MS-DRG v41 (FY 2024) MDC 11 | Turquoise Health MS-DRG Manual

Enhanced MS-DRG Definitions Manual

MS-DRG v41 (FY 2024) Definitions Manual • MDC 11

MDC 11 Diseases and disorders of the kidney and urinary tract 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 11 Assignment of Diagnosis Codes

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

Kidney transplant with hemodialysis

Patients who qualify for Kidney transplant with hemodialysis 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	650	KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC	Medical
No	651	KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC	Medical

Kidney transplant

All patients who qualify for the subsection Kidney transplant will be automatically grouped into DRG 652 - KIDNEY TRANSPLANT.

View the requirements to qualify for this subsection.

DRG	Name	Type
652	KIDNEY TRANSPLANT	Medical

Major bladder procedures

Patients who qualify for Major bladder procedures 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	653	MAJOR BLADDER PROCEDURES WITH MCC	Medical
No	Yes	654	MAJOR BLADDER PROCEDURES WITH CC	Medical
No	No	655	MAJOR BLADDER PROCEDURES WITHOUT CC/MCC	Medical

Kidney and ureter procedures

Patients who qualify for Kidney and ureter procedures will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.

Neoplasm	MCC	CC	DRG	Name	Type
Yes	Yes	n/a	656	KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC	Medical
Yes	No	Yes	657	KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC	Medical
Yes	No	No	658	KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC	Medical
No	Yes	n/a	659	KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC	Medical
No	No	Yes	660	KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC	Medical
No	No	No	661	KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC	Medical

Minor bladder procedures

Patients who qualify for Minor bladder procedures 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	662	MINOR BLADDER PROCEDURES WITH MCC	Medical
No	Yes	663	MINOR BLADDER PROCEDURES WITH CC	Medical
No	No	664	MINOR BLADDER PROCEDURES WITHOUT CC/MCC	Medical

Prostatectomy

Patients who qualify for Prostatectomy 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	665	PROSTATECTOMY WITH MCC	Medical
No	Yes	666	PROSTATECTOMY WITH CC	Medical
No	No	667	PROSTATECTOMY WITHOUT CC/MCC	Medical

Transurethral procedures

Patients who qualify for Transurethral procedures 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	668	TRANSURETHRAL PROCEDURES WITH MCC	Medical
No	Yes	669	TRANSURETHRAL PROCEDURES WITH CC	Medical
No	No	670	TRANSURETHRAL PROCEDURES WITHOUT CC/MCC	Medical

Urethral procedures

Patients who qualify for Urethral 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	671	URETHRAL PROCEDURES WITH CC/MCC	Medical
No	672	URETHRAL PROCEDURES WITHOUT CC/MCC	Medical

Other kidney and urinary tract procedures

Patients who qualify for Other kidney and urinary tract procedures 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	673	OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC	Medical
No	Yes	674	OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC	Medical
No	No	675	OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC	Medical

Renal failure

Patients who qualify for Renal failure 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	682	RENAL FAILURE WITH MCC	Medical
No	Yes	683	RENAL FAILURE WITH CC	Medical
No	No	684	RENAL FAILURE WITHOUT CC/MCC	Medical

Kidney and urinary tract neoplasms

Patients who qualify for Kidney and urinary tract neoplasms 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	686	KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC	Medical
No	Yes	687	KIDNEY AND URINARY TRACT NEOPLASMS WITH CC	Medical
No	No	688	KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC	Medical

Kidney and urinary tract infections

Patients who qualify for Kidney and urinary tract infections 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	689	KIDNEY AND URINARY TRACT INFECTIONS WITH MCC	Medical
No	690	KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC	Medical

Urinary stones

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

MCC	CC or MCC	DRG	Name	Type
Yes	n/a	693	URINARY STONES WITH MCC	Medical
No	n/a	694	URINARY STONES WITHOUT MCC	Medical

Kidney and urinary tract signs and symptoms

Patients who qualify for Kidney and urinary tract signs and symptoms 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	695	KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC	Medical
No	696	KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC	Medical

Urethral stricture

All patients who qualify for the subsection Urethral stricture will be automatically grouped into DRG 697 - URETHRAL STRICTURE.

View the requirements to qualify for this subsection.

DRG	Name	Type
697	URETHRAL STRICTURE	Medical

Other kidney and urinary tract diagnoses

Patients who qualify for Other kidney and urinary tract diagnoses 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	698	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC	Medical
No	Yes	699	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC	Medical
No	No	700	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/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.