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November 27, 1995

Delirium, DRGs, and Documentation-Reply

Arch Intern Med. 1995;155(21):2355-2356. doi:10.1001/archinte.1995.00430210105018

In reply  We agree with Kirkland that the failure of physicians to document the occurrence of delirium among hospitalized patients is a significant problem. In another publication, we have documented the poor outcomes and increased resource use of hospitalized patients with delirium.1 The suggestion that recognizing and documenting delirium could have implications for reimbursement was intriguing. We examined our data and found that among the 64 patients with delirium, there were 28 patients with a "paired DRG." Of these, 24 patients (86%) had the DRG associated with greater reimbursement, the diagnosis with CC designation, even though delirium was not listed as a complication. In our cohort, documenting delirium would have had an impact in four (14%) of 28 patients with a paired DRG, since most of the patients had other conditions or complications that resulted in the DRG associated with the higher reimbursement rate.As a result of our

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