Inpatient Facility Coding & Compliance Alert

Reader Question:

How to Assign DRGs for Appendectomy

Question: A patient has to undergo appendectomy. She is anemic and obese. How should I assign the case into a proper DRG?

Mississippi Subscriber

Answer: The ICD-9 CM code for anemia is 285.9 and for obesity is 278.0. These do not comprise a CC (comorbidity/complication) or MCC (major comorbidity/complication). In this perspective, you can assign the case into an MS-DRG 343 (Appendectomy W/O complicated principal diag W/O CC/MCC)

However, if she had an acute post hemorrhagic anemia (285.1) or morbid obesity (278.01), these would count as a CC and the MS DRG assignment would then change to MS DRG 342 (Appendectomy W/O complicated principal diag W CC). 

Other Articles in this issue of

Inpatient Facility Coding & Compliance Alert

View All