MS-DRG 064: Intracranial Hemorrhage or Cerebral Infarction with MCC
Stroke admission with major comorbidity
Typical indications
- Ischemic stroke
- ICH
- SAH
Common denial patterns
- MCC clinical validation
- tPA timing documentation
Appeal angles
Document NIHSS, imaging timing, tPA window per AHA/ASA guidelines.
Context: how MS-DRGs work
MS-DRGs bundle hospital inpatient payment into a single amount per admission. Each DRG has a relative weight that multiplies the hospital's base rate to determine payment. 064 has relative weight 1.9542. Major Complication or Comorbidity (MCC) and Complication or Comorbidity (CC) secondary diagnoses can move a case to a higher-paying DRG within the same family.
Frequently asked questions
What is MS-DRG 064?
Intracranial Hemorrhage or Cerebral Infarction with MCC. Stroke admission with major comorbidity.
What are typical indications?
Ischemic stroke; ICH; SAH.
Why are claims under this DRG denied?
MCC clinical validation; tPA timing documentation.
How do I appeal?
Document NIHSS, imaging timing, tPA window per AHA/ASA guidelines.
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