KMAP BULLETIN: New DRG Grouper for April 2025
Date: 03/05/25
KMAP GENERAL BULLETIN 25041 (PDF)
Effective with discharge dates on and after April 1, 2025, MS-DRG Grouper version 42.1 will be used for inpatient claims processing.
The Neonatal MS-DRG Flowchart can be found here.
The summary of changes to the MS-DRG groupings can be found on the CMS website here.
Note: The effective date of the policy is April 1, 2025. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.