Inpatient coding and DRG validation
You learned to code what's written. Inpatient pays you to know it's true.
Taught by a nurse who validates DRGs for payers. You don't need to be a nurse to read the chart like one.
Who this is for
You already know how to code. This is about the chart.
01 · Already inpatient
Your audit came back marked wrong.
You coded what was documented. The feedback tells you what changed, never why.
02 · Outpatient now
Every inpatient posting wants experience.
PCS is the wall. Walk into the interview already building codes from the op note.
03 · Looking up
You want DRG validation.
Validators don't code the chart. They challenge it, on MS-DRG and APR-DRG claims alike.
What changes when you go inpatient
Four reversals your outpatient training never covered.
Reversal 01 · ICD-10-PCS
Build the code from the op note, not the index.
Root operation first, then one character at a time.
Reversal 02 · Outpatient habits
Probable, suspected and likely get coded.
At inpatient discharge, uncertain diagnoses are coded as if they exist. The principal diagnosis is the one found after study, and the POA indicator can decide whether a CC or MCC counts.
Reversal 03 · Two groupers
MS-DRG stops counting at the first MCC. APR-DRG keeps counting.
Medicare pays on MS-DRGs. About 30 state Medicaid programs pay on APR-DRGs, where the combination of secondaries sets severity of illness.
Reversal 04 · Clinical validation
Documented isn't the same as supported.
The provider wrote it and you coded it. It still has to hold up against the clinical indicators in the chart.
Who teaches it
I validate DRGs for payers. I know what the reviewer checks first.
My path ran through medical coding, risk adjustment, outpatient CDI and inpatient CDI before DRG validation, where I review inpatient claims on the payer side today. Most of my depth is in cardiology.
I started as an LPN. That's where my chart read comes from, and it's a skill you can learn without the license.
Jesse Gallop · LPN, CDIP, CCS, CCS-P, CPMA, CPB, CRC, HCS-D, HCS-O
AHIMA-Approved Trainer · AAPC-Approved Instructor
What coders ask first
Straight answers, before you ask.
01
"I'm not a nurse."
You don't need to be. You need to read the chart like one, and that can be taught.
02
"What if I'm not able to attend a class?"
Every class is recorded, so a missed class is never a missed lesson.
03
"Won't automation take this work?"
Automation is coding the X-ray. It isn't defending the DRG. One Midwestern health system now sends most eligible ancillary visits to billing with no coder review, and moved its coders to complex cases.
Source: HFMA, February 26, 2026
Other ways in
One to one · 60 minutes · $99
Audit feedback review
Bring the audit you don't understand, with every patient identifier removed. We go through it one to one, line by line.
Book a reviewCareer support
Interview prep
Mock interviews for DRG validation auditor roles, plus résumé and cover letter review.
See interview prepFor coding managers
Training a team?
Team seats and private cohorts for inpatient coders who need the same chart read.
Ask about team trainingLearn it live
Read the chart the way the reviewer does.
Every upcoming training for inpatient coders, in one place.