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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Ear, Nose, Mouth and ThroatDRG 147-ear-nose-mouth-and-throat-malignancy-with-cc
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    Ear, Nose, Mouth and Throat Malignancy with CC: Inpatient Reimbursement Overview

    DRG 147 addresses inpatient stays for malignancies of the ear, nose, mouth, and throat when a Complication or Comorbidity is present, encompassing surgical and medical management that increases resource use. It matters for inpatient reimbursement because the presence of a Complication or Comorbidity raises the relative payment weight under Medicare, impacting hospital payment for these complex head and neck cancer admissions.

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    DRG 147 Overview

    DRG 147 covers inpatient hospital admissions for malignant neoplasms of the ear, nose, mouth, and throat with a Complication or Comorbidity. Typical cases include surgical resections, reconstructive procedures, or medical management for head and neck cancers when an additional clinical condition increases resource use. This Diagnosis-Related Group influences Medicare payment by grouping cases with higher expected costs due to the presence of a Complication or Comorbidity, which affects relative payment weights and hospital reimbursement. Understanding this DRG helps clarify inpatient billing and expected resource allocation for affected hospital stays.

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    Clinical Trials

    • Trials evaluating perioperative multimodal treatment strategies for head and neck cancers with complications: These studies examine combinations or sequences of surgery, radiotherapy, and systemic therapy in patients hospitalized for ear, nose, mouth or throat malignancies who have significant comorbidities or perioperative complications (the CC population). The patient population includes adults requiring complex resections, reconstructive procedures, or inpatient management of treatment-related complications such as bleeding, infection, or airway compromise. Results inform hospital-level care pathways, expected resource utilization, and timing of adjunctive therapies, which is directly relevant to providers planning inpatient care and payers estimating episode costs for DRG 147 admissions.
    • Comparative effectiveness studies of airway and swallowing management approaches in complicated head and neck cancer admissions: These trials compare different inpatient interventions — for example, timing and type of tracheostomy, enteral feeding strategies, or protocols for swallow rehabilitation — in patients with malignancies of the ear, nose, mouth, or throat who develop airway obstruction or dysphagia. The focus population is patients admitted with acute functional compromise related to their tumor or its treatment, often with CC-level comorbidity burden. Findings guide clinical decision-making about interventions that impact length of stay, complication rates, readmissions, and downstream costs, making them highly relevant to clinicians and payers focused on quality and cost containment for this DRG.
    • Longitudinal outcomes and survivorship studies addressing readmission, functional recovery, and palliative needs after complicated head and neck cancer hospitalizations: These observational cohorts follow patients discharged after inpatient treatment for ENT malignancies with complications to measure rates of unplanned readmission, long-term swallowing and speech outcomes, symptom burden, and utilization of hospice or palliative services. The studied population includes survivors with CCs who may require ongoing rehabilitation, home health, or repeated hospital care. Such research helps providers and payers understand post-discharge resource needs, plan care coordination, and develop interventions to reduce costly readmissions and improve value across the full episode of care for DRG 147 patients.

    Related Codes

    135-SINUS-AND-MASTOID-PROCEDURES-WITH-CC-MCC

    Sinus and Mastoid Procedures with CC/MCC: Inpatient Reimbursement Overview

    136-SINUS-AND-MASTOID-PROCEDURES-WITHOUT-CC-MCC

    Sinus and Mastoid Procedures without CC/MCC: Inpatient Reimbursement Overview

    137-MOUTH-PROCEDURES-WITH-CC-MCC

    Mouth Procedures with CC/MCC: Inpatient Reimbursement Overview

    138-MOUTH-PROCEDURES-WITHOUT-CC-MCC

    Mouth Procedures without CC/MCC: Inpatient Reimbursement Overview

    139-SALIVARY-GLAND-PROCEDURES

    Salivary Gland Procedures: Inpatient Reimbursement Overview

    140-MAJOR-HEAD-AND-NECK-PROCEDURES-WITH-MCC

    Major Head and Neck Procedures with MCC: Inpatient Reimbursement Overview

    141-MAJOR-HEAD-AND-NECK-PROCEDURES-WITH-CC

    Major Head and Neck Procedures with CC: Inpatient Reimbursement Overview

    142-MAJOR-HEAD-AND-NECK-PROCEDURES-WITHOUT-CC-MCC

    Major Head and Neck Procedures without CC/MCC: Inpatient Reimbursement Overview

    143-OTHER-EAR-NOSE-MOUTH-AND-THROAT-O-R-PROCEDURES-WITH-MCC

    Other Ear, Nose, Mouth and Throat O.R. Procedures with MCC: Inpatient Reimbursement Overview

    144-OTHER-EAR-NOSE-MOUTH-AND-THROAT-O-R-PROCEDURES-WITH-CC

    Other Ear, Nose, Mouth and Throat O.R. Procedures with CC: 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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