ICD-10 MS-DRGs Version 37.2 Effective August 01, 2020

In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) (@CMSGov) is implementing 12 new procedure codes to describe the introduction or infusion of therapeutics, including remdesivir and convalescent plasma, into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective August 01, 2020.

The ICD-10 MS-DRG Grouper assigns each case into an MS-DRG based on the reported diagnosis and procedure codes and demographic information (age, sex, and discharge status).

The ICD-10 Medicare code editor (MCE) Version 37.2 software uses edits to detect and report errors in the claims data for the ICD-10 codes reported to validate correct coding on claims for discharges on or after August 01, 2020.

The ICD-10 MS-DRG Grouper software package to accommodate these new codes, Version 37.2, is effective for discharges on or after August 01, 2020. As indicated in the table below, these codes will not affect the MS-DRG assignment.

Assignment of the new ICD-10-PCS procedure codes is as follows:

*As the procedure codes are designated as non-O.R. procedures, there is no assigned MDC or MS-DRG. The ICD-10 MS-DRG assignment is dependent on the reported principal diagnosis, any secondary diagnoses defined as a complication or comorbidity (CC) or major complication or comorbidity (MCC), procedures or services performed, age, sex, and discharge status.

View the ICD-10 MS-DRG V37.2 Grouper Software, Definitions Manual Table of Contents and the Definitions of Medicare Code Edits V37.2 manual.

View the Code Tables, Index and related Addenda files for the 12 new procedure codes.