Delay in Loading New DRG Numbers

The West Region claims processor, Wisconsin Physicians Service (WPS), loaded the 20 new diagnostic-related group (DRG) codes (560 through 579) effective October 1, 2006 on December 8, 2006. These DRGs were part of the Fiscal Year 2007 updates to the TRICARE reimbursement systems implemented (unless otherwise indicated) for dates of service October 1, 2006 and forward.

This unavoidable delay affected a small number of claims. Any electronic claims submitted prior to December 8 with any of the new DRG codes would have been rejected. These 20 DRGs are now loaded for EDI submission, and providers should resubmit their claims.

TriWest apologizes for any inconvenience that this delay in loading the new DRGs has caused your facility.