When you need answers to your DRG assignment questions, turn to this truly comprehensive resource that works efficiently and effectively with the DRG Desk Reference.
Our experts have created this desk reference to provide practical advice on every issue from auditing to organisms that indicate CC conditions — essential strategies for improved DRG assignment practices.
A MUST-HAVE resource for anyone who assigns DRGs or audits claims for inpatient cases!
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EXCLUSIVE — The right tool for improving DRG assignment practices. This comprehensive resource provides you with all the crucial information needed to establish proven DRG assignment and auditing practices. Be confident in your DRG coding practices from the first step to the final step.
EXCLUSIVE — Potential DRG listing for optimal reimbursement. Each DRG is listed with all potential DRG choices to ensure optimal payment. Compliance factors involved in moving a patient from a lower-paying DRG to a higher one are discussed.
EXCLUSIVE — Top ICD-9-CM codes for each potential DRG for optimizing reimbursement. To help you optimize reimbursement, the book lists the top ICD-9-CM diagnosis and procedure codes that affect DRG assignment for quick audit reference.
EXCLUSIVE — Tips for the encoder user. Many decisions faced by coders using grouper software, or an encoder, have significant impacts on the final DRG assigned by the grouper. Tips are provided on how to avoid making the wrong decisions.
EXCLUSIVE — DRG assignment and auditing tutorial. The inpatient PPS is a complex system. These tutorials will explain DRG assignment in clear and understandable language.
EXCLUSIVE — Coding and documentation guidelines for DRG validation of the targeted DRGs. Focus DRG self-auditing toward those DRG assignments that will most likely be scrutinized by QIOs. Uncover potential coding problems, and ensure the accuracy and validity of DRG assignment. The effective date of the coding guidance is noted for doing retrospective audits.
EXCLUSIVE — Instructional tips. Help your staff avoid potential fraud and abuse by clearly outlining the required documentation for proper DRG assignment and validation.
EXCLUSIVE — Key abstracting field items. An in-depth look at the significance of key abstracting fields for DRG assignment and the impact on reimbursement.
EXCLUSIVE — Drug usage and treatment indicators. Help coders locate the drug, determine the action and know the indications for the use of common drugs.
EXCLUSIVE — Durable medical equipment. Dispensing of certain durable medical equipment to patients may indicate the presence of CCs affecting DRG assignment.
EXCLUSIVE — Noninvasive diagnostic test outcomes. Lists the most frequently ordered noninvasive diagnostic tests and the common conditions found as the outcome of the tests.
EXCLUSIVE — Abnormal EKG findings. Includes abnormal EKG graph signs and symptoms that indicate CC conditions.
EXCLUSIVE — Abnormal laboratory values. Lists batteries of lab tests and the conditions indicated, signs and symptoms, and common treatment modalities.
EXCLUSIVE — Cardiovascular complications. Provides a comprehensive list of conditions with signs, symptoms, treatment and diagnostic tests that may indicate a change in DRG assignment from DRG 122 to DRG 121.
EXCLUSIVE — Complex diagnoses. Lists all diagnoses with signs, symptoms, treatment and diagnostic tests that may change the DRG assignment from DRG 125 to DRG 124 for higher payment.
EXCLUSIVE — New technology and medical services. Descriptions of new technology and medical services.
DRG decision trees. Graphic representation of the logical process of assigning a DRG assignment.
CC principal diagnosis exclusion list. A complete list of all CC conditions and the principal diagnoses for which the CC does not affect DRG assignment.
Complete CC list. Complete list of conditions regarded as complications and comorbidities that affect DRG assignment.
Relative weights of valid DRG. Relative weights of all DRGs presented as options for optimizing reimbursement as a quick reference for payment calculations.
Earn CEUs from AAPC. Earn up to 3 CEUs awarded by the American Academy of Professional Coders (AAPC).
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