Course Provider
Learning Objectives
Identify the true meaning of Clinical Documentation Improvement and Integrity
2.Appreciate and define the role of Clinical Documentation Improvement and Integrity beyond strict reimbursement
3.Communicate the evolution of the business of medicine from the perspective of reimbursement.
4.Identify the roles pay-for-performance and medical necessity initiatives govern and directly impact all aspects of medicine.
5.Explain the History of ICD, the development of version nine (9 & 10) and its effect of Clinical Modification
6.Differentiate between the general principles and workings of ICD-9-CM coding and its relationship to DRG assignment under the CMS DRGs and transition into MS-DRGs.
7.Apply general coding guidelines to case studies including recognition of principal and secondary diagnoses.
8.Specify the difference between Complications/Comorbidities and Major Complications/Comorbidities, and know the definition of each for DRG coding and reporting perspective.
9.Explain the rationale for Medicares decision to implement Medicare Severity DRGS and the intended role of MS-DRGs in the Medicare Value Based Purchasing initiative.
10.Compare the similarities and differences between the MS-DRG system and how the expansion of DRGs is an asset to explaining variations in severity of illness, risk of mortality and morbidity, measures of quality of care outcomes and physician efficiency measures.