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DRG Payment System Update to Mapper Version 44.0 on October 1, 2026
Effective date
Oct 1, 2026
Identified
Oct 16, 2026
Summary
Effective October 1, 2026, Medi-Cal updated the DRG Mapper to version 44.0 to incorporate new ICD-10-CM and ICD-10-PCS codes released by CMS. Providers submitting claims with new codes for admission dates on or after October 1, 2026 may experience denials if the Medi-Cal system update was incomplete at submission time. Medi-Cal will reprocess affected claims through an Erroneous Payment Correction process, and providers may resubmit previous claims using this updated guidance.
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What to do
Action · 5 steps
01On or after October 1, 2026: Billing team should monitor for claim denials with RAD codes 67 (procedure code mismatch), 9124 (invalid diagnosis code), or 9962 (APR-DRG determination failure) when submitting claims with new ICD-10-CM and ICD-10-PCS codes.
02Include Present on Admission (POA) indicators on all submitted claims to prevent adjudication delays.
03If denials are received with these codes, resubmit the claim.
04Providers may contact DRG@dhcs.ca.gov for questions.
05Note: Medi-Cal will implement an Erroneous Payment Correction to automatically reprocess eligible claims; providers may also voluntarily correct and resubmit previous claims per CIF Submission and Timeliness Instructions in the Provider Manual.
Original notice
DRG Payment System Update to Mapper Version 44.0 on October 1, 2026
mcweb.apps.prd.cammis.medi-cal.ca.gov · Always check the source before changing claims.