Health Care Regulations, Reimbursement and Documentation Requirements

Course overview

The goal of this module is to provide nurses with information about the Inpatient Prospective Payment System (IPPS), Medicare Severity Diagnostic related Groups (MS-DRGs), complications/comorbidities under the MS-DRG system and the responsibilities of providers for documentation to support appropriate IPPS reimbursement. Define the IPPS and the process by which it is updated Identify two ways that Case Mix Index impacts reimbursement Describe surgical hierarchy and how it impacts DRG assignment