DRG Groupers and Pricers

DRG Grouper

DRGs, used in the Medicare Inpatient Prospect Payment System (IPPS), are assigned based on a combination of principal and secondary diagnoses, procedures, and patient demographics.

IRP’s DRG Grouper component provides results identical (to the penny) to the calculations approved by CMS. Our DRG Grouper is designed for high performance and ease of integration into existing applications.

Features

  • Full­compatibility with CMS federal grouper
  • Includes relevant weights and factors for all U.S. providers
  • Automatic selection of proper grouper based on case discharge date
  • Ability to force a particular grouper to be used on a case­by­case basis
  • Can be called as subroutines from batch or interactive application programs
  • Support for up to 50 diagnoses and 50 procedures, including DRG and MDC titles
  • Validation of all diagnoses and procedures
  • Re­grouping analysis of all diagnoses on a single call
  • Ability to re­map ICD­9­CM codes from prior/future years to the target grouper
  • Flexible formatting of input and output data files without programming
  • Outstanding performance in single­ or multi­user environments
  • True multi­platform software to work within your existing environment and application systems: IBM MVS, AS/400, RS/6000, PC (Windows 98, NT, OS/2), UNIX (SUN, DEC, HP, IBM, SCO, etc.), DEC VMS
  • Updated for current ICD­9­CM changes
  • Current as well as prior federal groupers available
  • Toll­free technical support and periodic CMS updates
  • Customization services and custom interfaces available

Benefits

  • Ensures accurate DRG grouping
  • Includes accurate and timely CMS updates
  • Minimizes manual errors
  • Improves quality
  • Streamlines workflow
  • Saves development and maintenance costs
  • Supports high performance capabilities, effectively analyzing single cases or millions of cases
  • Easily integrates with existing applications on any platform
  • Comes with unlimited site license or low­cost distribution license

DRG Pricers

Our DRG Pricer is a DRG payment and pricing component designed to work with DRG Grouper. When combined, these components produce complete and accurate results for all hospitals in the United States.