CABG with Coronary Endarterectomy : impact on DRG 3MM
I know coronary it is not inherent to usual CABG procedures. What I see in 3mm after the latest release concerns me.
Instead of reflecting greater resource utilization and increase operative time, 3MM Changes the principle procedure to the coronary endarterctomy which is not accurate. This results in lower weighted DRG and ALOS.
SEE BELOW:
DRG 234 CORONARY BYPASS WITH CATH W/O MCC
CMS WEIGHT 4.952 A/LOS 8.6
When you add the coronary endarterectomy CODE 02C00ZZ it changes the DRG to
DRG 229 OTHER CT PROCEDURE W/O MCC
CMS WEIGHT 4.7459 ALOS 5.5
Comments
Please see Coding Clinic® third quarter 1993, page 7-8 that states that endarterectomy is considered to be integral to the CABG to relieve the obstruction should be followed. No additional PCS code for Extirpation should be assigned. You will notice that an additional Extirpation PCS code will affect the DRG and cause a shift from the ICD-9 DRG grouping.