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Briefings on Coding Compliance Strategies (Single Article)
Severity counts despite MS-DRG inadequacies
November 2007
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I must start with an apology regarding my last diatribe about the newly effective Medicare Severity DRGs (MS-DRG). Last month's column referenced major complication and comorbidity (MCC) criteria that were available in the proposed rule. Although some of this information was slightly changed in the final rule, I still maintain that the presence of one CC or MCC does not determine severity of illness.
For example, Medicare deems that a patient with sepsis due to pneumonia has the same severity as a patient with sepsis, septic shock, acute renal failure, acute hepatic failure, acute respiratory failure, and metabolic encephalopathy due to pneumonia.
