Reference
Good afternoon all. I have been asked to submit a question so I hope am wording it properly. Does anyone know of or have acccess to a reference list or document that gives the DRG in which a CC/MCC is not a CC/MCC when in this DRG? Thanks! Dawn
Comments
Table 6K Complete list of CC exclusions for the MS-DRGs
There are actually 2 tables -- one where it tells you for a given code as a pdx, which cc/mcc are excluded & the second is for each cc code which codes as pdx the cc won't count for.
From the CMS IPPS home page:
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html
It appears the exclusion for a CC is based not on the DRG but rather specific ICD-9 codes as PDX's (a technical nuance I know, but still ... one of the areas where at least one CDI strategy rests, unstable angina is not a CC when 428.0 is pdx, but if have a specified HF, then it will act as a cc).
Don