Clinical Documentation Integrity
Encounter: 95445509 MRN: 72325985 Working DRG: 630

DRG & Rules

AI review queue

1 item needs review

2 lower-priority findings are grouped to reduce repeated alerts.

Needs review
Hypokalemia documentation opportunity
Criteria are met and the finding may affect the working DRG.
Informational
2 related findings grouped
Shown together because they relate to the same documentation opportunity.
Potassium replacement documented
Treatment supports the existing opportunity.
Telemetry monitoring active
Supporting context; no immediate action required.
E87.6
Hypokalemia
DRG 293 DRG 292
+0.277 relative
weight
w/o CC/MCC w/ CC +$1,540
Our criteria Criteria met
  • Serum potassium below 3.5 mmol/L
  • Active monitoring (EKG / telemetry)
  • Treatment / repletion ordered
  • Potassium level documented as clinically significant
  • Replacement therapy documented in plan
  • Condition impacts active inpatient management

Case Summary

Age / Gender
72Y / Male
LOS
4 Days
Primary Diagnosis
Acute on Chronic Diastolic Heart Failure
Admission Source
Emergency Department

Risk Score

78
Moderate Risk
Predicted SOI: 3

Payer Info

Medicare A
Plan ID: MC-8892

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