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    v1.0.30
    OpenPayerBilling CodesInfectious and Parasitic Diseases, Systemic or Unspecified SitesDRG 858-postoperative-or-post-traumatic-infections-with-o-r-procedures-without-cc-mcc
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    Postoperative or Post-Traumatic Infections with O.R. Procedures without CC/MCC: Inpatient Reimbursement Overview

    DRG 858 encompasses postoperative or post-traumatic infections requiring operating room procedures without Complication or Comorbidity or Major Complication or Comorbidity; it defines the clinical scope of admissions assigned to this payment group. Accurate coding and documentation of procedures and comorbid conditions matter because assignment to this Diagnosis-Related Group influences Medicare inpatient reimbursement and hospital case mix classification.

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    DRG 858 Overview

    DRG 858 covers inpatient stays for postoperative or post-traumatic infections that require operating room procedures and do not have a Complication or Comorbidity or a Major Complication or Comorbidity. This Diagnosis-Related Group captures cases where surgical intervention is performed for infection control but the patient’s record lacks additional coded complications that would increase reimbursement. It matters for Medicare inpatient payment because assignment to this DRG determines base payment relative to other infection-related groups and affects hospital case mix and revenue for surgical infection care.

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    Clinical Trials

    • Acute surgical intervention and antimicrobial timing studies: randomized or pragmatic trials testing different intraoperative and immediate postoperative strategies for source control and timing/duration of broad-spectrum antibiotics in patients undergoing operative management of postoperative or post-traumatic infections. These studies enroll adult surgical inpatients with documented wound, deep soft tissue, or intra‑abdominal infections following a prior operation or traumatic injury and compare outcomes such as time to infection resolution, need for re‑operation, length of stay, and emergence of resistant organisms. Results inform surgical teams and hospital administrators on protocols that may shorten inpatient stays, reduce readmissions, and optimize antibiotic stewardship, all of which impact DRG resource use and reimbursement risk.
    • Comparative effectiveness trials of wound management and adjunctive therapies: head‑to‑head studies that evaluate alternative operative adjuncts (for example negative pressure wound therapy versus standard dressing strategies, or different debridement techniques) and non‑systemic adjuncts (topical antiseptics, local antimicrobial delivery) in patients with post‑operative or post‑traumatic infections requiring OR procedures. These trials typically include heterogeneous surgical populations (orthopedic, general, and trauma surgery patients) and measure wound healing rates, reoperation frequency, functional outcomes, and cost per episode of care. Payers and hospital case‑management teams use these findings to determine which operative and perioperative wound‑care pathways reduce complications and costly downstream resource use within this DRG.
    • Post‑discharge outcomes and health‑services research: observational cohort studies and pragmatic trials assessing post‑acute care pathways, readmission predictors, and long‑term functional outcomes for patients discharged after OR procedures for postoperative or post‑traumatic infections. Studies often link inpatient clinical data to post‑discharge utilization (home health, skilled nursing, outpatient antibiotics) and patient‑reported outcomes to identify drivers of 30‑ and 90‑day readmissions and total episode‑of‑care costs. This research is relevant to quality improvement, bundled payment models, and DRG reconciliation because it identifies modifiable factors that reduce costly readmissions and improve value across the full care episode.

    Related Codes

    853-INFECTIOUS-AND-PARASITIC-DISEASES-WITH-O-R-PROCEDURES-WITH-MCC

    Infectious and Parasitic Diseases with O.R. Procedures with MCC: Inpatient Reimbursement Overview

    854-INFECTIOUS-AND-PARASITIC-DISEASES-WITH-O-R-PROCEDURES-WITH-CC

    Infectious and Parasitic Diseases with O.R. Procedures with CC: Inpatient Reimbursement Overview

    855-INFECTIOUS-AND-PARASITIC-DISEASES-WITH-O-R-PROCEDURES-WITHOUT-CC-MCC

    Infectious and Parasitic Diseases with O.R. Procedures without CC/MCC: Inpatient Reimbursement Overview

    856-POSTOPERATIVE-OR-POST-TRAUMATIC-INFECTIONS-WITH-O-R-PROCEDURES-WITH-MCC

    Postoperative or Post-Traumatic Infections with O.R. Procedures with MCC: Inpatient Reimbursement Overview

    857-POSTOPERATIVE-OR-POST-TRAUMATIC-INFECTIONS-WITH-O-R-PROCEDURES-WITH-CC

    Postoperative or Post-Traumatic Infections with O.R. Procedures with CC: Inpatient Reimbursement Overview

    862-POSTOPERATIVE-AND-POST-TRAUMATIC-INFECTIONS-WITH-MCC

    Postoperative and Post-Traumatic Infections with MCC: Inpatient Reimbursement Overview

    863-POSTOPERATIVE-AND-POST-TRAUMATIC-INFECTIONS-WITHOUT-MCC

    Postoperative and Post-Traumatic Infections without MCC: Inpatient Reimbursement Overview

    864-FEVER-AND-INFLAMMATORY-CONDITIONS

    Fever and Inflammatory Conditions: Inpatient Reimbursement Overview

    865-VIRAL-ILLNESS-WITH-MCC

    Viral Illness with MCC: Inpatient Reimbursement Overview

    866-VIRAL-ILLNESS-WITHOUT-MCC

    Viral Illness without MCC: Inpatient Reimbursement Overview

    Showing 1–10 of 16

    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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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.