Add or Edit Schedule Data in a DRG Weight Table

When you want to add data to a DRG weight table, you may either add codes manually or import codes from another file.

Use this procedure to manually add data to a DRG weight table.

  1. Access the Edit Schedule page.
    • Select Go To > Contract Loading > Lookup Table Management. The Lookup Table Management page opens.
    • Click a link in the Table Name field of a table that is checked out to you. The Edit Lookup Table page opens.
    • Select DRG Weight for the Table Type.
    • Select Checked out by me for the Check Out Status, and then click Refresh View. A list of available tables appears.
    • Click the Edit Schedule link. The Edit Schedule page opens.
  2. Specify the data to add to the table, and then click Add.
    - or -
    Click Edit to change existing data, alter the data, and then click Update.
  3. Optionally, you can perform one of the following functions:
    • Click Clear to delete the data you entered and return each field to its default value.
    • Click Edit, and then click Delete to delete an entry.

The following table describes the fields on the Edit Schedule page for DRG weight tables.

Field

Description

Capital Amount

Equipment and facilities costs for a particular DRG

Differential

The difference between the DRG reimbursement and the prevailing rate at the time of the patient's admission.

Disp. Share

Reimbursement based on Disproportionate Share Hospital operating costs (if applicable); for facilities with a disproportionately high percentage of Medicaid and Medicare SSI patients

DRG

Diagnosis Related Group code

DRG Severity Code

The Severity of Illness code (1-5) associated with the DRG.

DRG Weight

DRG weight factor, established by Medicare for each DRG

Edit

Link for editing an item

High Charge Amount

Amount of the most recent DRG high charge outlier in the current contract document; i.e., the point at which additional payment due to high cost of care is allowed. National average length of stay for patients with this DRG.

High Trim Days

Fewest number of days a patient must stay in the hospital for the hospital to receive full insurance reimbursement

Indirect Medical Ed./Education

Reimbursement for Indirect Medical Education costs

Low Trim Days

Day the account is eligible for the outlier

No.

Sequential reference number of the item

Standard Days

National average length of stay for patients with this DRG

Type

Type of modifier to apply (percentage or units)

Updated

Date, time and user information of when the lookup table was last updated

Weight

DRG weight factor, established by Medicare for each DRG