Statement from the ACDIS Advisory Board on ICD-10-PCS MS-DRG concerns

Earlier this year, ACDIS learned that several minor diagnostic and/or therapeutic procedures, when captured with ICD-10-PCS codes, group to surgical DRGs. This has led to significantly higher rates of reimbursement for these procedures and considerable consternation amongst CDI and coding professionals, who fear that these payments will eventually result in eventual recoupment from CMS and/or private payers. As a result, some hospitals are opting not to code these procedures. Others are coding them as usual, citing that it is their obligation to do so under HIPAA and per the ICD-10-CM/PCS Official Guidelines for Coding and Reporting.