Class: Encounter_drg

Description of: Encounter_drg

Class steward is Patient Administration
A detailed categorization, based upon included procedures and diagonses, that applies to the encounter.

OpenIssue: 1) This description does not appropriately appear to fit with the actual meaning of the class itself and is internally inconstent.. 2) The meaning of this class is ambiguous based upon its instance connections and attributes.

Attribute definitions for: Encounter_drg

approval_ind ::

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

|DG1^9^00383^DRG Approval Indicator| |DRG^3^00383^DRG Approval Indicator|

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.

|DG1^13^00387^Outlier Cost| |DRG^7^00387^Outlier Cost|

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.

|DG1^10^00384^DRG Grouper Review Code| |DRG^4^00384^DRG Grouper Review Code|

grouper_version_id ::

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

OpenIssue: Either the description or the attribute type of this attribute is wrong. If it is type ID, then it is simply 'The identifier of the grouper . . .' If it is both version and type, then there should be two attributes to hold this data.

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

outlier_days_nbr ::

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

Rationale: This attrubute is required to meet reporting requirements on DRGs as imposed by HCFA.

|DG1^12^00386^Outlier Days| |DRG^6^00386^Outlier Days|

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

OpenIssue: This attribute and the attribute outlier_reimbursement_amt do not work together. Either this is the outlier_reimbursement_type_cd or the definition of outlier_reimbursement should be changed to correspond to the definition of outlier_days_amt.

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

Association definitions for: Encounter_drg

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

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

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