AR-DRG Version 12.0
Date published: 29 July 2025
The Australian Refined Diagnosis Related Groups (AR-DRG) classification provides a clinically meaningful way to group together treatments and services provided for admitted acute episodes of care to enable hospitals to be funded for these services using activity based funding.
The AR-DRG classification is underpinned by the following diagnosis and intervention classifications and standards:
- International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM)
- Australian Classification of Health Interventions (ACHI)
- Australian Coding Standards (ACS); collectively known as ICD-10-AM/ACHI/ACS.
AR-DRG Version 12.0 was approved by the Pricing Authority in April 2025 and has been developed in accordance with the Governance Framework for the Development of the Admitted Care Classifications. This included consultation with clinicians and other health sector stakeholders represented on IHACPA’s technical and advisory committees. AR-DRG Version 12.0 supersedes AR-DRG Version 11.0 and is proposed to be used to price admitted acute care episodes from 1 July 2026, subject to approval by the Pricing Authority.
The Definitions Manual for AR-DRG Version 12.0 is published as a set of three volumes which contain the following products:
- Volume 1: DRGs A13A–I80Z
- Volume 2: DRGs J01A–Z66Z
- Volume 3: Appendices
The AR-DRG Version 12.0 Definitions Manual is available to purchase from the Lane Print website.
Additional resources related to Version 12.0 include:
- Final Report – outlines the changes made for AR-DRG Version 12.0 and details the refinement process and rationale for changes.
- Technical Specifications – details the methodology and technical specifications used in the development of AR-DRG Version 12.0, including:
- data preparation and modification
- Adjacent Diagnosis Related Group (ADRG) intervention hierarchy review
- derivation of the Episode Clinical Complexity Score (ECCS)
- ADRG splitting review.
- Descriptions – provides a full listing of long and short descriptions for Major Diagnostic Categories, Adjacent Diagnosis Related Groups and Diagnosis Related Groups.
- Definitions Manual Appendices – electronic versions of the AR-DRG Version 12.0 Definitions Manual Volume 3: Appendices:
- Appendix A: Diagnosis code/Major Diagnostic Category/Adjacent Diagnosis Related Group Index
- Appendix B: Intervention code/Major Diagnostic Category/Adjacent Diagnosis Related Group Index
- Appendix C: Diagnosis Complexity Level exclusions
- Appendix D: Age, sex and length of stay conflicts
- Appendix E: General Interventions
Please note that the purchase and use of these products are subject to licence arrangements.
Key updates for AR-DRG V12.0 include:
- Review of MDC 14 Pregnancy, childbirth and the puerperium with refinements to improve the clinical meaningfulness and resource homogeneity within this MDC.
- Creation of ADRG A16 Posthumous organ procurement.
- Development of guiding principles to inform the grouping of episodes of care to the intervention partition of the AR-DRG classification.
IHACPA will release education to support the implementation of AR-DRG V12.0 through IHACPA Learn.
Resources
Previous versions:
Last updated: 29 July 2025