MDC 14 Pregnancy, Childbirth & the Puerperium is broken down into subgroups, listed here from most to least resource intensive. If a patient received qualifying treatment in listed in more than one subgroup, the first one listed will determine the DRG assigned to the patient.
To determine if a patient qualifies for a subgroup, click on the subgroup name and check the requirements listed. Typically, each subgroup requires one of a serious of ICD-10-CM diagnostic codes or PCS codes to have been assigned to the patient.
To qualify for any subsection in this MDC, the patient's primary diagnostic code must be included in this list.
Patients who qualify for Cesarean Section will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
| CC or MCC | SDX Twins | PDX Malpresentation | DRG | Name | Type |
|---|---|---|---|---|---|
| Yes | No | No | 765 | CESAREAN SECTION WITH CC/MCC | Medical |
| No | Yes | No | 765 | CESAREAN SECTION WITH CC/MCC | Medical |
| No | No | Yes | 766 | CESAREAN SECTION WITHOUT CC/MCC | Medical |
| No | Yes | Yes | 766 | CESAREAN SECTION WITHOUT CC/MCC | Medical |
| No | No | No | 766 | CESAREAN SECTION WITHOUT CC/MCC | Medical |
All patients who qualify for the subsection Postpartum and Post Abortion Diagnoses with Major Procedure will be automatically grouped into DRG 769 - POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURE.
View the requirements to qualify for this subsection.
All patients who qualify for the subsection Abortion with D&C, Aspiration Curettage or Hysterotomy will be automatically grouped into DRG 770 - ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 770 | ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY | Medical |
All patients who qualify for the subsection Ectopic Pregnancy will be automatically grouped into DRG 777 - ECTOPIC PREGNANCY.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 777 | ECTOPIC PREGNANCY | Medical |
All patients who qualify for the subsection Threatened Abortion will be automatically grouped into DRG 778 - THREATENED ABORTION.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 778 | THREATENED ABORTION | Medical |
All patients who qualify for the subsection Abortion without D&C will be automatically grouped into DRG 779 - ABORTION WITHOUT D&C.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 779 | ABORTION WITHOUT D&C | Medical |
All patients who qualify for the subsection False Labor will be automatically grouped into DRG 780 - FALSE LABOR.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 780 | FALSE LABOR | Medical |
Patients who qualify for Vaginal Delivery with O.R. procedure will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
| Sterilization and/or D&C | DRG | Name | Type |
|---|---|---|---|
| Yes | 767 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C | Medical |
| No | 768 | VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C | Medical |
Patients who qualify for Vaginal Delivery with Complicating Diagnoses will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
All patients who qualify for the subsection Vaginal Delivery without Complicating Diagnoses will be automatically grouped into DRG 775 - VAGINAL DELIVERY WITHOUT COMPLICATING DIAGNOSES.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 775 | VAGINAL DELIVERY WITHOUT COMPLICATING DIAGNOSES | Medical |
All patients who qualify for the subsection Postpartum and Post Abortion Diagnoses without listed procedure will be automatically grouped into DRG 776 - POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURE.
View the requirements to qualify for this subsection.
All patients who qualify for the subsection Other Antepartum Diagnoses with Medical Complications will be automatically grouped into DRG 781 - OTHER ANTEPARTUM DIAGNOSES WITH MEDICAL COMPLICATIONS.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 781 | OTHER ANTEPARTUM DIAGNOSES WITH MEDICAL COMPLICATIONS | Medical |
All patients who qualify for the subsection Other Antepartum Diagnoses without Medical Complications will be automatically grouped into DRG 782 - OTHER ANTEPARTUM DIAGNOSES WITHOUT MEDICAL COMPLICATIONS.
View the requirements to qualify for this subsection.
All patients who qualify for the subsection Principal Diagnosis Invalid as Discharge Diagnosis will be automatically grouped into DRG 998 - PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 998 | PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS | Medical |