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Tuesday, 19 January 2010 00:00 |
| Issue Name: |
MS-DRG Validation for MS-DRGs with Ventilator Support of 96+ Hours (At this time, Medical Necessity is excluded from review.) |
| Issue Number |
A000302009 |
| 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, 207, 870, 927 and 933; principal diagnosis, secondary diagnosis, and procedures affecting or potentially affecting the DRG. |
| Type of Review |
DRG Validation
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| 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, Section A - C - DRG Validation Review, DRG Desk Reference Ingenix 2009. CodeWrite, April 2007; AHIMA |
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Last Updated on Wednesday, 03 March 2010 18:24 |
