Medicare Severity Diagnosis Related Groups Reclassification Request (MS-DRGs) (CMS-10775)

ICR 202509-0938-007

OMB: 0938-1431

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2025-09-04
IC Document Collections
IC ID
Document
Title
Status
248700 Modified
ICR Details
0938-1431 202509-0938-007
Received in OIRA 202108-0938-002
HHS/CMS CM-FFS
Medicare Severity Diagnosis Related Groups Reclassification Request (MS-DRGs) (CMS-10775)
Extension without change of a currently approved collection   No
Regular 09/04/2025
  Requested Previously Approved
36 Months From Approved 09/30/2025
50 50
48,000 48,000
0 0

Generally, under the Inpatient Prospective Payment System (IPPS), Medicare payment to the hospital varies based on hospital-specific and patient-specific characteristics. Each Medicare claim for inpatient services is classified into the applicable Medicare Severity Diagnosis-Related Group (MS-DRG) for payment based on certain patient-specific elements, including the principal diagnosis, additional or secondary diagnoses, and procedures reported on the claim. The MS– DRG classification system currently has 337 base DRGs, most of which are split into 2 or 3 MS– DRGs based on the presence of either a complication or comorbidity (CC) or major complication or comorbidity (MCC), resulting in a total of 767 MS-DRGs for FY 2021. Effective October 1, 2015, providers use the International Classification of Diseases, 10th Revision, Clinical Modification (ICD–10–CM) diagnosis code set in all healthcare settings and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD–10– PCS) is the code set used for inpatient hospital procedure coding. These diagnosis and procedure codes are mapped or “grouped” to specific MS-DRGs for payment under the IPPS using the ICD-10 MS-DRG Grouper software. The public may submit requests to create a new MS-DRG(s), modify an existing MS-DRG(s), change the severity level designation for a diagnosis code(s), change the operating room (O.R.) designation of a procedure code(s), reassign diagnosis and/or procedure codes among Major Diagnostic Categories (MDCs), modify the Medicare Code Editor (MCE), or modify the surgical hierarchy. We examine these requests using statistical analysis and the judgment of our clinical advisors to evaluate the requested changes and consider any proposed updates to the MS-DRGs. Interested parties can include any information they choose to support a MS-DRG change request.

US Code: 42 USC 1395ww Name of Law: PAYMENT TO HOSPITALS FOR INPATIENT HOSPITAL SERVICES
  
None

Not associated with rulemaking

  90 FR 24630 06/11/2025
90 FR 42411 09/02/2025
No

1
IC Title Form No. Form Name
MS-DRG classification change requests CMS-10775 MEARIS Login ScreenShots

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 50 50 0 0 0 0
Annual Time Burden (Hours) 48,000 48,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$217,300
No
    No
    No
No
No
No
No
Malcolm Wilson 667 414-0087 malcolm.wilson@cms.hhs.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/04/2025


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