Catalog Number : cra1728
Title : Problem DRGs and the RACs
Speaker : Duane Abbey

Webplay Recording Date : 2-9-2011
Webplay Price : $ 200 for two weeks viewing

Webinar Objectives:

• To review the DRG Payment System Including the Medicare Severity Refinement
• To delineate coding and payment compliance issues with DRGs in general
• To understand general statistical analyses of relative frequencies of DRG within associated series of DRG categories
• To review Recovery Audit Contractor concerns for DRGs and sequences of DRGs
• To understand the key issues for documenting and properly coding for proper DRG grouping including medical necessity
• To appreciate the use of Coding Clinic guidelines for proper coding and documentation
• To appreciate key diagnosis codes within the sequences of problem DRGs
• To assess selected sequences of DRG categories and the relationship relative to severity, payment and associated documentation
• To discuss the critical involvement of physicians and key diagnostic statements
• To recognize situations that will cause special attention for auditors including the RACs

Webinar Outline/Agenda:

• Brief Review of DRGs
  • SR-DRGs - CCs and MCCs
  • DRG Categories
  • DRG Grouping and ICD-9 Coding
  • Sequences of DRGs
  • Case Mix Index (CMI)
  • Compliance Issues and Reports
• RACs and Compliance
  • DRG Compliance Issues
  • RAC DRG Issues and Complex Reviews
  • Other Auditing Entities and Reports
• Coding Clinic and Documentation Guidelines
  • Coding Clinic - Official Source
  • ICD-9 Coding Guidelines
  • Documentation Standard
  • Medical Necessity Issues and Underlying Documentation
• Problem Sequences of DRGs
  • Overview of Related Sequences of DRGs
  • Diseases and Disorders of the Respiratory System
    • DRGs 177-179
    • DRGs 193-195
    • DRGs 189-192
    • DRGs 202-203
    • DRGs 291-293
  • Diseases and Disorders of the Circulatory System
    • DRGs 280-282
    • DRGs 286-287
    • DRGs 291-293
    • DRGs 311 and 313
  • Diseases and Disorders of the Digestive System
    • DRGs 377-379
    • DRGs 391-392
• The Future of DRG Auditing and Problem Sequences
• Sources for Further Information

Target Audience:

• Internal Auditing Personnel
• Financial and Compliance Personnel
• Physicians
• Other Interested Personnel

Attendance Certificate:

Upon attending this course you will receive a 1.5 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.