Wiki What is the best software to determine DRG assignment?

[CatherineOwen]

Hi,

I am a coder with HCC experience who is now trying to break in to inpatient coding. I am very new to DRG assignment and am currently trying to figure out what the best software program is to help with figuring that out. (Sorry if this sounds ignorant). Any advice or recommendations would be greatly appreciated. Thank you so much!

 

[KellyLR]

Hi Catherine,

There are several vendors that incorporate DRG into their software for a module price. We use 3M Health Information Systems (3M-HIS), who developed the new International Classification of Diseases Tenth Edition (ICD-10) MS-DRG Grouper, Version 36.0, software package effective for discharges on or after October 1, 2018. The GROUPER assigns each case into a MS-DRG on the basis of the reported diagnosis and procedure codes and demographic information (that is age, sex, and discharge status).
3M is way over the moon expensive. I started out with Ingenix Encoder which is now Optum 360. I think it is around $1500/yr. Not sure I don't use it any longer having access to 3M. 3M also develops for CMS as they are the contractor for CMS.
Look up a DRG grouper software on CMS. It might be available for free. I know there is a link to their DRG and MCC list and other info. I sometimes use it to compare and play around with it.
https://www.cms.gov/ICD10Manual/version36-fullcode-cms/fullcode_cms/P0001.html

Good Luck!