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Case 4.9, page 178 Estimated Medicare-Severity Diagnosis Related Group Payments

Case 4.9, page 178 Estimated Medicare-Severity Diagnosis Related Group Payments

The assigned cases are found in this text: Case Studies in Health Information Management, 4th edition.
These Case Studies are developed to assess the student’s ability to reference previous knowledge or use of critical thinking to find solutions to the cases. Students may have to use resources to locate the information they need to correctly answer the cases.  These include previous course texts or Internet searches, although most of the concepts have been discussed in previous course work.  The cases resemble ‘real-life scenarios” that graduates may encounter.  Be resourceful and apply concepts to answer the questions. Justify your reasoning and/or provide your reference for each case.

Complete the following cases: 
Case 4.6, p. 175 Official Coding Resource (25 points)
Upon completion of this assignment, students should be able to meet the following module learning objective:
MLO 9: Utilize references in the Encoder (Coding Clinic, CPT Assistant, lab and/or pharmacy references).
Hint for completing Case 4.6:
Review the 3M Assign 1: CRS References. Log into the AHIMA VLab 3M Encoder. Then click on “References”. You will want to look at CPT Assistant, Coding Clinic, and Coding Clinic for HCPCS to complete this assignment. Start by opening CPT Assistant, then click on “By Subject”, you then can look each of the procedures and/or diagnoses listed in the assignment to see if you can find a reference listed.
If you do not find one listed in the CPT Assistant, then search Coding Clinic the same way. And, finally, search Coding Clinic for HCPCS the same way. Be searching all three you should be able to find a reference for each of the procedures and/or diagnoses listed.
Case 4.9, page 178 Estimated Medicare-Severity Diagnosis Related Group Payments (25 points)
Upon completion of this assignment, students should be able to meet the following module learning objective:
MLO 13: Calculate estimated payments.
HINT: Relative Weight x Hospital’s base rate = Estimated payment

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