Influenza without Pneumonia
I have been approached by our case management team regarding DRG 193-194-195 when PDx is Influenza with Other respiratory manifestations. If such patient is readmitted within 30 days there is a MediCare penalty because the previous admission was DRG "Simple pneumonia and pleurisy".
Has anyone found a way to exclude such patients from the penalty count when patient did NOT have PNA during the first admission? Would a statement in the DC Summary of these patients such as "No clinical evidence of pneumonia during this admission" have any effect?
Thanks!
Jeanne McCorkle BSN, RN, CCDS
Has anyone found a way to exclude such patients from the penalty count when patient did NOT have PNA during the first admission? Would a statement in the DC Summary of these patients such as "No clinical evidence of pneumonia during this admission" have any effect?
Thanks!
Jeanne McCorkle BSN, RN, CCDS
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