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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Hepatobiliary System and PancreasDRG 443-disorders-of-liver-except-malignancy-cirrhosis-or-alcoholic-hepatitis-without-cc-mcc
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    Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis without CC/MCC: Inpatient Reimbursement Overview

    DRG 443 addresses inpatient admissions for nonmalignant, noncirrhotic liver disorders without Complication or Comorbidity or Major Complication or Comorbidity and is important because it defines a lower resource-intensity payment category. Understanding this Diagnosis-Related Group is important for hospitals and coders to align clinical documentation with Medicare payment rules and case assignment.

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    DRG 443 Overview

    DRG 443 covers hospital inpatient admissions for disorders of the liver excluding malignancy, cirrhosis, or alcoholic hepatitis without a Complication or Comorbidity or a Major Complication or Comorbidity. Typical diagnoses include noncirrhotic liver disease, benign hepatic lesions, and transient liver function abnormalities managed primarily with medical therapy and monitoring. This Diagnosis-Related Group groups cases with relatively lower resource use compared with liver admissions involving complicated comorbid conditions. It is used by Centers for Medicare & Medicaid Services to determine base payment for such inpatient stays under Medicare.

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    Clinical Trials

    • Acute management interventional studies: randomized or pragmatic trials comparing different inpatient medical management strategies for acute non-malignant liver disorders (for example acute cholestatic exacerbations, acute hepatic decompensation without cirrhosis, or severe drug-induced liver injury). These studies enroll hospitalized adults presenting with biochemical liver injury, jaundice, coagulopathy, or hepatic encephalopathy of non-malignant etiology and test interventions such as timing/intensity of supportive care, alternative intravenous fluid regimens, or standardized protocols for monitoring and reversal of coagulopathy. Results are directly relevant to hospitalists and hepatologists because they can define best practices that shorten length of stay, reduce complications, and inform bundled payments and utilization management for this DRG.
    • Comparative effectiveness and diagnostic pathway research: prospective cohort studies or randomized trials evaluating different diagnostic algorithms and early in-hospital treatment strategies for distinguishing reversible liver disorders (e.g., ischemic hepatitis, biliary obstruction, acute fatty liver of pregnancy excluded by age) from progressive intrinsic liver disease. These studies focus on adult inpatients with elevated transaminases or cholestasis without known cirrhosis, comparing approaches such as expedited imaging plus targeted endoscopic or interventional procedures versus conservative workup, and measuring time-to-diagnosis, need for invasive procedures, resource use, and short-term clinical outcomes. Findings help clinicians and payers optimize resource allocation, reduce unnecessary procedures, and improve coding accuracy and case-mix adjustment for DRG 443 by clarifying which pathways reduce complications and resource use.
    • Post-discharge outcomes and care-transition studies: observational and interventional studies assessing readmission risk reduction, outpatient follow-up models, and care coordination for patients discharged after hospitalization for non-malignant liver disorders without major complications. These studies enroll the DRG 443 population to evaluate interventions such as structured discharge planning, early hepatology clinic follow-up, medication reconciliation focused on hepatotoxic agents, and patient education on alcohol and medication avoidance, tracking 30- and 90-day readmissions, functional status, and outpatient costs. This research is important to providers and payers because effective transition-of-care strategies can lower readmissions, improve long-term liver-related outcomes, and influence post-acute reimbursement and quality metrics tied to this DRG.

    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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