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The hospital identified the following MAO payer-specific negotiated charge information for MS-DRG 123 from its January 1, 2027 MRF: MA1: $7,400 MA2: $7,200 MA3: $7,500 MA4: $7,300 (algorithm-based) MA6: $7,400 Note, as the payer-specific negotiated charge for MA4 was based on an algorithm, the hospital substituted the dollar amount in the MRF required under 45 CFR 180.50(b)(2)(ii)(C) for the algorithm

GavriatopoulouMKastritisENtanasis-StathopoulosIFotiouDRoussouMMigkouMet al.The addition of IMiDs for patients with daratumumab-refractory multiple myeloma can overcome refractoriness to both agents

- Requires complete and accurate documentation (labs such as serum ferritin and transferrin saturation/TSAT, diagnosis codes, prior oral-iron trial or intolerance) to support medical necessity and reimbursement