The Centers for Medicare & Medicaid Services (CMS) is announcing important updates regarding the Medicare Severity Diagnosis Related Group (MS-DRG) Grouper and Medicare Code Editor (MCE) software. These are critical tools for hospitals and healthcare providers involved in medical coding and billing, particularly concerning DRG (Diagnosis Related Group) assignments. This article will provide a clear overview of the upcoming changes and how they will impact your operations, ensuring a smooth transition and continued accuracy in medical coding.
Understanding the Shift to Java 17
Currently, the MS-DRG Grouper and MCE software operate on Java version 8. However, with support for Java 8 ending in November 2026, CMS is proactively migrating these programs to Java version 17. This change is significant, especially for hospitals and software vendors utilizing these programs within mainframe environments. To facilitate this transition, CMS is implementing a phased approach, ensuring compatibility and providing ample time for system upgrades.
This proactive move to Java 17 is essential for maintaining the security and efficiency of these vital medical coding tools. Java 17 offers enhanced performance, security features, and long-term support, ensuring the reliability of MS-DRG and MCE software for years to come.
Phased Rollout: What to Expect in FY 2025 and FY 2026
For the Fiscal Year 2025 releases, effective October 2024, CMS will introduce a dual-bridge module system. Instead of a single Common Business-Oriented Language (COBOL) Java bridge module, two will be provided:
- Existing Bridge Module (Java 8): This maintains backward compatibility, utilizing the 31-bit, Java 8 Java Virtual Machine (JVM) environment. This ensures current mainframe deployments (both batch and Customer Information Control System (CICS)) remain functional without immediate changes.
- New Bridge Module (Java 17): This forward-looking module will utilize the 64-bit, Java 17 JVM. The Java jar file for both modules will still be compiled using Java 8 to ensure initial compatibility.
This dual approach for FY 2025 provides a valuable “demo period” for users to test and adapt to the Java 17 environment. Installation guides will clearly outline these changes, allowing ample time for testing system upgrades in preparation for the full transition.
By the Fiscal Year 2026 release, effective October 2025, the transition to Java 17 will be complete. Only the Java 17, 64-bit COBOL calling module will be delivered, compiled with Java 17. This means providers and software vendors must plan and implement the necessary upgrades by Fall 2025 to ensure continued operation of their MS-DRG and MCE software.
Why MS-DRGs and MCE Matter in Medical Coding
Understanding the importance of MS-DRGs and MCE is crucial in the context of these software updates. MS-DRGs are a classification system established by the Secretary to categorize inpatient discharges. This system is fundamental to the Inpatient Prospective Payment System (IPPS), where hospitals are paid a rate per discharge based on the assigned DRG. The DRG weight reflects the average resources needed to treat cases within that specific group, relative to all other DRGs.
Congress mandates annual recalculations of DRG relative weights to account for evolving treatment patterns, technological advancements, and other factors influencing hospital resource utilization. Currently, MS-DRG assignment relies on data reported by hospitals, including:
- Principal diagnosis
- Up to 24 additional diagnoses
- Up to 25 procedures performed during the stay
- In some cases, patient age, sex, and discharge status
Since October 1, 2015, ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) and ICD-10-PCS (Procedure Coding System) codes are used for reporting diagnosis and procedure information, respectively. The accuracy and efficiency of MS-DRG assignment directly impact hospital reimbursement and revenue cycle management.
The MCE, or Medicare Code Editor, complements the MS-DRG Grouper by identifying coding errors and inconsistencies in hospital claims data. Together, these software tools ensure accurate and compliant medical coding, which is paramount for appropriate healthcare payments and data integrity.
Preparing for the Java 17 Conversion: A Step-by-Step Guide
To ensure a seamless transition to Java 17, hospitals and software vendors should begin planning immediately. Here are key steps to take:
- Assess Current Systems: Evaluate your existing mainframe environments and software dependencies to understand the scope of the Java 17 upgrade.
- Test the FY 2025 Dual-Bridge Module: Utilize the FY 2025 releases with the dual bridge modules to test the Java 17 compatibility within your systems. This “demo” period is invaluable for identifying and resolving potential issues proactively.
- Plan for Java 17 Upgrade: Develop a detailed plan for upgrading to Java 17 by Fall 2025. This plan should include timelines, resource allocation, and testing protocols.
- Engage Software Vendors: Collaborate closely with your software vendors to ensure their systems are also prepared for the Java 17 transition and that they will provide compatible updates in a timely manner.
- Stay Informed: Regularly check for updates and announcements from CMS regarding the MS-DRG Grouper and MCE software. Utilize the provided resources and contact points for any questions or clarifications.
Resources and Support for a Smooth Transition
CMS is committed to supporting users through this Java 17 transition. For questions specifically related to the Java 17 conversion, please reach out to the dedicated resource mailbox: [email protected].
For general inquiries regarding MS-DRGs, including classification changes, the [email protected] mailbox remains available. However, please note that requests for annual MS-DRG classification changes are now exclusively accepted through the Medicare Electronic Application Request Information SystemTM (MEARISTM), accessible at https://mearis.cms.gov.
Conclusion: Embracing the Future of Medical Coding Software
The transition to Java 17 for MS-DRG Grouper and MCE software is a necessary step to ensure the continued reliability, security, and efficiency of these critical medical coding tools. By providing a phased approach with the FY 2025 dual-bridge module release, CMS is offering a valuable opportunity for hospitals and software vendors to prepare and adapt. Proactive planning, testing during the “demo” period of FY2025, and timely upgrades are essential for a successful transition. Embrace these changes and leverage the provided resources to navigate the Java 17 migration smoothly, ensuring accurate and compliant medical coding practices for the future.
