Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Hepatobiliary System and PancreasDRG 442-disorders-of-liver-except-malignancy-cirrhosis-or-alcoholic-hepatitis-with-cc
    Ask Trek AI about this page

    Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with CC: Inpatient Reimbursement Overview

    DRG 442 includes nonmalignant liver disorders excluding cirrhosis and alcoholic hepatitis when a Complication or Comorbidity is present, encompassing acute hepatic conditions and related procedures. It matters for inpatient reimbursement because the Complication or Comorbidity designation raises expected resource use and therefore impacts Medicare payment under the prospective payment system.

    Customize your policy alerts

    Sign up for drg 442 policy alerts

    Get alerted when payer policies referencing 442 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    DRG 442 Overview

    DRG 442 covers inpatient cases for disorders of the liver excluding malignancy, cirrhosis, or alcoholic hepatitis when a Complication or Comorbidity is present. Typical diagnoses include acute hepatic dysfunctions, biliary disorders, and nonmalignant hepatic necrosis that require inpatient medical or procedural management. This Diagnosis-Related Group matters for Medicare payment because the presence of a Complication or Comorbidity elevates resource intensity and influences the prospective payment amount. Accurate assignment affects hospital reimbursement, coding audit risk, and case-mix index calculations.

    Table of contents

    Progress1 / 3

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical Trials

    • Acute management and supportive care intervention studies: Trials in this category examine short-term treatments and protocols for hospitalized patients with non-malignant liver disorders (such as acute hepatitis exacerbations, biliary-related liver dysfunction, or drug-induced liver injury) complicated by comorbid conditions that qualify as CC-level severity. These studies enroll inpatients during the index admission to evaluate interventions like optimized fluid and electrolyte management, strategies to prevent or treat hepatic encephalopathy, noninvasive monitoring protocols, or timing of specialty consultations. Results are directly relevant to clinicians and payers because they can define evidence-based inpatient pathways that reduce complications, length of stay, and resource utilization for this high-acuity DRG population.
    • Comparative effectiveness and care-delivery trials for etiologic-specific management: This research compares different diagnostic and therapeutic approaches for subgroups within the DRG (for example, autoimmune versus cholestatic versus metabolic liver disorders excluding cirrhosis and malignancy) to determine which approaches yield better clinical stabilization and lower readmission risk. Studies may randomize or observationally compare strategies such as differing medication regimens, imaging-driven versus empiric management, or timing of endoscopic/interventional procedures in patients with coexisting comorbidities that elevate the DRG severity. Findings inform providers and payers about which care pathways are most effective and cost-efficient for specific etiologies, enabling more targeted utilization of inpatient resources and potentially reducing downstream costs.
    • Post-discharge outcomes, transitions of care, and readmission prevention studies: These trials assess interventions implemented during hospitalization or at discharge—such as structured discharge planning, early outpatient hepatology follow-up, medication reconciliation, and patient education—focused on patients with non-malignant liver disorders and complex comorbid CCs. The patient population includes survivors of the index admission who are at elevated risk for complications, medication-related liver injury recurrence, or readmission due to unresolved or progressive liver dysfunction. This research is critical to payers and health systems because improved transition processes can lower 30- and 90-day readmissions, reduce avoidable post-acute utilization, and improve allocation of outpatient specialty resources for this DRG cohort.

    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

    Showing 1–10 of 35

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.