CHFS Releases Decision on Coding and Reimbursement for Sepsis
Friday, November 22, 2019 2:30 PM
After months of discussions with the Cabinet for Health and Family Services (CHFS) via the KHA Medicaid Technical Advisory Committee (TAC) meetings, monthly Medicaid managed care organization (MCO) issue list meetings, individual meetings with CHFS and presentations to the Medicaid Advisory Committee (MAC), the Cabinet has made a final decision regarding sepsis.
On Wednesday, Department for Medicaid Services (DMS) Medical Director Judy Ann Theriot released a memo detailing coding and reimbursement guidelines for sepsis. CHFS will follow the CMS DRG and ICD-10 definitions of sepsis. MCOs are directed to "...base utilization management for sepsis on sepsis-2 criteria until such time that CMS adopts sepsis-3 criteria."
View the memo for more details.