MDC 25 Human immunodeficiency virus infections 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 HIV with extensive 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.
| MCC | DRG | Name | Type |
|---|---|---|---|
| Yes | 969 | HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC | Medical |
| No | 970 | HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC | Medical |
Patients who qualify for HIV with major related condition 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 | 974 | HIV WITH MAJOR RELATED CONDITION WITH MCC | Medical |
| No | Yes | 975 | HIV WITH MAJOR RELATED CONDITION WITH CC | Medical |
| No | No | 976 | HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC | Medical |
All patients who qualify for the subsection HIV with or without other related condition will be automatically grouped into DRG 977 - HIV WITH OR WITHOUT OTHER RELATED CONDITION.
View the requirements to qualify for this subsection.
| DRG | Name | Type |
|---|---|---|
| 977 | HIV WITH OR WITHOUT OTHER RELATED CONDITION | Medical |