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  3. Diagnosis Codes in MS-DRG 306 - Cardiac Congenital And Valvular Disorders With MCC

Diagnosis Codes in MS-DRG 306 - Cardiac Congenital And Valvular Disorders With 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: Cardiac Congenital and Valvular Disorders with MCC from October 1, 2024, through September 30, 2025.

MS-DRG: 306

MS-DRG Title: Cardiac Congenital and Valvular Disorders with MCC

MCD: 05

Relative Weight: 1.4974 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: 1.50 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: 3.90 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.

  1. A52.0 - Cardiovascular and cerebrovascular syphilis
  2. B33.2 - Viral carditis
  3. I01 - Rheumatic fever with heart involvement
  4. I05 - Rheumatic mitral valve diseases
  5. I06 - Rheumatic aortic valve diseases
  6. I07 - Rheumatic tricuspid valve diseases
  7. I08 - Multiple valve diseases
  8. I09 - Other rheumatic heart diseases
  9. I09.8 - Other specified rheumatic heart diseases
  10. I23 - Certain current complications following ST elevation (
  11. I34 - Nonrheumatic mitral valve disorders
  12. I34.8 - Other nonrheumatic mitral valve disorders
  13. I35 - Nonrheumatic aortic valve disorders
  14. I36 - Nonrheumatic tricuspid valve disorders
  15. I37 - Nonrheumatic pulmonary valve disorders
  16. I51 - Complications and ill-defined descriptions of heart di
  17. Q20 - Congenital malformations of cardiac chambers and conne
  18. Q21 - Congenital malformations of cardiac septa
  19. Q21.1 - Atrial septal defect
  20. Q21.2 - Atrioventricular septal defect
  21. Q22 - Congenital malformations of pulmonary and tricuspid va
  22. Q23 - Congenital malformations of aortic and mitral valves
  23. Q23.8 - Other congenital malformations of aortic and mitral
  24. Q24 - Other congenital malformations of heart
  25. Q25 - Congenital malformations of great arteries
  26. Q25.2 - Atresia of aorta
  27. Q25.4 - Other congenital malformations of aorta
  28. Q25.7 - Other congenital malformations of pulmonary artery
  29. Q26 - Congenital malformations of great veins
  30. Q87.4 - Marfan syndrome
  31. Q87.41 - Marfan syndrome with cardiovascular manifestations
  32. R01 - Cardiac murmurs and other cardiac sounds
  33. T82.01 - Breakdown (mechanical) of heart valve prosthesis
  34. T82.02 - Displacement of heart valve prosthesis
  35. T82.03 - Leakage of heart valve prosthesis
  36. T82.09 - Other mechanical complication of heart valve prosth

  • -

    • I38 - Endocarditis, valve unspecified

    • I39 - Endocarditis and heart valve disorders in diseases classified elsewhere

  • A52.0 - Cardiovascular and cerebrovascular syphilis

    • A52.01 - Syphilitic aneurysm of aorta

    • A52.02 - Syphilitic aortitis

  • B33.2 - Viral carditis

  • I01 - Rheumatic fever with heart involvement

    • I01.1 - Acute rheumatic endocarditis

  • I05 - Rheumatic mitral valve diseases

    • I05.0 - Rheumatic mitral stenosis

    • I05.1 - Rheumatic mitral insufficiency

    • I05.2 - Rheumatic mitral stenosis with insufficiency

    • I05.8 - Other rheumatic mitral valve diseases

    • I05.9 - Rheumatic mitral valve disease, unspecified

  • I06 - Rheumatic aortic valve diseases

    • I06.0 - Rheumatic aortic stenosis

    • I06.1 - Rheumatic aortic insufficiency

    • I06.2 - Rheumatic aortic stenosis with insufficiency

    • I06.8 - Other rheumatic aortic valve diseases

    • I06.9 - Rheumatic aortic valve disease, unspecified

  • I07 - Rheumatic tricuspid valve diseases

    • I07.0 - Rheumatic tricuspid stenosis

    • I07.1 - Rheumatic tricuspid insufficiency

    • I07.2 - Rheumatic tricuspid stenosis and insufficiency

    • I07.8 - Other rheumatic tricuspid valve diseases

    • I07.9 - Rheumatic tricuspid valve disease, unspecified

  • I08 - Multiple valve diseases

    • I08.0 - Rheumatic disorders of both mitral and aortic valves

    • I08.1 - Rheumatic disorders of both mitral and tricuspid valves

    • I08.2 - Rheumatic disorders of both aortic and tricuspid valves

    • I08.3 - Combined rheumatic disorders of mitral, aortic and tricuspid valves

    • I08.8 - Other rheumatic multiple valve diseases

    • I08.9 - Rheumatic multiple valve disease, unspecified

  • I09 - Other rheumatic heart diseases

    • I09.1 - Rheumatic diseases of endocardium, valve unspecified

  • I09.8 - Other specified rheumatic heart diseases

    • I09.89 - Other specified rheumatic heart diseases

  • I23 - Certain current complications following ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (within the 28 day period)

    • I23.4 - Rupture of chordae tendineae as current complication following acute myocardial infarction

    • I23.5 - Rupture of papillary muscle as current complication following acute myocardial infarction

  • I34 - Nonrheumatic mitral valve disorders

    • I34.0 - Nonrheumatic mitral (valve) insufficiency

    • I34.1 - Nonrheumatic mitral (valve) prolapse

    • I34.2 - Nonrheumatic mitral (valve) stenosis

    • I34.9 - Nonrheumatic mitral valve disorder, unspecified

  • I34.8 - Other nonrheumatic mitral valve disorders

    • I34.81 - Nonrheumatic mitral (valve) annulus calcification

    • I34.89 - Other nonrheumatic mitral valve disorders

  • I35 - Nonrheumatic aortic valve disorders

    • I35.0 - Nonrheumatic aortic (valve) stenosis

    • I35.1 - Nonrheumatic aortic (valve) insufficiency

    • I35.2 - Nonrheumatic aortic (valve) stenosis with insufficiency

    • I35.8 - Other nonrheumatic aortic valve disorders

    • I35.9 - Nonrheumatic aortic valve disorder, unspecified

  • I36 - Nonrheumatic tricuspid valve disorders

    • I36.0 - Nonrheumatic tricuspid (valve) stenosis

    • I36.1 - Nonrheumatic tricuspid (valve) insufficiency

    • I36.2 - Nonrheumatic tricuspid (valve) stenosis with insufficiency

    • I36.8 - Other nonrheumatic tricuspid valve disorders

    • I36.9 - Nonrheumatic tricuspid valve disorder, unspecified

  • I37 - Nonrheumatic pulmonary valve disorders

    • I37.0 - Nonrheumatic pulmonary valve stenosis

    • I37.1 - Nonrheumatic pulmonary valve insufficiency

    • I37.2 - Nonrheumatic pulmonary valve stenosis with insufficiency

    • I37.8 - Other nonrheumatic pulmonary valve disorders

    • I37.9 - Nonrheumatic pulmonary valve disorder, unspecified

  • I51 - Complications and ill-defined descriptions of heart disease

    • I51.1 - Rupture of chordae tendineae, not elsewhere classified

    • I51.2 - Rupture of papillary muscle, not elsewhere classified

  • Q20 - Congenital malformations of cardiac chambers and connections

    • Q20.0 - Common arterial trunk

    • Q20.1 - Double outlet right ventricle

    • Q20.2 - Double outlet left ventricle

    • Q20.3 - Discordant ventriculoarterial connection

    • Q20.4 - Double inlet ventricle

    • Q20.5 - Discordant atrioventricular connection

    • Q20.6 - Isomerism of atrial appendages

    • Q20.8 - Other congenital malformations of cardiac chambers and connections

    • Q20.9 - Congenital malformation of cardiac chambers and connections, unspecified

  • Q21 - Congenital malformations of cardiac septa

    • Q21.0 - Ventricular septal defect

    • Q21.3 - Tetralogy of Fallot

    • Q21.4 - Aortopulmonary septal defect

    • Q21.8 - Other congenital malformations of cardiac septa

    • Q21.9 - Congenital malformation of cardiac septum, unspecified

  • Q21.1 - Atrial septal defect

    • Q21.10 - Atrial septal defect, unspecified

    • Q21.11 - Secundum atrial septal defect

    • Q21.12 - Patent foramen ovale

    • Q21.13 - Coronary sinus atrial septal defect

    • Q21.14 - Superior sinus venosus atrial septal defect

    • Q21.15 - Inferior sinus venosus atrial septal defect

    • Q21.16 - Sinus venosus atrial septal defect, unspecified

    • Q21.19 - Other specified atrial septal defect

  • Q21.2 - Atrioventricular septal defect

    • Q21.20 - Atrioventricular septal defect, unspecified as to partial or complete

    • Q21.21 - Partial atrioventricular septal defect

    • Q21.22 - Transitional atrioventricular septal defect

    • Q21.23 - Complete atrioventricular septal defect

  • Q22 - Congenital malformations of pulmonary and tricuspid valves

    • Q22.0 - Pulmonary valve atresia

    • Q22.1 - Congenital pulmonary valve stenosis

    • Q22.2 - Congenital pulmonary valve insufficiency

    • Q22.3 - Other congenital malformations of pulmonary valve

    • Q22.4 - Congenital tricuspid stenosis

    • Q22.5 - Ebstein's anomaly

    • Q22.6 - Hypoplastic right heart syndrome

    • Q22.8 - Other congenital malformations of tricuspid valve

    • Q22.9 - Congenital malformation of tricuspid valve, unspecified

  • Q23 - Congenital malformations of aortic and mitral valves

    • Q23.0 - Congenital stenosis of aortic valve

    • Q23.1 - Congenital insufficiency of aortic valve

    • Q23.2 - Congenital mitral stenosis

    • Q23.3 - Congenital mitral insufficiency

    • Q23.4 - Hypoplastic left heart syndrome

    • Q23.9 - Congenital malformation of aortic and mitral valves, unspecified

  • Q23.8 - Other congenital malformations of aortic and mitral valves

    • Q23.81 - Bicuspid aortic valve

    • Q23.82 - Congenital mitral valve cleft leaflet

    • Q23.88 - Other congenital malformations of aortic and mitral valves

  • Q24 - Other congenital malformations of heart

    • Q24.0 - Dextrocardia

    • Q24.1 - Levocardia

    • Q24.2 - Cor triatriatum

    • Q24.3 - Pulmonary infundibular stenosis

    • Q24.4 - Congenital subaortic stenosis

    • Q24.5 - Malformation of coronary vessels

    • Q24.8 - Other specified congenital malformations of heart

    • Q24.9 - Congenital malformation of heart, unspecified

  • Q25 - Congenital malformations of great arteries

    • Q25.0 - Patent ductus arteriosus

    • Q25.1 - Coarctation of aorta

    • Q25.3 - Supravalvular aortic stenosis

    • Q25.5 - Atresia of pulmonary artery

    • Q25.6 - Stenosis of pulmonary artery

    • Q25.8 - Other congenital malformations of other great arteries

    • Q25.9 - Congenital malformation of great arteries, unspecified

  • Q25.2 - Atresia of aorta

    • Q25.21 - Interruption of aortic arch

    • Q25.29 - Other atresia of aorta

  • Q25.4 - Other congenital malformations of aorta

    • Q25.40 - Congenital malformation of aorta unspecified

    • Q25.41 - Absence and aplasia of aorta

    • Q25.42 - Hypoplasia of aorta

    • Q25.43 - Congenital aneurysm of aorta

    • Q25.44 - Congenital dilation of aorta

    • Q25.45 - Double aortic arch

    • Q25.46 - Tortuous aortic arch

    • Q25.47 - Right aortic arch

    • Q25.48 - Anomalous origin of subclavian artery

    • Q25.49 - Other congenital malformations of aorta

  • Q25.7 - Other congenital malformations of pulmonary artery

    • Q25.71 - Coarctation of pulmonary artery

    • Q25.72 - Congenital pulmonary arteriovenous malformation

    • Q25.79 - Other congenital malformations of pulmonary artery

  • Q26 - Congenital malformations of great veins

    • Q26.0 - Congenital stenosis of vena cava

    • Q26.1 - Persistent left superior vena cava

    • Q26.2 - Total anomalous pulmonary venous connection

    • Q26.3 - Partial anomalous pulmonary venous connection

    • Q26.4 - Anomalous pulmonary venous connection, unspecified

    • Q26.8 - Other congenital malformations of great veins

    • Q26.9 - Congenital malformation of great vein, unspecified

  • Q87.4 - Marfan syndrome

    • Q87.40 - Marfan syndrome, unspecified

    • Q87.42 - Marfan syndrome with ocular manifestations

    • Q87.43 - Marfan syndrome with skeletal manifestation

  • Q87.41 - Marfan syndrome with cardiovascular manifestations

    • Q87.410 - Marfan syndrome with aortic dilation

    • Q87.418 - Marfan syndrome with other cardiovascular manifestations

  • R01 - Cardiac murmurs and other cardiac sounds

    • R01.0 - Benign and innocent cardiac murmurs

    • R01.1 - Cardiac murmur, unspecified

  • T82.01 - Breakdown (mechanical) of heart valve prosthesis

    • T82.01XA - Breakdown (mechanical) of heart valve prosthesis, initial encounter

  • T82.02 - Displacement of heart valve prosthesis

    • T82.02XA - Displacement of heart valve prosthesis, initial encounter

  • T82.03 - Leakage of heart valve prosthesis

    • T82.03XA - Leakage of heart valve prosthesis, initial encounter

  • T82.09 - Other mechanical complication of heart valve prosthesis

    • T82.09XA - Other mechanical complication of heart valve prosthesis, initial encounter