More than 350 guidelines that contain acute care inpatient review criteria with MS-DRG and APR-DRG Length of Stay data.
Evidence-based, with comprehensive reference links.
Provides utilization management and claims departments with essential information to assist in medically-necessary benefit determinations.
Includes a section entirely devoted to Managing Unplanned Readmissions, which includes issues, innovative programs, resources and strategies needed to manage CMS targeted readmission diagnoses and avoid financial penalties.
Detailed review criteria by MS-DRG focus on medical necessity and appropriateness of care.
Search guidelines by DRG, CPT/HCPCS, ICD-9 or keyword.