Requesting that delirium achieve parity with acute encephalopathy in the MS-DRG system

Since 2007, the Medicare Severity Diagnosis Related Groups (MS-DRG) classification system has favored billing codes for acute encephalopathy over delirium codes in determining hospital reimbursement and several quality-of-care value metrics, despite broad overlap between these sets of diagnostic codes. Toxic and metabolic encephalopathy codes are designated as major complication or comorbidity (MCC) whereas causally specified delirium codes are designated as complication or comorbidity (CC) and thus associated with lower reimbursement and lesser impact on value metrics.