Diagnosis-Related Group

Updated: 29 February 2024

A diagnosis-related group is a group of hospital patients classified together for the purpose of health insurance billing. Diagnosis-related groups allow both hospitals and insurers to know which diagnosis the patient has received and what the financial implications of this diagnosis will be.

Some diagnosis-related groups are associated with more expensive claims than others. For example, a cancer diagnosis will generally place a patient in a more expensive diagnosis-related group than they would be in if they suffered from a broken ankle.

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