DRG Cost or Day Outlier code

SAS Name
DRG_OUTLIER_STAY_CD

The code identifying if the stay has an unusually long length (day outlier) or high cost (cost outlier)

Comments

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

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