MDC List

Major Diagnostic Category (MDC) List:

MDC                                      Description

0                      -                       Pre-MDC

1                      -                       Nervous System

2                      -                       Eye

3                      -                       Ear, Nose, Mouth and Throat

4                      -                       Respiratory System

5                      -                       Circulatory System

6                      -                       Digestive System

7                      -                       Hepatobiliary System and Pancreas

8                      -                       Musculoskeletal System and Connective Tissue

9                      -                       Skin, Subcutaneous Tissue And Breast

10                    -                       Endocrine, Nutritional And Metabolic System

11                    -                       Kidney And Urinary Tract

12                    -                       Male Reproductive System

13                    -                       Female Reproductive System

14                    -                       Pregnancy, Childbirth And Puerperium

15                    -                       Newborn And Other Neonates (Perinatal Period)

16                    -                       Blood and Blood Forming Organs and Immunological Disorders

17                    -                       Myeloproliferative DDs (Poorly Differentiated Neoplasms)

18                    -                       Infectious and Parasitic DDs

19                    -                       Mental Diseases and Disorders

20                    -                       Alcohol/Drug Use or Induced Mental Disorders

21                    -                       Injuries, Poison And Toxic Effect of Drugs

22                    -                       Burns

23                    -                       Factors Influencing Health Status

24                    -                       Multiple Significant Trauma

25                    -                       Human Immunodeficiency Virus Infection

MDC

Major Diagnostic Category (MDC)

            The Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses (from ICD-9) into 25 mutually exclusive diagnosis areas.

            The diagnoses in each MDC correspond to a single organ system or etiology and in general are associated with a particular medical specialty. MDC 1 to MDC 23 are grouped according to principal diagnoses.

            Patients are assigned to MDC 24 (Multiple Significant Trauma) with at least two significant trauma diagnosis codes (either as principal or secondaries) from different body site categories.

DRG

Diagnostic Related Groups (DRG)

            A grouping of disease and disorders into medically meaningful sets as developed by the Centers for Medicare & Medicaid Services (CMS).

            This reimbursement system consists of established payment levels for groupings of patients according to medically meaningful characteristics. There are six major criteria, which are utilized in assigning a particular admission to a specific DRG.

        

    These consist of:

            - Patient's principal diagnosis

            - Procedures performed on the patient

            - Patient's age

            - Patient's gender

            - Patient's discharge status

            - Multiple diagnoses, complications or comorbid conditions.

Why MS-DRGs?

WHY MS-DRGs?

According to the 8/22/07 Final Rule, CMS chose MS-DRGs over the other DRG systems because:

            - MS-DRGs remains an improvement over the current CMS DRGs;

            - MS-DRGs are more up-to-date (in relation to the review of MCCs & CCs);

            - MS-DRGs are understandable;

            - MS-DRGs will have fewer transition issues than other systems; and

            - MS-DRGs allow for updates and maintenance to continue using the same process as under the current CMS DRGs.