DRG and LOS

Does anyone let the physician know the LOS based on the DRG for their inpatients? Does this impact how they document?

Comments

  • edited May 2016
    Yes we use LOS stickers on the charts. It usually doesn't make a difference as to how the physician documents.

    Tracy M Peyton RN, CCDS
    Case Management
    Bradford Regional Medical Center
    Upper Allegany Health Systems
    116 Interstate Parkway
    Bradford, PA 16701
    814-558-0406
  • In my former position, the CFO would harass the physicians based on the projected DRG/GLOS that came from my daily workflow. I had one hospitalist who would come to me and ask me what MCC she needed to write in order to increase the GLOS. I tried to tell case management that my DRG assignments were only interim and that the final DRG might be very different. There are few exceptions of course, like trachs, thoracic ELGs, kidney transplants, etc., that are pretty much carved in stone.

    Renee


    Linda Renee Brown, RN, CCRN, CCDS
    Certified Clinical Documentation Specialist
    Banner Good Samaritan Medical Center
  • edited May 2016
    Our Resource Management Dept. (CM/UM/DP) uses LOS but our CDS Dept focuses on documentation.

    When I worked in UM we were responsible for starting the coding on the floor to set our DRG and LOS. Most physicians ignored the LOS info. we placed and some were annoyed.

    Also, if you do not get back to update your coding you could be using the wrong DRG. If the patient has a procedure, an MCC or CC is added or the PDx changes, the DRG will change as well. Not having the correct DRG/LOS could result in a patient leaving too early to a NH/HHC/Rehab and the hospital not receiving full DRG payment.

    Our CMs receive a spreadsheet daily from finance with updated DRGs (when CDI updates coding & the DRG changes). They move through a Green/Yellow/Red process to let the CM know how much time they have. At this time I don't believe they place stckers- they just push the Doc for safe discharge.

    NBrunson,RHIA/CCDS
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