Why Would a Coder or Coding Manager Automatically Review And/or

question 51

Multiple Choice

Why would a coder or coding manager automatically review and/or revise patients assigned to DRG 469 and/or DRG 470?

• A) The hospital might not be entitled to the reimbursement for these DRGs.
• B) The federal government reviews these DRGs for fraud and abuse.
• C) There is something incorrect with the codes assigned and/or data when a patient is grouped into either of these DRGs.
• D) Both a and b are true.

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Definitions:

Concentration Differences

Variations in the amount of a particular substance within a given volume, leading to a gradient that can cause diffusion.

Sodium-Potassium Pump

A membrane-bound ATPase enzyme that pumps sodium out of cells while moving potassium into cells, crucial for maintaining cellular ion balance and membrane potential.

Plasma Membrane

A bi-layer of lipids and proteins that surrounds a cell, controlling the passage of substances in and out of the cell.

Membrane Potential

The electrical potential difference across a cell's plasma membrane, vital for the conduction of nerve impulses, muscle contraction, and transport processes.