Working DRG

tkreilingtkreiling
in CDI Talk Archive
I was wondering how many of the CDS currently place a working DRG in the chart for case management or physicians to see? Do they actually use the LOS to help with discharge planning? We are considering starting this, as of now the working DRG is only on my worksheet which I keep and does not go on the chart. Just curious if this practice has found to be helpful? Where do you place this on the chart? Do you feel you are spending more time putting in codes than actually reviewing charts? Any insight or tips is appreciated?
Thanks,
Tara

Comments

  • robert.hodges2robert.hodges2
    edited May 2016
    I share working DRG's with the UR nurses, but not the providers. They have found it useful.

    Robert

    Robert S. Hodges, BSN, MSN, RN, CCDS
    Clinical Documentation Improvement Specialist
    Aleda E. Lutz VAMC
    Mail Code 136
    1500 Weiss Street
    Saginaw MI 48602
     
    P: 989-497-2500 x13101
    F: 989-321-4912
    E: Robert.Hodges2@va.gov
     
    "The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens

  • catladyrncatladyrn
    I had to provide a working DRG in my previous position. It was submitted on an electronic database and became part of a corporate report that everyone used. I always, always warned CM and the docs that it was only a working DRG and subject to change. Unless they'd had a trach or a thoracic ELG, there was always the possibility the final coding might be different, for any one of a thousand reasons. And heaven forbid I had a CC/MCC query waiting to be answered, because then there'd be two DRGs on the report. I encouraged CM to check with me before making decisions based on the working DRG, as to my degree of confidence that it would hold up.

    Renee


    Linda Renee Brown, RN, CCRN, CCDS
    Certified Clinical Documentation Specialist
    Banner Good Samaritan Medical Center
  • robert.hodges2robert.hodges2
    edited May 2016
    Amen Renee. When I share that is always my disclaimer, but then mine doesn't go into any permanent reports either. The coder assigns the final DRG and I make sure people understand that.

    Robert
     
    "The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens
     
    "This email is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this email does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this email in error, please notify this office immediately at the telephone number listed above."



  • Unknown
    edited May 2016
    My worksheets are left on the chart with working DRG's. I am not sure who looks at them but I have had physicians write on the worksheet regarding secondary diagnoses they did not agree with.

    Charlene

  • kmckaigkmckaig
    edited May 2016
    We send the Working DRG to the Coders via electronic message center but we do not send it to the physicians as our consultant advised against it. For one reason, it could give the appearance of making decisions based on the financial impact vs clinical.

    We do not find this process to be inhibiting in terms of productivity in that it just goes along with our chart review.





    Karen McKaig, BSN, RN, CCM, CPUR, CCDS
    Case Manager
    Clinical Documentation Specialist
    Baxter Regional Medical Center
    Mountain Home, AR 72653
    870-508-1499
    kmckaig@baxterregional.org


  • tpeytontpeyton
    edited May 2016
    We place our worksheets in the progress notes, as well as a drg sticker on the chart to aide the physician and casemgr with LOS but they all understand the final drg may vary depending on the coders.

    Tracy M Peyton RN, CCDS
    Case Management
    Bradford Regional Medical Center
    Upper Allegany Health Systems
    116 Interstate Parkway
    Bradford, PA 16701
    814-558-0406





  • digardskdigardsk
    edited May 2016
    We place a worksheet with working DRG on the chart which some case managers and some physicians find helpful. One of our hospitalists looks for our worksheet first when she comes on to get a quick summary of what is going on with the patient!

    We also place our DRG into the financial software, which then feeds into a report for the case managers for a LOS guide.

  • sharon.colesharon.cole
    edited May 2016
    You have to remove yourself. See the ACDIS website and CDI Talk.

  • arsusott@msn.comarsusott@msn.com
    We provide our case managers with a spreadsheet every morning with our drg/gmlos and a cue if we are placing a query (like everyone else they know that the drg is subject to change at the end). They use this information to give the physician a gentle nudge if the patient is out staying there drg and is medically ready to d/c. We also have a meeting with our physician champion every Wednesday to discuss any outliers and decide what needs to happen with them (whether it is medical, family, social, etc. variance). My director tracks this information and presents it at our quarterly UR meetings which are attended by our hospitatlist and medical advisor.
  • dallend@einstein.edudallend@einstein.edu
    edited May 2016
    We no longer keep our worksheets on the charts or assign DRGs. Our program is 9 years old - we stopped assigning DRGs about 5 years ago.

  • thicksthicks
    edited May 2016
    Curious...why did you stop?

    Thanks,

    Tamara

  • dallend@einstein.edudallend@einstein.edu
    edited May 2016
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    We changed our focus away from agreeing or disagreeing with the coded DRG and towards ensuring that the chart documentation was as complete as possible. We still document a principal dx on our worksheet and we do match that up with the principal dx on the attestation. We just don't worry about the DRG assignment. We query what needs to be queried (with certain exceptions) regardless of DRG assignment.

  • tiffany_susantiffany_susan
    edited May 2016
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    We have moved away from tracking "matches" to basic productivity and CMI.
    We still assign DRG's for informational purposes, common patients, areas
    that need focus, etc ...... like Deb, we focus on a complete record.
    Thank You,
    Susan Tiffany RN, CCDS
    Supervisor Clinical Documentation Program
    Guthrie Healthcare System

    email: tiffany_susan@guthrie.org
    "Twenty years from now you will be more disappointed by the things you
    didn't do than by the ones you did do. So throw off the bowlines. Sail
    away from safe harbor.Catch the trade winds in your sails. Explore. Dream.
    Discover." Mark Twain






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