MS-DRG 196: INTERSTITIAL LUNG DISEASE WITH MCC
MS-DRG 196 is interstitial lung disease with mcc, in MDC 04 (a medical DRG), at the with-MCC (major complication or comorbidity) level. Its FY2027 relative weight is 1.8336, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 4.80 days. 100 ICD-10-CM principal diagnoses group into MS-DRGs 196–198 under the CMS definitions manual; the most-searched are listed below.
FY2027 payment factors
- Relative weight
- 1.8336
- Geometric mean LOS
- 4.80
- Arithmetic mean LOS
- 6.40
- Post-acute transfer
- Yes
This DRG is subject to the post-acute care transfer policy: a discharge to a qualifying setting below the mean length of stay is paid per diem rather than in full.
Principal diagnoses that group to MS-DRGs 196–198
From the CMS MS-DRG definitions manual’s principal-diagnosis index: 100 ICD-10-CM codes route here, and the CC/MCC status of the secondary diagnoses decides which of 196–198 the case lands in. The 24 most-searched:
- J84.9Interstitial pulmonary disease, unspecified
- J84.10Pulmonary fibrosis, unspecified
- J99Respiratory disorders in diseases classified elsewhere
- J84.112Idiopathic pulmonary fibrosis
- D86.0Sarcoidosis of lung
- D86.9Sarcoidosis, unspecified
- J60Coalworker's pneumoconiosis
- J61Pneumoconiosis due to asbestos and other mineral fibers
- J82.83Eosinophilic asthma
- J84.89Other specified interstitial pulmonary diseases
- P27.1Bronchopulmonary dysplasia originating in the perinatal period
- B90.9Sequelae of respiratory and unspecified tuberculosis
- D86.85Sarcoid myocarditis
- J64Unspecified pneumoconiosis
- J66.8Airway disease due to other specific organic dusts
- J84.170Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere
- B44.81Allergic bronchopulmonary aspergillosis
- D86.1Sarcoidosis of lymph nodes
- D86.2Sarcoidosis of lung with sarcoidosis of lymph nodes
- D86.3Sarcoidosis of skin
- D86.81Sarcoid meningitis
- D86.82Multiple cranial nerve palsies in sarcoidosis
- D86.83Sarcoid iridocyclitis
- D86.84Sarcoid pyelonephritis
76 more codes group here. Open any code above for its full hierarchy, or check a whole claim in the free DRG calculator.
The severity splits
Same base DRG, split by whether a secondary diagnosis is a CC or MCC. The last column is the weight change from MS-DRG 196.
| 196 | INTERSTITIAL LUNG DISEASE WITH MCC | 1.8336 | |
| 197 | INTERSTITIAL LUNG DISEASE WITH CC | 0.9492 | -0.8844 |
| 198 | INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC | 0.7259 | -1.1077 |
All FY2027 MS-DRGs · MDC 04