Diagnostic Related Groups, or DRGs, include various groups, codes and categories that comprise designations such as MDC 1, which medical professionals use to represent diseases and disorders of the nervous system; MS-DRG 428.0, which refers to congestive heart failure; and MS-DRG 707.09, which stands for “decubitus ulcer, other site,” explains Advanced Healthcare Network. Other DRG designations include MDC 3, which refers to diseases of the ear, nose, mouth and throat; and MS-DRG 425.4, which refers to primary cardiomyopathy.
Other designations include MS-DRG K70.41, which hospitals use to refer to alcoholic hepatic failure that has a co-occurring coma; MS-DRG K50.114, which refers to Crohn’s disease of the large intestine accompanied by an abscess; and L89.153, which medical professionals use to refer to a stage 3 pressure ulcer of the sacral region, according to the American Health Information Management Association.
Yale University developed the DRG system in the 1970s to help medical professionals gauge, group and document the intensity of resources that each case required, notes the American Health Information Management Association. The system evolved over time into a tool for computing reimbursements, aiding comparability and benchmarking, managing data, measuring risk and gauging severity.
The DRG system is hierarchical, reports the American Health Information Management Association. Major diagnostic categories, or MDCs, which represent major body systems such as the nervous system and the eye, occupy one tier. The succeeding tier splits these MDCs into surgical and medical sections. The next tier assigns surgical patients to a DRG that varies by nature of procedure, and assigns non-surgical patients to a DRG depending on the examining physicians’ principal diagnosis.