APR DRG of the Week: APR-DRG 347: Other Back & Neck Disorders, Fractures & Injuries

Oct 3 2011 5:05 PM

Change the Principal diagnosis

  • Alternate principal diagnoses recommended by FairCode docs include ...
    • 353.0     Thoracic outlet syndrome                                                             →  DRG 48
    • 998.59   Postoperative infection                                                                 →  DRG 721
    • 730.XX Osteomyelitis                                                                               →  DRG 344
    • 725        Polymyalgia Rheumatica                                                             →  DRG 346
    • 733.13   Pathologic fracture of vertebra or 733.10 Pelvis                         →  DRG 343
    • 806.00   Cervical fracture with cord injury                                                →  DRG 40
    • 198.5     Bone metastases                                                                           →  DRG 343

Add A Secondary diagnosis

  • Cardiovascular conditions: 358.9 hypotension, 428.0 congestive heart failure, 416.8 pulmonary hypertension, 397.0 tricuspid regurgitation
  • Respiratory conditions: 780.57 sleep apnea, 486 pneumonia, 511.9 pleural effusion
  • Nutritional & Electrolyte disorders: 276.1 hyponatremia, 275.42, hypercalcemia, 275.2 hypomagnesemia, 276.8 hypokalemia, 273.8 hypoalbuminemia, 278.01 morbid obesity, V85.4 BMI>40, malnutrition
  • Renal disorders: 788.20 urinary retention, 788.30 urinary incontinence, 440.1 renal artery stenosis, 584.9 Acute renal failure
  • Other: 348.30 Encephalopathy, 042 HIV, 038.9 Septicemia, 287.5 Thrombocytopenia, 437.3 Cerebral aneurysm, 250.02 Diabetes uncontrolled

Add a Procedure

  • 78.19 Application of External fixator device                                                      →  DRG 310

Discussion

  • The most frequent change to this DRG by far resulted from the patient being admitted for more that one acute condition, both meeting the definition for principal diagnosis.
  • Look for a recent procedure, which may have been complicated by the presenting complaint.  This DRG assignment has been changed after recognition that the patient's pain was causally related to complications or an infection from a recent operation.

 

Add a Comment