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    v1.0.28
    OpenPayerBilling CodesInjuries, Poisonings and Toxic Effects of DrugsDRG 920-complications-of-treatment-with-cc
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    Complications of Treatment with CC: Inpatient Reimbursement Overview

    DRG 920 covers admissions for complications of medical or surgical treatment with a Complication or Comorbidity, typically requiring additional interventions or monitoring. It matters for inpatient reimbursement because it groups these higher-resource cases separately for Medicare payment and case-mix adjustment.

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    DRG 920 Overview

    DRG 920 encompasses inpatient admissions primarily for complications of medical or surgical treatment where a Complication or Comorbidity is present. These cases often involve additional diagnostic evaluation, medical management, or procedural intervention to address treatment-related adverse events. This Diagnosis-Related Group affects Medicare payment because it groups resource use for treatment complications separately from routine care, influencing reimbursement levels and hospital case-mix reporting. Understanding the clinical scope helps clarify why these admissions are categorized distinctly for Medicare inpatient reimbursement.

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    Clinical Trials

    • Acute procedural safety and mitigation studies: Trials focused on procedural and peri-procedural interventions to prevent or rapidly manage complications that occur during inpatient treatments (for example, hemorrhage control protocols, device-related injury response algorithms, or strategies to reduce intraoperative bacterial contamination). These studies enroll patients who develop acute, treatment-related complications requiring critical-care resources and evaluate immediate interventions, monitoring protocols, or rescue techniques. Findings guide clinicians on best practices to reduce ICU stays and high-cost resource utilization, and inform payers about interventions that can shorten lengths of stay or prevent escalation of care.
    • Comparative effectiveness research on management pathways: Studies comparing different inpatient management strategies for common treatment-related complications (such as conservative management versus interventional procedures, different antibiotic stewardship approaches for device-associated infections, or choice of anticoagulation reversal tactics). These trials typically include a heterogeneous inpatient population with complications from diverse index therapies and assess outcomes like complication resolution, need for reoperation, readmission, and complication-related costs. Results are directly relevant for providers selecting evidence-based care pathways and for payers assessing which management approaches offer the best balance of clinical benefit and cost-effectiveness.
    • Post-discharge outcomes and readmission prevention studies: Observational cohorts and implementation studies that follow patients discharged after treatment-related complications to evaluate long-term functional outcomes, complication recurrence, patient-reported quality of life, and drivers of readmission. These studies focus on transitions of care, outpatient monitoring strategies, and targeted follow-up interventions for high-risk subgroups (for example, patients with device-related complications or those who required prolonged inpatient support). Insights help health systems design discharge planning and post-acute services to reduce readmissions and downstream costs, which are critical metrics for payers managing episodes of care.

    Related Codes

    901-WOUND-DEBRIDEMENTS-FOR-INJURIES-WITH-MCC

    Wound Debridements for Injuries with MCC: Inpatient Reimbursement Overview

    902-WOUND-DEBRIDEMENTS-FOR-INJURIES-WITH-CC

    Wound Debridements for Injuries with CC: Inpatient Reimbursement Overview

    903-WOUND-DEBRIDEMENTS-FOR-INJURIES-WITHOUT-CC-MCC

    Wound Debridements for Injuries without CC/MCC: Inpatient Reimbursement Overview

    904-SKIN-GRAFTS-FOR-INJURIES-WITH-CC-MCC

    Skin Grafts for Injuries with CC/MCC: Inpatient Reimbursement Overview

    905-SKIN-GRAFTS-FOR-INJURIES-WITHOUT-CC-MCC

    Skin Grafts for Injuries without CC/MCC: Inpatient Reimbursement Overview

    906-HAND-PROCEDURES-FOR-INJURIES

    Hand Procedures for Injuries: Inpatient Reimbursement Overview

    907-OTHER-O-R-PROCEDURES-FOR-INJURIES-WITH-MCC

    Other O.R. Procedures for Injuries with MCC: Inpatient Reimbursement Overview

    908-OTHER-O-R-PROCEDURES-FOR-INJURIES-WITH-CC

    Other O.R. Procedures for Injuries with CC: Inpatient Reimbursement Overview

    909-OTHER-O-R-PROCEDURES-FOR-INJURIES-WITHOUT-CC-MCC

    Other O.R. Procedures for Injuries without CC/MCC: Inpatient Reimbursement Overview

    913-TRAUMATIC-INJURY-WITH-MCC

    Traumatic Injury with MCC: Inpatient Reimbursement Overview

    Showing 1–10 of 19

    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.