2021 DRG Desk Reference (eBook)

Optum360 | 2021 | Karen Krawzik



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Item #: EDDR21
ISBN: 9781622546442
Available: Nov 2020


With the implementation of ICD-10 codes in October 2015, the 2021 DRG Desk Reference 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 is designed to work hand-in-hand with DRG Expert and the Guide to Clinical Validation and Documentation Improvement for Coding, which is the clinical section from the DRG Desk Reference based on ICD-10 codes. This product is needed to answer all your DRG questions for all inpatient stays starting after October 1, 2020, 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 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, 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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