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Ethical and operational issues concerning DRGs and the prospective
whats the future bottom line for health care?
Quality control of diagnosis and procedure coding
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accuracy administrators admission algorithms analysis average cost Case-mix classification systems case-mix complexity cians clinically coherent coders coding errors complication or comorbidity concurrent review CPHA data base data quality defined determine developed diag diagnosis code Diagnosis related groups differences DRG assignment DRG classification DRG-based effect Error type federal focused HCFA Hospital Discharge Data hospital's implementation Jersey length of stay MADC or DRG major diagnostic categories measure Medicaid medical record department medical record practitioners medical staff Medicare ment methodology operating room patient classification scheme payer payment system peer review per-case reimbursement percent physi physicians principal diagnosis problems prospective payment prospective payment system PSROs quality assurance reabstracting reduce reim reimbursement system reporting require resource intensity result review organizations secondary diagnoses severity of illness statute surgical class surgical procedure systematic errors tion UHDDS definitions Uniform Hospital Discharge utilization review variable