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April 2022 Update to the Medicare Severity – Diagnosis Related Group (MS-DRG) Grouper and Medicare Code Editor (MCE) Version 39.1 for the International Classification of Diseases, Tenth Revision (ICD-10) Diagnosis Codes for 2019 Novel Coronavirus (COVID…


I. SUMMARY OF CHANGES: This Change Request (CR) implements new ICD-10-Clinical Modification (CM) codes Z28.310, Z28.311, and Z28.39 for reporting COVID-19 vaccination status, and introduces 7 new ICD-10-PCS codes to the Medicare Severity – Diagnosis Related Groups (MS-DRG) Grouper and Medicare Code Editor (MCE) to describe the introduction or infusion of therapeutics, including vaccines for COVID-19 treatments, effective for discharges on and after April 1, 2022. This CR also includes updates for a new MCE Edit for "Unspecified" ICD-10-CM diagnosis codes where there are other diagnosis codes available in that diagnosis code subcategory that further specify the anatomic site.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 14, 2022

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.