Patients who qualify for Ear, Nose, Mouth and Throat Malignancy will be grouped into a DRG according to the logic below.
| MCC | CC | DRG | Name | Type |
|---|---|---|---|---|
| Yes | n/a | 146 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC | Medical |
| No | Yes | 147 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC | Medical |
| No | No | 148 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC | Medical |
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.
| Code | Description |
|---|---|
| C00.0 |
Malignant neoplasm of external upper lip |
| C00.1 |
Malignant neoplasm of external lower lip |
| C00.2 |
Malignant neoplasm of external lip, unspecified |
| C00.3 |
Malignant neoplasm of upper lip, inner aspect |
| C00.4 |
Malignant neoplasm of lower lip, inner aspect |
| C00.5 |
Malignant neoplasm of lip, unspecified, inner aspect |
| C00.6 |
Malignant neoplasm of commissure of lip, unspecified |
| C00.8 |
Malignant neoplasm of overlapping sites of lip |
| C00.9 |
Malignant neoplasm of lip, unspecified |
| C01 |
Malignant neoplasm of base of tongue |
| C02.0 |
Malignant neoplasm of dorsal surface of tongue |
| C02.1 |
Malignant neoplasm of border of tongue |
| C02.2 |
Malignant neoplasm of ventral surface of tongue |
| C02.3 |
Malignant neoplasm of anterior two-thirds of tongue, part unspecified |
| C02.4 |
Malignant neoplasm of lingual tonsil |
| C02.8 |
Malignant neoplasm of overlapping sites of tongue |
| C02.9 |
Malignant neoplasm of tongue, unspecified |
| C03.0 |
Malignant neoplasm of upper gum |
| C03.1 |
Malignant neoplasm of lower gum |
| C03.9 |
Malignant neoplasm of gum, unspecified |
| C04.0 |
Malignant neoplasm of anterior floor of mouth |
| C04.1 |
Malignant neoplasm of lateral floor of mouth |
| C04.8 |
Malignant neoplasm of overlapping sites of floor of mouth |
| C04.9 |
Malignant neoplasm of floor of mouth, unspecified |
| C05.0 |
Malignant neoplasm of hard palate |
| C05.1 |
Malignant neoplasm of soft palate |
| C05.2 |
Malignant neoplasm of uvula |
| C05.8 |
Malignant neoplasm of overlapping sites of palate |
| C05.9 |
Malignant neoplasm of palate, unspecified |
| C06.0 |
Malignant neoplasm of cheek mucosa |
| C06.1 |
Malignant neoplasm of vestibule of mouth |
| C06.2 |
Malignant neoplasm of retromolar area |
| C06.80 |
Malignant neoplasm of overlapping sites of unspecified parts of mouth |
| C06.89 |
Malignant neoplasm of overlapping sites of other parts of mouth |
| C06.9 |
Malignant neoplasm of mouth, unspecified |
| C07 |
Malignant neoplasm of parotid gland |
| C08.0 |
Malignant neoplasm of submandibular gland |
| C08.1 |
Malignant neoplasm of sublingual gland |
| C08.9 |
Malignant neoplasm of major salivary gland, unspecified |
| C09.0 |
Malignant neoplasm of tonsillar fossa |
| C09.1 |
Malignant neoplasm of tonsillar pillar (anterior) (posterior) |
| C09.8 |
Malignant neoplasm of overlapping sites of tonsil |
| C09.9 |
Malignant neoplasm of tonsil, unspecified |
| C10.0 |
Malignant neoplasm of vallecula |
| C10.1 |
Malignant neoplasm of anterior surface of epiglottis |
| C10.2 |
Malignant neoplasm of lateral wall of oropharynx |
| C10.3 |
Malignant neoplasm of posterior wall of oropharynx |
| C10.4 |
Malignant neoplasm of branchial cleft |
| C10.8 |
Malignant neoplasm of overlapping sites of oropharynx |
| C10.9 |
Malignant neoplasm of oropharynx, unspecified |
| C11.0 |
Malignant neoplasm of superior wall of nasopharynx |
| C11.1 |
Malignant neoplasm of posterior wall of nasopharynx |
| C11.2 |
Malignant neoplasm of lateral wall of nasopharynx |
| C11.3 |
Malignant neoplasm of anterior wall of nasopharynx |
| C11.8 |
Malignant neoplasm of overlapping sites of nasopharynx |
| C11.9 |
Malignant neoplasm of nasopharynx, unspecified |
| C12 |
Malignant neoplasm of pyriform sinus |
| C13.0 |
Malignant neoplasm of postcricoid region |
| C13.1 |
Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect |
| C13.2 |
Malignant neoplasm of posterior wall of hypopharynx |
| C13.8 |
Malignant neoplasm of overlapping sites of hypopharynx |
| C13.9 |
Malignant neoplasm of hypopharynx, unspecified |
| C14.0 |
Malignant neoplasm of pharynx, unspecified |
| C14.2 |
Malignant neoplasm of Waldeyer's ring |
| C14.8 |
Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx |
| C30.0 |
Malignant neoplasm of nasal cavity |
| C30.1 |
Malignant neoplasm of middle ear |
| C31.0 |
Malignant neoplasm of maxillary sinus |
| C31.1 |
Malignant neoplasm of ethmoidal sinus |
| C31.2 |
Malignant neoplasm of frontal sinus |
| C31.3 |
Malignant neoplasm of sphenoid sinus |
| C31.8 |
Malignant neoplasm of overlapping sites of accessory sinuses |
| C31.9 |
Malignant neoplasm of accessory sinus, unspecified |
| C32.0 |
Malignant neoplasm of glottis |
| C32.1 |
Malignant neoplasm of supraglottis |
| C32.2 |
Malignant neoplasm of subglottis |
| C32.3 |
Malignant neoplasm of laryngeal cartilage |
| C32.8 |
Malignant neoplasm of overlapping sites of larynx |
| C32.9 |
Malignant neoplasm of larynx, unspecified |
| C39.0 |
Malignant neoplasm of upper respiratory tract, part unspecified |
| C46.2 |
Kaposi's sarcoma of palate |
| C76.0 |
Malignant neoplasm of head, face and neck |
| D00.00 |
Carcinoma in situ of oral cavity, unspecified site |
| D00.01 |
Carcinoma in situ of labial mucosa and vermilion border |
| D00.02 |
Carcinoma in situ of buccal mucosa |
| D00.03 |
Carcinoma in situ of gingiva and edentulous alveolar ridge |
| D00.04 |
Carcinoma in situ of soft palate |
| D00.05 |
Carcinoma in situ of hard palate |
| D00.06 |
Carcinoma in situ of floor of mouth |
| D00.07 |
Carcinoma in situ of tongue |
| D00.08 |
Carcinoma in situ of pharynx |
| D02.0 |
Carcinoma in situ of larynx |
| D37.01 |
Neoplasm of uncertain behavior of lip |
| D37.02 |
Neoplasm of uncertain behavior of tongue |
| D37.030 |
Neoplasm of uncertain behavior of the parotid salivary glands |
| D37.031 |
Neoplasm of uncertain behavior of the sublingual salivary glands |
| D37.032 |
Neoplasm of uncertain behavior of the submandibular salivary glands |
| D37.039 |
Neoplasm of uncertain behavior of the major salivary glands, unspecified |
| D37.04 |
Neoplasm of uncertain behavior of the minor salivary glands |
| D37.05 |
Neoplasm of uncertain behavior of pharynx |
| D37.09 |
Neoplasm of uncertain behavior of other specified sites of the oral cavity |
| D38.0 |
Neoplasm of uncertain behavior of larynx |
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.