Severity DRGs (SDRGs)

All Patient DRGs (AP-DRGs)

Prior to the invent of AP-DRGs, DRGs were only used by medicare. Then there was a legislation that called on to used DRG based prospective payment for all non medicare patients in New York. Since it was found that Medicare DRGs were not adequate for a non-Medicare population a new DRG system was needed to address this need which was developed by NYDH and 3M HIS and was named as as the All Patient DRGs or AP-DRGs. AP-DRG system was an modified version of a previously developed DRG system called Pediatric Modified Diagnosis Related Groups or PM-DRGs.

In the newly created AP-DRGs there were DRGs specifically for neonatal and pediatric
patients and also a new DRG 24 was created for HIV infection patients. Assignment to MDC 24 was based on the principal diagnosis of an HIV infection or a principal diagnosis of an HIV related complication combined with a secondary diagnosis of an HIV infection. Some other significant modifications were made for nutritional disorders, transplants, hemophilia, cystic fibrosis, long term mechanical ventilation patients, acute leukemia, high-risk obstetric care, and sickle cell anemia. AP-DRGs are updated in January of every year and several modifications have been made till now.

Refined DRGs (RDRGs)

Refined DRGs (RDRGs) was developed at Yale University to revise the use of complications and comorbidities in the Medicare DRGs . Health Care Financing Administration funded this project during 1980s. Yale University modified the original medicare DRGs and expanded the numbers of DRGs to 1263. The DRG system developed by the Yale project is referred to as Refined DRGs or RDRGs.

Before the Yale project there as no concept of CCs and MCCs. In the medicare DRG system DRGs were assigned depending upon the primary and secondary diagnosis, but now Yale project created 136 secondary DRG for CCs. So now if a patient has a CC then instead of assigning the next DRG there was a DRG code with CC in the same DRG group. For surgical patients each secondary diagnosis group was assigned to one of four CC complexity levels, (non CC, moderate CC, major CC, and catastrophic CC). For medical patients each secondary diagnosis group was assigned to one of three CC complexity levels (non-CC, moderate or major CC and catastrophic CC).

RDRGs were basically designed for Medicare purpose only where all the patient population were in elderly ages. This DRG system was not adequate to handle a patient population of all ages especially neonates and patients with Human Immunodeficiency Virus (HIV) infections as there were no DRGs for these patients. This deficiency led to the development of other DRG systems that can cater to the needs of patients of all ages.

Inova Health System medical coding Jobs

Inova Health System employees more than 16,500 talented individuals who provide exceptional patient care. They recruit medical coders at Fairfax, Alexandria, Falls Church, Dulles South, Virginia. They have recruited at all levels and offer part time and full time positions. They have also recruited coding Auditors.
They prefer certified coders : CPC-H or CCS or CCA. Additional certification in RHIT or RHIA is preferred.

http://jobs.inova.org/careers/featured-jobs

TriWest Healthcare Alliance medical coding jobs

TriWest Healthcare Alliance, headquartered in Phoenix, Arizona, manages and administers quality healthcare services for our nation's active and retired uniformed military service members and their families.

They have a coding department that have recruited experianced coders in the past. They prefer experiacned coders with certification. Tbey are located at Phoenix, AZ. The jobs offered are full time.



https://recruiter.triwest.com/

AtlantiCare medical coding jobs

AtlantiCare is the region’s largest healthcare organization and largest non-casino employer, with more than 5,170 employees and 600 physicians in nearly 70 locations. They have recruited medical coding team lead with Certified Coding Specialist (CCS) preferred with 10 years of experiance. They have a coding department that recruits full time coders as coders and team leads.

They have operations at multiple locations including Atlanta City(New Jerdey), Pomona, Egg Harbor Twp.

https://www.atlanticare.apply2jobs.com/

Anthelio (PHNS) medical coding jobs

Anthelio is a world leader in the healthcare industry providing healthcare IT services including medical coding, medical billing, Cancer registry, etc. Anthelio recruits medical coders through out the United States at all levels. Anthelio was formerly known as PHNS and was recently acquired by an Indian based company called Conjoin Group. Anthelio plans to remapup their US headcount from the present 1300 employees to 5000 by 2015. Anthelio recruits medical coders for both inpatient and outpatient work. They also offer remote coding positions in the United States for experianced coders.

http://www.antheliohealth.com/