There are also technical adjustments for local wage variations, teaching hospitals, and hospitals with a disproportionate share of financially indigent patients.
There are also adjustments applied to certain types of transfers for some payments.
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.
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.
When making comparisons among various hospitals or patient groups, the case mix index can be used to adjust indicators such as average charges.
(Case mix adjusted average charges would be actual charges divided by the classification system is a useful tool for managing inpatient quality measurements and operating costs.