Q&A: Understanding MDCs

Q: I’m having trouble understanding what major diagnostic categories (MDC) are. For example, why would circulatory disorders be an MDC, but heart failure wouldn’t?

A: An MDC is what I like to refer to as the “chapters” in a DRG Expert. When you look at the information contained in each MDC, you will find both surgical and medical diagnosis related groups (DRG).

Each DRG is made up of the principal diagnoses that are assigned to them. In contrast, most MDCs are made up of body systems, such a neurology, respiratory, digestive, and circulatory.

There are a few exceptions such as “Pre-MDC,” which is made up of transplants and tracheostomy DRGs, and “DRGs Assigned to All MDCs,” which is the MDC you would end up in when your principal procedure is not found in the same MDC as the principal medical diagnosis.

To go back to your example, “heart failure” is a diagnosis that would be assigned to the circulatory MDC. The same would be true for chest pain and for patients who undergo cardiac catheterizations, for example.

Editor’s Note: Sharme Brodie, RN, CCDS, CDI education specialist and CDI Boot Camp instructor for HCPro in Middleton, Massachusetts, answered this question. For information, contact her at sbrodie@hcpro.com. For information regarding CDI Boot Camps, click here.