October 31, 2011

Important: Now Available from CMS: Draft MS Grouper ICD-10 Software

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Those who want a reference to all things ICD-10 should check out the CMS Medicare Severity (MS) Grouper with Medicare Code Editor (MCE) ICD-10 R1 Pilot Software (v28). Also available is the updated ICD-10 MS-DRG (v28) R1 Definitions Manual. The draft ICD-10 MS DRG 28.0 R1 definitions are displayed in “grouper logic order” and listed in the order in which the grouper recognizes them. This, in turn, enables users to see instances where grouper logic order differs from strict numerical order.

 

Although the software has been updated, it is still a draft grouper, and changes will be made. The Centers for Medicare & Medicaid Services decided to provide the public with this version so they can more easily review and provide feedback on updates to the ICD-10 MS-DRGs. The final grouper (v31.0) ICD-10 MS-DRGs will be developed through the fiscal year (FY) 2014 rulemaking process.

With the software, users can group and edit claims with both ICD-9-CM codes and ICD-10 CM and ICD-10 PCS codes as defined by the code set indicator. This will help providers and suppliers with their internal implementation planning and impact analysis for conversion to I-10.

Based on the feedback received, CMS will continue to make annual updates to the MS-DRGs. The software will not be used to process claims since the ICD-10 code set will not be mandated for use until October 1, 2013.

 

Software Details

 

The ICD-10 pilot software contains ICD-9-CM codes that took effect on October 1, 2010, and ICD-10 codes published on December 27, 2010. This piloted version will only group and edit claims using version 28 of the MS Grouper with version 27 of the Medicare code editor (MCE) with effective dates October 1, 2010, through September 30, 2011. No grouping or editing will occur for claims prior to the valid date range for this component.

A CD-ROM containing the software may be purchased for $350 through National Technical Information Service (NTIS) at http://www.ntis.gov/products/cms-medicare.aspx. This release includes the following:

  • MS Grouper with Medicare Code Editor ICD-10 R1 Pilot Software, version 28.0 CD-ROM - October 1, 2010
  • The Pilot Installation and User’s Manual for the above
  • Definitions of Medicare Code Edits User’s ICD-10 Draft manual, version 27.0 CD

Also on its web site, CMS provides information on the project for using the general equivalence mappings (GEMs) to convert the draft MS-DRGs v28.0 to ICD-10-CM and ICD-10-PCS. The agency also refers to a similar conversion project, which, in a nutshell, meansmapping and converting ICD-9-CM codes to ICD-10-CM and ICD-10-PCS codes and vice versa.

For More Information

  • For the software, go to “Related Links Outside” at http://www.cms.gov/ICD10/17_ICD10_MS_DRG_Conversion_Project.asp.
  • For the definitions manual, go to the same web site. The text version is under the Downloads section and the HTML version is under the Related Links Inside CMS section.
  • Most of what you want to know about the ICD-10 system, including the FY 2011 ICD-10 long and abbreviated code descriptions, can be found at http://www.cms.gov/ICD10.

 

Read 2156 times Updated on March 14, 2016
Lynn Cleasby, RHIT, AHIMA-Approved ICD-10-CM/PCS Trainer

Lynn’s expertise includes inpatient HIM coding audits and coding staff training. She also performs CDIP analysis and CDIP staff and Physician training projects. She is also an AHIMA certified ICD-10 Trainer.