00

Pre-MDC

Pre-MDC DRGs are assigned before MDC logic runs, driven by the procedure rather than the principal diagnosis. On a grouped claim the API still reports the principal diagnosis's own MDC, so a heart transplant can come back as MDC 05.

Surgical hierarchy

In the order the grouper applies them, highest first. A patient with several procedures is assigned to the highest surgical class one of them belongs to, so this ordering decides the DRG, not the order procedures appear on the claim.

1. 1 Chimeric Antigen Receptor (CAR) T-Cell and Other Immunotherapies
   • 018 Chimeric Antigen Receptor (CAR) T-Cell and Other Immunotherapies 45.1464
2. 2 Heart Transplant or Implant of Heart Assist System
   • 001 Heart Transplant or Implant of Heart Assist System with MCC 28.0947
   • 002 Heart Transplant or Implant of Heart Assist System without MCC 11.0088
3. 3 ECMO or Tracheostomy with MV >96 Hours or Principal Diagnosis Except Face, Mouth and Neck
   • 003 ECMO or Tracheostomy with MV >96 Hours or Principal Diagnosis Except Face, Mouth and Neck with Major O.R. Procedures 21.2763
4. 4 Lung Transplant
   • 007 Lung Transplant 14.8769
5. 5 Tracheostomy with MV >96 Hours or Principal Diagnosis Except Face, Mouth and Neck without Major O.R. Procedures
   • 004 Tracheostomy with MV >96 Hours or Principal Diagnosis Except Face, Mouth and Neck without Major O.R. Procedures 13.5832
6. 6 Allogeneic Bone Marrow Transplant
   • 014 Allogeneic Bone Marrow Transplant 11.7942
7. 7 Liver or Intestinal Transplant
   • 005 Liver Transplant with MCC or Intestinal Transplant 10.4787
   • 006 Liver Transplant without MCC 4.5774
8. 8 Pancreas or Islet Cell Transplant
   • 010 Pancreas or Islet Cell Transplant 7.5259
9. 9 Simultaneous Pancreas, Islet Cell and Kidney Transplant with Hemodialysis
   • 019 Simultaneous Pancreas, Islet Cell and Kidney Transplant with Hemodialysis 7.5493
10. 10 Autologous Bone Marrow Transplant
    • 016 Autologous Bone Marrow Transplant with CC/MCC 6.0162
    • 017 Autologous Bone Marrow Transplant without CC/MCC 4.8891
11. 11 Simultaneous Pancreas, Islet Cell and Kidney Transplant
    • 008 Simultaneous Pancreas, Islet Cell and Kidney Transplant 5.5146
12. 12 Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy
    • 011 Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC 5.6154
    • 012 Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC 4.3810
    • 013 Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC 2.7307

Other surgical DRGs

Surgical DRGs in this MDC that Appendix D does not rank.

• 981 Extensive O.R. Procedures Unrelated to Principal Diagnosis with MCC 4.7412
• 982 Extensive O.R. Procedures Unrelated to Principal Diagnosis with CC 2.4249
• 983 Extensive O.R. Procedures Unrelated to Principal Diagnosis without CC/MCC 1.6133
• 987 Non-Extensive O.R. Procedures Unrelated to Principal Diagnosis with MCC 3.3515
• 988 Non-Extensive O.R. Procedures Unrelated to Principal Diagnosis with CC 1.6477
• 989 Non-Extensive O.R. Procedures Unrelated to Principal Diagnosis without CC/MCC 1.1044