DRG Reimbursement

edited December 2016 in Inpatient Coding

I read an article on debridement and the changes with ICD-10. I am looking, but didn't see anything on how reimbursement will or can change (reduction in payment). I had a patient on a ventilator, with a decubitus ulcer. The patient had an excision debridement done down to the bone.

I feel that It was coded correctly with the information given. It has not been submitted for payment as of yet, but the expected reimbursement was approx. $72,000 due to the DRG 207. But, when the debridement was entered (excision down to the bone), the DRG changed and so did the reimbursement; it went down to $52,000. My thoughts are that maybe there are not enough MCCs or CCs to change the weights, or maybe it’s because the decubitus ulcer increased in size during the patient’s stay here.

Has anyone had a similar experience who could offer any advice? How would your facility code something like this?

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