Diagnosis Related Groups Essay Example | Topics and Well Written Essays - 750 words

Diagnosis Related Groups - Essay ExampleA persevering is assigned this category of DRG when all the operating populate functions performed on this patient are unrelated to the major diagnostic category of the patients principal diagnosis. DRG 468 thus pays for discharge in which the patient undergoes an operating room procedure entirely unrelated to this admissions principal diagnosis. This is against the PPS classification of discharges of clinically coherent groups. Although this is possible in many cases, DRG 468 can be an example of DRG creep. The attending physician may misspecify the principal diagnosis, secondary diagnosis, or the procedure on the attestation sheet. It can also be the result of mis cryptogram, where the infirmary assigns an incorrect numeric edict to the diseases or procedures which had been correctly attested by the physician in charge. In some cases to avoid investigation, the hospital may substitute a secondary diagnosis for the correct principal diagn osis. Therefore for appropriation of facts, auditing and refreshen is necessary that would identify discharges in which coding rules are either ignored or not apply appropriately.DRG 468 is assigned when all the operating room procedures are unrelated to the major diagnostic category for which the patient had been admitted. Most often, these patients are admitted with a principal diagnosis that does not need any surgery. ... To assess the appropriateness, the ICD-9-CM coding guidelines should be applied to do the initial coding and for auditing if such has been use. The principal diagnosis is always the crusade for admission, which should be backed by records indicating circumstances at admission, diagnostic workup, and therapy provided. The scenario is not an admission of the patient to cross twain conditions, it is rather two conditions present during admission. While auditing and reviewing, it is to be determined whether the principal diagnosis was the cause for admission a nd treatment. If at admission, there were more than one diagnoses, use of guidelines for selecting the principal diagnosis would be used with consideration of circumstances at admission, diagnosis workup, and the therapy provided. The principal procedure essential be performed for definitive treatment, not for diagnostic purposes, exploratory purposes, or for a complication. If there are two procedures done, then the one to the highest degree related to the principal diagnosis would be selected as the principal procedure. The procedure must be operative as defined by the Uniform Hospital Discharge Data Set would be used, and for this to qualify, it must be surgical under anesthesia with the operator being specially trained. The audit must get wind at the detailed documentation in the medical record. There must be enough trial impression and substantiation that it was medically necessary. The coding should be done from the narrative description of the procedure, not from the writ ten deed of the procedure. The approach and closure of the procedure are integral part of one significant procedure, not two separate