DRG Codes Lookup

MS-DRGs are Easily Supported Through Codify

Facilities billing inpatient care rely on Multiple Severity-Diagnostic Related Groups (MS-DRGs) to report episodes of care and receive reimbursement. Encompassing 20 body areas and gathered into around 500 groupings, MS-DRGs are determined based on the ICD-10-CM primary diagnosis codes assigned to the case. Complications and comorbidities (CC) add to the severity and reimbursement of the episodes of care.

Proper MS-DRG assignment requires the right tools based on ICD-10-CM and PCS codes and guidelines, current Inpatient Prospective Payment System (IPPS) data, up-to-date federal guidelines, and well-written software, all of which Codify provides. Here are some examples:

• ICD-10-CM and ICD-10-PCS coding - Quickly find the ICD-10 code that best describes the patient's diagnosis or procedure with a look-up tool that includes the latest from CMS. Intuitive and accurate, our electronic coding tools are designed for coders by coders.
• Major Diagnostic Categories - Codify's MDC look-up tool helps you crosswalk the proper ICD-10 codes with the MDCs your patient represents. Outlier and CC status won't fool you as you use our intuitive tool.
• DRG Grouper - Imagine calculating in a few moments what it would take a spreadsheet to accomplish. Codify's grouper allows you to:
  1. Enter one or more ICD-10 codes along with other required inputs
  2. Click a button
  3. Get the resulting DRG and other important information (including the Relative Weight, Length of Stay, Procedure Type, Post-Acute Indication and other items)
• DRG Payment Calculator - You can calculate your reimbursement with our integrated DRG Payment Calculator. Here, you can input additional information to see how much Medicare will pay for a particular episode of care. The payment calculator shows the different payment components — Federal Operating Payment, Operating Indirect Medical Education Add-on, Operating Disproportionate Share Hospital Add-on, other add-ons and adjustments etc.  It also shows the Billed Outlier Threshold if costs were unusually high, which can qualify for an additional outlier payment.
• Codify's Additional Content - Codify keeps you current on regulatory changes by updating when needed. You'll find links, articles, and regulation information easily, helping you be more efficient and effective. Coding Clinic and other resources can be added on as you need them.