May 30, 2013

DRG Code to Appear on Remittance Advices June 1

To prepare hospitals for transition to diagnosis related group (DRG) pricing, beginning June 1, 2013, Florida Medicaid will report the DRG code on remittance advices (RA) for each inpatient claim containing an admission date of January 1, 2013 or later. The code consists of the three-digit DRG code followed immediately by the one-digit severity of illness code. Actual DRG pricing will not occur until the admission date of a claim is on or after July 1, 2013. Early availability of the DRG code on the RA will enable hospitals to view the DRG assignments of current Florida Medicaid claims. For more information on DRG implementation, visit the Florida Medicaid DRG pricing Web page.