CPB Certified Professional Biller Certification Practice Exam

What does the All Patient Diagnosis-Related Group (AP-DRG) system pertain to?

1. A system focused on outpatient reimbursements

2. A DRG system for Medicare beneficiaries only

3. A system for non-Medicare beneficiaries' inpatient care reimbursement

4. A billing system primarily for dental services

The correct answer is: A system for non-Medicare beneficiaries' inpatient care reimbursement

The All Patient Diagnosis-Related Group (AP-DRG) system is designed to classify hospital patients into groups that are clinically similar and require similar amounts of hospital resources, regardless of the payer. This classification system is particularly notable for including all patients, not just those covered by Medicare, which aligns with the context of inpatient care reimbursement for non-Medicare beneficiaries. This system serves various payer types, making it an essential method for understanding the costs and resource utilization in hospitals for a broader patient population. It takes into account a variety of insurance plans and patients without limiting its application to Medicare patients. By categorizing inpatient stays based on diagnosis, there is a standardized approach to billing that benefits hospitals and providers alike.