Issue Number Issue Name Type of Review Provider Type State(s) Impacted Date Posted Details

Transcription

1 Issue Number Issue Name Type of Review Provider Type State(s) Impacted Date Posted A Postpayment Review - Manual Medical Review of Outpatient Therapy Claims Above the $3,700 Threshold A SNF Psychiatric Condition A CT Scans, Head and Neck, Incorrect Billing - Issue Closed CT Scans, Trunk and A Extremities, Incorrect Billing - Issue Closed A Vitamin D Assay Testing - Issue closed. Postpayment Review - Manual A Medical Review of Outpatient Therapy Claims Above the $3,700 Threshold Portable X-ray Transportation A and Setup Billed Without a Radiology Code - JK A Cardiac PET Scans - JA A Cataract Surgery Once in a Lifetime JK A Ranibizumab (Lucentis ) and Aflibercept (Eylea ) A Observation Care for Fewer Than 8 Hours - JL Evaluation and Management A Coding in Skilled Nursing Facilities - JL A Bariatric Surgery - Region A Radiologic Exam of the Chest, A Incorrect Billing for Indications That Are Not Medically Necessary Skilled Nursing Facility (Part B Only) Skilled Nursing Facility Skilled Nursing Facility Skilled Nursing Facility Skilled Nursing Facility Rehabilitation Agency (Comprehensive Outpatient Rehabilitation Facility) Portable X-ray Supplier Physician/ Physician/ Physician/ Physician/ Physician/ Physician/ Physician/ ME, NH,,, PA, 4/22/2013 NY CT, DC, DE, MD, ME, MA, NH,, NY, PA, 1/18/2013 NY 4/2/2012 NY 4/2/2012 CT, DC, MA, MD, ME, NH,, NY, PA, 6/4/2012 ME, NH,,, NY, PA CT, MA, ME, NH, NY, CT, MA, ME, NH, NY, RI & VT 4/22/ /22/2013 2/11/2016 8/13/2015 9/1/2015 DC, DE, MD,, PA 9/3/2015 DC, DE, MD,, PA 9/10/2015 8/11/2015 CT, NY 6/4/2012

2 A A A A A A A A A A A A A A A Pulmonary Diagnostic Procedures and Evaluation & Management Services - Issue closed. Diagnostic Colonoscopy, Sigmoidoscopy and Proctosigmoidoscopy - JK Nerve Conduction Studies (NCS) / Electromyography (EMG) - JK Pegfilgrastim, 6 mg, Without Diagnoses Meeting Medical Necessity - JK Panretinal (Scatter) Laser Photocoagulation Excess Frequency - JK Filgrastim Billed without a Medically Necessary Diagnosis - JK Annual Wellness Visit (AWV) - JK Cardiovascular Nuclear Medicine - JK Incorrect Bilateral Billing for Codes with Bilateral Indicator 3 Region A Evaluation and Management Per Diem Codes, Excess Units - JK Annual Wellness Visit (AWV) - JL Evaluation and Management Per Diem Codes, Excess Units - JL Observation Care Admission and Discharge Same Date - JK Maximum Allowed Units for Part B Drugs and Biologicals - JL Billing for Dead Beneficiaries - Jurisdiction K Semi-automated CT, MA, ME, NH, NY, CT, NY, MA, ME, NH, RI and VT CT, MA, ME, NH, NY, CT, MA, ME, NH, NY, The following states are added as of 10/25/2013: Massachusetts, Maine, New Hampshire, Rhode Island and Vermont CT, MA, ME, NH, NY, CT, MA, ME, NH, NY, CT, MA, ME, NH, NY, CT, DC, DE, MD, MA, CT, MA, ME, NH, NY, 2/11/2011 8/6/ /27/2012 1/10/2013 5/2/2013 5/23/2013 6/13/2013 1/25/2013 2/18/ /12/2013 DC, DE, MD,, PA 10/17/2013 DC, DE, MD,, PA 11/5/2013 CT, NY, ME, MA, NH, 10/14/2013 DC, DE, MD,, PA 9/5/2013 CT, NY 9/5/2013

3 A A A A A A A A A A Billing for Dead Beneficiaries - Jurisdiction L Trastuzumab (Herceptin ), Multi-dose Vial Waste Maximum Allowed Units for Part B Drugs and Biologicals - Semi-automated JK Observation Care for Fewer Than 8 Hours - JK Mohs Micrographic Surgery (MMS) with Pathology Different Providers - JK - Issue closed. Mohs Micrographic Surgery (MMS) with Pathology Different Providers - JL - Issue closed. Observation Care Admission and Discharge Same Date - JL Evaluation and Management Coding in Skilled Nursing Facilities - JK Place of Service Coding for Semi- Physician Services Bilateral In Nature Procedures - Issue closed. A Duplicate Claims - Part B Global Billing of Radiology or A Diagnostic Tests in the Facility Setting - Issue Closed. A Global Surgery - Pre and Post- Operative Visits National Correct Coding A Initiative (CCI) - Part B Professional Services ISSUE CLOSED 08/09/2013 DC, DE, MD,, PA 9/5/2013 9/10/2013 CT, NY 8/15/2013 CT, MA, ME, NH, NY, 12/13/2013 CT, NY, MA, ME, NH, 11/8/2013 DC, DE, MD,, PA 11/8/2013 DC, DE, MD,, PA 11/8/2013 CT, MA, ME, NH, NY, 11/22/2013 CT, DC, DE MA, MD, 12/7/2010 2/10/2011 NY,, DC, PA, MD, DE, CT, MA, ME, NH, 6/17/2010 CT, DC, DE, MD,, NY, PA, MA, ME, NH, 6/17/2010 VT, RI 6/17/2010 PA, DE, DC, MD, CT,, NY, NH, MA, ME, 8/1/2011 VT, RI.

4 A Add-On Codes Paid without a Paid Required Primary Procedure-Type 1 A Ranibizumab and Aflibercept - JL - Issue closed. Semi- A Transthoracic Echocardiography (TTE) - JL A Transthoracic Echocardiography (TTE) - JK A Neulasta A Nerve Conduction Studies (NCS) - Maximum Units- JK A Cetuximab - JL - Issue closed. Semi- A Hyaluronic Acid - JL - Issue closed. Semi- A Nerve Conduction Studies (NCS) Semi- - Maximum Units- J12 A Inappropriate Payment For GZ Modifier - JK Semi- A Doxorubicin Hydrochloride - JL Semi- - Issue closed. A Octreotide Maximum Units - JK Semi- - Issue closed. A Octreotide Maximum Units - JL - Semi- Issue closed. A Intensity-Modulated Radiation Therapy (IMRT) - Region A 6/17/2010 DC, DE, MD,, PA 2/11/2013 DC, DE, MD,, PA 1/11/2013 CT, NY, MA, ME, NH, 1/11/2013 6/17/2010 CT, NY 3/8/2013 DC, DE, MD,, PA 3/22/2013 DC, DE, MD,, PA 3/28/2013 DC, DE, MD,, PA 4/3/2013 CT, MA, ME, NH, NY, 4/3/2013 DC, DE, MD,, PA 4/4/2013 CT, MA, ME, NH, NY, 4/11/2013 DC, DE, MD,, PA 4/11/2013 CT, DE, DC, ME, MD, MA, NH,, NY, PA, 6/18/2013

5 A Blepharoplasty - Eyelid Lifts Evaluation and Management A (E/M) Facility vs. Non-facility - Incorrect Place of Service (POS) - JK A Magnetic Resonance Angiography (MRA) - JK Procedures in the Post Op Period A of Other Procedures - All of Semi- Region A A Darbepoetin Alfa - Maximum Units - JL - Issue closed. Semi- Cardiac Monitoring, Outpatient, A Real-time - J12, DOS on or after 6/29/2011 Cardiac Monitoring, Outpatient, A Real-time - J12 for DOS through 6/28/2011 A Pemetrexed - JL - Issue closed. Semi- A Topotecan Hydrochloride (Hycamtin ) - JL - Issue closed. Semi- A Trastuzumab - JL - Issue closed. Semi- RAST (Radioallergosorbent) A Testing without a Medically Necessary Diagnosis - JK - Issue closed. A Bevacizumab - JL - Issue closed. Semi- Esophagogastroduodenoscopy (EGD) - potential incorrect billing occurred for claims billed A with ICD-9-CM codes that are not listed by National Government Services (NGS) Local Coverage Determination 6/19/2013 CT, MA, ME, NH, NY, 5/23/2013 CT, MA, ME, NH, NY, 5/23/2013 CT, NY, DC, DE, MD,, PA, MA, ME, NH, 4/25/2013 DC, DE, MD,, PA 4/18/2013 DC, DE, MD,, PA 4/22/2013 DC, DE, MD,, PA 4/22/2013 DC, DE, MD,, PA 1/10/2013 DC, DE, MD,, PA 1/10/2013 DC, DE, MD,, PA 1/10/2013 CT, MA, ME, NH, NY, 1/10/2013 DC, DE, MD,, PA 1/10/2013 CT, NY 11/29/2012

6 (LCD) L26394 (A45920) as medically necessary - Issue closed. A Electrocardiography (EKG) Laser Ablation of the Prostate A without a Diagnosis Meeting Medical Necessity - Issue closed. A Gemcitabine Hydrochloride - JL Semi- - Issue closed A Paclitaxel - JL - Issue closed. Semi- A Abatacept - JL - Issue closed. Semi- A Bortezomib - JL - Issue closed. Semi- A Docetaxel - JL - Issue closed. Semi- A Fulvestrant - JL - Issue closed. Semi- A Infliximab - JL - Issue closed. Semi- A Octreotide (Sandostatin ) - JL - Semi- Issue closed. A Oxaliplatin - JL - Issue closed. Semi- Evaluation and Management A Services with Allergy Services - Issue closed. Incorrect Use of Modifier 51 A with CPT Code Issue closed. CT, NY, DC, DE, MD,, PA 8/6/2012 CT, NY 10/12/2012 DC, DE, MD,, PA 11/30/2012 DC, DE, MD,, PA 11/30/2012 DC, DE, MD,, PA 11/30/2012 DC, DE, MD,, PA 11/30/2012 DC, DE, MD,, PA 11/30/2012 DC, DE, MD,, PA 11/30/2012 DC, DE, MD,, PA 11/30/2012 DC, DE, MD,, PA 11/30/2012 DC, DE, MD,, PA 11/30/2012 CT, DC, DE, MD,, NY, PA, MA, ME, NH, 2/11/2011 NY 2/11/2011

7 Anesthesia Care and Packaged A Evaluation Management Services - Issue closed. Radiologists Billing Evaluation A & Management Services with Mammography Services - JK - Issue closed. Verteporfin & Ocular A Photodynamic Therapy without Fluoroscein Angiography "ISSUE CLOSED 2/26/2013" CT Scans, Trunk and A Extremities, Incorrect Billing - Issue Closed A CT Scans, Head and Neck, Incorrect Billing - Issue Closed A Hepatic Function Panel Testing JK - Issue closed. A MRI Scans - Issue Closed Failure to Correctly Bill Codes A on the Medically Unlikely Edit List - Issue Closed Postpayment Review - Manual A Medical Review of Outpatient Therapy Claims Above the $3,700 Threshold A Nerve Conduction Studies (NCS) Semi- - Maximum Units- J12 A Once In A Lifetime A New Patient Visits A IV Hydration - JA CT, DC, DE, MD,, NY, PA, MA, ME, NH, 2/11/2011 NY, CT, MA, ME, NH, 2/11/2011 NY, PA,, CT, DE, MD, DC, MA, ME, NH, 2/11/2011 VT, RI CT, NY 4/2/2012 CT, NY 4/2/2012 CT, NY 8/6/2012 CT, NY 5/7/2012 CT, NY, PA,, DE, MD, DC, ME, MA, NH, 12/7/2011 VT, RI Outpatient ME, NH,,, PA, 4/22/2013 Rehabilitation Facility NY Outpatient DC, DE, MD,, & PA 5/3/2013 Rehabilitation Facility Outpatient Hospital, 6/17/2010 Outpatient Hospital, NY, CT, DC, DE, MD,, PA, NH, MA, ME, VT, RI 6/17/2010 Outpatient Hospital, 6/17/2010

8 A A A Bronchoscopy Services - Issue closed. Blood Transfusion - Issues closed. Untimed Codes - Region A - Issue retired. A Initial Infusion Services - JA A Technical Component of Radiology A Vitamin D Assay Testing A A A A A Home Health Consolidated Billing and Therapy Services - JK Home Health Consolidated Billing and Therapy Services - JL Global vs. TC/PC Split Reimbursements Newborn/Pediatric Codes Billed For Patients Which Exceed Age Limit Bevacizumab (e.g., AvastinTM) Injection - JK Outpatient Hospital, Outpatient Hospital, Outpatient Hospital, Outpatient Hospital, Outpatient Hospital, Outpatient Hospital, Laboratory Outpatient Hospital, (TOB 12X only) Outpatient Hospital, (TOB 12X only) Outpatient Hospital, Critical Access Hospital, Non-physician Outpatient Hospital, Critical Access Hospital, Outpatient Hospital, Critical Access 6/17/2010 6/17/2010 CT, DC,DE, MA, MD, 6/17/2010 CT, DC, DE, MD,, NY, PA, ME, MA, NH, 2/10/2011 6/17/2010 Originally approved for MD, NH,, NY, PA,. JL states (DC, 6/5/2012 DE, MD,, and PA) removed from issue for DOS 10/1/2015 and after. CT, MA, ME, NH, NY, 8/15/2013 DC, DE, MD,, PA 8/15/2013 6/17/2010 6/17/2010 CT, MA, ME, NH, NY, 6/4/2012

9 A A A A A A A A A A A A A A Hospital, Inpatient Hospital (TOB 12X Only) Outpatient Hospital Cardiovascular Nuclear Medicine CT, MA, ME, NH, NY, and - JK (TOB 12X Only) 3/5/2013 Electromyography (EMG) and Nerve Conduction Studies - Outpatient Hospital PA, MD, DC,, DE 3/19/2013 Diagnoses - J12 Nerve Conduction Studies (NCS) - Maximum Units- JK Outpatient Hospital CT, NY 3/8/2013 Human Papillomavirus (HPV) Testing without Medically Necessary Diagnosis - Issue Outpatient Hospital CT, NY 1/10/2013 retired. Diagnostic Colonoscopy, CT, MA, ME, NH, NY, Sigmoidoscopy and Outpatient Hospital Proctosigmoidoscopy - JK 1/18/2013 Hepatic Function Panel Testing - JK - Issue closed. Outpatient Hospital CT, NY 1/25/2013 Syphilis Tests - J13 - Issue closed. Outpatient Hospital CT, NY 1/25/2013 Nerve Conduction Studies (NCS) Semi- - Maximum Units- J12 Outpatient Hospital DC, DE, MD,, & PA 5/3/2013 Zoledronic Acid (Zometa ) Excessive Daily Units - JK - Outpatient Hospital CT, NY 5/2/2013 Issue closed. Postpayment Review - Manual Medical Review of Outpatient Outpatient Hospital ME, NH,,, PA, 4/22/2013 Therapy Claims Above the NY $3,700 Threshold Partial Hospitalization Programs Outpatient Hospital (PHP) 4/18/2013 CPT and HCPCS Code, CT, MA, ME, NH, NY, Semi-automated Outpatient Hospital Duplicate Billing - JK 4/18/2013 Panretinal (Scatter) Laser CT, MA, ME, NH, NY, Photocoagulation Excess Outpatient Hospital Frequency - JK 5/23/2013 CT, DE, DC, ME, MD, Intensity-Modulated Radiation Outpatient Hospital MA, NH,, NY, PA, Therapy (IMRT) - Region A 6/11/2013

10 A Blepharoplasty - Eyelid Lifts Outpatient Hospital 6/12/2013 A MRI Scans - Issue Closed Outpatient Hospital CT, NY 5/29/2012 A A A A A A A A A A A A Radiologic Exam of the Chest, Incorrect Billing - Issue closed. Outpatient Hospital CT, NY 6/4/2012 Adenosine 30 mg Excessive Outpatient Hospital Units Reported - Issue closed. 8/20/2012 CT Scans, Trunk and Extremities, Incorrect Billing - Outpatient Hospital CT, NY 4/2/2012 Issue Closed ECGs with Cardiac DC, CT, DE, MD,, Catheterization Procedures - Outpatient Hospital NY, PA, ME, MA, NH, 2/11/2011 Issue closed. CT Scans, Head and Neck, Incorrect Billing - Issue Closed Outpatient Hospital CT, NY 4/2/2012 Adenosine 6 mg - Incorrect Units CT, DC, DE, MD,, Semi- Outpatient Hospital Reported - J12 and J13 NY, PA 9/14/2012 Esophagogastroduodenoscopy (EGD) - potential incorrect billing occurred for claims billed with ICD-9-CM codes that are not listed by National Government Services (NGS) Outpatient Hospital CT, NY 11/29/2012 Local Coverage Determination (LCD) L26394 (A45920) as medically necessary - Issue closed. Pegfilgrastim, 6 mg, Without CT, MA, ME, NH, NY, Diagnoses Meeting Medical Outpatient Hospital Necessity - JK 12/13/2012 Beta2-Microglobulin Testing without a Medically Necessary Outpatient Hospital CT, NY 12/13/2012 Diagnosis (J13) - Issue closed. Fluoroscopic Imaging Guidance - JL Outpatient Hospital MD 1/4/2013 Zoledronic Acid (Reclast & Zometa ) - JL - Issue closed. Semi- Outpatient Hospital DC, DE, MD,, PA 1/10/2013 Filgrastim Billed without a CT, MA, ME, NH, NY, Medically Necessary Diagnosis - Outpatient Hospital 1/10/2013 JK

11 A Neulasta - Issue closed. Outpatient Hospital 6/17/2010 A CT, DC, DE, MD,, Cataract Removal - Excess Units Outpatient Hospital NY, PA, ME, MA, NH, - Issue closed. 10/7/2010 A National Correct Coding Initiative (CCI) - OPPS ISSUE CLOSED 08/09/2013 Outpatient Hospital NY, PA, CT,, DC, DE, MA, ME, NH, RI, VT 9/28/2010 A Failure to Correctly Bill Codes CT, DC, DE, MD,, on the Medically Unlikely Edit Outpatient Hospital NY, PA, ME, MA, NH, List for OP Hospital Services - Issue closed 2/11/2011 A Add-On Codes Paid without a Paid Required Primary Procedure Outpatient Hospital 2/11/ Type 1 A CT, DC, DE, MD,, Colonoscopy - Excess Units - Outpatient Hospital NY, PA, MA, ME, NH, Issue closed. 2/10/2011 A Outpatient Hospital - E/M Code with Status S or T Code - Issue Outpatient Hospital VT, NH, ME, MA, RI, CT, NY,, PA, MD, 2/10/2011 closed. DE, DC A Zoledronic Acid (Zometa ) Excessive Daily Units - JL - Issue closed. Outpatient Hospital DC, DE, MD,, PA 7/11/2013 A Trastuzumab (Herceptin ), Outpatient Hospital Multi-dose Vial Waste 9/10/2013 A Pre-admission Services - JK Outpatient Hospital CT, NY, MA, ME, NH, RI and VT 9/26/2013 A Once-per-day Procedure Codes - CT, MA, ME, NH, NY, Outpatient Hospital JK 10/10/2013 A Pre-admission Services - JL Outpatient Hospital DC, DE, MD,, PA 10/17/2013 A Bariatric Surgery - Region A Outpatient Hospital 8/11/2015 A Cataract Surgery Once in a CT, MA, ME, NH, NY, Outpatient Hospital Lifetime JK RI & VT 8/13/2015 Sacral Nerve Stimulation for A Urinary and Fecal Incontinence - Outpatient Hospital DC, DE, MD,, and PA 10/6/2015 JL A Sacral Nerve Stimulation for CT, MA, ME, NH, NY, Outpatient Hospital Urinary Incontinence - JK RT, VT 10/6/2015

12 A Cardiac PET Scans - JA Outpatient Hospital A A A A A Ranibizumab (Lucentis ) and Aflibercept (Eylea ) Cataract Surgery Once in a Lifetime JL Human Papillomavirus (HPV) Testing without Medically Necessary Diagnosis - Issue closed. RAST Testing without a Medically Necessary Diagnosis (JK) - Laboratory - Issue closed. Outpatient Hospital 2/11/2016 9/1/2015 Outpatient Hospital DC, DE, MD,, PA 8/13/2015 Laboratory CT, NY 1/10/2013 Laboratory CT, MA, ME, NH, NY, 12/13/2012 Hepatic Function Panel Testing - Laboratory CT, NY 8/6/2012 JK - Issue closed. A Syphilis Tests - JK - Issue closed. Laboratory CT, NY 11/30/2012 A A A A A A Late Submissions of IRF-PAI Data Inpatient Rehabilitation Facility (IRF) Admission Inpatient Psychiatric Hospital and Inpatient Psychiatric Unit Services (Medical Necessity Review of MDC 19: Mental Diseases and Disorders, and of MDC 20: Alcohol/Drug and Alcohol/Drug-Induced Organic Mental Disorders) CT Scans, Trunk and Extremities, Incorrect Billing - Issue Closed CT Scans, Head and Neck, Incorrect Billing - Issue Closed Radiologic Exam of the Chest, Incorrect Billing for Indications That Are Not Medically Necessary -Issue Closed Semi- A MRI Scans - Issue closed ME, MA, NH,, Inpatient PA, MD, DC,, DE, Rehabilitation Facility NY, CT Inpatient Rehabilitation Facility Inpatient Psychiatric Facility (IPF) (Inpatient Psychiatric Hospital and Inpatient Psychiatric Unit) (Part B) (Part B) (Part B) (Part B) NH,, NY PA, 7/8/2013 4/26/2012 8/5/2013 CT, NY 4/2/2012 CT, NY 4/2/2012 CT, NY 6/4/2012 CT, NY 5/29/2012

13 A A A A A A A A A A A Cancelled Elective Surgeries - Acute - Region A (MNR) for MS-DRG 682 Renal Failure w/, MS-DRG 683 Renal Failure w/cc, and 684 Renal Failure w/o CC/ (MNR) for MS-DRG 193 Simple Pneumonia and Pleurisy w/,ms-drg 194 Simple Pneumonia and Pleurisy w/cc, and MS-DRG 195 Simple Pneumonia and Pleurisy w/o CC/ Same Day Same Hospital Readmission IPPS Acute Care Hospital to Hospital Transfers (MNR) MDC 9: Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast 3 (MNR) for MS-DRG 327 Stomach, Esophageal and Duodenal Procedures with CC (MNR) for MS-DRG 506 Major Thumb or Joint Procedures (MNR) for MS-DRG 442 Disorders of Liver Except Malignancy, Cirrhosis, Alcoholic Hepatitis with CC (MNR) for MS-DRG 284 Acute Myocardial Infarction, Expired with CC (MNR) for MS-DRG 444 Disorders of the BiliaryTract with (Acute) CT, DC, DE, ME, MD, MA, NH,, NY, PA, 6/11/2013 Maryland (MD) 4/11/2013 Maryland (MD) 4/11/2013 NY, NH, MA, ME, VT, PA, DE, DC, RI, CT, 9/5/2012 NY, NH, MA, ME, VT. PA, DE, DC, RI, CT, 9/11/2012 3/19/2012 VT, PA, DE, DC, RI, CT, 12/9/2011 VT, PA, DE, DC, RI, CT, 12/9/2011 VT, PA, DE, DC, RI, CT, 12/9/2011 VT, PA, DE, DC, RI, CT, 12/12/2011 VT, PA, DE, DC, RI, CT, 12/12/2011

14 A (MNR) for MS-DRG 199 VT, PA, DE, DC, RI, CT, 12/12/2011 Pneumothorax with A (MNR) for MS-DRG 024 Craniotomy with Major Device Implant/Acute Central Nervous System Principal VT, PA, DE, DC, RI, CT, 12/12/2011 Diagnosis without A (MNR) for MS-DRG 407 Pancreas, Liver and Shunt Procedures without CC- VT, PA, DE, DC, RI, CT, 12/12/2011 A (MNR) for MS-DRG 037 Extracranial Procedures with VT, PA, DE, DC, RI, CT, 12/12/2011 (MNR) for MS-DRG 462 A Bilateral or Multiple Major Joint VT, PA, DE, DC, RI, CT, 12/12/2011 Procedures of Lower Extremity without A (MNR) for MS-DRG 032 Ventricular Shunt Procedures with CC VT, PA, DE, DC, RI, CT, 12/12/2011 A (MNR) for MS-DRG 945 VT, PA, DE, DC, RI, CT, 12/12/2011 Rehabilitation with CC- (MNR) for MS-DRG 023 Craniotomy with Major Device A Implant/Acute Central VT, PA, DE, DC, RI, CT, 12/12/2011 Nervous System Principal Diagnosis with or Chemo Implant A (MNR) for MS-DRG 923 Other Injury Poisoning Toxic Effect Diagnosis without VT, PA, DE, DC, RI, CT, 12/12/2011 A (MNR) for MS-DRG 834 Acute Leukemia without Major O.R. Procedure with VT, PA, DE, DC, RI, CT, 12/13/2011

15 (MNR) for MS-DRG 825 A Lymphoma and Nonacute VT, PA, DE, DC, RI, CT, 12/13/2011 Leukemia with other O.R. Procedure without CC- A (MNR) for MS-DRG 433 Cirrhosis and Alcoholic Hepatitis with CC VT, PA, DE, DC, RI, CT, 12/13/2011 A (MNR) for MS-DRG 455 Combined Anterior/Posterior Spinal Fusion without CC- VT, PA, DE, DC, RI, CT, 12/13/2011 (MNR) for MS-DRG 025 A Craniotomy and Endovascular VT, PA, DE, DC, RI, CT, 12/13/2011 Intracranial Procedures with (MNR) for MS-DRG 585 Breast A Biopsy, Local Excision and VT, PA, DE, DC, RI, CT, 12/13/2011 Other Breast Procedures without CC- (MNR) for MS-DRG 822 A Lymphoma and Leukemia with VT, PA, DE, DC, RI, CT, 12/13/2011 Major O.R. Procedure without CC- A (MNR) for MS-DRG 219 Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization VT, PA, DE, DC, RI, CT, 12/13/2011 with A (MNR) for MS-DRG 781 Other Antepartum Diagnoses with Medical Complications VT, PA, DE, DC, RI, CT, 12/13/2011 A (MNR) for MS-DRG 216 Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with VT, PA, DE, DC, RI, CT, 12/15/2011

16 A (MNR) for MS-DRG 709 Penis VT, PA, DE, DC, RI, CT, 12/15/2011 Procedures with CC- A (MNR) for MS-DRG 465 Wound Debridement and Skin Graft Except Hand, for Musculo- Connective Tissue Disorders 12/15/2011 without CC- A (MNR) for MS-DRG 163 Major 12/15/2011 Chest Procedures with A (MNR) for MS-DRG 821 Lymphoma and Leukemia with Major O.R. Procedure with CC 12/15/2011 A (MNR) for MS-DRG 577 Skin Graft Except Skin Ulcer or Cellulitis with CC 12/15/2011 A (MNR) for MS-DRG /15/2011 Peritoneal Adhesiolysis with CC A (MNR) for MS-DRG 726 Benign Prostatic Hypertrophy without 12/15/2011 A (MNR) for MS-DRG 842 Lymphoma and Nonacute Leukemia without CC- 12/15/2011 A (MNR) for MS-DRG /16/2011 Endocrine Disorders with CC (MNR) for MS-DRG 217 A Cardiac Valve and Other Major 12/16/2011 Cardiothoracic Procedures with Cardiac Catheterization with CC A (MNR) for MS-DRG 896 Alcohol/Drug Abuse or Dependence without Rehabilitation Therapy with VT, PA, DE, DC, RI, CT, 12/16/2011

17 A (MNR) for MS-DRG 645 Endocrine Disorder without CC- 12/16/2011 A (MNR) for MS-DRG 840 Lymphoma and Nonacute Leukemia with 12/16/2011 (MNR) for MS-DRG 084 A Traumatic Stupor and Coma, 12/16/2011 Coma Greater than One Hour without CC- (MNR) for MS-DRG 987 A Nonextensive O.R. Procedure 12/16/2011 Unrelated to Principal Diagnosis with A (MNR) for MS-DRG 975 HIV with Major Related Condition with CC 12/16/2011 A (MNR) for MS-DRG 655 Major Bladder Procedures without CC- VT, PA, DE, DC, RI, CT, 12/16/2011 A (MNR) for MS-DRG 935 VT, PA, DE, DC, RI, CT, 12/16/2011 Nonextensive Burns (MNR) for MS-DRG 740 A Uterine, Adnexa Procedures for 12/16/2011 Nonovarian Adnexal Malignancy with CC (MNR) for MS-DRG 940 O.R. A Procedure with Diagnoses of VT, PA, DE, DC, RI, CT, 12/16/2011 Other Contact with Health Services with CC A (MNR) for MS-DRG 596 Major VT, PA, DE, DC, RI, CT, 12/19/2011 Skin Disorders without A (MNR) for MS-DRG 285 Acute VT, PA, DE, DC, RI, CT, 12/19/2011

18 Myocardial Infarction, Expired without CC- A (MNR) for MS-DRG 508 Major Shoulder or Elbow Procedures without CC- VT, PA, DE, DC, RI, CT, 12/19/2011 A (MNR) for MS-DRG 166 Other Respiratory System O.R. Procedures with VT, PA, DE, DC, RI, CT, 12/19/2011 A (MNR) for MS-DRG 951 Other VT, PA, DE, DC, RI, CT, 12/19/2011 Factors Influencing Health Status A (MNR) for MS-DRG 957 Other O.R Procedures for Multiple Significant Trauma with VT, PA, DE, DC, RI, CT, 12/19/2011 A (MNR) for MS-DRG 132 Cranial/Facial Procedures without CC- VT, PA, DE, DC, RI, CT, 12/19/2011 A (MNR) for MS-DRG 405 Pancreas, Liver and Shunt Procedures with VT, PA, DE, DC, RI, CT, 12/19/2011 (MNR) for MS-DRG 443 A Disorders of Liver Except VT, PA, DE, DC, RI, CT, 12/19/2011 Malignancy, Cirrhosis, Alcoholic Hepatitis without CC- (MNR) for MS-DRG 511 A Shoulder, Elbow or Forearm VT, PA, DE, DC, RI, CT, 12/19/2011 Procedure, Except Major Joint Procedure with CC MS-DRG Validation for MS- A DRG 016 and 017 Autologous Bone Marrow Transplant NH,, NY, PA, 12/22/2011 (Medical Necessity Excluded) MS-DRG Validation for MS- A DRG 570, 571 and 572 Skin Debridement (Medical Necessity NH,, NY, PA, 12/22/2011 Excluded)

19 (MNR) for MS-DRG 941 O.R. A Procedure with Diagnoses of VT, PA, DE, DC, RI, CT, 12/22/2011 Other Contact with Health Services without CC- A (MNR) for MS-DRG 029 Spinal Procedures with CC or Spinal Neurostimulator VT, PA, DE, DC, RI, CT, 12/22/2011 A (MNR) for MS-DRG 220 Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization VT, PA, DE, DC, RI, CT, 12/22/2011 with CC A (MNR) for MS-DRG 326 Stomach, Esophageal and Duodenal Procedures with VT, PA, DE, DC, RI, CT, 12/22/2011 (MNR) for MS-DRG 496 Local A Excision and Removal Internal VT, PA, DE, DC, RI, CT, 12/22/2011 Fixation Devices Except Hip and Femur with CC A (MNR) for MS-DRG 746 Vagina, Cervix and Vulva Procedures with CC- VT, PA, DE, DC, RI, CT, 12/22/2011 A (MNR) for MS-DRG 963 Other Multiple Significant Trauma with VT, PA, DE, DC, RI, CT, 12/22/2011 A (MNR) for MS-DRG 535 Fractures of Hip and Pelvis with VT, PA, DE, DC, RI, CT, 12/22/2011 A (MNR) for MS-DRG 501 Soft VT, PA, DE, DC, RI, CT, 12/22/2011 Tissue Procedures with CC A (MNR) for MS-DRG 835 Acute Leukemia without Major O.R. Procedure with CC VT, PA, DE, DC, RI, CT, 12/22/2011

20 (MNR) for MS-DRG 342 A Appendectomy without VT, PA, DE, DC, RI, CT, 12/22/2011 Complicated Principal Diagnosis with CC A (MNR) for MS-DRG 482 Hip and Femur Procedures Except Major Joint without CC- VT, PA, DE, DC, RI, CT, 12/22/2011 A (MNR) for MS-DRG 130 Major Head and Neck Procedures without CC- VT, PA, DE, DC, RI, CT, 12/28/2011 (MNR) for MS-DRG 469 Major A Joint Replacement or VT, PA, DE, DC, RI, CT, 12/28/2011 Reattachment of Lower Extremity with A (MNR) for MS-DRG 808 Major Hematologic-Immunologic Diagnosis Except Sickle Cell Crisis and Coagulation with VT, PA, DE, DC, RI, CT, 12/28/2011 A (MNR) for MS-DRG 904 Skin VT, PA, DE, DC, RI, CT, 12/28/2011 Grafts for Injuries with CC- A (MNR) for MS-DRG 471 Cervical Spinal Fusion with VT, PA, DE, DC, RI, CT, 12/29/2011 A (MNR) for MS-DRG 131 Cranial/Facial Procedures with CC- VT, PA, DE, DC, RI, CT, 12/29/2011 (MNR) for MS-DRG 824 A Lymphoma-Nonacute Leukemia VT, PA, DE, DC, RI, CT, 12/29/2011 with Other O.R. Procedure with CC A (MNR) for MS-DRG 829 Myeloproliferative Disorders or Poorly Differentiated Neoplasms VT, PA, DE, DC, RI, CT, 12/29/2011

21 with Other O.R. Procedure with CC- (MNR) for MS-DRG 745 D&C, A Conization, Laparoscopy and VT, PA, DE, DC, RI, CT, 12/29/2011 Tubal Interruption without CC- (MNR) for MS-DRG 628 Other A Endocrine, Nutritional and VT, PA, DE, DC, RI, CT, 12/29/2011 Metabolic O.R. Procedures with (MNR) for MS-DRG 625 A Thyroid, Parathyroid and VT, PA, DE, DC, RI, CT, 12/29/2011 Thyroglossal Procedures with A (MNR) for MS-DRG 687 Kidney and Urinary Tract Neoplasms with CC VT, PA, DE, DC, RI, CT, 12/29/2011 A (MNR) for MS-DRG 744 D&C, Conization, Laparoscopy and Tubal Interruption with CC- VT, PA, DE, DC, RI, CT, 12/29/2011 (MNR) for MS-DRG 735 Pelvic A Evisceration, Radical VT, PA, DE, DC, RI, CT, 12/29/2011 Hysterectomy and Radical Vulvectomy without CC- A (MNR) for MS-DRG 659 Kidney and Ureter Procedures for Nonneoplasm with VT, PA, DE, DC, RI, CT, 12/29/2011 A (MNR) for MS-DRG 949 VT, PA, DE, DC, RI, CT, 12/29/2011 Aftercare with CC- A (MNR) for MS-DRG 615 Adrenal and Pituitary Procedures without CC- VT, PA, DE, DC, RI, CT, 12/29/2011 PA, DE, DC, CT,, A (MNR) for MS-DRG 946 NY, NH, MA, ME, VT, 12/29/2011 Rehabilitation without CC- RI.

22 A (MNR) for MS-DRG 915 VT, PA, DE, DC, RI, CT, 12/29/2011 Allergic Reactions with A (MNR) for MS-DRG 034 Carotid Artery Stent Procedures with VT, PA, DE, DC, RI, CT, 12/29/2011 A (MNR) for MS-DRG 755 Malignancy, Female Reproductive System with CC VT, PA, DE, DC, RI, CT, 12/29/2011 A (MNR) for MS-DRG 334 Rectal VT, PA, DE, DC, RI, CT, 12/29/2011 Resection without CC- (MNR) for MS-DRG 760 A Menstrual and Other Female VT, PA, DE, DC, RI, CT, 12/29/2011 Reproductive System Disorders with CC- A (MNR) for MS-DRG /29/2011 Depressive Neuroses A (MNR) for MS-DRG 593 Skin VT, PA, DE, DC, RI, CT, 12/29/2011 Ulcers with CC A (MNR) for MS-DRG 922 Other Injury, Poisoning and Toxic Effect Diagnosis with VT, PA, DE, DC, RI, CT, 1/5/2012 A (MNR) for MS-DRG 464 Wound Debridement and Skin Graft Except Hand, for Musculo- Connective Tissue Disorders VT, PA, DE, DC, RI, CT, 1/5/2012 with CC A (MNR) for MS-DRG 617 Amputation of Lower Limb for Endocrine, Nutritional, and Metabolic Disorders with VT, PA, DE, DC, RI, CT, 1/5/2012 CCDisorders with CC A (MNR) for MS-DRG 215 Other VT, PA, DE, DC, RI, CT, 1/5/2012 Heart Assist System Implant

23 (MNR) for MS-DRG 734 Pelvic A Evisceration, Radical VT, PA, DE, DC, RI, CT, 1/5/2012 Hysterectomy and Radical Vulvectomy with CC- A (MNR) for MS-DRG 836 Acute Leukemia without Major O.R. Procedure with CC VT, PA, DE, DC, RI, CT, 1/5/2012 (MNR) for MS-DRG 340 A Appendectomy with Complicated VT, PA, DE, DC, RI, CT, 1/5/2012 Principal Diagnosis without CC- A (MNR) for MS-DRG 815 Reticuloendothelial and Immunity Disorders with CC VT, PA, DE, DC, RI, CT, 1/5/2012 (MNR) for MS-DRG 716 Other A Male Reproductive System O.R. VT, PA, DE, DC, RI, CT, 1/5/2012 Procedures for Malignancy without CC- A (MNR) for MS-DRG 614 Adrenal and Pituitary Procedures with CC- VT, PA, DE, DC, RI, CT, 1/5/2012 A (MNR) for MS-DRG 810 Major Hematologic/Immunologic Diagnoses Except Sickle Cell Crisis and Coagulation without VT, PA, DE, DC, RI, CT, 1/5/2012 CC- A (MNR) for MS-DRG 297 Cardiac Arrest, Unexplained with CC VT, PA, DE, DC, RI, CT, 1/5/2012 A (MNR) for MS-DRG 579 Other Skin, Subcutaneous Tissue and Breast Procedures with VT, PA, DE, DC, RI, CT, 1/5/2012 A (MNR) for MS-DRG 643 VT, PA, DE, DC, RI, CT, 1/5/2012 Endocrine Disorders with

24 A (MNR) for MS-DRG 481 Hip and Femur Procedures Except Major Joint with CC 1/5/2012 A (MNR) for MDC 8: Diseases and Disorders of the Musculoskeletal System and Connective Tissue 1 VT, PA, DE, DC, RI, CT, 1/16/2012 (MNR) MDC 9: Diseases and A Disorders of the Skin, VT, PA, DE, DC, RI, CT, 1/16/2012 Subcutaneous Tissue and Breast 1 (MNR) MDC 17: A Myeloproliferative Diseases and VT, PA, DE, DC, RI, CT, 1/16/2012 Disorders and Poorly Differentiated Neoplasms 1 A (MNR) for MS-DRG 115 Extraocular Procedures Except Orbit VT, PA, DE, DC, RI, CT, 1/16/2012 (MNR) for MS-DRG 761 A Menstrual and Other Female VT, PA, DE, DC, RI, CT, 1/16/2012 Reproductive System Disorders without CC/ (MNR) MDC 9: Diseases and A Disorders of the Skin, VT, PA, DE, DC, RI, CT, 1/16/2012 Subcutaneous Tissue and Breast 2 A (MNR) MDC 10: Endocrine, Nutritional and Metabolic Diseases and Disorders VT, PA, DE, DC, RI, CT, 1/16/2012 A (MNR) MDC 11: Diseases and Disorders of the Kidney and Urinary Tract VT, PA, DE, DC, RI, CT, 1/16/2012 (MNR) MDC 17: A Myeloproliferative Diseases and VT, PA, DE, DC, RI, CT, 1/17/2012 Disorders and Poorly Differentiated Neoplasms 2

25 A (MNR) for MDC 8: Diseases and Disorders of the Musculoskeletal System and Connective Tissue 2 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 1: Diseases and Disorders of the Nervous System 1 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 1: Diseases and Disorders of the Nervous System 2 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 3: Diseases and Disorders of the Ear, Nose, Mouth and Throat VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 5: Diseases and Disorders of the Circulatory System 1 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 5: Diseases and Disorders of the Circulatory System 2 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 6: Diseases and Disorders of the Digestive System VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 7: Diseases and Disorders of the Hepatobiliary System and Pancreas 1 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 7: Diseases and Disorders of the Hepatobiliary System and Pancreas 2 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 8: Diseases and Disorders of the Musculoskeletal System and Connective Tissue 3 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 8: Diseases and Disorders of the Musculoskeletal System and Connective Tissue 4 VT, PA, DE, DC, RI, CT, 1/17/2012

26 A (MNR) MDC 12: Diseases and Disorders of the Male Reproductive System 1 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 12: Diseases and Disorders of the Male Reproductive System 2 VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 13: Diseases and Disorders of the Female Reproductive System VT, PA, DE, DC, RI, CT, 1/17/2012 A (MNR) MDC 14: Pregnancy, VT, PA, DE, DC, RI, CT, 1/17/2012 Childbirth and the Puerperium 1 A (MNR) MDC 14: Pregnancy, VT, PA, DE, DC, RI, CT, 1/17/2012 Childbirth and the Puerperium 2 A (MNR) MDC 1: Diseases and Disorders of the Nervous System 3 VT, PA, DE, DC, RI, CT, 1/22/2012 (MNR) MDC 16: Diseases and A Disorders of the Blood and VT, PA, DE, DC, RI, CT, 1/22/2012 Blood-Forming Organs and Immunological Disorders A (MNR) MDC 18: Infectious and VT, PA, DE, DC, RI, CT, 1/22/2012 Parasitic Diseases A (MNR) MDC 19: Mental VT, PA, DE, DC, RI, CT, 1/22/2012 Diseases and Disorders A (MNR) MDC 21: Injury, Poisoning and Toxic Effects of Drugs VT, PA, DE, DC, RI, CT, 1/22/2012 A (MNR) MDC 22: Burns 1/22/2012 (MNR) MDC 23: Factors A Influencing Health Status and 1/22/2012 Other Contacts with Health Services

27 A (MNR) MDC 24: Multiple 1/22/2012 Significant Trauma A (MNR) MDC 25: Human Immunodeficiency Virus Infections 1/22/2012 A (MNR) Pre MDC 1/22/2012 A (MNR) for MS-DRG 116 Intraocular Procedures with CC/ 1/22/2012 (MNR) for MS-DRG 895 A Alcohol/Drug Abuse or VT, PA, DE, DC, RI, CT, 1/22/2012 Dependence with Rehabilitation Therapy A (MNR) for MS-DRG 146 Ear, Nose, Mouth and Throat Malignancy with 1/22/2012 A (MNR) for MS-DRG 183 Major 1/22/2012 Chest Trauma with A (MNR) DRGs Associated with 1/22/2012 All MCDs (MNR) for MS-DRG 846 A Chemotherapy without Acute 4/25/2011 Leukemia as secondary diagnoses with A (MNR) for MS-DRG 113 Orbital 4/26/2011 Procedures with CC/ A (MNR) for MS-DRG 088 4/26/2011 Concussion with A (MNR) for MS-DRG 117 Intraocular Procedures without CC/ 4/26/2011

28 (MNR) for MS-DRG 847 A Chemotherapy without Acute VT, PA, DE, DC, RI, CT, 4/26/2011 Leukemia as secondary diagnoses with CC (MNR) for MS-DRG 848 A Chemotherapy w/o Acute 4/26/2011 Leukemia as secondary diagnosis w/o CC/ A (MNR) for MS-DRG 637 4/26/2011 Diabetes with A (MNR) for MS-DRG 152 Otitis 4/26/2011 Media and URI with A (MNR) for MS-DRG 974 HIV with Major Related Condition with 4/26/2011 A (MNR) for MS-DRG 121 Acute Major Eye Infections with CC/ 4/26/2011 A (MNR) for MS-DRG 122 Acute Major Eye Infections without CC/ 4/26/2011 A (MNR) for MS-DRG 137 Mouth 4/26/2011 Procedures with CC/ A (MNR) for MS-DRG 502 Soft Tissue Procedures without CC/ 4/26/2011 (MNR) for MS-DRG 604 A Trauma to the Skin, 4/27/2011 Subcutaneous Tissue & Breast with A (MNR) for MS-DRG 058 Multiple Sclerosis and Cerebellar Ataxia with 4/27/2011

29 A (MNR) for MS-DRG 059 Multiple Sclerosis and Cerebellar Ataxia with CC 4/27/2011 A (MNR) for MS-DRG 060 Multiple Sclerosis and Cerebellar Ataxia without CC/ 4/27/2011 A (MNR) for MS-DRG 064 Intracranial Hemorrhage or Cerebral Infarction with 4/27/2011 A (MNR) for MS-DRG 065 Intracranial Hemorrhage or Cerebral Infarction with CC VT, PA, DE, DC, RI, CT, 4/27/2011 (MNR) for MS-DRG 066 A Intracranial Hemorrhage or VT, PA, DE, DC, RI, CT, 4/27/2011 Cerebral Infarction without CC/ A (MNR) for MS-DRG 089 4/27/2011 Concussion with CC A (MNR) for MS-DRG 638 VT, PA, DE, DC, RI, CT, 4/27/2011 Diabetes with CC A (MNR) for MS-DRG 639 4/27/2011 Diabetes without CC/ A (MNR) for MS-DRG 091 Other Disorders of Nervous System with 4/27/2011 A (MNR) for MS-DRG 092 Other Disorders of Nervous System with CC 4/27/2011 A (MNR) for MS-DRG 093 Other Disorders of Nervous System without CC/ 4/27/2011 A (MNR) for MS-DRG 149 Dysequilibrium NY, NH, MA, ME, VT, PA, DE, DC, RI, CT, ; 4/27/2011

30 A (MNR) for MS-DRG 157 Dental 4/27/2011 & Oral Diseases w A (MNR) for MS-DRG 158 Dental 4/27/2011 & Oral Diseases with CC A (MNR) for MS-DRG 159 Dental & Oral Diseases without CC/ 4/27/2011 A (MNR) for MS-DRG 181 4/27/2011 Respiratory Neoplasms with CC A (MNR) for MS-DRG 182 Respiratory Neoplasms without CC/ 4/27/2011 A (MNR) for MS-DRG 233 Coronary Bypass w Cardiac cath with 4/27/2011 A (MNR) for MS-DRG 234 Coronary Bypass with Cardiac Catheterization without 4/29/2011 A (MNR) for MS-DRG 250 Percutaneous Cardiovascular Procedure without Coronary NH,, NY, PA, 4/29/2011 Artery Stent with A (MNR) for MS-DRG 251 Percutaneous Cardiovascular Procedure without Coronary NY, NH, MA, ME, VT, PA, DE, DC, RI, CT, ; 4/29/2011 Artery Stent without A (MNR) for MS-DRG 329 Major Small & Large Bowel Procedures with 4/29/2011 A (MNR) for MS-DRG 330 Major Small & Large Bowel Procedures with CC 5/3/2011

31 A (MNR) for MS-DRG 331 Major Small & Large Bowel Procedures without CC/ 5/3/2011 A (MNR) for MS-DRG 436 Malignancy of Hepatobiliary System or Pancreas with CC 5/3/2011 A (MNR) for MS-DRG 435 Malignancy of Hepatobiliary System or Pancreas with 5/3/2011 (MNR) for MS-DRG 437 A Malignancy of Hepatobiliary 5/3/2011 System or Pancreas without CC/ A (MNR) for MS-DRG 438 Disorders of Pancreas Except Malignancy with 5/3/2011 A (MNR) for MS-DRG 439 Disorders of Pancreas Except Malignancy with CC VT, PA, DE, DC, RI, CT, 5/3/2011 A (MNR) for MS-DRG 440 Disorders of Pancreas Except Malignancy without CC/ 5/3/2011 A (MNR) for MS-DRG 445 Disorders of the Biliary Tract with CC 5/3/2011 A (MNR) for MS-DRG 446 Disorders of the Biliary Tract without CC/ 5/3/2011 A (MNR) for MS-DRG 168 Other Respiratory O.R. Procedures without CC/ 5/3/2011 A (MNR) for MS-DRG 671 Urethral Procedures with CC/ 5/3/2011

32 A (MNR) for MS-DRG 906 Hand 5/3/2011 Procedures for Injuries A (MNR) for MS-DRG 916 5/3/2011 Allergic Reactions without A (MNR) for MS-DRG 948 Signs VT, PA, DE, DC, RI, CT, 5/3/2011 and Symptoms without A (MNR) for MS-DRG 672 Urethral Procedures without CC/ 5/3/2011 (MNR)- MDC 5 Conditions of the Circulatory System (Medical) A MS-DRGs: 286, 287, 288, 289, 290, 291, 292, 293, 299, 300, NY, NH, MA, ME, VT, PA, DE, DC, RI, CT, ; 5/4/ , 302, 303, 304, 305, 308, 309, 310, 311, 312, 313, 314, 315, 316 A (MNR)- Surgical Cardiovascular Procedures MS-DRGs: , NY, NH, MA, ME, VT, PA, DE, DC, RI, CT, ; 5/4/ (MNR)- MDC 6 Diseases and Disorders of the Digestive System MS-DRGs: 347, 348, A , 350, 351, 352, 353, 354, 355, 356, 357, 358, 368, 369, 370, 371, 372, 373, 374, 375, NY, NH, MA, ME, VT, PA, DE, DC, RI, CT, ; 5/5/ , 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, and 395 (MNR) for MS-DRG -208 A Respiratory System Diagnosis 5/18/2011 with Ventilator Support <96 hours A (MNR) for MS-DRG 282 Acute 5/18/2011 Myocardial Infarction

33 Discharged Alive without CC- A (MNR) for MS-DRG 533 Fractures of Femur with NY, NH, MA, ME, VT, PA, DE, DC, RI, CT, ; 5/18/2011 A (MNR) for MS-DRG 296 Cardiac Arrest Unexplained with 5/18/2011 A (MNR) for MS-DRG 189 Pulmonary Edema and Respiratory Failure VT, PA, DE, DC, RI, CT, 5/18/2011 A (MNR) for MS-DRG 283 Acute Myocardial Infarction, Expired w 6/3/2011 A (MNR) for MS-DRG 918 Poisoning-Toxic Effects of Drugs without 6/3/2011 (MNR) for MS-DRG 087 A Traumatic Stupor and Coma, 6/3/2011 Coma Less Than One Hour without CC- A (MNR) for MS-DRG 188 Pleural 6/3/2011 Effusion without CC- A (MNR) for MS-DRG 885 VT, PA, DE, DC, RI, CT, 6/3/2011 Psychoses A (MNR) for MS-DRG /6/2011 Neurological Eye Disorders A (MNR) for MS-DRG -280 Acute Myocardial Infarction, Discharged Alive with 6/6/2011 A (MNR) for MS-DRG 281 Acute Myocardial Infarction, Discharged Alive with CC VT, PA, DE, DC, RI, CT, 6/6/2011

34 A A A A A A A A A A (MNR) for MS-DRG 294 Deep Vein Thrombophlebitis with CC- 6/6/2011 (MNR) for MS-DRG /6/2011 Fractures of Femur without (MNR) for MS-DRG 313-Chest Pain (All Serverity and Risk of Maryland (MD) 7/27/2011 Mortality Levels) (MNR) for MS-DRG 312- Syncope (All Severity and Risk Maryland (MD) 7/27/2011 of Mortality Levels) (MNR) for MS-DRG 069 Transient Ischemia (All Severity Maryland (MD) 7/27/2011 and Risk of Mortality Levels) (MNR) for MS-DRG 190,191,192 Chronic Obstructive Maryland (MD) 7/27/2011 Pulmonary Disease (All Severity and Risk of Mortality Levels) (MNR) for MS-DRG 149 Vertigo & Other Labyrinth Maryland (MD) 8/1/2011 Disorders (All Severity and Risk of Mortality Levels) (MNR) for MS-DRG 286,287 Cardiac Catheterization for Ischemic Heart Disease (All Maryland (MD) 8/1/2011 Severity and Risk of Mortality Levels) (MNR)- MDC 5 Conditions of the Circulatory System (Medical) MS-DRGs: 286, 287, 288, 289, 290, 291, 292, 293, 299, 300, Maryland (MD) 9/19/ , 302, 303, 304, 305, 308, 309, 310, 311, 312, 313, 314, 315, 316 Medical Necessity: Acute Maryland (MD) 9/27/2011 Inpatient Admission

35 A A A A A A A Neurological Disorders MS- DRG's 068, 069, 070, 071, 072, 073, 074, 103, 312(Collaborative) (MNR)- MDC 6 Diseases and Disorders of the Digestive System MS-DRGs: 347, 348, 349, 350, 351, 352, 353, 354, 355, 356, 357, 358, 368, 369, Maryland (MD) 9/27/ , 371, 372, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, and 395 Medical Necessity: Acute Inpatient Admission Respiratory Conditions (Collaborative) The MS DRGs affected are MS DRG Maryland (MD) 9/27/ , MS DRG and MS DRG (MNR)- Surgical Cardiovascular Procedures MS-DRGs: , Maryland (MD) 10/26/ Acute ization - Infections MS-DRG: ; ; ;539- Maryland (MD) 10/26/ ; ; ; ;862-9; ;977 Acute ization - Musculoskeletal Disorders MS- Maryland (MD) 10/26/2011 DRGs: (MNR)- Renal and Urinary Tract Disorders MS-DRG: 657, 658, Maryland (MD) 10/26/ , 661, 663, 664, 666, , , , (MNR) for MS-DRG 291 Heart Failure and Shock w/, MS- DRG 292 Heart Failure and Maryland (MD) 10/27/2011 Shock w/cc, MS-DRG 293 Heart Failure and Shock w/o CC/

36 A A A A A A A A A A A (MNR) for MS-DRG 302 Atherosclerosis w/, and MS-DRG 303 Atherosclerosis w/o Maryland (MD) 10/27/2011 (MNR) for MD MS-DRG -516 Other Musculoskeletal System Maryland (MD) 10/27/2011 and Connective Tissue O.R. Procedure with CC (MNR) for MS-DRG /27/2011 Pneumothorax with CC (MNR) for MS-DRG 307 Cardiac Congenital and Valvular Disorders without 10/27/2011 (MNR) for MS-DRG 187 Pleural 10/27/2011 Effusion with CC (MNR) for MS-DRG 186 Pleural VT, PA, DE, DC, RI, CT, 10/27/2011 Effusion with (MNR) for MS-DRG 184 Major VT, PA, DE, DC, RI, CT, 10/27/2011 Chest Trauma with CC (MNR) for MS-DRG 081 VT, PA, DE, DC, RI, CT, 10/27/2011 Nontraumatic Stupor and Coma without (MNR) for MS-DRG 917 VT, PA, DE, DC, RI, CT, 10/28/2011 Poisoning and Toxic Effects of Drugs with (MNR) for MS-DRG -516 Other PA, DE, DC, CT,, Musculoskeletal System and NY, NH, MA, ME, VT, 10/28/2011 Connective Tissue O.R. RI Procedure with CC (MNR) for MS-DRG 897 Alcohol/Drug Abuse or Dependence without Rehabilitation Therapy without 10/28/2011

37 A (MNR) for MS-DRG 813 VT, PA, DE, DC, RI, CT, 10/28/2011 Coagulation Disorders (MNR) for MS-DRG 894 A Alcohol/Drug Abuse or VT, PA, DE, DC, RI, CT, 10/28/2011 Dependence, Left Against Medical Advice (MNR) for MS-DRG 082 A Traumatic Stupor and Coma, VT, PA, DE, DC, RI, CT, 10/28/2011 Coma Greater Than One Hour with A (MNR) for MS-DRG 054 Nervous System Neoplasms with VT, PA, DE, DC, RI, CT, 10/28/2011 A (MNR) for MS-DRG 238 Major Cardiovascular Procedures without VT, PA, DE, DC, RI, CT, 11/2/2011 A (MNR) for MS-DRG 237 Major Cardiovascular Procedures with VT, PA, DE, DC, RI, CT, 11/2/2011 A (MNR) for MS-DRG 460 Spinal Fusion Except Cervical without VT, PA, DE, DC, RI, CT, 11/2/2011 (MNR) for MS-DRG 207 A Respiratory System Diagnosis VT, PA, DE, DC, RI, CT, 11/2/2011 with Ventilator Support 96+ Hours A (MNR) for MS-DRG 708 Major Male Pelvic Procedures without CC- VT, PA, DE, DC, RI, CT, 11/2/2011 (MNR) for MS-DRG 627 A Thyroid,Parathyroid and 11/2/2011 Thyroglossal Procedure without CC-

38 A (MNR) for MS-DRG 419 Laparoscopic Cholecystectomy without C.D.E. without CC- VT, PA, DE, DC, RI, CT, 11/2/2011 (MNR) for MS-DRG 743 Uterine A and Adnexa Procedure for VT, PA, DE, DC, RI, CT, 11/2/2011 Nonmalignancy without CC- A (MNR) for MS-DRG 621 O.R. Procedures for Obesity without CC- 11/2/2011 A (MNR) for MS-DRG 714 Transurethral Prostatectomy without CC- 11/2/2011 (MNR) for MS-DRG 490 Back A and Neck Procedures Except 11/2/2011 Spinal Fusion with CC- or Disc Device/Neurostimulator A (MNR) for MS-DRG 748 Female Reproductive System Reconstructive Procedures VT, PA, DE, DC, RI, CT, 11/2/2011 A (MNR) for MS-DRG 038 VT, PA, DE, DC, RI, CT, 11/2/2011 Extracranial Procedures with CC (MNR) for MS-DRG 484 Major A Joint-Limb Reattachment VT, PA, DE, DC, RI, CT, 11/2/2011 Procedures of Upper Extremity without CC- A (MNR) for MS-DRG 036 Carotid Artery Stent Procedure without CC- 11/2/2011 (MNR) for MS-DRG 027 A Craniotomy and Endovascular 11/4/2011 Intracranial Procedures without CC-

39 (MNR) for MS-DRG 581 Other A Skin,Subcutaneous Tissue and 11/4/2011 Breast Procedures without CC- A (MNR) for MS-DRG-100 VT, PA, DE, DC, RI, CT, 11/4/2011 Seizures with A (MNR) for MS-DRG 176 Pulmonary Embolism without 11/4/2011 (MNR) for MS-DRG 085 A Nontraumatic Stupor and Coma, VT, PA, DE, DC, RI, CT, 11/4/2011 Coma Less Than One Hour with A (MNR) for MS-DRG 432 Cirrhosis and Alcoholic Hepatitis with VT, PA, DE, DC, RI, CT, 11/4/2011 A (MNR) for MS-DRG 175 VT, PA, DE, DC, RI, CT, 11/4/2011 Pulmonary Embolism with A (MNR) for MS-DRG 306 Cardiac Congenital and Valvular Disorders with VT, PA, DE, DC, RI, CT, 11/4/2011 A (MNR) for MS-DRG 201 VT, PA, DE, DC, RI, CT, 11/4/2011 Pneumothorax without CC- A (MNR) for MS-DRG 061 Acute Ischemic Stroke with Use of Thrombolytic Agent with VT, PA, DE, DC, RI, CT, 11/4/2011 (MNR) for MS-DRG 728 A Inflammation of the Male VT, PA, DE, DC, RI, CT, 11/4/2011 Reproduction System without A (MNR) for MS-DRG 185 Major VT, PA, DE, DC, RI, CT, 11/4/2011 Chest Trauma without CC-

40 A (MNR) for MS-DRG 147 Ear,Nose,Mouth-Throat Malignancy wcc VT, PA, DE, DC, RI, CT, 11/4/2011 A (MNR) for MS-DRG 080 Nontraumatic Stupor and Coma with VT, PA, DE, DC, RI, CT, 11/4/2011 A (MNR) for MS-DRG 148 Ear, Nose, Mouth and Throat Malignancy without CC- VT, PA, DE, DC, RI, CT, 11/4/2011 A (MNR) for MS-DRG 592 Skin VT, PA, DE, DC, RI, CT, 11/4/2011 Ulcers with A (MNR) for MS-DRG 155 Other Ear, Nose, Mouth, Throat Diagnosis with CC VT, PA, DE, DC, RI, CT, 11/7/2011 (MNR) for MS-DRG 042 A Peripheral-Cranial Nerve and VT, PA, DE, DC, RI, CT, 11/8/2011 Other Nervous System Procedures without CC- A (MNR) for MS-DRG 033 Ventricular Shunt Procedures without CC- VT, PA, DE, DC, RI, CT, 11/8/2011 A (MNR) for MS-DRG 710 Penis VT, PA, DE, DC, RI, CT, 11/8/2011 Procedures without CC- (MNR) for MS-DRG 494 Lower A Extremity-Humerus Procedures VT, PA, DE, DC, RI, CT, 11/8/2011 Except Hip, Foot, Femur without CC- A (MNR) for MS-DRG /8/2011 Cervical Spinal Fusion with CC A (MNR) for MS-DRG 853 Infectious-Parasitic Diseases with O.R. Procedure with VT, PA, DE, DC, RI, CT, 11/8/2011