Most Common DRG’s with Recommendations 2018: Part 5

by Jan 11, 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 5 of a series as we’ve been looking at the top 5 DRG’s with recommendations over this week.

#5 DRG with the most recommendations

DRG 64—Intracranial hemorrhage or cerebral infarction with MCC

For this DRG recommendation the majority (almost all) were recommended to DRG 65 (Intracranial hemorrhage or cerebral infarction with CC) with deletion of the reported MCC.

  • Verify that the MCC reported is clearly documented and supported in the medical record. If there’s a chance that the condition is not present or was ruled out, a query is necessary to obtain clarification. When only 1 MCC is present on a record it is always best practice to double check to insure that it can’t be removed in an audit.

One thing that was also noticed but didn’t change the DRG was that the stroke code was not coded to the highest specificity documented. Coders should be reviewing the medical record for specificity of the vessel involved.

Here’s a quick summary of the top 5 DRG’s with recommendations by HIA in 2018.

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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