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 12 of 15

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

PROCEDURES

0SRB04ZReplacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Open Approach
0SRB07ZReplacement of Left Hip Joint with Autologous Tissue Substitute, Open Approach
0SRB0J9Replacement of Left Hip Joint with Synthetic Substitute, Cemented, Open Approach
0SRB0JAReplacement of Left Hip Joint with Synthetic Substitute, Uncemented, Open Approach
0SRB0JZReplacement of Left Hip Joint with Synthetic Substitute, Open Approach
0SRB0KZReplacement of Left Hip Joint with Nonautologous Tissue Substitute, Open Approach
0SRC07ZReplacement of Right Knee Joint with Autologous Tissue Substitute, Open Approach
0SRC0J9Replacement of Right Knee Joint with Synthetic Substitute, Cemented, Open Approach
0SRC0JAReplacement of Right Knee Joint with Synthetic Substitute, Uncemented, Open Approach
0SRC0JZReplacement of Right Knee Joint with Synthetic Substitute, Open Approach
0SRC0KZReplacement of Right Knee Joint with Nonautologous Tissue Substitute, Open Approach
0SRC0L9Replacement of Right Knee Joint with Unicondylar Synthetic Substitute, Cemented, Open Approach
0SRC0LAReplacement of Right Knee Joint with Unicondylar Synthetic Substitute, Uncemented, Open Approach
0SRC0LZReplacement of Right Knee Joint with Unicondylar Synthetic Substitute, Open Approach
0SRD07ZReplacement of Left Knee Joint with Autologous Tissue Substitute, Open Approach
0SRD0J9Replacement of Left Knee Joint with Synthetic Substitute, Cemented, Open Approach
0SRD0JAReplacement of Left Knee Joint with Synthetic Substitute, Uncemented, Open Approach
0SRD0JZReplacement of Left Knee Joint with Synthetic Substitute, Open Approach
0SRD0KZReplacement of Left Knee Joint with Nonautologous Tissue Substitute, Open Approach
0SRD0L9Replacement of Left Knee Joint with Unicondylar Synthetic Substitute, Cemented, Open Approach
0SRD0LAReplacement of Left Knee Joint with Unicondylar Synthetic Substitute, Uncemented, Open Approach
0SRD0LZReplacement of Left Knee Joint with Unicondylar Synthetic Substitute, Open Approach
0SRE009Replacement of Left Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRE00AReplacement of Left Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRE00ZReplacement of Left Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Open Approach
0SRE019Replacement of Left Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Cemented, Open Approach
0SRE01AReplacement of Left Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Uncemented, Open Approach
0SRE01ZReplacement of Left Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Open Approach
0SRE039Replacement of Left Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRE03AReplacement of Left Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRE03ZReplacement of Left Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Open Approach
0SRE07ZReplacement of Left Hip Joint, Acetabular Surface with Autologous Tissue Substitute, Open Approach
0SRE0J9Replacement of Left Hip Joint, Acetabular Surface with Synthetic Substitute, Cemented, Open Approach
0SRE0JAReplacement of Left Hip Joint, Acetabular Surface with Synthetic Substitute, Uncemented, Open Approach
0SRE0JZReplacement of Left Hip Joint, Acetabular Surface with Synthetic Substitute, Open Approach
0SRE0KZReplacement of Left Hip Joint, Acetabular Surface with Nonautologous Tissue Substitute, Open Approach
0SRR019Replacement of Right Hip Joint, Femoral Surface with Metal Synthetic Substitute, Cemented, Open Approach
0SRR01AReplacement of Right Hip Joint, Femoral Surface with Metal Synthetic Substitute, Uncemented, Open Approach
0SRR01ZReplacement of Right Hip Joint, Femoral Surface with Metal Synthetic Substitute, Open Approach
0SRR039Replacement of Right Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRR03AReplacement of Right Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRR03ZReplacement of Right Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Open Approach
0SRR07ZReplacement of Right Hip Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach
0SRR0J9Replacement of Right Hip Joint, Femoral Surface with Synthetic Substitute, Cemented, Open Approach
0SRR0JAReplacement of Right Hip Joint, Femoral Surface with Synthetic Substitute, Uncemented, Open Approach
0SRR0JZReplacement of Right Hip Joint, Femoral Surface with Synthetic Substitute, Open Approach
0SRR0KZReplacement of Right Hip Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach
0SRS019Replacement of Left Hip Joint, Femoral Surface with Metal Synthetic Substitute, Cemented, Open Approach
0SRS01AReplacement of Left Hip Joint, Femoral Surface with Metal Synthetic Substitute, Uncemented, Open Approach
0SRS01ZReplacement of Left Hip Joint, Femoral Surface with Metal Synthetic Substitute, Open Approach
0SRS039Replacement of Left Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRS03AReplacement of Left Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRS03ZReplacement of Left Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Open Approach
0SRS07ZReplacement of Left Hip Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach
0SRS0J9Replacement of Left Hip Joint, Femoral Surface with Synthetic Substitute, Cemented, Open Approach
0SRS0JAReplacement of Left Hip Joint, Femoral Surface with Synthetic Substitute, Uncemented, Open Approach
0SRS0JZReplacement of Left Hip Joint, Femoral Surface with Synthetic Substitute, Open Approach
0SRS0KZReplacement of Left Hip Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach
0SRT07ZReplacement of Right Knee Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach
0SRT0J9Replacement of Right Knee Joint, Femoral Surface with Synthetic Substitute, Cemented, Open Approach
0SRT0JAReplacement of Right Knee Joint, Femoral Surface with Synthetic Substitute, Uncemented, Open Approach
0SRT0JZReplacement of Right Knee Joint, Femoral Surface with Synthetic Substitute, Open Approach
0SRT0KZReplacement of Right Knee Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach
0SRU07ZReplacement of Left Knee Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach
0SRU0J9Replacement of Left Knee Joint, Femoral Surface with Synthetic Substitute, Cemented, Open Approach
0SRU0JAReplacement of Left Knee Joint, Femoral Surface with Synthetic Substitute, Uncemented, Open Approach
0SRU0JZReplacement of Left Knee Joint, Femoral Surface with Synthetic Substitute, Open Approach
0SRU0KZReplacement of Left Knee Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach
0SRV07ZReplacement of Right Knee Joint, Tibial Surface with Autologous Tissue Substitute, Open Approach
0SRV0J9Replacement of Right Knee Joint, Tibial Surface with Synthetic Substitute, Cemented, Open Approach
0SRV0JAReplacement of Right Knee Joint, Tibial Surface with Synthetic Substitute, Uncemented, Open Approach
0SRV0JZReplacement of Right Knee Joint, Tibial Surface with Synthetic Substitute, Open Approach
0SRV0KZReplacement of Right Knee Joint, Tibial Surface with Nonautologous Tissue Substitute, Open Approach
0SRW07ZReplacement of Left Knee Joint, Tibial Surface with Autologous Tissue Substitute, Open Approach
0SRW0J9Replacement of Left Knee Joint, Tibial Surface with Synthetic Substitute, Cemented, Open Approach
0SRW0JAReplacement of Left Knee Joint, Tibial Surface with Synthetic Substitute, Uncemented, Open Approach
0SRW0JZReplacement of Left Knee Joint, Tibial Surface with Synthetic Substitute, Open Approach
0SRW0KZReplacement of Left Knee Joint, Tibial Surface with Nonautologous Tissue Substitute, Open Approach
0SU90BZSupplement Right Hip Joint with Resurfacing Device, Open Approach
0SUA0BZSupplement Right Hip Joint, Acetabular Surface with Resurfacing Device, Open Approach
0SUB0BZSupplement Left Hip Joint with Resurfacing Device, Open Approach
0SUE0BZSupplement Left Hip Joint, Acetabular Surface with Resurfacing Device, Open Approach
0SUR0BZSupplement Right Hip Joint, Femoral Surface with Resurfacing Device, Open Approach
0SUS0BZSupplement Left Hip Joint, Femoral Surface with Resurfacing Device, Open Approach

AND

SECONDARY DIAGNOSIS

I2602Saddle embolus of pulmonary artery with acute cor pulmonale
I2609Other pulmonary embolism with acute cor pulmonale
I2692Saddle embolus of pulmonary artery without acute cor pulmonale
I2699Other pulmonary embolism without acute cor pulmonale
I82401Acute embolism and thrombosis of unspecified deep veins of right lower extremity
I82402Acute embolism and thrombosis of unspecified deep veins of left lower extremity
I82403Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral
I82409Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity
I82411Acute embolism and thrombosis of right femoral vein
I82412Acute embolism and thrombosis of left femoral vein
I82413Acute embolism and thrombosis of femoral vein, bilateral
I82419Acute embolism and thrombosis of unspecified femoral vein
I82421Acute embolism and thrombosis of right iliac vein
I82422Acute embolism and thrombosis of left iliac vein
I82423Acute embolism and thrombosis of iliac vein, bilateral
I82429Acute embolism and thrombosis of unspecified iliac vein
I82431Acute embolism and thrombosis of right popliteal vein
I82432Acute embolism and thrombosis of left popliteal vein
I82433Acute embolism and thrombosis of popliteal vein, bilateral
I82439Acute embolism and thrombosis of unspecified popliteal vein
I82441Acute embolism and thrombosis of right tibial vein
I82442Acute embolism and thrombosis of left tibial vein
I82443Acute embolism and thrombosis of tibial vein, bilateral
I82449Acute embolism and thrombosis of unspecified tibial vein
I82491Acute embolism and thrombosis of other specified deep vein of right lower extremity
I82492Acute embolism and thrombosis of other specified deep vein of left lower extremity
I82493Acute embolism and thrombosis of other specified deep vein of lower extremity, bilateral
I82499Acute embolism and thrombosis of other specified deep vein of unspecified lower extremity
I824Y1Acute embolism and thrombosis of unspecified deep veins of right proximal lower extremity
I824Y2Acute embolism and thrombosis of unspecified deep veins of left proximal lower extremity
I824Y3Acute embolism and thrombosis of unspecified deep veins of proximal lower extremity, bilateral
I824Y9Acute embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity
I824Z1Acute embolism and thrombosis of unspecified deep veins of right distal lower extremity
I824Z2Acute embolism and thrombosis of unspecified deep veins of left distal lower extremity
I824Z3Acute embolism and thrombosis of unspecified deep veins of distal lower extremity, bilateral
I824Z9Acute embolism and thrombosis of unspecified deep veins of unspecified distal lower extremity

HAC 11: SURGICAL SITE INFECTION FOLLOWING BARIATRIC SURGERY

PROCEDURES

0D16079Bypass Stomach to Duodenum with Autologous Tissue Substitute, Open Approach
0D1607ABypass Stomach to Jejunum with Autologous Tissue Substitute, Open Approach
0D1607BBypass Stomach to Ileum with Autologous Tissue Substitute, Open Approach
0D1607LBypass Stomach to Transverse Colon with Autologous Tissue Substitute, Open Approach
0D160J9Bypass Stomach to Duodenum with Synthetic Substitute, Open Approach
0D160JABypass Stomach to Jejunum with Synthetic Substitute, Open Approach
0D160JBBypass Stomach to Ileum with Synthetic Substitute, Open Approach
0D160JLBypass Stomach to Transverse Colon with Synthetic Substitute, Open Approach
0D160K9Bypass Stomach to Duodenum with Nonautologous Tissue Substitute, Open Approach
0D160KABypass Stomach to Jejunum with Nonautologous Tissue Substitute, Open Approach
0D160KBBypass Stomach to Ileum with Nonautologous Tissue Substitute, Open Approach
0D160KLBypass Stomach to Transverse Colon with Nonautologous Tissue Substitute, Open Approach
0D160Z9Bypass Stomach to Duodenum, Open Approach
0D160ZABypass Stomach to Jejunum, Open Approach
0D160ZBBypass Stomach to Ileum, Open Approach
0D160ZLBypass Stomach to Transverse Colon, Open Approach
0D16479Bypass Stomach to Duodenum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0D1647ABypass Stomach to Jejunum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0D1647BBypass Stomach to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0D1647LBypass Stomach to Transverse Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0D164J9Bypass Stomach to Duodenum with Synthetic Substitute, Percutaneous Endoscopic Approach
0D164JABypass Stomach to Jejunum with Synthetic Substitute, Percutaneous Endoscopic Approach
0D164JBBypass Stomach to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach
0D164JLBypass Stomach to Transverse Colon with Synthetic Substitute, Percutaneous Endoscopic Approach
0D164K9Bypass Stomach to Duodenum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0D164KABypass Stomach to Jejunum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0D164KBBypass Stomach to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0D164KLBypass Stomach to Transverse Colon with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0D164Z9Bypass Stomach to Duodenum, Percutaneous Endoscopic Approach
0D164ZABypass Stomach to Jejunum, Percutaneous Endoscopic Approach
0D164ZBBypass Stomach to Ileum, Percutaneous Endoscopic Approach
0D164ZLBypass Stomach to Transverse Colon, Percutaneous Endoscopic Approach
0D16879Bypass Stomach to Duodenum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic
0D1687ABypass Stomach to Jejunum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic
0D1687BBypass Stomach to Ileum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic
0D1687LBypass Stomach to Transverse Colon with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic
0D168J9Bypass Stomach to Duodenum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic
0D168JABypass Stomach to Jejunum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic
0D168JBBypass Stomach to Ileum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic
0D168JLBypass Stomach to Transverse Colon with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic
0D168K9Bypass Stomach to Duodenum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic
0D168KABypass Stomach to Jejunum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic
0D168KBBypass Stomach to Ileum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic
0D168KLBypass Stomach to Transverse Colon with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic



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