Complicated Peptic Ulcer without CC/MCC DRG Reimbursement

DRG 382 addresses complicated peptic ulcer disease admissions that lack Major Complication or Comorbidity and Complication or Comorbidity, focusing on local ulcer-related complications without higher-severity comorbid conditions. This classification matters for inpatient reimbursement because Diagnosis-Related Group assignment establishes the Medicare prospective payment for the hospitalization and influences hospital revenue for these surgical and medical encounters.

DRG 382 Overview

DRG 382 covers inpatient admissions for complicated peptic ulcer disease without a Major Complication or Comorbidity and without a Complication or Comorbidity. This includes cases with local complications such as hemorrhage or perforation that do not meet coding criteria for higher-severity payment adjustments. It matters for Medicare payment because the Diagnosis-Related Group assignment drives the fixed prospective payment amount for the hospital stay. Accurate coding of associated procedures and comorbid conditions determines whether the case remains in DRG 382 or shifts to a higher-paying Diagnosis-Related Group.

Trials of acute endoscopic and minimally invasive interventions for bleeding or perforated peptic ulcers: randomized or cohort studies comparing timing and techniques of endoscopic hemostasis, use of interventional radiology embolization, and surgical approaches in patients hospitalized with complicated peptic ulcer disease (active GI bleeding, perforation, or gastric outlet obstruction). The patient population includes adults admitted emergently with complications requiring urgent procedures; outcomes assess hemostasis success, rebleeding rates, need for salvage surgery, length of stay, and in-hospital mortality. This research is important to clinicians and payers because it informs which acute interventions reduce resource use, complications, and costly prolonged hospitalizations in the inpatient episode covered by this DRG.
Comparative effectiveness studies of peri-procedural medical management strategies in hospitalized patients without major comorbid complications: pragmatic trials or observational comparative-effectiveness research evaluating proton pump inhibitor dosing strategies, eradication therapy timing for Helicobacter pylori when applicable, and transfusion thresholds in patients admitted for complicated peptic ulcer but without CC/MCC. The focus population is patients with modifiable medical management variables during the index admission who are at moderate risk for rebleeding but do not have major coexisting illnesses; endpoints include rebleeding, readmission within 30 days, transfusion requirements, and inpatient costs. Results guide hospital protocols and payer policy around standardized care bundles that may shorten stays and reduce variation in resource utilization for this DRG cohort.
Post-discharge outcomes and care-transition studies examining readmission prevention, outpatient follow-up, and long-term ulcer recurrence: cohort studies or interventional trials testing structured discharge pathways, patient education, outpatient endoscopy scheduling, adherence support for eradication therapy, and coordination with primary care for NSAID deprescribing. The study population is survivors of an index hospitalization for complicated peptic ulcer without major complications, monitored for 30- to 180-day outcomes including readmissions, recurrent bleeding, medication adherence, and outpatient resource use. These studies are relevant because reducing post-discharge events and readmissions directly impacts total episode costs and quality metrics that matter to both providers and payers managing care under this DRG.

Trials of acute endoscopic and minimally invasive interventions for bleeding or perforated peptic ulcers: randomized or cohort studies comparing timing and techniques of endoscopic hemostasis, use of interventional radiology embolization, and surgical approaches in patients hospitalized with complicated peptic ulcer disease (active GI bleeding, perforation, or gastric outlet obstruction). The patient population includes adults admitted emergently with complications requiring urgent procedures; outcomes assess hemostasis success, rebleeding rates, need for salvage surgery, length of stay, and in-hospital mortality. This research is important to clinicians and payers because it informs which acute interventions reduce resource use, complications, and costly prolonged hospitalizations in the inpatient episode covered by this DRG.
Comparative effectiveness studies of peri-procedural medical management strategies in hospitalized patients without major comorbid complications: pragmatic trials or observational comparative-effectiveness research evaluating proton pump inhibitor dosing strategies, eradication therapy timing for Helicobacter pylori when applicable, and transfusion thresholds in patients admitted for complicated peptic ulcer but without CC/MCC. The focus population is patients with modifiable medical management variables during the index admission who are at moderate risk for rebleeding but do not have major coexisting illnesses; endpoints include rebleeding, readmission within 30 days, transfusion requirements, and inpatient costs. Results guide hospital protocols and payer policy around standardized care bundles that may shorten stays and reduce variation in resource utilization for this DRG cohort.
Post-discharge outcomes and care-transition studies examining readmission prevention, outpatient follow-up, and long-term ulcer recurrence: cohort studies or interventional trials testing structured discharge pathways, patient education, outpatient endoscopy scheduling, adherence support for eradication therapy, and coordination with primary care for NSAID deprescribing. The study population is survivors of an index hospitalization for complicated peptic ulcer without major complications, monitored for 30- to 180-day outcomes including readmissions, recurrent bleeding, medication adherence, and outpatient resource use. These studies are relevant because reducing post-discharge events and readmissions directly impacts total episode costs and quality metrics that matter to both providers and payers managing care under this DRG.

OpenPayer

Summary & Overview

Complicated Peptic Ulcer without CC/MCC: Inpatient Reimbursement Overview

DRG 382 Overview

Clinical Trials

Related Codes

Clinical Trials

Related Codes