Transferring Hospital DRG Rate Calculation and Discharge Status Code Addition

March 22, 2019

Blue Cross and Blue Shield of Texas (BCBSTX) will implement system logic effective July 15, 2019, to include Discharge Status Code 05 (Discharge/transferred to a designated cancer center or children’s hospital) to appropriately apply the Diagnosis Related Group (DRG) Per Diem calculation.

The DRG Per Diem rate calculation will continue to apply to the following Discharge Status Codes:

  • 02 (Discharged/transferred to short term general hospital for inpatient care)
  • 82 (Discharged/transferred to short term general hospital with a planned acute care hospital inpatient readmission)

If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative.