Certified in Healthcare Compliance (CHC) 2025 – 400 Free Practice Questions to Pass the Exam

DRG creep refers specifically to the phenomenon where there is inaccurate coding related to inpatient services. This can occur when healthcare providers assign a higher Diagnosis Related Group (DRG) than what is clinically justified based on the patient's condition and the services provided. As a result, this leads to increased reimbursement because higher-paying DRGs correspond to more complex and resource-intensive cases.

The issue with DRG creep is that it can lead to inflated costs for healthcare systems and patients alike, as it distorts the true cost and severity of care. Proper coding practices are essential in maintaining the integrity of healthcare billing and ensuring compliance with regulations. This erroneous coding not only affects financial outcomes but can also have implications for healthcare audits and compliance reviews.

In comparison, the other options are less relevant to the definition of DRG creep. While billing for unnecessary tests, increasing patient costs, and billing for services not provided illustrate various unethical billing practices or issues within healthcare finance, they don't specifically capture the essence of DRG creep as it pertains to improper coding of inpatient services. Thus, the focus here is indeed on the inaccuracies in coding that lead to DRG creep.