ECMO PCS code changes
with the new PCS code changes for ECMO to specify if central vs peripheral it is now changing what DRG these patients are going to. now only the central (open/sternotomy) are going to DRG 003 and the others now driven by whatever the pdx is. it seems that if there is documentation with the peripheral ECMO that you are also using pVAD (peripheral ventricular assist device) that that is driving to a procedure for DRG 215. the equipment we are currently using does not allow us to use the pVAD. what are other facilities doing related to documentation opportunity?
thanks so much,
Alicia Mitchell
Comments
There is an ongoing discussion about this presently in one of our committees. There was no public commenting allowed on the changes to ECMO and it took many of us by surprise. CMS is going to wait until they have data about the average costs, length of stay, outcomes and mortality for peripheral ECMO to judge any further regarding their valuation. Since this is not a super common procedure in the Medicare population and since new ICD 10 PCS codes were just created on Oct 1, it could be a long wait indeed. CMS is encouraging you to write in the maintenance and coordination committee regarding the actual charges and outcomes associated with patients who get this therapy in comparison to what the stated GMLOS and cost reimbursed are...as soon as you have the data.