Medical Billing and Coding Assignment

Added on - 20 Sep 2019

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MEDICAL BILLING AND CODINGAPPLICATION PAPER
1Application paper on MS-DRGsTheMS – DRG (Medicare severity diagnosis affiliated group) is a system in order to classify aMedicare hospital stay of patients to groups to grease up the service payments that furtherenables for payment to align closely with the maximum utilization of resources. The diagnosisaffiliated to groups is defined as the inpatient division that further classifies the patients whichare similar in terms of treatment, resources, duration of stay, age and diagnosis. Under thesystem of prospective payment, the hospitals are being paid in order to treat the patients in acategory of DRG. Further, it is a system which is used as a tool to utilize the procedure ofreview, measurement of the risk and the reimbursement (Centers for Medicare & MedicaidServices. 2013). MS – DRG is used to demonstrate the various kind of patients care likepaediatric, management of data, comparability, newborn, benchmarking and reimbursement.Moreover, the DRG is entrusted along with the episode’s numeric value of care with the weightthat is betrothed to demonstrate the intensity of resources of the clinical group. The paymentlevel of the group is being determined, and further the guidelines are given which are utilized forthe formulation of the system of DRG. Firstly, the attributes of the patients which are used in thedefinition of DRG and should be restricted to the information which is collected on the billingform of the hospital. Secondly, the number of DRGs should be manageable which encompassesthe patients on the basis of inpatient. Thirdly, every DRG must include the patients with theanalogous pattern on the basis of the intensity of resources. Lastly, every DRG must includepatients who will be comparable from the clinical perception (Rosenbaum et al., 2014).Furthermore, the architecture of the system of DRG is hierarchical, and the greatest level isknown as the major diagnostic category. It demonstrates the system body which is being treatedby the medicine and includes 23 MDCs along with the DRG group that is related with all the
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