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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-19) Vaccination Status and ICD-10 Procedure Coding System (PCS) Codes for Introduction or Infusion of Therapeutics and Vaccines for COVID-19 Treatment

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 9 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. This new code edit is effective with discharges on or after April 1, 2022.

Download the Guidance Document

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

Issue Date: February 04, 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.