DRG Expert - 2015

The DRG Expert has been a trusted and comprehensive reference to the DRG classification system for over 25 years. Organized by major diagnostic category (MDC), the convenient and innovative book layout follows the logical MS-DRG decision process. This is a must-have reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively based on ICD-10-CM methodology, which goes into effect October 1, 2015.

Key Features and Benefits

Optum Edge Visual indicators notify you of special alerts. Easily identify CC and MCC restrictions, special payment status, transfer DRG status, surgical/medical partitioning, and other requirements.

Optum Edge Medicare CMS rate structure. Updated to provide current relative weight (RW), geometric mean length-of-stay (GMLOS), and arithmetic mean length-of-stay (AMLOS) for each MS-DRG under IPPS.

Optum Edge MS-DRG structure. Every diagnosis and procedure code that defines each DRG is listed.

Optum Edge LTC-DRG crosswalk and current rate structure. Know what the RW and length-of-stay data are for each MS-DRG under the LTCH prospective payment system.

Optum Edge MDC diagnosis list. Complete list of mutually exclusive diagnoses defining each MDC.

Optum Edge Transfer DRG symbol. Indicates a DRG selected as a qualified discharge that may be paid at the per diem rate.

Optum Edge Average national payment. Listed for every MS-DRG as a quick benchmark comparison.

Easily locate the correct DRG. Use the numeric or alphabetic index to quickly identify a DRG based on its diagnosis or procedure code.

Surgical hierarchy table. Quickly find the DRG hierarchy for multiple procedure cases to help you assign the code that reflects the greatest resource utilization. Alphabetic and numeric indexes. Search for DRGs by the numeric codes or by code titles for fast look-up.

Icons indicate which CC subclass the DRG belongs to based upon the presence or absence of CCs or major CCs (MCCs).

Complete list of diagnoses considered CCs and MCCs.

List of those Principal Diagnoses that are their own CC and their own MCC

Full titles for each MS-DRG. Selection of the correct DRG begins with knowing its accurate and complete description.

Inpatient Medicare MedPAR benchmarking data designed to provide a high-level benchmark of discharges, length of stay, age, total charges, and total reimbursement on a DRG basis at a national level for hospitals.