ICD-10-CM/PCS MS-DRG v41.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v41.0 Definitions Manual |
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| MDC 11 Diseases and disorders of the kidney and urinary tract |
| Kidney and ureter procedures |
| Page 1 of 4 |
| Neoplasm | MCC | CC | DRG |
|---|---|---|---|
| Yes | Yes | n/a | 656 |
| Yes | No | Yes | 657 |
| Yes | No | No | 658 |
| No | Yes | n/a | 659 |
| No | No | Yes | 660 |
| No | No | No | 661 |
DRG 656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC
DRG 657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC
DRG 658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC
DRG 659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
DRG 660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC
DRG 661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
KIDNEY AND URETER PROCEDURES
OPERATING ROOM PROCEDURES
| 0410093 | Bypass Abdominal Aorta to Right Renal Artery with Autologous Venous Tissue, Open Approach |
| 0410094 | Bypass Abdominal Aorta to Left Renal Artery with Autologous Venous Tissue, Open Approach |
| 0410095 | Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Venous Tissue, Open Approach |
| 04100A3 | Bypass Abdominal Aorta to Right Renal Artery with Autologous Arterial Tissue, Open Approach |
| 04100A4 | Bypass Abdominal Aorta to Left Renal Artery with Autologous Arterial Tissue, Open Approach |
| 04100A5 | Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Arterial Tissue, Open Approach |
| 04100J1 | Bypass Abdominal Aorta to Celiac Artery with Synthetic Substitute, Open Approach |
| 04100J2 | Bypass Abdominal Aorta to Mesenteric Artery with Synthetic Substitute, Open Approach |
| 04100J3 | Bypass Abdominal Aorta to Right Renal Artery with Synthetic Substitute, Open Approach |
| 04100J4 | Bypass Abdominal Aorta to Left Renal Artery with Synthetic Substitute, Open Approach |
| 04100J5 | Bypass Abdominal Aorta to Bilateral Renal Artery with Synthetic Substitute, Open Approach |
| 04100K3 | Bypass Abdominal Aorta to Right Renal Artery with Nonautologous Tissue Substitute, Open Approach |
| 04100K4 | Bypass Abdominal Aorta to Left Renal Artery with Nonautologous Tissue Substitute, Open Approach |
| 04100K5 | Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Open Approach |
| 04100Z1 | Bypass Abdominal Aorta to Celiac Artery, Open Approach |
| 04100Z2 | Bypass Abdominal Aorta to Mesenteric Artery, Open Approach |
| 04100Z3 | Bypass Abdominal Aorta to Right Renal Artery, Open Approach |
| 04100Z4 | Bypass Abdominal Aorta to Left Renal Artery, Open Approach |
| 04100Z5 | Bypass Abdominal Aorta to Bilateral Renal Artery, Open Approach |
| 0410493 | Bypass Abdominal Aorta to Right Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 0410494 | Bypass Abdominal Aorta to Left Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 0410495 | Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 04104A3 | Bypass Abdominal Aorta to Right Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 04104A4 | Bypass Abdominal Aorta to Left Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 04104A5 | Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 04104J3 | Bypass Abdominal Aorta to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 04104J4 | Bypass Abdominal Aorta to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 04104J5 | Bypass Abdominal Aorta to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 04104K3 | Bypass Abdominal Aorta to Right Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 04104K4 | Bypass Abdominal Aorta to Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 04104K5 | Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 04104Z3 | Bypass Abdominal Aorta to Right Renal Artery, Percutaneous Endoscopic Approach |
| 04104Z4 | Bypass Abdominal Aorta to Left Renal Artery, Percutaneous Endoscopic Approach |
| 04104Z5 | Bypass Abdominal Aorta to Bilateral Renal Artery, Percutaneous Endoscopic Approach |
| 0413093 | Bypass Hepatic Artery to Right Renal Artery with Autologous Venous Tissue, Open Approach |
| 0413094 | Bypass Hepatic Artery to Left Renal Artery with Autologous Venous Tissue, Open Approach |
| 0413095 | Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Venous Tissue, Open Approach |
| 04130A3 | Bypass Hepatic Artery to Right Renal Artery with Autologous Arterial Tissue, Open Approach |
| 04130A4 | Bypass Hepatic Artery to Left Renal Artery with Autologous Arterial Tissue, Open Approach |
| 04130A5 | Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Arterial Tissue, Open Approach |
| 04130J3 | Bypass Hepatic Artery to Right Renal Artery with Synthetic Substitute, Open Approach |
| 04130J4 | Bypass Hepatic Artery to Left Renal Artery with Synthetic Substitute, Open Approach |
| 04130J5 | Bypass Hepatic Artery to Bilateral Renal Artery with Synthetic Substitute, Open Approach |
| 04130K3 | Bypass Hepatic Artery to Right Renal Artery with Nonautologous Tissue Substitute, Open Approach |
| 04130K4 | Bypass Hepatic Artery to Left Renal Artery with Nonautologous Tissue Substitute, Open Approach |
| 04130K5 | Bypass Hepatic Artery to Bilateral Renal Artery with Nonautologous Tissue Substitute, Open Approach |
| 04130Z3 | Bypass Hepatic Artery to Right Renal Artery, Open Approach |
| 04130Z4 | Bypass Hepatic Artery to Left Renal Artery, Open Approach |
| 04130Z5 | Bypass Hepatic Artery to Bilateral Renal Artery, Open Approach |
| 0413493 | Bypass Hepatic Artery to Right Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 0413494 | Bypass Hepatic Artery to Left Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 0413495 | Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 04134A3 | Bypass Hepatic Artery to Right Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 04134A4 | Bypass Hepatic Artery to Left Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 04134A5 | Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 04134J3 | Bypass Hepatic Artery to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 04134J4 | Bypass Hepatic Artery to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 04134J5 | Bypass Hepatic Artery to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 04134K3 | Bypass Hepatic Artery to Right Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 04134K4 | Bypass Hepatic Artery to Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 04134K5 | Bypass Hepatic Artery to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 04134Z3 | Bypass Hepatic Artery to Right Renal Artery, Percutaneous Endoscopic Approach |
| 04134Z4 | Bypass Hepatic Artery to Left Renal Artery, Percutaneous Endoscopic Approach |
| 04134Z5 | Bypass Hepatic Artery to Bilateral Renal Artery, Percutaneous Endoscopic Approach |
| 041C0J3 | Bypass Right Common Iliac Artery to Right Renal Artery with Synthetic Substitute, Open Approach |
| 041C0J4 | Bypass Right Common Iliac Artery to Left Renal Artery with Synthetic Substitute, Open Approach |
| 041C0J5 | Bypass Right Common Iliac Artery to Bilateral Renal Artery with Synthetic Substitute, Open Approach |
| 041C0Z3 | Bypass Right Common Iliac Artery to Right Renal Artery, Open Approach |
| 041C0Z4 | Bypass Right Common Iliac Artery to Left Renal Artery, Open Approach |
| 041C0Z5 | Bypass Right Common Iliac Artery to Bilateral Renal Artery, Open Approach |
| 041C4J3 | Bypass Right Common Iliac Artery to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 041C4J4 | Bypass Right Common Iliac Artery to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 041C4J5 | Bypass Right Common Iliac Artery to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 041C4Z3 | Bypass Right Common Iliac Artery to Right Renal Artery, Percutaneous Endoscopic Approach |
| 041C4Z4 | Bypass Right Common Iliac Artery to Left Renal Artery, Percutaneous Endoscopic Approach |
| 041C4Z5 | Bypass Right Common Iliac Artery to Bilateral Renal Artery, Percutaneous Endoscopic Approach |
| 041D0J3 | Bypass Left Common Iliac Artery to Right Renal Artery with Synthetic Substitute, Open Approach |
| 041D0J4 | Bypass Left Common Iliac Artery to Left Renal Artery with Synthetic Substitute, Open Approach |
| 041D0J5 | Bypass Left Common Iliac Artery to Bilateral Renal Artery with Synthetic Substitute, Open Approach |
| 041D0Z3 | Bypass Left Common Iliac Artery to Right Renal Artery, Open Approach |
| 041D0Z4 | Bypass Left Common Iliac Artery to Left Renal Artery, Open Approach |
| 041D0Z5 | Bypass Left Common Iliac Artery to Bilateral Renal Artery, Open Approach |
| 041D4J3 | Bypass Left Common Iliac Artery to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 041D4J4 | Bypass Left Common Iliac Artery to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 041D4J5 | Bypass Left Common Iliac Artery to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 041D4Z3 | Bypass Left Common Iliac Artery to Right Renal Artery, Percutaneous Endoscopic Approach |
| 041D4Z4 | Bypass Left Common Iliac Artery to Left Renal Artery, Percutaneous Endoscopic Approach |
| 041D4Z5 | Bypass Left Common Iliac Artery to Bilateral Renal Artery, Percutaneous Endoscopic Approach |
| 04S90ZZ | Reposition Right Renal Artery, Open Approach |
| 04S93ZZ | Reposition Right Renal Artery, Percutaneous Approach |
| 04S94ZZ | Reposition Right Renal Artery, Percutaneous Endoscopic Approach |
| 04SA0ZZ | Reposition Left Renal Artery, Open Approach |
| 04SA3ZZ | Reposition Left Renal Artery, Percutaneous Approach |
| 04SA4ZZ | Reposition Left Renal Artery, Percutaneous Endoscopic Approach |
| 06S90ZZ | Reposition Right Renal Vein, Open Approach |
| 06S93ZZ | Reposition Right Renal Vein, Percutaneous Approach |
| 06S94ZZ | Reposition Right Renal Vein, Percutaneous Endoscopic Approach |
| 06SB0ZZ | Reposition Left Renal Vein, Open Approach |
| 06SB3ZZ | Reposition Left Renal Vein, Percutaneous Approach |
| 06SB4ZZ | Reposition Left Renal Vein, Percutaneous Endoscopic Approach |
| 07T80ZZ | Resection of Right Internal Mammary Lymphatic, Open Approach |
| 07T84ZZ | Resection of Right Internal Mammary Lymphatic, Percutaneous Endoscopic Approach |
| 07T90ZZ | Resection of Left Internal Mammary Lymphatic, Open Approach |
| 07T94ZZ | Resection of Left Internal Mammary Lymphatic, Percutaneous Endoscopic Approach |
| 07TC0ZZ | Resection of Pelvis Lymphatic, Open Approach |
| 07TC4ZZ | Resection of Pelvis Lymphatic, Percutaneous Endoscopic Approach |
| 07TD0ZZ | Resection of Aortic Lymphatic, Open Approach |
| 07TD4ZZ | Resection of Aortic Lymphatic, Percutaneous Endoscopic Approach |
| 07TH0ZZ | Resection of Right Inguinal Lymphatic, Open Approach |
| 07TH4ZZ | Resection of Right Inguinal Lymphatic, Percutaneous Endoscopic Approach |
| 07TJ0ZZ | Resection of Left Inguinal Lymphatic, Open Approach |
| 07TJ4ZZ | Resection of Left Inguinal Lymphatic, Percutaneous Endoscopic Approach |
| 0DX80ZC | Transfer Small Intestine to Right Ureter, Open Approach |
| 0DX80ZD | Transfer Small Intestine to Left Ureter, Open Approach |
| 0DX80ZF | Transfer Small Intestine to Bilateral Ureters, Open Approach |
| 0DX84ZC | Transfer Small Intestine to Right Ureter, Percutaneous Endoscopic Approach |
| 0DX84ZD | Transfer Small Intestine to Left Ureter, Percutaneous Endoscopic Approach |
| 0DX84ZF | Transfer Small Intestine to Bilateral Ureters, Percutaneous Endoscopic Approach |
| 0T13073 | Bypass Right Kidney Pelvis to Right Kidney Pelvis with Autologous Tissue Substitute, Open Approach |
| 0T13074 | Bypass Right Kidney Pelvis to Left Kidney Pelvis with Autologous Tissue Substitute, Open Approach |
| 0T13076 | Bypass Right Kidney Pelvis to Right Ureter with Autologous Tissue Substitute, Open Approach |
| 0T13077 | Bypass Right Kidney Pelvis to Left Ureter with Autologous Tissue Substitute, Open Approach |
| 0T13078 | Bypass Right Kidney Pelvis to Colon with Autologous Tissue Substitute, Open Approach |
| 0T13079 | Bypass Right Kidney Pelvis to Colocutaneous with Autologous Tissue Substitute, Open Approach |
| 0T1307A | Bypass Right Kidney Pelvis to Ileum with Autologous Tissue Substitute, Open Approach |
| 0T1307B | Bypass Right Kidney Pelvis to Bladder with Autologous Tissue Substitute, Open Approach |
| 0T1307C | Bypass Right Kidney Pelvis to Ileocutaneous with Autologous Tissue Substitute, Open Approach |
| 0T1307D | Bypass Right Kidney Pelvis to Cutaneous with Autologous Tissue Substitute, Open Approach |
| 0T130J3 | Bypass Right Kidney Pelvis to Right Kidney Pelvis with Synthetic Substitute, Open Approach |
| 0T130J4 | Bypass Right Kidney Pelvis to Left Kidney Pelvis with Synthetic Substitute, Open Approach |
| 0T130J6 | Bypass Right Kidney Pelvis to Right Ureter with Synthetic Substitute, Open Approach |
| 0T130J7 | Bypass Right Kidney Pelvis to Left Ureter with Synthetic Substitute, Open Approach |
| 0T130J8 | Bypass Right Kidney Pelvis to Colon with Synthetic Substitute, Open Approach |
| 0T130J9 | Bypass Right Kidney Pelvis to Colocutaneous with Synthetic Substitute, Open Approach |
| 0T130JA | Bypass Right Kidney Pelvis to Ileum with Synthetic Substitute, Open Approach |
| 0T130JB | Bypass Right Kidney Pelvis to Bladder with Synthetic Substitute, Open Approach |
| 0T130JC | Bypass Right Kidney Pelvis to Ileocutaneous with Synthetic Substitute, Open Approach |
| 0T130JD | Bypass Right Kidney Pelvis to Cutaneous with Synthetic Substitute, Open Approach |
| 0T130K3 | Bypass Right Kidney Pelvis to Right Kidney Pelvis with Nonautologous Tissue Substitute, Open Approach |
| 0T130K4 | Bypass Right Kidney Pelvis to Left Kidney Pelvis with Nonautologous Tissue Substitute, Open Approach |
| 0T130K6 | Bypass Right Kidney Pelvis to Right Ureter with Nonautologous Tissue Substitute, Open Approach |
| 0T130K7 | Bypass Right Kidney Pelvis to Left Ureter with Nonautologous Tissue Substitute, Open Approach |
| 0T130K8 | Bypass Right Kidney Pelvis to Colon with Nonautologous Tissue Substitute, Open Approach |
| 0T130K9 | Bypass Right Kidney Pelvis to Colocutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T130KA | Bypass Right Kidney Pelvis to Ileum with Nonautologous Tissue Substitute, Open Approach |
| 0T130KB | Bypass Right Kidney Pelvis to Bladder with Nonautologous Tissue Substitute, Open Approach |
| 0T130KC | Bypass Right Kidney Pelvis to Ileocutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T130KD | Bypass Right Kidney Pelvis to Cutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T130Z3 | Bypass Right Kidney Pelvis to Right Kidney Pelvis, Open Approach |
| 0T130Z4 | Bypass Right Kidney Pelvis to Left Kidney Pelvis, Open Approach |
| 0T130Z6 | Bypass Right Kidney Pelvis to Right Ureter, Open Approach |
| 0T130Z7 | Bypass Right Kidney Pelvis to Left Ureter, Open Approach |
| 0T130Z8 | Bypass Right Kidney Pelvis to Colon, Open Approach |
| 0T130Z9 | Bypass Right Kidney Pelvis to Colocutaneous, Open Approach |
| 0T130ZA | Bypass Right Kidney Pelvis to Ileum, Open Approach |
| 0T130ZB | Bypass Right Kidney Pelvis to Bladder, Open Approach |
| 0T130ZC | Bypass Right Kidney Pelvis to Ileocutaneous, Open Approach |
| 0T130ZD | Bypass Right Kidney Pelvis to Cutaneous, Open Approach |
| 0T133JD | Bypass Right Kidney Pelvis to Cutaneous with Synthetic Substitute, Percutaneous Approach |
| 0T13473 | Bypass Right Kidney Pelvis to Right Kidney Pelvis with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T13474 | Bypass Right Kidney Pelvis to Left Kidney Pelvis with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T13476 | Bypass Right Kidney Pelvis to Right Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T13477 | Bypass Right Kidney Pelvis to Left Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T13478 | Bypass Right Kidney Pelvis to Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T13479 | Bypass Right Kidney Pelvis to Colocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1347A | Bypass Right Kidney Pelvis to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1347B | Bypass Right Kidney Pelvis to Bladder with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1347C | Bypass Right Kidney Pelvis to Ileocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1347D | Bypass Right Kidney Pelvis to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134J3 | Bypass Right Kidney Pelvis to Right Kidney Pelvis with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134J4 | Bypass Right Kidney Pelvis to Left Kidney Pelvis with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134J6 | Bypass Right Kidney Pelvis to Right Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134J7 | Bypass Right Kidney Pelvis to Left Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134J8 | Bypass Right Kidney Pelvis to Colon with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134J9 | Bypass Right Kidney Pelvis to Colocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134JA | Bypass Right Kidney Pelvis to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134JB | Bypass Right Kidney Pelvis to Bladder with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134JC | Bypass Right Kidney Pelvis to Ileocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134JD | Bypass Right Kidney Pelvis to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T134K3 | Bypass Right Kidney Pelvis to Right Kidney Pelvis with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134K4 | Bypass Right Kidney Pelvis to Left Kidney Pelvis with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134K6 | Bypass Right Kidney Pelvis to Right Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134K7 | Bypass Right Kidney Pelvis to Left Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134K8 | Bypass Right Kidney Pelvis to Colon with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134K9 | Bypass Right Kidney Pelvis to Colocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134KA | Bypass Right Kidney Pelvis to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134KB | Bypass Right Kidney Pelvis to Bladder with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134KC | Bypass Right Kidney Pelvis to Ileocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134KD | Bypass Right Kidney Pelvis to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T134Z3 | Bypass Right Kidney Pelvis to Right Kidney Pelvis, Percutaneous Endoscopic Approach |
| 0T134Z4 | Bypass Right Kidney Pelvis to Left Kidney Pelvis, Percutaneous Endoscopic Approach |
| 0T134Z6 | Bypass Right Kidney Pelvis to Right Ureter, Percutaneous Endoscopic Approach |
| 0T134Z7 | Bypass Right Kidney Pelvis to Left Ureter, Percutaneous Endoscopic Approach |
| 0T134Z8 | Bypass Right Kidney Pelvis to Colon, Percutaneous Endoscopic Approach |
| 0T134Z9 | Bypass Right Kidney Pelvis to Colocutaneous, Percutaneous Endoscopic Approach |
| 0T134ZA | Bypass Right Kidney Pelvis to Ileum, Percutaneous Endoscopic Approach |
| 0T134ZB | Bypass Right Kidney Pelvis to Bladder, Percutaneous Endoscopic Approach |
| 0T134ZC | Bypass Right Kidney Pelvis to Ileocutaneous, Percutaneous Endoscopic Approach |
| 0T134ZD | Bypass Right Kidney Pelvis to Cutaneous, Percutaneous Endoscopic Approach |
| 0T14073 | Bypass Left Kidney Pelvis to Right Kidney Pelvis with Autologous Tissue Substitute, Open Approach |
| 0T14074 | Bypass Left Kidney Pelvis to Left Kidney Pelvis with Autologous Tissue Substitute, Open Approach |
| 0T14076 | Bypass Left Kidney Pelvis to Right Ureter with Autologous Tissue Substitute, Open Approach |
| 0T14077 | Bypass Left Kidney Pelvis to Left Ureter with Autologous Tissue Substitute, Open Approach |
| 0T14078 | Bypass Left Kidney Pelvis to Colon with Autologous Tissue Substitute, Open Approach |
| 0T14079 | Bypass Left Kidney Pelvis to Colocutaneous with Autologous Tissue Substitute, Open Approach |
| 0T1407A | Bypass Left Kidney Pelvis to Ileum with Autologous Tissue Substitute, Open Approach |
| 0T1407B | Bypass Left Kidney Pelvis to Bladder with Autologous Tissue Substitute, Open Approach |
| 0T1407C | Bypass Left Kidney Pelvis to Ileocutaneous with Autologous Tissue Substitute, Open Approach |
| 0T1407D | Bypass Left Kidney Pelvis to Cutaneous with Autologous Tissue Substitute, Open Approach |
| 0T140J3 | Bypass Left Kidney Pelvis to Right Kidney Pelvis with Synthetic Substitute, Open Approach |
| 0T140J4 | Bypass Left Kidney Pelvis to Left Kidney Pelvis with Synthetic Substitute, Open Approach |
| 0T140J6 | Bypass Left Kidney Pelvis to Right Ureter with Synthetic Substitute, Open Approach |
| 0T140J7 | Bypass Left Kidney Pelvis to Left Ureter with Synthetic Substitute, Open Approach |
| 0T140J8 | Bypass Left Kidney Pelvis to Colon with Synthetic Substitute, Open Approach |
| 0T140J9 | Bypass Left Kidney Pelvis to Colocutaneous with Synthetic Substitute, Open Approach |
| 0T140JA | Bypass Left Kidney Pelvis to Ileum with Synthetic Substitute, Open Approach |
| 0T140JB | Bypass Left Kidney Pelvis to Bladder with Synthetic Substitute, Open Approach |
| 0T140JC | Bypass Left Kidney Pelvis to Ileocutaneous with Synthetic Substitute, Open Approach |
| 0T140JD | Bypass Left Kidney Pelvis to Cutaneous with Synthetic Substitute, Open Approach |
| 0T140K3 | Bypass Left Kidney Pelvis to Right Kidney Pelvis with Nonautologous Tissue Substitute, Open Approach |
| 0T140K4 | Bypass Left Kidney Pelvis to Left Kidney Pelvis with Nonautologous Tissue Substitute, Open Approach |
| 0T140K6 | Bypass Left Kidney Pelvis to Right Ureter with Nonautologous Tissue Substitute, Open Approach |
| 0T140K7 | Bypass Left Kidney Pelvis to Left Ureter with Nonautologous Tissue Substitute, Open Approach |
| 0T140K8 | Bypass Left Kidney Pelvis to Colon with Nonautologous Tissue Substitute, Open Approach |
| 0T140K9 | Bypass Left Kidney Pelvis to Colocutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T140KA | Bypass Left Kidney Pelvis to Ileum with Nonautologous Tissue Substitute, Open Approach |
| 0T140KB | Bypass Left Kidney Pelvis to Bladder with Nonautologous Tissue Substitute, Open Approach |
| 0T140KC | Bypass Left Kidney Pelvis to Ileocutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T140KD | Bypass Left Kidney Pelvis to Cutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T140Z3 | Bypass Left Kidney Pelvis to Right Kidney Pelvis, Open Approach |
| 0T140Z4 | Bypass Left Kidney Pelvis to Left Kidney Pelvis, Open Approach |
| 0T140Z6 | Bypass Left Kidney Pelvis to Right Ureter, Open Approach |
| 0T140Z7 | Bypass Left Kidney Pelvis to Left Ureter, Open Approach |
| 0T140Z8 | Bypass Left Kidney Pelvis to Colon, Open Approach |
| 0T140Z9 | Bypass Left Kidney Pelvis to Colocutaneous, Open Approach |
| 0T140ZA | Bypass Left Kidney Pelvis to Ileum, Open Approach |
| 0T140ZB | Bypass Left Kidney Pelvis to Bladder, Open Approach |
| 0T140ZC | Bypass Left Kidney Pelvis to Ileocutaneous, Open Approach |
| 0T140ZD | Bypass Left Kidney Pelvis to Cutaneous, Open Approach |
| 0T143JD | Bypass Left Kidney Pelvis to Cutaneous with Synthetic Substitute, Percutaneous Approach |
| 0T14473 | Bypass Left Kidney Pelvis to Right Kidney Pelvis with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T14474 | Bypass Left Kidney Pelvis to Left Kidney Pelvis with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T14476 | Bypass Left Kidney Pelvis to Right Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T14477 | Bypass Left Kidney Pelvis to Left Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T14478 | Bypass Left Kidney Pelvis to Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T14479 | Bypass Left Kidney Pelvis to Colocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1447A | Bypass Left Kidney Pelvis to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1447B | Bypass Left Kidney Pelvis to Bladder with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1447C | Bypass Left Kidney Pelvis to Ileocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1447D | Bypass Left Kidney Pelvis to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144J3 | Bypass Left Kidney Pelvis to Right Kidney Pelvis with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144J4 | Bypass Left Kidney Pelvis to Left Kidney Pelvis with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144J6 | Bypass Left Kidney Pelvis to Right Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144J7 | Bypass Left Kidney Pelvis to Left Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144J8 | Bypass Left Kidney Pelvis to Colon with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144J9 | Bypass Left Kidney Pelvis to Colocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144JA | Bypass Left Kidney Pelvis to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144JB | Bypass Left Kidney Pelvis to Bladder with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144JC | Bypass Left Kidney Pelvis to Ileocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144JD | Bypass Left Kidney Pelvis to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T144K3 | Bypass Left Kidney Pelvis to Right Kidney Pelvis with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144K4 | Bypass Left Kidney Pelvis to Left Kidney Pelvis with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144K6 | Bypass Left Kidney Pelvis to Right Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144K7 | Bypass Left Kidney Pelvis to Left Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144K8 | Bypass Left Kidney Pelvis to Colon with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144K9 | Bypass Left Kidney Pelvis to Colocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144KA | Bypass Left Kidney Pelvis to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144KB | Bypass Left Kidney Pelvis to Bladder with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144KC | Bypass Left Kidney Pelvis to Ileocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144KD | Bypass Left Kidney Pelvis to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T144Z3 | Bypass Left Kidney Pelvis to Right Kidney Pelvis, Percutaneous Endoscopic Approach |
| 0T144Z4 | Bypass Left Kidney Pelvis to Left Kidney Pelvis, Percutaneous Endoscopic Approach |
| 0T144Z6 | Bypass Left Kidney Pelvis to Right Ureter, Percutaneous Endoscopic Approach |
| 0T144Z7 | Bypass Left Kidney Pelvis to Left Ureter, Percutaneous Endoscopic Approach |
| 0T144Z8 | Bypass Left Kidney Pelvis to Colon, Percutaneous Endoscopic Approach |
| 0T144Z9 | Bypass Left Kidney Pelvis to Colocutaneous, Percutaneous Endoscopic Approach |
| 0T144ZA | Bypass Left Kidney Pelvis to Ileum, Percutaneous Endoscopic Approach |
| 0T144ZB | Bypass Left Kidney Pelvis to Bladder, Percutaneous Endoscopic Approach |
| 0T144ZC | Bypass Left Kidney Pelvis to Ileocutaneous, Percutaneous Endoscopic Approach |
| 0T144ZD | Bypass Left Kidney Pelvis to Cutaneous, Percutaneous Endoscopic Approach |
| 0T16076 | Bypass Right Ureter to Right Ureter with Autologous Tissue Substitute, Open Approach |
| 0T16077 | Bypass Right Ureter to Left Ureter with Autologous Tissue Substitute, Open Approach |
| 0T16078 | Bypass Right Ureter to Colon with Autologous Tissue Substitute, Open Approach |
| 0T16079 | Bypass Right Ureter to Colocutaneous with Autologous Tissue Substitute, Open Approach |
| 0T1607A | Bypass Right Ureter to Ileum with Autologous Tissue Substitute, Open Approach |
| 0T1607B | Bypass Right Ureter to Bladder with Autologous Tissue Substitute, Open Approach |
| 0T1607C | Bypass Right Ureter to Ileocutaneous with Autologous Tissue Substitute, Open Approach |
| 0T1607D | Bypass Right Ureter to Cutaneous with Autologous Tissue Substitute, Open Approach |
| 0T160J6 | Bypass Right Ureter to Right Ureter with Synthetic Substitute, Open Approach |
| 0T160J7 | Bypass Right Ureter to Left Ureter with Synthetic Substitute, Open Approach |
| 0T160J8 | Bypass Right Ureter to Colon with Synthetic Substitute, Open Approach |
| 0T160J9 | Bypass Right Ureter to Colocutaneous with Synthetic Substitute, Open Approach |
| 0T160JA | Bypass Right Ureter to Ileum with Synthetic Substitute, Open Approach |
| 0T160JB | Bypass Right Ureter to Bladder with Synthetic Substitute, Open Approach |
| 0T160JC | Bypass Right Ureter to Ileocutaneous with Synthetic Substitute, Open Approach |
| 0T160JD | Bypass Right Ureter to Cutaneous with Synthetic Substitute, Open Approach |
| 0T160K6 | Bypass Right Ureter to Right Ureter with Nonautologous Tissue Substitute, Open Approach |
| 0T160K7 | Bypass Right Ureter to Left Ureter with Nonautologous Tissue Substitute, Open Approach |
| 0T160K8 | Bypass Right Ureter to Colon with Nonautologous Tissue Substitute, Open Approach |
| 0T160K9 | Bypass Right Ureter to Colocutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T160KA | Bypass Right Ureter to Ileum with Nonautologous Tissue Substitute, Open Approach |
| 0T160KB | Bypass Right Ureter to Bladder with Nonautologous Tissue Substitute, Open Approach |
| 0T160KC | Bypass Right Ureter to Ileocutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T160KD | Bypass Right Ureter to Cutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T160Z6 | Bypass Right Ureter to Right Ureter, Open Approach |
| 0T160Z7 | Bypass Right Ureter to Left Ureter, Open Approach |
| 0T160Z8 | Bypass Right Ureter to Colon, Open Approach |
| 0T160Z9 | Bypass Right Ureter to Colocutaneous, Open Approach |
| 0T160ZA | Bypass Right Ureter to Ileum, Open Approach |
| 0T160ZB | Bypass Right Ureter to Bladder, Open Approach |
| 0T160ZC | Bypass Right Ureter to Ileocutaneous, Open Approach |
| 0T160ZD | Bypass Right Ureter to Cutaneous, Open Approach |
| 0T163JD | Bypass Right Ureter to Cutaneous with Synthetic Substitute, Percutaneous Approach |
| 0T16476 | Bypass Right Ureter to Right Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T16477 | Bypass Right Ureter to Left Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T16478 | Bypass Right Ureter to Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T16479 | Bypass Right Ureter to Colocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1647A | Bypass Right Ureter to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1647B | Bypass Right Ureter to Bladder with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1647C | Bypass Right Ureter to Ileocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1647D | Bypass Right Ureter to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164J6 | Bypass Right Ureter to Right Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T164J7 | Bypass Right Ureter to Left Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T164J8 | Bypass Right Ureter to Colon with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T164J9 | Bypass Right Ureter to Colocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T164JA | Bypass Right Ureter to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T164JB | Bypass Right Ureter to Bladder with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T164JC | Bypass Right Ureter to Ileocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T164JD | Bypass Right Ureter to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0T164K6 | Bypass Right Ureter to Right Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164K7 | Bypass Right Ureter to Left Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164K8 | Bypass Right Ureter to Colon with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164K9 | Bypass Right Ureter to Colocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164KA | Bypass Right Ureter to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164KB | Bypass Right Ureter to Bladder with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164KC | Bypass Right Ureter to Ileocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164KD | Bypass Right Ureter to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T164Z6 | Bypass Right Ureter to Right Ureter, Percutaneous Endoscopic Approach |
| 0T164Z7 | Bypass Right Ureter to Left Ureter, Percutaneous Endoscopic Approach |
| 0T164Z8 | Bypass Right Ureter to Colon, Percutaneous Endoscopic Approach |
| 0T164Z9 | Bypass Right Ureter to Colocutaneous, Percutaneous Endoscopic Approach |
| 0T164ZA | Bypass Right Ureter to Ileum, Percutaneous Endoscopic Approach |
| 0T164ZB | Bypass Right Ureter to Bladder, Percutaneous Endoscopic Approach |
| 0T164ZC | Bypass Right Ureter to Ileocutaneous, Percutaneous Endoscopic Approach |
| 0T164ZD | Bypass Right Ureter to Cutaneous, Percutaneous Endoscopic Approach |
| 0T17076 | Bypass Left Ureter to Right Ureter with Autologous Tissue Substitute, Open Approach |
| 0T17077 | Bypass Left Ureter to Left Ureter with Autologous Tissue Substitute, Open Approach |
| 0T17078 | Bypass Left Ureter to Colon with Autologous Tissue Substitute, Open Approach |
| 0T17079 | Bypass Left Ureter to Colocutaneous with Autologous Tissue Substitute, Open Approach |
| 0T1707A | Bypass Left Ureter to Ileum with Autologous Tissue Substitute, Open Approach |
| 0T1707B | Bypass Left Ureter to Bladder with Autologous Tissue Substitute, Open Approach |
| 0T1707C | Bypass Left Ureter to Ileocutaneous with Autologous Tissue Substitute, Open Approach |
| 0T1707D | Bypass Left Ureter to Cutaneous with Autologous Tissue Substitute, Open Approach |
| 0T170J6 | Bypass Left Ureter to Right Ureter with Synthetic Substitute, Open Approach |
| 0T170J7 | Bypass Left Ureter to Left Ureter with Synthetic Substitute, Open Approach |
| 0T170J8 | Bypass Left Ureter to Colon with Synthetic Substitute, Open Approach |
| 0T170J9 | Bypass Left Ureter to Colocutaneous with Synthetic Substitute, Open Approach |
| 0T170JA | Bypass Left Ureter to Ileum with Synthetic Substitute, Open Approach |
| 0T170JB | Bypass Left Ureter to Bladder with Synthetic Substitute, Open Approach |
| 0T170JC | Bypass Left Ureter to Ileocutaneous with Synthetic Substitute, Open Approach |
| 0T170JD | Bypass Left Ureter to Cutaneous with Synthetic Substitute, Open Approach |
| 0T170K6 | Bypass Left Ureter to Right Ureter with Nonautologous Tissue Substitute, Open Approach |
| 0T170K7 | Bypass Left Ureter to Left Ureter with Nonautologous Tissue Substitute, Open Approach |
| 0T170K8 | Bypass Left Ureter to Colon with Nonautologous Tissue Substitute, Open Approach |
| 0T170K9 | Bypass Left Ureter to Colocutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T170KA | Bypass Left Ureter to Ileum with Nonautologous Tissue Substitute, Open Approach |
| 0T170KB | Bypass Left Ureter to Bladder with Nonautologous Tissue Substitute, Open Approach |
| 0T170KC | Bypass Left Ureter to Ileocutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T170KD | Bypass Left Ureter to Cutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0T170Z6 | Bypass Left Ureter to Right Ureter, Open Approach |
| 0T170Z7 | Bypass Left Ureter to Left Ureter, Open Approach |
| 0T170Z8 | Bypass Left Ureter to Colon, Open Approach |
| 0T170Z9 | Bypass Left Ureter to Colocutaneous, Open Approach |
| 0T170ZA | Bypass Left Ureter to Ileum, Open Approach |
| 0T170ZB | Bypass Left Ureter to Bladder, Open Approach |
| 0T170ZC | Bypass Left Ureter to Ileocutaneous, Open Approach |
| 0T170ZD | Bypass Left Ureter to Cutaneous, Open Approach |
| 0T173JD | Bypass Left Ureter to Cutaneous with Synthetic Substitute, Percutaneous Approach |
| 0T17476 | Bypass Left Ureter to Right Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T17477 | Bypass Left Ureter to Left Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T17478 | Bypass Left Ureter to Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T17479 | Bypass Left Ureter to Colocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1747A | Bypass Left Ureter to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1747B | Bypass Left Ureter to Bladder with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1747C | Bypass Left Ureter to Ileocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0T1747D | Bypass Left Ureter to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 01 Mar 2023 06:12:40 CMS, code-revision=344, description-revision=1357 |