A hospital is not able to be reimbursed for care a particular client received while in the emergency department.The client came in with chest pain,which was later diagnosed as gastric reflux.Which problem with documentation might have caused the lack of reimbursement?
A)The client's record contained an incorrect DRG.
B)The client was charged for an ECG.
C)A code cart was opened and the client was charged for medications opened but not used.
D)The physician made a diagnostic mistake.

Question

Quizplus · Accepted Answer

The client's record containing an incorrect Diagnosis-Related Group (DRG) could lead to a lack of reimbursement because DRGs are used to classify hospital cases into groups for the purposes of payment. If the DRG does not accurately reflect the services provided, the hospital may not receive appropriate reimbursement.

A Hospital Is Not Able to Be Reimbursed for Care