Where can I find the MS DRG definitions manual?

ICD-10 MS-DRG Definitions Manual Files v37 R1 (Updated September 19, 2019) (ZIP): A zip file with the ICD-10 MS DRG Definitions Manual (Text Version) contains the complete documentation of the ICD-10 MS-DRG Grouper logic. ICD-10-CM/PCS MS-DRG v37 R1 Definitions Manual Table of Contents – Full Titles – HTML Versions-UPDATED – Opens in a new window

How are Ms-DRGs classified for Medicare payment?

Currently, cases are classified into Medicare Severity Diagnosis Related Groups (MS-DRGs) for payment under the IPPS based on the following information reported by the hospital: the principal diagnosis, up to 24 additional diagnoses, and up to 25 procedures performed during the stay.

When do we need to change the DRG classifications?

Congress recognized that it would be necessary to recalculate the DRG relative weights periodically to account for changes in resource consumption. Accordingly, section 1886 (d) (4) (C) of the Act requires that the Secretary adjust the DRG classifications and relative weights at least annually.

How are DRGs used in the Medicare payment system?

Design and development of the Diagnosis Related Group (DRG) Prospective payment rates based on Diagnosis Related Groups (DRGs) have been established as the basis of Medicare’s hospital reimbursement system. The DRGs are a patient classification scheme which provides a means of relating the type of patients a hospital treats (i.e., its case

What are the different versions of the DRG?

There are currently three major versions of the DRG in use: basic DRGs, All Patient DRGs, and All Patient Refined DRGs. The basic DRGs are used by the Centers for Medicare and Medicaid Services (CMS) for hospital payment for Medicare beneficiaries.

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Which is an expansion of the basic DRGs?

(AP-DRGs) are an expansion of the basic DRGs to be more representative of non-Medicare pop-ulations such as pediatric patients. The All Patient Refined DRGs (APR-DRG) incorporate severity of illness subclasses into the AP-DRGs. Since the APR-DRGs include both the CMS