​​Microdyn Update for Ambulatory Payment Classifications (APCs), and Diagnostic Related Groups (DRG’s), CRs 120481, 120482, 120475, 120743​

Dec 07, 2023

Effective October 28, 2023, the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates are complete in MIHMS.      

The following CMS documents provide the details of the APC updates:   
  

• October 2023 Integrated Outpatient Code Editor Specs:    

r12226cp.pdf (cms.gov) 

• October 2023 Update of the Hospital OPPS:     

r12227cp.pdf (cms.gov) 

• October 2023 Update for DRG License: 

1) New FY20-24 Version. Implementation of the FY24 MS-DRG specifications valid for Medicare hospital discharges 10/1/23 and after. Details can be found on the CMS website: FY 2024 IPPS Final Rule Home Page | CMS 

MaineCare denied some claims in error, due to receiving the Microdyn updates late from Medicare. MaineCare will reprocess claims that denied in error and no provider action is needed.