How Is the DRG Grouper Calculator?


Quick Answer

The MS-DRG Grouper, Calculator & Analyzer is a software product produced by Wolters Kluwer that maps diagnostic health information codes to a Medicare system called the IPPS, or Inpatient Prospective Payment System, according to Wolters Kluwer. The IPSS is updated annually by the Centers for Medicare and Medicaid Services, and the MS-DRG Grouper can be used by hospital finance personnel to estimate, benchmark and forecast Medicare payments for their patients.

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Full Answer

Software programs called pricers or groupers assign hospital cases into DRGs for the purpose of billing Medicare, according to the American Health Information Management Association. MS-DRG stands for Medicare Severity Diagnosis Related Code. It is a measure assigned to each patient's hospital stay that combines diagnosis and procedure codes with statistics such as the mean length of the patient's stay. The MS-DRGs system went into effect for all hospital discharges that occurred after October 1, 2007. It includes three tiers used to record major complication/comorbidity, or MCC; complication/comorbidity, or CC; and no complication/comorbidity, or Non-CC.

Wolters Kluwer introduced the MS-DRG Grouper in 2015 to give hospitals a decision support tool to increase the accuracy of patient and Medicare claims accuracy while remaining in compliance with regulations, notes Globe News Wire.

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