Q&A: DRG 067 and 068; nonspecific CVA and pre-cerebral occlusion without infarct

Q: What exactly are DRG 067 and 068; nonspecific cerebrovascular accident (CVA) and pre-cerebral occlusion without infarct? How is it different than transient ischemic attack (TIA) or CVA?

A: Diagnostic related groups (DRGs) assist us in classifying patients into one of the 751 different groups depending upon the identified principal diagnosis (reason for admission) and any secondary diagnoses identified as complications and comorbidities. The performance of a procedure can also influence the DRG assignment. The conditions grouped in each MS-DRG category are expected to require the same level of hospital resources. Thus your organization is paid a flat fee that is assigned to the specific DRG grouping.

Each DRG has a list of specific diagnoses contained within that grouping. DRG 067 and 068 are two of the three diagnostic groupings that encompass admissions related to TIAs and occlusion or stenosis of pre-cerebral and cerebral arteries, others include:

• DRG  067/068: assigned for patients admitted with the diagnoses related to an occlusion and stenosis of pre-cerebral or cerebral arteries, not resulting in a cerebral infarction.
• DRG 69: assigned for an admission for a TIA; there are 13 different diagnoses that map to this DRG that differ related to the location of the TIA.
• DRGs 061, 062, 063: assigned to patients admitted with a cerebral infarction and receives administration of thrombolytics.
• DRGs 064, 065, 066: assigned to patients with a cerebral infarction and thrombolytics were not administered at that facility.

Editor’s note: Laurie L. Prescott, RN, MSN, CCDS, CDIP, AHIMA Approved ICD-10-CM/PCS Trainer, and CDI Education Director at HCPro in Danvers, Massachusetts, answered this question. Contact her atlprescott@hcpro.com. For information regarding CDI Boot Camps visitwww.hcprobootcamps.com/courses/10040/overview.