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This variable is contained in the following files: Inpatient (Fee-for-Service)
Short SAS Name
OUTLR_CD
SAS Name
CLM_DRG_OUTLIER_STAY_CD

On an institutional claim, the code that indicates the beneficiary stay under the prospective payment system (PPS) which, although classified into a specific diagnosis related group, has an unusually long length (day outlier) or exceptionally high cost (cost outlier). 

Comments

Source: NCH

CodeCode value
0
No outlier
1
Day outlier (condition code 60)
2
Cost outlier, (condition code 61)
***Non-PPS Only***
CodeCode value
6
Valid diagnosis related groups (DRG) received from the intermediary
7
CMS developed DRG
8
CMS developed DRG using patient status code
9
Not groupable