Other Injury, Poisoning and Toxic Effect Diagnoses with MCC: Inpatient Reimbursement Overview

DRG 922 encompasses other injury, poisoning, and toxic effect diagnoses when a Major Complication or Comorbidity is present, reflecting higher clinical severity. This Diagnosis-Related Group matters for inpatient reimbursement because the Major Complication or Comorbidity status increases resource intensity and Medicare payment under the Centers for Medicare & Medicaid Services Inpatient Prospective Payment System.

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DRG 922 Overview

DRG 922 covers hospitalizations for a variety of other injury, poisoning, and toxic effect diagnoses when a Major Complication or Comorbidity is present. Cases in this Diagnosis-Related Group often involve significant resource use due to the severity of the primary condition and the impact of the Major Complication or Comorbidity. This DRG matters for Medicare reimbursement because the presence of a Major Complication or Comorbidity increases the relative weight and payment compared with similar cases without a Major Complication or Comorbidity. Accurate capture of diagnoses and documentation directly affects payment under the Inpatient Prospective Payment System administered by the Centers for Medicare & Medicaid Services.

Clinical Trials

Acute trauma intervention trials focusing on stabilization and early operative versus nonoperative management for complex injuries: these studies enroll patients admitted with diverse injuries, poisonings, or toxic effects who have one or more major complications (MCC) such as hemorrhage, multi-organ failure, or severe neurovascular compromise. They evaluate time-sensitive interventions (for example, damage-control surgery, embolization, airway management protocols, or antidote administration in severe toxic exposures) and compare immediate outcomes like mortality, ICU length of stay, and complication rates. Results inform hospitals and payers about which acute pathways and resource-intensive interventions yield the best survival and shortest high-cost critical care utilization for this heterogeneous DRG population.
Comparative effectiveness and care pathway studies examining inpatient multidisciplinary management strategies: these trials compare coordinated care models (orthopedic/trauma surgery with geriatric co-management, toxicology consultation pathways, or integrated critical care bundles) versus usual care for patients with other injury/poisoning diagnoses complicated by MCCs. Populations typically include older adults with fragility-related injuries plus complications, or adults with severe poisoning who develop organ dysfunction; outcomes measured include complication reduction, readmission, functional recovery, and cost per episode. Findings are relevant for providers designing evidence-based care teams and for payers assessing which care pathways reduce downstream costs, length of stay, and post-acute care needs.
Post-discharge outcomes and rehabilitation trials assessing long-term functional recovery and resource use after hospitalization for severe injuries or toxic effects with major complications: these prospective cohort studies or randomized trials examine rehabilitation timing, intensity, and community-based interventions (physical therapy, cognitive rehabilitation, substance-use counseling) in patients discharged after an index admission with MCCs. They target measurement of functional status, return to baseline activities, long-term healthcare utilization, and quality-of-life up to 6–12 months post-discharge, which helps health systems and payers plan post-acute services, predict readmission risk, and evaluate cost-effectiveness of investment in rehabilitation and transitional care for this high-risk DRG group.

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.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

Acute trauma intervention trials focusing on stabilization and early operative versus nonoperative management for complex injuries: these studies enroll patients admitted with diverse injuries, poisonings, or toxic effects who have one or more major complications (MCC) such as hemorrhage, multi-organ failure, or severe neurovascular compromise. They evaluate time-sensitive interventions (for example, damage-control surgery, embolization, airway management protocols, or antidote administration in severe toxic exposures) and compare immediate outcomes like mortality, ICU length of stay, and complication rates. Results inform hospitals and payers about which acute pathways and resource-intensive interventions yield the best survival and shortest high-cost critical care utilization for this heterogeneous DRG population.
Comparative effectiveness and care pathway studies examining inpatient multidisciplinary management strategies: these trials compare coordinated care models (orthopedic/trauma surgery with geriatric co-management, toxicology consultation pathways, or integrated critical care bundles) versus usual care for patients with other injury/poisoning diagnoses complicated by MCCs. Populations typically include older adults with fragility-related injuries plus complications, or adults with severe poisoning who develop organ dysfunction; outcomes measured include complication reduction, readmission, functional recovery, and cost per episode. Findings are relevant for providers designing evidence-based care teams and for payers assessing which care pathways reduce downstream costs, length of stay, and post-acute care needs.
Post-discharge outcomes and rehabilitation trials assessing long-term functional recovery and resource use after hospitalization for severe injuries or toxic effects with major complications: these prospective cohort studies or randomized trials examine rehabilitation timing, intensity, and community-based interventions (physical therapy, cognitive rehabilitation, substance-use counseling) in patients discharged after an index admission with MCCs. They target measurement of functional status, return to baseline activities, long-term healthcare utilization, and quality-of-life up to 6–12 months post-discharge, which helps health systems and payers plan post-acute services, predict readmission risk, and evaluate cost-effectiveness of investment in rehabilitation and transitional care for this high-risk DRG group.

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.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.

Other Injury, Poisoning and Toxic Effect Diagnoses with MCC: Inpatient Reimbursement Overview

Sign up for drg 922 policy alerts

DRG 922 Overview

Other Injury, Poisoning and Toxic Effect Diagnoses with MCC: Inpatient Reimbursement Overview

Sign up for drg 922 policy alerts

DRG 922 Overview

Clinical Trials

Related Codes

References

Clinical Trials

Related Codes

References