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    v1.0.30
    OpenPayerBilling CodesFactors Influencing Health Status and Other Contacts with Health ServicesDRG 941-o-r-procedures-with-diagnoses-of-other-contact-with-health-services-without-cc-mcc
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    O.R. Procedures with Diagnoses of Other Contact with Health Services without CC/MCC: Inpatient Reimbursement Overview

    DRG 941 includes operating room procedures tied to diagnoses of other contact with health services without Complication or Comorbidity or Major Complication or Comorbidity, typically representing lower-severity inpatient surgical encounters. Accurate assignment affects Medicare reimbursement by placing cases into a lower-paying Diagnosis-Related Group that reflects expected resource use for these non-acute, procedure-focused admissions.

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    DRG 941 Overview

    DRG 941 covers inpatient cases involving operating room procedures for patients whose principal diagnoses are coded as encounters for other contact with health services without Complication or Comorbidity or Major Complication or Comorbidity. This Diagnosis-Related Group groups relatively low-severity surgical or invasive procedures when the diagnosis is not an acute illness or injury but rather an encounter related to health services. It matters for Medicare payment because it assigns a lower relative weight and payment level than more complex surgical Diagnosis-Related Groups, influencing hospital reimbursement and resource expectations for these encounters.

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    Clinical Trials

    • Studies of perioperative infection prevention and management for procedures related to “other contact with health services”: randomized or prospective cohort studies evaluating timing and protocols for surgical site antisepsis, perioperative antibiotic prophylaxis duration, and infection surveillance in patients undergoing minor-to-moderate O.R. procedures prompted by non-primary disease encounters (such as removal of foreign bodies, wound exploration, or device-related interventions). These trials focus on patients who present for operative management of complications or contacts with the healthcare system rather than primary disease treatment, and are relevant because reducing perioperative complications can shorten length of stay and lower readmission risk—key concerns for hospitals and payers managing DRG 941 cases.
    • Comparative effectiveness research comparing operative approaches and anesthesia strategies for short O.R. procedures performed for diagnoses coded as other contact with health services: pragmatic studies might compare local/regional anesthesia versus general anesthesia, minimally invasive versus open technique, or sedation protocols in subpopulations such as elderly, frail, or comorbid patients. The objective is to identify approaches that minimize perioperative morbidity, resource utilization, and recovery time in a heterogeneous group of patients whose index admission is for a procedure secondary to prior healthcare contact; results inform clinical pathways that can reduce costs and improve throughput for providers and payers.
    • Post-discharge outcomes and health services research tracking functional recovery, complication rates, and subsequent healthcare utilization after O.R. procedures tied to other healthcare contacts: longitudinal observational cohorts or registry-based studies examine factors predicting readmission, emergency visits, or need for further procedures in the 30–90 day period after discharge. This research targets the diverse patient mix in DRG 941 to identify high-risk subgroups and care transitions interventions (for example enhanced discharge planning or outpatient follow-up schedules) that could reduce costly downstream utilization and improve quality metrics important to hospitals and payers.

    Related Codes

    939-O-R-PROCEDURES-WITH-DIAGNOSES-OF-OTHER-CONTACT-WITH-HEALTH-SERVICES-WITH-MCC

    O.R. Procedures with Diagnoses of Other Contact with Health Services with MCC: Inpatient Reimbursement Overview

    940-O-R-PROCEDURES-WITH-DIAGNOSES-OF-OTHER-CONTACT-WITH-HEALTH-SERVICES-WITH-CC

    O.R. Procedures with Diagnoses of Other Contact with Health Services with CC: Inpatient Reimbursement Overview

    945-REHABILITATION-WITH-CC-MCC

    Rehabilitation with CC/MCC: Inpatient Reimbursement Overview

    946-REHABILITATION-WITHOUT-CC-MCC

    Rehabilitation without CC/MCC: Inpatient Reimbursement Overview

    947-SIGNS-AND-SYMPTOMS-WITH-MCC

    Signs and Symptoms with Major Complication or Comorbidity: Inpatient Reimbursement Overview

    948-SIGNS-AND-SYMPTOMS-WITHOUT-MCC

    Signs and Symptoms without MCC: Inpatient Reimbursement Overview

    949-AFTERCARE-WITH-CC-MCC

    Aftercare with CC/MCC: Inpatient Reimbursement Overview

    950-AFTERCARE-WITHOUT-CC-MCC

    Aftercare without CC/MCC: Inpatient Reimbursement Overview

    951-OTHER-FACTORS-INFLUENCING-HEALTH-STATUS

    Other Factors Influencing Health Status: 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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    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.