Case Management

Case management Q&A

Case Management Weekly, November 21, 2012

Q. How do DRGs and MS-DRGs differ? 

A. A Diagnosis-Related Group (DRG) is an inpatient classification system designed to categorize patients into medically-related groups by treatment and diagnosis based on similar resource consumption and length of stay patterns. CMS implemented Medicare Severity–Diagnosis-Related Groups (MS-DRG) October 1, 2007, to incorporate severity adjustment into the DRG reimbursement system. This introduced major complications and comorbidities (MCC), reassigned and eliminated many other complications and comorbidities (CC), and recalculated relative weights. 

Editor’s note: This Q&A is adapted from 2012 CDI Pocket Guide published by HCPro, Inc.

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