MS-DRG
MS-DRG 690: Kidney and Urinary Tract Infections without MCC
UTI/pyelo no MCC. Very high volume
DRG
690
MDC
MDC 11: Kidney/Urinary
Severity
without MCC
Relative weight
0.7445
Avg LOS
3.0 days
Typical indications
- Pyelonephritis IV ABx
Common denial patterns
- Inpatient vs observation
Appeal angles
Document failed PO + need for IV.
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. 690 has relative weight 0.7445. 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 690?
Kidney and Urinary Tract Infections without MCC. UTI/pyelo no MCC. Very high volume.
What are typical indications?
Pyelonephritis IV ABx.
Why are claims under this DRG denied?
Inpatient vs observation.
How do I appeal?
Document failed PO + need for IV.
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