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DRG Calculator Updated - Posted 10.23.2019 pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
The 3M APR-DRG Version 37 calculator has been updated for hospital inpatient discharges effective October 1, 2019, with system implementation scheduled for November 12, 2019. Inpatient DRG claims may suspend with specific error codes until the new grouper is loaded, after which they will automatically reprocess.
Action Required
Immediately: Hospital billing teams should monitor inpatient DRG claims with discharge dates October 1, 2019 and forward for suspension with EOB codes 0693 'Invalid Principal Diagnosis' or 0920 '3M Grouper Error'. Do not rebill these claims - they will automatically recycle for processing after November 12, 2019 when the updated 3M Grouper is implemented. Prepare for DRG Weight, ALOS and Outlier Threshold updates effective January 1, 2020.