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Medical Billing and Coding Assignment
Added on -2019-09-20
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MEDICAL BILLING AND CODINGAPPLICATION PAPER
1Application paper on MS-DRGsThe MS – DRG (Medicare severity diagnosis affiliated group) is a system in order to classify a Medicare hospital stay of patients to groups to grease up the service payments that further enables for payment to align closely with the maximum utilization of resources. The diagnosis affiliated to groups is defined as the inpatient division that further classifies the patients which are similar in terms of treatment, resources, duration of stay, age and diagnosis. Under the system of prospective payment, the hospitals are being paid in order to treat the patients in a category of DRG. Further, it is a system which is used as a tool to utilize the procedure of review, measurement of the risk and the reimbursement (Centers for Medicare & Medicaid Services. 2013). MS – DRG is used to demonstrate the various kind of patients care like paediatric, management of data, comparability, newborn, benchmarking and reimbursement. Moreover, the DRG is entrusted along with the episode’s numeric value of care with the weight that is betrothed to demonstrate the intensity of resources of the clinical group. The payment level of the group is being determined, and further the guidelines are given which are utilized for the formulation of the system of DRG. Firstly, the attributes of the patients which are used in the definition of DRG and should be restricted to the information which is collected on the billing form of the hospital. Secondly, the number of DRGs should be manageable which encompasses the patients on the basis of inpatient. Thirdly, every DRG must include the patients with the analogous pattern on the basis of the intensity of resources. Lastly, every DRG must include patients 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 is known as the major diagnostic category. It demonstrates the system body which is being treated by the medicine and includes 23 MDCs along with the DRG group that is related with all the
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