Summary & Overview
Other Antepartum Diagnoses with O.R. Procedures without CC/MCC: Inpatient Reimbursement Overview
DRG 819 encompasses other antepartum diagnoses requiring operating room procedures in the absence of a Major Complication or Comorbidity or a Complication or Comorbidity. It defines the clinical scope for grouping resource use and directly impacts inpatient reimbursement under Medicare payment policies.
DRG 819 Overview
DRG 819 covers antepartum admissions for other maternal diagnoses that involve operating room procedures without a Major Complication or Comorbidity or a Complication or Comorbidity. Typical cases include surgical interventions during pregnancy that are not associated with higher-severity comorbid conditions. This Diagnosis-Related Group affects Medicare payment by grouping resource use and setting the inpatient prospective payment relative to other antepartum groups. Proper assignment influences inpatient reimbursement and hospital case mix reporting.