MS-DRG v41 (FY 2024) MDC 02 | Turquoise Health MS-DRG Manual

Enhanced MS-DRG Definitions Manual

MS-DRG v41 (FY 2024) Definitions Manual • MDC 02

MDC 02 Diseases and disorders of the eye 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.

MDC 02 Assignment of Diagnosis Codes

To qualify for any subsection in this MDC, the patient's primary diagnostic code must be included in this list.

Orbital procedures

Patients who qualify for Orbital procedures 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	113	ORBITAL PROCEDURES WITH CC/MCC	Medical
No	114	ORBITAL PROCEDURES WITHOUT CC/MCC	Medical

Extraocular procedures except orbit

All patients who qualify for the subsection Extraocular procedures except orbit will be automatically grouped into DRG 115 - EXTRAOCULAR PROCEDURES EXCEPT ORBIT.

View the requirements to qualify for this subsection.

DRG	Name	Type
115	EXTRAOCULAR PROCEDURES EXCEPT ORBIT	Medical

Intraocular procedures

Patients who qualify for Intraocular procedures 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	116	INTRAOCULAR PROCEDURES WITH CC/MCC	Medical
No	117	INTRAOCULAR PROCEDURES WITHOUT CC/MCC	Medical

Acute major eye infections

Patients who qualify for Acute major eye infections 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	121	ACUTE MAJOR EYE INFECTIONS WITH CC/MCC	Medical
No	122	ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC	Medical

Neurological eye disorders

All patients who qualify for the subsection Neurological eye disorders will be automatically grouped into DRG 123 - NEUROLOGICAL EYE DISORDERS.

View the requirements to qualify for this subsection.

DRG	Name	Type
123	NEUROLOGICAL EYE DISORDERS	Medical

Other disorders of the eye

Patients who qualify for Other disorders of the eye will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.

MCC	Thrombolytic Agent	DRG	Name	Type
Yes	n/a	124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	Medical
n/a	Yes	124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	Medical
No	No	125	OTHER DISORDERS OF THE EYE WITHOUT MCC	Medical

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.