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  3. Diagnosis Codes in MS-DRG 176 - Pulmonary Embolism Without MCC

Diagnosis Codes in MS-DRG 176 - Pulmonary Embolism Without 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: Pulmonary Embolism without MCC from October 1, 2024, through September 30, 2025.

MS-DRG: 176

MS-DRG Title: Pulmonary Embolism without MCC

MCD: 04

Relative Weight: 0.8145 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.

Geometric LOS: 0.81 Geometric Length of Stay
The geometric mean length of stay (GMLOS) is used by Medicare to calculate the reimbursement for patients whose medical treatment takes a much longer or shorter time than average.

Arithmetic LOS: 2.40 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.

  • I26.0 - Pulmonary embolism with acute cor pulmonale

    • I26.01 - Septic pulmonary embolism with acute cor pulmonale

    • I26.02 - Saddle embolus of pulmonary artery with acute cor pulmonale

    • I26.03 - Cement embolism of pulmonary artery with acute cor pulmonale

    • I26.04 - Fat embolism of pulmonary artery with acute cor pulmonale

    • I26.09 - Other pulmonary embolism with acute cor pulmonale

  • I26.9 - Pulmonary embolism without acute cor pulmonale

    • I26.90 - Septic pulmonary embolism without acute cor pulmonale

    • I26.92 - Saddle embolus of pulmonary artery without acute cor pulmonale

    • I26.93 - Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale

    • I26.94 - Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale

    • I26.95 - Cement embolism of pulmonary artery without acute cor pulmonale

    • I26.96 - Fat embolism of pulmonary artery without acute cor pulmonale

    • I26.99 - Other pulmonary embolism without acute cor pulmonale

  • I27.8 - Other specified pulmonary heart diseases

    • I27.82 - Chronic pulmonary embolism

  • T79.0 - Air embolism (traumatic)

    • T79.0XXA - Air embolism (traumatic), initial encounter

  • T79.1 - Fat embolism (traumatic)

    • T79.1XXA - Fat embolism (traumatic), initial encounter

  • T80.0 - Air embolism following infusion, transfusion and therapeutic injection

    • T80.0XXA - Air embolism following infusion, transfusion and therapeutic injection, initial encounter