Medicare Plans to Modernize Payment Grouping and Code Editor Software

MLN Matters Number: SE19013
Article Release Date: July 10, 2019

The Centers for Medicare & Medicaid Services (CMS) is modernizing its grouping and code editor software. Medicare processes all Original Medicare institutional claims through one of three sub-systems within the Fiscal Intermediary Shared System (FISS):

  • The Medicare Code Editor (MCE)
  • The Inpatient Grouper (MS-DRG)
  • The Integrated Outpatient Code Editor (IOCE).

These sub-systems are built with an antiquated programming language (Assembler) that is difficult to extend, maintain, support and test. Modernizing these programs will protect CMS from future quality and integration risks.

View the complete CMS Medicare Learning Network (MLN) Matters (MM) Special Edition (SE)19013.

Last Updated Jul 11, 2019