Microdyn Update for Ambulatory Payment Classification (APC) and Diagnostic Related Groups (DRG) – CRs 135015, 135189, 135705, 135712
Effective October 18, 2025, we completed the CMS quarterly updates for DRGs in MIHMS. Updates are as follows:
- Update DRG License
- Add new DRGs (402, 426, 427, 428, 429, 430, 447, 448, 450, 451)
Effective December 22, 2025, we completed the CMS quarterly updates for APCs in MIHMS. The following CMS documents provide the details about the APC updates.
- October 2025 Integrated Outpatient Code Editor Specs
- October 2025 Hospital Outpatient Prospective Payment System (OPPS)
Claims Adjustment
MIHMS denied some claims in error due to the lag time between when CMS made procedure code updates and we updated them in MIHMS. We will adjust the affected claims, and no provider action is needed.
For questions, please contact Tiffany Norton, Provider Relations Specialist.