NANO DRG

Grouping, costing and shadow billing for DRG-funded care

When funding moves to DRG, revenue follows the coded record

An IHACPA-certified AR-DRG grouper, in both of the coding worlds the Gulf actually runs

DRG changes what a hospital is paid for. Not the number of line items on a bill, but the class the episode lands in — and that class is only ever as good as the record behind it. The same operation, documented two ways, is two different payments.

Certified, not just claimed. NANO holds IHACPA certification for its AR-DRG grouper through AR-DRG V12.0 — the version approved to price admitted acute care episodes from 1 July 2026, underpinned by ICD-10-AM/ACHI/ACS Thirteenth Edition. IHACPA has certified grouper software since V10.0, and certification means the grouper has been independently tested to reproduce the classification correctly. It is the difference between a grouper you can put in front of a regulator and one you cannot.

Both coding worlds, and the crosswalk between them. Saudi Arabia codes in ICD-10-AM with ACHI procedures and groups on AR-DRG; the UAE runs ICD-10-CM and CPT. A group operating in both is running two standards at once. NANO DRG supports ICD-10-CM, ICD-10-AM and ICD-9-CM with ACHI, and crosswalks to ICD-10-AM — one system that speaks both.

Shadow billing, before the money changes. Run DRG grouping and pricing alongside your existing billing and see your real case-mix, and what it is worth, while you can still act on it. Finding out after the payment rules switch is the expensive way to learn.

Deterministic grouping. Given the coded episode, the grouper applies the classification logic exactly, every time — which is what certification tests. What varies is the documentation feeding it, and that is why grouping, coding and documentation integrity belong on one platform rather than three.

Integration & Deriving Medical Data

DRG Grouping Algorithms

Return on investment

The same patient, documented two ways

A 52-year-old woman is admitted for a thyroidectomy, principal diagnosis nontoxic multinodular goitre. Recorded as that alone, the episode groups to K06B — Thyroid Interventions, Minor Complexity, at a cost weight of 1.84.

Document the comorbidities that were actually treated — asthma, type 2 diabetes, anaemia — and the identical episode groups to K06A, Major Complexity, at a cost weight of 3.57. Same patient, same operation, nearly double the weight. That gap is what clinical documentation integrity is worth on a single admission, and it is why NANO DRG is built to sit beside NANO AI CDI 360.

What you get

IHACPA-certified AR-DRG grouper, through AR-DRG V12.0

Shadow billing — model DRG revenue against your current billing before the switch

Easy enhancement and augmentation of medical diagnoses and procedures

An intelligent batch bundle grouper, for episode volumes a person cannot review one by one

Case-mix centralised costing, so what an episode costs and what it classifies as sit in one place

Real-time configuration and administration of information to the current software

Case-mix centralised costing, plus reporting, notification and customised report engines

Scrubber Coding Rules Engine

The coding rules engine runs production rules against inpatient state transitions before an episode is grouped, so contradictions, age and gender mismatches and sequencing problems surface while the record can still be corrected — not in a rejection letter weeks later.

Certified, and built for a region mid-transition

Gulf funding models are moving to classification-based payment on their own timelines, and most groups will run old and new side by side for a while. NANO DRG is designed for that overlap: an IHACPA-certified grouper through V12.0, support for the classification versions still in regional use, multiple code sets at once, shadow billing against live operations, and integration into the systems already in place rather than a replacement programme.