Health Information Management

Refresh your knowledge of CC/MCCs

HIM-HIPAA Insider, April 6, 2015

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ICD-9-CM and ICD-10-CM/PCS are currently under a code freeze as the industry prepares for ICD-10 implementation. As a result, CMS has made only minimal changes to the CC and MCC lists for the past several years.

Coders and CDI specialists still need to pay attention to what conditions are considered CCs and MCCs, as well as sequencing rules which could affect MS-DRGs.
The MS-DRG system requires only one MCC to maximize relative weight and reimbursement, says Laurie L. Prescott, MSN, RN, CCDS, CDIP, AHIMA-approved ICD-10-CM/PCS trainer, CDI education specialist with HCPro, a division of BLR, in Danvers, Massachusetts. No matter how many CCs or MCCs are added to the account, it will remain at that level.
For example, an admission for aspiration pneumonia with the single MCC of acute respiratory failure leads to MS-DRG 177 with a relative weight of 2.0549. "Even if this patient developed a pulmonary embolus and suffered from end-stage renal disease, which are both MCCs, the DRG would remain at 177 with the same relative weight," Prescott says.
Continue reading "Refresh your knowledge of CC/MCCs" on the HCPro website. Subscribers to Briefings on Coding Compliance Strategies have free access to this article in the April issue.

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