ICD-10

Understanding MS-DRG Grouping under ICD-10

Rayellen Kishbach's picture

Now that ICD-10 is in full swing, we are seeing a lot of activity with providers, payers, consultants and regulators who need to understand how Acute Inpatient and Long Term Care Hospital claims "behave" when the claim is coded in ICD-10. This includes both prospective and retrospective review of claims scenarios to understand MS-DRG grouping. This article offers a basic primer on MS-DRG grouping logic, and research techniques for using related MediRegs Coding Suite tools.

How we can help you "Ramp Up" your ICD-10 Operations

Rayellen Kishbach's picture

On July 31, 2014, CMS announced that the U.S. Department of Health and Human Services (HHS) issued a rule finalizing Oct. 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. According to CMS:

"This deadline allows providers, insurance companies and others in the health care industry time to ramp up their operations to ensure their systems and business processes are ready to go on Oct. 1, 2015."

ICD-10-CM: Myths Gone Wild

As the ICD-10-CM implementation date nears, it seems that the buzz has heightened and along with the buzz comes half-truths and misconceptions.   A recent online article in Forbes’s magazine focused on coding.  The article, “Doctors Lag Far Behind On New Medicare Diagnosis Codes,” implies that ICD-10-CM codes are Medicare codes.  Because the United States uses ICD-9-CM (and eventually ICD-10-CM) in the billing process, we have ventured away from real reason we code:  to have an efficient, consistent system of capturing data that supports healthcare decision making in our country.   Do we ca

Maria Bounos from Wolters Kluwer joins "Talk Ten Tuesday" to discuss ICD-10: Now and Then

 Maria Bounos, RN, MPM, CPC-H, Practice Lead Coding and Reimbursement Products from Wolters Kluwer, will appear on ICD10monitor.com’s “Talk Ten Tuesday” on October 14, 2013 at 10am EDT as part of an expert panel to discuss ICD-10: Now and Then. Register Now!

Is ICD-10 really needed in the US?

Key industry players, such as the AMA and MGMA, have questioned whether we really need ICD-10-CM in this country.  They seem to think there will be no benefit to clinicians with the upcoming change in the diagnosis coding system.  I think they’re wrong.  The current system hasn’t been overhauled since 1979.  It’s been updated every year but it can’t move forward to work in the electronic environment and it can’t capture information about current day medical practice.  It’s pretty hard to describe cutting edge medicine with a 34 year old system. 

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