Q&A: DRG code book for CCDS exam

Q: I am wondering why it is recommended to bring a DRG code book when taking the ACDIS CCDS certification exam? Most CDI programs use online software, and many teams are remote now. Are programs buying code books for their staff?

A: The CCDS exam allows candidates to bring the DRG Expert reference into the exam as a resource. While the CCDS Certification Committee recognizes the use of a number of tools and references in our daily work, the DRG Expert has a number of references that can assist you in your exam success. The DRG Expert is not a code book. It is a reference book that allows you to group an encounter to the most appropriate DRG. It is, in essence, a manual replacement for grouping software.

We obviously cannot allow internet access while taking the exam, so the use of encoders/groupers cannot be used. Additionally, due to the wide variety of CDI software tools we cannot assure standardization in using such a tool for the exam. Thus, we have allowed you the ability to use the DRG Expert.

That said, many individuals take the exam without this reference and pass the exam successfully. It is your choice if you wish to bring this book to the exam.

. If someone uses encoder and grouper software to assist in identifying the working DRG, they may not actually understand the underlying logic involved as to why a medical encounter groups to one DRG or another. CDI professionals need to understand the Official Guidelines for Coding and Reporting, as well as coding instructions contained within the Alphabetic Index and Tabular List of the ICD-10-CM code set. Correct code assignment drives MS-DRG assignment. And, of course, capturing the documentation needed to ensure accurate code assignment is what CDI is all about. This knowledge is different than the ability to input information into a software program. As you are aware, this software is only as strong as the user, and one can easily get to the wrong DRG using an encoder.

We encourage CDI professionals to familiarize themselves with ICD-10-CM and code books, and the DRG Expert. ACDIS consistently teaches this in its educational programs. This foundational learning contributes strongly to one’s success in the role, but you don’t need to purchase a code book to learn this. You can download both the Alphabetic and Tabular Lists for ICD-10-CM and the Guidelines from CMS. The electronic code book can be found here and is available at no cost.

Editor’s Note: Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC, ACDIS interim director, answered this question. Contact her at lprescott@hcpro.com.