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HHSC on behalf of the Office of Inspector General (OIG) Medical Services, Medicaid Program Integrity (MPI) division, is soliciting bid responses, under NIGP codes 924-16, -25, -40 and -86, for International Classification of Diseases, 10th Revision (ICD-10) training for the Utilization Review staff. Staff are registered nurses and medical coders that conduct retrospective reviews. The staff utilizes the information during medical record review of claims or encounters submitted for reimbursement by hospital providers. Staff validate inpatient hospital diagnoses including Diagnosis Related Group (DRG) assignments and validate the accuracy of provider billing based on medical record documentation. The codes are updated annually, and the unit has new staff that require initial training.
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