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Incorrect RAD Code Does Not Indicate Incorrect DRG Reimbursement

August 29, 2017

Previous notification informed diagnosis-related groups (DRG) hospitals that Erroneous Payment Correction (EPC) 35389 would be implemented for affected claims with Remittance Advice Details(RAD) code 0883: Retroactive price correction beginning with RADs dated August 10, 2017. However, the adjusted claims appeared with RAD code 0899: Inpatient retroactive rate adjustment.

Despite the incorrect RAD code within the EPC 35389 letter, providers should understand that the incorrectly-stated code does not indicate an incorrect reimbursement.