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MS-DRGs (Medicare-Severity Diagnosis Related Groups) Questions And Answers Latest Updates $8.39   Add to cart

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MS-DRGs (Medicare-Severity Diagnosis Related Groups) Questions And Answers Latest Updates

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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...

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  • October 2, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • MS-DRGs (Medicare-Severity Diagnosis Related Group
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PatrickKaylian
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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