A client is admitted with chest pain. a series of diagnostic tests are ordered, and the client undergoes coronary artery bypass
grafting. the cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (icu) stay by 3 days because of respiratory problems. the case manager realizes that under the terms of the diagnosis-related group (drg) payment system for this diagnosis:
Although the cost of care for this client was greater than the DRG reimbursement amount, the hospital will be reimbursed only at the set fee.
Explanation;
-A Diagnosis-Related Group (DRG) is a statistical system of classifying any inpatient stay into groups for the purposes of payment.
-It divides possible diagnoses into more than 20 major body systems and subdivides them into almost 500 groups for the purpose of Medicare reimbursement.
