A nurse is working at a facility as part of a group involved with billing. Which data would the group most likely use to categorize clients for a system of prospective payment?
A) ICD codes with clinical modifications (ICD-CM)
B) Diagnosis-related groups (DRGs)
C) Healthcare Common Procedure Coding System
D) Alternative Billing Code Set

Question

Quizplus · Accepted Answer

Diagnosis-related groups (DRGs) are used to categorize patients for the purpose of prospective payment systems. DRGs classify patients into groups based on their diagnoses, procedures, age, sex, and discharge status, which allows for the establishment of a fixed fee for hospital services, thereby facilitating the management of healthcare costs.

A Nurse Is Working at a Facility as Part of a Group