The Reporting Dilemma: DRG Mismatches (Part II)

The term “DRG mismatches” is most often used to describe situations wherein the working diagnosis-related group (DRG) selected by the clinical documentation improvement specialist (CDIS) differs from the final coded DRG, signaling that the CDIS and the coder have arrived at different principal diagnoses. In other situations, a procedure may have been coded incorrectly by the CDI professional, causing the DRG mismatch.

But here’s good news: there’s a new workflow for resolving inpatient DRG mismatches. With this new workflow, the CDIS and coder no longer have to spend countless hours reconciling DRG mismatches.

During the next live edition of Talk Ten Tuesdays, Patty Chua, president of Innova Revenue Group, will report on the positive coding implications this new workflow has created.

The live broadcast will also feature these other segments:

• Revenue Cycle Report: Susan A. Vestevich, JD, chief operations officer for Tia Tech USA, will report on the need for physician credentialing to ensure proper billing and reimbursement.
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will make her debut appearance on Talk Ten Tuesdays, having been a regular panelist on the long-running Monitor Mondays. Ferguson will report on the news that’s happening at the intersection of coding and the SDoH.
• Journaling John, MD: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
• Point of View: James S. Kennedy, MD, president of CDIMD, will serve as co-host, and will report on a subject that has caught his attention.

Chapters

• 3:22 Timothy Powell, CPA
• 5:34 ICD10monitor Commercial
• 6:38 Tiffany Ferguson, LMSW
• 9:55 John Zelem, MD
• 14:14 ICD10monitor Commercial
• 15:14 Susan A. Vestevich, JD
• 20:05 Patricia Chua, RHIT
• 24:12 James Kennedy, MD