Start your revenue cycle strong by ensuring that critical, and accurate, patient information is in place before patient visits begin.
Health Information Management
Our team of coding experts, with a deep understanding of the healthcare industry and its specialties, paired with smart technology creates a tangible, positive impact on cash flow.
Extended Business Office
AGS Health provides a comprehensive suite of RCM services that are customized for each customer. Our experienced team of experts serves as an extension of your business office.
Analytics and Reporting
Obtain answers to critical questions related to performance benchmarking, root cause analysis, predictive analytics, and operational improvements.
Connect with us
Request a demo
Latest CASE STUDIES
By AGS Health
September 26, 2022
Many Clinical Documentation Improvement (CDI) specialists. with clinical backgrounds are encoder-dependent, having been taught to "code" using an encoder and create a working MS-DRG using grouper software. Many coders also rely on the encoder. However, CDI specialists and coders should also understand how to manually assign an MS-DRG.
The basic steps in assigning an MS-DRG are as follows:
The Uniform Hospital Discharge Data Set (UHDDS) defines reportable diagnoses and procedures. Diagnoses definitions are well-known among coders and CDI specialists, but coders tend to be less familiar with procedure definitions. You should only report significant procedures. According to UHDDS, a significant procedure is either:
In addition, UHDDS defines the principal procedure as:
Because not all procedures affect the MS-DRG, the UHDDS definitions of significant procedures are handy. Some procedures will have no effect on the MS-DRG, while others will change the base medical MS-DRG or transfer the case to a surgical MS-DRG.
Diagnostic procedures are less likely to impact MS-DRG assignment because they are typically performed in the outpatient setting, so they are less likely to be the principal procedure. Also, the principal procedure is usually linked to the primary diagnosis, implying that they are both located in the same MDC/body system. ICD-10-PCS has specific guidelines regarding the assignment of the principal procedure.
If a procedure was performed, determine if it is significant:
AGS Health is more than a revenue cycle management company–we’re a strategic partner for growth. By blending technologies, services, and expert support, AGS Health partners with leading healthcare organizations across the US to deliver tailored solutions that solve the unique needs and challenges of each provider’s revenue cycle operations. The company leverages the latest advancements in automation, process excellence, security, and problem-solving through the use of technology and analytics–all made possible with college-educated, trained RCM experts. AGS Health employs more than 10,000 team members globally and partners with more than 100 clients across a variety of care settings, specialties, and billing systems.
connect with us
Let’s transform your revenue cycle today
When you create a high-performance revenue cycle, you’re finally free to invest your full resources into what matters most: the care of your patients.