MedicaidBilling CodesMedium impact
MS-DRG and LTC-DRG updates and inpatient claim reprocessing
Oregon Health Plan·OR · OB-GYN, Neurology, PM&R (Physical Medicine & Rehab)·Provider
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Oregon Medicaid is updating to Version 37 of the MS-DRG grouper software effective October 1, 2019, which changes 9 Oregon Unique DRG codes (317-325 become 521-529). The state will automatically reprocess all affected inpatient claims paid between October 1-November 3, 2019.
Action Required
No action required by billing team. Oregon Health Authority will automatically reprocess all affected inpatient claims between October 1-November 3, 2019. Billing staff should expect to see adjustment codes 8008 on paper remittance advice and code 16 on electronic remittance advice for reprocessed claims.