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    v1.0.28
    OpenPayerBilling CodesPregnancy, Childbirth and the PuerperiumDRG 818-other-antepartum-diagnoses-with-o-r-procedures-with-cc
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    Other Antepartum Diagnoses with O.R. Procedures with CC: Inpatient Reimbursement Overview

    DRG 818 applies to antepartum encounters with operating room procedures and at least one Complication or Comorbidity, impacting how inpatient obstetric surgical cases are classified. Accurate grouping matters for inpatient reimbursement because it determines Medicare Severity Diagnosis-Related Group weight and payment considerations by the Centers for Medicare & Medicaid Services.

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    DRG 818 Overview

    DRG 818 covers admissions for other antepartum diagnoses that require operating room procedures and are accompanied by a Complication or Comorbidity. This category captures a range of obstetric surgical interventions performed during the antepartum period when additional clinical complexity is present. It matters for Medicare payment because the presence of an operating room procedure plus a Complication or Comorbidity affects the inpatient classification and relative resource weighting used by the Centers for Medicare & Medicaid Services. Correct assignment of this Diagnosis-Related Group influences reimbursement and hospital case-mix reporting.

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    Clinical Trials

    • Acute perioperative management trials: studies focusing on optimizing anesthesia techniques, perioperative anticoagulation, and intraoperative monitoring for pregnant patients undergoing non-obstetric or obstetric operative procedures for antepartum complications with a concomitant comorbidity (CC). These trials enroll pregnant women in the antepartum period who require an operating room procedure (for example, surgical management of adnexal masses, obstetric hemorrhage control, or intervention for pregnancy-related hypertensive complications) to evaluate short-term maternal and fetal safety endpoints, hemodynamic stability, and complication rates. Findings inform clinicians and payers about resource utilization, length of stay drivers, and risk-adjusted costs associated with different perioperative strategies in this higher-acuity DRG.
    • Comparative effectiveness trials of procedural approaches: randomized or pragmatic comparative studies that evaluate different surgical or interventional techniques (open vs minimally invasive approaches, timing of procedure relative to gestational age, or use of adjunctive hemostatic technologies) for antepartum diagnoses requiring OR procedures in patients with relevant comorbidities. These trials target pregnant patients with specific antepartum diagnoses complicated by conditions such as anemia, infection, or hypertensive disorders, and assess outcomes including surgical morbidity, need for transfusion, preterm delivery, and readmission. Results are directly relevant to hospitals and payers because they can demonstrate which approaches reduce complications, ICU utilization, or downstream neonatal/maternal costs in this DRG.
    • Post-discharge and longitudinal outcome studies: cohort studies and registries that follow mothers and infants after discharge to measure maternal recovery, recurrence of the antepartum condition, neonatal outcomes, and functional status up to months or years postpartum. These observational studies enroll the DRG population who underwent antepartum OR procedures with CCs to quantify readmission rates, long-term maternal morbidity (e.g., chronic pelvic pain, mental health sequelae), and child developmental outcomes, and to identify predictors of higher post-acute care needs. Data from these studies help payers and care managers plan post-discharge services, bundle payments, and risk stratification strategies by highlighting drivers of prolonged costs and opportunities for targeted follow-up.

    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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