| Business Data Model Data Model |
| Description | An association between an encounter and a diagnosis related group (DRG). Indicates the DRG assigned to a given encounter based on the logic of a specific DRG grouper. An encounter can be assigned more than one DRG if different groupers are run for the encounter. |
| Relationship | |
 Encounter / DRG_Diagnosis Related Group_FK |
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| Encounter / DRG_Encounter_FK |
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| Encounter / DRG_ Translated Diagnosis Related Group_FK |
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| Dependencies | |
 NONE |
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| Reverse Dependencies | |
| |
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| Attribute Details |
Confidential Ind
| Description | Indicates whether or not the DRG contains a confidential diagnosis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Currency
| Description | The currency that is used as the basis for all monetary amounts. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
DRG Approval Ind
| Description | Indicates whether or not the DRG has been approved by a reviewing entity. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
DRG Grouper
| Description | Diagnosis Related Group Grouper. Identifies the grouper used to assign this diagnosis related group. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
DRG Grouper Review
| Description | Indicates that the grouper results have been reviewed and approved. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
DRG Payor
| Description | Indicates the associated DRG Payor. For example: Medicare Champus Managed Care Organization |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
DRG Transfer Type
| Description | Indicates the type of hospital receiving a transfer patient, for example, exempt or non-exempt. This affects how a facility is reimbursed under diagnosis related group (DRG). |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
DRG Translation Date
| Description | The date on which the diagnosis related group (DRG) code translation was performed. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
DRG Translation Rule Applied
| Description | The business rule used to perform the diagnosis related group (DRG) translation. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
DRG Translation Rule Descr
| Description | A textual description of the business rule used to perform the Diagnosis Related Group (DRG) translation. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Outlier Cost Amt
| Description | The amount of money that has been approved for an outlier payment. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Outlier Days Cnt
| Description | The number of days that have been approved as an outlier payment. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Outlier Reimbursement Amt
| Description | The part of the total reimbursement designated for reimbursement of outlier conditions (day or cost). |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Outlier Type
| Description | Indicates the type of outlier (i.e. period of care beyond DRG-standard stay in facility) that has been paid. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Relationship Type
| Description | Identifies the type of the relationship as defined in the business data model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
Encounter / DRG_Diagnosis Related Group_FK
| Is Identifying Relationship | true |
| Child Table | Encounter / DRG |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Diagnosis Related Group |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Encounter / DRG_Encounter_FK
| Is Identifying Relationship | true |
| Child Table | Encounter / DRG |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Encounter |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Encounter / DRG_ Translated Diagnosis Related Group_FK
| Is Identifying Relationship | false |
| Child Table | Encounter / DRG |
| Child Role Name | translated DRG |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Diagnosis Related Group |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
| Business Data Model Data Model |