This page addresses follow-up questions and additional information pertinent to our webinar
2025 Hospital Payment Update: A Coder’s Guide to MS-DRG Changes.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: Now that the Medicare Code Edits (MCE) are not released as part of the IPPS Final Rule, where can we find information about changes to the MCE?
A: You can locate information about MS-DRG Classifications and Software at CMS’ website at: https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ms-drg-classifications-and-software. This webpage has a lot of information about the release of the MCE, including a new publication, Definition of Medicare Code Edits Version 42 (https://www.cms.gov/files/zip/definition-medicare-code-edits-version-42.zip).
Q: Which fiscal year of claims did CMS use to set rates for FY 2025?
A: Claims from FY 2023 (October 1, 2022, through September 30, 2023)
Q: If we want to submit proposals for changes to the FY 2026 IPPS, where do we send proposals?
A: All proposals for changes to the IPPS can be submitted through CMS’ MEARIS™ system at https://mearis.cms.gov/public/home. To be considered for the FY 2026 IPPS, requests must be submitted before October 1, 2024.
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Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Director of Coding Quality & Education
Kristi is the Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.
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