MS-DRGs (Medicare-Severity Diagnosis Related Group
MS-DRGs (Medicare-Severity Diagnosis Related Group
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MS-DRGs (Medicare-Severity Diagnosis Related Groups) Questions And Answers Latest Updates
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MS-DRGs (Medicare-Severity Diagnosis Related Group
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MS-DRGs (Medicare-Severity Diagnosis Related Group
Code range - ️️may consist of PDx, operating room (OR) procedure, or a diagnosis
& procedure combination
What do MDCs represent? How many categoriea? - ️️Body systems treated by
medicine
25 MDCs, which are further divides MDC groups into surgical and medical sections
How many MS-DRGs p...
MS-DRGs (Medicare-Severity Diagnosis Related Group
MS-DRGs (Medicare-Severity Diagnosis Related Group
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MS-DRGs (Medicare-Severity Diagnosis
Related Groups)
Code range - ✔️✔️may consist of PDx, operating room (OR) procedure, or a diagnosis
& procedure combination
What do MDCs represent? How many categoriea? - ✔️✔️Body systems treated by
medicine
25 MDCs, which are further divides MDC groups into surgical and medical sections
How many MS-DRGs pre-MDCs are there? - ✔️✔️15
Computer systems that assign pts to case-mix groups are generically called? -
✔️✔️Groupers
What is the highest level in the DRG system? - ✔️✔️MDCs (Major Diagnostic
categories)
Groupers have - ✔️✔️Internal logic, or an alogorithn, thst determines the patients
groups
What is the four step process used used to assign MS-DRGs for hospital inpatient
encounters? - ✔️✔️Step 1: Pre-MDC Assignment
Step 2: MDC Determination
Step 3: Medical/Surgical determination
Step 4: Refinement
Define each step of the MDC assignment - ✔️✔️Step 1: Pre-MDC Assignment = the
PDx is used to assign the MS-DRG; once the encounter has been determines to qualify
for pre-MDC assignment, the MS-DRG assignment is made and process is complete.
Example- MS-DRG 010 is assigned for pt. received a pancreatic transplant
Step 2: MDC Determination = the PDX is used to place the encounter into one of the 24
MDCs. Example, ICD code for Group A Streptococcus pneumonia is assigned to MDC
04, Diseases and Disorders of the Respiratory System.
Step 3: Medical/Surgical determination = mS-DRG Definitions Manual identifies which
procedures are valid/nonvalid OR procedures. If a qualifying OR procedure was not
performed , the case is assigned a medical status
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