Denial Related to Principle Diagnosis / Federal Registry
I'm currently appealing a denial where the insurance wants to flip the PDX into the lower paying DRG. (Cellulitis vs Heart Failure). Both were equally treated.
I know there is a statement in the Federal Registry by CMS stating they fully understand and support hospitals sequencing the higher paying DRG when it meets the definition of the principle.
Does anyone know the date / or pages in the Federal Registry where this is located. I want to use this in my appeal. I had a copy of the regulation but have lost it.