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Tuesday, 19 January 2010 00:00 |
| Issue Name: |
MS-DRG Validation for MS-DRGs for Tracheostomy (At this time, Medical Necessity is excluded from review.) |
| Issue Number |
A000362009 |
| Issue Description: |
DRG Validation requires that diagnostic and procedural information and the discharge status of the beneficiary, as coded and reported by the hospital on its claim, matches both the attending physician description and the information contained in the beneficiary's medical record. Reviewers will validate for MS DRGs 003, 004, 011, 012, 013; principal diagnosis, secondary diagnosis, and procedures affecting or potentially affecting the DRG. |
| Type of Review |
DRG Validation |
| State(s) Affected: |
DC, CT, MA, ME, DE, NJ, NY, NH, PA, RI, VT |
| Providers Affected: |
Inpatient Hospitals |
| Date Posted: |
January 19, 2010 |
| Dates of Service: |
October 1, 2007 - Present |
| Issue References |
ICD-9-CM Coding Manual (for dates of service on claim), ICD-9-CM Addendums and Coding Clinics, PIM Ch 6.5.3 A-C DRG Validation Review; UHDDS - Reporting of Inpatient Data Elements, July 31, 1985, Federal Register (Vol. 50, No. 147), Pages 31038-31040 |
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Last Updated on Wednesday, 03 March 2010 18:26 |
