07

Diseases and Disorders of the Hepatobiliary System and Pancreas

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 Pancreas, Liver and Shunt Procedures
   • 405 Pancreas, Liver and Shunt Procedures with MCC 5.3839
   • 406 Pancreas, Liver and Shunt Procedures with CC 2.9492
   • 407 Pancreas, Liver and Shunt Procedures without CC/MCC 2.1709
2. 2 Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E.
   • 408 Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with MCC 3.3234
   • 409 Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with CC 2.2334
   • 410 Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. without CC/MCC 1.7662
3. 3 Cholecystectomy
   • 411 Cholecystectomy with C.D.E. with MCC 2.9730
   • 412 Cholecystectomy with C.D.E. with CC 2.1533
   • 413 Cholecystectomy with C.D.E. without CC/MCC 1.8301
   • 414 Cholecystectomy Except by Laparoscope without C.D.E. with MCC 3.6402
   • 415 Cholecystectomy Except by Laparoscope without C.D.E. with CC 2.0075
   • 416 Cholecystectomy Except by Laparoscope without C.D.E. without CC/MCC 1.4118
   • 417 Laparoscopic Cholecystectomy without C.D.E. with MCC 2.4014
   • 418 Laparoscopic Cholecystectomy without C.D.E. with CC 1.7363
   • 419 Laparoscopic Cholecystectomy without C.D.E. without CC/MCC 1.4108
4. 4 Hepatobiliary Diagnostic Procedures
   • 420 Hepatobiliary Diagnostic Procedures with MCC 3.0664
   • 421 Hepatobiliary Diagnostic Procedures with CC 1.7121
   • 422 Hepatobiliary Diagnostic Procedures without CC/MCC 1.4255
5. 5 Other Hepatobiliary or Pancreas O.R. Procedures
   • 423 Other Hepatobiliary or Pancreas O.R. Procedures with MCC 4.1649
   • 424 Other Hepatobiliary or Pancreas O.R. Procedures with CC 2.1596
   • 425 Other Hepatobiliary or Pancreas O.R. Procedures without CC/MCC 1.8827

Medical DRGs

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

• 432 Cirrhosis and Alcoholic Hepatitis with MCC 1.9828
• 433 Cirrhosis and Alcoholic Hepatitis with CC 1.0397
• 434 Cirrhosis and Alcoholic Hepatitis without CC/MCC 0.6413
• 435 Malignancy of Hepatobiliary System or Pancreas with MCC 1.8430
• 436 Malignancy of Hepatobiliary System or Pancreas with CC 1.1224
• 437 Malignancy of Hepatobiliary System or Pancreas without CC/MCC 0.8081
• 438 Disorders of Pancreas Except Malignancy with MCC 1.5765
• 439 Disorders of Pancreas Except Malignancy with CC 0.8402
• 440 Disorders of Pancreas Except Malignancy without CC/MCC 0.5965
• 441 Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with MCC 1.8219
• 442 Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with CC 0.9602
• 443 Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis without CC/MCC 0.6885
• 444 Disorders of the Biliary Tract with MCC 1.6665
• 445 Disorders of the Biliary Tract with CC 1.0872
• 446 Disorders of the Biliary Tract without CC/MCC 0.8124