DRAFT

ICD-10-CM/PCS MS-DRG v41.0 Definitions Manual

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Pre-MDC
Autologous bone marrow transplant
Bone Marrow Transplant CC or MCC DRG
Yes Yes 016
Yes No 017

DRG 016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC

DRG 017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC

BONE MARROW TRANSPLANT

NON-OPERATING ROOM PROCEDURES

30233AZ*Transfusion of Embryonic Stem Cells into Peripheral Vein, Percutaneous Approach
30233C0*Transfusion of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modified into Peripheral Vein, Percutaneous Approach
30233G0*Transfusion of Autologous Bone Marrow into Peripheral Vein, Percutaneous Approach
30233X0*Transfusion of Autologous Cord Blood Stem Cells into Peripheral Vein, Percutaneous Approach
30233Y0*Transfusion of Autologous Hematopoietic Stem Cells into Peripheral Vein, Percutaneous Approach
30243AZ*Transfusion of Embryonic Stem Cells into Central Vein, Percutaneous Approach
30243C0*Transfusion of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modified into Central Vein, Percutaneous Approach
30243G0*Transfusion of Autologous Bone Marrow into Central Vein, Percutaneous Approach
30243X0*Transfusion of Autologous Cord Blood Stem Cells into Central Vein, Percutaneous Approach
30243Y0*Transfusion of Autologous Hematopoietic Stem Cells into Central Vein, Percutaneous Approach
XW133B8*Transfusion of Betibeglogene Autotemcel into Peripheral Vein, Percutaneous Approach, New Technology Group 8
XW133F8*Transfusion of OTL-103 into Peripheral Vein, Percutaneous Approach, New Technology Group 8
XW133G8*Transfusion of OTL-200 into Peripheral Vein, Percutaneous Approach, New Technology Group 8
XW133H9*Transfusion of Lovotibeglogene Autotemcel into Peripheral Vein, Percutaneous Approach, New Technology Group 9
XW133J8*Transfusion of Exagamglogene Autotemcel into Peripheral Vein, Percutaneous Approach, New Technology Group 8
XW143B8*Transfusion of Betibeglogene Autotemcel into Central Vein, Percutaneous Approach, New Technology Group 8
XW143F8*Transfusion of OTL-103 into Central Vein, Percutaneous Approach, New Technology Group 8
XW143G8*Transfusion of OTL-200 into Central Vein, Percutaneous Approach, New Technology Group 8
XW143H9*Transfusion of Lovotibeglogene Autotemcel into Central Vein, Percutaneous Approach, New Technology Group 9
XW143J8*Transfusion of Exagamglogene Autotemcel into Central Vein, Percutaneous Approach, New Technology Group 8



Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244
01 Mar 2023 06:12:40
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