Attempting to manipulate “the system” in an illegal or unethical manner. The terms “gaming” and “to game the system” are used, for example, in connection with efforts to bill under the prospective payment system (PPS) in such a way as to maximize income by giving as the principal diagnosis that diagnosis which places the patient in the highest-priced Diagnosis Related Group (DRG), even though a lower-priced one more correctly reflects the patient’s problem and the services rendered.