Diagnosis-Related Group

What Does Diagnosis-Related Group Mean?

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.

Insuranceopedia Explains Diagnosis-Related Group

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.