The diagnostic related group to which a hospital claim belongs for prospective payment purposes.
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Starting in January 2021 with NCH version L, this field changed from 3 characters to 4.
GROUPER is the software that determines the DRG from data elements reported by the hospital.
Once determined, the DRG code is one of the elements used to determine the price upon which to base the reimbursement to the hospitals under prospective payment.
Nonpayment claims (zero reimbursement) may not have a DRG present.
Starting in January 2021 with NCH version L, this field changed from 3 characters to 4.
GROUPER is the software that determines the DRG from data elements reported by the hospital.
Once determined, the DRG code is one of the elements used to determine the price upon which to base the reimbursement to the hospitals under prospective payment.
Nonpayment claims (zero reimbursement) may not have a DRG present.
Source: NCH