Royal Melbourne Makes Successful Transition to DRG 8 with a Coding and Documentation Audit Program

Australia transitioned from DRG 7 to DRG 8 in July 2016.

In response to this change Royal Melbourne developed a comprehensive coding and documentation audit program, encompassing all clinical specialties. A few key responsibilities of this program are:
• Coders look for probable diagnoses that have not been documented and request clinician review and confirmation. If confirmed these conditions must be coded and the episode re-grouped.
• Clinicians are reminded that they must document all diagnoses monitored

As a result, 2015/16 to date, 11% of Weighted Inlier Equivalent Separations (WIES) funded separations have been audited, realising $30M in additional WIES revenue.

Click here to view a summary slide of the Innovation.