All PlansAdministrativeMedium impact
3M Grouper and DRG Calculator for ICD-10-CM Updates
Connecticut Medicaid (HUSKY Health)·Coding
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
The 3M DRG Grouper system was updated on October 30, 2024 for ICD-10-CM coding, affecting all inpatient hospital claims with discharge dates October 1, 2024 and forward. Previously suspended claims with grouper errors will be automatically reprocessed and appear on November remittance advices.
Action Required
By November 13, 2024: Billing team should review the November 13th Remittance Advice for previously suspended claims with EOB codes 0693 and 0920 that will be automatically reprocessed. By November 26, 2024: Review the November 26th Remittance Advice for any inpatient claims that were reprocessed due to incorrect DRG coding. Contact Gainwell Technologies at ctxixhosppay@gainwelltechnologies.com with any questions about the updated grouper.