MedicaidAdministrativeMedium impact
Inpatient Hospitals: MESA Issues Impacting Inpatient Claims Payment
Mississippi Medicaid (DOM)·MS·Claims & Billing
We identified it
Jun 21, 2026
Summary
Mississippi Medicaid has updated their DRG Grouper Settings for State Fiscal Year 2022, providing detailed technical specifications for how inpatient hospital claims should be processed using the 3M APR-DRG grouper system. This document outlines the specific desktop Core Grouping Software settings that providers should use to replicate Mississippi Medicaid's grouping results for accurate claim processing and reimbursement.
Action Required
Immediately: Hospitals billing Mississippi Medicaid inpatient claims should review and update their 3M desktop Core Grouping Software settings to match the Division's specifications. Key settings to verify include: discharge DRG option set to 'Compute excluding only non-POA Complication of Care Codes' (effective July 1, 2015), birth weight option set to 'coded weight with default', and appropriate HAC utility version for Mississippi with pediatric age break at less than 21 years. Billing teams should ensure their grouper version aligns with the claim discharge dates and POA indicators are properly coded.