Instructions Snapshot of how APR-DRG works 1. Review the primary and secondary diagnoses in each column below. 2. As you move from the left column to the furthest right column, pay attention to the changes in the information that is located in the grey sections at the bottom of each column as the diagnoses and the specificity of documentation changes. Primary dx: Primary dx: Primary dx: Primary dx: Primary dx: Pneumonia Secondary dx: Sepsis Secondary dx: Sepsis Secondary dx: Sepsis Secondary dx: Sepsis Secondary dx: Bacteremia Pneumonia Pneumonia Klebsiella Pneumonia Klebsiella Pneumonia Diastolic CHF Diastolic CHF APR DRG 720 SOI 3 ROM 3 RW: 1.1700 Acute Respiratory Failure APR DRG 720 SOI 4 ROM 4 RW: 2.7338 Diastolic CHF APR DRG 139 SOI 2 ROM 2 RW: 0.5793 APR DRG 720 SOI 2 ROM 2 RW: 0.7113 APR DRG 720 SOI 2 ROM 3 RW: 0.7113 Note 3. Remember that payment is determined by the Severity of Illness (SOI). 4. When documentation of the primary and secondary diagnoses is specific & detailed, the occurrence of appropriate coding and appropriate reimbursement of claims improves significantly. lcollingwood Sept 2014 Co-morbid conditions increase the SOI. The increase in SOI reflects the difficulty and costs that are involved in treating the patient.
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