MS-DRG 065: Intracranial Hemorrhage or Cerebral Infarction with CC or tPA in 24 Hours
Stroke with CC or tPA administered
Typical indications
- Stroke + UTI
- Stroke + tPA
Common denial patterns
- CC clinical validation
- tPA documentation
Appeal angles
Document acute care needed, tPA administration timing.
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. 065 has relative weight 1.3742. 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 065?
Intracranial Hemorrhage or Cerebral Infarction with CC or tPA in 24 Hours. Stroke with CC or tPA administered.
What are typical indications?
Stroke + UTI; Stroke + tPA.
Why are claims under this DRG denied?
CC clinical validation; tPA documentation.
How do I appeal?
Document acute care needed, tPA administration timing.
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