MS-DRG v38 (FY 2021) MDC 17 Chemotherapy | Turquoise Health MS-DRG Manual

Enhanced MS-DRG Definitions Manual

MS-DRG v38 (FY 2021) Definitions Manual • MDC 17 • Chemotherapy

DRG Assignment Logic for Chemotherapy

Patients who qualify for Chemotherapy will be grouped into a DRG according to the logic below.

SDX Acute Leukemia	High Dose Chemo Agent	MCC	CC	DRG	Name	Type
Yes	n/a	Yes	n/a	837	CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC	Medical
No	Yes	Yes	n/a	837	CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC	Medical
Yes	No	No	Yes	838	CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT	Medical
No	Yes	No	n/a	838	CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT	Medical
Yes	No	No	No	839	CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS 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.

CHEMOTHERAPY PRINCIPAL DIAGNOSIS

Codes in CHEMOTHERAPY PRINCIPAL DIAGNOSIS
Code	Description
Z08	Encounter for follow-up examination after completed treatment for malignant neoplasm
Z51.11	Encounter for antineoplastic chemotherapy
Z51.12	Encounter for antineoplastic immunotherapy

ACUTE LEUKEMIA SECONDARY DIAGNOSIS

Codes in ACUTE LEUKEMIA SECONDARY DIAGNOSIS
Code	Description
C91.00	Acute lymphoblastic leukemia not having achieved remission
C91.01	Acute lymphoblastic leukemia, in remission
C91.02	Acute lymphoblastic leukemia, in relapse
C92.00	Acute myeloblastic leukemia, not having achieved remission
C92.01	Acute myeloblastic leukemia, in remission
C92.02	Acute myeloblastic leukemia, in relapse
C92.40	Acute promyelocytic leukemia, not having achieved remission
C92.41	Acute promyelocytic leukemia, in remission
C92.42	Acute promyelocytic leukemia, in relapse
C92.50	Acute myelomonocytic leukemia, not having achieved remission
C92.51	Acute myelomonocytic leukemia, in remission
C92.52	Acute myelomonocytic leukemia, in relapse
C92.60	Acute myeloid leukemia with 11q23-abnormality not having achieved remission
C92.61	Acute myeloid leukemia with 11q23-abnormality in remission
C92.62	Acute myeloid leukemia with 11q23-abnormality in relapse
C92.A0	Acute myeloid leukemia with multilineage dysplasia, not having achieved remission
C92.A1	Acute myeloid leukemia with multilineage dysplasia, in remission
C92.A2	Acute myeloid leukemia with multilineage dysplasia, in relapse
C93.00	Acute monoblastic/monocytic leukemia, not having achieved remission
C93.01	Acute monoblastic/monocytic leukemia, in remission
C93.02	Acute monoblastic/monocytic leukemia, in relapse
C94.00	Acute erythroid leukemia, not having achieved remission
C94.01	Acute erythroid leukemia, in remission
C94.02	Acute erythroid leukemia, in relapse
C95.00	Acute leukemia of unspecified cell type not having achieved remission
C95.01	Acute leukemia of unspecified cell type, in remission
C95.02	Acute leukemia of unspecified cell type, in relapse

HIGH DOSE CHEMO AGENT

Codes in HIGH DOSE CHEMO AGENT
Code	Description
3E03002	Introduction of High-dose Interleukin-2 into Peripheral Vein, Open Approach
3E03302	Introduction of High-dose Interleukin-2 into Peripheral Vein, Percutaneous Approach
3E04002	Introduction of High-dose Interleukin-2 into Central Vein, Open Approach
3E04302	Introduction of High-dose Interleukin-2 into Central Vein, Percutaneous Approach
3E05002	Introduction of High-dose Interleukin-2 into Peripheral Artery, Open Approach
3E05302	Introduction of High-dose Interleukin-2 into Peripheral Artery, Percutaneous Approach
3E06002	Introduction of High-dose Interleukin-2 into Central Artery, Open Approach
3E06302	Introduction of High-dose Interleukin-2 into Central Artery, Percutaneous Approach
3E0R302	Introduction of High-dose Interleukin-2 into Spinal Canal, Percutaneous Approach
3E0S302	Introduction of High-dose Interleukin-2 into Epidural Space, Percutaneous Approach

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.