2025 DRG Expert - Volume 1 & 2 (Spiral)

• Optum 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.
• Optum 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. 
• Optum Edge — MS-DRG structure. Every diagnosis and procedure code that defines each DRG is listed. 
• Optum 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. 
• Optum Edge — MDC diagnosis list. Complete list of mutually exclusive diagnoses defining each MDC. 
• Optum Edge — Transfer DRG symbol. Indicates a DRG selected as a qualified discharge that may be paid at the per diem rate. 
• Optum 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 on the presence or absence of CCs or major CCs (MCCs). 
• Complete list of diagnoses considered CCs and MCCs. 
• List of those principal diagnoses that are their own CC and their own MCC.
• Full titles for each MS-DRG. Selection of the correct DRG begins with knowing its accurate and complete description.

Ms. Krawzik has expertise in ICD-10-CM, ICD-9-CM, CPT^®/HCPCS, DRG and data quality and analytics, with more than 30 years’ experience coding in multiple settings, including inpatient, observation, ambulatory surgery, ancillary and emergency room. She has served as a DRG analyst and auditor of commercial and government payer claims, as a contract administrator, and worked on a team providing enterprise-wide conversion of the ICD-9-CM code set to ICD-10. More recently, she has been developing print and electronic content related to ICD-10-CM and ICD-10-PCS coding systems, MS-DRGs and HCCs. Ms. Krawzik is credentialed by the American Health Information Management Association (AHIMA) as a Registered Health Information Technician (RHIT) and 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.

CPT is a registered trademark of the American Medical Association.

Ms. Schmidt has expertise in Level I Adult and Pediatric Trauma hospital coding, specializing in ICD-9-CM, ICD-10-CM/PCS, DRG, and CPT coding. Her experience includes analysis of medical record documentation, assignment of ICD-10-CM and PCS codes, DRG validation, as well as CPT code assignments for same-day surgery cases. She has conducted coding training and auditing, including DRG validation, conducted electronic health record training, and worked with clinical documentation specialists to identify documentation needs and potential areas for physician education. Most recently she has been developing content for resource and educational products related to ICD-10-CM and ICD-10-PCS. Ms. Schmidt is an AHIMA-approved ICD-10-CM/PCS trainer and is an active member of the American Health Information Management Association (AHIMA) and the Minnesota Health Information Management Association (MHIMA).