Why might a coding manager automatically review and/or revise patients assigned to DRG 469 (MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC) or DRG 470 (MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC) ?
A) The hospital might not be entitled to the reimbursement for these DRGs.
B) The federal government always reviews these DRGs for fraud and abuse.
C) There is something incorrect with the codes assigned and/or data when a patient is grouped into either of these DRGs.
D) These DRGs are on the OIG workplan this year.
Correct Answer:
Verified
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