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    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of Blood, Blood Forming Organs and Immunologic DisordersDRG 810-major-hematological-and-immunological-diagnoses-except-sickle-cell-crisis-and-coagulation-disorders-without-cc-mcc
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    Major Hematological and Immunological Diagnoses: Inpatient Reimbursement Overview

    DRG 810 encompasses major hematological and immunological conditions other than sickle cell crisis and coagulation disorders when there is no Complication or Comorbidity or Major Complication or Comorbidity; it defines the clinical scope for inpatient hospital reimbursement. Correct classification matters for Medicare payment because it sets the base payment rate and reflects the expected resource needs for these inpatient cases.

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    DRG 810 Overview

    DRG 810 covers major hematological and immunological diagnoses excluding sickle cell crisis and coagulation disorders when no Complication or Comorbidity or Major Complication or Comorbidity is present. This group includes significant blood and immune system conditions that require inpatient medical management but do not meet higher-severity coding criteria. It matters for Medicare payment because assignment to DRG 810 determines base reimbursement for hospital stays with these principal diagnoses and influences resource allocation. Accurate coding of diagnoses and presence or absence of Complication or Comorbidity or Major Complication or Comorbidity is central to correct Medicare Severity Diagnosis-Related Group assignment.

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    Clinical Trials

    • Acute therapeutic trials evaluating novel immunomodulatory or hematopoietic-support interventions for hospitalized patients with major non-sickle hematologic or immunologic diagnoses (eg, severe autoimmune cytopenias, aplastic anemia presentations, or acute exacerbations of primary immunodeficiency). These studies enroll inpatients during the acute care episode to assess short-term efficacy and safety endpoints such as rapid reversal of cytopenias, reduction in transfusion needs, infection rates, and time to clinical stabilization. Results inform hospital clinicians about interventions that may shorten length of stay and reduce intensive resource use, and they help payers project inpatient cost savings tied to faster recovery or fewer complications.
    • Comparative effectiveness or management strategy trials comparing transfusion thresholds, supportive care bundles, or immunosuppressive regimens for patients admitted with major hematologic/immunologic disorders without CC/MCC. These trials enroll broad inpatient populations (eg, adults with severe immune thrombocytopenia or chronic hemolytic anemias presenting for exacerbation) to compare outcomes such as bleeding events, transfusion volume, readmission rates, and adverse events across different standard-of-care approaches. Findings guide clinicians on optimal in-hospital management pathways and support payers and hospitals in selecting protocols that balance clinical benefit with resource utilization and cost-effectiveness.
    • Post-discharge outcomes and care-transition studies tracking readmission risk, infection or complication rates, and long-term functional outcomes for patients discharged after an index hospitalization for major hematologic or immunologic diagnoses. These prospective cohort or pragmatic studies follow patients across outpatient care to identify predictors of early readmission, adherence to follow-up treatments, and need for home health or transfusion services. Such research is relevant to providers and payers because it identifies opportunities to reduce avoidable readmissions and downstream costs through targeted discharge planning, outpatient monitoring, and coordination of services for this vulnerable population.

    Related Codes

    799-SPLENIC-PROCEDURES-WITH-MCC

    Splenic Procedures with MCC: Inpatient Reimbursement Overview

    800-SPLENIC-PROCEDURES-WITH-CC

    Splenic Procedures with CC: Inpatient Reimbursement Overview

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    Splenic Procedures without CC/MCC: Inpatient Reimbursement Overview

    802-OTHER-O-R-PROCEDURES-OF-THE-BLOOD-AND-BLOOD-FORMING-ORGANS-WITH-MCC

    Other O.R. Procedures of the Blood and Blood Forming Organs with MCC: Inpatient Reimbursement Overview

    803-OTHER-O-R-PROCEDURES-OF-THE-BLOOD-AND-BLOOD-FORMING-ORGANS-WITH-CC

    Other O.R. Procedures of the Blood and Blood Forming Organs with CC: Inpatient Reimbursement Overview

    804-OTHER-O-R-PROCEDURES-OF-THE-BLOOD-AND-BLOOD-FORMING-ORGANS-WITHOUT-CC-MCC

    Other O.R. Procedures of the Blood and Blood Forming Organs without CC/MCC: Inpatient Reimbursement Overview

    808-MAJOR-HEMATOLOGICAL-AND-IMMUNOLOGICAL-DIAGNOSES-EXCEPT-SICKLE-CELL-CRISIS-AND-COAGULATION-DISORDERS-WITH-MCC

    Major Hematological and Immunological Diagnoses: Inpatient Reimbursement Overview

    809-MAJOR-HEMATOLOGICAL-AND-IMMUNOLOGICAL-DIAGNOSES-EXCEPT-SICKLE-CELL-CRISIS-AND-COAGULATION-DISORDERS-WITH-CC

    Major Hematological and Immunological Diagnoses: Inpatient Reimbursement Overview

    811-RED-BLOOD-CELL-DISORDERS-WITH-MCC

    Red Blood Cell Disorders with MCC: Inpatient Reimbursement Overview

    812-RED-BLOOD-CELL-DISORDERS-WITHOUT-MCC

    Red Blood Cell Disorders without MCC: Inpatient Reimbursement Overview

    Showing 1–10 of 14

    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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