2019 OB DRG Billing

Date: 07/11/19

ICD-10-CM and Medicare Severity Diagnosis Related Groups (MS-DRG) are continuously monitored and revised by CMS. Because Inpatient Prospective Payment System (IPPS) hospitals are paid based on DRGs, additions, deletions, or alterations to MS DRGs can affect hospital claim submission protocols.

Recently, CMS announced changes to the Diagnosis Related Group (DRG) coding that impacts billing for C-Sections and vaginal deliveries. In order to remain compliant with CMS coding guidelines, Managed Health Services (MHS) is updating our billing instructions for these procedures.

Please review the below complete schedule of DRG codes impacted by this change, along with updated codes and titles. Please don’t hesitate to reach out to MHS Provider Services at 1-877-647-4848 with any questions you may have. Thank you for being our partner in care.