KMAP BULLETIN: New DRG Groupers for 2020
Date: 01/15/20
KMAP HOSPITAL BULLETIN 19225 (PDF)
The Medicare Severity Diagnosis-Related Group (MS-DRG) Grouper version 37 and corresponding DRG weights, limits, and hospital rates will be installed and effective for dates of discharge on and after January 1, 2020.
The following MS-DRGs have been added:
- 319
- 320
The following MS-DRGs have been revised:
- 207
- 266
- 267
- 291
- 296
- 693
- 694
- 870
The following MS-DRGs have been deleted:
- 691
- 692
The Neonatal MS-DRG Flowchart can be found here: https://www.kmap-state-ks.us/Documents/Content/Provider/Neonatal_DRGs.pdf
The Hospital DRG Weights and Limits are available online at: https://www.kmap-state-ks.us/Documents/Content/Provider/Hospital_DRG_Weights-Rates.xlsx.
The Hospital Rates are available online at: https://www.kmap-state-ks.us/Documents/Content/Provider/Hospital_Rates.xlsx.
Note: The effective date of the policy is January 1, 2020. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented.
For the changes resulting from this provider bulletin, view the updated Hospital Fee-for-Service Provider Manual, DRG Weights and Rates.