Same logic and specifications apply to medical

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Same logic and specifications apply to medical patients in MDC 10 with pituitary neoplasms. A3X: PDX and OR Procedure Æ PDX and OR Procedure together clarify assignment to new MDC and APR-DRG assignment is made based upon the surgical hierarchy of the new MDC. If surgical patient in MDC 5 (Diseases & Disorders of the Circulatory System) has PDX peripheral vascular disease and a lower limb amputation procedure except toe and no major cardiovascular OR procedure, then reassign patient to MDC 8 (Diseases & Disor- ders of the Musculoskeletal System and Connective Tissue) where APR-DRG assignment will be made based upon the MDC 8 surgical hierarchy. Note, all or nearly all of these patients will be assigned to APR-DRG 305 Amputation Of Lower Limb Except Toe. If surgical patient in MDC 5 (Diseases & Disorders of the Circulatory System) has PDX peripheral vascular disease and a toe amputation and no other MDC 5 surgical proce- dures except those in APR-DRG 180 Other Circulatory System Procedures, then reassign patient to MDC 8 (Diseases & Disorders of the Musculoskeletal System and Connective Tissue) where APR-DRG assignment will be made based upon the MDC 8 surgical hierarchy. Note, most of these patients will be assigned to APR-DRG 314 Foot & Toe Procedures. A4X: PDX and Only OR Procedure Except Related OR Procedures Æ PDX and OR procedure together clarify MDC and APR-DRG assignment is made based upon the surgical hierarchy of the new MDC. If surgical patient in MDC 11 (Diseases & Disorders of the Kidney & Urinary Tract) has PDX complication of genitourinary device and penile prosthesis procedure and no other OR procedure except related penile procedures, then reassign patient to MDC 12 (Dis- eases & Disorders of the Male Reproductive System) where APR-DRG assignment is made based upon the surgical hierarchy of MDC 12. A5X: SDX and OR Procedure Æ OR Procedure clarifies assignment to new MDC and APR-DRG assignment is made based upon the surgical hierarchy of the new MDC. If surgical patient in MDC 9 (Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast) has SDX diabetes and lower limb amputation procedure, then reassign to MDC 8 (Diseases & Disorders of the Musculoskeletal System and Connective Tissue) where the patient will be assigned to a specific APR-DRG based upon the MDC 8 surgical hierarchy. Note, most of these patients have a PDX of chronic skin ulcer or cellulitis. A6P: PDX and SDX and Medical Æ Resequence PDX-SDX for APR-DRG grouping purposes and assign patient to new MDC and APR-DRG. If medical patient in MDC 18 (Infectious & Parasitic Diseases, Systemic or Unspecified Sites) has a PDX of fever or viral infection NOS and an SDX of agranulocytosis/neutrope- nia, then for APR-DRG grouping purposes, resequence the PDX-SDX so agranulocytosis/neutropenia is the PDX and assign patient to MDC 16 (Diseases & Disor-
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67 ders of Blood, Blood Forming Organs & Immunological Disorders) and APR-DRG 660 Major Hematologic/Immunologic Diag Exc Sick Cell Crisis & Coagul.
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  • Fall '18
  • Diagnosis-related group, DRGs

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