Implementation Guide to Severity-Adjusted DRGs
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The biggest change in 24 years to Medicare’s DRG payment system will have occurred on October 1, 2007. Medicare has replaced the current DRG payment system with a consolidated severity-adjusted DRG methodology to better classify and categorize patient illness.
The new Medicare Severity DRG (MS-DRG) payment system impacts all areas of the revenue cycle.
To promote a smooth and complete transition to MS-DRGs within your facility, you can rely on the Implementation Guide to Severity-Adjusted DRGs as a definitive source of information on this new DRG system.
- Find out what’s involved in moving from 538 DRGs to 745 MS-DRGs.
- Understand how the relative weights are based on the estimated cost of providing care rather than charges.
- Segment each department in the revenue cycle and outline the roles, responsibilities and strategies that will make the implementation process successful while preventing the loss of reimbursement.
- Get guidance on how to adapt to the new system as it relates to coding, documentation, reporting, physician documentation and other areas of the revenue cycle.
- Train your staff on how to extract more information from the medical record in order to accurately arrive at the correct MS-DRG.
- This package contains form, samples, policies, training guides, worksheets, tips, educational materials and so much more.
Ingenix offers practical results-oriented services for coding, physician documentation, billing compliance, reimbursement, training services for hospitals and physicians, and more. Learn from the experts who help write the books other consultants are using. Thousands of physicians and health care professionals rely on Ingenix for expert advice. Start benefiting from our 100+ years of combined experience and expertise.
Sharon R. Powell, RHIA, is a registered health information administrator (RHIA) with a B.S. in medical records administration from Louisiana Tech University. Prior to joining Ingenix in 2004 as the Facility Product Manager, she worked at 3M Health Information Systems with product marketing and technical development teams to create 3M proprietary products for inpatient care, including coding, classification, reimbursement, and decision support products. She also held the position of the Associate Director of Patient Financial Services and Data Management for the University of Texas Medical Branch in Galveston. Other previous positions include Health Information Manager, Compliance Representative, Inpatient/Outpatient Coding Manager and Professional Fee Coordinator in Physician Billing. National speaking experience at major industry association conferences includes National Association of Subacute and Post Acute Care (NASPAC) 2001-2004 and American Health Information Management Association (AHIMA) 2002. She is a member of AHIMA's newly formed ICD-10 Task Force and participates in state and local HIM functions in Texas.
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Please remember that the government no longer allows a grace period for annual code sets. The new HIPAA Transaction and Code Set Rule requires providers to use national medical code sets that are valid at the time that a service is provided. ICD-9-CM code revisions become effective October 1st each year while CPT and HCPCS code revisions become effective January 1st. In order for you to meet this requirement, you must have the revised CPT, HCPCS, and ICD-9-CM codes in your possession before the implementation dates. The best way to do this is to order your code books early. Review current coding resources.
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