RHIT Question of the Day
🏥 How does the practice of undercoding affect a hospital's MS-DRG case mix?
Options: a) Makes it lower than warranted by the actual service and resource intensity of the facility b) Makes it higher than warranted by the actual service and resource intensity of the facility c) Hospital's MS-DRG case mix is never monitored so there is no impact d) Coding has nothing to do with a hospital's MS-DRG case mix
Answer: a) Makes it lower than warranted by the actual service and resource intensity of the facility
💡 Why? Undercoding results in assigning less severe or fewer diagnosis codes than appropriate. This causes the hospital’s MS-DRG (Medicare Severity Diagnosis-Related Group) case mix index to appear artificially lower, misrepresenting the actual patient care complexity and resource use.
Overcoding would make it higher.
The case mix is carefully monitored and affects reimbursement.
Coding directly impacts MS-DRG assignment.
