You are the coding manager at XYZ Hospital and tasked with s…

You are the coding manager at XYZ Hospital and tasked with selecting cases for a random audit.  You obtain a list of all cases for the time period of the audit.  If there are 148 discharges for DRG 207 and you want to audit 10%, how many records will you pull (round UP to next whole number)?

Karen presented the Emergency Room for treatment for a lacer…

Karen presented the Emergency Room for treatment for a laceration.  She is a Medicaid patient and presents her identification and insurance card.  Her sister, Katherine, uses Karen’s card the following week when she visits the emergency room.  What is this an example of?