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Diagnosis Codes in MS-DRG 293 - Heart Failure And Shock Without CC/MCC

The Medicare Severity Diagnosis-Related Group (MS-DRG) is a patient classification system used to categorize hospital cases based on clinical similarity and expected resource use. MS-DRGs organize all possible principal diagnoses into mutually exclusive groups known as Major Diagnostic Categories (MDCs), which help determine reimbursement under the Medicare Inpatient Prospective Payment System.

This section lists the diagnosis codes included in MS-DRG V42.0: Heart Failure and Shock without CC/MCC from October 1, 2024, through September 30, 2025.

MS-DRG: 293

MS-DRG Title: Heart Failure and Shock without CC/MCC

MCD: 05

Relative Weight: 0.5490 Relative Weight
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Geometric LOS: 0.55 Geometric Length of Stay
The geometric mean length of stay (GMLOS) is used by Medicare to calculate the reimbursement for patients whose medical treatment takes a much longer or shorter time than average.

Arithmetic LOS: 2.10 Arithmetic Length of Stay
The average length of stay (ALOS) reflects the average number of days a patient spends in a hospital for each admission.

  • I09.8 - Other specified rheumatic heart diseases

    • I09.81 - Rheumatic heart failure

  • I11 - Hypertensive heart disease

    • I11.0 - Hypertensive heart disease with heart failure

  • I13 - Hypertensive heart and chronic kidney disease

    • I13.0 - Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease

    • I13.2 - Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease

  • I50 - Heart failure

    • I50.1 - Left ventricular failure, unspecified

    • I50.9 - Heart failure, unspecified

  • I50.2 - Systolic (congestive) heart failure

    • I50.20 - Unspecified systolic (congestive) heart failure

    • I50.21 - Acute systolic (congestive) heart failure

    • I50.22 - Chronic systolic (congestive) heart failure

    • I50.23 - Acute on chronic systolic (congestive) heart failure

  • I50.3 - Diastolic (congestive) heart failure

    • I50.30 - Unspecified diastolic (congestive) heart failure

    • I50.31 - Acute diastolic (congestive) heart failure

    • I50.32 - Chronic diastolic (congestive) heart failure

    • I50.33 - Acute on chronic diastolic (congestive) heart failure

  • I50.4 - Combined systolic (congestive) and diastolic (congestive) heart failure

    • I50.40 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure

    • I50.41 - Acute combined systolic (congestive) and diastolic (congestive) heart failure

    • I50.42 - Chronic combined systolic (congestive) and diastolic (congestive) heart failure

    • I50.43 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure

  • I50.8 - Other heart failure

    • I50.82 - Biventricular heart failure

    • I50.83 - High output heart failure

    • I50.84 - End stage heart failure

    • I50.89 - Other heart failure

  • I50.81 - Right heart failure

    • I50.810 - Right heart failure, unspecified

    • I50.811 - Acute right heart failure

    • I50.812 - Chronic right heart failure

    • I50.813 - Acute on chronic right heart failure

    • I50.814 - Right heart failure due to left heart failure

  • R57 - Shock, not elsewhere classified

    • R57.0 - Cardiogenic shock

    • R57.9 - Shock, unspecified