MDC 20 Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental Disorders 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.
All patients who qualify for the subsection Alcohol/Drug Abuse or Dependence, Left AMA will be automatically grouped into DRG 894 - ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 894 | ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | Medical |
Patients who qualify for Alcohol/Drug Abuse or Dependence will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
| Rehabilitation Therapy | MCC | DRG | Name | Type |
|---|---|---|---|---|
| Yes | n/a | 895 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | Medical |
| No | Yes | 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | Medical |
| No | No | 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | Medical |