  • No longer CCs (not a complete list)
  • 135 Sarcoidosis
  • 138 Late effect acute polio
  • 250.01 DMI w/out cmp nt st uncntrl
  • 250.02 DMII w/out cmp uncntrld
  • 250.03 DMI w/out cmp uncntrld
  • 263.0 Malnutrition mod degree
  • 263.1 Malnutrition mild degree
  • 276.50 Volume depletion NOS
  • 276.51 Dehydration
  • 276.52 Hypovolemia
  • 276.6 Fluid overload
  • 276.7 Hyperpotassemia

67
Medicare Severity DRGs MS-DRGs
  • No longer CCs (not a complete list)
  • 340 Multiple sclerosis
  • 358.00 Myesthenia gravis w/out acute exacerbation
  • 413.9 Angina pectoris NEC/NOS
  • 424.0 Mitral valve disorder
  • 424.1 Aortic valve disorder
  • 427.31 Atrial fibrillation
  • 428.0 CHF NOS
  • 491.20 Obst chr bronc w/out exacerbation
  • 492.8 Emphysema NEC
  • 496 Chronic airway obstruct NEC
  • 515 Postinflamatory pulmonary fibrosis

68
Medicare Severity DRGs MS-DRGs
  • No longer CCs (not a complete list)
  • 536.40 Gastrostomy complication NOS
  • 536.49 Gastrostomy complication NEC
  • 571.2 Alcoholic cirrhosis liver
  • 571.49 Chronic hepatitis NEC
  • 571.5 Cirrhosis of liver NOS
  • 571.6 Biliary cirrhosis
  • 573.3 Hepatitis NOS
  • 585.1 Chronic Kidney disease stage I
  • 585.2 Chronic Kidney disease stage II
  • 585.3 Chronic Kidney disease stage III
  • 585.9 Chronic Kidney disease NOS
  • 599.7 Hematuria

69
Medicare Severity DRGs MS-DRGs
  • No longer CCs (not a complete list)
  • 696.0 Psoriatic arthropathy
  • 710.0 Systemic lupus erythematosus
  • 710.1 Systemic sclerosis
  • 722.80 Postlaminectomy syndrome NOS
  • 722.81 Postlaminectomy syndrome-cervical
  • 722.82 Postlaminectomy syndrome-thoracic
  • 722.83 Postlaminectomy syndrome-lumbar
  • 780.39 Convulsions NEC
  • 788.20 Retention urine NOS
  • 997.5 Surgical complication-urinary tract
  • 998.89 Other specific complication of procedure
    NEC
  • V42.2 Heart valve transplant
  • V45.1 Renal dialysis status

70
Opportunities for Documentation Improvement
  • Malnutrition
  • 260 Kwashiorkor MCC
  • 261 Nutritional marasmus MCC
  • 262 Other severe protein-calorie malnutrition
    MCC
  • 263.2 Arrested development following
    protein-calorie malnutrition CC
  • 263.8 Other protein-calorie malnutrition CC
  • 263.9 Unspecified protein-calorie malnutrition
    CC
  • 263.0 Malnutrition of Moderate degree Not a CC
  • 263.1 Malnutrition of Mild degree Not a CC

71
Opportunities for Documentation Improvement
  • Congestive Heart Failure, Major CCs
  • 428.21 Acute systolic heart failure MCC
  • 428.23 Acute on chronic systolic heart failure
    MCC
  • 428.31 Acute diastolic heart failure MCC
  • 428.33 Acute on chronic diastolic heart failure
    MCC
  • 428.41 Acute combined systolic and diastolic
    heart failure MCC
  • 428.43 Acute on chronic combined systolic and
    diastolic heart failure MCC

72
Opportunities for Documentation Improvement
  • Congestive Heart Failure, CCs
  • 428.1 Left heart failure CC
  • 428.20 Unspecified systolic heart failure CC
  • 428.22 Chronic systolic heart failure CC
  • 428.30 Unspecified diastolic heart failure CC
  • 428.32 Chronic diastolic heart failure CC
  • 428.40 Unspecified combined systolic and
    diastolic heart failure CC
  • 428.42 Chronic combined systolic and diastolic
    heart failure CC
  • 428.0 Congestive heart failure unspecified Not a
    CC
  • 428.9 Heart Failure Unspecified Not a CC

73
Opportunities for Documentation Improvement
  • Coding Clinic 2002 Q2
  • For Inpatient Discharges, requires the attending
    physician to confirm the results of diagnostic
    testing in the progress notes or discharge
    summary. (Do not code from radiology or
    laboratory reports.)
  • Coding Clinic 2004 Q1
  • For Inpatient Discharges, documentation from a
    physician other than the attending may be used
    for coding purposes as long as the documentation
    does not conflict with information written by the
    attending physician.

74
Resources
  • Federal Register
  • http//a257.g.akamaitech.net/7/257/2422/01jan20071
    800/edocket.access.gpo.gov/2007/pdf/07-3820.pdf
  • ICD-9-CM Official Guidelines for Coding and
    Reporting, Effective October 1, 2007
  • www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdguide07
    .pdf
  • Major CC List
  • http//www.cms.hhs.gov/AcuteInpatientPPS/FFD/itemd
    etail.asp?filterTypenonefilterByDID-99sortByDI
    D2sortOrderascendingitemIDCMS1201733intNumPe
    rPage10
  • CC list
  • http//www.cms.hhs.gov/AcuteInpatientPPS/FFD/itemd
    etail.asp?filterTypenonefilterByDID-99sortByDI
    D2sortOrderascendingitemIDCMS1201734intNumPe
    rPage10

75
Resources
  • Crosswalk V24.0 to V25.0
  • http//www.cms.hhs.gov/AcuteInpatientPPS/FFD/itemd
    etail.asp?filterTypenonefilterByDID0sortByDID
    2sortOrderascendingitemIDCMS1198678intNumPerP
    age10
  • V25.0 DRGs and Weights
  • http//www.cms.hhs.gov/AcuteInpatientPPS/FFD/itemd
    etail.asp?filterTypenonefilterByDID0sortByDID
    2sortOrderascendingitemIDCMS1198553intNumPerP
    age10
  • Ingenix DRG Calculator
  • https//www.hospitalbenchmarks.com/DRGCalculator.a
    spx
  • 3M MS-DRG V 25.0 Definitions Manual
  • Barry Libman Inc., Resources
  • www.barrylibmaninc.com

76
Recommendations
  • Review the lists of new DRGS, major CCs and CCs
  • Test the new encoders
  • Practice, Practice, Practice

77
Questions?
  • Barry Libman, RHIA, CCS, CCS-P
  • President, Barry Libman Inc.
  • 978-369-7180
  • Email barry_at_barrylibmaninc.com
  • www.barrylibmaninc.com
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