Part 5: Most Common DRG’s with Recommendations 2018

#5 DRG with the most recommendations

DRG 64—Intracranial hemorrhage or cerebral infarction with MCC

For this DRG recommendation the majority (almost all) were recommended to DRG 65 (Intracranial hemorrhage or cerebral infarction with CC) with deletion of the reported MCC.

• Verify that the MCC reported is clearly documented and supported in the medical record. If there is a chance that the condition is not present or was ruled out, a query is necessary to obtain clarification. When only 1 MCC is present on a record it is always best practice to double check to ensure that it cannot be removed in an audit.

One thing that was also noticed but did not change the DRG was that the stroke code was not coded to the highest specificity documented. Coders should be reviewing the medical record for specificity of the vessel involved.

Here is a quick summary of the top 5 DRG’s with recommendations by HIA in 2018.

• #1—DRG 871 Septicemia w/o MV 96+ hours with MCC
• #2—DRG 872 Septicemia w/o MV 96+ hours without MCC
• #3—DRG 853 Infectious & parasitic disease with O.R. procedure with MCC
• #4—DRG 190—Chronic obstructive pulmonary disease with MCC
• #5—DRG 64—Intracranial hemorrhage or cerebral infarction with MCC
  
  The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.