MS-DRG
MS-DRG 293: Heart Failure and Shock without CC/MCC
Uncomplicated ADHF
DRG
293
MDC
MDC 05: Circulatory System
Severity
without CC/MCC
Relative weight
0.6845
Avg LOS
2.6 days
Typical indications
- ADHF rapid response
Common denial patterns
- Inpatient vs observation
Appeal angles
Document IV diuresis need + 2-midnight expectation.
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. 293 has relative weight 0.6845. 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 293?
Heart Failure and Shock without CC/MCC. Uncomplicated ADHF.
What are typical indications?
ADHF rapid response.
Why are claims under this DRG denied?
Inpatient vs observation.
How do I appeal?
Document IV diuresis need + 2-midnight expectation.
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