Diagnosis Related Group (DRG) 470 Module

This module is about the Major joint replacement or reattachment of the lower extremity (Diagnosis Related Group (DRG) 470). DRG 470 is one of Medicare's top volume Medicare Severity (MS) DRGs. Due to the high volume of these claims, CMS has had multiple entities - Recovery Auditors, Comprehensive Error Rate Testing (CERT) contractors and Medicare Administrative Contractors (MACs) - reviewing claims for these MS-DRGs. The findings have demonstrated very high paid-claim error rates among hospital and professional claims associated with major joint replacement surgery.