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

OMB 0938-1431

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10775 MS-DRG classification change requests Form and Instruction
CMS-10775 Supporting Statement A.docx Supporting Statement A
MS-DRG classification change requests Form and Instruction

All Historical Document Collections

202509-0938-007	Extension without change of a currently approved collection	2025-09-04
202108-0938-002 Approved with change	Existing collection in use without an OMB Control Number	2021-08-10