MS-DRG
MS-DRG 236: Coronary Bypass without Cardiac Catheterization with MCC
CABG + MCC
DRG
236
MDC
MDC 05: Circulatory System
Severity
with MCC
Relative weight
8.5634
Avg LOS
9.7 days
Typical indications
- Multi-vessel CABG + comorbid
Common denial patterns
- MCC clinical validation
Appeal angles
Document MCC + cardiology assessment supporting CABG over PCI.
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. 236 has relative weight 8.5634. 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 236?
Coronary Bypass without Cardiac Catheterization with MCC. CABG + MCC.
What are typical indications?
Multi-vessel CABG + comorbid.
Why are claims under this DRG denied?
MCC clinical validation.
How do I appeal?
Document MCC + cardiology assessment supporting CABG over PCI.
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