Question

Need help to find the codes

f coded data and provide preventive measures. Assignment: A. Last year when you were hired as the HIM direct you to focus on increasing the case mix index. The hospital base rate is or at a small community hospital, the CEO wanted 62. At the time you came $7.8 Certified Coding Specialist (CCS). onboard, there were three coders; only one of whom was certified as a You began by reviewing the number of MS-DRGs submitted over the past year jumped out was: MS-DRG 304, whic MS-DROG The MS-DRG that h is hypertension with an MCC. There were 53 submissions of this As you reviewed the data for 10 of those below to identify the issue. submissions you began to notice a trend. Evaluate the data Chart Codes submitted 110, J44.9, N18.6, E11.9 110, N18.6, E10.9, E03.9, G47.33 110, G20, 125.10, N18.5 110, F17.210, 170.213, N18.6, E11.9 110, N18.6, 125.5, 125.10 110. E08.22, N18.6 110, E66.01, E03.9, N18.6, F17.210 110, E87.6, J45.909, N18.6 44.9, N19 3 4 6 110, E11.9, E66.9, E78.5, N18.5 110, 125.10, N,R33.9, N18.6, E10.9 10 After review of all 53 cases in MS-DRG 304, you determined that 46 of them had the same error. Correcting the errors results in reassignment of those cases to a different MS-DRG. Calculate the Continue using the same information from above impact this has on reimbursement by determining the relative weight of the two MS-DRGs and performing the calculations to determine the reimbursement difference.

Answer 1

1. I10, J44.9 ,N18.6 ,E11.9

I10-Hypertensive Chronic Kidney Disease(billable)

J44.9 - Obstructive chronic airway diseases (billable)

N18.6- End stage renal disease (billable )

E11.9- Type 2 diabetes mellitus without complications( billable and is not usually sufficient justification for admission to an acute care hospital when used a principal diagnosis)

2. I10, N18.6, E10.9,E03.9,G47.33

I10-Hypertensive Chronic Kidney Disease(billable)

N18.6- End stage renal disease (billable )

E10.9- Type 1 diabetes mellitus without complications (billable)

E03.9 - Hypothyroidism,unspecified(billable)

G47.33 -Obstructive sleep apnea (pediatric)(billable)

3. I10, G20, I25.10, N18.5

I10-Hypertensive Chronic Kidney Disease(billable)

G20- Parkinson's disease(billable)

I25.10- Atherosclerotic heart disease of native coronary artery without angina pectoris(billable)

N18.5 -Chronic kidney disease, stage 5 (billable)

4. I10, F17.210, I70.213, N18.6, E11.9

I10-Hypertensive Chronic Kidney Disease(billable)

F17.210 -Nicotine dependence, cigarettes, uncomplicated(billable)

I70.213- Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs(billable)

N18.6- End stage renal disease (billable )

E11.9- Type 2 diabetes mellitus without complications( billable and is not usually sufficient justification for admission to an acute care hospital when used a principal diagnosis)

5.I10, N18.6, I25.5, I25.10

I10-Hypertensive Chronic Kidney Disease(billable)

N18.6- End stage renal disease (billable )

I25.5- Ischemic cardiomyopathy(Billable)

I25.10- Atherosclerotic heart disease of native coronary artery without angina pectoris(billable)

6.I10, E08.22, N18.6

I10-Hypertensive Chronic Kidney Disease(billable)

E08.22- Diabetes mellitus due to underlying condition with diabetic chronic kidney disease(billable)

N18.6- End stage renal disease (billable )

7.I10, E66.01, E03.9, N18.6, F17.210

I10-Hypertensive Chronic Kidney Disease(billable)

E66.01- Morbid (severe) obesity due to excess calories(billable)

E03.9- Hypothyroidism, unspecified(billable)

N18.6- End stage renal disease (billable )

F17.210- Nicotine dependence, cigarettes, uncomplicated(billable)

8. I10, E87.6, J45.909, N18.6

I10-Hypertensive Chronic Kidney Disease(billable)

E87.6- Hypokalemia(billable)

J45.909- Unspecified asthma, uncomplicated(billable)

N18.6- End stage renal disease (billable )

9.I10, E11.9, E66.9, E78.5, N18.5

I10-Hypertensive Chronic Kidney Disease(billable)

E11.9- Type 2 diabetes mellitus without complications( billable and is not usually sufficient justification for admission to an acute care hospital when used a principal diagnosis)

E66.9- Unspecified obesity (billable)

E78.5- Unspecified hyperlipidemia(billable)

N18.5- Stage 5 chronic kidney disease(billable)

10) I10, I25.10,R33.9, N18.6, E10.9

I10-Hypertensive Chronic Kidney Disease(billable)

I25.10- Atherosclerotic heart disease of native coronary artery without angina pectoris(billable)

R33.9 Unspecified urinary retention(billable)

N18.6- End stage renal disease (billable )

E10.9- Type 1 diabetes mellitus without complications (billable)