--- title: Coding Q & A with ECLAT Expert - Marie Thomas description: medical coding Q & A with medical coding company ECLAT Expert - Marie Thomas. image: https://www.eclathealth.com/hubfs/Untitled-design-14.png --- [![ECLAT 2](https://www.eclathealth.com/hs-fs/hubfs/ECLAT%20Corporate%20Logo/ECLAT%20Corporate%20Logo%20with%20Tagline/ECLAT%202.png?width=225&height=84&name=ECLAT%202.png)](https://eclathealth.com)   [Contact Us](https://eclathealth.com/index.php/contact/)[subscribe](https://www.eclathealth.com/en/newsroom/coding-q-a-with-eclat-expert-marie-thomas#) ### I’d like to learn more about ECLAT Health Solutions! read # Coding Q & A with ECLAT Expert - Marie Thomas Posted By Giovanna Stahl ![medical coding company](https://www.eclathealth.com/hubfs/Untitled-design-14.png) - ** - ** - ** ## Question: J96.00 (Principal DX) – Acute respiratory failure, unspecified whether with hypoxia or hypercapnia S06.6X6A (Admitting DX) – Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter 00N.00ZZ (Principle Procedure Code- ICD-10-PCS) – Release Brain, Open Approach What would be the appropriate APR DRG, is it 020-1, 020-2, 020-3, or 020-4, or something else? ## Answer: All Patient Refined Diagnosis Related Groups (APR-DRGs) are similar to Medicare Severity Diagnosis Related Groups (MS-DRGs) in that they are calculated from a preassigned numerical weight listing - multiplied by a fixed dollar amount based on each individual provider.  The base rate of APR-DRG is derived from how sick the patient is via codes assigned, considering the severity of illness and the risk of mortality.  APR-DRGs are unlike MS-DRG’s in that the base rate for MS-DRG is calculated from the codes assigned from a single complication or comorbidity.  Medicare groups claim using MS-DRG for reimbursement.  Some Medicaid, Workers' compensation, no-fault, and commercial payers group to APR-DRG for reimbursement.  3M developed the APR-DRGs version (v#) and provide updates annually.  It is important to work with payers to understand the APR-DRG listing and weights. Using the 3M APR-DRG grouper Version 18.3.1.0 (131), PDX J96.00 admitting DX S06.6X6A PCS 00N00ZZ, the APR DRG is 950 SOI = 1 ROM = 2 (a relatively low-risk patient based on the coding) If the documentation supports the PDX J96.00 admitting DX S06.6X6A and secondary diagnosis S06.6X6A with the PCS 00N00ZZ the APR DRG is 10 and the SOI = 3 and ROM = 4 (these codes reflect a much sicker patient with risk of dying). [https://support3mhis.com](https://support3mhis.com) [www.cms.gov](http://www.cms.gov) Tags: [Coding](https://www.eclathealth.com/en/newsroom/tag/coding), [Medical Coding](https://www.eclathealth.com/en/newsroom/tag/medical-coding) ### Related Articles** ## [Coding Review: Viral vs. Bacterial Pneumonia](https://www.eclathealth.com/en/newsroom/coding-review-viral-vs.-bacterial-pneumonia) *( read )* Topics: [Coding](https://www.eclathealth.com/en/newsroom/tag/coding), [Medical Coding](https://www.eclathealth.com/en/newsroom/tag/medical-coding) ## [Split/Shared E/M Visits](https://www.eclathealth.com/en/newsroom/em-visits) *( read )* Topics: [Coding](https://www.eclathealth.com/en/newsroom/tag/coding), [Medical Coding](https://www.eclathealth.com/en/newsroom/tag/medical-coding) ## [Know the Code- Resistant Hypertension](https://www.eclathealth.com/en/newsroom/resistant-hypertension) *( read )* Topics: [Coding](https://www.eclathealth.com/en/newsroom/tag/coding), [Medical Coding](https://www.eclathealth.com/en/newsroom/tag/medical-coding) ### Subscribe to The ECLAT Blog ### Follow Us - [****](https://www.linkedin.com/company/eclat-health-solutions) - [****](https://www.facebook.com/eclathealthsolutions) - [****](https://twitter.com/eclathealthsol) - [****](https://eclathealth.com/index.php/contact/) ### About ECLAT ECLAT Health Solutions, Inc. (ECLAT) partners with some of the country's largest health systems and government payers. Our Business Processing Outsourcing (BPO) and technology solutions provide revenue intelligence that enables our clients to reduce costs and improve revenue recognition and cash flow. Our ability to improve clients' outcomes through flexible, scalable services and technologies sets ECLAT apart from our competitors. ECLAT is a U.S. private-equity company with offices in the US and internationally. [![ECLAT all white logo](https://www.eclathealth.com/hs-fs/hubfs/ECLAT%20all%20white%20logo.png?width=2206&name=ECLAT%20all%20white%20logo.png "ECLAT all white logo")](https://eclathealth.com/) - [CONTACT US](https://eclathealth.com/index.php/contact/) - [CAREERS](https://eclathealth.com/index.php/careers/) 13221 Woodland Park Road Suite 420 Herndon, VA 20171 Main Office: [(703) 665-4499](tel:7036654499) © 2021 ECLAT Health Solutions ![](https://ws.zoominfo.com/pixel/6Wp2Zfvbb1SrrOIyFGtd)