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  3. MS-DRG - 865 VIRAL ILLNESS WITH MCC

MS-DRG - 865 VIRAL ILLNESS 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 - 865 VIRAL ILLNESS 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
865 VIRAL ILLNESS WITH MCC 18 1.6728 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.		 4.20 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.		 6.30 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

  • A70 - Chlamydia psittaci infections BILLABLE CODE
  • A74.81 - Chlamydial peritonitis BILLABLE CODE
  • A74.89 - Other chlamydial diseases BILLABLE CODE
  • A74.9 - Chlamydial infection, unspecified BILLABLE CODE
  • A80.4 - Acute nonparalytic poliomyelitis BILLABLE CODE
  • A90 - Dengue fever [classical dengue] BILLABLE CODE
  • A91 - Dengue hemorrhagic fever BILLABLE CODE
  • A92.0 - Chikungunya virus disease BILLABLE CODE
  • A92.1 - O'nyong-nyong fever BILLABLE CODE
  • A92.30 - West Nile virus infection, unspecified BILLABLE CODE
  • A92.31 - West Nile virus infection with encephalitis BILLABLE CODE
  • A92.32 - West Nile virus infection with other neurologic manifestation BILLABLE CODE
  • A92.39 - West Nile virus infection with other complications BILLABLE CODE
  • A92.4 - Rift Valley fever BILLABLE CODE
  • A92.5 - Zika virus disease BILLABLE CODE
  • A92.8 - Other specified mosquito-borne viral fevers BILLABLE CODE
  • A92.9 - Mosquito-borne viral fever, unspecified BILLABLE CODE
  • A93.0 - Oropouche virus disease BILLABLE CODE
  • A93.1 - Sandfly fever BILLABLE CODE
  • A93.2 - Colorado tick fever BILLABLE CODE
  • A93.8 - Other specified arthropod-borne viral fevers BILLABLE CODE
  • A94 - Unspecified arthropod-borne viral fever BILLABLE CODE
  • A95.0 - Sylvatic yellow fever BILLABLE CODE
  • A95.1 - Urban yellow fever BILLABLE CODE
  • A95.9 - Yellow fever, unspecified BILLABLE CODE
  • A96.0 - Junin hemorrhagic fever BILLABLE CODE
  • A96.1 - Machupo hemorrhagic fever BILLABLE CODE
  • A96.2 - Lassa fever BILLABLE CODE
  • A96.8 - Other arenaviral hemorrhagic fevers BILLABLE CODE
  • A96.9 - Arenaviral hemorrhagic fever, unspecified BILLABLE CODE
  • A98.0 - Crimean-Congo hemorrhagic fever BILLABLE CODE
  • A98.1 - Omsk hemorrhagic fever BILLABLE CODE
  • A98.2 - Kyasanur Forest disease BILLABLE CODE
  • A98.3 - Marburg virus disease BILLABLE CODE
  • A98.4 - Ebola virus disease BILLABLE CODE
  • A98.8 - Other specified viral hemorrhagic fevers BILLABLE CODE
  • A99 - Unspecified viral hemorrhagic fever BILLABLE CODE
  • B03 - Smallpox BILLABLE CODE
  • B04 - Monkeypox BILLABLE CODE
  • B05.9 - Measles without complication BILLABLE CODE
  • B06.9 - Rubella without complication BILLABLE CODE
  • B08.010 - Cowpox BILLABLE CODE
  • B08.011 - Vaccinia not from vaccine BILLABLE CODE
  • B08.04 - Paravaccinia, unspecified BILLABLE CODE
  • B08.09 - Other orthopoxvirus infections BILLABLE CODE
  • B08.3 - Erythema infectiosum [fifth disease] BILLABLE CODE
  • B08.4 - Enteroviral vesicular stomatitis with exanthem BILLABLE CODE
  • B08.60 - Parapoxvirus infection, unspecified BILLABLE CODE
  • B08.61 - Bovine stomatitis BILLABLE CODE
  • B08.62 - Sealpox BILLABLE CODE
  • B08.69 - Other parapoxvirus infections BILLABLE CODE
  • B08.70 - Yatapoxvirus infection, unspecified BILLABLE CODE
  • B08.71 - Tanapox virus disease BILLABLE CODE
  • B08.72 - Yaba pox virus disease BILLABLE CODE
  • B08.79 - Other yatapoxvirus infections BILLABLE CODE
  • B08.8 - Other specified viral infections characterized by skin and mucous membrane lesions BILLABLE CODE
  • B09 - Unspecified viral infection characterized by skin and mucous membrane lesions BILLABLE CODE
  • B25.8 - Other cytomegaloviral diseases BILLABLE CODE
  • B25.9 - Cytomegaloviral disease, unspecified BILLABLE CODE
  • B26.9 - Mumps without complication BILLABLE CODE
  • B27.00 - Gammaherpesviral mononucleosis without complication BILLABLE CODE
  • B27.01 - Gammaherpesviral mononucleosis with polyneuropathy BILLABLE CODE
  • B27.02 - Gammaherpesviral mononucleosis with meningitis BILLABLE CODE
  • B27.09 - Gammaherpesviral mononucleosis with other complications BILLABLE CODE
  • B27.10 - Cytomegaloviral mononucleosis without complications BILLABLE CODE
  • B27.11 - Cytomegaloviral mononucleosis with polyneuropathy BILLABLE CODE
  • B27.12 - Cytomegaloviral mononucleosis with meningitis BILLABLE CODE
  • B27.19 - Cytomegaloviral mononucleosis with other complication BILLABLE CODE
  • B27.80 - Other infectious mononucleosis without complication BILLABLE CODE
  • B27.81 - Other infectious mononucleosis with polyneuropathy BILLABLE CODE
  • B27.82 - Other infectious mononucleosis with meningitis BILLABLE CODE
  • B27.89 - Other infectious mononucleosis with other complication BILLABLE CODE
  • B27.90 - Infectious mononucleosis, unspecified without complication BILLABLE CODE
  • B27.91 - Infectious mononucleosis, unspecified with polyneuropathy BILLABLE CODE
  • B27.92 - Infectious mononucleosis, unspecified with meningitis BILLABLE CODE
  • B27.99 - Infectious mononucleosis, unspecified with other complication BILLABLE CODE
  • B33.1 - Ross River disease BILLABLE CODE
  • B33.3 - Retrovirus infections, not elsewhere classified BILLABLE CODE
  • B33.4 - Hantavirus (cardio)-pulmonary syndrome [HPS] [HCPS] BILLABLE CODE
  • B33.8 - Other specified viral diseases BILLABLE CODE
  • B34.0 - Adenovirus infection, unspecified BILLABLE CODE
  • B34.1 - Enterovirus infection, unspecified BILLABLE CODE
  • B34.2 - Coronavirus infection, unspecified BILLABLE CODE
  • B34.3 - Parvovirus infection, unspecified BILLABLE CODE
  • B34.4 - Papovavirus infection, unspecified BILLABLE CODE
  • B34.8 - Other viral infections of unspecified site BILLABLE CODE
  • B34.9 - Viral infection, unspecified BILLABLE CODE
  • B97.0 - Adenovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.10 - Unspecified enterovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.11 - Coxsackievirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.12 - Echovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.19 - Other enterovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.21 - SARS-associated coronavirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.29 - Other coronavirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.30 - Unspecified retrovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.31 - Lentivirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.32 - Oncovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.33 - Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.34 - Human T-cell lymphotrophic virus, type II [HTLV-II] as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.35 - Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.39 - Other retrovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.5 - Reovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.6 - Parvovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.7 - Papillomavirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.81 - Human metapneumovirus as the cause of diseases classified elsewhere BILLABLE CODE
  • B97.89 - Other viral agents as the cause of diseases classified elsewhere BILLABLE CODE
  • J09.X3 - Influenza due to identified novel influenza A virus with gastrointestinal manifestations BILLABLE CODE
  • J09.X9 - Influenza due to identified novel influenza A virus with other manifestations BILLABLE CODE
  • J10.2 - Influenza due to other identified influenza virus with gastrointestinal manifestations BILLABLE CODE
  • J10.81 - Influenza due to other identified influenza virus with encephalopathy BILLABLE CODE
  • J10.82 - Influenza due to other identified influenza virus with myocarditis BILLABLE CODE
  • J10.83 - Influenza due to other identified influenza virus with otitis media BILLABLE CODE
  • J10.89 - Influenza due to other identified influenza virus with other manifestations BILLABLE CODE
  • J11.2 - Influenza due to unidentified influenza virus with gastrointestinal manifestations BILLABLE CODE
  • J11.81 - Influenza due to unidentified influenza virus with encephalopathy BILLABLE CODE
  • J11.82 - Influenza due to unidentified influenza virus with myocarditis BILLABLE CODE
  • J11.83 - Influenza due to unidentified influenza virus with otitis media BILLABLE CODE
  • J11.89 - Influenza due to unidentified influenza virus with other manifestations BILLABLE CODE
  • L44.4 - Infantile papular acrodermatitis [Gianotti-Crosti] BILLABLE CODE
  • T88.1XXA - Other complications following immunization, not elsewhere classified, initial encounter BILLABLE CODE
  • Z21 - Asymptomatic human immunodeficiency virus [HIV] infection status BILLABLE CODE