Claims Reprocessing for DRG Grouper 30

NCTracks will be reprocessing the relevant inpatient institutional claims filed between July 1 and November 10, 2013, which is the date when version 30 of the DRG Grouper was implemented. Affected providers will see the reprocessed claims in a separate section of the paper Remittance Advice only for the April 22 checkwrite. The EOB associated with these reprocessed claims will be 06041 - "DRG Grouper Version 30 Adjustments".

The 835 transactions will include the reprocessed claims along with other claims submitted for the checkwrite. (There is no separate 835.)

Based on the application of the grouper, the reimbursement for the reprocessed claims may change. No action is required by providers.

The schedule for reprocessing the remaining claims for DRG Grouper version 30 and version 29 will be announced shortly.