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This variable is contained in the following files:
SAS Name
DRG_OUTLIER_STAY_CD
The code identifying if the stay has an unusually long length (day outlier) or high cost (cost outlier)
| Code | Code value |
|---|---|
| 0 | No Outlier |
| 1 | Day Outlier |
| 2 | Cost Outlier |
| 6 | Valid DRG Received From Intermediary |
| 7 | HCFA-Developed DRG |
| 8 | HCFA-Developed DRG Using Claim Status Code |
| 9 | Not Groupable |
This field is the actual DRG outlier stay code that is present on the last claim record included in the stay for PPS providers.
For non-PPS providers, the DRG is obtained using the grouper software and outliers are identified.
Source: NCH