Coding For Quality: Documentation for the Top Seven DRGs
Second Edition, Revised 1/1/05
IPRO conducted a Medicare Payment Error Prevention (PEPP) study of the highest volume Prospective Payment System (PPS) DRGs billed in New York State for calendar year 1999. Preliminary coding validation review of a targeted sample of medical records for these Top Seven DRGs identified a 15.7% coding error rate ranging from a low of 0% for DRG 209 to a high of 37.1% for DRG 089. Therefore, the following documentation and coding materials were prepared to assist hospitals in their ongoing educational programs and internal auditing and monitoring activities to ensure the accuracy of DRG assignments and completeness of documentation.
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