Question

list and explain four steps for MS-DRG

Answer 1

The four basic for MS-DRG are as under:

There are four steps used when determining a MS-DRG with the first step being Pre-MDC Assignment. This step will determine if the visit qualifies for MS-DRG or not, if qualification is met then this step is complete. MDC determination is the next step. There are 25 MDC categories into which the visit can be placed which will be based on the principal diagnosis. The third step is the medical or surgical determination. A surgical status is assigned to procedures that qualify as and/or operating room procedure. A medical status is assigned for all other procedures not requiring any type of surgery. The fourth and final step is used to isolate he correct MS-DRG and is called refinement.

1. Identification of all the reportable diagnoses in the health record and assigning their applicable ICD code.
2. Identification of the principal diagnosis (the condition after study determined to be chiefly responsible for occasioning the admission). The remaining diagnoses are secondary diagnoses, some of which may be classified by CMS as a CC or MCC.
3. Using the Alphabetic Index of diagnoses in the DRG Expert to identify the base/medical MS-DRG, noting its Major Diagnostic Category (MDC)/body system by scanning the MS-DRGs associated with the listed pages to see which applies to the particular scenario. The MDC is necessary to assign the surgical MS-DRG when applicable.
4. Identification of all reportable procedures and their associated procedure code.