2019 DRG Expert--Volumes 1 & 2 (eBook)
Optum360 | 2019 |
The DRG Expert has been a trusted and comprehensive reference to the DRG classification system for more than 25 years. Organized by major diagnostic category (MDC), the convenient and innovative book layout follows the logical MS-DRG decision process. This is a must-have reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively based on
ICD-10-CM methodology, which goes into effect October 1, 2018.
- Optum360 Edge—Visual indicators notify you of special alerts. Easily identify CC and MCC restrictions, special payment status, transfer DRG status, surgical/medical partitioning, and other requirements.
- Optum360 Edge—Medicare CMS rate structure. Updated to provide current relative weight (RW), geometric mean length-of-stay (GMLOS), and arithmetic mean length-of-stay (AMLOS) for each
- MS-DRG under IPPS.
- Optum360 Edge—MS-DRG structure. Every diagnosis and procedure code that defines each DRG is listed.
- Optum360 Edge—LTC-DRG crosswalk and current rate structure. Know what the RW and length-of-stay data are for each MS-DRG under the LTCH prospective payment system.
- Optum360 Edge—MDC diagnosis list. Complete list of mutually exclusive diagnoses defining each MDC.
- Optum360 Edge—Transfer DRG symbol. Indicates a DRG selected as a qualified discharge that may be paid at the per diem rate.
- Optum360 Edge—Average national payment. Listed for every MS-DRG as a quick benchmark comparison.
- Easily locate the correct DRG. Use the numeric or alphabetic index to quickly identify a DRG based on its diagnosis or procedure code.
- Surgical hierarchy table. Quickly find the DRG hierarchy for multiple procedure cases to help you assign the code that reflects the greatest resource utilization.
- Alphabetic and numeric indexes. Search for DRGs by the numeric codes or by code titles for fast look-up.
- Icons indicate which CC subclass the DRG belongs to based upon the presence or absence of CCs or major CCs (MCCs).
- Complete list of diagnoses considered CCs and MCCs.
- Full titles for each MS-DRG. Selection of the correct DRG begins with knowing its accurate and complete description.
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.