IR-DRG Classification - Diagnosis Related Group – UAE

Course Overview

The IR-DRG course provides an in-depth understanding of the classification, dimensions, principles, and components of Diagnostic Related Groups (DRGs). It covers the assignment logic, calculation, and application of DRGs in the context of patient care. The course explores the impact of DRGs on a patient’s quality of care by standardizing medical data, accurately capturing patient severity, risk of mortality, resource weight, and average length of stay. Participants will gain practical insights into how DRGs influence optimal reimbursement and the financial implications of severity drivers, using real-world case studies. Furthermore, the course highlights the importance of clinical documentation improvement (CDI) in optimizing DRG accuracy, influencing the Case Mix Index (CMI), and improving hospital performance.

Objectives

By the end of this module, you should be able to:

• Know what Diagnostic Related Groups (DRGs) are
• Understand the dimensions of IR- DRG classification
• Understand the basic principles of DRG
• Know the generic components of IR-DRG
• Know how to calculate DRG
• Understand the DRG Assignment Logic
• Understand the conceptual framework of IR-DRG classification
• Know the definition of principal and secondary diagnosis in the context of coding guidelines
• Understand patient severity levels for the level of care provided in the context of clinical documentation
• Know the procedure hierarchy
• Know Dubai IR-DRG – Parameters
• Understand the Case Mix Index (CMI) and how it is impacted by Clinical Documentation Improvement (CDI)
• Understand the importance of CDI in capturing accurate patient severity of illness, risk of mortality, and length of stays
• Understand examples of IR-DRG and CDI Impact on severity of illness, risk of mortality, length of stay, resource weight and reimbursements
• Assess case studies

Learning Outcomes

By the end of this course, participants will be able to:

• Define what Diagnostic Related Groups (DRGs) are and explain their role in healthcare classification.
• Describe the dimensions of the IR-DRG classification system and its components.
• Understand the basic principles behind DRGs, including assignment logic and calculation methods.
• Explain the generic components of the IR-DRG classification.
• Calculate DRGs based on patient data and documentation.
• Demonstrate the DRG assignment logic and its application in real-world scenarios.
• Understand the conceptual framework of IR-DRG classification and its relevance in clinical settings.
• Differentiate between principal and secondary diagnoses and explain their significance in the coding process.
• Identify patient severity levels and understand how they affect the level of care provided.
• Explain the procedure hierarchy and its importance in DRG classification.
• Understand the Dubai IR-DRG parameters and their specific applications in the region.
• Analyze the Case Mix Index (CMI) and assess how it is impacted by Clinical Documentation Improvement (CDI).
• Understand the role of CDI in accurately capturing patient severity of illness, risk of mortality, and length of stay.
• Evaluate examples of IR-DRG and CDI impacts on severity of illness, risk of mortality, length of stay, resource weight, and reimbursement.
• Assess case studies to gain practical insights into applying IR-DRG principles and CDI in healthcare settings.

Curriculum