Health Information Management

Break the encoder addiction to ensure compliance

Briefings on Coding Compliance Strategies, April 1, 2008

Although coders may have been able to rely on coding software and encoders under the original DRG system, the debut of Medicare Severity DRGs (MS-DRG) in October 2007 has created a new environment in which coders can no longer use encoders as a crutch. Relying on an encoder can potentially result in an increased prevalence and incidence of clinically inaccurate principal and secondary diagnoses, which can create an inaccurate reflection of the acuity, risk of morbidity and mortality, and hospital resource consumption and result in inaccurate reimbursement for the hospital. MS-DRGs require a heightened clinical knowledge and understanding of clinical medicine as a road map.

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