Certified Inpatient Coding (CIC) Practice Exam

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What should a coder do when multiple MS-DRGs could be assigned?

Choose the MS-DRG with the highest relative weight
Choose the MS-DRG related to the primary diagnosis code
Choose the MS-DRG with the lowest relative weight
Choose the MS-DRG with the highest ALOS

The correct answer is: Choose the MS-DRG related to the primary diagnosis code

When facing a situation where multiple MS-DRGs could be assigned, it is essential to select the MS-DRG that is most closely related to the primary diagnosis code. The primary diagnosis code reflects the principal reason for a patient's admission and guides the coding process. The selection of the appropriate MS-DRG is critical because it affects reimbursement and accurately represents the patient’s care. Focusing on the primary diagnosis ensures that the coder not only complies with coding standards but also maintains the integrity of the healthcare data. It signifies the main health issue encountered during the inpatient stay, and aligning the MS-DRG with this diagnosis promotes clarity and consistency in medical records. While factors like relative weight and average length of stay (ALOS) may influence the overall financial implications of coding choices, they should not supersede the fundamental principle of coding based on the primary diagnosis. Therefore, prioritizing the primary diagnosis code when multiple MS-DRGs are possible will lead to a more accurate assignment and better reflect the complexity of the patient's condition.