PDF: Re-review Deadlines 3 27.2017 Revised Final

Deadlines for Requesting Re-Review of Inspector General DRG Change Notification

3.27.2017

THOT and other Hospital Coding Coalition participants worked with the Inspector General’s (IG) office to extend timelines for requesting a re-review of claims subject to IG DRG Change Notification received by hospitals on or after September 1, 2015 and before April 18, 2016. 

  • The IG previously pended its coding reviews as it implemented processes and policies consistent with federal coding guidelines.
  • The IG offered hospitals an opportunity to request a re-review of claims subject to IG DRG Notification if received by hospitals on or after September 1, 2015, and before the new processes and policies were implemented.

The IG has been posting via TMHP, timelines for hospitals to submit requests for re-review of claims subject to IG DRG Change Notification received by hospitals on or after September 1, 2015. Most were due by Friday, March 24, 2017.

The IG has agreed to extend the timelines as indicated below, with the exception of audits from the 2nd quarter of 2010.  However, the IG will allow hospitals to request an exception to the original timeline (January 27, 2017) and review on an individual basis. Note: Please submit any requests for an exception to the IG by April 7, 2017.

Updated Re-Review Request Schedule and Deadlines:

Sample Quarters Original Deadline Revised Deadline to IG
2nd Quarter 2010 January 27, 2017) No change. However, hospitals that wish to request by

April 7, 2017, an exception to the January 27, 2017

deadline for the 2nd Quarter sample only.

3rd Quarter, 2010 January 27, 2017 and March 24, 2017 Will be extended to April 7, 2017.
4th Quarter, 2010 February 24, 2017 and March 24, 2017 Will be extended to April 7, 2017.
1st Quarter, 2011 March 24, 2017 Will be extended to April 7, 2017.

Re-review requests must be submitted to the appropriate IG-UR regional office. The requests must be submitted by fax or mail by the appropriate deadline. The requests must include the copy of the original DRG notification and the Remittance and Status (R&S) Report.

The IG will submit a banner revision to TMHP about March 24th, and will extend the deadlines for the 3rd and 4th quarters of 2010 and the first quarter of 2011 as noted above.

We appreciate the IG’s flexibility and help in extending these timelines.