Information Collection Request

Medicare Severity Diagnosis Related Groups Reclassification Request (MS-DRGs) (CMS-10775)

ICR 202108-0938-002 · OMB 0938-1431 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10775 Supporting Statement.docx Supporting Statement A Uploaded 2021-08-06 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
248700 MS-DRG classification change requests New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2025 36 Months From Approved
50 0 0
48,000 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
MS-DRG classification change requests CMS-10775

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 50 0 0 0 0 50
Annual Time Burden (Hours) 48,000 0 0 0 0 48,000
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No