MS-DRG Grouper, Calculator & Analyzer

Our new and improved provider-specific MS-DRG Grouper, Calculator & Analyzer, powered by New Health Analytics, demonstrates MS-DRG grouping and payment logic under the Inpatient Prospective Payment System, and now includes an integrated grouper, batch grouping capability, and an MS-DRG analyzer.

Integrated into all of our mid- to top-tiered Coding and Compliance Suite solutions, the MS-DRG Grouper & Calculator demystifies payment under IPPS, and helps you understand and compare payment for different MS-DRGs or for the same MS-DRG over time. A stand-alone ICD-9 grouper is  available in our Coder's Resource Center—Student Edition.

The MS-DRG Analyzer takes understanding IPPS to a new level, giving consultants, cost report analysts, product line managers and regulators the ability to instantly compare any provider’s Medicare Expected Payment to other providers, as well as benchmark against regional, state and national averages. This tool also helps analyze Outlier payments, and demonstrates the payment impact of health reform on provider payment.

Multi-function Grouper simulates inpatient claims, groups to the MS-DRG from ICD-9-CM codes

  • Easy data-entry screen to understand grouping logic for ICD-9 and ICD-10 codes
  • Use the grouper as a stand-alone tool or integrate directly with the calculator
  • Detailed on-screen reporting shows data validation edits, MCE edits, code descriptions and details

Accurate MS-DRG Calculator with multiple input and output options

  • Calculate payment for one to hundreds of MS-DRGs
  • Get provider-specific payment adjustments or reference national unadjusted rates
  • Detailed on-screen reporting shows provider, MS-DRG and calculation details

Get instant insight into changes by using the MS-DRG Analyzer

  • Batch upload capability to group and calculate Medicare Expected Payment for up to two hundred claims instantly
  • Calculate MS-DRG Outlier Payments
  • Analyze a single MS-DRG against multiple providers, states and regions/counties
  • Analyze multiple MS-DRGs
  • Get national unadjusted federal MS-DRG payment rate and provider-specific MS-DRG payment rate (as published) – all providers available, up to 5 compared in a single report
  • Forecast , compare quarters, compare pricer versions
  • Benchmark comparisons of payment amount and variables used in the calculations

Simple to use lookup tools

  • MS-DRG and/or MDC “look-up” by keyword
  • Provider “look-up” by name, ID or address

Enhanced user tools

  • Export reports to PDF and Excel
  • Bookmark to save your favorite searches