Under the inpatient prospective payment system, which statement best describes what drives MS-DRG assignment?
Select an answer to reveal the explanation.
Short Explanation
MS-DRGs aren’t picked by who signed the chart or how big the bill looks—they’re built from what you code. Principal diagnosis, complications/comorbidities, procedures, and basic demographics feed the Grouper. Accurate coding is what steers the DRG.
Full Explanation
MS-DRG assignment under IPPS is determined by Grouper logic using principal diagnosis, applicable secondary diagnoses (including CC/MCC), procedures, and demographic factors such as age and sex. Physician specialty, charges alone, or length of stay without coded clinical data do not assign the DRG. Coding quality therefore directly affects DRG weight and payment.