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  3. MS-DRG - 438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC

MS-DRG - 438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH 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 - 438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH 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
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC 07 1.6574 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.		 4.70 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.		 6.40 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.

ICD-10 Codes in Diagnostic Related Group

  • B25.2 - Cytomegaloviral pancreatitis BILLABLE CODE
  • B26.3 - Mumps pancreatitis BILLABLE CODE
  • D13.6 - Benign neoplasm of pancreas BILLABLE CODE
  • K85.00 - Idiopathic acute pancreatitis without necrosis or infection BILLABLE CODE
  • K85.01 - Idiopathic acute pancreatitis with uninfected necrosis BILLABLE CODE
  • K85.02 - Idiopathic acute pancreatitis with infected necrosis BILLABLE CODE
  • K85.10 - Biliary acute pancreatitis without necrosis or infection BILLABLE CODE
  • K85.11 - Biliary acute pancreatitis with uninfected necrosis BILLABLE CODE
  • K85.12 - Biliary acute pancreatitis with infected necrosis BILLABLE CODE
  • K85.20 - Alcohol induced acute pancreatitis without necrosis or infection BILLABLE CODE
  • K85.21 - Alcohol induced acute pancreatitis with uninfected necrosis BILLABLE CODE
  • K85.22 - Alcohol induced acute pancreatitis with infected necrosis BILLABLE CODE
  • K85.30 - Drug induced acute pancreatitis without necrosis or infection BILLABLE CODE
  • K85.31 - Drug induced acute pancreatitis with uninfected necrosis BILLABLE CODE
  • K85.32 - Drug induced acute pancreatitis with infected necrosis BILLABLE CODE
  • K85.80 - Other acute pancreatitis without necrosis or infection BILLABLE CODE
  • K85.81 - Other acute pancreatitis with uninfected necrosis BILLABLE CODE
  • K85.82 - Other acute pancreatitis with infected necrosis BILLABLE CODE
  • K85.90 - Acute pancreatitis without necrosis or infection, unspecified BILLABLE CODE
  • K85.91 - Acute pancreatitis with uninfected necrosis, unspecified BILLABLE CODE
  • K85.92 - Acute pancreatitis with infected necrosis, unspecified BILLABLE CODE
  • K86.0 - Alcohol-induced chronic pancreatitis BILLABLE CODE
  • K86.1 - Other chronic pancreatitis BILLABLE CODE
  • K86.2 - Cyst of pancreas BILLABLE CODE
  • K86.3 - Pseudocyst of pancreas BILLABLE CODE
  • K86.81 - Exocrine pancreatic insufficiency BILLABLE CODE
  • K86.89 - Other specified diseases of pancreas BILLABLE CODE
  • K86.9 - Disease of pancreas, unspecified BILLABLE CODE
  • Q45.0 - Agenesis, aplasia and hypoplasia of pancreas BILLABLE CODE
  • Q45.1 - Annular pancreas BILLABLE CODE
  • Q45.2 - Congenital pancreatic cyst BILLABLE CODE
  • Q45.3 - Other congenital malformations of pancreas and pancreatic duct BILLABLE CODE
  • S36.200A - Unspecified injury of head of pancreas, initial encounter BILLABLE CODE
  • S36.201A - Unspecified injury of body of pancreas, initial encounter BILLABLE CODE
  • S36.202A - Unspecified injury of tail of pancreas, initial encounter BILLABLE CODE
  • S36.209A - Unspecified injury of unspecified part of pancreas, initial encounter BILLABLE CODE
  • S36.220A - Contusion of head of pancreas, initial encounter BILLABLE CODE
  • S36.221A - Contusion of body of pancreas, initial encounter BILLABLE CODE
  • S36.222A - Contusion of tail of pancreas, initial encounter BILLABLE CODE
  • S36.229A - Contusion of unspecified part of pancreas, initial encounter BILLABLE CODE
  • S36.230A - Laceration of head of pancreas, unspecified degree, initial encounter BILLABLE CODE
  • S36.231A - Laceration of body of pancreas, unspecified degree, initial encounter BILLABLE CODE
  • S36.232A - Laceration of tail of pancreas, unspecified degree, initial encounter BILLABLE CODE
  • S36.239A - Laceration of unspecified part of pancreas, unspecified degree, initial encounter BILLABLE CODE
  • S36.240A - Minor laceration of head of pancreas, initial encounter BILLABLE CODE
  • S36.241A - Minor laceration of body of pancreas, initial encounter BILLABLE CODE
  • S36.242A - Minor laceration of tail of pancreas, initial encounter BILLABLE CODE
  • S36.249A - Minor laceration of unspecified part of pancreas, initial encounter BILLABLE CODE
  • S36.250A - Moderate laceration of head of pancreas, initial encounter BILLABLE CODE
  • S36.251A - Moderate laceration of body of pancreas, initial encounter BILLABLE CODE
  • S36.252A - Moderate laceration of tail of pancreas, initial encounter BILLABLE CODE
  • S36.259A - Moderate laceration of unspecified part of pancreas, initial encounter BILLABLE CODE
  • S36.260A - Major laceration of head of pancreas, initial encounter BILLABLE CODE
  • S36.261A - Major laceration of body of pancreas, initial encounter BILLABLE CODE
  • S36.262A - Major laceration of tail of pancreas, initial encounter BILLABLE CODE
  • S36.269A - Major laceration of unspecified part of pancreas, initial encounter BILLABLE CODE
  • S36.290A - Other injury of head of pancreas, initial encounter BILLABLE CODE
  • S36.291A - Other injury of body of pancreas, initial encounter BILLABLE CODE
  • S36.292A - Other injury of tail of pancreas, initial encounter BILLABLE CODE
  • S36.299A - Other injury of unspecified part of pancreas, initial encounter BILLABLE CODE
  • T86.890 - Other transplanted tissue rejection BILLABLE CODE
  • T86.891 - Other transplanted tissue failure BILLABLE CODE
  • T86.892 - Other transplanted tissue infection BILLABLE CODE
  • T86.898 - Other complications of other transplanted tissue BILLABLE CODE
  • T86.899 - Unspecified complication of other transplanted tissue BILLABLE CODE
  • Z94.83 - Pancreas transplant status BILLABLE CODE