Enhanced MS-DRG Definitions Manual

MS-DRG v35 (FY 2018) Definitions Manual • MDC 14 • Vaginal Delivery with O.R. procedure

DRG Assignment Logic for Vaginal Delivery with O.R. procedure

Patients who qualify for Vaginal Delivery with O.R. procedure will be grouped into a DRG according to the logic below.

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

Detailed Rules

The tables below list the codes required to qualify for this subsection according to the logic listed above. By matching the codes on a patient's account to those listed below, you can work out how a patient will be grouped by the MS-DRG grouper. However, sometimes this can be difficult to work out by hand. If you are looking for automated DRG grouping software that can be integrated into your workflow, please let us know.

TWO CONDITIONS MUST BE MET SOME CODES MAY MEET MORE THAN ONE OF THE CONDITIONS FIRST CONDITION - VAGINAL DELIVERY PRINCIPAL DIAGNOSIS OR SECONDARY DIAGNOSIS

OR DELIVERY PROCEDURE

OR DELIVERY OUTCOME SECONDARY DIAGNOSIS

SECOND CONDITION - O.R. PROCEDURES WITH VAGINAL DELIVERY STERILIZATION OPERATING ROOM PROCEDURES

OR OTHER OPERATING ROOM PROCEDURES

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.

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