(MS-DRG) Software - National Technical Information Service

Table 1–2. Information returned by the MS-DRG softwareNameLength inbytesDescriptionPRFLGS 175 See table 1–6Grouper return codeThe grouper return code (RTC) indicates whether or not the groupingprocess was successful for a given record. Table 1–3 describesthe values for the Return Code.Table 1–3. Return code descriptionsReturncodeDescription1 The first listed diagnosis is a valid code but it can not be usedas principal diagnosis. An example of this situation would beany one of the “E” codes, which are not indicative of the MDCinto which this patient should be classified.2 This code occurs when all of the DRG criteria for the MDChave been examined and the record does not match any ofthem.3, 4 and 5 These codes occur only for those DRGs that are part ofgrouping criteria (i.e., the grouper does not perform anautomatic edit check of age, sex, and discharge status).6 The principal diagnosis is considered illogical, meaning that itis unlikely that there would be an occurrence. For example,diagnosis code 76509 (extreme immat 2500+g) is flagged asan illogical diagnosis whenever it is coded as the principaldiagnosis.7 The code used as principal diagnosis is not a valid ICD-9-CMcode.9, 10, 11,15These codes occur when there is at least one HAC on therecord and there is an issue with either the POA logicindicator or the POA values assigned to the HAC.10/10Introduction 1.7