DRG (diagnosis related group)

code used for diagnosis; hospital reimbursement by insurers is based on a formula using DRGs More test answers on https://studyhippo.com/chapter-3-2-43835/

The case-mix management system that utilizes information from the Minimum Data Set (MDS) in long-term care settings is called a. Resource Utilization Groups (RUGs). b. Ambulatory Patient Classifications (APCs). c. Medicare Severity Diagnosis Related Groups (MS-DRGs). d. Resource Based Relative Value System (RBRVS).

a. Resource Utilization Groups (RUGs). More test answers on https://studyhippo.com/medical-billing-and-reimbursement-48896/

Diagnosis Related Groups

Inpatient hospital cases classified into groups that are expected to consume similar hospital resources. Example: Hospital inpatient are discharged once the acute illness has passed and are transferred to outpatient care facility such as rehab. home health care. More test answers on https://studyhippo.com/health-information-management/

Exercise 6.7 Using the information in the table below, calculate (round to two decimal places) the postoperative death rate at Community Hospital for each Medicare Severity Diagnosis Related Group (MS-DRG) listed for July through December and the total for this semiannual

338 Appendectomy w complicated principal diao w MCC 8 1 (1 x 100)/8 = 12.50% 327 Stomach, esophageal & duodenal proc w CC 67 2 (2 x 1001167 = 2.99o/o 005 Liver transplant w MCC or intestinal transplant 17 6 (6 x 100)/17 = 35.29% 139 Salivary gland orocedures 5 1 (1 x 100)/5 = 20.00o/o 405 Pancreas, liver & shunt procedures w MCC 54 3 (3 x 100)/54 = 5.56% 625 Thyroid, parathyroid & thyroglossal procedures w MCC 195 2 (2 x 100)/195 = 1.03o/o 736 Uterine & adnexa proc for ovarian or adnexal maliqnancv w MCC 132 5 (5 x 100)/132 = 3.79o/o 217 Cardiac valve & oth maj cardiothoracic proc w card cath w cc 201 3 (3 x 100)/201 = 1.49Yo 239 Amputation for circ sys disorders exc upper limb & toe w MCC 8 3 (3 x 100)/8 = 37.50% 469 Major joint replacement or reattachment of lower extremitv w MCC 132 4 (4 x 10011132 = 3.03% Totals 819 30 (30 x 100)/8 More test answers on https://studyhippo.com/calculating-and-reporting-health-statistics-chapter-6/

“True or False? Even though Medicare-severity Long-term care diagnosis related groups (MS-LTC-DRGs) are based on the same general factors as the acute-care MS-DRGs for the IPPS, MS-LTC-DRGS differ from acute-care MS-DRGs because MS-LTC-DRGs have different relative weights and use quintiles for low volumes.”

True More test answers on https://studyhippo.com/healthcare-reb-final-47589/

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