ICD-10-CM/PCS MS-DRG v38.1 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
MDC 01 Diseases and disorders of the nervous system
MDC 02 Diseases and disorders of the eye
MDC 03 Diseases and disorders of the ear, nose, mouth and throat
MDC 04 Diseases and disorders of the respiratory system
MDC 05 Diseases and disorders of the circulatory system
MDC 06 Diseases and disorders of the digestive system
MDC 07 Diseases and disorders of the hepatobiliary system and pancreas
MDC 08 Diseases and disorders of the musculoskeletal system and connective tissue
MDC 09 Diseases and disorders of the skin, subcutaneous tissue and breast
MDC 10 Endocrine, nutritional and metabolic diseases and disorders
MDC 11 Diseases and disorders of the kidney and urinary tract
MDC 12 Diseases and disorders of the male reproductive system
MDC 13 Diseases and disorders of the female reproductive system
MDC 14 Pregnancy, childbirth and the puerperium
MDC 15 Newborns and other neonates with conditions originating in perinatal period
MDC 16 Diseases and disorders of blood, blood forming organs and immunologic disorders
MDC 17 Myeloproliferative diseases and disorders, poorly differentiated neoplasms
MDC 18 Infectious and parasitic diseases, systemic or unspecified sites
MDC 19 Mental diseases and disorders
MDC 20 Alcohol or drug use or induced organic mental disorders
MDC 21 Injuries, poisonings and toxic effects of drugs
MDC 22 Burns
MDC 23 Factors influencing health status and other contacts with health services
MDC 24 Multiple significant trauma
MDC 25 Human immunodeficiency virus infections

Appendix A List of MS-DRGs Version 38.1
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