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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Hepatobiliary System and PancreasDRG 432-cirrhosis-and-alcoholic-hepatitis-with-mcc
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    Cirrhosis and Alcoholic Hepatitis with MCC: Inpatient Reimbursement Overview

    DRG 432 includes inpatient stays for cirrhosis and alcoholic hepatitis when a Major Complication or Comorbidity is documented, indicating higher clinical complexity requiring significant hospital resources. Accurate classification into this Diagnosis-Related Group affects Medicare inpatient reimbursement by reflecting increased expected resource use for patients with severe complications.

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    DRG 432 Overview

    DRG 432 covers hospital admissions for cirrhosis and alcoholic hepatitis when a Major Complication or Comorbidity is present, reflecting higher clinical complexity such as hepatic failure, sepsis, or other life‑threatening conditions. This group captures patients with advanced liver disease and organ dysfunction who typically require intensive inpatient management, diagnostics, and longer lengths of stay. It matters for Medicare payment because the presence of a Major Complication or Comorbidity elevates the payment relative to lower‑severity groups, aligning reimbursement with expected resource use for sicker patients.

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    Clinical Trials

    • Acute management trials of complications in hospitalized patients with advanced cirrhosis and alcoholic hepatitis: randomized or prospective studies testing interventions to manage life‑threatening in‑hospital complications such as variceal hemorrhage, spontaneous bacterial peritonitis, hepatorenal syndrome, or severe alcohol‑related hepatic inflammation. These studies enroll patients admitted with decompensated liver disease and often stratify by severity (MELD, ACLF grades) to evaluate short‑term mortality, organ support needs, and safety of intensive interventions. Results inform inpatient clinical pathways, resource utilization, and short‑stay mortality risk—key drivers of reimbursement and DRG cost variation for providers and payers.
    • Comparative effectiveness and care‑bundle studies for inpatient stabilization and transition planning: pragmatic trials or observational comparative studies evaluating different bundles of care (early infection screening and treatment, standardized lactulose/paracentesis protocols, alcohol withdrawal management, and structured discharge planning including addiction services referral) in patients hospitalized with cirrhosis and alcoholic hepatitis. These studies focus on real‑world populations with high comorbidity burden and frequent readmissions, measuring outcomes such as 30‑ and 90‑day readmission rates, length of stay, and post‑discharge healthcare costs. Findings help hospitals and payers identify which care processes reduce costly readmissions and improve value across episodes classified under this DRG.
    • Post‑discharge and longitudinal outcomes research including secondary prevention and transplant evaluation pathways: cohort studies and interventional trials that follow survivors of hospitalizations for cirrhosis and alcoholic hepatitis to assess long‑term outcomes (survival, sustained alcohol abstinence, progression to transplant, quality of life, and healthcare utilization) and to test outpatient interventions such as addiction treatment models, nutrition support, or integrated hepatology‑primary care clinics. These investigations enroll patients after discharge or at time of stabilization and address barriers to continuity of care and transplant candidacy, providing evidence on long‑term cost offsets and outcome improvements that are critical for payers planning post‑acute care networks and for providers managing downstream resource allocation.

    Related Codes

    405-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITH-MCC

    Pancreas, Liver and Shunt Procedures with MCC: Inpatient Reimbursement Overview

    406-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITH-CC

    Pancreas, Liver and Shunt Procedures with CC: Inpatient Reimbursement Overview

    407-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITHOUT-CC-MCC

    Pancreas, Liver and Shunt Procedures without CC/MCC: Inpatient Reimbursement Overview

    408-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITH-MCC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with MCC: Inpatient Reimbursement Overview

    409-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITH-CC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with CC: Inpatient Reimbursement Overview

    410-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITHOUT-CC-MCC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E.: Inpatient Reimbursement Overview

    411-CHOLECYSTECTOMY-WITH-C-D-E-WITH-MCC

    Cholecystectomy with C.D.E. with MCC: Inpatient Reimbursement Overview

    412-CHOLECYSTECTOMY-WITH-C-D-E-WITH-CC

    Cholecystectomy with Common Duct Exploration with Complication or Comorbidity: Inpatient Reimbursement Overview

    413-CHOLECYSTECTOMY-WITH-C-D-E-WITHOUT-CC-MCC

    Cholecystectomy with C.D.E. without CC/MCC: Inpatient Reimbursement Overview

    414-CHOLECYSTECTOMY-EXCEPT-BY-LAPAROSCOPE-WITHOUT-C-D-E-WITH-MCC

    Cholecystectomy Except by Laparoscope without C.D.E. with MCC: 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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