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CASE: High-Risk Medicare-Severity Diagnosis-Related Groups (MS-DRGs)
You are the coding supervisor at a 250-bed acute care hospital. The facility averages about 1050 discharges per month. About 41% of the discharges are Medicare. You have been given the responsibility of ensuring that there are no problems with the OIG's MS-DRG target areas.
1. On the www.pepperresources.com website, identify the current target area MS-DRGs for improper reimbursement.
2. Create a plan for monitoring these MS-DRGs. In this plan include at least:
· The types of monitoring to be performed· Sample size to monitor· Frequency of the monitoring· Case selection criteria· Documentation of monitoring activities· A format for reporting the monitoring results · A corrective action plan.
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