Snapshot of how APR-DRG works - Carondelet Health Network

[Pages:1]Snapshot of how APR-DRG works

Instructions

1. Review the primary and secondary diagnoses in each column below.

2. As you move from the left column to the furthest right column, pay attention to the changes in

the information that is located in the grey sections at the bottom of each column as the diagnoses and the specificity of documentation changes.

Primary dx:

Primary dx:

Primary dx:

Primary dx:

Primary dx:

Pneumonia Secondary dx:

Sepsis Secondary dx:

Sepsis Secondary dx:

Sepsis Secondary dx:

Sepsis Secondary dx:

Bacteremia

Pneumonia

Pneumonia Diastolic CHF

Klebsiella Pneumonia

Diastolic CHF

Klebsiella Pneumonia

Diastolic CHF

APR DRG 139 SOI 2 ROM 2 RW: 0.5793

APR DRG 720 SOI 2 ROM 2 RW: 0.7113

APR DRG 720 SOI 2 ROM 3 RW: 0.7113

APR DRG 720 SOI 3 ROM 3 RW: 1.1700

Note 3. Remember that payment is determined by the Severity of Illness (SOI).

Acute Respiratory Failure APR DRG 720 SOI 4 ROM 4 RW: 2.7338

4. When documentation of the primary and secondary diagnoses is specific & detailed, the occurrence of appropriate coding and appropriate reimbursement of claims improves significantly.

Co-morbid conditions increase the SOI.

The increase in SOI reflects the difficulty and costs that are involved in treating the patient.

lcollingwood Sept 2014

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download