View the DRG Lookup Table

The DRG Lookup Table page displays the FinThrive DRG code definition. Use this procedure to access the DRG Lookup Table page.

  1. Access the DRG Lookup Table page.
    • Select Go To > Contract Research > Contract Profiles. The Contract Profile page opens.
    • Select the contract name from the Profiles list. For more information about searching for a contract profile, refer to Select Contract Profile Research Criteria.
    • Click Display Profile. The View Contract Profile page opens.
    • Click a link in the Service Type column. The DRG Lookup Table page opens.
  2. View the DRG information.
    • The termination date for the DRG code, if any, appears above the table.
    • If there are multiple DRG grouper versions present, all versions display. The version is indicated in the Version column.

The following table describes each of the fields on the DRG Lookup Table page. For internal users only, the source information is given for some fields, in the format: “Table.Field.” The URL for this page is drg_lookup.asp.

Field

Description

DRG Code

Numeric Diagnosis Related Group code

Source: Billmast.DRG

DRG Description

Meaning of the DRG code

DRG Payment

Payment consisting of the DRG weight multiplied by the conversion factor. Includes pass-through amounts

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

High Trim

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

Low Trim

Day the account is eligible for the outlier

Outlier/High Charge

Point at which additional payment due to high cost of care is allowed

Standard Days

National average length of stay for patients with this DRG