CQW Panacea-re-brand-rev3

For the Week of July 27, 2015

Question:

Will Medicare hospital payments under ICD-10 be the same as the payments currently received under ICD-9?

Answer:

The Centers for Medicare & Medicaid Services (CMS) conducted a fiscal year 2015 study on the impact of converting Medicare severity diagnosis-related groups (MS-DRGs) to ICD-10. The study found that moving from an ICD-9-CM-based system to an ICD-10 MS-DRG replicated system resulted in a statistically zero impact on payment.

Specifically, 99 percent of the records did not shift to another MS-DRG when using an ICD-10 MS-DRG system. For the 1 percent of records that shifted, 41 percent were to a higher-weighted MS-DRG and 66 percent were to a lower-weighted MS-DRG. The net impact across all MS-DRGs was a reduction of minus 4 cents per $100, which is statistically zero impact, according to CMS.

For more information about this study, refer to “Converting MS-DRGs to ICD-10-CM and ICD-10-PCS – Updated 03/03/15 With New 2015 Impact Article” located in the Downloads section at http://www.cms.gov/Medicare/Coding/ICD10/ICD-10-MS-DRG-Conversion-Project.html on the CMS website.

 

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