Home Health & Hospice Week

The DRG for psychoses will be the newest addition to the post-acute transfer payment policy beginning Oct. 1. The Centers forMedicare & Medicaid Services proposed adding DRG 430 in the May 18 Federal Register, as well as eliminating DRG 483 (Tracheotomy With Mechanical Ventilation 96+ Hours or Principal Diagnosis Except Face, Mouth and Neck Diagnoses). Instead, two more specific trach DRGs, the proposed 541 and 542, would take its place. When the proposed rule is finalized, the post-acute transfer policy will apply to the following DRGs:

12 Degenerative Nervous System Disorders
14 Intracranial Hemorrhage and Stroke With Infarction
24 Seizure and Headache Age >17 With CC
25 Seizure and Headache Age >17 Without CC
88 Chronic Obstructive Pulmonary Disease
89 Simple Pneumonia and Pleurisy Age > 17 With CC
90 Simple Pneumonia and Pleurisy Age > 17 Without CC
113 Amputation for Circulatory System Disorders Except Upper Limb and Toe
121 Circulatory Disorders With AMI and Major Complication, Discharged Alive
122 Circulatory Disorders With AMI and Without Major Complication, Discharged Alive
127 Heart Failure and Shock
130 Peripheral Vascular Disorders With CC
131 Peripheral Vascular Disorders Without CC
209 Major Joint and Limb Reattachment Procedures of Lower Extremity
210 Hip and Femur Procedures Except Major Joint Age >17 With CC
211 Hip and Femur Procedures Except Major Joint Age >17 Without CC
236 Fractures of Hip and Pelvis
239 Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy
277 Cellulitis Age >17 With CC
278 Cellulitis Age >17 Without CC
294 Diabetes Age >35
296 Nutritional and Miscellaneous Metabolic Disorders Age >17 With CC
297 Nutritional and Miscellaneous Metabolic Disorders Age >17 Without CC
320 Kidney and Urinary Tract Infections Age >17 With CC
321 Kidney and Urinary Tract Infections Age >17 Without CC
395 Red Blood Cell Disorders Age >17
429 Organic Disturbances and Mental Retardation
430 Psychoses
468 Extensive O.R. Procedure Unrelated to Principal Diagnosis
Proposed 541 Tracheostomy with Mechanical Ventilation 96+ Hours or Principal Diagnosis Except Face, Mouth and Neck Diagnoses With Major O.R. Procedure.
Proposed 542 Tracheostomy with Mechanical Ventilation 96+ Hours or Principal Diagnosis Except Face, Mouth and Neck Diagnoses Without Major O.R. Procedure.