Health Information Management

News: CMS releases latest MS-DRG version, hosts ICD-10 teleconference

CDI Strategies, May 12, 2011

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Hospitals can start experimenting with how new ICD-10-CM/PCS codes will translate to MS-DRGs since CMS released its MS-DRG Version 28 Definitions Manual. ICD-10 is expected to map similarly to ICD-9; meaning when coders correctly report the same record in both ICD-9 and ICD-10, MS-DRG assignment should be the same, says Richard Averill, MS, senior vice president of clinical and economic research at 3M Health Information Systems in Wallingford, CT. 3M, is under CMS contract to convert MS-DRGs from ICD-9 to ICD-10.

Even though the impact may be minimal, appropriate MS-DRG assignment depends on coders capturing the appropriate ICD-10 codes. And that depends on the level of detail included in the medical record, says James S. Kennedy, MD, CCS, managing director of FTI Healthcare in Atlanta and a member of the ACDIS advisory board. The assumption that ICD-10 changes will only have limited impact on MS-DRG assignment is based on the assumption that hospitals have a strong CDI program and that coders are currently assigning accurate ICD-9 codes, Kennedy explains.
"Garbage in is garbage out. This axiom doesn't change in ICD-10. There's going to be more incomplete documentation identified in ICD-10 because ICD-10 is expanded and it does require added specificity," he says.
"If you're struggling with documentation and reimbursement in ICD-9, you will continue to struggle with this in ICD-10," agrees Kathy DeVault, RHIA, CCS, CCS-P, manager of professional practice resources at AHIMA in Chicago.
Next week, CMS will discuss a number of ICD-10-related initiatives in its national provider teleconference to be held on Wednesday, May 18, 1-2:30 p.m. (EST). Agency experts will talk about how CMS is currently handling its own conversion process and present a case study from the CMS Coverage and Analysis Group on its transition to ICD-10 for the lab national coverage determinations (NCDs). A question and answer session will follow the presentations. The agenda includes:
  • ICD-10 overview
  • Lab NCDs conversion process from ICD-9-CM to 1CD-10-CM
  • Home health conversion
  • OASIS and procedure code reporting
  • Update on claims spanning the implementation date
  • National ICD-10 implementation issues
To register visit the CMS website. Registration closes at Tuesday, May 17, at 1 p.m. The next ICD-10 national provider teleconference will be held on Wednesday, August 3.
Editor’s Note: This article was adapted from the newsletter Briefings on Coding Compliance Strategies.

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