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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 087-traumatic-stupor-and-coma-1-hour-without-cc-mcc
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    Traumatic Stupor and Coma <1 Hour without CC/MCC: Inpatient Reimbursement Overview

    DRG 087 addresses inpatient admissions for traumatic stupor and coma lasting less than one hour without Major Complication or Comorbidity and without Complication or Comorbidity; it encompasses brief traumatic loss of consciousness requiring hospitalization. This Diagnosis-Related Group matters for inpatient reimbursement because it assigns a bundled Medicare payment based on the anticipated hospital resources for this specific, limited-severity traumatic brain injury presentation.

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    DRG 087 Overview

    DRG 087 covers inpatient admissions for traumatic stupor and coma lasting less than one hour without any Major Complication or Comorbidity and without any Complication or Comorbidity. This category captures short-duration loss of consciousness from traumatic brain injury where no significant comorbid conditions are coded, and it groups patients for payment purposes based on resource use typical of brief, acute neurologic impairment. The Diagnosis-Related Group affects Medicare payment by assigning a bundled inpatient reimbursement rate that reflects expected hospital resource consumption for this clinical presentation. Accurate clinical documentation and coding determine assignment to this Diagnosis-Related Group and thus the applicable Medicare payment.

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    Clinical Trials

    • Acute resuscitation and early neuroprotection trials: Studies that evaluate immediate in-hospital interventions (for example optimized airway and ventilation strategies, blood pressure and intracranial pressure management protocols, or early neuroprotective approaches) in adult patients presenting with brief traumatic stupor or coma lasting under one hour. These trials focus on the hyperacute phase from ED arrival through the first 24 hours to determine which acute care processes reduce secondary brain injury and short-term neurological deterioration. Findings are relevant to providers for protocol selection and to payers because improved early management can decrease ICU utilization, shorten length of stay, and reduce downstream costs associated with complications.
    • Comparative effectiveness studies of monitoring intensity and disposition: Pragmatic trials comparing levels of inpatient monitoring (observation unit versus step-down unit versus ICU) and imaging/neurologic reassessment schedules for patients with transient traumatic loss of consciousness without complicating comorbidities. These studies enroll patients with low to moderate risk features to define which patients safely require minimal inpatient resources versus more intensive monitoring, assessing outcomes such as clinical deterioration, readmission, and resource utilization. Results inform clinicians about safe triage and documentation practices and inform payers and hospitals on cost-effective allocation of beds and monitoring resources for this DRG.
    • Post-discharge functional outcome and care coordination studies: Prospective cohort studies and interventional trials examining short-term functional recovery, return-to-work/school, cognitive screening, and the effect of targeted discharge planning or early outpatient follow-up in patients discharged after brief traumatic stupor/coma. These studies typically follow patients over weeks to months to quantify residual cognitive or functional deficits and test models (e.g., early rehabilitation referral, telehealth check-ins) that might reduce readmissions and unmet needs. Evidence from these studies is important to providers for designing discharge pathways and to payers because improved post-discharge care can lower readmission rates and long-term disability 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

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    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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