03

Diseases and Disorders of the Ear, Nose, Mouth and Throat

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 Major Head and Neck Procedures
   • 140 Major Head and Neck Procedures with MCC 4.3117
   • 141 Major Head and Neck Procedures with CC 2.2351
   • 142 Major Head and Neck Procedures without CC/MCC 1.7045
2. 2 Other Ear, Nose, Mouth and Throat O.R. Procedures
   • 143 Other Ear, Nose, Mouth and Throat O.R. Procedures with MCC 3.8517
   • 144 Other Ear, Nose, Mouth and Throat O.R. Procedures with CC 1.7834
   • 145 Other Ear, Nose, Mouth and Throat O.R. Procedures without CC/MCC 1.2340
3. 3 Sinus and Mastoid Procedures
   • 135 Sinus and Mastoid Procedures with CC/MCC 2.1802
   • 136 Sinus and Mastoid Procedures without CC/MCC 1.0619
4. 4 Mouth Procedures
   • 137 Mouth Procedures with CC/MCC 1.3439
   • 138 Mouth Procedures without CC/MCC 0.9188
5. 5 Salivary Gland Procedures
   • 139 Salivary Gland Procedures 1.1547

Medical DRGs

14 medical DRGs. The surgical hierarchy does not apply to these, so they are listed by number.

• 146 Ear, Nose, Mouth and Throat Malignancy with MCC 2.1329
• 147 Ear, Nose, Mouth and Throat Malignancy with CC 1.3055
• 148 Ear, Nose, Mouth and Throat Malignancy without CC/MCC 0.8008
• 149 Dysequilibrium 0.7527
• 150 Epistaxis with MCC 1.4473
• 151 Epistaxis without MCC 0.7615
• 152 Otitis Media and URI with MCC 1.1151
• 153 Otitis Media and URI without MCC 0.7421
• 154 Other Ear, Nose, Mouth and Throat Diagnoses with MCC 1.5921
• 155 Other Ear, Nose, Mouth and Throat Diagnoses with CC 0.9322
• 156 Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC 0.6659
• 157 Dental and Oral Diseases with MCC 1.8090
• 158 Dental and Oral Diseases with CC 0.9366
• 159 Dental and Oral Diseases without CC/MCC 0.6893