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APC/Grouper with OCE Edits

APC/Grouper is the most comprehensive ambulatory grouper available and is part of a family of state-of-the-art grouper and component products by IRP. APC/Grouper determines accurate APC assignment by evaluating the diagnoses & procedure codes and grouping in accordance with OPPS regulations.

APC/Grouper Features

  • Contains all current HCFA APCs and mandated regulations
  • Includes Medicare's Out-Patient Code Editor (OCE), a comprehensive set of clinical code edits
  • Includes line item and claim disposition, including reasons for denial, rejection or suspension
  • Option to automatically select or specify the desired grouper
  • Ability to re-map ICD-9-CM/CPT4 codes from prior/future years to the target grouper Flexible formatting of input/output data files without programming
  • Outstanding performance in single or multi-user environments
  • True multi-platform software to work within your existing environment and application systems IBM MVS, AS/400, RS/6000, PC (Windows 98, NT, OS/2), UNIX (SUN, DEC, HP, IBM, SCO, etc.), DEC VMS
  • Easy integration into your existing applications
  • License Agreement provides for Toll-Free Technical Support and periodic HCFA updates
  • Ability to handle the entire out-patient population, as well as Medicare cases
  • Customization services and custom interfaces are available

APC/Grouper Benefits

  • Ensures accurate APC assignment
  • Accurate and timely HCFA updates
  • Saves development and maintenance costs
  • High Performance - effectively analyze single cases or millions of cases
  • Easily integrates to your existing application, on any platform
  • Call as subroutines from your existing programs; easy to use in batch with flexible file interface
  • Unlimited Site License or low-cost Distribution License
  • Unparalleled industry experience and technical expertise via toll-free support line


APC/Pricer is an APC payment and pricing component designed to work together with APC/Grouper. APC/Pricer provides the flexibility to customize rules and payment rate methodologies for the entire out-patient population. APC/Pricer combined with APC/Grouper produces complete and accurate results. Call IRP for more information on the APC/Pricer component.


With IRP's unparalleled knowledge, combined with our commitment to bring you cost-effective software, you can be confident in our solutions.