MDC 13 Diseases and disorders of the female 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 Pelvic evisceration, radical hysterectomy and radical vulvectomy 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 Uterine and adnexa 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 Uterine and adnexa procedures for non-malignancy 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 | 742 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC | Medical |
| No | 743 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | Medical |
Patients who qualify for D&C, conization, laparoscopy and tubal interruption 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 Vagina, cervix and vulva 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 | 746 | VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC | Medical |
| No | 747 | VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC | Medical |
All patients who qualify for the subsection Female reproductive system reconstructive procedures will be automatically grouped into DRG 748 - FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 748 | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | Medical |
Patients who qualify for Other female 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.
| CC or MCC | DRG | Name | Type |
|---|---|---|---|
| Yes | 749 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC | Medical |
| No | 750 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | Medical |
Patients who qualify for Malignancy, female 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 | 754 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC | Medical |
| No | Yes | 755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC | Medical |
| No | No | 756 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | Medical |
Patients who qualify for Infections, female 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 | 757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC | Medical |
| No | Yes | 758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC | Medical |
| No | No | 759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | Medical |
Patients who qualify for Menstrual and other female reproductive system disorders will be grouped into a DRG according to the logic below. View detailed requirements for qualifying for the DRGs in this subsection.