MS-DRG v37 (FY 2020) Pre ECMO or Tracheostomy with MV >96 Hours or PDX Except Face, Mouth and Neck

Enhanced MS-DRG Definitions Manual

MS-DRG v37 (FY 2020) Definitions Manual • Pre • ECMO or Tracheostomy with MV >96 Hours or PDX Except Face, Mouth and Neck

DRG Assignment Logic for ECMO or Tracheostomy with MV >96 Hours or PDX Except Face, Mouth and Neck

Patients who qualify for ECMO or Tracheostomy with MV >96 Hours or PDX Except Face, Mouth and Neck will be grouped into a DRG according to the logic below.

ECMO	Tracheostomy	MV>96	PDX Exc Face, Mouth, Neck	Major O.R.Procedure	DRG	Name	Type
Yes	n/a	n/a	n/a	n/a	003	ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE	Medical
No	Yes	Yes	n/a	Yes	003	ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE	Medical
No	Yes	n/a	Yes	Yes	003	ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE	Medical
No	Yes	Yes	n/a	No	004	TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE	Medical
No	Yes	n/a	Yes	No	004	TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE	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.

ECMO OPERATING ROOM PROCEDURES

Codes in ECMO OPERATING ROOM PROCEDURES
Code	Description
5A1522F	Extracorporeal Oxygenation, Membrane, Central

NON-OPERATING ROOM PROCEDURES

Codes in NON-OPERATING ROOM PROCEDURES
Code	Description
5A1522G	Extracorporeal Oxygenation, Membrane, Peripheral Veno-arterial
5A1522H	Extracorporeal Oxygenation, Membrane, Peripheral Veno-venous

TRACHEOSTOMY OPERATING ROOM PROCEDURES

Codes in TRACHEOSTOMY OPERATING ROOM PROCEDURES
Code	Description
0B110F4	Bypass Trachea to Cutaneous with Tracheostomy Device, Open Approach
0B110Z4	Bypass Trachea to Cutaneous, Open Approach
0B114F4	Bypass Trachea to Cutaneous with Tracheostomy Device, Percutaneous Endoscopic Approach
0B114Z4	Bypass Trachea to Cutaneous, Percutaneous Endoscopic Approach

OR NON-OPERATING ROOM PROCEDURES

Codes in OR NON-OPERATING ROOM PROCEDURES
Code	Description
0B113F4	Bypass Trachea to Cutaneous with Tracheostomy Device, Percutaneous Approach
0B113Z4	Bypass Trachea to Cutaneous, Percutaneous Approach

MECHANICAL VENTILATION >96 HOURS NON-OPERATING ROOM PROCEDURES

Codes in MECHANICAL VENTILATION >96 HOURS NON-OPERATING ROOM PROCEDURES
Code	Description
5A1955Z	Respiratory Ventilation, Greater than 96 Consecutive Hours

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.