Calculate the expected reimbursement for the following DRG’s. Community Hospital
ID: 368831 • Letter: C
Question
Calculate the expected reimbursement for the following DRG’s.Community Hospital has a Labor amount of $3,260; a wage index of 0.8934; and a non-labor amount of $2,000
MS
DRG
DESCRIPTION
Relative Weight
Expected Reimbursement
061
Acute Ischemic Stroke with use of Thrombolytic Agent w MCC
190
Chronic Obstructive Pulmonary Disease w MCC
231
Coronary Bypass w PTCA w MCC
483
Major Joint & Limb Reattachment Procedure of Upper Extremity w CC/MCC
820
Lymphoma & Leukemia w Major OR Procedure w MCC
MS
DRG
DESCRIPTION
Relative Weight
Expected Reimbursement
061
Acute Ischemic Stroke with use of Thrombolytic Agent w MCC
190
Chronic Obstructive Pulmonary Disease w MCC
231
Coronary Bypass w PTCA w MCC
483
Major Joint & Limb Reattachment Procedure of Upper Extremity w CC/MCC
820
Lymphoma & Leukemia w Major OR Procedure w MCC
Explanation / Answer
Operating base payment rate =
(Labor Share * Wage Index) + (Non Labor Share * Cost of Living Adjustment)
3260x0.8934+2000 x1 = 2912.48+2000 = 4912.38
Operating payment = Operating base payment rate x DRG relative weight
The table is given below.
MS DESCRIPTION Relative Weight Expected Reimbursement DRG 61 Acute Ischemic Stroke with use of Thrombolytic Agent w MCC 2.6843 13186.30 190 Chronic Obstructive Pulmonary Disease w MCC 1.1578 5687.55 231 Coronary Bypass w PTCA w MCC 7.8056 38344.07 483 Major Joint & Limb Reattachment Procedure of Upper Extremity w CC/MCC 2.4127 11852.09 820 Lymphoma & Leukemia w Major OR Procedure w MCC 13.3054 65361.18Related Questions
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