I need to know two different things about reimbursement for cardiac
output. First, what DRGs include cardiac output monitoring, ICD-9
code 89.68, as an accepted procedure. I heard from one source that
DRG 127, Heart Failure includes this procedure. The relative weight
in the year 2004, for DRG 127 is 0.9358.
I assume there are five or perhaps even more DRGs, where the cardiac
output is included as one of the procedures that fall under that DRG,
and I need to know what DRGs they are and what are the Relative
Weights of those DRGs. I would guess it would be some other cardiac
DRGs, and maybe something with Pulmonary edema. Can one of the really
smart Google Answers researchers tell me what they are?
Just in case you do not remember, DRGs are Diagnostic Related Groups,
and they are the method that is used to pay hospitals for treating
patients. Patients are categorized by a principal diagnosis, and
grouped into DRG?s based on specific procedures performed. It is a
confusing web of reimbursement, but the first question that I have
asked is not too hard. If someone has access to DRG information, it
will be right there.
The second question is about the physician payment, and the bundling
used with the CPT codes. Does a physician bill for 93503 in addition
to 93561 when they perform a cardiac output. The 93503 is for the
insertion of the pulmonary artery catheter, and the 93561 for the
?Indicator dilution studies such as dye or thermal dilution, including
arterial and/or venous catheterization with cardiac output
measurement? . I will be happy to pay a tip for the answer of the
second part. If someone knows the answer to the second part, and not
the first part, let me know and we can work it out.
I am happy to answer any questions ? or just clarify in any way. |
Clarification of Question by
crystal4290-ga
on
15 Apr 2004 17:54 PDT
Thank you for your request for clarification.
I would actually like to know the National Medicare Average, for the
amount, but I will calculate this once I know the DRGs and the
relative weight. The relative weight is a federally assigned number -
once a year in the Federal Register....and actually I think I can get
this. But what I can not get is the actual DRG's where the particular
ICD-9 is applicable.
I know that Medicare is the one area where DRG's are used
consistently. If you can tell me the particular DRGs, and the payment
for Medicare and a Private Pay for all the DRGs where cardiac output
is applicable, that will be most helpful.
If, in my naivity, I have not answered your question, I am sorry, and
I will be happy to clarify further.
Thank you
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