MS-DRG
MS-DRG 292: Heart Failure and Shock with CC
ADHF + CC. Very high volume
DRG
292
MDC
MDC 05: Circulatory System
Severity
with CC
Relative weight
0.9242
Avg LOS
3.4 days
Typical indications
- ADHF + DM uncomplicated
Common denial patterns
- CC validation
Appeal angles
Document CC + IV diuresis need.
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. 292 has relative weight 0.9242. 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 292?
Heart Failure and Shock with CC. ADHF + CC. Very high volume.
What are typical indications?
ADHF + DM uncomplicated.
Why are claims under this DRG denied?
CC validation.
How do I appeal?
Document CC + IV diuresis need.
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