Congenital Anomaly ICD-10-CM/PCS Coding and DRG Implications

Congenital Anomalies are most often identified within the first hours or days of life. For those conditions representing immediate threat to life and viability, a corrective or lifesaving procedure may be necessary within hours or days of birth. Other anomalies may represent functional or cosmetic conditions that may require corrective or restorative procedures over time, and may involve more than one procedure, such as prosthetic implants, and removal or relocation of tissue or organs as the individual grows. Due to the range and varying anomalies that may need surgical intervention, it is important to understand the structure and varied DRGs assigned from many different body systems.

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Original presentation date

July 21, 2016

Viewing the recording does not constitute eligibility to receive a CE. Only attendees of the live event are eligible to receive a CE Certificate.

Learning objectives

By the end of this webinar participants will be able to:

  • Recall the logic for assigning congenital anomaly diagnoses to surgical/procedural DRGs
  • Evaluate the differences between MS-DRGs and APR-DRGs for surgical/procedurals and congenital anomaly diagnoses
  • Identify the major procedures that link to surgical/procedural DRGs for congenital anomaly diagnoses


Deborah Gardner-Brown, RHIT, CCS, C-CDI, CI-CDI, CDIP, AHIMA Approved ICD-10-CM/PCS Trainer/Ambassador
Deborah Gardner-Brown is the founder and President of Reimbursement Review Associates, Inc. She holds the credentials of RHIT, CCS, as well as the new Clinical Documentation Improvement Professional (CDIP) credential from The American Health Information Management Association (AHIMA), and Certified in Clinical Documentation Integrity (C-CDI), Certified Instructor- Clinical Documentation Integrity (CI-CDI) from the AIHCS.

Ms. Brown has more than 28 years’ experience in both hospital and professional coding and reimbursement management. She has held positions as director, administrator, and consultant in both acute care and outpatient health care settings. Ms. Brown’s expertise includes CDIP implementation, support, and design. Most recently she has developed an education program to incorporate severity APR-DRG’s into a hospital’s clinical documentation improvement program. Ms. Brown provides APG, APC and MS-DRG validation for coding compliance in both the acute care and outpatient settings. She is also an AHIMA approved ICD-10-CM/PCS Trainer. Ms. Brown is the founder of the NJ ACDIS state chapter association, and a member of AHIMA, NJHIMA, HCCA, AAPC, NJACDIS, AIHCD, and ACDIS.

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