Guidance on species combinations and reasons for accepting the 274d benefit (version 1.0)

The CKS in its DRG Data and Hospital Costing Working Group has prepared a guideline to specify more precisely the reporting of admissions to the ICU through the items Type of Admission (No.36) and Reason for Admission (No.37) from the Data Interface for Reporting of Inpatient Health Care Procedures under DRG DR274d. At the same time, the guideline specifies the obligations and options for merging inpatient cases from the Rules defining the calculation of the case lump sum and the rules for merging inpatient cases document.

Guideline document (version 1.0):

• Guideline-for-combinations-of-cases-and-cases-of-acceptance-of-claims-274d_1.0.pdf

The guideline is effective as of 1/1/2024. For the first time, health care providers will use the obligations and aggregation options from Table 1 for inpatient admissions with an admission date on or after 1/1/2024.