Diagnostic Related Groups (DRG)
A grouping of disease and disorders into medically meaningful sets as developed by the Centers for Medicare & Medicaid Services (CMS).
This reimbursement system consists of established payment levels for groupings of patients according to medically meaningful characteristics. There are six major criteria, which are utilized in assigning a particular admission to a specific DRG.
These consist of:
- Patient's principal diagnosis
- Procedures performed on the patient
- Patient's age
- Patient's gender
- Patient's discharge status
- Multiple diagnoses, complications or comorbid conditions.
