CPB (Certified Professional Biller) Certification Practice Exam

What element does the All Patient Diagnosis-Related Group (AP-DRG) system use to assign DRGs for reimbursement of hospitals for inpatient care for non-Medicare beneficiaries?

1. Mortality risk assessment

2. Intensity of resources

3. Severity of illness

4. Geographical location

The correct answer is: Intensity of resources

The correct answer is B. Intensity of resources. The All Patient Diagnosis-Related Group (AP-DRG) system uses the intensity of resources needed to treat a patient's condition as the main element to assign Diagnosis-Related Groups (DRGs) for reimbursement of hospitals for inpatient care. This system focuses on the resources utilized during the patient's hospital stay, such as the type and amount of services provided, procedures performed, and length of stay. This method helps ensure fair and accurate reimbursement based on the level of resources used in treating each patient. Mortality risk assessment, severity of illness, and geographical location are not the main factors used by the AP-DRG system to assign DRGs for reimbursement in hospitals for non-Medicare beneficiaries. While these factors may play a role in patient care and outcomes, they are not the primary focus of the AP-DRG system in determining reimbursement levels.