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The Auditor Was Reviewing the Hospital Bills and Noticed That

Question 28

Multiple Choice

The auditor was reviewing the hospital bills and noticed that for several cases billed to a commercial payer the DRG assignment, based on the MS-DRG description of the DRG code, did not match the diagnosis/procedure codes. One possible reason for this is:


A) the coder made an error assigning the DRG.
B) the grouper isn't working properly.
C) that payer uses a different DRG than Medicare.
D) the MS-DRG description is incorrect.

Correct Answer:

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