October 2, 2014
Inpatient Services for Cardiac Defibrillator Implant without MCC: Diagnosis Related Group (DRG) 227: Complex Review, Ohio – Discontinued
The J15 Part A Medical Review department performed a service-specific complex review on inpatient services for Diagnosis Related Group (DRG) 227, type of bill (TOB) 11X in Ohio for Cardiac Defibrillator Implant without MCC. Based on the results summarized below, this complex edit will be discontinued in Ohio.
Charges | Claims | |
---|---|---|
Reviewed | $100,317.29 | 3 |
Denied | $0.0 | 0 |
Charge Denial Rate | 0.0% |
There were no denials for this review.
For more information, refer to:
- CMS Medicare Program Integrity Manual (Pub. 100-08), chapter 6, section 6.5.
- CMS Medicare Program Integrity Manual (Pub. 100-08), chapter 3, section 3.3.2.4
- CMS MLN Matters Article MM6698 (Signature Guidelines for Medical Review Purposes)
If you have questions regarding this review, please call the CGS Part A Provider Contact Center at 866.590.6703.