DRG Validation Savings Example

Diagnosis:

401.1 Acute Myocardial Infarction

414.0 Coronary Atherosclerosis

427.9 Cardiac Dysrhythmia, Unspecified

Procedures:

36.11 Aortocoronary bypass of One Coronary Artery

36.01 Single Vessel PTCA

38.91 Arterial Catheterization

99.29 Injection of Therapeutic Agent

Revision: The bypass was not performed and should not have been coded. The patient had signed a consent form for the bypass and the admission notes indicated that a bypass was a possibility depending on the findings of the Catheterization but no bypass was performed. The DRG changed from 112 to 108.

SAVINGS: $5,612

Diagnosis:

V30 Single Live Birth

769.5 Respiratory Distress, Birthweight 1250-1499 gr.

Procedures:

31.29 Permanent Tracheostomy

Revision: The tracheostomy was temporary, not permanent. The DRG changed from 606 to 607.

SAVINGS: $10,573