Executives-Auditors-DRG

 Conduct comprehensive reviews of inpatient medical records to validate that assigned ICD-10-CM/PCS codes and DRG classifications accurately reflect the documented clinical conditions and procedures.

 Ensure compliance with IPPS (Inpatient Prospective Payment System) methodology, CMS guidelines, and official coding rules when determining DRG assignment.

 Verify accuracy and specificity of diagnoses, procedures, POA indicators, and discharge disposition, ensuring documentation supports all coding decisions.

 Identify documentation gaps and collaborate with clinical teams to obtain necessary clarifications for accurate code assignment.

 Mentor, coach, and support coding staff, providing guidance on complex DRG and inpatient coding scenarios.

 Deliver feedback and ongoing education to both coders and Clinical Documentation Improvement (CDI) specialists to improve coding quality and documentation completeness.

 Perform routine co...