Next

Diagnosis Related Groups: Navigation

The 'ICD' book title has turned Red, to indicate this is the active book, the book spine 'CODES' has a black triangle to indicate this is the portion of the book you are looking at.

Once you have clicked on the DRG MDC Headings link (it's in red at the bottom of the ICD Chapter Heading page), you can see the 25 Major Diagnostic Categories that contain all of the DRGs.

(1) We will be navigating to the DRGs within Pre MDC categories.
We have navigated to DRGs for Pre-MDCs. You can shift back to MDCs by clicking the 'H' button or go to ICD codes found within any given DRG by clicking on the arrow or DRG number. (2) We'll go to the ICD codes for DRG 482 'Tracheostomy for Face, Mouth and Neck Diagnosis
The DRG - ICD code layout looks like this. We will display the top and bottom halves of this screen shot in the next few images along with explanations of what each item means. For now, just take a look at the layout---you will be able to navigate to the MDCs, DRGs, and ICDs with one click of a button.
1. If you wish to view ICD codes or if you entered the DRG to ICD codes layout after performing an ICD search, click the back button.
2, 3 The hierarchy is displayed here with the Major Diagnostic Category listed first, followed by the Diagnosis Related Group.
The arrow next to MDC will display the 25 Major Diagnostic Categories
The arrow next to DRG will display all of the Diagnostic Related Groupings associated with the MDC listed just above it. (in this case the preMDCs for Transplants and Tracheostomy
At this point we can examine the bottom half of the DRG Information and Setup screen:

1. The GMLOS, AMLOS, and Relative Weight are all listed for the DRG you are viewing. If you know the hospital payment rate, you can quickly calculate your expected reimbursement by multiplying it with the Rel Wt. number

2. Each DRG has a listing of ICD codes (using Volume 1 Diagnosis, Volume 3 Procedures, or both). These listings of codes often require the presence of ICD codes in combination to qualify for a particular DRG. In this case, DRG 482, you can see that several ICD codes can be used from a listing of Operating room procedures, Principal diagnoses, and Non-operating Room Procedures.

When the DRG is initially displayed, all ICD codes in the list will be displayed in the lowest box (3). These lists can be quite lengthy, so Flash Code provides a shortcut. Just click on any of the areas of interest in box (2) in order to focus on only the ICD codes represented by that subset, such as Operating Room Procedures, and etc.