MS-DRG v34 (FY 2017) MDC XX | Turquoise Health MS-DRG Manual

Enhanced MS-DRG Definitions Manual

MS-DRG v34 (FY 2017) Definitions Manual • MDC XX

MDC XX Unrelated Operating Room Procedures 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.

Extensive Procedure Unrelated to Principal Diagnosis

Patients who qualify for Extensive Procedure Unrelated to Principal Diagnosis will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.

MCC	CC	DRG	Name	Type
Yes	n/a	981	EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC	Medical
No	Yes	982	EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC	Medical
No	No	983	EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC	Medical

Prostatic Procedure Unrelated to Principal Diagnosis

Patients who qualify for Prostatic Procedure Unrelated to Principal Diagnosis will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.

MCC	CC	DRG	Name	Type
Yes	n/a	984	PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC	Medical
No	Yes	985	PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC	Medical
No	No	986	PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC	Medical

Non-extensive Procedure Unrelated to Principal Diagnosis

Patients who qualify for Non-extensive Procedure Unrelated to Principal Diagnosis will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.

MCC	CC	DRG	Name	Type
Yes	n/a	987	NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC	Medical
No	Yes	988	NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC	Medical
No	No	989	NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC	Medical

About the Turquoise Health MS-DRG Manual Browser

We build tools and machine learning systems that simplify healthcare revenue cycle operations. We were frustrated with the formatting of the MS-DRG rules, so we built our own solution.

MS-DRG rules and ICD-10 CM/PCS codes are automatically parsed from CMS's MS-DRG data files. All content is provided strictly “AS IS” and may contain parsing errors. If you spot an error, please let us know.

We have converted the MS-DRG logic into fully structured, machine-readable data. If you need structured data versions of the MS-DRG manuals, we would love to talk with you.