KMAP MS-DRG/CMS-DRG Crosswalk

[Pages:35]KMAP MS-DRG/CMS-DRG Crosswalk

Legend

No MS-DRG to cross-walk

Crosswalk reviewed, selected and approved by

KHPA 9/24/07

Crosswalk reviewed, selected and approved by KHPA 9/24/07

CMS crosswalk revised by KHPA

CMS V24 103

103

MDC MedSurg MS v25

PR

S

001

002

MS-DRG Descriptions Heart transplant or implant of heart assist system w MCC Heart transplant or implant of heart assist system w/o MCC

541

PR

S

003

ECMO or trach w MV 96+ hrs or

PDX exc face, mouth & neck w

maj O.R.

542

PR

S

004

Trach w MV 96+ hrs or PDX exc

face, mouth & neck w/o maj O.R.

Comments by CMS Comments

480

PR

S

005

Liver transplant w MCC or

Procedure 4697 (Transplant of intestine) is

intestinal transplant

always assigned to MS-DRG 005 regardless

of severity level

480

006

Liver transplant w/o MCC

495

PR

S

007

Lung transplant

512

PR

S

008

Simultaneous pancreas/kidney

transplant

481

PR

S

009

Bone marrow transplant

513

PR

S

010

Pancreas transplant

482

PR

S

011

482

012

482

013

528

01

S

020

528

021

528

022

543

01

S

023

Revised 12/07/2007

Tracheostomy for face,mouth & neck diagnoses w MCC Tracheostomy for face,mouth & neck diagnoses w CC Tracheostomy for face,mouth & neck diagnoses w/o CC/MCC

Intracranial vascular procedures w PDX hemorrhage w MCC

Intracranial vascular procedures w PDX hemorrhage w CC

Intracranial vascular procedures w PDX hemorrhage w/o CC/MCC

Cranio w major dev impl/acute complex CNS PDX w MCC or chemo implant

Non-or procedure 0010(Implant chemothera agent) is always assigned to MS-DRG 023 regardless of severity level; Added procedure 0062 to MS-DRG 023-027

Page: 1

KMAP MS-DRG/CMS-DRG Crosswalk

Legend

No MS-DRG to cross-walk

Crosswalk reviewed, selected and approved by

KHPA 9/24/07

Crosswalk reviewed, selected and approved by KHPA 9/24/07

CMS crosswalk revised by KHPA

Comments by CMS

CMS V24 543

MDC MedSurg MS v25 024

MS-DRG Descriptions Cranio w major dev impl/acute complex CNS PDX w/o MCC

Comments

001

002 003*

531 532 532

01

S

025

026 027

01

S

028

029

030

Craniotomy & endovascular intracranial procedures w MCC

Craniotomy & endovascular intracranial procedures w CC Craniotomy & endovascular intracranial procedures w/o CC/MCC

*CMS v24 DRG 003 procedures are split between MS-DRGs 025,026,027,031,032,033; Added procedure 0062 to MS-DRG 023-027

Spinal procedures w MCC

Spinal procedures w CC or spinal Combination of 0393 with (8694 or 8695 or

neurostimulators

8697 or 8698) is always assigned to MS-DRG

029 regardless of severity level

Spinal procedures w/o CC/MCC

529

01

S

031

Ventricular shunt procedures w

MCC

530

032

Ventricular shunt procedures w

CC

530

033

Ventricular shunt procedures w/o

CC/MCC

577

01

S

034

Carotid artery stent procedure w

MCC

577

035

Carotid artery stent procedure w

CC

577

036

Carotid artery stent procedure

w/o CC/MCC

533

01

S

037

Extracranial procedures w MCC

534

038

Extracranial procedures w CC

534

039

Extracranial procedures w/o

CC/MCC

006

01

S

040

Periph & cranial nerve & other

nerv syst proc w MCC

007

041

Periph/cranial nerve & other nerv Combination of 0492 with (8694 or 8695 or

syst proc w CC or periph

8697 or 8698) is always assigned to MS-DRG

neurostim

041 regardless of severity

008

042

Periph & cranial nerve & other

nerv syst proc w/o CC/MCC

009

01

M

052

Spinal disorders & injuries w

CC/MCC

009

053

Spinal disorders & injuries w/o

CC/MCC

010

01

M

054

Nervous system neoplasms w

MCC

011

055

Nervous system neoplasms w/o

MCC

Revised 12/07/2007

Page: 2

KMAP MS-DRG/CMS-DRG Crosswalk

Legend

No MS-DRG to cross-walk

Crosswalk reviewed, selected and approved by

KHPA 9/24/07

Crosswalk reviewed, selected and approved by KHPA 9/24/07

CMS crosswalk revised by KHPA

CMS V24 012

012

MDC MedSurg MS v25

01

M

056

057

MS-DRG Descriptions Degenerative nervous system disorders w MCC Degenerative nervous system disorders w/o MCC

013

01

M

058

Multiple sclerosis & cerebellar

ataxia w MCC

013

059

Multiple sclerosis & cerebellar

ataxia w CC

013

060

Multiple sclerosis & cerebellar

ataxia w/o CC/MCC

559

01

M

061

Acute ischemic stroke w use of

thrombolytic agent w MCC

559

062

Acute ischemic stroke w use of

thrombolytic agent w CC

559

063

Acute ischemic stroke w use of

thrombolytic agent w/o CC/MCC

014

01

M

064

Intracranial hemorrhage or

cerebral infarction w MCC

014

065

Intracranial hemorrhage or

cerebral infarction w CC

014

066

Intracranial hemorrhage or

cerebral infarction w/o CC/MCC

015

01

M

067

Nonspecific cva & precerebral

occlusion w/o infarct w MCC

015

068

Nonspecific cva & precerebral

occlusion w/o infarct w/o MCC

524

01

M

069

Transient ischemia

Comments by CMS Comments

016

01

M

070

017

071

017

072

018

01

M

073

019

074

021

01

M

075

021

076

022

01

M

077

022

078

022

079

Revised 12/07/2007

Nonspecific cerebrovascular disorders w MCC Nonspecific cerebrovascular disorders w CC Nonspecific cerebrovascular disorders w/o CC/MCC

Cranial & peripheral nerve disorders w MCC Cranial & peripheral nerve disorders w/o MCC

Viral meningitis w CC/MCC Viral meningitis w/o CC/MCC

Hypertensive encephalopathy w MCC Hypertensive encephalopathy w CC Hypertensive encephalopathy w/o CC/MCC

Page: 3

KMAP MS-DRG/CMS-DRG Crosswalk

Legend

No MS-DRG to cross-walk

Crosswalk reviewed, selected and approved by

KHPA 9/24/07

Crosswalk reviewed, selected and approved by KHPA 9/24/07

CMS crosswalk revised by KHPA

Comments by CMS

CMS V24 023 023

MDC MedSurg MS v25

01

M

080

081

MS-DRG Descriptions

Nontraumatic stupor & coma w MCC Nontraumatic stupor & coma w/o MCC

Comments

027 027 027

028 029 030

031 032 033 034 035 035

560

560

560

561

561 561

026* 562 563 564 564

01

M

082

083

084

01

M

085

086

087

01

M

088

089

090

01

M

091

092

093

01

M

094

095

096

01

M

097

098 099

01

M

100

101

01

M

102

103

Traumatic stupor & coma, coma >1 hr w MCC Traumatic stupor & coma, coma >1 hr w CC Traumatic stupor & coma, coma >1 hr w/o CC/MCC

Traumatic stupor & coma, coma ................
................

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