TABLE 6P.-- ICD-10-CM and ICD-10-PCS Codes for MS-DRG Changes and Analysis with Application of the NonCC Subgroup Criteria - FY 2025		
Note to Reviewers:  The following tables (identified under separate worksheets (tabs)) within this Excel workbook display the ICD-10-CM and ICD-10-PCS codes for the following MS-DRG issues and analysis.  We refer readers to section II. of the FY 2025 IPPS/LTCH PPS final rule for a detailed discussion regarding the finalized MS-DRG changes for the listed codes.		
		
Tables (Tab)  1	MS-DRG Issue	Description
6P.1a	"ICD-10 MS-DRG Test Grouper, Version 42"	List of ICD-10-CM diagnosis code mappings between Version 41 and Version 42 of the MS-DRGs 
6P.1b	"ICD-10 MS-DRG Test Grouper, Version 42"	List of ICD-10-PCS procedure code mappings between Version 41.1 and Version 42 of the MS-DRGs
Tables (Tab)  2	 Coding and MS-DRG GROUPER Logic Issues	Description
6P.2a	Endovascular Cardiac Valve Procedures 	List of ICD-10-PCS procedure codes describing endovascular cardiac valve replacement and supplement procedures
6P.2b	Endovascular Cardiac Valve Procedures 	List of ICD-10-PCS procedure codes describing surgical cardiac valve replacement and supplement procedures
6P.2c	Endovascular Cardiac Valve Procedures 	List of ICD-10-PCS procedure codes describing cardiac catheterization
6P.2d	Interbody Spinal Fusion Procedures 	List of ICD-10-PCS procedure codes describing single level combined anterior and posterior fusion except cervical
6P.2e	Interbody Spinal Fusion Procedures 	List of ICD-10-PCS procedure codes describing multiple level combined anterior and posterior fusion except cervical and custom-made anatomiclally designed interbody fusion
6P.2f	Interbody Spinal Fusion Procedures 	List of ICD-10-PCS procedure codes describing combined anterior and posterior cervical spinal fusion 
6P.2g	Interbody Spinal Fusion Procedures 	List of ICD-10-PCS procedure codes describing single level spinal fusion except cervical and single level custom-made anatomically designed interbody fusion  
6P.2h	Interbody Spinal Fusion Procedures 	List of ICD-10-PCS procedure codes describing multiple level spinal fusion except cervical and custom-made anatomically designed interbody fusion
6P.3a	Social Determinants of Health (SDOH) - Inadequate Housing/Housing Instability	"Description of the columns in Tab 6P.3b and a description of the logic used to set the flag [NC, 1+, 2+, 2-, 3-] in Column N in Tab 6P.3b"
6P.3b	Social Determinants of Health (SDOH) - Inadequate Housing/Housing Instability	"List of the ICD-10-CM diagnosis codes, with data on impact on resource use when reported as a secondary diagnosis, that commenters suggested CMS review to determine if changes to the severity level designations are warranted in future rulemaking"
Tables (Tab)  3	Analysis with Application of the NonCC Subgroup Criteria	Description
6P.4a	Analysis with Application of the NonCC Subgroup Criteria	Table displaying the five criteria to create subgroups for a three-way MS-DRG split and either of the two-way MS-DRG splits
6P.4b	Analysis with Application of the NonCC Subgroup Criteria	List of the 141 MS-DRGs that would potentially be subject to deletion with application of the NonCC Subgroup Criteria and list of 86 MS-DRGs that would potentially be created 
6P.4c	Analysis with Application of the NonCC Subgroup Criteria	Base MS-DRG data analysis for the 141 MS-DRGs with a current three-way split and application of the NonCC Subgroup criteria 
6P.4d	Analysis with Application of the NonCC Subgroup Criteria	Field data dictionary for data analysis of the base MS-DRGs with application of the NonCC Subgroup Criteria 
		
1 Tables 6P.1a - 6P.1b MS-DRG Issues		
2 Tables 6P.2a - 6P.3b Coding and MS-DRG GROUPER Logic Issues		
3 Tables 6P.4a - 6P.4d Analysis with Application of the NonCC Subgroup Criteria		
