Posted: June 17th, 2023

The health information management team at Anywhere University Hospital (AUH)

The health information management team at
Anywhere University Hospital (AUH) contracted with an auditing firm to perform
full assessment coding review. The results from this baseline assessment are
provided in four tables:

Variation Log by Type of Error
Variation Log by Coder
Variation
Log by MS-DRG
MS-DRG
Relationship Assessment

Which Citation Styles Can You Handle?

We get a lot of “Can you do MLA or APA?”—and yes, we can! Our writers ace every style—APA, MLA, Turabian, you name it. Tell us your preference, and we’ll format it flawlessly.

You are the inpatient coding manager at AUH. Your
director has asked you to develop an ongoing review and monitoring schedule for
the next year based on the results from the outside review.
Include internal and external reviews, coding
in-services, physician workshops, and external seminars/educational sessions
that will be performed and or provided for your staff. The schedule should be
specific (include volumes and/or percentages of charts to be reviewed). Keep in
mind that on average it takes 18 minutes to review one inpatient chart. Budget
provides for $65,000 for external reviews. The average cost for reviewing one
inpatient record by an external review team is $55.00 (fully loaded).
In addition to preparing the schedule, outline how you
will maintain coding quality statistics and report them back to the HIM
Director and Compliance Committee at your facility.

How will you reward your staff members
who show great improvements?
How will you reward and/or recognize
that your staff has made improvements overall?

Your Coding Team consists of:
Coding Manager (you)
1-Data Quality Auditor (1 FTE)
8-Inpatient Coders (8 FTE)
2-RHIA, CCS
3-CCS
3-RHIT

Results of the full assessment coding review for AUH:

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Two audits were
performed:
1. Coding quality review by MS-DRG
2. MS-DRG Relationship Analysis

Variation
Log by Type of Error

%
of errors

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Inaccurate
sequencing or specificity principal diagnosis, affect MS-DRG

17%

Inaccurate
sequencing or specificity principal diagnosis, non affect MS-DRG

16%

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100%! We encrypt everything—your details stay secret. Papers are custom, original, and yours alone, so no one will ever know you used us.

Omission CC,
affect MS-DRG

33%

Omission CC, non
affect MS-DRG

2%

Is AI Involved in Writing?

Nope—all human, all the time. Our writers are pros with real degrees, crafting unique papers with expertise AI can’t replicate, checked for originality.

Inaccurate
principal procedure, affect MS-DRG

3%

Omission
procedure, affect MS-DRG

4%

Why Are You the Best for Research?

Our writers are degree-holding pros who tackle any topic with skill. We ensure quality with top tools and offer revisions—perfect papers, even under pressure.

More specific
coding of diagnosis or procedure, non affect MS-DRG

12%

Inaccurate
coding

5%

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Experts with degrees—many rocking Master’s or higher—who’ve crushed our rigorous tests in their fields and academic writing. They’re student-savvy pros, ready to nail your essay with precision, blending teamwork with you to match your vision perfectly. Whether it’s a tricky topic or a tight deadline, they’ve got the skills to make it shine.

Missed diagnosis
or procedure code

8%

Variation
Log by Coder

Coder

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Guaranteed—100%! We write every piece from scratch—no AI, no copying—just fresh, well-researched work with proper citations, crafted by real experts. You can grab a plagiarism report to see it’s 95%+ original, giving you total peace of mind it’s one-of-a-kind and ready to impress.

Error
Rate

Standard

Coder 1

3%

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Yep—APA, Chicago, Harvard, MLA, Turabian, you name it! Our writers customize every detail to fit your assignment’s needs, ensuring it meets academic standards down to the last footnote or bibliography entry. They’re pros at making your paper look sharp and compliant, no matter the style guide.

5%

Coder 2

9%

5%

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For sure—you’re not locked in! Chat with your writer anytime through our handy system to update instructions, tweak the focus, or toss in new specifics, and they’ll adjust on the fly, even if they’re mid-draft. It’s all about keeping your paper exactly how you want it, hassle-free.

Coder 3

8%

5%

Coder 4

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It’s a breeze—submit your order online with a few clicks, then track progress with drafts as your writer brings it to life. Once it’s ready, download it from your account, review it, and release payment only when you’re totally satisfied—easy, affordable help whenever you need it. Plus, you can reach out to support 24/7 if you’ve got questions along the way!

2%

5%

Coder 5

4%

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Need it fast? We can whip up a top-quality paper in 24 hours—fully researched and polished, no corners cut. Just pick your deadline when you order, and we’ll hustle to make it happen, even for those nail-biting, last-minute turnarounds you didn’t see coming.

5%

Coder 6

16%

5%

Coder 7

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Absolutely—bring it on! Our writers, many with advanced degrees like Master’s or PhDs, thrive on challenges and dive deep into any subject, from obscure history to cutting-edge science. They’ll craft a standout paper with thorough research and clear writing, tailored to wow your professor.

12%

5%

Coder 8

3%

5%

How Do You Match Professor Expectations?

We follow your rubric to a T—structure, evidence, tone. Editors refine it, ensuring it’s polished and ready to impress your prof.

Variation Log by MS-DRG*

MS-DRG

Volume

Error Rate

How Do You Edit My Work?

Send us your draft and goals—our editors enhance clarity, fix errors, and keep your style. You’ll get a pro-level paper fast.

470

420

2%

313

233

Can You Brainstorm Topics?

Yep! We’ll suggest ideas tailored to your field—engaging and manageable. Pick one, and we’ll build it into a killer paper.

14%

392

232

1%

291

232

17%

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Yes! Need a quick fix? Our editors can polish your paper in hours—perfect for tight deadlines and top grades.

247

220

3%

292

216

5%

Can You Start With an Outline?

Sure! We’ll sketch an outline for your approval first, ensuring the paper’s direction is spot-on before we write.

871

213

12%

641

209

0%

194

195

Can You Add Charts or Stats?

Definitely! Our writers can include data analysis or visuals—charts, graphs—making your paper sharp and evidence-rich.

3%

293

193

1%

885

188

3%

312

177

0%

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We’ve got it—each section delivered on time, cohesive and high-quality. We’ll manage the whole journey for you.

191

175

7%

287

173

Do You Adapt to International Rules?

Yes! UK, US, or Aussie standards—we’ll tailor your paper to fit your school’s norms perfectly.

2%

310

171

15%

689

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If your assignment needs a writer with some niche know-how, we call it complex. For these, we tap into our pool of narrow-field specialists, who charge a bit more than our standard writers. That means we might add up to 20% to your original order price. Subjects like finance, architecture, engineering, IT, chemistry, physics, and a few others fall into this bucket—you’ll see a little note about it under the discipline field when you’re filling out the form. If you pick “Other” as your discipline, our support team will take a look too. If they think it’s tricky, that same 20% bump might apply. We’ll keep you in the loop either way!

157

11%

603

143

Who is my writer? How can I communicate with him/her?

Our writers come from all corners of the globe, and we’re picky about who we bring on board. They’ve passed tough tests in English and their subject areas, and we’ve checked their IDs to confirm they’ve got a master’s or PhD. Plus, we run training sessions on formatting and academic writing to keep their skills sharp. You’ll get to chat with your writer through a handy messenger on your personal order page. We’ll shoot you an email when new messages pop up, but it’s a good idea to swing by your page now and then so you don’t miss anything important from them.

2%

379

137

3%

192

131

9%

683

116

11%

189

114

1%

069

110

2%

190

92

12%

193

87

10%

690

76

4%

065

76

5%

195

72

2%

066

52

2%

064

41

5%

906

35

2%

*MS-DRG descriptions provided below

Variation Log by MS-DRG* Set

MS-DRG Set

Hospital %

Nation %

064

24.3%

21.4%

065

45.0%

43.8%

066

30.8%

34.8%

190

23.1%

15.2%

191

44.0%

33.5%

192

32.9%

51.3%

193

24.6%

17.5%

194

55.1%

54.2%

195

20.3%

28.3%

291

34.6%

29.2%

292

36.7%

38.8%

293

28.8%

31.9%

689

67.4%

21.7%

690

32.6%

78.3%

*MS-DRG
descriptions provided below

MS-DRG

MS-DRG Title (FY 2008)

064

Intracranial hemorrhage or
cerebral infarction w MCC

065

Intracranial hemorrhage or
cerebral infarction w CC

066

Intracranial hemorrhage or
cerebral infarction w/o CC/MCC

069

Transient ischemia

189

Pulmonary edema &
respiratory failure

190

Chronic obstructive pulmonary
disease w MCC

191

Chronic obstructive pulmonary
disease w CC

192

Chronic obstructive pulmonary
disease w/o CC/MCC

193

Simple pneumonia &
pleurisy w MCC

194

Simple pneumonia &
pleurisy w CC

195

Simple pneumonia &
pleurisy w/o CC/MCC

247

Perc cardiovasc proc w
drug-eluting stent w/o MCC

287

Circulatory disorders except
AMI, w card cath w/o MCC

291

Heart failure & shock w
MCC

292

Heart failure & shock w
CC

293

Heart failure & shock w/o
CC/MCC

310

Cardiac arrhythmia &
conduction disorders w/o CC/MCC

312

Syncope & collapse

313

Chest pain

379

G.I. hemorrhage w/o CC/MCC

392

Esophagitis, gastroent &
misc digest disorders w/o MCC

470

Major joint replacement or
reattachment of lower extremity w/o MCC

603

Cellulitis w/o MCC

641

Nutritional & misc
metabolic disorders w/o MCC

683

Renal failure w CC

689

Kidney & urinary tract
infections w/ MCC

690

Kidney & urinary tract
infections w/o MCC

871

Septicemia w/o MV 96+ hours w
MCC

885

Psychoses

906

Hand procedures for injuries

Submit the following question to think
about as you design this:

Who will be responsible for providing education
regarding coding issues?
Who will be responsible for arranging clinical
education sessions?
Who will audit charts?
Who will answer coding questions for the coders?
Who will monitor coding improvement and provide
progressive discipline when required?
Note: The more administrative
duties given to the data quality auditor, the fewer number of charts he or she
can review on a daily basis.

Please
also include the following:

A schedule that
optimally utilizes the data quality auditor’s position before scheduling
external reviews that have an additional cost. The data quality auditor’s
review schedule should be designed not to delay the completion of accounts
for billing. If the DQA has piles of charts to review, then the bills are
not being released for payment. The workflow must be logical.
There should be at
least one education session per month. The month of September should
include an in-service for ICD-9-CM updates, and December should include an
in-service for CPT/HCPCS updates. Keep in mind that scheduling too many
sessions per month may negatively affect productivity.

Educational topics should be related to clinical areas
where there was significant MS-DRG coding variation [Respiratory, Cardiology
and Vascular Services].
Educational topics should relate to coding areas
identified in the Variation Log by Type of Error including:

Correct coding of
major complications and comorbidities and complications and comorbidities

i.
This is again emphasized in the MS-DRG relationship assessment where
several pairs of with and without MCC/CC MS-DRGs are reported at a higher rate
at the hospital than in the state.

Correct sequencing
of diagnoses
Specificity of codes

i.
A conversation regarding documentation issues may be warranted here.

Be CREATIVE!

Reporting coding quality statistics:

How are you going to
maintain the coding quality statistics? I

Rewards, etc.
1. How are you going to
reward your team, think about what incentives you appreciate at your current
position or a previous position.

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