S528 fracture radius with ulna upper en any part

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S528 Fracture, radius with ulna, upper en (any part) 9054101 Open reduction, separated epiphysis, radius and ulna The resulting AR-DRG assignment is: DRG I19Z Average length of stay 2.7700 days Income per patient = Cost weight 1.1700 x Benchmark price (say $A1,500.00) = $A1,755.00 An income difference of $950. Example 2 The effect of not coding or not correctly coding the surgical procedure(s). AR-DRG Hospital Income Cholecysitis H64B $A990.00 Cholecysitis with cholecystectomy H04B $A1,830.00 Cholecysitis with cholecystectomy and bile duct exploration H026 $A4,095.00 Considerable lost income results from incomplete medical record coding.
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An Introduction to DRG's TC Health Administration © 12 Medical Record Coding – special features Edits If patient morbidity or demographic data is missing or incorrect then the DRG "960Z Unacceptable DRG" will result. There is no payment for DRG 960Z and Hospitals need to detect errors before submitting for reimbursement.. The "Casemix Grouper" applies numerous edits to the processing cycle. The coding and other errors are displayed on screen. Figure 5 – display of coding edits For "Batch" processing the operator can "drill down" and make corrections. Edits displayed "on screen"
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An Introduction to DRG's TC Health Administration © 13 Attestation Form The Australian system requires an attestation (responsibility) form to be signed by the responsible doctor. The doctor's approval of the discharge diagnosis is required. The attestation forms are used as a mechanism for periodic audit of Hospital coding accuracy, to monitor "Gaming", "Fudging the DRG" or other means of illegally claiming a higher payment. Software features that support Medical Record Coding In a DRG financing environment the coding of the medical record becomes a specialty occupation. The current German environment where the doctor undertakes the coding requires urgent consideration. Other countries recognise the complexity and specialised nature of this work and provide university degree programs to train medical record administrators. There are also correspondence programs to train coders who work under the supervision of medical record administrators. The TC Health "Casemix Grouper" provides considerable assistance for coders and including: head2right "Fast Code" - to speed up the entry of data; head2right "Code Search" - to find the correct code; head2right “Encoder” to present the choice of codes during the selection process; head2right "Optimiser" - to select the highest legitimate income entitlement; head2right "Edits" - to detect incorrect coding or missing data; head2right "Reports" - to detect unsatisfactory DRG assignment, check for uncoded records etc.; head2right "Mapping" - technical design allows unique mapping tables to be applied; head2right "Choice of Grouper engine" - earlier version grouper engines can be applied with choice of ICD database for research application; head2right "Batch Processing" - process all records for a defined period in a single application of the grouper engine; head2right "Grouper Interface" - applies Windows 95/98/NT operating system; head2right
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  • Fall '18
  • Diagnosis-related group, DRG

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