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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Kidney and Urinary TractDRG 696-kidney-and-urinary-tract-signs-and-symptoms-without-mcc
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    Kidney and Urinary Tract Signs and Symptoms without MCC: Inpatient Reimbursement Overview

    DRG 696 addresses inpatient stays for kidney and urinary tract signs and symptoms without Major Complication or Comorbidity, focusing on conditions like hematuria and dysuria that require hospital evaluation. It matters for inpatient reimbursement because it establishes the bundled Medicare payment tied to the documented diagnoses and resource use for these non-complicated urinary presentations.

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    DRG 696 Overview

    DRG 696 covers hospital admissions for kidney and urinary tract signs and symptoms without Major Complication or Comorbidity. Typical cases include hematuria, dysuria, flank pain, and other non-complicated urinary complaints that require inpatient evaluation or short-term treatment. This Diagnosis-Related Group groups patients by resource use, affecting Medicare payment by assigning a bundled inpatient reimbursement amount. Proper coding of diagnoses and any comorbid conditions determines eligibility for this payment category.

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    Clinical Trials

    • Studies of rapid diagnostic algorithms and biomarker-guided evaluation for acute kidney and urinary tract symptom presentations: trials compare protocols using point-of-care urinalysis, serum creatinine trends, and novel biomarkers to standard assessment for patients admitted with acute flank pain, dysuria, hematuria, or unexplained creatinine rise. These studies enroll adults admitted from the emergency department or urgent care with undifferentiated urinary or renal-related signs to determine diagnostic yield, time to definitive diagnosis, and reduction in unnecessary imaging or admissions; results are relevant to clinicians for streamlining inpatient workups and to payers for reducing avoidable resource use.
    • Comparative effectiveness trials of inpatient management strategies for symptomatic urinary tract obstruction and non-complicated urinary infections: randomized or pragmatic trials examine approaches such as expedited urologic decompression versus conservative observation, or short-course versus standard-course inpatient-directed antibiotic strategies for patients without major comorbid complications (no MCC). These studies target the typical DRG 696 population—patients with significant signs or symptoms but without major complications—and inform which inpatient interventions most effectively reduce length of stay, prevent progression to complicated infection or renal impairment, and optimize resource utilization.
    • Post-discharge outcomes and transitional care research measuring functional recovery, readmission risk, and outpatient follow-up protocols for patients discharged after workup for kidney and urinary tract signs and symptoms: cohort studies and randomized care-pathway trials test structured discharge planning, early outpatient nephrology/urology follow-up, or remote monitoring of renal function versus usual care. These investigations focus on patients categorized under this DRG to identify predictors of 30-day readmission, persistent renal dysfunction, or repeat ED visits, providing actionable data for providers to reduce complications and for payers to decrease readmission-related costs.

    Related Codes

    650-KIDNEY-TRANSPLANT-WITH-HEMODIALYSIS-WITH-MCC

    Kidney Transplant with Hemodialysis with Major Complication or Comorbidity: Inpatient Reimbursement Overview

    651-KIDNEY-TRANSPLANT-WITH-HEMODIALYSIS-WITHOUT-MCC

    Kidney Transplant with Hemodialysis without MCC: Inpatient Reimbursement Overview

    652-KIDNEY-TRANSPLANT

    Kidney Transplant: Inpatient Reimbursement Overview

    653-MAJOR-BLADDER-PROCEDURES-WITH-MCC

    Major Bladder Procedures with MCC: Inpatient Reimbursement Overview

    654-MAJOR-BLADDER-PROCEDURES-WITH-CC

    Major Bladder Procedures with CC: Inpatient Reimbursement Overview

    655-MAJOR-BLADDER-PROCEDURES-WITHOUT-CC-MCC

    Major Bladder Procedures without CC/MCC: Inpatient Reimbursement Overview

    656-KIDNEY-AND-URETER-PROCEDURES-FOR-NEOPLASM-WITH-MCC

    Kidney and Ureter Procedures for Neoplasm with MCC: Inpatient Reimbursement Overview

    657-KIDNEY-AND-URETER-PROCEDURES-FOR-NEOPLASM-WITH-CC

    Kidney and Ureter Procedures for Neoplasm with CC: Inpatient Reimbursement Overview

    658-KIDNEY-AND-URETER-PROCEDURES-FOR-NEOPLASM-WITHOUT-CC-MCC

    Kidney and Ureter Procedures for Neoplasm without CC/MCC: Inpatient Reimbursement Overview

    659-KIDNEY-AND-URETER-PROCEDURES-FOR-NON-NEOPLASM-WITH-MCC

    Kidney and Ureter Procedures for Non-Neoplasm with MCC: Inpatient Reimbursement Overview

    Showing 1–10 of 41

    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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