Define DRG, CPT, and ICD; explain how they pertain to claims.

DRG (diagnosis-related group) is define as a code used for diagnosis; hospital reimbursement by insurers is established on a formula using DRGs. CPT (current procedural terminology) is define as codes laboratory tests, treatments and other procedures. ICD (International Classification of Disease; ICD-9-CM or 10) is termed as codes 1,000 diseases, a medical code set preserved by the World Health Organization (WHO). ICD pertains to claims in a way that it allows victims to a set amount of reimbursement. ICD’s main purpose is to categorize causes of death. It also allows for the classification of morbidity and mortality information for statistical reference of reimbursement. DRG pertains to claims in a way that it allows framework for specifying hospital case mix and identifies classifications of illnesses and injuries for which payment is made under potential pricing programs. CPT pertains to claims in a way that it determines Medicare reimbursement rates–classifying healthcare procedures to determine costs of compensation.