Summary & Overview
Bronchitis and Asthma with CC/MCC: Inpatient Reimbursement Overview
Diagnosis-Related Group 202 covers inpatient admissions for bronchitis and asthma when accompanied by a Complication or Comorbidity or Major Complication or Comorbidity that increases resource use; it includes cases such as severe exacerbations requiring additional treatments or monitoring. Accurate classification matters because the CC/MCC designation affects Medicare Severity Diagnosis-Related Group relative weight and thus inpatient reimbursement for hospitals.
DRG 202 Overview
Diagnosis-Related Group 202, Bronchitis and Asthma with Complication or Comorbidity (CC) or Major Complication or Comorbidity (MCC), encompasses inpatient admissions for acute exacerbations of bronchitis or asthma where additional diagnoses increase resource use. This DRG is important for Medicare payment because presence of a CC or MCC typically raises the relative weight and reimbursement compared with the non-CC/MCC counterpart, reflecting higher anticipated costs for care, monitoring, and potential interventions. Hospitals and coders must accurately capture secondary diagnoses that meet CC/MCC criteria to ensure payments align with clinical complexity.
National Payment Rates
Mean rates across payers range from $6,824.70 for Medicare to $16,323.07 for Cigna, with a wide spread between Medicare and the highest commercial payer. Among commercial payers, Cigna and Aetna report the highest mean rates while BCBS and BUCA are lower. See the table and chart below for payer-specific means and percentile distributions.
The CMS 2023 data represent national Medicare fee-for-service inpatient payments reported under the Centers for Medicare and Medicaid Services Provider Utilization and Payment Data program. The table below shows average total payment, average submitted covered charges, average Medicare payment amount, and total discharges for Diagnosis-Related Group .
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