DRG and ICD9 Exclusions

[APTNurs]

Can anyone share with me if HCI3 has recommended a rationale to
provide to CMS for the MSDRG and ICD9 exclusions? Is there a standard
response that HCI3 would recommend or that other organizaitons have
used as a justification for each exclusion? Do you plan on submitting
an individual rationale for each exclusion or utilizing the HCUP
clinical classification categories to group exclusions for ICD9 Codes?

[Elizabeth Bailey]

Hi,

We are suggesting that applicants note "not clinically relevant" for
the rationale for each DRG and ICD9 exclusion.

Thanks,
Elizabeth

--
Elizabeth (Siteman) Bailey
Program Implementation Leader
Central Region
Health Care Incentives Improvement Institute
(e): elizabet...@hci3.org
(o): 989.486.1428
(c): 757.630.4235
www.hci3.org

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[Elizabeth Bailey]

Hi all -

We've received some questions regarding the version of MS-DRGs this
particular freeware employs. To clarify, we are using version 25. CMMI
has requested that applicants use version 26. However, the differences
between the two versions are very minor and using v25 will not have
much of an impact. Attached is a crosswalk of the most recent MS-DRG
version compared to v25 in case any users would like to review and/or
use as a basis for refinement of your exclusions. Thanks.

--
Elizabeth Bailey