أمثلة عملية علي ربط الترميز بالمجموعات مرتبطة التشخيص DRGs

Examples that demonstrate significance of correct code order on AR-DRG allocation

All examples are public inlier cases, calculated with WIES17 = $3725.

• Patient has tonsillitis and obstructive sleep apnoea.

Code for tonsillitis sequenced first (principal diagnosis).  Assigned to AR-DRG:

D63Z - Otitis Media and URI
Inlier cost weight: 0.4737
Potential reimbursement - $1764

Code for sleep apnoea sequenced first (principal diagnosis). Assigned to AR-DRG:

E63Z - Sleep Apnoea
Inlier cost weight: 0.6142
Potential reimbursement:$2287

• Patient with cerebral palsy and contracture of specific joint with release of contracture.

Code for cerebral palsy sequenced first (principal diagnosis).  Assigned to AR-DRG:

B06B - Procs for Cerebral Palsy, Muscular Dystrophy, Neuropathy W/O CC
Inlier cost weight: 0.7364
Potential reimbursement: $2743

Code for contracture of specific joint sequenced first (principal diagnosis). Assigned to AR-DRG:

I27A - Soft tissue procedures
Inlier cost weight: 2.4294
Potential reimbursement: $9049