For the purposes of coding diagnoses on claims, a complication is a condition that arises during the hospital stay that prolongs the length of stay. A comorbidity is a pre-existing condition that affects the treatment received and/or prolongs the length of stay.
The chart below shows potential complications and comorbidities associated with a cesarean section and a transurethral prostatectomy.
Examples of potential complications and comorbidities
Implications on DRG
In some cases, DRG payment may change due to patient complications and comorbidities. Complications and comorbidities should be documented in the patient record and listed on the discharge face sheet.
This document incorporates one or more revisions made since it was originally published. See "revision history" for a summary of the revision(s).
|Rev#:||Date:||Nature of Change:|
|1.0||11/07/2007||Format: spacing adjustment|
|1.1||01/17/2014||Adjusted a minor formatting issue.|