Over the last six months, Panacea, health information management (HIM) consultants, and other consulting firms have leveraged Panacea's DRGcheck.com (also referred to as CLAIMSauditor.com) system to enter ICD-10 codes side by side with ICD-9 codes – along with notes included in the record and diagnosis and procedure code levels related to documentation issues found upon audit.
Auditors were able to instantly regroup and re-price these records based on findings, and the best part is that within seconds, a set of reports showing the financial impact and the statistical impact – sorted by DRG, diagnosis code, procedure code, auditor, physician, coder, reason for change and more – was produced. Such reports otherwise would take days for someone to compile, and without the level of precision and detail.
One benefit is that instead of determining the estimated impact of going from ICD-9 to ICD-10, your hospital can identify the actual difference in reimbursement based on those cases that have been audited or dual coded. Secondary benefits, of course, include the identification of areas where improvement is needed and the ability to write rules within DRGcheck to monitor your improvement against the audit period baseline, even in the post-ICD-10 environment.
DRGcheck.com could complement your internal audit or ICD-10 readiness programs in and one or more of the following scenarios:
- If you have completed documentation training and education and would like our auditors to select records having a high probability or requirement for detailed documentation, code the records under ICD-10, and produce the relevant financial and statistical impact reports
- If you have a dual-coding initiative underway and would like to determine the financial impacts of those records under ICD-10 (as compared to ICD-9)
- If you would like to implement a system that identifies pre-ICD-10 implementation issues and then tracks coding, documentation, and financial improvements against a pre-ICD-10 implementation baseline
- If you would like to leverage technology to review 100 percent of recently or retrospectively coded records by applying RAC, OIG, PEPPER, or other rules written by you or taken from our library (and then selecting those flagged by the system for an audit)
If you would like more information, you can register to see an on-demand presentation at www.DRGcheck.com today.