MDC 12 Diseases and disorders of the male reproductive system 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 Major male pelvic 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 | 707 | MAJOR MALE PELVIC PROCEDURES WITH CC/MCC | Medical |
| No | 708 | MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC | Medical |
Patients who qualify for Penis 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 | 709 | PENIS PROCEDURES WITH CC/MCC | Medical |
| No | 710 | PENIS PROCEDURES WITHOUT CC/MCC | Medical |
Patients who qualify for Testes 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 | 711 | TESTES PROCEDURES WITH CC/MCC | Medical |
| No | 712 | TESTES PROCEDURES WITHOUT CC/MCC | Medical |
Patients who qualify for Transurethral prostatectomy 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 | 713 | TRANSURETHRAL PROSTATECTOMY WITH CC/MCC | Medical |
| No | 714 | TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC | Medical |
Patients who qualify for Other male reproductive system 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 Malignancy, male reproductive system 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 | 722 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC | Medical |
| No | Yes | 723 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC | Medical |
| No | No | 724 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | Medical |
Patients who qualify for Benign prostatic hypertrophy 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 | 725 | BENIGN PROSTATIC HYPERTROPHY WITH MCC | Medical |
| No | 726 | BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC | Medical |
Patients who qualify for Inflammation of the male reproductive system 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 Other male reproductive system diagnoses 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 | 729 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC | Medical |
| No | 730 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | Medical |