2020 DRG Expert Volumes 1 & 2 (eBook)

Optum360 | 2020 | Karen Krawzik



CALL 1-800-464-3649, Option 1

Item #: EDRG20
ISBN: 9781622545605
Available: NOW

To purchase Optum360 Data Files please contact Optum360 Customer Service at CALL 1-800-464-3649, option 1



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, 2019.


 

• 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

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.

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