MS-DRG v40 (FY 2023) Definitions Manual - Browse Assignment Rules and Codes

CMS (Centers for Medicare & Medicaid Services) created the MS-DRG system as a way to classify each Medicare patient's hospital stay into a severity group. These severity groups help to determine how much a hospital is paid for treating the patient based on the expected cost and complexity of the treatment.

Each year, CMS updates the MS-DRGs to reflect current trends in treatment and to reflect any changes in how patients are being treated. Use the MS-DRG Versions menu above to choose the year you would like to see.

Major Diagnostic Categories (MDCs)

MS-DRGs are divided into Major Diagnostic Categories (MDCs) that represent each area of treatment. The order of MDCs reflects their relative importance. If a patient receives treatment in multiple MDCs, the first one listed below takes precedence. Pre-MDC contains treatments that are considered so complex that they take priority over any specific area of treatment.

MDC Description
Pre Pre-MDC
MDC 01 Diseases and disorders of the nervous system
MDC 02 Diseases and disorders of the eye
MDC 03 Diseases and disorders of the ear, nose, mouth and throat
MDC 04 Diseases and disorders of the respiratory system
MDC 05 Diseases and disorders of the circulatory system
MDC 06 Diseases and disorders of the digestive system
MDC 07 Diseases and disorders of the hepatobiliary system and pancreas
MDC 08 Diseases and disorders of the musculoskeletal system and connective tissue
MDC 09 Diseases and disorders of the skin, subcutaneous tissue and breast
MDC 10 Endocrine, nutritional and metabolic diseases and disorders
MDC 11 Diseases and disorders of the kidney and urinary tract
MDC 12 Diseases and disorders of the male reproductive system
MDC 13 Diseases and disorders of the female reproductive system
MDC 14 Pregnancy, childbirth and the puerperium
MDC 15 Newborns and other neonates with conditions originating in perinatal period
MDC 16 Diseases and disorders of blood, blood forming organs and immunologic disorders
MDC 17 Myeloproliferative diseases and disorders, poorly differentiated neoplasms
MDC 18 Infectious and parasitic diseases, systemic or unspecified sites
MDC 19 Mental diseases and disorders
MDC 20 Alcohol or drug use or induced organic mental disorders
MDC 21 Injuries, poisonings and toxic effects of drugs
MDC 22 Burns
MDC 23 Factors influencing health status and other contacts with health services
MDC 24 Multiple significant trauma
MDC 25 Human immunodeficiency virus infections
MDC XX Unrelated Operating Room Procedures
Appendix A - List of MS-DRGs

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