Summary & Overview
Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy without CC/MCC: Inpatient Reimbursement Overview
DRG 738 encompasses uterine and adnexa procedures for ovarian or adnexal malignancy without Major Complication or Comorbidity or Complication or Comorbidity. This Diagnosis-Related Group defines a payment grouping that influences Medicare inpatient reimbursement by reflecting the expected resource use for oncologic surgical admissions lacking additional coded severity.
DRG 738 Overview
DRG 738 covers inpatient cases involving uterine and adnexa procedures performed for ovarian or adnexal malignancy without a Major Complication or Comorbidity and without a Complication or Comorbidity. This Diagnosis-Related Group groups clinically similar surgical admissions to standardize Medicare payment for care focused on tumor-directed procedures such as oophorectomy, salpingo-oophorectomy, and affected uterine surgery when no higher-severity diagnoses are present. It matters for Medicare payment because classification into this Diagnosis-Related Group affects the base payment rate, resource intensity assumptions, and hospital reimbursement for these oncologic surgical admissions. Accurate coding of diagnoses and procedures determines assignment to this Diagnosis-Related Group and thus the appropriate inpatient payment.