2019 DRG Desk Reference
Optum360 | 2019 |
With the implementation of ICD-10 codes in October 2015, the 2019 DRG Desk Reference (ICD-10-CM) gives access to crucial information to improve MS-DRG assignment practices, guidance on how to accurately assign DRGs under the MS-DRG system, and focuses on the Optimizing section of the DRG Desk Reference based on ICD-10 codes.
The DRG Desk Reference (ICD-10-CM) is designed to work hand-in-hand with DRG Expert and the Guide to Clinical Validation, Documentation and Coding, which is the clinical section from the DRG Desk Reference based on ICD-9 codes. This product is needed to answer all your DRG questions for all inpatient stays starting after October 1, 2018, as those claims will use the MS-DRG methodology based on ICD-10-CM.
- Optum360 Edge — Optimizing tips. Know the major factors involved in moving a patient from a lower-paying MS-DRG to a higher one to receive optimal payment while staying in compliance.
- Optum360 Edge — Recovery Audit Contractor (RAC) program resource. Understand the types of reviews, target strategies, and targeted and top-audited DRGs.
- Most commonly missed CC and MCC references. Perform accurate audits by knowing the most commonly missed CCs in the medical record.
- ICD-10-CM codes for common diagnoses and procedures. Quickly identify the key diagnosis or procedure by ICD-10-CM code.
- Case mix index section. Discusses the importance of calculating and tracking case mix on a regular basis as well as tips for documenting case mix index changes and their causes.
- Complete CC and MCC list. Know how codes considered MCCs and CCs will affect DRG assignment—helping to legitimately improve reimbursement.
- Relative weights of every valid DRG. A quick reference of the relative weights of all DRGs presented as options for optimizing.
- List of ICD-10 codes driving MS-DRG assignment.
Karen Krawzik, RHIT, CCS, AHIMA-approved ICD-10-CM/PCS Trainer
Ms. Krawzik has expertise in ICD-10-CM, ICD-9-CM, and CPT/HCPCS coding. Her coding experience includes inpatient, ambulatory surgery, and ancillary and emergency room records. She has served as a DRG analyst and auditor of commercial and government payer claims, and as a contract administrator. Most recently she was responsible for the conversion of the ICD-9-CM code set to ICD-10 and for analyzing audit results, identifying issues and trends, and developing remediation plans. Ms. Krawzik is credentialed by the American Health Information Management Association (AHIMA) as a Certified Coding Specialist (CCS) and is an AHIMA-approved ICD-10-CM/PCS trainer. She is an active member of AHIMA and the Missouri Health Information Management Association.