Coding and Reimbursement Support

The below information and links about new, deleted and revised ICD-10 diagnosis codes, and changes to the Complication and Comorbidity (CC) and Major Complication and Comorbidity (MCC) lists for the Medicare Severity-Diagnosis Related Groups (MS-DRGs) used in the Medicare Inpatient Prospective Payment System (IPPS) effective October 1, 2024, is available for download from the CMS website at https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2025-ipps-final-rule-home-page, Tables 6A-6K and Tables 6P.1a-6P.4d (ZIP). The attached version was downloaded as of 10/7/2024; providers should be aware that files could be updated during the year. This information is not intended to instruct physicians or hospitals as to which codes to use for a particular diagnosis, service, supply, procedure or treatment. Physicians and hospitals are solely responsible for identifying and submitting appropriate codes and charges for services rendered. They should contact payers to verify correct coding procedures prior to submitting claims related to any service. Carlsmed cannot guarantee reimbursement with the codes listed in these resources. In all cases, physicians and hospitals will need to follow local payer policies for billing and reimbursement.