This is not a request for interpretation, but a question about the Severity of Illness DRG codes for Medicaid requirements. Medicaid is requesting the Severity of Illness codes (1-4) be added to the claims, but I do not see any loop or segment in the 5010 837 Inst guidelines for this information. Will this be added to the 5010 guidelines, or dealt with in a newer version?
Within the 005010X223A2 5010 837 Institutional TR#, the 2300 HI - DIAGNOSIS RELATED GROUP (DRG) INFORMATION, HI01-02 data element has size attributes of a minimum of 1 and maximum of 30. This allows for the severity of illness code of the DRG to be included.
TGB/WG2 will be making a public comment on the 837 Institutional TR3 related to the Code Source referenced in the Loop 2300 HI01-01.
CMS published transmittal 424 in 2003 related to DRG usage under HIPAA: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/down…