ICD-10-CM/PCS MS-DRG v36.0 Definitions Manual

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Table of Contents

Within each MDC, the MS-DRGs are listed in the order in which the grouper recognizes them. This enables users to see instances where grouper logic order differs from strict numerical order.
Procedure codes that are listed with an * indicate that they are non-operating room procedures. All procedures without an * are considered operating room procedures.

Defining the Medicare Severity Diagnosis Related Groups (MS-DRGs)
Design and development of the Diagnosis Related Group (DRGs)

Index by MS-DRG
Pre-MDC
MDC 01 Diseases & Disorders of the Nervous System
MDC 02 Diseases & Disorders of the Eye
MDC 03 Diseases & Disorders of the Ear, Nose, Mouth & Throat
MDC 04 Diseases & Disorders of the Respiratory System
MDC 05 Diseases & Disorders of the Circulatory System
MDC 06 Diseases & Disorders of the Digestive System
MDC 07 Diseases & Disorders of the Hepatobiliary System & Pancreas
MDC 08 Diseases & Disorders of the Musculoskeletal System & Connective Tissue
MDC 09 Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast
MDC 10 Endocrine, Nutritional & Metabolic Diseases & Disorders
MDC 11 Diseases & Disorders of the Kidney & Urinary Tract
MDC 12 Diseases & Disorders of the Male Reproductive System
MDC 13 Diseases & Disorders of the Female Reproductive System
MDC 14 Pregnancy, Childbirth & the Puerperium
MDC 15 Newborns & Other Neonates with Conditions Originating in Perinatal Period
MDC 16 Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders
MDC 17 Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms
MDC 18 Infectious & Parasitic Diseases, Systemic or Unspecified Sites
MDC 19 Mental Diseases & Disorders
MDC 20 Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental Disorders
MDC 21 Injuries, Poisonings & Toxic Effects of Drugs
MDC 22 Burns
MDC 23 Factors Influencing Health Status & Other Contacts with Health Services
MDC 24 Multiple Significant Trauma
MDC 25 Human Immunodeficiency Virus Infections

Appendix A List of MS-DRGs Version 36.0
Appendix B Diagnosis Code/MDC/MS-DRG Index
Appendix C Complications or Comorbidities Exclusion list
Appendix D MS-DRG Surgical Hierarchy by MDC and MS-DRG
Appendix E Operating Room Procedures and Procedure Code/MS-DRG Index
Appendix F Unrelated Operating Room Procedures (MS-DRGs 981-989)
Appendix G Diagnoses Defined as Complications or Comorbidities
Appendix H Diagnoses Defined as Major Complications or Comorbidities
Appendix I Hospital Acquired Conditions (HACS) List