Abstract:Objective：To analyze the common problems of diagnosis and coding in the first page of medical records of patients discharged from orthopedic surgery，andto improve the accuracy of DRGs into the group. Methods：Randomly select 708 medical records of surgical patients from January to December 2019 in an orthopedic ward of a hospital. The main problems of diagnosis and coding in the first page of the medical records were retrospectively analyzed，which were improved after reaching a consensus with the clinic，and the changes of DRGs-related indicators in the twice enrolled patients were compared. Results：708 medical record home page main problems focus on：76 cases description is not concrete，selection of surgical errors in 49 cases，surgery coding missed in 32 cases，code selection error in 19 cases，QY in 13 cases，make improvements to existing problems，the rate of group improved significantly，DRG groups，CMI，total weight all have varying degrees of increase. Conclusion：The main diagnosis and main surgery are the key points that affect of DRGs in to the group for the first page of the medical record of orthopedic surgery patients，clinical doctors should accurately fill in the diagnosis and operation names，and master the main principles of diagnosis and surgical choice，coders need to strengthen the audit of specialist error-prone point，the home page data should be effective mapping actual clinical diagnosis and treatment，can accurately into DRG groups.