Ms-drg-icd-10 coding presentation


The MS-DRG grouper logic for ICD-10 has been designed so that for almost all cases, the DRG assigned for a case coded in ICD-10 is the same as in ICD-9. 2 The basic concepts of the DRG system have also remained stable: the number, title, and structure of the DRGs have remained the same; there are still pre-Major Diagnostic Category (MDC) DRGs; the principal diagnosis …

FAQ ms-drg-icd-10 coding presentation

Will ICD-10-CM/PCS impact MS-DRG reimbursement?

Prior to the October 1, 2015 implementation of ICD-10-CM/PCS, every hospital must examine how the new code set will impact MS-DRG reimbursement. A recent Centers for Medicare and Medicaid Services (CMS) analysis indicates the overall effect of the transition to ICD-10 on hospital reimbursement will be negligible.

How is the ICD-10 code treated for DRG logic?

For the purposes of DRG logic, typically, the more specific ICD-10 code is treated in the same way as its less specific ICD-9 counterpart for grouping purposes. For example, in ICD-10-CM, there are three code choices for atrial flutter:

What is a combination code in ICD 10?

ICD-10 combination codes that incorporate a CC or MCC into a single diagnosis code pose an issue for DRG grouping. A combination code is a single code which represents multiple clinical issues. Clinical concepts that required two or more codes in ICD-9 only require a single combination code to be assigned in ICD-10.

How are the MS-DRG codes listed in the MDC?

ICD-10-CM/PCS MS-DRG v37.0 Definitions Manual Within each MDC, the MS-DRGs are listed in the order in which the grouper recognizes them. This enables users to see instances where grouper logic order differs from strict numerical order. Procedure codes that are listed with an * indicate that they are non-operating room procedures.

Pre-MDCs in inpatient coding – MS-DRG assignment using ICD-10-PCS

MS-DRG assignment for facility coding from principal diagnosis to DRG

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