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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Ear, Nose, Mouth and ThroatDRG 156-other-ear-nose-mouth-and-throat-diagnoses-without-cc-mcc
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    Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC: Inpatient Reimbursement Overview

    DRG 156 groups admissions for miscellaneous ear, nose, mouth and throat diagnoses without a Major Complication or Comorbidity or a Complication or Comorbidity; it captures lower-severity otolaryngologic inpatient care. This grouping matters for inpatient reimbursement because it generally yields lower Medicare payment rates and depends on precise coding to ensure correct Diagnosis-Related Group assignment.

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    DRG 156 Overview

    DRG 156 covers hospital admissions for other ear, nose, mouth and throat diagnoses that do not involve a Major Complication or Comorbidity or a Complication or Comorbidity. Typical cases include non-complex otolaryngologic conditions managed with medical therapy or straightforward procedures. This Diagnosis-Related Group is significant for Medicare payment because it represents lower-severity inpatient encounters with correspondingly lower reimbursement relative to higher-severity groups. Accurate coding of diagnoses and procedures directly influences assignment to this Diagnosis-Related Group and associated Medicare inpatient payment.

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    Clinical Trials

    • Acute procedural efficacy and safety studies focused on otolaryngologic interventions for non-complex ENT diagnoses: These trials evaluate short-term outcomes of common hospital-based procedures such as incision and drainage of peritonsillar abscesses, flexible endoscopy-guided foreign body removal from the upper airway, or inpatient management protocols for complicated otitis media without CC/MCC. They enroll adults and children admitted for acute ENT problems requiring procedural intervention and measure metrics like procedure success, immediate complication rates, length of stay, and need for escalation of care. Findings are relevant to providers and payers because they inform best-practice procedural pathways that can reduce variability in care, avoid unnecessary ICU use, and shorten inpatient stays for DRG 156 patients.
    • Comparative effectiveness and care pathway trials comparing conservative versus escalation strategies for common ENT diagnoses: These studies compare inpatient treatment approaches—for example, early surgical intervention versus optimized medical therapy for severe tonsillitis or inpatient observation protocols for epistaxis—to determine which strategies yield better symptom control, lower readmission rates, and more efficient resource use. They typically enroll heterogeneous adult and pediatric cohorts with ENT conditions that lack major comorbidity (aligning with DRG 156) and assess outcomes such as treatment failure, need for secondary procedures, patient-reported symptom resolution, and total hospital costs. Results guide clinicians and payers in selecting pathways that balance clinical benefit with cost-effectiveness, supporting protocolization that can reduce unnecessary procedures and admissions.
    • Post-discharge outcomes and readmission risk prediction studies for patients hospitalized with non-CC/MCC ENT diagnoses: These observational and prospective cohort studies track functional recovery, complication rates (eg, recurrent infection, persistent obstruction), health-related quality of life, and 30–90 day readmission or ED revisit rates after discharge for patients treated for ENT conditions within DRG 156. They focus on identifying risk factors—such as age, social determinants, or index treatment modality—that predict poor recovery or early return to care, and may evaluate transitional care interventions like targeted discharge education or early outpatient follow-up. This research is important to providers and payers because reducing preventable readmissions and optimizing post-discharge care can improve patient outcomes while lowering downstream costs associated with repeat inpatient utilization.

    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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