06

Diseases and Disorders of the Digestive 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 Stomach, Esophageal and Duodenal Procedures
   • 326 Stomach, Esophageal and Duodenal Procedures with MCC 4.9436
   • 327 Stomach, Esophageal and Duodenal Procedures with CC 2.4485
   • 328 Stomach, Esophageal and Duodenal Procedures without CC/MCC 1.6472
2. 2 Major Small and Large Bowel Procedures
   • 329 Major Small and Large Bowel Procedures with MCC 4.5476
   • 330 Major Small and Large Bowel Procedures with CC 2.4263
   • 331 Major Small and Large Bowel Procedures without CC/MCC 1.7465
3. 3 Rectal Resection
   • 332 Rectal Resection with MCC 3.7887
   • 333 Rectal Resection with CC 2.1275
   • 334 Rectal Resection without CC/MCC 1.6847
4. 4 Peritoneal Adhesiolysis
   • 335 Peritoneal Adhesiolysis with MCC 3.5032
   • 336 Peritoneal Adhesiolysis with CC 2.1021
   • 337 Peritoneal Adhesiolysis without CC/MCC 1.5251
5. 5 Appendix Procedures
   • 397 Appendix Procedures with MCC 2.3810
   • 398 Appendix Procedures with CC 1.5224
   • 399 Appendix Procedures without CC/MCC 1.2034
6. 6 Minor Small and Large Bowel Procedures
   • 344 Minor Small and Large Bowel Procedures with MCC 2.8202
   • 345 Minor Small and Large Bowel Procedures with CC 1.4946
   • 346 Minor Small and Large Bowel Procedures without CC/MCC 1.2674
7. 7 Anal and Stomal Procedures
   • 347 Anal and Stomal Procedures with MCC 2.3564
   • 348 Anal and Stomal Procedures with CC 1.1930
   • 349 Anal and Stomal Procedures without CC/MCC 0.9134
8. 8 Hernia Procedures
   • 350 Inguinal and Femoral Hernia Procedures with MCC 2.5766
   • 351 Inguinal and Femoral Hernia Procedures with CC 1.5641
   • 352 Inguinal and Femoral Hernia Procedures without CC/MCC 1.2224
   • 353 Hernia Procedures Except Inguinal and Femoral with MCC 2.7523
   • 354 Hernia Procedures Except Inguinal and Femoral with CC 1.7190
   • 355 Hernia Procedures Except Inguinal and Femoral without CC/MCC 1.3907
9. 9 Other Digestive System O.R. Procedures
   • 356 Other Digestive System O.R. Procedures with MCC 4.3375
   • 357 Other Digestive System O.R. Procedures with CC 2.2844
   • 358 Other Digestive System O.R. Procedures without CC/MCC 1.4889

Medical DRGs

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

• 368 Major Esophageal Disorders with MCC 1.6433
• 369 Major Esophageal Disorders with CC 0.9922
• 370 Major Esophageal Disorders without CC/MCC 0.6744
• 371 Major Gastrointestinal Disorders and Peritoneal Infections with MCC 1.7089
• 372 Major Gastrointestinal Disorders and Peritoneal Infections with CC 0.9964
• 373 Major Gastrointestinal Disorders and Peritoneal Infections without CC/MCC 0.6941
• 374 Digestive Malignancy with MCC 2.1109
• 375 Digestive Malignancy with CC 1.1838
• 376 Digestive Malignancy without CC/MCC 0.8929
• 377 Gastrointestinal Hemorrhage with MCC 1.8127
• 378 Gastrointestinal Hemorrhage with CC 0.9732
• 379 Gastrointestinal Hemorrhage without CC/MCC 0.6381
• 380 Complicated Peptic Ulcer with MCC 1.9245
• 381 Complicated Peptic Ulcer with CC 1.0838
• 382 Complicated Peptic Ulcer without CC/MCC 0.7281
• 383 Uncomplicated Peptic Ulcer with MCC 1.3536
• 384 Uncomplicated Peptic Ulcer without MCC 0.8469
• 385 Inflammatory Bowel Disease with MCC 1.5543
• 386 Inflammatory Bowel Disease with CC 0.9647
• 387 Inflammatory Bowel Disease without CC/MCC 0.6464
• 388 Gastrointestinal Obstruction with MCC 1.4709
• 389 Gastrointestinal Obstruction with CC 0.7891
• 390 Gastrointestinal Obstruction without CC/MCC 0.5404
• 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders with MCC 1.2392
• 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC 0.7645
• 393 Other Digestive System Diagnoses with MCC 1.5881
• 394 Other Digestive System Diagnoses with CC 0.9228
• 395 Other Digestive System Diagnoses without CC/MCC 0.6382