O.R. Procedures with Principal Diagnosis of Mental Illness: Inpatient Reimbursement Overview

DRG 876 addresses inpatient episodes involving operating room procedures with a principal diagnosis of mental illness, defining the clinical scope where surgical intervention occurs in the context of psychiatric primary diagnoses. This grouping matters for inpatient reimbursement because it bundles operating room resource use with the impact of the principal mental health diagnosis on payment and case-mix.

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DRG 876 Overview

DRG 876 covers inpatient cases where patients undergo operating room procedures and have a principal diagnosis of a mental illness, encompassing surgical interventions that are necessitated while the primary reason for admission is a psychiatric disorder. This Diagnosis-Related Group groups cases for Medicare payment purposes where the interaction of surgical care and psychiatric diagnosis affects resource use. It matters for Medicare payment because the bundled payment considers the combination of operating room resource intensity and the clinical complexity tied to mental health principal diagnoses. Accurate assignment influences reimbursement and hospital case-mix reporting.

Clinical Trials

Studies evaluating perioperative psychiatric stabilization protocols for patients with acute severe mental illness undergoing urgent or elective operating room procedures: these trials test structured preoperative psychiatric assessment, medication adjustment strategies, and perioperative monitoring pathways for adults with primary diagnoses such as major depressive disorder with suicidal behavior, psychotic disorders, or severe bipolar disorder who require surgical intervention. The research objective is to reduce intra- and postoperative psychiatric decompensation, minimize anesthesia-related complications, and shorten length of stay; findings are relevant to clinicians coordinating surgical and psychiatric care and to payers because improved stabilization can reduce costly complications and readmissions.
Comparative effectiveness trials of anesthesia and analgesia approaches tailored to patients with mental illness receiving O.R. procedures: these studies compare different anesthetic techniques (for example, general versus regional blocks with standardized sedation plans), opioid-sparing multimodal analgesia, or protocols for managing psychotropic medications perioperatively in adult inpatients with primary psychiatric diagnoses. The goal is to evaluate postoperative pain control, delirium incidence, interactions with psychotropic agents, and resource utilization; results inform perioperative teams and payers about best practices that balance safety, shorter recovery, and potential cost savings.
Post-discharge outcomes and care-transition research focusing on readmission prevention and long-term functional recovery for surgical inpatients whose principal diagnosis is mental illness: these cohort studies and intervention trials examine discharge planning models, integrated psychiatric follow-up, community mental health linkage, and social determinants that affect recovery in patients after O.R. procedures. By measuring metrics such as 30-day readmissions, emergency visits for psychiatric crises, and subsequent need for inpatient psychiatric care, this research area is critical for providers and payers aiming to reduce downstream utilization and improve continuity of mental health and surgical care.

Acute Adjustment Reaction and Psychosocial Dysfunction: Inpatient Reimbursement Overview

881-DEPRESSIVE-NEUROSES

Depressive Neuroses: Inpatient Reimbursement Overview

882-NEUROSES-EXCEPT-DEPRESSIVE

Neuroses Except Depressive: Inpatient Reimbursement Overview

883-DISORDERS-OF-PERSONALITY-AND-IMPULSE-CONTROL

Disorders of Personality and Impulse Control: Inpatient Reimbursement Overview

884-ORGANIC-DISTURBANCES-AND-INTELLECTUAL-DISABILITY

Organic Disturbances and Intellectual Disability: Inpatient Reimbursement Overview

885-PSYCHOSES

Psychoses: Inpatient Reimbursement Overview

886-BEHAVIORAL-AND-DEVELOPMENTAL-DISORDERS

Behavioral and Developmental Disorders: Inpatient Reimbursement Overview

887-OTHER-MENTAL-DISORDER-DIAGNOSES

Other Mental Disorder Diagnoses: Inpatient Reimbursement Overview

References

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.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.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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Clinical Trials

Studies evaluating perioperative psychiatric stabilization protocols for patients with acute severe mental illness undergoing urgent or elective operating room procedures: these trials test structured preoperative psychiatric assessment, medication adjustment strategies, and perioperative monitoring pathways for adults with primary diagnoses such as major depressive disorder with suicidal behavior, psychotic disorders, or severe bipolar disorder who require surgical intervention. The research objective is to reduce intra- and postoperative psychiatric decompensation, minimize anesthesia-related complications, and shorten length of stay; findings are relevant to clinicians coordinating surgical and psychiatric care and to payers because improved stabilization can reduce costly complications and readmissions.
Comparative effectiveness trials of anesthesia and analgesia approaches tailored to patients with mental illness receiving O.R. procedures: these studies compare different anesthetic techniques (for example, general versus regional blocks with standardized sedation plans), opioid-sparing multimodal analgesia, or protocols for managing psychotropic medications perioperatively in adult inpatients with primary psychiatric diagnoses. The goal is to evaluate postoperative pain control, delirium incidence, interactions with psychotropic agents, and resource utilization; results inform perioperative teams and payers about best practices that balance safety, shorter recovery, and potential cost savings.
Post-discharge outcomes and care-transition research focusing on readmission prevention and long-term functional recovery for surgical inpatients whose principal diagnosis is mental illness: these cohort studies and intervention trials examine discharge planning models, integrated psychiatric follow-up, community mental health linkage, and social determinants that affect recovery in patients after O.R. procedures. By measuring metrics such as 30-day readmissions, emergency visits for psychiatric crises, and subsequent need for inpatient psychiatric care, this research area is critical for providers and payers aiming to reduce downstream utilization and improve continuity of mental health and surgical care.

Acute Adjustment Reaction and Psychosocial Dysfunction: Inpatient Reimbursement Overview

881-DEPRESSIVE-NEUROSES

Depressive Neuroses: Inpatient Reimbursement Overview

882-NEUROSES-EXCEPT-DEPRESSIVE

Neuroses Except Depressive: Inpatient Reimbursement Overview

883-DISORDERS-OF-PERSONALITY-AND-IMPULSE-CONTROL

Disorders of Personality and Impulse Control: Inpatient Reimbursement Overview

884-ORGANIC-DISTURBANCES-AND-INTELLECTUAL-DISABILITY

Organic Disturbances and Intellectual Disability: Inpatient Reimbursement Overview

885-PSYCHOSES

Psychoses: Inpatient Reimbursement Overview

886-BEHAVIORAL-AND-DEVELOPMENTAL-DISORDERS

Behavioral and Developmental Disorders: Inpatient Reimbursement Overview

887-OTHER-MENTAL-DISORDER-DIAGNOSES

Other Mental Disorder Diagnoses: Inpatient Reimbursement Overview

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

O.R. Procedures with Principal Diagnosis of Mental Illness: Inpatient Reimbursement Overview

Sign up for drg 876 policy alerts

DRG 876 Overview

O.R. Procedures with Principal Diagnosis of Mental Illness: Inpatient Reimbursement Overview

Sign up for drg 876 policy alerts

DRG 876 Overview

Clinical Trials

Related Codes

References

Clinical Trials

Related Codes

References