MS DRG of the Week: MS-DRG 556: Signs and Symptom of Musculoskeletal and Connective Tissue Disease without MCC

Change the Principal diagnosis

  • Alternate principal diagnoses recommended by FairCode docs include ...
    • 038.9 Septicemia                                                                                DRG 872
    • 338.18 Acute postoperative pain                                                        DRG 948
    • 342.30 Unspecified hemiparesis of unspecified side                         DRG 57
    • 356.9 Peripheral neuropathy                                                              DRG 74
    • 438.20  Hemiparesis as late effect of cerebrovascular dz                  DRG 57
    • 441.9 Aortic aneurysm                                                                      DRG 301
    • 682.6 Abscess of hip                                                                          DRG 603
    • 707.15 Ischemic ulcer of the toe                                                        DRG 594
    • 715.36 Localized osteoarthrosis, lower leg                                       DRG 554
    • 724.4 Lumbar radiculopathy                                                             DRG 552
    • 728.88  Rhabdomyolysis                                                                   DRG 558
    • 794.31 Abnormal EKG                                                                      DRG 316
    • 820.09  Fracture of neck of femur                                                     DRG 536
    • 996.47 Mechanical complication of prosthetic joint                         DRG 561

CC  Conditions

  • None;  this DRG can't be changed by the addition of a CC condition.
  • Remember that CC conditions may complicate DRGs assigned from alternative principal diagnoses above.

MCC Conditions

  • 486 Pneumonia                                                                                             DRG 555

Add a procedure

  • 77.45 Biopsy of femur                                                                                  DRG 479
  • 83.63 Rotator cuff repair                                                                              DRG 512

Discussion

  • The principal diagnoses that lead to DRG 556 describe symptoms like pain or weakness and other conditions which are described in a general or nonspecific way.  Coding guidelines favor a more specific principal diagnosis when supported by the records in file, this DRG offers an opportunity to improve the precision with which the case is coded.
  • Remember to look for procedures;  finding an uncoded procedure is another good way to improve the specificity of coding for these cases.

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