NCH DRG Outlier Approved Payment Amount

SAS Name
NCH_DRG_OUTLIER_APRVD_PMT_AMT

On an institutional claim, the additional payment amount approved by the Quality Improvement Organization due to an outlier situation for a beneficiary's stay under the prospective payment system (PPS), which has been classified into a specific diagnosis related group (DRG).

This variable will typically include the total outlier payment amount, if any, for the claim.

Comments

Source: NCH QA Process