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Other Multiple Significant Trauma with CC: Inpatient Reimbursement Overview
DRG 964 encompasses patients with multiple significant traumatic injuries including at least one Complication or Comorbidity but no Major Complication or Comorbidity, representing a high-resource inpatient trauma population. Understanding this Diagnosis-Related Group is important because it determines Medicare inpatient reimbursement and influences hospital case-mix index and payment under the prospective payment framework.
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DRG 964 Overview
DRG 964 covers hospital admissions for patients with multiple significant traumatic injuries where at least one injury is a Complication or Comorbidity and there is no Major Complication or Comorbidity present. This Diagnosis-Related Group aggregates complex trauma care that typically requires multisystem evaluation, operative or nonoperative interventions, and extended inpatient resource use. It matters for Medicare payment because it groups resource intensity for reimbursement and affects hospital case-mix and prospective payment calculations. Accurate clinical documentation and coding determine assignment to this Diagnosis-Related Group and related payment implications.