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    v1.0.30
    OpenPayerBilling CodesMental Diseases and DisordersDRG 884-organic-disturbances-and-intellectual-disability
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    Organic Disturbances and Intellectual Disability: Inpatient Reimbursement Overview

    DRG 884 encompasses inpatient stays for organic disturbances of mental functioning and intellectual disability, focusing on acute management, evaluation, and support for cognitive disorders. Accurate classification into this Diagnosis-Related Group matters for inpatient reimbursement because it determines the Medicare prospective payment rate tied to the resources used during the hospitalization.

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    DRG 884 Overview

    DRG 884 covers hospital admissions primarily for organic disturbances of mental functioning and intellectual disability, including delirium, dementia, and developmental disorders when the primary reason for inpatient care is management of these conditions. This Diagnosis-Related Group captures resource use tied to psychiatric assessment, medical evaluation for underlying causes, and supportive care needs. It matters for Medicare payment because classification into DRG 884 influences the prospective payment amount that hospitals receive for inpatient services centered on cognitive and intellectual impairments. Appropriate DRG assignment affects reimbursement tied to the intensity of diagnostic testing, medical comorbidities, and length of stay.

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    National Payment Rates

    Across commercial payers in the table and chart below, negotiated allowed amounts for DRG 884 range from about $370 up to $42K, with the widest spread observed between the lowest and highest payer values (roughly $42K). Blue Cross Blue Shield, Anthem, Cigna, and Aetna show distinct median and upper-quartile positions that drive the overall range. Refer to the table and chart below for payer-specific percentiles and distribution details.

    The CMS 2023 figures reflect national Medicare fee-for-service inpatient payments reported under the CMS Provider Utilization and Payment Data program. The table columns below show average total payment, average submitted covered charges, average Medicare payment amount, and total discharges for DRG 884. Values summarize national-level payment and charge benchmarks for Medicare FFS patients in 2023.

    Average Total PaymentAverage Submitted ChargesAverage Medicare PaymentTotal Discharges
    $15K$59K$12K21K

    Patient Population

    This DRG’s population skew is mixed but includes a substantial share of Medicare-age beneficiaries, reflecting meaningful representation among older adults as well as working-age patients covered by commercial payers. Commercial payers (Blue Cross Blue Shield, Anthem, Cigna, Aetna) capture a sizable portion of non-Medicare discharges, while Medicare fee-for-service accounts for the national aggregate counts reported by CMS. Overall, the population spans both Medicare-age and working-age groups rather than being limited to a single age cohort.

    State Payment Rates

    State: Alaska1 / 49

    Alaska Benchmarks

    In Alaska, payer rates for DRG 884 span from roughly $2.5K up to $44K across the reported payers, with Cigna showing the highest mean reimbursement and Blue Cross Blue Shield and Anthem the lowest mean levels. Cigna’s mean of $29K notably exceeds the other local payer means (~$19K) and represents the most significant deviation from typical national medians. See the table and chart below for payer-specific distributions.

    Key Insights for Alaska

    • Highest payer: Cigna (mean $29K, max $44K) is the highest-paying among listed payers; Lowest payer: Blue Cross Blue Shield / Anthem (mean $19K, median $16K, min $2.5K) are the lowest-paying in AK.
    • The state exhibits a wide rate range from about $2.5K to $44K across payers; Cigna’s mean of $29K sits noticeably above the other local payers and above several national medians, indicating a meaningful positive deviation from national averages.

    Clinical Trials

    • Acute behavioral and medical stabilization trials: studies designed to evaluate interventions for rapid stabilization of acute organic disturbances (for example, delirium due to metabolic encephalopathy or acute exacerbations of neurocognitive disorders) in hospitalized adults. These trials typically enroll patients admitted for sudden changes in cognition, consciousness, or behavior and test protocols such as multidisciplinary inpatient care bundles, medication-sparing strategies, or standardized diagnostic algorithms to shorten time to cognitive recovery and reduce complications. Findings are relevant to providers because they inform best practices for inpatient management, and to payers because successful stabilization protocols can reduce length of stay, prevent costly complications, and lower readmission risk.
    • Comparative effectiveness research on long-term management strategies for intellectual disability and chronic organic brain conditions: pragmatic trials or observational cohort studies comparing different care models (e.g., integrated inpatient-outpatient care pathways, community-supported discharge planning, or varied rehabilitation intensity) for patients with stable but persistent cognitive impairment or intellectual disability. These studies focus on functional outcomes, quality of life, resource utilization, and caregiver burden across diverse populations including children and adults with developmental disabilities or adults with chronic neurocognitive disorders. Results guide clinicians and health systems on which management approaches best preserve function and reduce avoidable inpatient utilization, helping payers optimize coverage for effective long-term supports and post-acute services.
    • Post-discharge outcomes and transitional care studies assessing readmission prevention and continuity of care for patients with organic disturbances or intellectual disability: prospective studies and quality-improvement trials testing interventions such as structured discharge planning, targeted caregiver education, telehealth follow-up, and coordination with community services. These investigations enroll recently discharged inpatients at high risk for relapse, medication-related complications, or care fragmentation and measure 30- to 90-day readmissions, emergency visits, adherence to follow-up, and caregiver strain. This research is pertinent to providers and payers because improved transitional care can reduce costly readmissions, improve patient safety, and inform reimbursement policies for post-acute support services.

    Related Codes

    876-O-R-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-OF-MENTAL-ILLNESS

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

    880-ACUTE-ADJUSTMENT-REACTION-AND-PSYCHOSOCIAL-DYSFUNCTION

    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

    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. 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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    Mean Rates by Payer — National — DRG 884
    Mean Rates by Payer — Alaska — DRG 884