2027 DRG Expert

2027 DRG Expert

The DRG Expert has been a trusted and comprehensive reference to the DRG classification system over 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, 2026.

See also Optum's DRG Desk Reference which is designed to work hand-in-hand with Optum's DRG Expert.  These products will answer all your DRG questions for all inpatient stays.

Key Features and Benefits

• 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 reative 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 — MS-DRG Listed by MDC. Identify the MS-DRG by its major diagnostic category and page number it appears on in the DRG Expert.
• Surgical hierarchy table. Quickly find the DRG hierarchy for multiple procedure cases to help you assign the code that reflects the greatest resource utilization.
• Easily locate the correct DRG. Search the numeric indexes of ICD-10-CM and ICD-10-PCS codes to quickly identify a DRG, and the page in the DRG Expert where it is located.
• 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.
• Searchable PDFs. The following valuable tools are available to download from the Optum Product Update page at https://www.optumcoding.com/Product/Updates
  • DRG decision trees. Optum created DRG decision trees illustrate the DRG structure for each MDC.
  • MCCs and CCs. Complete list of ICD-10-CM diagnosis codes that are considered CCs and MCCs.
  • Average national payment. Listed for every MS-DRG as a quick benchmark comparison.