← Work Queue|OKONKWO, SAMUEL74MMRN 9000008241 · Acct 402000030775 · South Coast GMCAdmit 07/13/2026 · Disch 07/17/2026
AI ScreenedLindqvist, Sarah MD (Hospitalist) · 07/13/2026 22:08
74-year-old male with HFrEF (EF 30%) admitted for acute decompensated heart failure with volume overload.
LABS: Creatinine 2.1 on admission, up from documented baseline of 1.1 three weeks ago.
ASSESSMENT AND PLAN: 1) Acute on chronic systolic heart failure: IV diuresis, daily weights, strict I/O. 2) Renal function: monitor while diuresing. 3) Continue GDMT as tolerated.
AI screening summary
Documented AKI meets KDIGO criteria and is confirmed by the attending on Day 2, but is missing from the working code set. Adding N17.9 as an MCC regroups the encounter from DRG 292 to DRG 291.
Acute Kidney InjuryKDIGO 2012 · Creatinine >=1.5x baseline within 7 days, or increase >=0.3 within 48h
2/2 metMet
- MetSerum creatinine >=1.5x baseline within 7 daysAdmission creatinine 2.1 vs baseline 1.1 (1.9x).
- MetProvider documentation of AKIAttending documented acute kidney injury in Day 2 progress note.
Code suggestionsCoder decision required on every line
N17.9MCCNEWAcute kidney failure, unspecifiedconf 92%
KDIGO stage 1-2 by creatinine criteria with explicit provider documentation of AKI on Day 2. Not captured in the current working code set.
I50.23PrincipalAcute on chronic systolic (congestive) heart failureconf 95%
Documented admission diagnosis; retained as principal.
DRG and estimated reimbursement (Medicare inpatient)
As coded
DRG 292wt 0.9741
Heart failure and shock with CC
$5,931.76
With N17.9 (if accepted)
DRG 291wt 1.3454
Heart failure and shock with MCC
$8,192.79
Potential reimbursement delta+$2,261.03
Payment = DRG weight x blended base rate ($6,089.48)