FY 2021 IPPS proposed rule: Take a closer look at important MS-DRG updates

Why This Topic Matters

CMS proposed inpatient payment and grouping changes can affect how hospital claims are classified and paid. Staying current with these proposed MS-DRG updates helps coding and revenue cycle teams understand likely operational impacts and prepare comments or internal review.

Article Sections

1. Development guiding principles

   Discusses CMS listening-session themes and the broader review of severity-level methodology used in MS-DRG refinement. The section focuses on general rulemaking background and the ongoing evaluation process.

2. Update to antimicrobials and antifungals

   Summarizes proposed CMS changes related to new technology add-on payment and related grouping considerations for antimicrobial and antifungal products. It also addresses proposed adjustments to subgroup structure within the MS-DRG system.

3. Proposed MS-DRG updates

   Reviews the major proposed MS-DRG restructuring topics included in the rule, including inpatient procedure reassignment, new DRG creation, and selected diagnosis-grouping revisions. The section also notes related CMS proposals affecting kidney-related, cardiac, appendectomy, transplant, and orthopedic grouping logic.