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Major Diagnostic Category (MDC) to MS-DRG Mapping Cheat Sheet by

MDC Mapping to DRG
medical     coding

Major Diagnostic Category (MDC)

MDC Descri­ption
MS-DRG
1 Nervous system
020 - 103
2 Eye
113 - 125
3 Ear, Nose, Mouth & Throat
129 - 159
4 Respir­atory System
163 - 208
5 Circul­atory System
215 - 316
6 Digestive System
326 - 395
7 Hepato­biliary System & Pancreas
405 - 446
8 Muscul­osk­eletal System & Connective Tissue
453 - 566
9 Skin, Subcut­aneous Tissue & Breast
573 - 607
10 Endocrine, Nutrit­ional & Metabolic System
614 - 645
11 Kidney & Urinary Tract
652 - 700
12 Male Reprod­uctive System
707 - 730
13 Female Reprod­uctive System
734 - 761
14 Pregnancy; Childbirth
765 - 782; 998
15 Newborns & Neonates (Perinatal Period)
789 - 795
16 Blood, Blood Forming Organs & Immuno­logical Disorders
799 - 816
17 Myelop­rol­ife­rative Diseases & Disorders
820 - 849
18 Infectious & Parasitic Disease & Disorders
853 - 872
19 Mental Diseases & Disorders
876 - 887
20 Alcoho­l/Drug Use or Induced Mental Disorders
894 - 897
21 Injuries, Poison & Toxic Effects of Drugs
901 - 923
22 Burns
927 - 935
23 Factors influe­ncing Health Status
939 - 951
24 Multiple Signif­icant Trauma
955 - 965
25 Human Immuno­def­iciency Virus Infections
969 – 977
26 Transp­lants
001 – 013
27 Extensive Procedures Unrelated to Principal Diagnosis
981-989, 999
One MS-DRG is assigned to each inpatient stay. The MS-DRGs are assigned using the principal diagnosis and additional diagnoses, the principal procedure and additional proced­ures, sex and discharge status. Diagnoses and procedures assigned by using ICD-9-CM codes determine the MS-DRG assignment
 

About MDC

The Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses (from ICD-9-CM) into 25 mutually exclusive diagnosis areas. MDC codes, like diagno­sis­-re­lated group (DRG) codes, are primarily a claims and admini­str­ative data element unique to the United States medical care reimbu­rsement system. DRG codes also are mapped, or grouped, into MDC codes.

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. Patients assigned to MDC 25 (HIV Infect­ions) must have a principal diagnosis of an HIV Infection or a principal diagnosis of a signif­icant HIV related condition and a secondary diagnosis of an HIV Infection.

MDC 0, unlike the others, can be reached from a number of diagno­sis­/pr­ocedure situat­ions, all related to transp­lants. This is due to the expense involved for the transp­lants so designated and because these transp­lants can be needed for a number of reasons which do not all come from one diagnosis domain. DRGs which reach MDC 0 are assigned to the MDC for the principal diagnosis instead of to the MDC associated with the designated DRG.

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