The Medicare Part A Direct Data Entry (MEDA DDE) system allows you to generate and print your own diagnosis related group (DRG) reimbursement for a weight of one. These DRG reports are available online, and you can generate and print your own reports on site at any time.

This function can also be used to calculate standard DRG claim payments for acute care hospitals. However, it does not calculate any transfer, cost outlier or new technology payments.

MEDA DDE users can access this feature under the Inquiry Menu, Selection 11 (MAP1702), DRG (PRICER/GROUPER), which will display additional screens for the Cost Disclosure Inquiry.

To display the three new screens of the Cost Disclosure Inquiry

Select the <PF8> function key.

To calculate a specific DRG payment ( MAP178B):

Type the discharge date, <Tab> down and type the DRG code

Select the <Enter> key, and the payment data will be displayed for that DRG

To create/view a reconciliation based on a DRG weight of one (MAP178C and MAP178D):

<PF8> to the next two screens to view entire reconciliation report.

All rate data and the from/through dates on the reconciliation screens are pulled directly from the Fiscal Intermediary Shared System (FISS) Provider Specific File. The dates display the “from” date of the most recent record, and the “through” date of the fiscal year end. These dates may not necessarily represent the prospective payment system (PPS) PRICER or federal fiscal year dates.

The online reconciliation will always use the current rates that are in place at the time the provider enters their request. When there are prospective rate changes, it is your responsibility to generate and print an updated reconciliation report to keep for your records.

Please contact staff within your office/facility that work with the MEDA DDE system to obtain a copy of this report.