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    OpenPayerBilling CodesPregnancy, Childbirth and the PuerperiumDRG 817-other-antepartum-diagnoses-with-o-r-procedures-with-mcc
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    Other Antepartum Diagnoses with O.R. Procedures with MCC: Inpatient Reimbursement Overview

    DRG 817 encompasses other antepartum diagnoses with operating room procedures accompanied by a Major Complication or Comorbidity, reflecting higher clinical severity during pregnancy. This Diagnosis-Related Group influences inpatient reimbursement because operating room utilization and major comorbid conditions raise expected resource use and payment under Medicare.

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    DRG 817 Overview

    DRG 817 covers inpatient admissions for other antepartum diagnoses that required an operating room procedure and included a Major Complication or Comorbidity. This category captures a range of obstetric surgical interventions for pregnant patients with significant clinical complexity. It matters for Medicare payment because the presence of a Major Complication or Comorbidity and use of the operating room increase resource intensity and reimbursement relative to lower-severity antepartum groups. Accurate coding of principal and secondary diagnoses and procedures determines assignment to this higher-weighted Diagnosis-Related Group and affects inpatient payment.

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    Clinical Trials

    • Trials evaluating surgical and perioperative strategies for complex antepartum conditions requiring operating room procedures (acute intervention studies). These studies focus on pregnant patients with non-routine antepartum diagnoses—such as placenta accreta spectrum, severe hemorrhagic complications, or acute abdominal conditions—who require operative management during pregnancy. Research compares timing, surgical approaches, blood management protocols, and intraoperative monitoring to reduce maternal and fetal morbidity; results inform hospital resource allocation, perioperative risk stratification, and payer decisions about bundled payment adequacy for high-acuity O.R. cases.
    • Comparative effectiveness studies of multidisciplinary care pathways for high-risk antepartum admissions (care-process and outcomes research). These trials examine cohorts of pregnant patients admitted with complex antepartum diagnoses who may or may not undergo O.R. procedures, comparing standardized multidisciplinary protocols (OB anesthesia, maternal-fetal medicine, neonatology, interventional radiology availability) versus usual care. The objective is to quantify impacts on length of stay, complication rates, readmissions, and cost of care to guide providers on best-practice implementation and help payers evaluate the value of coordinated care models for this DRG.
    • Longitudinal studies of maternal and neonatal outcomes after operative antepartum events (post-discharge and long-term outcomes research). These observational or interventional cohort studies follow patients and their infants after discharge to assess functional recovery, postpartum morbidity (e.g., transfusion-related complications, thromboembolism, mental health), and neonatal development following in utero exposure to acute surgical interventions. Understanding downstream clinical trajectories and resource utilization is crucial for payers and health systems to plan post-discharge services, rehabilitation needs, and to refine reimbursement pathways for high-cost antecedent inpatient events.

    Related Codes

    768-VAGINAL-DELIVERY-WITH-O-R-PROCEDURES-EXCEPT-STERILIZATION-AND-OR-D-C

    Vaginal Delivery with O.R. Procedures Except Sterilization and/or D&C: Inpatient Reimbursement Overview

    769-POSTPARTUM-AND-POST-ABORTION-DIAGNOSES-WITH-O-R-PROCEDURES

    Postpartum and Post Abortion Diagnoses with O.R. Procedures: Inpatient Reimbursement Overview

    770-ABORTION-WITH-D-C-ASPIRATION-CURETTAGE-OR-HYSTEROTOMY

    Abortion with D&C, Aspiration Curettage or Hysterotomy: Inpatient Reimbursement Overview

    776-POSTPARTUM-AND-POST-ABORTION-DIAGNOSES-WITHOUT-O-R-PROCEDURES

    Postpartum and Post Abortion Diagnoses without O.R. Procedures: Inpatient Reimbursement Overview

    779-ABORTION-WITHOUT-D-C

    Abortion without D&C: Inpatient Reimbursement Overview

    783-CESAREAN-SECTION-WITH-STERILIZATION-WITH-MCC

    Cesarean Section with Sterilization with MCC: Inpatient Reimbursement Overview

    784-CESAREAN-SECTION-WITH-STERILIZATION-WITH-CC

    Cesarean Section with Sterilization with CC: Inpatient Reimbursement Overview

    785-CESAREAN-SECTION-WITH-STERILIZATION-WITHOUT-CC-MCC

    Cesarean Section with Sterilization without CC/MCC: Inpatient Reimbursement Overview

    786-CESAREAN-SECTION-WITHOUT-STERILIZATION-WITH-MCC

    Cesarean Section without Sterilization with MCC: Inpatient Reimbursement Overview

    787-CESAREAN-SECTION-WITHOUT-STERILIZATION-WITH-CC

    Cesarean Section without Sterilization with CC: Inpatient Reimbursement Overview

    Showing 1–10 of 22

    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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