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News: CMS releases 2009 Inpatient Prospective Payment System (IPPS) proposed rule

CDI Strategies, April 17, 2008

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On April 14, CMS released the 2009 IPPS proposed rule. The rule includes proposed revisions to Medicare Severity (MS) DRGs for acute care hospitals and long-term care hospital DRGs.

According to a press release, CMS is proposing to subdivide current MS-DRG 245 (AICD lead and generator procedures) and create a new MS-DRG to separate the implantation or replacement of the AICD leads from the implantation or replacement of the AICD pulse generators. The title for MS-DRG 245 would be revised to “AICD generator procedures” and include procedure codes 37.96, 37.98, and 00.54 that identify the implantation or replacement of AIC pulse generators. The proposed new MS-DRG would include procedure codes that identify the AICD leads (i.e., 37.95, 37.97, and 00.52) and be titled “MS-DRG 265, AICD lead procedures.”

The proposed rule would also insert the words “or severe sepsis” after “Septicemia” in the titles of the following MS-DRGs that became effective October 1, 2007:

• MS-DRG 870: Septicemia with mechanical ventilation 96+ hours
• MS-DRG 871: Septicemia without mechanical ventilation 96+ hours with MCC 
• MS-DRG 872: Septicemia without mechanical ventilation 96+ hours without MCC

Other proposed changes include 43 new inpatient quality data measures that hospitals must report to receive their full annual IPPS payment update. Providers—including CDI specialists—have until June 13 to submit their comments on the rule to CMS. The final rule will take effect October 1, 2008.

To view the rule, click here.

To comment on the rule, click here.

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