04

Diseases and Disorders of the Respiratory System

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 Chest Procedures
   • 163 Major Chest Procedures with MCC 4.4892
   • 164 Major Chest Procedures with CC 2.5157
   • 165 Major Chest Procedures without CC/MCC 1.9294
2. 2 Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolism
   • 173 Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolism 2.9556
3. 3 Other Respiratory System O.R. Procedures
   • 166 Other Respiratory System O.R. Procedures with MCC 3.8736
   • 167 Other Respiratory System O.R. Procedures with CC 1.8244
   • 168 Other Respiratory System O.R. Procedures without CC/MCC 1.3896

Medical DRGs

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

• 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale 1.3652
• 176 Pulmonary Embolism without MCC 0.8063
• 177 Respiratory Infections and Inflammations with MCC 1.6092
• 178 Respiratory Infections and Inflammations with CC 0.9744
• 179 Respiratory Infections and Inflammations without CC/MCC 0.7345
• 180 Respiratory Neoplasms with MCC 1.7806
• 181 Respiratory Neoplasms with CC 1.0936
• 182 Respiratory Neoplasms without CC/MCC 0.7439
• 183 Major Chest Trauma with MCC 1.4903
• 184 Major Chest Trauma with CC 1.0647
• 185 Major Chest Trauma without CC/MCC 0.7715
• 186 Pleural Effusion with MCC 1.5835
• 187 Pleural Effusion with CC 1.0001
• 188 Pleural Effusion without CC/MCC 0.6654
• 189 Pulmonary Edema and Respiratory Failure 1.2108
• 190 Chronic Obstructive Pulmonary Disease with MCC 1.0748
• 191 Chronic Obstructive Pulmonary Disease with CC 0.8261
• 192 Chronic Obstructive Pulmonary Disease without CC/MCC 0.6288
• 193 Simple Pneumonia and Pleurisy with MCC 1.2825
• 194 Simple Pneumonia and Pleurisy with CC 0.7888
• 195 Simple Pneumonia and Pleurisy without CC/MCC 0.6063
• 196 Interstitial Lung Disease with MCC 1.8336
• 197 Interstitial Lung Disease with CC 0.9492
• 198 Interstitial Lung Disease without CC/MCC 0.7259
• 199 Pneumothorax with MCC 1.7322
• 200 Pneumothorax with CC 1.0774
• 201 Pneumothorax without CC/MCC 0.6782
• 202 Bronchitis and Asthma with CC/MCC 0.9474
• 203 Bronchitis and Asthma without CC/MCC 0.6512
• 204 Respiratory Signs and Symptoms 0.8210
• 205 Other Respiratory System Diagnoses with MCC 1.8244
• 206 Other Respiratory System Diagnoses without MCC 0.9257
• 207 Respiratory System Diagnosis with Ventilator Support >96 Hours 6.3977
• 208 Respiratory System Diagnosis with Ventilator Support <=96 Hours 2.7506