Next

DRG Codes as navigated from ICD codes.
You can see what DRG classifications any ICD might be a part of by finding the ICD code you wish, then clicking on the DRG button (provided it is active).

Here's an example:

A 15 year old male lives in crowded conditions and becomes ill with a mucopurulent sputum. He is hospitalized due to respiratory distress. Chest X-Ray shows pneumonia and the sputum culture returns an identification of the organism as Klebsiella.

We perform a search for 'kelbsiella pneumonia' and return the following 3 codes.

1. Code 482.0 is the ICD code we want, the DRG button is active (an inactive button is grayed out at the edges). Clicking the active DRG button will show all DRG's that this ICD code belongs to.
The ICD code you have selected continues to be referenced at the top of the page. All DRGs to which it may be assigned are listed separately in a box below.

1. Note that the GMLOS, AMLOS, and Relative Weight for each DRG are listed here. If you know the mean payment for your hospital, you can quickly estimate payment by multiplying it with the Relative Weight.

2. In this case, the 15 year old would fall within DRG 081. If you wanted to review all ICD codes that fall within any of the listed DRGs, you would click on the corresponding Arrow to the left of that DRG. By doing so, all of the
If you want to review all of the ICD codes that fall within any of the liste DRGs, you would click on the corresponding arrow to the left of that DRG.

1. The Major Diagnostic Category (MDC) is listed. Click on the arrow to its left to see all of the MDCs

2. All of the DRGs in this MDC, in this case MDC 04, can be viewed by clickint the arrow to the left of DRG: 081

3. The organization of the DRG is displayed here. Many DRGs have several combinations of codes that are required in order to qualify for billing. Some can be billed on the basis of a Diagnosis code alone; others require an ICD from a Primary Diagnosis AND an ICD from a list of Secondary Diagnoses; others might require a Primary Diagnosis followed by a Surgical Procedure, and so on.

4. The entire listing of ICD codes is found in this area. If there are multiple subcategories of codes listed in area (3), you can click on that link to view only the ICD codes that are part of that DRG subcategory.