DRG 056: Degenerative Nervous System Disorders with MCC, DRG 057: Degenerative Nervous System Disorders without MCC

Published 01/28/2022

Each of the Medicare Severity Diagnosis Related Groups (MS-DRG) is defined by a particular set of patient attributes which include principal diagnosis, specific secondary diagnoses, procedures, sex and discharge status.

DRG 056 (Degenerative Nervous System Disorders with MCC) and DRG 057 (Degenerative Nervous System Disorders without MCC) is classified as a Medicare Diagnostic Category (MDC) 1 — Disease and Disorders of the Nervous System. The category is Neurology and the Surgical Category is non-surgical. The CD-10 MS-DRG Definitions Manual Files v37 R1 (Updated September 19, 2019), (ZIP), is available on the CMS website.

Many situations can cause a neuropathic condition. The most common medical condition to cause peripheral neuropathy is diabetes mellitus. The hyperglycemic state can cause direct injury to parts of the nerve cell, as well as indirect injury caused by lack of circulation (and subsequent nutrient deprivation) to the cells. Other medical conditions, such as HIV, kidney disorders, hormonal imbalances and cancers may also damage nerve cells. Heredity can play a role, as can traumatic situations such as a crush injury or fractured bone, which can result in compression, stretching, or severing of the nerve cell, leading to a neuropathic condition.

Below is the FY 2020 Final Rule and Correction Notice Tables; Table 5 — List of MS-DRGs, Relative Weighting Factors and Geometric & Arithmetic Mean Length of Stay, found on the CMS website.

 DRG
Type
MS-DRG Title
Weights
Geometric Mean LOS
Arithmetic Mean LOS
056
MED
Degenerative Nervous System Disorders w/MCC
2.1924
5.5
8.2
057
MED
Degenerative Nervous System Disorders w/o MCC
1.2108
3.8
5.6

Further Information