From Report on Medicare Compliance - Clinical validation is changing the nature of MS-DRG audits, which are eating away at hospital revenue. As Medicare auditors layer clinical validation onto coding validation, diagnoses that affect MS-DRG assignment may not be safe just because the physician documented them. “The bulk of recent audit findings are related to medical necessity, but there is still a lot of money at risk with DRG validation,” says Sandra Routhier, senior healthcare consultant for Panacea Healthcare Solutions. Read more