When K26.4 is used as a secondary diagnostic code, the patient's visit may be considered to have Complications & Comorbid Conditions (CC) or Major Complications & Comorbid Conditions (MCC).
Exclusions apply. When the primary diagnostic code is is in the exclusion list, the patient visit CC/MCC does not qualify for a CC or MCC.
CC/MCC grouping rules are adjusted each year, so check the rules for the fiscal year of the patient's discharge date.
Diagnostic codes are the first step in the DRG mapping process.
The patient's primary diagnostic code is the most important. Assuming the patient's primary diagnostic code is K26.4, look in the list below to see which MDC's "Assignment of Diagnosis Codes" is first. That is the MDC that the patient will be grouped into.
From there, check the subsections of the MDC listed. The patient will be mapped into the first subsection for which the treatment performed on the patient meet the listed requirements of that subsection.
DRG grouping rules are adjusted each year, so make sure to check the rules for the fiscal year of the patient's discharge date.