is assigned to MS-DRGs 619, 620, and 621, OR Procedures for
Obesity, with MCC, with CC, and without CC/MCC, respectively. Procedure code 43.82 was added to the “noncovered procedures” edit of the Medicare Code Editor as laparoscopic sleeve
gastrectomy and is not covered for Medicare beneficiaries.
CMS added discharge status code 66, Discharged/Transferred
to Critical Access Hospital (CAH), to the grouper logic for MS-DRG 789, Neonate, Died or Transferred to Another Acute Care
Facility. This was a correction from FY 2011.
CC/MCC Additions
New additions to the CC list for FY 2012 include:
x 294.21, Dementia, unspecified, with behavioral distur-
bance
x 358.30, Lambert-Eaton syndrome, unspecified
x 358.31, Lambert-Eaton syndrome in neoplastic disease
x 358.39, Lambert-Eaton syndrome in other diseases clas-
sified elsewhere
x 512.2, Postoperative air leak
x 516.5, Adult pulmonary Langerhans cell histiocytosis
x 539.01, Infection due to gastric band procedure
x 539.09, Other complications of gastric band procedure
x 539.81, Infection due to other bariatric procedure
x 539.89, Other complications of other bariatric procedure
x 596.81, Infection of cystostomy
x 596.82, Mechanical complication of cystostomy
x 596.83, Other complication of cystostomy
x 808.44, Multiple closed pelvic fractures without disrup-
tion of pelvic circle
x 996.88, Complications of transplanted organ, stem cell
x 997.32, Postprocedural aspiration pneumonia
x 999.32, Bloodstream infection due to central venous cath-
eter
x 999.33, Local infection due to central venous catheter
x 999.34, Acute infection following transfusion, infusion, or
injection of blood and blood products
x 999.41, Anaphylactic reaction due to administration of
blood and blood products
x 999.42, Anaphylactic reaction due to vaccination
x 999.49, Anaphylactic reaction due to other serum
New additions to the MCC list for FY 2012 include:
x 284.11, Antineoplastic chemotherapy induced pancyto-
penia
x 284.12, Other drug-induced pancytopenia
x 348.82, Brain death
x 415.13, Saddle embolus of pulmonary artery
x 444.01, Saddle embolus of abdominal aorta
x 488.81, Influenza due to identified novel influenza A virus
with pneumonia
x 516.4, Lymphangioleiomyomatosis
x 516.61, Neuroendocrine cell hyperplasia of infancy
x 516.62, Pulmonary interstitial glycogenosis
x 516.63, Surfactant mutations of the lung
x 516.64, Alveolar capillary dysplasia with vein misalign-
ment
x 516.69, Other interstitial lung diseases of childhood
x 808.54, Multiple open pelvic fractures without disruption
of pelvic circle
x 998.01, Postoperative shock, cardiogenic
x 998.02, Postoperative shock, septic
x 998.09, Postoperative shock, other
Hospital-Acquired Conditions
For FY 2012, CMS did not add contrast-induced acute kidney
injury to the list of hospital-acquired condition (HAC) program
as the diagnosis is difficult to identify with the current ICD-9-
CM codes. The decision to add this diagnosis has been deferred
until improved coding is available.
HACs were modified to reflect the FY 2012 code changes.
These include the following new codes:
x 415.13, Saddle embolus of pulmonary artery (MCC)
x 539.01, Infection due to gastric band procedure (CC)
x 539.81, Infection due to other bariatric procedure (CC)
x 808.44, Multiple closed pelvic fractures without disrup-
tion of pelvic circle (CC)
x 808.54, Multiple open pelvic fractures without disruption
of pelvic circle (MCC)
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