Dubai Health Authority
IR DRG Event
12 December, 2016
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How to read the IR-DRG number
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MBDS
 Unique patient identifier
 Birth Date or Age in years (if 0
year old : age in days)
 Encounter identifier
 Admit-Discharge Date
 Provider Organization/
Responsible physician
 Location of service
 Encounter Type
 Discharge Status
 Principal Diagnosis
 Secondary diagnoses
 Activities Interventions/procedures
Patient Weight – if age < 8 days on
admission (newborns & neonates)
IR-DRG Code
IR DRG ALOS (not submitted on claim )
High Trim
(not submitted on claim )
Low Trim
(not submitted on claim )
Severity of Illness (SOI
Risk of Mortality (ROM)
Present on Admission (POA)
indicator
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Example of a Grouped Encounter
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Example 2
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eClaimLink Updates
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New Fields
DxInfoType – The type of additional information for the diagnosis
▪ The field is mandatory, with default value = POA Present on Admission
DxInfoCode – Value indicating the POA status
▪ Y= Yes, N = No, U= Unknown, W= Clinically Undetermined, 1= Unreported/Not used, OP= Outpatient claim.
▪ Full definitions of the values are available in the eClaimLink schema CommonTypes, XSD and Sample
▪ OP transactions do not require DRGs at this time.
CommonTypes
CommonTypes
XSD
CS Sample
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New Fields
Patient Weight - Required for newborn and neonate encounters.
▪ Age on admission is 7 days or less
▪ Ex: A baby born on 1 October (day 0) remains a neonate until completion of 7 days on 8 October and is no longer a
neonate on 9 October.
XSD
CommonTypes
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Updated fields/definitions
ActivityType – a new type was added to accommodate the DRG code.
▪ Type 9: DRG
▪ A predefined list of DRG codes as published on the eClaimLink website.
ObservationType – two new observation types are added to accommodate the
DRG related details
Type 1: ROM = Risk of Mortality
 This is based on the primary and secondary diagnosis and it is supplied by the DRG grouper along with the
DRG code
 Possible values = 1, 2, 3
Type 2: ExcludeFromDRG
 This is used to indicate that an activity from the DRG will not be claimed from insurance
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ClaimSubmission Sample

All activities should be listed with Net = amount requested from the payer

The DRG activity should be listed with Net = 0
DRG code
Diagnosis
Granular activities
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Q&A
Regulatory – [email protected]
Data – [email protected]
Grouper – [email protected]
eClaimLink – [email protected]
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