Bone Marrow: Proposed CMS changes to MS-DRG 9 (BMT) for FY2011

[Guest guest]

CMS recently released its annual proposed changes to

Medicare’s Hospital Inpatient Prospective Payment System (IPPS). As part

of the rule, CMS proposed the split of MS-DRG 009 (Bone Marrow Transplant) into

two new MS-DRGs – MS-DRG 014 (Allogeneic Bone Marrow Transplant) and

MS-DRG 015 (Autologous Bone Marrow Transplant). The rule cites an analysis that

shows the dramatic difference in average cost between the transplant types,

which are currently reimbursed at the same amount with MS-DRG 009. This will result

in more accurate payment rates for both autologous and allogeneic transplants

starting on October 1, 2010. Please share this with whoever handles your

Medicare billing and please remind them to report all donor and cell-related

charges under revenue code 0819 for the new MS-DRG 014. This will be crucially

important in helping to establish an allogeneic payment rate that truly reflects

the full cost to the transplant centers.

I am attaching a short copy of this section. The full rule

can be found at http://www.cms.gov/acuteinpatientpps/ipps2010/itemdetail.asp?itemid=CMS1234657

(Click on link CMS-1498-P under “