Question

1. A(n) _________________________________________________________ is an organization that contracts with payers, specifically Medicare and Medicaid, to review care and reimbursement issues.
2. Non-Medicare patients, patients who self-pay, or those who have other insurance may be grouped using the ____________________________________________ system.
3. The ______________________________ is the software used to derive the DRG from the ICD-10-CM diagnoses and procedures.
4. Which record would take longest to code?:
5. 1. normal newborn
   2. treatment of fracture in ED
   3. annual physical by PCP
   4. bowel resection

Answer 1

1) An insurance company is an organization that contracts with payers, specifically Medicare and Medicaid, to review care and reimbursement issues.

2) Non-Medicare patients, patients who self-pay, or those who have other insurance may be grouped using the MS-DRG system.

3) The Grouper software v34.0  is the software used to derive the DRG from the ICD-10-CM diagnoses and procedures.

4) Which record would take longest to code?:

Answer: d) bowel resection ( Z90.49)