2026 DRG Desk Reference (eBook)
Optum | 2026
The 2026 DRG Desk Reference gives access to crucial information to improve MS-DRG assignment practices, guidance on how to accurately assign DRGs under the MS-DRG system and focuses on the Optimizing section of the DRG Desk Reference based on ICD-10 codes.
The DRG Desk Reference is designed to work hand-in-hand with Optum’s DRG Expert. These products will answer all your DRG questions for all inpatient stays starting after October 1, 2025, as those claims will use the MS-DRG methodology based on ICD-10-CM.
The DRG Desk Reference is designed to work hand-in-hand with Optum’s DRG Expert. These products will answer all your DRG questions for all inpatient stays starting after October 1, 2025, as those claims will use the MS-DRG methodology based on ICD-10-CM.
- Optum Edge — Optimizing tips. Quickly identify the key diagnoses, procedures, or CC/MCC requirements involved in moving a patient from a lower-paying MS-DRG to a higher one to receive optimal payment while staying in compliance.
- Optum Edge — DRG decision trees. Optum created DRG decision trees illustrate the DRG structure for each MDC.
- Commonly missed CC and MCC references. Perform accurate audits by knowing the most commonly missed CC/MCCs in the medical record.
- ICD-10-CM/PCS Codes by MS-DRG. Includes every MS-DRG along with all associated ICD-10 diagnosis and procedure codes.
- Complete CC and MCC list. Know how codes considered MCCs and CCs will affect DRG assignment—helping to legitimately improve reimbursement.
- Relative weights for every valid MS-DRG. A quick reference of the relative weights of all DRGs presented as options for optimizing.
- Related ICD-10-PCS appendixes. ICD-10-PCS root operation Definitions, Body Part Key, and Devise Key and Aggregation Table providing further clarity of the coding process.
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