Class: Encounter_drg

Description of: Encounter_drg

Class steward is Patient Administration
A broad categorization, based primarily upon included procedures and diagnoses, that applies to the Healthcare event as a whole. Used for grouping and evaluating Healthcare encounters with respect to duration of care and cost.

Attribute definitions for: Encounter_drg

approval_ind

An indication that the DRG assignment has been or has not been approved by a reviewing entity.

Rationale: DG1^9 was retained in v2.3 for backward compatibility only. This field isan indicator and the definition should clearly reflect that.

assigned_dttm

The date and time the DRG was assigned to the encounter.

|DRG^2^00769^DRG Assigned Date/Time |

confidential_ind

An indication as to whether the DRG assigned to this encounter contains a confidential diagnosis.

|DG1^18^00767^Confidential Indicator| |DRG^10^00767^Confidential Indicator|

cost_outlier_amt

The amount of the encounter cost that is beyond the standard cost amount for the assigned DRG.

Rationale: DG1^13 was retained for backward compatibility only.

desc

A description providing additional information about the assignment of the DRG to the encounter.

grouper_review_cd

A code indicating that the grouper results have been reviewed and approved.

Rationale: DG1^10 was retained for v2.3 for backward compatibility only.

grouper_version_id

The version and type of the grouper used to derive the DRG.

Rationale: DG1^14 was retained for v2.3 for backware compatibility only and the DRG reference should be used.

|URS^4^00055^R/U What User Qualifier|

outlier_days_qty

The number of days beyond the standard day count for the assigned DRG.

Rationale: DG1^12 was retained for v2.3 for backward compatibility only

outlier_reimbursement_amt

The portion of the total reimbursement amount designated for reimbursement of outlier days or costs.

|DRG^9^00771^Outlier Reimbursement|

outlier_type_cd

A code depicting the type of outlier (day, cost) associated with the encounter DRG.

Rationale: This is the v2.3 reference

|DG1^11^00385^Outlier Type| |DRG^5^00385^Outlier Type|

Association definitions for: Encounter_drg

is_assigned_to (1,1) :: Inpatient_encounter :: is_assigned (0,n)

is_assigned_by (1,1) :: Organization :: assigns (0,n)

is_an_assignment_of (1,1) :: Diagnostic_related_group :: is_assigned_as (0,n)