Coding and Grouping

An Admissions is considered to been coded when it has been 'grouped' (had the DRG - Diagnosis Related Group code set). Note: Users completing this process require a specific privilege - please contact your System Administrator.

There are two ways to code an Admission in CareRight:

• Manually
• Automatically - utilising the integrated grouping software

Clinical Coding Expertise

CareRight is a sophisticated tool designed to collect admission data and produce the extract files for the federal and state statutory reporting bodies. However, Clintel support staff are not coding experts and are not qualified to advise on what clinical data should be entered for an admission.

You need to engage with a qualified clinical coder to establish which values should be entered against each admission. To code an Admission in CareRight you need the appropriate access - this can be granted by your System Administrator.

Manual Grouping

To manually group a admission you or your coder will need to have access to a third party coding product.

Automatic Grouping

CareRight Integrates with 3M grouping software*. This process utilises the Diagnosis and Procedure codes and determines the relevant DRG. Note: If you have a Diagnosis Related Group (DRG) or Major Diagnostic Category (MDC) already entered, then these will be overwritten when the grouper returns the DRG and MDC.

Grouping a Record

1. Search for a patient.
2. Click Show.
3. Select the relevant Admission.
   1. Note: Before pressing Group, you need to add at least one diagnosis to the admission record.
4. Select the Group button.
   1. You will see a message confirming that the Episode has been submitted for grouping.
5. Within ~2 minutes, if the grouping has been successful:
   1. A message will appear on the Admission > Show screen: This episode has been grouped successfully.
   2. The admission record will be updated with a Diagnosis Related Group (DRG) and Major Diagnostic Category (MDC).

Troubleshooting:

• If you receive an error message back from the Grouper - please contact 3M to remedy.
• If you do not receive a response back from the Grouper within 15 minutes then please contact Clintel Support.

* A licence and subscription is required with Clintel and 3M to use the Grouping integration.