MDC 09 Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast 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.
Patients who qualify for Skin Graft will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
PDX Skin Ulcer or Cellulitis | MCC | CC | DRG | Name | Type |
---|---|---|---|---|---|
Yes | Yes | n/a | 573 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC | Medical |
Yes | No | Yes | 574 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC | Medical |
Yes | No | No | 575 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC | Medical |
No | Yes | n/a | 576 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC | Medical |
No | No | Yes | 577 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC | Medical |
No | No | No | 578 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC | Medical |
Patients who qualify for Skin Debridement will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
MCC | CC | DRG | Name | Type |
---|---|---|---|---|
Yes | n/a | 570 | SKIN DEBRIDEMENT WITH MCC | Medical |
No | Yes | 571 | SKIN DEBRIDEMENT WITH CC | Medical |
No | No | 572 | SKIN DEBRIDEMENT WITHOUT CC/MCC | Medical |
Patients who qualify for Other Skin, Subcutaneous Tissue and Breast Procedures will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
Patients who qualify for Mastectomy for Malignancy will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
CC or MCC | DRG | Name | Type |
---|---|---|---|
Yes | 582 | MASTECTOMY FOR MALIGNANCY WITH CC/MCC | Medical |
No | 583 | MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC | Medical |
Patients who qualify for Breast Biopsy, Local Excision and Other Breast Procedures will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
Patients who qualify for Skin Ulcers will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
MCC | CC | DRG | Name | Type |
---|---|---|---|---|
Yes | n/a | 592 | SKIN ULCERS WITH MCC | Medical |
No | Yes | 593 | SKIN ULCERS WITH CC | Medical |
No | No | 594 | SKIN ULCERS WITHOUT CC/MCC | Medical |
Patients who qualify for Major Skin Disorders will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
MCC | DRG | Name | Type |
---|---|---|---|
Yes | 595 | MAJOR SKIN DISORDERS WITH MCC | Medical |
No | 596 | MAJOR SKIN DISORDERS WITHOUT MCC | Medical |
Patients who qualify for Malignant Breast Disorders will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
MCC | CC | DRG | Name | Type |
---|---|---|---|---|
Yes | n/a | 597 | MALIGNANT BREAST DISORDERS WITH MCC | Medical |
No | Yes | 598 | MALIGNANT BREAST DISORDERS WITH CC | Medical |
n/a | n/a | 599 | MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | Medical |
Patients who qualify for Non-Malignant Breast Disorders will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
CC or MCC | DRG | Name | Type |
---|---|---|---|
Yes | 600 | NON-MALIGNANT BREAST DISORDERS WITH CC/MCC | Medical |
No | 601 | NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | Medical |
Patients who qualify for Cellulitis will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
MCC | DRG | Name | Type |
---|---|---|---|
Yes | 602 | CELLULITIS WITH MCC | Medical |
No | 603 | CELLULITIS WITHOUT MCC | Medical |
Patients who qualify for Trauma to the Skin, Subcutaneous Tissue and Breast will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
Patients who qualify for Minor Skin Disorders will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
MCC | DRG | Name | Type |
---|---|---|---|
Yes | 606 | MINOR SKIN DISORDERS WITH MCC | Medical |
No | 607 | MINOR SKIN DISORDERS WITHOUT MCC | Medical |