A retrospective analysis using comorbidity detecting algorithmic software to determine the incidence of International Classification of Diseases (ICD) code omissions and appropriateness of Diagnosis-Related Group (DRG) code modifiers

We successfully used rules-based algorithms and raw structured EHR data to identify omitted ICD codes from inpatient medical record claims. These missing ICD codes often had downstream effects such as inaccurate DRG modifiers and missed reimbursement. Embedding augmented intelligence into this problematic workflow has the potential for improvements in administrative data, but more importantly, improvements in administrative data accuracy and financial outcomes.