Replacement of Aortic Valve Replacement Using Zooplastic is associated with lower 30 Day readmission rates in DRG 220


In Cardiovascular

By: Avinash Kumar  May. 07, 2019

Hospitals use ICD 10 procedure code X2RF032 to get NTAP payments of Aortic valve replacement from Medicare. NTAP payment is an additional payment over and above the DRG payment amount.

CMS has approved two Zooplastic vendors, Perceval (LivaNova, PLC, London, UK) and Intuity Elite (Edwards Lifesciences, Irvine, US) for Aortic valve replacement payments under NTAP payment program. These Zooplastic Aortic valves are widely used in Rapid deployment aortic valve replacement (RDAVR) and emerged as an attractive alternative to conventional aortic valve replacement because these are sutureless and facilitates quick implantation.

The clinical data from trials of the valve showed that its use resulted in reduced procedure time, decreased postoperative complications and shorter hospital stays. The valve can be used in traditional open surgery as well as minimally invasive surgical approaches.

Dexur analysed Medicare claims data from Jan 2017 to Dec 2017 when Aortic valve replacement was used as a primary procedure and the top DRG where it was used.The most extensive use of the Aortic valve replacement procedures is in DRG 220 - Cardiac Valve & Other Major Cardiothoracic Procedure without Cardiac Catheterization with Complication or Comorbidity (CC). The all cause readmission rate at the DRG is 19.16% versus 15.49% when Zooplastic is used.

Diagnosis Related Groups (DRGs) is a classification system which assigns a hospital stay to one of approximately 750 DRG codes.  Dexur also has a more in depth database of patients who have Aortic valve diseases and can benefit from Aortic valve replacement.

DEXUR PRO MEMBERS:

Dexur Pro members get detailed quality outcomes for a combination of Aortic Valve replacement usage and that DRG. Quality outcomes include LOS, Mortality, Readmission and SNF Discharge rates.


ABOUT THE AUTHOR

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Avinash Kumar

Avinash Kumar is a Business analyst with over 9 years of healthcare experience. He has expertise in Real World Evidence (RWE), healthcare claims analytics, market research, data analytics, benefits configuration, claim contractual reprising, adjudication, implementation of reimbursement rule edits for healthcare payers and revenue cycle management for providers. Avinash holds a Master's degree in Operations management and life sciences. He is a certified medical coder from American Association of Professional Coders (AAPC).