A hospital is not able to be reimbursed for care a particular client received while in the emergency department. The client came in with chest pain, which was later diagnosed as gastric reflux. A problem in documentation that may have caused the lack of reimbursement would be which of the following?

Question

Quizplus · Accepted Answer

The client's record containing an incorrect Diagnosis-Related Group (DRG) could lead to reimbursement issues because DRGs are used to classify hospital cases into groups for the purpose of payment. If the DRG does not accurately reflect the services provided, the hospital may not receive appropriate reimbursement.

A Hospital Is Not Able to Be Reimbursed for Care