Medicare Plans to Modernize Payment Grouping and Code Editor Software

Published 07/11/2019

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) and 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.