Microdyn Update for Diagnostic Related Groups (DRG), and Ambulatory Payment Classifications (APC), CRs 127722, 127723, 128406, 128150, & 128151
The Centers for Medicare & Medicaid Services’ (CMS) quarterly updates are complete in MIHMS.
The following dates indicate when the CRs are effective in MIHMS:
DRG CRs:
October 26, 2024: 127722 and 127723
November 26, 2024: 128406
APC CRs
November 23, 2024: 128150 and 128151–
The following DRGs are effective in MIHMS as of October 01, 2024:
- 402
- 426
- 427
- 428
- 429
- 430
- 447
- 448
- 450
- 451
See the following CMS documents for the details of these updates:
- October 2024 Integrated Outpatient Code Editor Specs: https://www.cms.gov/files/document/r12815cp.pdf
- October Update of the Hospital OPPS:
https://www.cms.gov/files/document/r12816cp.pdf
The Office of MaineCare Services (OMS) released the DRG claims that we held. OMS will adjust DRG or APC claims that processed prior to these updates and were denied. No provider action is needed.
For questions, please contact Tiffany Norton, Provider Relations Specialist.