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CGI adds new DRG validation issues

Recovery Auditor Report, February 4, 2010

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• Acute respiratory failure: MS-DRG 189
• Cardiac defibrillator implant with cardiac catheter without AMI/HF/shock with major complication/comorbidity (MCC)
• Cardiac valve and other major cardiothoracic procedures with complication/comorbidity (CC) or MCC
• Carotid artery stent and extracranial procedures with CC or MCC
• Coronary bypass with PTCA/cardiac catheter with MCC
• Cranial/facial procedures with CC or MCC
• Craniotomy, endovascular and intracranial vascular procedures with CC or MCC
• Disorders of the eye, infections and procedures (orbital and interocular) with CC or MCC
• Major cardiovascular thoracic aortic aneurysm repair procedures with CC or MCC
• Major chest procedures with CC or MCC
• Major head and neck procedures with CC or MCC
• Other cardiothoracic procedures with CC or MCC
• Other ear, nose, mouth and throat OR procedures with CC or MCC
• Percutaneous cardiovascular procedure with drug-eluting or non-drug-eluting stent with MCC or four-plus vessels/stents
• Periph/cranial nerve and other nervous system procedure with CC or MCC
• Tracheostomy MS-DRG validation—overpayment and underpayment
• Ventricular shunt procedures with CC or MCC

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