The 2017 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, 2016.
Our 2017 DRG Expert (ICD-10-CM) includes:
- 28,795 code changes in 178 DRG groups
- Assign 52 ICD-10-PCS endovascular thrombectomy codes of the lower limbs to MS-DRGs 270, 271, 272 Other Major Cardiovascular Procedures with MCC, with CC, without CC/MCC.
- Modify Grouper logic for MS-DRGs 242, 243, and 244 Permanent Cardiac Pacemaker Implant with MCC, with CC, without CC/MCC, MS-DRGs 258 - 259 Cardiac Pacemaker Device Replacement with MCC, without MCC and MS-DRGs 260 - 262 Cardiac Pacemaker Revision Except Device Replacement with MCC, with CC, Without CC/MCC
- 58 new knee joint revision code combinations assigned to MS-DRGs
- 466 Revision of Hip or Knee Replacement with MCC
- 467 Revision of Hip or Knee Replacement with CC
- 468 Revision of Hip or Knee Replacement without CC/ MCC
- And many more changes
Key Features and Benefits
- Optum360 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.
- Optum360 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.
- Optum360 Edge — MS-DRG structure. Every diagnosis and procedure code that defines each DRG is listed.
- Optum360 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.
- Optum360 Edge — MDC diagnosis list. Complete list of mutually exclusive diagnoses defining each MDC.
- Optum360 Edge — Transfer DRG symbol. Indicates a DRG selected as a qualified discharge that may be paid at the per diem rate.
- Optum360 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.