VLAB MS-DRG EVALUATION QUESTIONS AND ANSWERS 2024/2025

Which two diagnostic conditions provide the highest weighted DRG when each is selected for the principal diagnosis for this Part 1 case scenario? Select the top two. → I5042 → J129 Coding guidelines indicate that which of the following diagnoses should be listed as the principal diagnosis for the Part 1 case scenario? → Either is appropriate dependent on physician query What effect does the addition of a patient who is a pack-a-day smoker have on the DRG assignment when viral pneumonia is the principal diagnosis? → no effect on the DRG Which of the following coding rules might affect the ethical and appropriate assignment of the principal diagnosis and DRG for this case? Select all that apply. → 1. Respiratory failure is always due to an underlying condition. → 2. Careful review of the medical record is required for accurate coding and sequencing of respiratory failure. → 3.Respiratory failure may be assigned as the principal diagnosis when it meets the definition and the selection is supported by the alphabetic and tabular listing of ICD10-CM. → 4. The principal diagnosis should be based on physician query to determine whether the pneumonia or the respiratory failure was the reason for the admission. 2 0 2 4 /2025 | © copyright | This work may not be copied for profit gain Excel! 1 | P a g e | G r a d e A + | 2 0 24 / 2 0 2 5 The physician indicates that both the pneumonia and the respiratory failure are equally responsible for the admission of the patient to the facility. The coding professional and/or healthcare analyst should: → Report the viral pneumonia because it yields the higher paying, most appropriate DRG Which of the following principal diagnoses produces the highest paying DRG? → fracture of left tibia Which of the following diagnoses meets the definition of principal diagnosis for the Part 2 case scenario? Select all that apply. → STEMI → Fracture of the left tibia → Dislocation of the patella Which of the following diagn