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Complete the following Case Studies in the Case Studies in Health Information Management Book 2-26 Medicare-Severity Diagnosis-Related Group (Medicare-Severity Diagnosis MS-DRG) Changes
NOTE: Refer to the coding guidelines below if you need additional information on principal diagnosis to add support your choice of diagnosis in the letter. (Hint: Look in Section II of the Guidelines)
2016-ICD-10-CM-Guidelines.pdf
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View in a new window 2-28 Estimated Medicare-Severity Diagnosis-Related Group (MS-DRG) Payments
NOTE: This is a basic manual calculation case. Keep in mind that a facility's base payment = the facility base rate + add on percentage. The estimated payment = facility's base payment x the DRG relative weight. For clarification purposes, the add on percentage is 3% (not 1.03% as the book states, 1.03 would be the multiplier that gives you the end result of a 3% add on)
example: if the base rate is 10, then 10 x 1.03 = 10.3 (facility Base Payment) x a DRG relative weight of 2.52 gives you 10.3 x 2.52 = 25.956 (this would be the estimated payment)
