Health Information Management

MS-DRGs on OIG radar--Ensure compliant coding

HIM-HIPAA Insider, January 6, 2009

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Since October 1, 2007, providers have been adapting to a revised hospital inpatient reimbursement system, also known as the Medicare Severity DRG (MS-DRG) system.

In October 2008, the Office of Inspector General (OIG) released its 2009 Work Plan, in which it stated it will "examine coding trends and patterns under the new system and determine whether specific MS-DRGs are vulnerable to potential upcoding."

The move wasn’t quite unexpected, says Gloryanne Bryant, BS, RHIA, RHIT, CCS, senior corporate director of coding and HIM compliance at Catholic Healthcare West in San Francisco. "It’s a good message to tell providers to be checking in this area because [the OIG is] going to be checking in this area," she says. That means coders should understand how their codes affect MS-DRG assignment, and physicians should understand the importance of thorough documentation.

Editor’s note: For more information about MS-DRGs and the OIG or to purchase a copy of this article for $10, click here. Subscribers to Briefings on Coding Compliance Strategies have access to this article in the December issue of the newsletter.



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