MS-DRG Grouper for ICD-10-CM and ICD-10-PCS - Diagnosis-Related Groups
quickly calculate the DRG based on ICD-10-CM and ICD-10-PCS codes
The DRG-Grouper is used to calculate payments to cover operating costs for inpatient hospital stays. Under the inpatient prospective payment system (IPPS) each individual case is categorized into a diagnosis related group – DRG. Payment weights are assigned to each DRG based on average resources used to treat Medicare patients in that DRG.
Access to this feature is available in the following products:
Facility Inpatient Reimbursement Tools
Find-A-Code Facility Complete
Select the "demo" button to view sample results.
About Diagnosis-Related Groups (DRG)
The Centers for Medicare and Medicaid Services (CMS) developed the DRG (Diagnosis-Related Group) payment system to determine reimbursement amounts for acute care in hospitals and critical access hospitals. DRGs are assigned by a "grouper" program (such as the one shown here) based on ICD (International Classification of Diseases) diagnoses, procedures, age, sex, discharge status, and the presence of complications or comorbidities.
DRGs are used to determine how much Medicare reimburses the hospital for each "product" (a grouping of procedures, services and supplies), since patients in each DRG category are deemed to be clinically similar. DRGs may be further grouped into Major Diagnostic Categories (MDCs). DRGs are also standard practice for establishing reimbursements for other Medicare related reimbursements such as to home healthcare providers.
To use Find-A-Code's MS-DRG grouper...
Enter a ICD-10-CM principle diagnosis, as well as any ICD-10-CM secondary diagnoses and ICD-10-PCS procedures, in the boxes below.
Select the "more" links for additional boxes. When done, select the "group" button. The resultant DRG will display below.