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  3. Diagnosis Codes in MS-DRG 815 - Reticuloendothelial And Immunity Disorders With CC

Diagnosis Codes in MS-DRG 815 - Reticuloendothelial And Immunity Disorders With CC

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: Reticuloendothelial and Immunity Disorders with CC from October 1, 2024, through September 30, 2025.

MS-DRG: 815

MS-DRG Title: Reticuloendothelial and Immunity Disorders with CC

MCD: 16

Relative Weight: 1.0161 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: 1.02 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: 3.00 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.

  1. A18 - Tuberculosis of other organs
  2. A18.8 - Tuberculosis of other specified organs
  3. A28 - Other zoonotic bacterial diseases, not elsewhere class
  4. D15 - Benign neoplasm of other and unspecified intrathoracic
  5. D18 - Hemangioma and lymphangioma, any site
  6. D36 - Benign neoplasm of other and unspecified sites
  7. D3A.09 - Benign carcinoid tumors of other sites
  8. D47 - Other neoplasms of uncertain behavior of lymphoid, hem
  9. D68.31 - Hemorrhagic disorder due to intrinsic circulating a
  10. D68.5 - Primary thrombophilia
  11. D68.6 - Other thrombophilia
  12. D72 - Other disorders of white blood cells
  13. D72.1 - Eosinophilia
  14. D72.11 - Hypereosinophilic syndrome [HES]
  15. D72.8 - Other specified disorders of white blood cells
  16. D72.81 - Decreased white blood cell count
  17. D72.82 - Elevated white blood cell count
  18. D73 - Diseases of spleen
  19. D73.8 - Other diseases of spleen
  20. D75 - Other and unspecified diseases of blood and blood-form
  21. D75.8 - Other specified diseases of blood and blood-forming
  22. D75.83 - Thrombocytosis
  23. D76 - Other specified diseases with participation of lymphor
  24. D80 - Immunodeficiency with predominantly antibody defects
  25. D82 - Immunodeficiency associated with other major defects
  26. D83 - Common variable immunodeficiency
  27. D84 - Other immunodeficiencies
  28. D84.8 - Other specified immunodeficiencies
  29. D84.82 - Immunodeficiency due to drugs and external causes
  30. D89 - Other disorders involving the immune mechanism, not el
  31. D89.4 - Mast cell activation syndrome and related disorders
  32. D89.8 - Other specified disorders involving the immune mecha
  33. D89.83 - Cytokine release syndrome
  34. E32 - Diseases of thymus
  35. I88 - Nonspecific lymphadenitis
  36. I89 - Other noninfective disorders of lymphatic vessels and
  37. L04 - Acute lymphadenitis
  38. Q89.0 - Congenital absence and malformations of spleen
  39. R16 - Hepatomegaly and splenomegaly, not elsewhere classifie
  40. R59 - Enlarged lymph nodes
  41. R76 - Other abnormal immunological findings in serum
  42. S36.00 - Unspecified injury of spleen
  43. S36.020 - Minor contusion of spleen
  44. S36.021 - Major contusion of spleen
  45. S36.029 - Unspecified contusion of spleen
  46. S36.030 - Superficial (capsular) laceration of spleen
  47. S36.031 - Moderate laceration of spleen
  48. S36.032 - Major laceration of spleen
  49. S36.039 - Unspecified laceration of spleen
  50. S36.09 - Other injury of spleen
  51. T80.82 - Complication of immune effector cellular therapy
  52. Z94.8 - Other transplanted organ and tissue status

  • -

    • D77 - Other disorders of blood and blood-forming organs in diseases classified elsewhere

    • R75 - Inconclusive laboratory evidence of human immunodeficiency virus [HIV]

  • A18 - Tuberculosis of other organs

    • A18.2 - Tuberculous peripheral lymphadenopathy

  • A18.8 - Tuberculosis of other specified organs

    • A18.85 - Tuberculosis of spleen

  • A28 - Other zoonotic bacterial diseases, not elsewhere classified

    • A28.1 - Cat-scratch disease

  • D15 - Benign neoplasm of other and unspecified intrathoracic organs

    • D15.0 - Benign neoplasm of thymus

  • D18 - Hemangioma and lymphangioma, any site

    • D18.1 - Lymphangioma, any site

  • D36 - Benign neoplasm of other and unspecified sites

    • D36.0 - Benign neoplasm of lymph nodes

  • D3A.09 - Benign carcinoid tumors of other sites

    • D3A.091 - Benign carcinoid tumor of the thymus

  • D68.31 - Hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors

    • D68.312 - Antiphospholipid antibody with hemorrhagic disorder

  • D68.5 - Primary thrombophilia

    • D68.51 - Activated protein C resistance

    • D68.52 - Prothrombin gene mutation

    • D68.59 - Other primary thrombophilia

  • D68.6 - Other thrombophilia

    • D68.61 - Antiphospholipid syndrome

    • D68.62 - Lupus anticoagulant syndrome

    • D68.69 - Other thrombophilia

  • D72 - Other disorders of white blood cells

    • D72.9 - Disorder of white blood cells, unspecified

  • D72.1 - Eosinophilia

    • D72.10 - Eosinophilia, unspecified

    • D72.12 - Drug rash with eosinophilia and systemic symptoms syndrome

    • D72.18 - Eosinophilia in diseases classified elsewhere

    • D72.19 - Other eosinophilia

  • D72.11 - Hypereosinophilic syndrome [HES]

    • D72.110 - Idiopathic hypereosinophilic syndrome [IHES]

    • D72.111 - Lymphocytic Variant Hypereosinophilic Syndrome [LHES]

    • D72.118 - Other hypereosinophilic syndrome

    • D72.119 - Hypereosinophilic syndrome [HES], unspecified

  • D72.8 - Other specified disorders of white blood cells

    • D72.89 - Other specified disorders of white blood cells

  • D72.81 - Decreased white blood cell count

    • D72.810 - Lymphocytopenia

    • D72.818 - Other decreased white blood cell count

    • D72.819 - Decreased white blood cell count, unspecified

  • D72.82 - Elevated white blood cell count

  • D73 - Diseases of spleen

    • D73.0 - Hyposplenism

    • D73.1 - Hypersplenism

    • D73.2 - Chronic congestive splenomegaly

    • D73.3 - Abscess of spleen

    • D73.4 - Cyst of spleen

    • D73.5 - Infarction of spleen

    • D73.9 - Disease of spleen, unspecified

  • D73.8 - Other diseases of spleen

    • D73.81 - Neutropenic splenomegaly

    • D73.89 - Other diseases of spleen

  • D75 - Other and unspecified diseases of blood and blood-forming organs

    • D75.0 - Familial erythrocytosis

    • D75.1 - Secondary polycythemia

    • D75.9 - Disease of blood and blood-forming organs, unspecified

    • D75.A - Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia

  • D75.8 - Other specified diseases of blood and blood-forming organs

    • D75.89 - Other specified diseases of blood and blood-forming organs

  • D75.83 - Thrombocytosis

  • D76 - Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue

    • D76.1 - Hemophagocytic lymphohistiocytosis

    • D76.2 - Hemophagocytic syndrome, infection-associated

    • D76.3 - Other histiocytosis syndromes

  • D80 - Immunodeficiency with predominantly antibody defects

    • D80.0 - Hereditary hypogammaglobulinemia

    • D80.1 - Nonfamilial hypogammaglobulinemia

    • D80.2 - Selective deficiency of immunoglobulin A [IgA]

    • D80.3 - Selective deficiency of immunoglobulin G [IgG] subclasses

    • D80.4 - Selective deficiency of immunoglobulin M [IgM]

    • D80.5 - Immunodeficiency with increased immunoglobulin M [IgM]

    • D80.7 - Transient hypogammaglobulinemia of infancy

  • D82 - Immunodeficiency associated with other major defects

    • D82.2 - Immunodeficiency with short-limbed stature

    • D82.3 - Immunodeficiency following hereditary defective response to Epstein-Barr virus

    • D82.4 - Hyperimmunoglobulin E [IgE] syndrome

    • D82.8 - Immunodeficiency associated with other specified major defects

    • D82.9 - Immunodeficiency associated with major defect, unspecified

  • D83 - Common variable immunodeficiency

    • D83.0 - Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function

    • D83.1 - Common variable immunodeficiency with predominant immunoregulatory T-cell disorders

    • D83.2 - Common variable immunodeficiency with autoantibodies to B- or T-cells

    • D83.8 - Other common variable immunodeficiencies

    • D83.9 - Common variable immunodeficiency, unspecified

  • D84 - Other immunodeficiencies

    • D84.0 - Lymphocyte function antigen-1 [LFA-1] defect

    • D84.9 - Immunodeficiency, unspecified

  • D84.8 - Other specified immunodeficiencies

    • D84.81 - Immunodeficiency due to conditions classified elsewhere

    • D84.89 - Other immunodeficiencies

  • D84.82 - Immunodeficiency due to drugs and external causes

    • D84.821 - Immunodeficiency due to drugs

    • D84.822 - Immunodeficiency due to external causes

  • D89 - Other disorders involving the immune mechanism, not elsewhere classified

    • D89.0 - Polyclonal hypergammaglobulinemia

    • D89.2 - Hypergammaglobulinemia, unspecified

    • D89.3 - Immune reconstitution syndrome

    • D89.9 - Disorder involving the immune mechanism, unspecified

  • D89.8 - Other specified disorders involving the immune mechanism, not elsewhere classified

    • D89.84 - IgG4-related disease

    • D89.89 - Other specified disorders involving the immune mechanism, not elsewhere classified

  • D89.83 - Cytokine release syndrome

    • D89.831 - Cytokine release syndrome, grade 1

    • D89.832 - Cytokine release syndrome, grade 2

    • D89.833 - Cytokine release syndrome, grade 3

    • D89.834 - Cytokine release syndrome, grade 4

    • D89.835 - Cytokine release syndrome, grade 5

    • D89.839 - Cytokine release syndrome, grade unspecified

  • E32 - Diseases of thymus

    • E32.0 - Persistent hyperplasia of thymus

    • E32.1 - Abscess of thymus

    • E32.8 - Other diseases of thymus

    • E32.9 - Disease of thymus, unspecified

  • I88 - Nonspecific lymphadenitis

    • I88.1 - Chronic lymphadenitis, except mesenteric

    • I88.8 - Other nonspecific lymphadenitis

    • I88.9 - Nonspecific lymphadenitis, unspecified

  • I89 - Other noninfective disorders of lymphatic vessels and lymph nodes

    • I89.8 - Other specified noninfective disorders of lymphatic vessels and lymph nodes

    • I89.9 - Noninfective disorder of lymphatic vessels and lymph nodes, unspecified

  • L04 - Acute lymphadenitis

    • L04.0 - Acute lymphadenitis of face, head and neck

    • L04.1 - Acute lymphadenitis of trunk

    • L04.2 - Acute lymphadenitis of upper limb

    • L04.3 - Acute lymphadenitis of lower limb

    • L04.8 - Acute lymphadenitis of other sites

    • L04.9 - Acute lymphadenitis, unspecified

  • Q89.0 - Congenital absence and malformations of spleen

    • Q89.01 - Asplenia (congenital)

    • Q89.09 - Congenital malformations of spleen

  • R16 - Hepatomegaly and splenomegaly, not elsewhere classified

    • R16.1 - Splenomegaly, not elsewhere classified

  • R59 - Enlarged lymph nodes

    • R59.0 - Localized enlarged lymph nodes

    • R59.1 - Generalized enlarged lymph nodes

    • R59.9 - Enlarged lymph nodes, unspecified

  • R76 - Other abnormal immunological findings in serum

    • R76.0 - Raised antibody titer

    • R76.8 - Other specified abnormal immunological findings in serum

    • R76.9 - Abnormal immunological finding in serum, unspecified

  • S36.00 - Unspecified injury of spleen

    • S36.00XA - Unspecified injury of spleen, initial encounter

  • S36.020 - Minor contusion of spleen

    • S36.020A - Minor contusion of spleen, initial encounter

  • S36.021 - Major contusion of spleen

    • S36.021A - Major contusion of spleen, initial encounter

  • S36.029 - Unspecified contusion of spleen

    • S36.029A - Unspecified contusion of spleen, initial encounter

  • S36.030 - Superficial (capsular) laceration of spleen

    • S36.030A - Superficial (capsular) laceration of spleen, initial encounter

  • S36.031 - Moderate laceration of spleen

    • S36.031A - Moderate laceration of spleen, initial encounter

  • S36.032 - Major laceration of spleen

    • S36.032A - Major laceration of spleen, initial encounter

  • S36.039 - Unspecified laceration of spleen

    • S36.039A - Unspecified laceration of spleen, initial encounter

  • S36.09 - Other injury of spleen

    • S36.09XA - Other injury of spleen, initial encounter

  • T80.82 - Complication of immune effector cellular therapy

    • T80.82XA - Complication of immune effector cellular therapy, initial encounter

  • Z94.8 - Other transplanted organ and tissue status

    • Z94.81 - Bone marrow transplant status

    • Z94.84 - Stem cells transplant status