GretchenC123
Networker
I am an LNC completing a medical record review of a patient who had lumbar fusion/decompression surgery and had terrible complications. I need to do an audit of the billing. Does Medicare pay per DRG even when there are complications and the patient ends up in the hospital for a lengthy period? If so, how do I determine what the DRGs are? I have an itemized bill that totals over 1 million dollars which I know Medicare did not pay. Any help would be appreciated.