MS-DRG
MS-DRG 794: Neonate with Other Significant Problems
Newborn w/ minor problems
DRG
794
MDC
MDC 15: Newborns
Severity
—
Relative weight
1.0142
Avg LOS
3.5 days
Typical indications
- NICU hyperbilirubinemia
- Feeding issues
Common denial patterns
- NICU vs nursery
Appeal angles
Document neonatal acuity.
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. 794 has relative weight 1.0142. 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 794?
Neonate with Other Significant Problems. Newborn w/ minor problems.
What are typical indications?
NICU hyperbilirubinemia; Feeding issues.
Why are claims under this DRG denied?
NICU vs nursery.
How do I appeal?
Document neonatal acuity.
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