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  3. MS-DRG - 600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

MS-DRG - 600 NON-MALIGNANT BREAST DISORDERS WITH 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 - 600 NON-MALIGNANT BREAST DISORDERS WITH 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
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC 09 1.0411 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.		 3.40 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.		 4.30 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

  • D49.3 - Neoplasm of unspecified behavior of breast BILLABLE CODE
  • I97.2 - Postmastectomy lymphedema syndrome BILLABLE CODE
  • N60.01 - Solitary cyst of right breast BILLABLE CODE
  • N60.02 - Solitary cyst of left breast BILLABLE CODE
  • N60.09 - Solitary cyst of unspecified breast BILLABLE CODE
  • N60.11 - Diffuse cystic mastopathy of right breast BILLABLE CODE
  • N60.12 - Diffuse cystic mastopathy of left breast BILLABLE CODE
  • N60.19 - Diffuse cystic mastopathy of unspecified breast BILLABLE CODE
  • N60.21 - Fibroadenosis of right breast BILLABLE CODE
  • N60.22 - Fibroadenosis of left breast BILLABLE CODE
  • N60.29 - Fibroadenosis of unspecified breast BILLABLE CODE
  • N60.31 - Fibrosclerosis of right breast BILLABLE CODE
  • N60.32 - Fibrosclerosis of left breast BILLABLE CODE
  • N60.39 - Fibrosclerosis of unspecified breast BILLABLE CODE
  • N60.41 - Mammary duct ectasia of right breast BILLABLE CODE
  • N60.42 - Mammary duct ectasia of left breast BILLABLE CODE
  • N60.49 - Mammary duct ectasia of unspecified breast BILLABLE CODE
  • N60.81 - Other benign mammary dysplasias of right breast BILLABLE CODE
  • N60.82 - Other benign mammary dysplasias of left breast BILLABLE CODE
  • N60.89 - Other benign mammary dysplasias of unspecified breast BILLABLE CODE
  • N60.91 - Unspecified benign mammary dysplasia of right breast BILLABLE CODE
  • N60.92 - Unspecified benign mammary dysplasia of left breast BILLABLE CODE
  • N60.99 - Unspecified benign mammary dysplasia of unspecified breast BILLABLE CODE
  • N61.0 - Mastitis without abscess BILLABLE CODE
  • N61.1 - Abscess of the breast and nipple BILLABLE CODE
  • N61.20 - Granulomatous mastitis, unspecified breast BILLABLE CODE
  • N61.21 - Granulomatous mastitis, right breast BILLABLE CODE
  • N61.22 - Granulomatous mastitis, left breast BILLABLE CODE
  • N61.23 - Granulomatous mastitis, bilateral breast BILLABLE CODE
  • N62 - Hypertrophy of breast BILLABLE CODE
  • N63.0 - Unspecified lump in unspecified breast BILLABLE CODE
  • N63.10 - Unspecified lump in the right breast, unspecified quadrant BILLABLE CODE
  • N63.11 - Unspecified lump in the right breast, upper outer quadrant BILLABLE CODE
  • N63.12 - Unspecified lump in the right breast, upper inner quadrant BILLABLE CODE
  • N63.13 - Unspecified lump in the right breast, lower outer quadrant BILLABLE CODE
  • N63.14 - Unspecified lump in the right breast, lower inner quadrant BILLABLE CODE
  • N63.15 - Unspecified lump in the right breast, overlapping quadrants BILLABLE CODE
  • N63.20 - Unspecified lump in the left breast, unspecified quadrant BILLABLE CODE
  • N63.21 - Unspecified lump in the left breast, upper outer quadrant BILLABLE CODE
  • N63.22 - Unspecified lump in the left breast, upper inner quadrant BILLABLE CODE
  • N63.23 - Unspecified lump in the left breast, lower outer quadrant BILLABLE CODE
  • N63.24 - Unspecified lump in the left breast, lower inner quadrant BILLABLE CODE
  • N63.25 - Unspecified lump in the left breast, overlapping quadrants BILLABLE CODE
  • N63.31 - Unspecified lump in axillary tail of the right breast BILLABLE CODE
  • N63.32 - Unspecified lump in axillary tail of the left breast BILLABLE CODE
  • N63.41 - Unspecified lump in right breast, subareolar BILLABLE CODE
  • N63.42 - Unspecified lump in left breast, subareolar BILLABLE CODE
  • N64.0 - Fissure and fistula of nipple BILLABLE CODE
  • N64.1 - Fat necrosis of breast BILLABLE CODE
  • N64.2 - Atrophy of breast BILLABLE CODE
  • N64.3 - Galactorrhea not associated with childbirth BILLABLE CODE
  • N64.4 - Mastodynia BILLABLE CODE
  • N64.51 - Induration of breast BILLABLE CODE
  • N64.52 - Nipple discharge BILLABLE CODE
  • N64.53 - Retraction of nipple BILLABLE CODE
  • N64.59 - Other signs and symptoms in breast BILLABLE CODE
  • N64.81 - Ptosis of breast BILLABLE CODE
  • N64.82 - Hypoplasia of breast BILLABLE CODE
  • N64.89 - Other specified disorders of breast BILLABLE CODE
  • N64.9 - Disorder of breast, unspecified BILLABLE CODE
  • N65.0 - Deformity of reconstructed breast BILLABLE CODE
  • N65.1 - Disproportion of reconstructed breast BILLABLE CODE
  • Q83.0 - Congenital absence of breast with absent nipple BILLABLE CODE
  • Q83.1 - Accessory breast BILLABLE CODE
  • Q83.2 - Absent nipple BILLABLE CODE
  • Q83.3 - Accessory nipple BILLABLE CODE
  • Q83.8 - Other congenital malformations of breast BILLABLE CODE
  • Q83.9 - Congenital malformation of breast, unspecified BILLABLE CODE
  • R92.0 - Mammographic microcalcification found on diagnostic imaging of breast BILLABLE CODE
  • R92.1 - Mammographic calcification found on diagnostic imaging of breast BILLABLE CODE
  • R92.2 - Inconclusive mammogram BILLABLE CODE
  • R92.8 - Other abnormal and inconclusive findings on diagnostic imaging of breast BILLABLE CODE
  • T85.41XA - Breakdown (mechanical) of breast prosthesis and implant, initial encounter BILLABLE CODE
  • T85.42XA - Displacement of breast prosthesis and implant, initial encounter BILLABLE CODE
  • T85.43XA - Leakage of breast prosthesis and implant, initial encounter BILLABLE CODE
  • T85.44XA - Capsular contracture of breast implant, initial encounter BILLABLE CODE
  • T85.49XA - Other mechanical complication of breast prosthesis and implant, initial encounter BILLABLE CODE
  • Z40.01 - Encounter for prophylactic removal of breast BILLABLE CODE