Patient admitted to the acute care hospital with acute appendicitis (K35.80).

Patient A (Bill Smith)

This is a 75-year-old male patient admitted to the acute care hospital with acute appendicitis (K35.80). He also has atrial fibrillation (I48.91) and known coronary artery disease (I25.10) with a history of MI 4 years ago (I25.2).  A laparoscopic appendectomy is performed (0DTJ4ZZ) and he is discharged to home on post-op day 2.

Based on the information above, what MS-DRG is assigned to this inpatient stay?

What is the expected length of stay for this MS-DRG?

What is the relative weight and expected total federal payment for this MS-DRG?

If this patient’s appendix ruptured before he could seek treatment and his diagnosis was instead acute appendicitis with perforation and localized peritonitis (K35.32), does the MS-DRG change when you change the principal diagnosis to code K35.32? If yes, why did it change? If no, why didn’t it change?

Consider the relative weight of the MS-DRG(s) in this scenario. How does the relative weight correlate to the expected payment amount?

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