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List of Common MCCs and CCs to document

Page history last edited by Kendall Rogers 6 years, 3 months ago


COMMON MAJOR COMPLICATIONS/COMORBID CONDITIONS (MCC)
**This is not a complete list of MCCs. 

 

Cardiovascular
427.5  Cardiac arrest (discharge alive)
428.21  Acute systolic heart failure
438.31  Acute diastolic heart failure
428.33  Acute on chronic diastolic heart failure
428.23  Acute on chronic systolic heart failure
428.43  Acute on chronic combined systolic/diastolic heart failure
(Note: if not acute --heart failure, systolic/diastolic/left only  implies CC)
415.0  Cor pulmonale, acute
422.90  Acute myocarditis, unspecified
421.9  Acute endocarditis, unspecified
410.**  Acute myocardial infarction, initial episode of care
 284.11  Pancytopenia due to chemotherapy
427.41  Ventricular fibrillation (discharge alive)
785.51  Cardiogenic shock
441.5  Ruptured aortic aneurysm

 

Respiratory
518.81  Respiratory failure, acute
518.84  Acute on chronic respiratory failure
506.1  Acute pulmonary edema
415.19  Acute pulmonary embolism
512.89  Pneumothorax
486  Pneumonia
507.0  Aspiration pneumonia
799.1  Respiratory arrest
807.4  Flail chest

 

Infectious Disease
042  HIV disease/AIDS
995.91  Sepsis
995.92  Severe sepsis
785.52   Septic shock
038.9  Septicemia
040.0  Gas gangrene

 

Neurology
436  Cerebral infarct or hemorrhage/CVA/stroke
430  Subarachnoid hemorrhage
432.1  Subdural hemorrhage
348.3*  Encephalopathy – metabolic, toxic, other or unspecified
780.01  Coma
323.01  Encephalitis and encephalomyelitis in viral diseases classified elsewhere
345.3  Epilepsy, grand mal
345.2  Epilepsy, petit mal
320.89  Meningitis due to other specified bacterium
358.01  Myasthenia Gravis with acute exacerbation
344.0*  Quadriplegia
348.82  Brain Death
348.5  Cerebral edema

 

Endocrine
250.1*  Diabetic ketoacidosis
250.2*  Diabetes with hyperosmolarity
250.3*  Diabetes with coma
242.91  Hyperthyroidism with mention of thyrotoxic storm or crisis


Gastrointestinal and Hepatobiliary
535.01  Acute gastritis with hemorrhage
535.61  Duodenitis with hemorrhage
562.03  Diverticulitis of small intestine with hemorrhage
562.13  Diverticulitis of colon with hemorrhage
531.91  Gastric ulcer, unspecified, without mention of hemorrhage, with    obstruction
577.0  Acute pancreatitis
567.21  Peritonitis, acute/generalized
560.2  Volvulus
456.0  Bleeding esophageal varices
572.2  Hepatitis with hepatic coma
535.31  Alcoholic gastritis with hemorrhage
570  Shock liver

 

Renal
585.6  End-stage renal disease
584.5    Acute renal failure with lesion of tubular necrosis

 

Skin
707.23  Decubitus or pressure ulcer stage 3
707.24  Decubitus or pressure ulcer stage 4
728.86  Necrotizing fasciitis

 

Other
260  Severe malnutrition/Kwashiorkor 
261  Marasmus/emaciation
262  Other severe protein-calorie malnutrition
800.0*-804.95 Open/closed fractures of the skull
807.10-807.19 Open fracture of rib(s)
**Most open fractures are considered MCCs

 

 

COMMON COMORBID CONDITIONS (CC)
**This is not a complete list of CCs. 
Please refer to your DRG Expert, Encoder or current ICD-9 CM book

 

Cardiovascular
411.89  Acute myocardial ischemia/coronary insufficiency without MI
411.89  Demand ischemia
411.1  Unstable angina
426.0  Heart block – complete AV/trifascicular
426.10  Mobitz II
426.53  Bilateral bundle branch block (BBBB)
427.32  Atrial flutter
428.20/428/22 Unspecified/chronic systolic heart failure
428.30/428/32 Unspecified/chronic diastolic heart failure
428.40/428/42 Unspecified/chronic combined systolic and diastolic heart failure
428.1  Left ventricular failure (LVF)
425.4  Cardiomyopathy - except ischemic
401.0  Accelerated or malignant hypertension (HTN)
453.4*  Deep vein thrombosis (DVT)
427.1  Ventricular tachycardia
427.0  Paroxysmal supraventricular tachycardia (PSVT)
451.**  Thrombophlebitis & phlebitis

 

Respiratory
493.92  Asthma exacerbation
491.21  COPD exacerbation
518.0  Atelectasis
518.82  Acute respiratory distress/insufficiency
518.83  Respiratory failure, chronic, acute
V46.11  Respirator weaning or dependence
786.30  Hemoptysis
511.9  Pleural effusion
995.93  SIRS non-infectious

 

Gastrointestinal
789.59  Ascites
V55.1  Attention to gastrostomy
008.45  C. Diff enteritis
574.1*  Cholelithiasis with cholecystitis (with/without mention of    obstruction)
569.62  Colostomy/enterostomy complications
555.9  Crohn’s disease
562.10  Diverticulitis (without mention of hemorrhage)
112.84  Esophagitis, candida
558.2  Gastroenteritis – toxic 
558.1  Gastritis, due to radiation
578.9  GI bleed
552.9  Hernia with obstruction
560.1  Paralytic ileus
009.0  Intestinal infections – viral, bacterial, E. Coli, Staph, Pseudomonas, etc.
579.9  Intestinal malabsorption
782.4  Jaundice, not newborn
577.1  Pancreatitis, chronic
577.2  Pancreatic pseudocyst
530.20    Ulcer, acute – esophageal/peptic without hemorrhage
531.30  Acute gastric ulcer without mention of hemorrhage, perforation or   obstruction
532.30  Acute duodenal ulcer without mention of hemorrhage, perforation   or obstruction
556.9  Ulcerative colitis
569.5  Abscess of the intestines
540.9  Acute appendicitis without mention of peritonitis

 

Neurology and Psychiatry
294.11  Alzheimer’s dementia with behavioral disturbance
296.2*  Depression, major
784.3  Aphasia
292.81  Delirium, drug-induced


Dementia with delirium, depression or delusion:
290.1*  presenile
290.2*  senile
290.4*  vascular
780.1  Hallucinations
342.9*  Hemiplegia
344.1  Paraplegia
295.9*  Schizophrenia except unspecified or in remission
V62.84  Suicidal ideation
435.9  Transient ischemic attack (TIA)
435.3  Vertebrobasilar insufficiency
291.81  Alcohol withdrawal
292.0  Drug withdrawal

 

Renal
584.9  Acute renal failure (ARF/AKI)
585.4  Chronic kidney disease (CKD), Stage 4
585.5  CKD stage 5 
592.1   Calculus of ureter
404.91  Hypertensive heart & kidney disease with CHF & CKD
591  Hydronephrosis
593.5  Hydroureter
581.9  Nephrotic syndrome
753.12  Polycystic kidney disease
590.80  Pyelonephritis
599.0   UTI

 

Skin and Musculoskeletal
682.*  Cellulitis/abscess
729.7*  Compartment syndrome, nontraumatic
996.77  Complications of prosthetic joint
733.1*  Fractures, pathologic/vertebral/compression
730.0*  Osteomyelitis, acute
730.1*  Osteomyelitis, chronic
730.2*  Osteomyelitis, unspecified
707.1*  Lower extremity ulcer
733.4*  Aseptic necrosis of bone (sites)

 

Hemato-oncology
285.1  Acute blood loss anemia
284.9  Aplastic anemia
202.8*  Lymphoma
208.**  Leukemia
284.19    Pancytopenia (except chemotherapy induced)
** Malignant neoplasm (most sites – not breast or prostate)

 

Other
790.7  Bacteremia
996.0-996.5 Complication /infection of device, implant, graft
995.93  SIRS due to noninfectious process
112.0  Thrush
V42.*  Transplant status – most organs
276.2  Acidosis
276.3  Alkalosis
V85.0  BMI <19
V85.4*  BMI >39
799.4  Cachexia
276.0  Hypernatremia
276.1  Hyponatremia
263.9  Malnutrition unspecified/other
998.2  Accidental puncture or laceration during a procedure
349.31  Accidental puncture or laceration of dura during a procedure

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