Explain the general concept of MS-DRGs.
What will be an ideal response?
MS-DRGs (Medicare severity diagnosis related groups) categorize or "group" diagnoses that are medically related, require similar treatment, and have similar lengths of stay. Each MS-DRG has a preset reimbursement amount that the hospital receives for each case that falls into a specific MS-DRG. Under the prospective payment system, reimbursement is based on the MS-DRG, and the patient's principal diagnosis, secondary diagnosis, procedures, and complications/comorbidity determine the MS-DRG. Other factors that affect MS-DRG assignment include the patient's age and discharge status.
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Code for lumpectomy or partial mastectomy:
A) 19301. B) 19303. C) 19305. D) 19307.
Which one of the following statements is most appropriate when communicating with the medical facility that will receive the patient?
A) "Inbound with a 52-year-old suffering from a myocardial infarction." B) "En route to your facility with a 73-year-old male complaining of dizziness." C) "Five minutes out with Mr. John Panzer who called us today for high blood pressure." D) "En route with a drug addict who has overdosed on an unspecified amount of heroin."