CHA News Article

DHCS Announces Mapping Requirements for 2015-16

The Department of Health Care Services (DHCS) has provided hospitals information to assist in setup for the APR-DRG desktop grouper for state fiscal year 2015-16, including claims with admission dates on and between July 1, 2015, and June 30, 2016. For discharges after Oct. 1, 2015, mapping is required due to ICD-10 implementation, even if the admission was prior to that date. Therefore, for state fiscal year 2015-16, any claim with a discharge date on or after Oct. 1, 2015, will require historical mapping. Mapping is also required for admissions on or after Oct. 1, 2015.

DHCS is evaluating version 33 of the APR-DRG grouper and continues to use version 32 in the meantime. Currently, version 32 of the mapper will not recognize approximately 50 new ICD-10 PCS (surgical) codes effective Oct. 1. For updates and more information, continue to monitor the DHCS DRG website for provider bulletins.