Excellent question as we have that same concern. We double check all DRG's submitted which sometimes results in our changing them to process the claim.
Claudia Melendrez
Service Manager
923-6736
3-222-6736
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Monday, July 15, 2002 8:38 AM
To: [EMAIL PROTECTED]
Subject: TCS: 835 and DRG Processing
If we received a DRG code in on an 837 but our DRG processing software
reviewed the procedure and diagnosis codes and returned a different DRG
through our adjudication system, would we be noncompliant if we sent that
DRG code back out on the 835?
Kelly R.Davis
Nationwide Health Plans
HIPAA Project Coordinator
[EMAIL PROTECTED]
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