Medicare Crosswalk Hospital Code Development Act of 2015
This bill amends Title XVIII (Medicare) of the Social Security Act to require the Centers for Medicare & Medicaid (CMS) to establish a crosswalk between Healthcare Common Procedure Coding System (HCPCS) codes and Medicaid Severity-Diagnosis Related Group (MS-DRG) codes for similar hospital services. (A crosswalk shows users where to put data from one scheme into a different scheme.)
Specifically, CMS must develop HCPCS versions for MS-DRGs that is similar to the Internal Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) codes for such MS-DRGs such that, to the extent possible, the MS-DRG assignment shall be similar for a claim coded with the HCPCS version as an identical claim coded with an ICD-10-PCS code.
CMS must develop and publish a freely available HCPCS/MS-DRG definitions manual and software.
[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3291 Introduced in House (IH)]
114th CONGRESS
1st Session
H. R. 3291
To amend title XVIII of the Social Security Act to develop a crosswalk
between HCPCS and MS-DRG codes for similar hospital services.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 29, 2015
Mr. Ryan of Wisconsin introduced the following bill; which was referred
to the Committee on Ways and Means, and in addition to the Committee on
Energy and Commerce, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to develop a crosswalk
between HCPCS and MS-DRG codes for similar hospital services.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare Crosswalk Hospital Code
Development Act of 2015''.
SEC. 2. DEVELOPMENT OF MEDICARE HCPCS VERSION OF MS-DRG CODES FOR
SIMILAR HOSPITAL SERVICES.
Section 1886 of the Social Security Act (42 U.S.C. 1395ww) is
amended by adding at the end the following new subsection:
``(t) Relating Similar Inpatient and Outpatient Hospital
Services.--
``(1) Development of hcpcs version of ms-drg codes.--
``(A) In general.--Not later than January 1, 2018,
the Secretary shall develop HCPCS versions for MS-DRGs
that is similar to the ICD-10-PCS for such MS-DRGs such
that, to the extent possible, the MS-DRG assignment
shall be similar for a claim coded with the HCPCS
version as an identical claim coded with an ICD-10-PCS
code.
``(B) Coverage of surgical ms-drgs.--In carrying
out subparagraph (A), the Secretary shall develop HCPCS
versions of MS-DRG codes for not fewer than 10 surgical
MS-DRGs.
``(C) Publication and dissemination of the hcpcs
versions of ms-drgs.--
``(i) In general.--The Secretary shall
develop an HCPCS MS-DRG definitions manual and
software that is similar to the definitions
manual and software for ICD-10-PCS codes for
such MS-DRGs. The Secretary shall post the
HCPCS MS-DRG definitions manual and software on
the Internet website of the Centers for
Medicare & Medicaid Services. The HCPCS MS-DRG
definitions manual and software shall be in the
public domain and available for use and
redistribution without charge.
``(ii) Use of previous analysis done by
medpac.--In developing the HCPCS MS-DRG
definitions manual and software under clause
(i), the Secretary shall consult with the
Medicare Payment Advisory Commission and shall
consider the analysis done by such Commission
in translating outpatient surgical claims into
inpatient surgical MS-DRGs in preparing chapter
7 (relating to hospital short-stay policy
issues) of its `Medicare and the Health Care
Delivery System' report submitted to Congress
in June 2015.
``(D) Definition and reference.--In this paragraph:
``(i) HCPCS.--The term `HCPCS' means, with
respect to hospital services (other than
inpatient hospital services) for which payment
is made under this title, the code under the
Healthcare Common Procedure Coding System
(HCPCS) (or a successor code) for such
services.
``(ii) ICD-10-PCS.--A reference to an ICD-
10-PCS code includes a reference to a successor
to such code.''.
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Introduced in House
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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