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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 061-ischemic-stroke-precerebral-occlusion-or-transient-ischemia-with-thrombolytic-agent-with-mcc
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    Ischemic Stroke with Thrombolytic Agent and MCC: Inpatient Reimbursement Overview

    DRG 061 pertains to ischemic stroke, precerebral occlusion, or transient ischemia treated with a thrombolytic agent in the presence of a Major Complication or Comorbidity, representing higher-acuity inpatient cases. This Diagnosis-Related Group matters for inpatient reimbursement because it groups patients who typically require more intensive care and resources, which influences Medicare payment levels.

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    DRG 061 Overview

    DRG 061 covers hospital inpatient admissions for ischemic stroke, precerebral artery occlusion, or transient ischemic attack where a thrombolytic agent was administered and a Major Complication or Comorbidity was present. This Diagnosis-Related Group reflects higher resource use due to thrombolytic therapy and the added clinical complexity of a Major Complication or Comorbidity. Payment under this Diagnosis-Related Group is adjusted to account for the intensity of services, monitoring, and potential complications associated with thrombolysis. Accurate clinical documentation and coding affect Medicare Severity Diagnosis-Related Group assignment and resulting reimbursement.

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    Clinical Trials

    • Acute thrombolysis optimization studies: Trials focusing on refining administration protocols, timing windows, and adjunctive measures for thrombolytic therapy in patients presenting with acute ischemic stroke or transient ischemic attacks who receive systemic thrombolytics. These studies typically enroll patients within the early emergency department or stroke unit window and investigate outcomes such as reperfusion rates, symptomatic hemorrhage, and early neurological improvement. Findings inform emergency stroke pathways and resource utilization decisions that directly affect hospital length of stay and costs for this DRG.
    • Comparative effectiveness and safety studies of reperfusion strategies: Research comparing systemic thrombolysis alone versus combinations with endovascular approaches or differing anticoagulation/antiplatelet strategies in subgroups such as large-vessel occlusion, precerebral stenosis, or patients with significant comorbidities (for example, atrial fibrillation or prior anticoagulant use). These studies address which patient populations derive the greatest net benefit and the trade-offs in complication rates and secondary interventions, providing evidence useful for clinical protocols, case-mix adjustment, and payer coverage decisions.
    • Post-acute outcomes, rehabilitation, and readmission prevention research: Trials and observational studies evaluating inpatient rehabilitation timing, intensity, secondary prevention adherence, and care transitions for patients who received thrombolytic therapy with major complications or comorbidities (MCC). These investigations measure functional recovery, discharge disposition (home versus skilled nursing facility), 30- and 90-day readmission rates, and cost-effectiveness of post-discharge services. Results are relevant for hospitals and payers aiming to reduce avoidable readmissions, optimize post-acute placement, and align reimbursement with expected outcomes for this high-acuity DRG.

    Related Codes

    020-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITH-MCC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with MCC: Inpatient Reimbursement Overview

    021-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITH-CC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with CC: Inpatient Reimbursement Overview

    022-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITHOUT-CC-MCC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage without CC/MCC: Inpatient Reimbursement Overview

    023-CRANIOTOMY-WITH-MAJOR-DEVICE-IMPLANT-OR-ACUTE-COMPLEX-CNS-PRINCIPAL-DIAGNOSIS-WITH-MCC-OR-ANTINEOPLASTIC-IMPLANT-OR-EPILEPSY-WITH-NEUROSTIMULATOR

    Craniotomy with Major Device Implant or Complex CNS DRG 023: Inpatient Reimbursement Overview

    024-CRANIOTOMY-WITH-MAJOR-DEVICE-IMPLANT-OR-ACUTE-COMPLEX-CNS-PRINCIPAL-DIAGNOSIS-WITHOUT-MCC

    Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis without MCC: Inpatient Reimbursement Overview

    025-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITH-MCC

    Craniotomy and Endovascular Intracranial Procedures with MCC: Inpatient Reimbursement Overview

    026-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITH-CC

    Craniotomy and Endovascular Intracranial Procedures with CC: Inpatient Reimbursement Overview

    027-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITHOUT-CC-MCC

    Craniotomy and Endovascular Intracranial Procedures without CC/MCC: Inpatient Reimbursement Overview

    028-SPINAL-PROCEDURES-WITH-MCC

    Spinal Procedures with MCC: Inpatient Reimbursement Overview

    029-SPINAL-PROCEDURES-WITH-CC-OR-SPINAL-NEUROSTIMULATORS

    Spinal Procedures with CC or Spinal Neurostimulators: Inpatient Reimbursement Overview

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    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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