ICD-10-CM/PCS MS-DRG v34.0 Definitions Manual

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Appendix I Hospital Acquired Conditions (HACS) List
Hospital Acquired Conditions
Page 11 of 15

HAC 08: SURGICAL SITE INFECTION, MEDIASTINITIS, FOLLOWING CORONARY ARTERY BYPASS GRAFT (CABG) (continued)

PROCEDURES

0213098Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Autologous Venous Tissue, Open Approach
0213099Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Autologous Venous Tissue, Open Approach
021309CBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Autologous Venous Tissue, Open Approach
021309FBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Autologous Venous Tissue, Open Approach
021309WBypass Coronary Artery, Four or More Arteries from Aorta with Autologous Venous Tissue, Open Approach
02130A3Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Autologous Arterial Tissue, Open Approach
02130A8Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Autologous Arterial Tissue, Open Approach
02130A9Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Autologous Arterial Tissue, Open Approach
02130ACBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Autologous Arterial Tissue, Open Approach
02130AFBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Autologous Arterial Tissue, Open Approach
02130AWBypass Coronary Artery, Four or More Arteries from Aorta with Autologous Arterial Tissue, Open Approach
02130J3Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Synthetic Substitute, Open Approach
02130J8Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Synthetic Substitute, Open Approach
02130J9Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Synthetic Substitute, Open Approach
02130JCBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Synthetic Substitute, Open Approach
02130JFBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Synthetic Substitute, Open Approach
02130JWBypass Coronary Artery, Four or More Arteries from Aorta with Synthetic Substitute, Open Approach
02130K3Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Nonautologous Tissue Substitute, Open Approach
02130K8Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Nonautologous Tissue Substitute, Open Approach
02130K9Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Nonautologous Tissue Substitute, Open Approach
02130KCBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Nonautologous Tissue Substitute, Open Approach
02130KFBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Nonautologous Tissue Substitute, Open Approach
02130KWBypass Coronary Artery, Four or More Arteries from Aorta with Nonautologous Tissue Substitute, Open Approach
02130Z3Bypass Coronary Artery, Four or More Arteries from Coronary Artery, Open Approach
02130Z8Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary, Open Approach
02130Z9Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary, Open Approach
02130ZCBypass Coronary Artery, Four or More Arteries from Thoracic Artery, Open Approach
02130ZFBypass Coronary Artery, Four or More Arteries from Abdominal Artery, Open Approach
0213483Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach
0213488Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach
0213489Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach
021348CBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach
021348FBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach
021348WBypass Coronary Artery, Four or More Arteries from Aorta with Zooplastic Tissue, Percutaneous Endoscopic Approach
0213493Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
0213498Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Autologous Venous Tissue, Percutaneous Endoscopic Approach
0213499Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Autologous Venous Tissue, Percutaneous Endoscopic Approach
021349CBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
021349FBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
021349WBypass Coronary Artery, Four or More Arteries from Aorta with Autologous Venous Tissue, Percutaneous Endoscopic Approach
02134A3Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
02134A8Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
02134A9Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
02134ACBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
02134AFBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
02134AWBypass Coronary Artery, Four or More Arteries from Aorta with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
02134J3Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
02134J8Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Synthetic Substitute, Percutaneous Endoscopic Approach
02134J9Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Synthetic Substitute, Percutaneous Endoscopic Approach
02134JCBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
02134JFBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
02134JWBypass Coronary Artery, Four or More Arteries from Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach
02134K3Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
02134K8Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
02134K9Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
02134KCBypass Coronary Artery, Four or More Arteries from Thoracic Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
02134KFBypass Coronary Artery, Four or More Arteries from Abdominal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
02134KWBypass Coronary Artery, Four or More Arteries from Aorta with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
02134Z3Bypass Coronary Artery, Four or More Arteries from Coronary Artery, Percutaneous Endoscopic Approach
02134Z8Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary, Percutaneous Endoscopic Approach
02134Z9Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary, Percutaneous Endoscopic Approach
02134ZCBypass Coronary Artery, Four or More Arteries from Thoracic Artery, Percutaneous Endoscopic Approach
02134ZFBypass Coronary Artery, Four or More Arteries from Abdominal Artery, Percutaneous Endoscopic Approach

AND

SECONDARY DIAGNOSIS

J9851Mediastinitis
J9859Other diseases of mediastinum, not elsewhere classified

HAC 09: MANIFESTATIONS OF POOR GLYCEMIC CONTROL

SECONDARY DIAGNOSIS

E0800Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E0801Diabetes mellitus due to underlying condition with hyperosmolarity with coma
E0810Diabetes mellitus due to underlying condition with ketoacidosis without coma
E0900Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E0901Drug or chemical induced diabetes mellitus with hyperosmolarity with coma
E0910Drug or chemical induced diabetes mellitus with ketoacidosis without coma
E1010Type 1 diabetes mellitus with ketoacidosis without coma
E1100Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E1101Type 2 diabetes mellitus with hyperosmolarity with coma
E1300Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E1301Other specified diabetes mellitus with hyperosmolarity with coma
E1310Other specified diabetes mellitus with ketoacidosis without coma
E15Nondiabetic hypoglycemic coma

HAC 10: DEEP VEIN THROMBOSIS (DTV) / PULMONARY EMBOLISM (PE) WITH TOTAL KNEE OR HIP REPLACEMENT

PROCEDURES

0SR9019Replacement of Right Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach
0SR901AReplacement of Right Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach
0SR901ZReplacement of Right Hip Joint with Metal Synthetic Substitute, Open Approach
0SR9029Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SR902AReplacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SR902ZReplacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Open Approach
0SR9039Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Cemented, Open Approach
0SR903AReplacement of Right Hip Joint with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SR903ZReplacement of Right Hip Joint with Ceramic Synthetic Substitute, Open Approach
0SR9049Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SR904AReplacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SR904ZReplacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Open Approach
0SR907ZReplacement of Right Hip Joint with Autologous Tissue Substitute, Open Approach
0SR90J9Replacement of Right Hip Joint with Synthetic Substitute, Cemented, Open Approach
0SR90JAReplacement of Right Hip Joint with Synthetic Substitute, Uncemented, Open Approach
0SR90JZReplacement of Right Hip Joint with Synthetic Substitute, Open Approach
0SR90KZReplacement of Right Hip Joint with Nonautologous Tissue Substitute, Open Approach
0SRA009Replacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRA00AReplacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRA00ZReplacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Open Approach
0SRA019Replacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Cemented, Open Approach
0SRA01AReplacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Uncemented, Open Approach
0SRA01ZReplacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Open Approach
0SRA039Replacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRA03AReplacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRA03ZReplacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Open Approach
0SRA07ZReplacement of Right Hip Joint, Acetabular Surface with Autologous Tissue Substitute, Open Approach
0SRA0J9Replacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Cemented, Open Approach
0SRA0JAReplacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Uncemented, Open Approach
0SRA0JZReplacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Open Approach
0SRA0KZReplacement of Right Hip Joint, Acetabular Surface with Nonautologous Tissue Substitute, Open Approach
0SRB019Replacement of Left Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach
0SRB01AReplacement of Left Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach
0SRB01ZReplacement of Left Hip Joint with Metal Synthetic Substitute, Open Approach
0SRB029Replacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRB02AReplacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRB02ZReplacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Open Approach
0SRB039Replacement of Left Hip Joint with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRB03AReplacement of Left Hip Joint with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRB03ZReplacement of Left Hip Joint with Ceramic Synthetic Substitute, Open Approach
0SRB049Replacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRB04AReplacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach



Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244
02 Nov 2016 09:53:07
PROD, CMS, code-revision=31, description-revision=86