CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue ButtonĀ®)
1.2.0 - STU 2 Ballot

This page is part of the CARIN Blue Button Implementation Guide (v1.2.0: STU 2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

CodeSystem: All Patient Diagnosis Related Groups (AP-DRGs)

Summary

Defining URL:http://uri.hddaccess.com/cs/apdrg
Version:1.2.0
Name:THREEMAPDRG
Title:All Patient Diagnosis Related Groups (AP-DRGs)
Status:Active as of 12/6/21 8:26 PM
Definition:

In 1987, the state of New York passed legislation instituting a DRG-based prospective payment system for all non-Medicare patients. The legislation included a requirement that the New York State Department of Health (NYDH) evaluate the applicability of the DRGs to a non-Medicare population. In particular, the legislation required that the DRGs be evaluated with respect to neonates and patients with Human Immunodeficiency Virus (HIV) infections. NYDH entered into an agreement with 3M HIS to assist with the evaluation of the need for DRG modifications as well as to make the necessary changes in the DRG definitions and software. The DRG definitions developed by NYDH and 3M HIS are referred to as the All Patient DRGs (AP DRGs).

The AP DRG code system is no longer updated as DRG classification system evolved to APR DRG. Evolution of DRG is summarized in the APR DRG methodology overview as well as in various articles.

Goldfield N. The evolution of diagnosis-related groups (DRGs): from its beginnings in case-mix and resource use theory, to its implementation for payment and now for its current utilization for quality within and outside the hospital. Qual Manage Health Care. 2010;19(1)3-16.

Averill RF, Goldfield NI, Muldoon J, Steinbeck BA, Grant TM. A closer look at All-Patient Refined DRGs. J AHIMA. 2002;73(1):46-49.

https://apps.3mhis.com/docs/Groupers/All_Patient_Refined_DRG/Methodology_overview_GRP041/grp041_aprdrg_meth_overview.pdf

Publisher:HL7 Financial Management Working Group
Content:Not Present: None of the concepts defined by the code system are included in the code system resource
Source Resource:XML / JSON / Turtle

This Code system is referenced in the content logical definition of the following value sets:

This code system http://uri.hddaccess.com/cs/apdrg defines many codes, but they are not represented here