MS-DRG
MS-DRG 219: Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC
Valve + MCC, no cath
DRG
219
MDC
MDC 05: Circulatory System
Severity
with MCC
Relative weight
10.4456
Avg LOS
11.3 days
Typical indications
- Valve surgery + MCC
Common denial patterns
- MCC validation
Appeal angles
Document MCC.
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. 219 has relative weight 10.4456. 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 219?
Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC. Valve + MCC, no cath.
What are typical indications?
Valve surgery + MCC.
Why are claims under this DRG denied?
MCC validation.
How do I appeal?
Document MCC.
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