All PlansAdministrativeMedium impact
3M Grouper and DRG Calculator for ICD-10-CM Updates
Connecticut Medicaid (HUSKY Health)·TX·Coding
Effective date
Oct 29, 2025
We identified it
Jun 20, 2026
Summary
The 3M Grouper and DRG Calculator will be updated on October 29, 2025, affecting how inpatient hospital claims with discharge dates of October 1, 2025 and forward are processed. Previously suspended claims will be automatically reprocessed and appear on November remittance advices.
Action Required
By October 29, 2025: Billing team must be prepared for automatic reprocessing of previously suspended inpatient claims with EOB codes 0693 and 0920. Monitor November 12, 2025 Remittance Advice for recycled claims and November 25, 2025 Remittance Advice for reprocessed claims with corrected DRG codes. Update DRG Calculator reference materials for discharge dates October 1, 2025 and forward. Contact ctxixhosppay@gainwelltechnologies.com with questions.