HCA Upgrade of APR-DRG Grouper Version - April 2018

Washington State Health Care Authority sent this bulletin at 01/02/2018 02:02 PM PST

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Apple Health (Medicaid) Provider

Attention Hospital Administrators:

Effective for hospital admission dates on and after April 1, 2018, the Health Care Authority (agency) will upgrade the APR-DRG grouper version in ProviderOne, from 31 to 33. The reason for this upgrade is that APR-DRG version 33 is fully ICD-10 compliant.

The agency performed an analysis to determine the impacts of upgrading to ARP-DRG version 33. The analysis confirmed the following:

No algorithmic changes between APR-DRG grouper versions 31 and 33
No DRG weight changes between APR-DRG grouper version 31 and 33
No need to apply budget neutrality factors to APR-DRG version 33

About the Health Care Authority (HCA)

The Washington State Health Care Authority purchases health care for more than 2 million Washington residents through Apple Health (Medicaid) and the Public Employees Benefits Board (PEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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HCA Upgrade of APR-DRG Grouper Version - April 2018

Apple Health (Medicaid) Provider

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About the Health Care Authority (HCA)

Disclosure notice