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MS-DRG - 195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC

The Medicare Severity Diagnosis-Related Group or MS-DRG is a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). This is the group for MS-DRG - 195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT Complication Comorbidity/Major Complication or Comorbidity diseases in version MS-DRG V40.0 applicable from 10/01/2022 through 09/30/2023.

MS-DRG MS-DRG Title MCD Relative Weight Geometric LOS Arithmetic LOS
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC 04 0.6418 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.		 2.30 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.		 2.80 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.

ICD-10 Codes in Diagnostic Related Group

  • B33.0 - Epidemic myalgia BILLABLE CODE
  • J09.X1 - Influenza due to identified novel influenza A virus with pneumonia BILLABLE CODE
  • J09.X2 - Influenza due to identified novel influenza A virus with other respiratory manifestations BILLABLE CODE
  • J10.1 - Influenza due to other identified influenza virus with other respiratory manifestations BILLABLE CODE
  • J12.0 - Adenoviral pneumonia BILLABLE CODE
  • J12.1 - Respiratory syncytial virus pneumonia BILLABLE CODE
  • J12.2 - Parainfluenza virus pneumonia BILLABLE CODE
  • J12.3 - Human metapneumovirus pneumonia BILLABLE CODE
  • J12.81 - Pneumonia due to SARS-associated coronavirus BILLABLE CODE
  • J12.82 - Pneumonia due to coronavirus disease 2019 BILLABLE CODE
  • J12.89 - Other viral pneumonia BILLABLE CODE
  • J12.9 - Viral pneumonia, unspecified BILLABLE CODE
  • J13 - Pneumonia due to Streptococcus pneumoniae BILLABLE CODE
  • J14 - Pneumonia due to Hemophilus influenzae BILLABLE CODE
  • J15.3 - Pneumonia due to streptococcus, group B BILLABLE CODE
  • J15.4 - Pneumonia due to other streptococci BILLABLE CODE
  • J15.7 - Pneumonia due to Mycoplasma pneumoniae BILLABLE CODE
  • J15.9 - Unspecified bacterial pneumonia BILLABLE CODE
  • J16.0 - Chlamydial pneumonia BILLABLE CODE
  • J16.8 - Pneumonia due to other specified infectious organisms BILLABLE CODE
  • J18.0 - Bronchopneumonia, unspecified organism BILLABLE CODE
  • J18.1 - Lobar pneumonia, unspecified organism BILLABLE CODE
  • J18.8 - Other pneumonia, unspecified organism BILLABLE CODE
  • J18.9 - Pneumonia, unspecified organism BILLABLE CODE
  • J92.0 - Pleural plaque with presence of asbestos BILLABLE CODE
  • J92.9 - Pleural plaque without asbestos BILLABLE CODE
  • J94.1 - Fibrothorax BILLABLE CODE
  • J94.9 - Pleural condition, unspecified BILLABLE CODE
  • R09.1 - Pleurisy BILLABLE CODE