CHA News Article

DHCS Resolves Processing Issue for Certain DRG Claims
Denied claims with RAD code 9953 may be resubmitted

The Department of Health Care Services (DHCS) has resolved a previously identified claim processing issue that caused diagnosis-related group (DRG) claims with remittance advice details code “9953: APR-DRG — Length of Stay Invalid for Interim Claim” to be erroneously denied. Hospital providers may resubmit previously denied level one or two administrative day claims and rehabilitation claims, provided the claims meet certain criteria. More information on resubmitting claims is available at the DHCS website.