MS-DRG 870: Septicemia or Severe Sepsis with MV >96 Hours
Severe sepsis + prolonged MV
Typical indications
- Septic shock + ARDS
Common denial patterns
- MV hours documentation
Appeal angles
Document precise MV duration + sepsis criteria (SEP-1 / Sepsis-3).
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. 870 has relative weight 6.0234. 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 870?
Septicemia or Severe Sepsis with MV >96 Hours. Severe sepsis + prolonged MV.
What are typical indications?
Septic shock + ARDS.
Why are claims under this DRG denied?
MV hours documentation.
How do I appeal?
Document precise MV duration + sepsis criteria (SEP-1 / Sepsis-3).
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