Most Common DRG’s with Recommendations 2018: Part 3

by Jan 9, 2019Industry News, Kim Carrier, Medical Coding Tips0 comments

Kim Carrier RHIT, CDIP, CCS, CCS-P
Director of Coding Quality Assurance
AHIMA Approved ICD-10-CM/PCS Trainer

In 2018, HIA reviewed 39,828 inpatient records. This is part 3 of a series as we look at the top 5 DRG’s with recommendations over this week.

#3 DRG with the most recommendations

DRG 853—Infectious & parasitic diseases with O.R. procedure with MCC

The majority of the recommendations from DRG 853 (Infectious & parasitic disease with O.R. procedure with MCC) were to DRG 871 (Septicemia w/o MV 96+ hours with MCC) with deletion or revision of the PCS code. Some of these required physician query.

  • Read the entire operative note when assigning PCS codes
  • Don’t code from the title of an operative note

The remainder of the DRG recommendation that weren’t due to the PCS coding were due to several different causes and went to multiple different DRG’s.

Here are some other suggestions for the multiple DRG’s that were recommended:

  • Look for cause of sepsis. If it is a postoperative, post-traumatic, or due to device the PDX will change and it may fall into a different DRG.
  • MCC was removed from the record. Either the MCC was ruled out or it was not clearly documented and query was needed.
  • Sepsis wasn’t documented to be present on admission so change in the PDX resulted in DRG change.

Be on the lookout for Part 4 tomorrow!

Happy Coding!

The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.

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