MDC 18 Infectious and parasitic diseases, systemic or unspecified sites 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 Postoperative or post-traumatic infections with O.R. 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 Infectious and parasitic diseases with O.R. 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 Postoperative and post-traumatic infections will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
All patients who qualify for the subsection Fever and inflammatory conditions will be automatically grouped into DRG 864 - FEVER AND INFLAMMATORY CONDITIONS.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 864 | FEVER AND INFLAMMATORY CONDITIONS | Medical |
Patients who qualify for Viral illness 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 | 865 | VIRAL ILLNESS WITH MCC | Medical |
| No | 866 | VIRAL ILLNESS WITHOUT MCC | Medical |
Patients who qualify for Other infectious and parasitic diseases diagnoses 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 Septicemia or severe sepsis will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.
| MV >96 Hours | MCC | DRG | Name | Type |
|---|---|---|---|---|
| Yes | No | 870 | SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | Medical |
| No | Yes | 871 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | Medical |
| No | No | 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | Medical |