2026 DRG Expert - Volume 1 & 2 (eBook)
Optum | 2026
The DRG Expert has been a trusted and comprehensive reference to the DRG classification system for more than 25 years. Organized by major diagnostic category (MDC), the convenient and innovative book layout follows the logical MS-DRG decision process. This is a must-have reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively based on
ICD-10-CM methodology, which goes into effect October 1, 2025.
ICD-10-CM methodology, which goes into effect October 1, 2025.
- Optum Edge — Visual indicators notify you of special alerts. Easily identify CC and MCC status, special payment status, transfer DRG status, surgical/medical partitioning, and other requirements.
- Optum Edge — Medicare CMS rate structure. Updated to provide current relative weight (RW), geometric mean length-of-stay (GMLOS), and arithmetic mean length-of-stay (AMLOS) for each MS-DRG under IPPS.
- Optum Edge — MS-DRG structure. Selection of the correct MS-DRG begins with knowing each MS-DRGs accurate and complete description and every diagnosis and/or procedure code that defines that MS-DRG.
- Optum Edge — DRG decision trees. Optum created DRG decision trees illustrate the DRG structure for each MDC.
- Optum Edge — LTC-DRG crosswalk and current rate structure. Know what the RW and length-of-stay data are for each MS-DRG under the LTCH prospective payment system.
- Optum Edge — MDC diagnosis list. Complete list of mutually exclusive diagnoses defining each MDC.
- Optum Edge — Average national payment. Listed for every MS-DRG as a quick benchmark comparison.
- Product Updates. Significant DRG changes and updates will be made available on the Optum Product Update page on optumcoding.com for our valued DRG Expert customers.
- Easily locate the correct DRG. Use the numeric or alphabetic index to quickly identify a DRG based on its diagnosis or procedure code.
- Surgical hierarchy table. Quickly find the DRG hierarchy for multiple procedure cases to help you assign the code that reflects the greatest resource utilization.
- Complete list of diagnoses considered CCs and MCCs.
Top