Addition of MS-DRG Subject to IPPS Replaced Devices Offered Without Cost or With a Credit Policy

MLN Matters Number: MM11508
Related CR Release Date: November 1, 2019
Related CR Transmittal Number: R2381OTN
Related Change Request (CR) Number: 11508
Effective Date: October 1, 2019
Implementation Date: April 6, 2020

Change Request (CR) 11508 adds Medicare Severity Diagnosis-Related Groups (MS-DRGs) 319 and 320 (Other Endovascular Cardiac Valve Procedures with and without major complications and comorbidities (MCC), respectively) to the list of MS-DRGs subject to the policy for replaced devices offered without cost or with a credit.

The Centers for Medicare & Medicaid Services (CMS) reduces a hospital's Inpatient Prospective Payment System (IPPS) payment for specified MS-DRGs, when the implantation of a device is replaced without cost or with a credit equal to 50 percent or more of the cost of the replacement device. New MS-DRGs are added to the list, subject to the IPPS payment policy for replaced devices offered without cost or with a credit, when they are formed from procedures assigned to MS-DRGs that were previously on the list.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11508.

Last Updated Nov 05, 2019