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and one of the following ICD-10-PCS code combinations, which captures cases involving neurostimulator generators inserted into the skull (including cases involving the use of the RNS© neurostimulator), to retitled MS-DRG 023 (Craniotomy with Major Device Implant or Acute Complex Central Nervous System (CNS) Principal Diagnosis (PDX) with MCC or Chemotherapy Implant or Epilepsy with Neurotimulator), even if there is no MCC reported:” CMS agreed with a requestor and finalized the proposal to add the following two codes representative of epilepsy diagnoses to the listing of epilepsy diagnosis codes for cases assigned to MS-DRG 023: CMS also sought public comment on a couple of issues specific to pacemakers.
CMS maintained their proposal to not create a new Pre-MDC MS-DRG for procedures involving the Civa Sheet® technology for FY 2019.
Laryngectomy Pre-MDC MS-DRGs 11, 12 and 13 (Tracheostomy for Face, Mouth and Neck Diagnoses with MCC, with CC, and without CC/MCC, respectively) Current logic for case assignment to MS-DRGs 11, 12 and 13: Chimeric Antigen Receptor (CAR) T-Cell Therapy “Chimeric Antigen Receptor (CAR) T-cell therapy is a cell-based gene therapy in which T-cells are genetically engineered to express a chimeric antigen receptor that will bind to a certain protein on a patient’s cancerous cells.
CMS indicated that “Our clinical advisors agree that until there is a way to specifically identify percutaneous ECMO in the claims data to enable further analysis, a proposal at this time is not warranted.” It just so happens that the FY 2019 ICD-10-PCS procedure code files include new ICD-10-PCS procedure codes identifying percutaneous ECMO procedures.
Additionally, the current code for ECMO procedures (ICD-10-PCS code 5A15223) has been revised. procedure, CMS reviewed the predecessor procedure code assignments.
MS-DRG 215 (Other Heart Assist System Implant) CMS stated in the FY 2018 IPPS Final Rule that they are aware of advice clarifying coding and reporting for certain external heart assist devices due to the technology being approved for new indications and current claims data does not reflect the updated guidance.
They also noted recent updates to descriptions of the codes for heart assist devices in the past year and provide the example qualifier “intraoperative” being added effective October 1, 2017 (FY 2018).
The Medicare Inpatient Prospective Payment System was first introduced in 1985 and the patient classification system was totally revised for the federal fiscal 2008 beginning October 1, 2007.
This revision was designed to better adjust for severity of illness.
Procedures described by these two ICD–10–PCS procedure codes are designated as non-O. procedures that have no impact on MS–DRG assignment.
CMS notes their “clinical advisors believe that patients receiving treatment utilizing CAR T-cell therapy procedures would have similar clinical characteristics and comorbidities to those seen in cases representing patients receiving treatment for other hematologic carcinomas who are treated with autologous bone marrow transplant therapy that are currently assigned to MS–DRG 016 (Autologous Bone Marrow Transplant with CC/MCC).