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Added line is this color Deleted line is this color <br> <h2>DRG Info</h2> <ul> <li><small>CMS Acute Inpatient PPS <a href= "http://www.cms.hhs.gov/AcuteInpatientPPS/FFD/list.asp?intNumPerPage=all&submit.x=11&submit.y=6">files</a> (2005-2008)</small></li> <li style="LIST-STYLE-TYPE: none"> <ul> <li><small>FY 2009 Proposed Rule <a href= "http://www.cms.hhs.gov/AcuteInpatientPPS/downloads/FY2009nprmtable5.zip" rel= "nofollow">Table 5 - List of MS-DRGs, Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay</a></small></li> <li><small>FY 2008 Final Rule <a href= "http://www.cms.hhs.gov/AcuteInpatientPPS/FFD/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=2&sortOrder=ascending&itemID=CMS1198553&intNumPerPage=2000" rel="nofollow">Table 5 - List of MS-DRGs, Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay</a> </small></li> </ul> </li> </ul> <h2>DRG worksheet calculators</h2> <ul> <li> <p><a href="http://www.resdac.umn.edu/Tools/TBs/TN-004-revised.asp"><font size= "2">Calculating Hospital-Specific DRG Payments</font></a></p> </li> <li> <p><font size="2"><strong>Calculating national average DRG payments</strong></font></p> <ul> <li> <p><font size="2">DRG = [<u>standardized amounts</u> (non-labor- and labor-related) x DRG <u>relative weight</u> (found at Table 5 of IPPS) + [<u>capital rate</u> x DRG <u>relative weight</u>)]</font></p> </li> <li> <p><font size="2">Double-check whether wage index is above/below 1</font></p> </li> <li> <p><font size="2">Excel <a href= "http://reimbursement.atwiki.com/file/open/37/Medicare%20National%20Average%20MS-DRG%20Payment%20Amounts%20%282008%2C%202009%20proposed%29.xls">file</a> -- Medicare average MS-DRG payment amounts (from 2008)</font></p> </li> </ul> </li> </ul> <h4>Standardized Amounts and Capital Standard Federal Payment Rate (Tables 1A, 1B, and 1D)</h4> <table border="1"> <tbody> <tr> <td></td> <td>Labor Amt</td> <td>Nonlabor Amt</td> <td>Capital Rate</td> </tr> <tr> <td><strong>2008</strong></td> <td>$3,459.66</td> <td>$1,503.98</td> <td>$423.34</td> </tr> <tr> <td></td> </tr> <tr> <td>#</td> <td>#</td> <td>#</td> <td>#</td> </tr> </tbody> </table> <p> </p> <h2>Online Medicare DRG Calculators</h2> <ul> <li>IRP <a href= "http://www.irpsys.com/cgi-bin/webplus.exe?Script=/irpsys/drgcalc.wml&calcver=medicare"><font size="2">DRG Calculator</font></a></li> <li><a href="https://www.hospitalbenchmarks.com/DRGCalculator.aspx">Ingenix DRG Calculator</a></li> </ul> <h2>Criteria to be met to warrant creation of a CC or an MCC subgroup within a base MS-DRG (<a href= -"http://a257.g.akamaitech.net/7/257/2422/01jan20071800/edocket.access.gpo.gov/2007/pdf/07-3820.pdf">72 +"http://frwebgate3.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=48899120018+0+1+0&WAISaction=retrieve">72 Fed Reg 47169</a>)</h2> <ol> <li>A reduction in variance of charges of at least 3 percent. </li> <li>At least 5 percent of the patients in the MS-DRG fall within the CC or MCC subgroup. </li> <li>At least 500 cases are in the CC or MCC subgroup. </li> <li>There is at least a 20-percent difference in average charges between subgroups. </li> <li>There is a $4,000 difference in average charges between subgroups.</li> </ol> <p> </p> |