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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 082-traumatic-stupor-and-coma-1-hour-with-mcc
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    Traumatic Stupor and Coma >1 Hour with MCC: Inpatient Reimbursement Overview

    DRG 082 includes traumatic stupor and coma lasting more than one hour with Major Complication or Comorbidity, representing severe traumatic brain injury requiring intensive inpatient care. Proper classification affects Medicare inpatient reimbursement because the Diagnosis-Related Group assignment reflects elevated resource use tied to major complications.

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    DRG 082 Overview

    DRG 082 covers patients admitted with traumatic stupor and coma lasting more than one hour with at least one Major Complication or Comorbidity. This group captures high-acuity traumatic brain injury cases that typically require intensive monitoring, advanced imaging, and prolonged inpatient resources. It matters for Medicare payment because the presence of a Major Complication or Comorbidity increases relative resource use and adjusts reimbursement to reflect higher expected costs. Accurate clinical documentation and coding determine assignment to this Diagnosis-Related Group and the associated payment level.

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    Clinical Trials

    • Acute neuroprotective and resuscitation intervention trials: studies testing early hospital-phase interventions aimed at limiting secondary brain injury in patients with prolonged traumatic stupor or coma (duration >1 hour) who present with severe head trauma and major comorbid conditions. These trials typically enroll adults with traumatic brain injury (TBI) requiring intensive monitoring or intracranial pressure management and evaluate short-term physiological endpoints (ICP control, cerebral perfusion, biomarker changes) and safety. Results inform acute care protocols, resource utilization in the ICU, and short-term costs that are directly relevant to both providers managing immediate treatment strategies and payers covering high-intensity inpatient services.
    • Comparative effectiveness studies of critical-care bundles and surgical timing: pragmatic trials or observational comparative-effectiveness research comparing different combinations of ICU care bundles (for example, protocols for intracranial pressure monitoring, hemodynamic targets, and ventilator strategies) and timing/indications for neurosurgical procedures (decompressive craniectomy, hematoma evacuation) in patients with traumatic stupor/coma and major complications. These studies focus on heterogeneous real-world populations with severe TBI and MCCs to assess in-hospital mortality, complication rates, length of stay, and need for subsequent levels of care. Findings guide best-practice clinical pathways and can influence reimbursement policies by identifying care approaches that improve outcomes while potentially reducing unnecessary resource use.
    • Post-acute outcomes and functional recovery cohorts: longitudinal studies and registry-based research following survivors of prolonged traumatic stupor/coma with major complications through discharge, rehabilitation, and 6–12+ month outcomes to characterize functional status, cognitive recovery, readmissions, and long-term care needs. These studies enroll patients transitioning from inpatient to post-acute settings and assess predictors of disability, utilization of rehabilitation services, and caregiver burden. Data are critical for providers planning discharge and rehabilitation strategies and for payers evaluating longer-term costs, benefit design for rehabilitation services, and programs aimed at reducing readmissions and durable medical costs.

    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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