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

$79 / year

This dataset contains a list of all of the codes which are assigned as a Major CC (Major Complication or Comorbidity) only for patients discharged alive. Otherwise, they are assigned as 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, Clinical Software, Code Book, ICD-10-CM Definition, ICD-10-CM Book, ICD-10-CM Manual, ICD-10-CM and ICD-10-PCS Coding Handbook

Other Titles

ICD-10-CM as MCC only Clinical Software, ICD-10-CM as MCC only CCS, ICD-10-CM as MCC only Clinical Classifications Software

Name Description Type Constraints
ICD_10_CM_Diagnosis_CodesICD-10-CM Codes assigned as MCC if patient is discharged alive.string-
ICD_10_CM_Codes_DescriptionDescription of ICD-10 MCC Codesstringrequired : 1
ICD_10_CM_Diagnosis_CodesICD_10_CM_Codes_Description
R578Other shock
R570Cardiogenic shock
R571Hypovolemic shock
R092Respiratory arrest
I4901Ventricular fibrillation
I469Cardiac arrest, cause unspecified
I468Cardiac arrest due to other underlying condition
I462Cardiac arrest due to underlying cardiac condition
R571Hypovolemic shock