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Home Health & Hospice Week

Hospitals:

PROPOSED DRGS SUBJECT TO POST-ACUTE TRANSFER POLICY

Published on Thu Jun 17, 2004

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.

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