AP-DRG MCC/CCs
We just recently started reviewing Medicaid records. We currently do not have an AP-DRG grouper as CDI Specialists. MCC/CCs are different between MS-DRG and AP-DRG. Does anyone have a quick reference list for AP-DRG MCC/CCs that they are willing to share?
Thank you in advance for your help
Dawn,RN,CCDS
Community Hospital
Thank you in advance for your help
Dawn,RN,CCDS
Community Hospital
Comments
However, it is really impossible to gauge impact of your efforts sans an APR/DRG grouper.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.637.9002
Fax: 415.600.1325
Ofc: 415.600.3739
evanspx@sutterhealth.org
Dawn M. Vitalone, RN, CCDS
Clinical Documentation Improvement Specialist
Community Hospital
219-513-2611
dvitalone@comhs.org
APR-DRGs look at all secondary diagnoses in relationship to the principal diagnosis as well as the other secondary diagnoses.
The addition of the same secondary dx can result in a different SOI/ROM depending on the principal.
The combination of 2 'lesser' diagnoses can result in a higher SOI.
Also even though a dx may have a SOI/ROM of 4/3, it will not necessarily raise the SOI or ROM score to 4 for the APR-DRG. For example 507.0 (asp. Pneumonia) is 4/3 but if 491.21 is prin dx results in APR-DRG of 140-3 (SOI of 3, ROM of 2).
Only the SOI is used in determining the APR-DRG.
As far having the APR-DRG Grouper, some states have a free version offered on line. It is a little difficult to work with but the one offered in California does work.
Sharon Salinas, CCS
Barlow Respiratory Hospital
2000 Stadium Way, Los Angeles CA 90026
Tel: 213-250-4200 ext 3336
ssalinas@barlow2000.org
Jillian Lightfoot RN
Clinical Documentation Team
Marshall Medical Center
Placerville, CA 95667
(530) 626-2770 Ext. 6203
jlightfoot@marshallmedical.org