MS-DRG 766: Cesarean Section without CC/MCC
Uncomplicated C-section. HUGE VOLUME — most common surgery in US
Typical indications
- Elective repeat
- Failed labor
Common denial patterns
- VBAC eligibility questioned
- Medical necessity
Appeal angles
Document obstetric indication per ACOG.
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. 766 has relative weight 0.7642. 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 766?
Cesarean Section without CC/MCC. Uncomplicated C-section. HUGE VOLUME — most common surgery in US.
What are typical indications?
Elective repeat; Failed labor.
Why are claims under this DRG denied?
VBAC eligibility questioned; Medical necessity.
How do I appeal?
Document obstetric indication per ACOG.
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