MS-DRG
MS-DRG 238: Major Cardiovascular Procedures without MCC
Uncomplicated major CV
DRG
238
MDC
MDC 05: Circulatory System
Severity
without MCC
Relative weight
4.1245
Avg LOS
4.7 days
Typical indications
- Elective CV procedure
Common denial patterns
- Inpatient classification
Appeal angles
Document 2-midnight rule.
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. 238 has relative weight 4.1245. 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 238?
Major Cardiovascular Procedures without MCC. Uncomplicated major CV.
What are typical indications?
Elective CV procedure.
Why are claims under this DRG denied?
Inpatient classification.
How do I appeal?
Document 2-midnight rule.
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