DRG Creep

A method of coding diagnosis-related groups (DRGs) under Medicare’s prospective payment plan, in a fashion that does not conform to the ‘optimisation’ rules governing coding DRGs; DRG creep often errs in favour of the hospital by paying more than it should receive
Causes Misspecification, miscoding, and resequencing
Mentioned in ?
References in periodicals archive ?
11), foi o da atribuicao, aos pacientes internados, de DRG que nao correspondiam exatamente ao seu perfil, e sim a grupos de mais alta pontuacao, no fenomeno denominado de DRG creep.
Multiple studies did find evidence for DRG creep during the implementation of PPS (Steinwald and Dummit, 1989; Chulis, 1991; Hsia et al.
Only 60-65 percent of that increase is real, with the remainder reflecting "upcoding" or DRG creep.
The phenomenon of DRG creep suggests that health care professionals may be adjusting their best professional judgment of patients' diagnoses in favor of the best financial judgment.
We need ways to prevent DRG creep, to insulate health care professionals against financial pressures, and to maintain the vitality of informed consent.
Although some quality evaluations revealed little DRG creep, it is not entirely clear that the payers have in place the necessary evaluative mechanisms to determine DRG creep.
1987) and preventing so-called DRG creep (upcoding to maximize hospital benefits: Ginsburg and Carter 1986; Hsia, Krushat, Fagan et al.
DRG creep and miscoding under the prospective payment system.