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Update: TMHP to Use Grouper Version 37.1 for Dates of Discharge on or after April 1, 2020

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This is an update to the article titled, “TMHP to Use Grouper Version 37.1 for Dates of Discharge on or after April 1, 2020,” that was published on this website on March 18, 2020.

In addition to the new diagnosis for vaping related disorders, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) is implementing a new diagnosis code into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), to respond to the national emergency declared for the COVID-19 outbreak. Grouper version 37.1 is being updated to accommodate new diagnosis code U07.1 (COVID-19) effective April 1, 2020.

This update has yet to be released and impacts to existing diagnosis-related groups (DRGs) are currently unknown. Changes to relative weights, mean length of stay, day thresholds, and definitions resulting from this addition will be made available on the Texas Medicaid Acute Care Hospital Reimbursement web page as soon as possible. Impacted claims will be reprocessed to capture All Patient Refined-Diagnosis Related Groups (APR-DRG) changes.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.