2021 DRG Expert: Volume 1 & 2 (Spiral)
Optum360 | 2021 |
ICD-10-CM methodology, which goes into effect October 1, 2020.
• 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 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.
Karen Krawzik, RHIT, CCS, AHIMA-approved ICD-10-CM/PCS Trainer
CPT is a registered trademark of the American Medical Association.