DRG Outlier Approved Payment Amount ($)

This variable is contained in the following files:

SAS Name

DRG_OUTLIER_PMT_AMT

The amount of additional payment (rounded to whole dollars) approved due to an outlier situation over the DRG allowance for the stay.

Comments

This field is derived by accumulating the DRG outlier approved payment amount (value code = 17 amount) that is present on any of the claim records included in the stay (i.e., the sum of outlier amounts reported on the claims that comprise the stay).

This amount is already included in the MEDPAR Medicare payment amount (field called PMT_AMT).

Source: MedPAR (derived)