ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual

Procedure Cluster/MS-DRG Index

Page 2 of 30

01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

CODE COMBINATION	MDC	MS-DRG	SURGICAL CATEGORY
02H73KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH608Z

02H74KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH608Z

02HK0KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH608Z

02HK3KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH608Z

02HK4KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH608Z

02HL0KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH608Z

02HL3KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH608Z

02HL4KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH608Z

02H60KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02H63KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02H64KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02H70KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02H73KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02H74KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02HK0KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02HK3KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02HK4KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02HL0KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02HL3KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02HL4KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH638Z

02H60KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02H63KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02H64KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02H70KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02H73KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02H74KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02HK0KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02HK3KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02HK4KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02HL0KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02HL3KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02HL4KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH808Z

02H60KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02H63KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02H64KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02H70KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02H73KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02H74KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02HK0KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02HK3KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02HK4KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02HL0KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02HL3KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

02HL4KZ	05	275-277	Cardiac Defibrillator Implant or Carotid Sinus Neurostimulator
and 0JH838Z

0DQ80ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQ90ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQA0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQB0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQE0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQF0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQG0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQH0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQK0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQL0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQM0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DQN0ZZ	06	344-346	Minor Small and Large Bowel Procedures
and 0WQFXZ2

0DT90ZZ	06	326-328	Stomach, Esophageal and Duodenal Procedures
and 0FTG0ZZ

0VT00ZZ	11	665-667	Prostatectomy
and 0VT30ZZ	12	707-708	Major Male Pelvic Procedures

0VT00ZZ	11	665-667	Prostatectomy
and 0VT34ZZ	12	707-708	Major Male Pelvic Procedures

0VT04ZZ	11	665-667	Prostatectomy
and 0VT30ZZ	12	707-708	Major Male Pelvic Procedures

0VT04ZZ	11	665-667	Prostatectomy
and 0VT34ZZ	12	707-708	Major Male Pelvic Procedures

0VT07ZZ	11	665-667	Prostatectomy
and 0VT30ZZ	12	707-708	Major Male Pelvic Procedures

0VT07ZZ	11	665-667	Prostatectomy
and 0VT34ZZ	12	707-708	Major Male Pelvic Procedures

0VT08ZZ	11	665-667	Prostatectomy
and 0VT30ZZ	12	707-708	Major Male Pelvic Procedures

0VT08ZZ	11	665-667	Prostatectomy
and 0VT34ZZ	12	707-708	Major Male Pelvic Procedures

0UT44ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT94ZZ
and 0UTC4ZZ

0UT40ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT90ZZ
and 0UTC0ZZ

0UT44ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT9FZZ
and 0UTC4ZZ

0UT47ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT97ZZ
and 0UTC7ZZ

0UT47ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT97ZZ
and 0UTC8ZZ

0UT48ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT97ZZ
and 0UTC7ZZ

0UT48ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT97ZZ
and 0UTC8ZZ

0UT47ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT98ZZ
and 0UTC7ZZ

0UT47ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT98ZZ
and 0UTC8ZZ

0UT48ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT98ZZ
and 0UTC7ZZ

0UT48ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UT98ZZ
and 0UTC8ZZ

0TTB0ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0TTD0ZZ
and 0UT20ZZ
and 0UT70ZZ
and 0UT90ZZ
and 0UTC0ZZ
and 0UTG0ZZ

07BH0ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UTM0ZZ

07BH4ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UTM0ZZ

07BJ0ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UTM0ZZ

07BJ4ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UTM0ZZ

07BH0ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UTMXZZ

07BH4ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UTMXZZ

07BJ0ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UTMXZZ

07BJ4ZZ	13	734-735	Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy
and 0UTMXZZ

0PS33ZZ	08	515-517	Other Musculoskeletal System and Connective Tissue O.R. Procedures
and 0PU33JZ

0PS43ZZ	08	515-517	Other Musculoskeletal System and Connective Tissue O.R. Procedures
and 0PU43JZ

0QS03ZZ	08	515-517	Other Musculoskeletal System and Connective Tissue O.R. Procedures
and 0QU03JZ

0QS13ZZ	08	515-517	Other Musculoskeletal System and Connective Tissue O.R. Procedures
and 0QU13JZ

0QSS3ZZ	08	515-517	Other Musculoskeletal System and Connective Tissue O.R. Procedures
and 0QUS3JZ

07T50ZZ	09	582-583	Mastectomy for Malignancy
and 0HTT0ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures

07T60ZZ	09	582-583	Mastectomy for Malignancy
and 0HTU0ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures

07T50ZZ	09	582-583	Mastectomy for Malignancy
and 07T60ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0HTV0ZZ

07T50ZZ	09	582-583	Mastectomy for Malignancy
and 0HTT0ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0KTH0ZZ

07T60ZZ	09	582-583	Mastectomy for Malignancy
and 0HTU0ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0KTJ0ZZ

07T50ZZ	09	582-583	Mastectomy for Malignancy
and 07T60ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0HTV0ZZ
and 0KTH0ZZ
and 0KTJ0ZZ

07T50ZZ	09	582-583	Mastectomy for Malignancy
and 07T70ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 07T80ZZ
and 0HTT0ZZ
and 0KTH0ZZ

07T60ZZ	09	582-583	Mastectomy for Malignancy
and 07T70ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 07T90ZZ
and 0HTU0ZZ
and 0KTJ0ZZ

07T50ZZ	09	582-583	Mastectomy for Malignancy
and 07T60ZZ	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 07T70ZZ
and 07T80ZZ
and 07T90ZZ
and 0HTV0ZZ
and 0KTH0ZZ
and 0KTJ0ZZ

0HRT37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD63ZZ

0HRT37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD73ZZ

0HRT37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD83ZZ

0HRT37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD93ZZ

0HRT37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JDL3ZZ

0HRT37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JDM3ZZ

0HRU37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD63ZZ

0HRU37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD73ZZ

0HRU37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD83ZZ

0HRU37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD93ZZ

0HRU37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JDL3ZZ

0HRU37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JDM3ZZ

0HRV37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD63ZZ

0HRV37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD73ZZ

0HRV37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD83ZZ

0HRV37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JD93ZZ

0HRV37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JDL3ZZ

0HRV37Z	09	584-585	Breast Biopsy, Local Excision and Other Breast Procedures
and 0JDM3ZZ

0TQB0ZZ	11	662-664	Minor Bladder Procedures
and 0WQFXZ2

0TQB0ZZ	11	662-664	Minor Bladder Procedures
and 0WQFXZZ

0TQB3ZZ	11	662-664	Minor Bladder Procedures
and 0WQFXZ2

0TQB3ZZ	11	662-664	Minor Bladder Procedures
and 0WQFXZZ

0TQB4ZZ	11	662-664	Minor Bladder Procedures
and 0WQFXZ2

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