Ms drg - Study guides, Class notes & Summaries

The term used to indicate that the service or procedure is reasonable and necessary for the diagnosis or treatment of illness or injury consistent with generally accepted standards of care is 1. appropriateness. 2. evidence-based medicine. 3. benchmarking. 4. medical necessity. (Ans- 4. medical necessity. Use the following table to answer the question. (See the word file) This information is the numerical identification of the service or supply. Each item has a unique number with a...

groupers - ️️today, most MS-DRGs are calculated using software tools known as groupers. Early on, they were determined using a flow-chart book. The book contains a series of decision tree diagrams. The same information would have been necessary to determine the correct DRG (as MS-DRGs were not implemented). Principal and Secondary Diagnosis and Procedure Codes - ️️Does the logic look for a principal procedure code first? -If no, then a principal diagnosis code is reviewed for appro...

What is an MS-DRG? - ️️An inpatient classification system designed to categorize patients who are medically related with respect to diagnoses and treatment and who are statistically similar in their lengths of stay. Each DRG has a preset reimbursement amount. All outpatient diagnostic services and admission-related therapeutic services provided by the same hospital on the day of the patient's admission or within three days preceding the date of inpatient admission must be included on ...

RHIT Practice Exam Questions with Complete Solutions The leapfrog group seeks to voluntarily collect data from hospitals about: A. Aging healthcare population B. Financial costs C. Medical errors D. Communicable diseases - Answer-C. Medical errors In analyzing the reason for changes in hospital Medicare case mix index overtime the analyst should start with which of the following levels of detail? A. Account level B. MS - DRG level C. MDC level D. MS - DRG triples pairs & singles - An...

principal diagnosis → the condition established after study to be chiefly responsible for admission to the hospital complication → an additional diagnosis that arises after the beginning of hospital observation and modifies the course of the patient's illness or medical care required comorbidity → a preexisting condition that will likely cause an increase in the patient's length of stay principal procedure → performed for definitive treatment (rather than diagnostic or e...

IPPS → inpatient prospective payment system MS-DRGs → Medicare severity diagnosis groups (MS-DRGs). DRGs → In 1983, the government enacted the system using diagnosis related groups (DRGs) as the payment methodology. The theory is based upon patients with similar characteristics consuming similar resources. Determining how patients are similar is a key factor for the system, which defines the similarities by the DRGs. → → The system was created by Medicare; however many ot...

RHIA MOCK EXAM Questions And Answers Rated A+. Each month the staff of the clinic with the lowest overall waiting time is awarded a free dessert in the Gulfside healthcare center cafeteria. take a look at the information listed above. the winner will be selected based on a. demonstrative clinical data b. comparative aggregate data c. objective individual data d. duplicate thematic data - correct answer. b. comparative aggregate data a union campaign is being conducted ...

medicare code edits - ️️a method to identify various situations based upon assigned ICD-10-CM codes hospital wage index - ️️a numeric factor defined by medicare that considers the geographic location of hospitals. this factor is used in the reimbursement calculations for facilities to account for geographic differences CC - ️️abbreviation for complications and comorbid conditions comorbid condition - ️️a pre-existing condition which, because of it's presence, causes an in...

CCS Exam Study Questions with Complete Solutions | 100% Correct malicious software - Answer ️️ -backdoor A female patient is diagnosed with congestive heart failure. Which of the following will increase the MS-DRG weight if present on admission? Atrial fibrillation Stage III pressure ulcer Blood loss anemia Coronary artery disease - Answer ️️ -Stage III pressure ulcer MS-DRG 291 (weight = 01.5010) for congestive heart failure with stage III pressure ulcer would optimize the MS-...