BC Advantage - 2019 Issue 1

DRG Big Bang Launched the Modern Age of Coding 35 Years Ago

Medicare's DRG payment system began 35 years ago this year. That "Big Bang" event launched the coding of medical claims for payment purposes into a burgeoning career for many individuals. It also positioned medical record coding as a strategic financial function for hospitals and physicians. Since that time, skilled coding has long been the providers' most potent weapon in the battle over coverage, coding, and reimbursement with payers. Before DRGs, medical record and coding departments were small, obscure entities with very limited revenue implication for hospitals. But with DRGs, these departments moved "out of the basement" of the...

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