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  3. Diagnosis Codes in MS-DRG 791 - Prematurity With Major Problems

Diagnosis Codes in MS-DRG 791 - Prematurity With Major Problems

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: Prematurity with Major Problems from October 1, 2024, through September 30, 2025.

MS-DRG: 791

MS-DRG Title: Prematurity with Major Problems

MCD: 15

Relative Weight: 4.0601 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: 4.06 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: 13.30 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.

  • P07.1 - Other low birth weight newborn

    • P07.10 - Other low birth weight newborn, unspecified weight

    • P07.14 - Other low birth weight newborn, 1000-1249 grams

    • P07.15 - Other low birth weight newborn, 1250-1499 grams

    • P07.16 - Other low birth weight newborn, 1500-1749 grams

    • P07.17 - Other low birth weight newborn, 1750-1999 grams

    • P07.18 - Other low birth weight newborn, 2000-2499 grams

  • P07.3 - Preterm [premature] newborn [other]

    • P07.30 - Preterm newborn, unspecified weeks of gestation

    • P07.31 - Preterm newborn, gestational age 28 completed weeks

    • P07.32 - Preterm newborn, gestational age 29 completed weeks

    • P07.33 - Preterm newborn, gestational age 30 completed weeks

    • P07.34 - Preterm newborn, gestational age 31 completed weeks

    • P07.35 - Preterm newborn, gestational age 32 completed weeks

    • P07.36 - Preterm newborn, gestational age 33 completed weeks

    • P07.37 - Preterm newborn, gestational age 34 completed weeks

    • P07.38 - Preterm newborn, gestational age 35 completed weeks

    • P07.39 - Preterm newborn, gestational age 36 completed weeks