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February 10, 2023

A 52-year-old patient is admitted for CABG. She also has a history of DM II, HTN, and hyperlipidemia. After surgery, the patient recovers, and her hospital stay is without complica

Scenario: A 52-year-old patient is admitted for CABG. She also has a history of DM II, HTN, and hyperlipidemia. After surgery, the patient recovers, and her hospital stay is without complication. She is discharged on day 4 to home with home health services to start within 3 days of her discharge. DRG Information DRG= 236 MS DRG Payment=$24,000 Answer the following questions based on the scenario above. Utilize the CMS Tables to also complete your answer.
1. Is DRG 236 a Transfer DRG?
2. What is the GMLOS for DRG 236?
3. What is the LOS of the patient?
4. Does this qualify for TDRG reimbursement?
5. What is the per diem amount?
6. What is the DRG payment for this patient?
7. How many transfer DRGs are there?
8. How many special pay DRGs are there?

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