Accurate and appropriate reimbursement for services is essential to the financial health of hospitals. Learn to navigate the ‘ins and outs’ of reimbursement for hospital inpatient services with Fundamentals of Reimbursement: Inpatient Services. Essential training for Coders, Clinical Documentation Improvement Specialists and other key actors in the hospital revenue cycle.
Fundamentals of Reimbursement: Inpatient Services
$99.00
CEUs: 1 1 AHIMA
1 AAPC
Included in eLearning Library.
Price per person. Group rates available.
Overview
Codes change yearly! We take seriously our obligation to provide you with accurate and up-to-date instruction. This course is updated for the FY 2026 code set.
Accurate and appropriate reimbursement for services is essential to the financial health of hospitals. Learn to navigate the ‘ins and outs’ of reimbursement for hospital inpatient services with Fundamentals of Reimbursement: Inpatient Services. Essential training for Coders, Clinical Documentation Improvement Specialists and other key actors in the hospital revenue cycle.
- Recognize key definitions and features of the Medicare Severity-Diagnosis Related Groups (MS-DRGs) and All Patient Refined DRGs (APR) systems
- Verify DRG assignment based on Inpatient Prospective Payment System (IPPS) definitions
- Evaluate the impact of code selection on Diagnosis Related Group (DRG) assignment
- Assign the present on admission (POA) indicator
- Identify features of the Medicare Code Editor (MCE)
- Recall the impact of assignment of the discharge disposition
Fundamentals of Reimbursement: Inpatient Services Syllabus
- Basics of DRG Reimbursement and Case Mix
- DRGs vs APCs
- DRG Reimbursement
- DRG Reimbursement weight
- Case mix interpretation
- MS-DRG System
- Hierarchy
- MDCs
- Subdivisions
- Other factors
- Divisions review
- Complications and comorbidities
- Appendix C – complications or comorbidities exclusion list
- Weights and other information
- Procedure unrelated to PDx
- Discharge status
- Appendices
- MS-DRG Calculation
- Transfer policy
- Steps for payment
- Present on admission (POA)
- 3 day payment window
- Other Medicare related payment issues
- Value based purchasing
- Hospital acquired conditions
- Reduction program (HACRP)
- Readmissions reduction program
- 2 midnight benchmark/rule
- Calculations
- Medicare code editor
- What is a MAC?
- DRGS: APR/DRG
- APR DRG Classes
- APR DRG assignment
- APR steps
- APR calculations
- MS-DRG vs. APR-DRG
The level of effort to complete this course, start to finish, is equivalent to 1 CEU and should take you approximately 1-3 hours to complete. Remember: You have access to the course materials for the full 4-week enrollment period and we encourage you to re-review any materials that are helpful to you.
Certificate of Completion
Upon successful completion of the course work, student will be able to download a Libman Education Certificate of Completion. The Certificate of Completion will list the course as awarding 1 CEU.
AHIMA: 1 CEU
This course has been approved for continuing education units (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
AAPC: 1 CEU
This program has the prior approval of AAPC for continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
- WebinarPlus™ multimedia and interactive online training format promotes engagement with challenging materials while offering independent self-study.
- Downloadable and printable “Course Highlights” saves time! This active learning tool assists with mastery of the course content.
- Teaching methods including audio and video files, diagrams, and animations to accommodate different learning styles. Where appropriate, the Merck Manual Professional Version supplements course materials with in-depth descriptions of diagnoses and/or procedures.
- Knowledge checks and/or final assessment ensure mastery of material.
- Online Flexibility! Materials available via secure Learning Management System (LMS). Work at your own pace — save time and travel costs.
- Earn Libman Education Certificate of Completion and CEUs.
- To receive CEU credit, students must achieve a passing rate on the course assessment(s).
- Course is self-paced. For planning purposes, assume 1-3 hours required for each CEU.
- Unlimited course access during enrollment period. For courses offering greater than one CEU, enrollment period is 16 weeks. For courses offering one or fewer CEUs, enrollment period is 4 weeks. Depending on the topic, some courses may offer an extended enrollment period. Courses purchased as a bundle or package may have a longer enrollment period.
- Extensions to the enrollment period are available.
- Price listed is per person/per course. Group rates available upon request.
“Very well put together and explained, as this subject can be confusing. Thank you!” — Certified Coding Specialist on Fundamentals of Reimbursement: Inpatient Services
“I’m pleasantly surprised at your response … really didn’t think I would receive anything at all, so, thank you! I believe that alone says a lot for Libman Education. I would recommend you to other coding professionals.” — Jennifer Jones, CPC
“LOVEEE Libman! Very happy with the classes I’ve taken.” — Linda C.
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“Thank you for all your help. Your team has always been open and dependable for clear advice and guidance. … [Y]our group has always shown they care about the student.” – former student
Required Resources:
- ICD-10-CM Code Book – 2026 or students may elect to use electronic files
- ICD-10-PCS Code Book – 2026 or students may elect to use electronic files
Recommended Resources:
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| How Many In Your Group? | Group Discount % |
|---|---|
| 1 | Retail Price |
| 2-4 | 5% Discount |
| 5-20 | 10% Discount |
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