#13 A hospital has 290 inpatient cases that are assigned to DRG 169, which has a relative weight of 1.106. What is the total relative weight for the cases?

a. 49,010.00

b. 54,205.06

c. 320.74

d. 262.21

Pay-for-performance (P4P) initiatives link reimbursement to health care performance criteria to promote the right care for every patient every time, regardless of a patient's ethnicity, gender, geographic location, and socioeconomic status, patients receive “right care." Which is an example of a P4P initiative?

a. Medicare physician fee schedule

b. hospital inpatient prospective payment system

c. intensity of services and severity of illness

d. hospital value-based purchasing program

Apply the ICD-10-CM Official Guidelines for Coding and Reporting of the Principal Diagnosis for Inpatient Care (Guidelines I A- J) to identify the principal diagnosis in the following scenario.

The patient was admitted to the hospital for a total right knee replacement for osteoarthritis of the knee. During the patient's preoperative preparation, the patient began having chest pain. The patient's knee surgery was canceled, and the patient had extensive testing to determine the source of the chest pain, which was determined to be due to hypertensive heart disease.

Established patient seen in PCP's office for LLQ pain, diagnosis appendicitis, level 2 E/M, arrangements for surgery made and patient heading to hospital. Assign code with appropriate modifier.