Enhanced MS-DRG Definitions Manual

MS-DRG v37 (FY 2020) Definitions Manual • MDC 03 • Other Ear,Nose,Mouth and Throat Diagnoses

DRG Assignment Logic for Other Ear,Nose,Mouth and Throat Diagnoses

Patients who qualify for Other Ear,Nose,Mouth and Throat Diagnoses will be grouped into a DRG according to the logic below.

MCC CC DRG Name Type
Yes n/a 154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC Medical
No Yes 155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Medical
No No 156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC 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.

PRINCIPAL DIAGNOSIS

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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