Which item is NOT used to assign a DRG?

• A. Discharge status
• B. Principal diagnosis
• C. Primary physician's preferences (not used)
• D. Surgical procedures performed

Answer: (C)

DRG assignment is a data-driven process that uses coded information from the hospitalization to group patients by similar diagnoses and resource use. The key factors that drive the DRG are the principal diagnosis at admission and the procedures performed during the stay, with the presence of complications or comorbidities (CC/MCC) shaping the specific DRG and its weight. Discharge disposition is a data point tracked in records and can influence payment in some contexts, but it does not define the DRG category. Personal preferences or treatment choices of the primary physician aren’t part of the coding or DRG calculation at all, since DRGs are determined from objective clinical data rather than individual physician opinions. Therefore, the item that is not used to assign a DRG is the primary physician's preferences.