Adding a DRG Pricing Rule
To add a DRG pricing rule:
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From the Reference tab menu, click the DRG List Code hyperlink.
The system shows the DRG Codes List page.
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If the code you want to view is not shown on the page, select a category from the Filter By drop-down, enter a search term or the wildcard character (%) in the adjacent text box, and click Go.
The system displays the DRG Codes List page with filtered results.
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Select the DRG Code hyperlink for the code you want to view.
The system shows the DRG Details page.
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Select the Add button above he DRG Pricing Information section.
The system displays the Associate Code dialog.
Important Note: You must enter the required fields on the Associate Code dialog and then perform a filter search using the Go button to populate the Available Pricing Rules list box.
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At the Associate Code field, enter the wildcard character (%) in the search field adjacent to the drop-down field that shows Pricing Rule.
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Select the Program from the drop-down list.
The system refreshes the dialog and populates the Claim Type drop-down with options for the program you selected.
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Select a claim type from the Claim Type drop-down. (Optional)
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Enter the priority level of the rule in the Priority Level field. Priority numbers range from 1 to 99, with 1 being the highest priority and 99 being the lowest priority.
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Enter or select the Association Start Date and Association End Date.
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Select the Go button to perform the filter search.
The system populates the Available Pricing Rules list box with codes that you can add to the To Be Associated Pricing Rules list box.
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Select the codes from the Available Pricing Rules list box that you want to associate and click the right double-arrow button to add the specified codes to the To Be Associated Pricing Rules field.
Note: Holding the Ctrl button allows you to select multiple codes at one time.
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When you have finished your selections, click OK.
The system exits the dialog back to the DRG Details page where the added pricing rule is now displayed in the DRG Pricing Information section with the status of “In Review.”