ICD-10 CM Codes Categorized as Complication or Comorbidity or Major CC

$79 / year

The dataset contains a list of all of the codes that are defined as either a complication or comorbidity (CC) or a major complication or comorbidity (MCC) when used as a secondary diagnosis. If the CC or MCC is allowed with all principal diagnoses, then the phrase NoExcl follows the CC/MCC indicator. Otherwise, a link is given to a collection of diagnosis codes which, when used as the principal diagnosis, will cause the CC or MCC to be considered as only a non CC.

Complexity

The MS-DRG System: The MS-DRGs range from 001-999, with many unused numbers to accommodate future MS-DRG expansion.
One MS-DRG is assigned to each inpatient stay. The MS-DRGs are assigned using the principal diagnosis and additional diagnoses, the principal procedure and additional procedures, sex and discharge status. Diagnoses and procedures assigned by using ICD-10-CM codes determine the MS-DRG assignment. Accurate and complete ICD-10-CM coding by HIM professionals is essential for correct MS-DRG assignment and subsequent reimbursement.

In the MS-DRG system, many DRGs are split into one, two or three MS-DRGs based on whether any one of the secondary diagnoses has been categorized as an MCC, a CC or no CC.

Example of MS-DRGs with a three way split include:
MS-DRG 539, Osteomyelitis with MCC
MS-DRG 540, Osteomyelitis with CC
MS-DRG 541, Osteomyelitis without CC/MCC

MCC/CC List: Under MS-DRGs, CMS identified those diagnoses whose presence as a secondary diagnosis leads to substantially increased hospital resource use. They then categorized this list into two different levels of severity as follows:
Major complications or comorbidities (MCCs) reflect the highest level of severity
CCs represent the next level of severity.

Some MCCs and CCs are excluded because they are too closely related to the principal diagnoses. This is called the CC Exclusion List and identifies conditions that will not be considered a CC or MCC for a given principal diagnosis. For example, primary cardiomyopathy (425.4) is not a CC for congestive heart failure (428.0).

Date Created

2007

Last Modified

2015-08-20

Version

33

Update Frequency

Annual

Temporal Coverage

N/A

Spatial Coverage

United States

Source

John Snow Labs => Centers for Medicare & Medicaid Services

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

ICD 10 Codes List, ICD 10 Procedure Code, ICD 10 Codes, ICD Codes, CCS, Code Book, ICD-10-CM Definition, ICD-10-CM Book, ICD-10-CM Manual

Other Titles

ICD-10-CM as CC or MCC, ICD-10-CM as CC or MCC Code Book, ICD-10-CM Manual as CC or MCC

Name Description Type Constraints
Primary_Diagnosis_Codes_CollectionCollection of Primary Diagnosis Codes categoried as CC or MCCstring-
ICD_10_CM_CodesICD-10-CM Diagnosis Codesstringrequired : 1
ICD_10_CM_Codes_DescriptionDescription of ICD Codesstring-
Primary_Diagnosis_Codes_CollectionICD_10_CM_CodesICD_10_CM_Codes_Description
PDX Collection 0131A8181Kuru
PDX Collection 0133A8181Kuru
PDX Collection 0134A8181Kuru
PDX Collection 0135A8181Kuru
PDX Collection 0193tion 0193
PDX Collection 515R401Stupor
PDX Collection 529K921Melena
PDX Collection 619K921Melena
PDX Collection 639K921Melena
PDX Collection 642K921Melena