• Insight
  • Medicare Coverage Gap Discount Program Guidance Beginning in 2011
  • CMS Proposed 2011 Policies and Payment Rates for Inpatient Services
  • CMS Issues Final 2011 Payment Policies for Medicare Advantage and Prescription Drug Plans
  • OPPS 2010 Rule Update
  • MPFS 2010 Rule Update
  • OIG releases CY 2010 Work Plan – Is your brand at risk?
  • Medicare Administrative Contractor Protest Update
  • Health Economics and Reimbursement
  • The Impact of ICD-10 on MS-DRGs

The Impact of ICD-10 on MS-DRGs

2009 is the first year that hospitals will experience the full impact of the Medicare Severity Diagnosis Related Groups (MS-DRGs). Many question how the proposed implementation of the International Classification of Diseases Tenth Revision (ICD-10) will change the way inpatient cases are grouped for reimbursement.

Further, observers now ask, will implementation of ICD-10 code sets change MS-DRG assignment yet again?

Reimbursement crosswalks allow users to easily identify ICD-9 and corresponding ICD-10 codes and MS-DRGs.  For a more complete description of the impact of ICD-10 on MS-DRGs, click here.

MS-DRG ICD-9 to ICD-10 Conversion Conventions

• If an ICD-10 code combines the descriptions of two separate ICD-9 codes, then the ICD-10 code replaces the more commonly used ICD-9 code. 
• Several general ICD-9 codes in a ‘cluster’ may be replaced with a single highly specific ICD-10 code.

New diagnosis codes could lead to different MS-DRGs and change reimbursement for inpatient stays.  As a result, hospitals may forego utilization of your product for another.  The Aequitas Group can help you to understand the ICD-9-CM conversion and prepare for ICD-10—preventing significant revenue loss that can result from this change.  For more information or to request a capabilities demonstration, contact us today.