Issue Details
| Name |
Spinal Procedures Neurostimulators W CC or MCC (At this time, Medical Necessity is excluded from review.) |
| Number |
B000552010 |
| Description |
The purpose of MS-DRG Validation is to determine that the principal diagnosis, procedures and all secondary diagnoses identified as CCs and MCCs are actually present, correctly sequenced, and coded. When a patient is admitted to the hospital, the condition established after study found to be chiefly responsible for occasioning the admission to the hospital should be sequenced as the principal diagnosis. The other diagnosis identified should represent all (MCC/CC) present during the admission that impact the stay. The POA indicator for all diagnoses reported must be coded correctly. Reviewers will validate for MS DRG 028, 029 principal diagnosis, secondary diagnosis, and procedures affecting or potentially affecting the DRG. |
| Claim Type |
Inpatient |
| Issue Type |
Complex |
| Overpayment / Underpayment |
Overpayment and Underpayment |
| Dates of Service |
10/1/2007 - Open |
| States |
IL, IN, KY, MI, MN, OH, WI |
| Policy Related Links |
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| Date Approved |
1/11/2010
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