AHIMA CCA: Reimbursement Methodologies QUESTIONS WITH COMPLETE SOLUTIONS

1. Given the following information, which of the following statements is correct? 191, MCD: 04, Type: MED MS-DRG, Title: Chronic obstructive pulmonary disease w/ CC, Weight: 0.9757, Discharges: 10, Geometric Mean: 4.1, Arithmetic Mean: 5.0, 192, MCD: 04, Type: COPD w/o CC/MCC, Weight: 0.7254, Discharges: 20, Geometric Mean: 3.3, Arithmetic Mean: 4.0 193, MCD: 04, Type: MED, Weight: Simple pneumonia & pleurisy w/ MCC, Weight: 1.4327, Discharges: 10, Geometric Mean: 5.4, Arithmetic Mean: 6.7 194, MCD: 04, Type: MED, MS-DRG Title: Simple pneumonia & pleurisy w/ CC, Weight: 1.0056, Discharges: 20, Geometric Mean: 4.4, Arithmetic Mean: 5.3 195, MCD: 04, Type: MED, MS-DRG Title: Simple pneumonia & pleurisy w/o CC/MCC, Weight: 0.7316, Discharges: 10, Geometric Mean: 3.5, Arithmetic Mean: 4.1 a. In each MS-DRG the geometric mean is lower than the arithmetic mean. b. In each MS-DRG the arithmetic mean is lower than the geometric mean. c. The higher the number of patients in each MS-DRG, the greater the geometric mean for that MS-DRG. d. The geometric means are lower in MS-DRGs that are associated with a CC or MCC. Correct Answer: a. In each MS-DRG the geometric mean is lower than the arithmetic mean. The GEOMETRIC MEAN LOS is define as the total days of service, excluding any outliers or transfers, divided by the total number or patients. 2. If another status T procedure were performed, how much would the facility receive for the second status T procedure? -billing#, V-status indicator, 99285-25-CPT/HCPCS, 0612-APC. -billing#, T-status indicator, 25500-CPT/HCPCS, 0044-APC. -billing#, X-status indicator, 72050-CPT/HCPCS, 0261-APC. -billing#, S-status indicator,