Diagnosis Codes in MS-DRG 157 - Dental And Oral Diseases With MCC
The Medicare Severity Diagnosis-Related Group (MS-DRG) is a patient classification system used to categorize hospital cases based on clinical similarity and expected resource use. MS-DRGs organize all possible principal diagnoses into mutually exclusive groups known as Major Diagnostic Categories (MDCs), which help determine reimbursement under the Medicare Inpatient Prospective Payment System.
This section lists the diagnosis codes included in MS-DRG V42.0: Dental and Oral Diseases with MCC from October 1, 2024, through September 30, 2025.
MS-DRG: 157
MS-DRG Title: Dental and Oral Diseases with MCC
MCD: 03
Relative Weight: 1.6374 Relative Weight
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Arithmetic LOS: 4.40 Arithmetic Length of Stay
The average length of stay (ALOS) reflects the average number of days a patient spends in a hospital for each admission.
- A69 - Other spirochetal infections
- B00 - Herpesviral [herpes simplex] infections
- B37 - Candidiasis
- B37.8 - Candidiasis of other sites
- D10 - Benign neoplasm of mouth and pharynx
- D10.3 - Benign neoplasm of other and unspecified parts of mo
- D16 - Benign neoplasm of bone and articular cartilage
- K00 - Disorders of tooth development and eruption
- K01 - Embedded and impacted teeth
- K02 - Dental caries
- K02.5 - Dental caries on pit and fissure surface
- K02.6 - Dental caries on smooth surface
- K03 - Other diseases of hard tissues of teeth
- K03.8 - Other specified diseases of hard tissues of teeth
- K04 - Diseases of pulp and periapical tissues
- K04.0 - Pulpitis
- K04.9 - Other and unspecified diseases of pulp and periapica
- K05 - Gingivitis and periodontal diseases
- K05.0 - Acute gingivitis
- K05.1 - Chronic gingivitis
- K05.2 - Aggressive periodontitis
- K05.21 - Aggressive periodontitis, localized
- K05.22 - Aggressive periodontitis, generalized
- K05.3 - Chronic periodontitis
- K05.31 - Chronic periodontitis, localized
- K05.32 - Chronic periodontitis, generalized
- K06 - Other disorders of gingiva and edentulous alveolar rid
- K06.01 - Gingival recession, localized
- K06.02 - Gingival recession, generalized
- K08 - Other disorders of teeth and supporting structures
- K08.10 - Complete loss of teeth, unspecified cause
- K08.11 - Complete loss of teeth due to trauma
- K08.12 - Complete loss of teeth due to periodontal diseases
- K08.13 - Complete loss of teeth due to caries
- K08.19 - Complete loss of teeth due to other specified cause
- K08.2 - Atrophy of edentulous alveolar ridge
- K08.40 - Partial loss of teeth, unspecified cause
- K08.41 - Partial loss of teeth due to trauma
- K08.42 - Partial loss of teeth due to periodontal diseases
- K08.43 - Partial loss of teeth due to caries
- K08.49 - Partial loss of teeth due to other specified cause
- K08.5 - Unsatisfactory restoration of tooth
- K08.53 - Fractured dental restorative material
- K08.8 - Other specified disorders of teeth and supporting st
- K09 - Cysts of oral region, not elsewhere classified
- K12 - Stomatitis and related lesions
- K12.3 - Oral mucositis (ulcerative)
- K13 - Other diseases of lip and oral mucosa
- K13.2 - Leukoplakia and other disturbances of oral epitheliu
- K13.7 - Other and unspecified lesions of oral mucosa
- K14 - Diseases of tongue
- M26 - Dentofacial anomalies [including malocclusion]
- M26.0 - Major anomalies of jaw size
- M26.1 - Anomalies of jaw-cranial base relationship
- M26.2 - Anomalies of dental arch relationship
- M26.21 - Malocclusion, Angle's class
- M26.22 - Open occlusal relationship
- M26.3 - Anomalies of tooth position of fully erupted tooth o
- M26.5 - Dentofacial functional abnormalities
- M26.6 - Temporomandibular joint disorders
- M26.60 - Temporomandibular joint disorder, unspecified
- M26.61 - Adhesions and ankylosis of temporomandibular joint
- M26.62 - Arthralgia of temporomandibular joint
- M26.63 - Articular disc disorder of temporomandibular joint
- M26.64 - Arthritis of temporomandibular joint
- M26.65 - Arthropathy of temporomandibular joint
- M26.7 - Dental alveolar anomalies
- M26.8 - Other dentofacial anomalies
- M27 - Other diseases of jaws
- M27.4 - Other and unspecified cysts of jaw
- M27.5 - Periradicular pathology associated with previous end
- M27.6 - Endosseous dental implant failure
- Q18 - Other congenital malformations of face and neck
- Q35 - Cleft palate
- Q36 - Cleft lip
- Q37 - Cleft palate with cleft lip
- Q38 - Other congenital malformations of tongue, mouth and ph
- R68.8 - Other general symptoms and signs
- S01.501 - Unspecified open wound of lip
- S01.502 - Unspecified open wound of oral cavity
- S01.511 - Laceration without foreign body of lip
- S01.512 - Laceration without foreign body of oral cavity
- S01.521 - Laceration with foreign body of lip
- S01.522 - Laceration with foreign body of oral cavity
- S01.531 - Puncture wound without foreign body of lip
- S01.532 - Puncture wound without foreign body of oral cavity
- S01.541 - Puncture wound with foreign body of lip
- S01.542 - Puncture wound with foreign body of oral cavity
- S01.551 - Open bite of lip
- S01.552 - Open bite of oral cavity
- S02.400 - Malar fracture, unspecified side
- S02.401 - Maxillary fracture, unspecified side
- S02.402 - Zygomatic fracture, unspecified side
- S02.40A - Malar fracture, right side
- S02.40B - Malar fracture, left side
- S02.40C - Maxillary fracture, right side
- S02.40D - Maxillary fracture, left side
- S02.40E - Zygomatic fracture, right side
- S02.40F - Zygomatic fracture, left side
- S02.411 - LeFort I fracture
- S02.412 - LeFort II fracture
- S02.413 - LeFort III fracture
- S02.5 - Fracture of tooth (traumatic)
- S02.600 - Fracture of unspecified part of body of mandible,
- S02.601 - Fracture of unspecified part of body of right mand
- S02.602 - Fracture of unspecified part of body of left mandi
- S02.609 - Fracture of mandible, unspecified
- S02.610 - Fracture of condylar process of mandible, unspecif
- S02.611 - Fracture of condylar process of right mandible
- S02.612 - Fracture of condylar process of left mandible
- S02.620 - Fracture of subcondylar process of mandible, unspe
- S02.621 - Fracture of subcondylar process of right mandible
- S02.622 - Fracture of subcondylar process of left mandible
- S02.630 - Fracture of coronoid process of mandible, unspecif
- S02.631 - Fracture of coronoid process of right mandible
- S02.632 - Fracture of coronoid process of left mandible
- S02.640 - Fracture of ramus of mandible, unspecified side
- S02.641 - Fracture of ramus of right mandible
- S02.642 - Fracture of ramus of left mandible
- S02.650 - Fracture of angle of mandible, unspecified side
- S02.651 - Fracture of angle of right mandible
- S02.652 - Fracture of angle of left mandible
- S02.66 - Fracture of symphysis of mandible
- S02.670 - Fracture of alveolus of mandible, unspecified side
- S02.671 - Fracture of alveolus of right mandible
- S02.672 - Fracture of alveolus of left mandible
- S02.69 - Fracture of mandible of other specified site
- S03.00 - Dislocation of jaw, unspecified side
- S03.01 - Dislocation of jaw, right side
- S03.02 - Dislocation of jaw, left side
- S03.03 - Dislocation of jaw, bilateral
- S03.2 - Dislocation of tooth
- S03.40 - Sprain of jaw, unspecified side
- S03.41 - Sprain of jaw, right side
- S03.42 - Sprain of jaw, left side
- S03.43 - Sprain of jaw, bilateral
- T18.0 - Foreign body in mouth
A69 - Other spirochetal infections
A69.0 - Necrotizing ulcerative stomatitis
B37 - Candidiasis
B37.0 - Candidal stomatitis
B37.8 - Candidiasis of other sites
B37.83 - Candidal cheilitis
D10 - Benign neoplasm of mouth and pharynx
D10.3 - Benign neoplasm of other and unspecified parts of mouth
D16 - Benign neoplasm of bone and articular cartilage
D16.5 - Benign neoplasm of lower jaw bone
K00 - Disorders of tooth development and eruption
K00.0 - Anodontia
K00.1 - Supernumerary teeth
K00.2 - Abnormalities of size and form of teeth
K00.3 - Mottled teeth
K00.4 - Disturbances in tooth formation
K00.5 - Hereditary disturbances in tooth structure, not elsewhere classified
K00.6 - Disturbances in tooth eruption
K00.7 - Teething syndrome
K00.8 - Other disorders of tooth development
K00.9 - Disorder of tooth development, unspecified
K01 - Embedded and impacted teeth
K02 - Dental caries
K02.5 - Dental caries on pit and fissure surface
K02.6 - Dental caries on smooth surface
K03 - Other diseases of hard tissues of teeth
K03.0 - Excessive attrition of teeth
K03.1 - Abrasion of teeth
K03.2 - Erosion of teeth
K03.3 - Pathological resorption of teeth
K03.4 - Hypercementosis
K03.5 - Ankylosis of teeth
K03.6 - Deposits [accretions] on teeth
K03.7 - Posteruptive color changes of dental hard tissues
K03.9 - Disease of hard tissues of teeth, unspecified
K03.8 - Other specified diseases of hard tissues of teeth
K04 - Diseases of pulp and periapical tissues
K04.0 - Pulpitis
K04.9 - Other and unspecified diseases of pulp and periapical tissues
K05 - Gingivitis and periodontal diseases
K05.0 - Acute gingivitis
K05.1 - Chronic gingivitis
K05.2 - Aggressive periodontitis
K05.20 - Aggressive periodontitis, unspecified
K05.21 - Aggressive periodontitis, localized
K05.22 - Aggressive periodontitis, generalized
K05.3 - Chronic periodontitis
K05.30 - Chronic periodontitis, unspecified
K05.31 - Chronic periodontitis, localized
K05.32 - Chronic periodontitis, generalized
K06 - Other disorders of gingiva and edentulous alveolar ridge
K06.01 - Gingival recession, localized
K06.02 - Gingival recession, generalized
K08 - Other disorders of teeth and supporting structures
K08.10 - Complete loss of teeth, unspecified cause
K08.101 - Complete loss of teeth, unspecified cause, class I
K08.102 - Complete loss of teeth, unspecified cause, class II
K08.103 - Complete loss of teeth, unspecified cause, class III
K08.104 - Complete loss of teeth, unspecified cause, class IV
K08.109 - Complete loss of teeth, unspecified cause, unspecified class
K08.11 - Complete loss of teeth due to trauma
K08.12 - Complete loss of teeth due to periodontal diseases
K08.121 - Complete loss of teeth due to periodontal diseases, class I
K08.122 - Complete loss of teeth due to periodontal diseases, class II
K08.123 - Complete loss of teeth due to periodontal diseases, class III
K08.124 - Complete loss of teeth due to periodontal diseases, class IV
K08.129 - Complete loss of teeth due to periodontal diseases, unspecified class
K08.13 - Complete loss of teeth due to caries
K08.19 - Complete loss of teeth due to other specified cause
K08.191 - Complete loss of teeth due to other specified cause, class I
K08.192 - Complete loss of teeth due to other specified cause, class II
K08.193 - Complete loss of teeth due to other specified cause, class III
K08.194 - Complete loss of teeth due to other specified cause, class IV
K08.199 - Complete loss of teeth due to other specified cause, unspecified class
K08.2 - Atrophy of edentulous alveolar ridge
K08.40 - Partial loss of teeth, unspecified cause
K08.401 - Partial loss of teeth, unspecified cause, class I
K08.402 - Partial loss of teeth, unspecified cause, class II
K08.403 - Partial loss of teeth, unspecified cause, class III
K08.404 - Partial loss of teeth, unspecified cause, class IV
K08.409 - Partial loss of teeth, unspecified cause, unspecified class
K08.41 - Partial loss of teeth due to trauma
K08.42 - Partial loss of teeth due to periodontal diseases
K08.421 - Partial loss of teeth due to periodontal diseases, class I
K08.422 - Partial loss of teeth due to periodontal diseases, class II
K08.423 - Partial loss of teeth due to periodontal diseases, class III
K08.424 - Partial loss of teeth due to periodontal diseases, class IV
K08.429 - Partial loss of teeth due to periodontal diseases, unspecified class
K08.43 - Partial loss of teeth due to caries
K08.49 - Partial loss of teeth due to other specified cause
K08.491 - Partial loss of teeth due to other specified cause, class I
K08.492 - Partial loss of teeth due to other specified cause, class II
K08.493 - Partial loss of teeth due to other specified cause, class III
K08.494 - Partial loss of teeth due to other specified cause, class IV
K08.499 - Partial loss of teeth due to other specified cause, unspecified class
K08.5 - Unsatisfactory restoration of tooth
K08.50 - Unsatisfactory restoration of tooth, unspecified
K08.51 - Open restoration margins of tooth
K08.52 - Unrepairable overhanging of dental restorative materials
K08.54 - Contour of existing restoration of tooth biologically incompatible with oral health
K08.55 - Allergy to existing dental restorative material
K08.56 - Poor aesthetic of existing restoration of tooth
K08.59 - Other unsatisfactory restoration of tooth
K08.53 - Fractured dental restorative material
K08.8 - Other specified disorders of teeth and supporting structures
K09 - Cysts of oral region, not elsewhere classified
K12.3 - Oral mucositis (ulcerative)
K13 - Other diseases of lip and oral mucosa
K13.2 - Leukoplakia and other disturbances of oral epithelium, including tongue
K13.7 - Other and unspecified lesions of oral mucosa
K14 - Diseases of tongue
M26 - Dentofacial anomalies [including malocclusion]
M26.0 - Major anomalies of jaw size
M26.1 - Anomalies of jaw-cranial base relationship
M26.2 - Anomalies of dental arch relationship
M26.21 - Malocclusion, Angle's class
M26.22 - Open occlusal relationship
M26.3 - Anomalies of tooth position of fully erupted tooth or teeth
M26.30 - Unspecified anomaly of tooth position of fully erupted tooth or teeth
M26.31 - Crowding of fully erupted teeth
M26.32 - Excessive spacing of fully erupted teeth
M26.33 - Horizontal displacement of fully erupted tooth or teeth
M26.34 - Vertical displacement of fully erupted tooth or teeth
M26.35 - Rotation of fully erupted tooth or teeth
M26.36 - Insufficient interocclusal distance of fully erupted teeth (ridge)
M26.37 - Excessive interocclusal distance of fully erupted teeth
M26.39 - Other anomalies of tooth position of fully erupted tooth or teeth
M26.5 - Dentofacial functional abnormalities
M26.50 - Dentofacial functional abnormalities, unspecified
M26.51 - Abnormal jaw closure
M26.52 - Limited mandibular range of motion
M26.53 - Deviation in opening and closing of the mandible
M26.54 - Insufficient anterior guidance
M26.55 - Centric occlusion maximum intercuspation discrepancy
M26.56 - Non-working side interference
M26.57 - Lack of posterior occlusal support
M26.59 - Other dentofacial functional abnormalities
M26.6 - Temporomandibular joint disorders
M26.69 - Other specified disorders of temporomandibular joint
M26.60 - Temporomandibular joint disorder, unspecified
M26.61 - Adhesions and ankylosis of temporomandibular joint
M26.62 - Arthralgia of temporomandibular joint
M26.63 - Articular disc disorder of temporomandibular joint
M26.64 - Arthritis of temporomandibular joint
M26.65 - Arthropathy of temporomandibular joint
M26.7 - Dental alveolar anomalies
M26.8 - Other dentofacial anomalies
M27 - Other diseases of jaws
M27.4 - Other and unspecified cysts of jaw
M27.5 - Periradicular pathology associated with previous endodontic treatment
M27.6 - Endosseous dental implant failure
Q18 - Other congenital malformations of face and neck
Q35 - Cleft palate
Q36 - Cleft lip
Q37 - Cleft palate with cleft lip
Q37.0 - Cleft hard palate with bilateral cleft lip
Q37.1 - Cleft hard palate with unilateral cleft lip
Q37.2 - Cleft soft palate with bilateral cleft lip
Q37.3 - Cleft soft palate with unilateral cleft lip
Q37.4 - Cleft hard and soft palate with bilateral cleft lip
Q37.5 - Cleft hard and soft palate with unilateral cleft lip
Q37.8 - Unspecified cleft palate with bilateral cleft lip
Q37.9 - Unspecified cleft palate with unilateral cleft lip
Q38 - Other congenital malformations of tongue, mouth and pharynx
R68.8 - Other general symptoms and signs
R68.84 - Jaw pain
S01.501 - Unspecified open wound of lip
S01.501A - Unspecified open wound of lip, initial encounter
S01.502 - Unspecified open wound of oral cavity
S01.502A - Unspecified open wound of oral cavity, initial encounter
S01.511 - Laceration without foreign body of lip
S01.511A - Laceration without foreign body of lip, initial encounter
S01.512 - Laceration without foreign body of oral cavity
S01.512A - Laceration without foreign body of oral cavity, initial encounter
S01.521 - Laceration with foreign body of lip
S01.521A - Laceration with foreign body of lip, initial encounter
S01.522 - Laceration with foreign body of oral cavity
S01.522A - Laceration with foreign body of oral cavity, initial encounter
S01.531 - Puncture wound without foreign body of lip
S01.531A - Puncture wound without foreign body of lip, initial encounter
S01.532 - Puncture wound without foreign body of oral cavity
S01.532A - Puncture wound without foreign body of oral cavity, initial encounter
S01.541 - Puncture wound with foreign body of lip
S01.541A - Puncture wound with foreign body of lip, initial encounter
S01.542 - Puncture wound with foreign body of oral cavity
S01.542A - Puncture wound with foreign body of oral cavity, initial encounter
S01.551 - Open bite of lip
S01.551A - Open bite of lip, initial encounter
S01.552 - Open bite of oral cavity
S01.552A - Open bite of oral cavity, initial encounter
S02.400 - Malar fracture, unspecified side
S02.401 - Maxillary fracture, unspecified side
S02.402 - Zygomatic fracture, unspecified side
S02.40A - Malar fracture, right side
S02.40B - Malar fracture, left side
S02.40C - Maxillary fracture, right side
S02.40D - Maxillary fracture, left side
S02.40E - Zygomatic fracture, right side
S02.40F - Zygomatic fracture, left side
S02.411 - LeFort I fracture
S02.412 - LeFort II fracture
S02.413 - LeFort III fracture
S02.5 - Fracture of tooth (traumatic)
S02.600 - Fracture of unspecified part of body of mandible, unspecified side
S02.601 - Fracture of unspecified part of body of right mandible
S02.602 - Fracture of unspecified part of body of left mandible
S02.609 - Fracture of mandible, unspecified
S02.610 - Fracture of condylar process of mandible, unspecified side
S02.611 - Fracture of condylar process of right mandible
S02.612 - Fracture of condylar process of left mandible
S02.620 - Fracture of subcondylar process of mandible, unspecified side
S02.621 - Fracture of subcondylar process of right mandible
S02.622 - Fracture of subcondylar process of left mandible
S02.630 - Fracture of coronoid process of mandible, unspecified side
S02.631 - Fracture of coronoid process of right mandible
S02.632 - Fracture of coronoid process of left mandible
S02.640 - Fracture of ramus of mandible, unspecified side
S02.641 - Fracture of ramus of right mandible
S02.642 - Fracture of ramus of left mandible
S02.650 - Fracture of angle of mandible, unspecified side
S02.651 - Fracture of angle of right mandible
S02.652 - Fracture of angle of left mandible
S02.66 - Fracture of symphysis of mandible
S02.670 - Fracture of alveolus of mandible, unspecified side
S02.671 - Fracture of alveolus of right mandible
S02.672 - Fracture of alveolus of left mandible
S02.69 - Fracture of mandible of other specified site
S03.00 - Dislocation of jaw, unspecified side
S03.00XA - Dislocation of jaw, unspecified side, initial encounter
S03.01 - Dislocation of jaw, right side
S03.01XA - Dislocation of jaw, right side, initial encounter
S03.02 - Dislocation of jaw, left side
S03.02XA - Dislocation of jaw, left side, initial encounter
S03.03 - Dislocation of jaw, bilateral
S03.03XA - Dislocation of jaw, bilateral, initial encounter
S03.2 - Dislocation of tooth
S03.2XXA - Dislocation of tooth, initial encounter
S03.40 - Sprain of jaw, unspecified side
S03.40XA - Sprain of jaw, unspecified side, initial encounter
S03.41 - Sprain of jaw, right side
S03.41XA - Sprain of jaw, right side, initial encounter
S03.42 - Sprain of jaw, left side
S03.42XA - Sprain of jaw, left side, initial encounter
S03.43 - Sprain of jaw, bilateral
S03.43XA - Sprain of jaw, bilateral, initial encounter
T18.0 - Foreign body in mouth
T18.0XXA - Foreign body in mouth, initial encounter