Which of the following categories can lead to adjusted reimbursement under the MS-DRG system?

The MS-DRG (Medicare Severity-Diagnosis Related Group) system is designed to categorize hospital cases to ensure appropriate reimbursement for services rendered. Adjusted reimbursement under this system often occurs in specific situations that account for the complexity and cost of care.

The correct option highlights two critical categories: Cost Outliers and Disproportionate Share. Cost Outliers refer to cases where the cost of care exceeds a certain threshold, allowing for additional reimbursement to cover the increased expenses incurred. The Disproportionate Share component acknowledges hospitals that treat a significantly higher proportion of low-income patients, ensuring they receive adequate funding to support their vital services.

These factors are key drivers that influence how reimbursement is calculated under the MS-DRG system, addressing the unique financial challenges faced by certain hospitals. The interplay of both categories ensures that reimbursement aligns with the actual costs and demands placed on healthcare facilities due to the patient population they serve.

The other options present elements that do not specifically lead to adjustments in reimbursement under the MS-DRG system. Factors such as surgery types and inpatient days relate more to the categorization of cases but not directly to additional adjustments. Patient age and diagnosis codes do play a role in determining the appropriate DRG but do not encompass the outlier