ICD-10-CM/PCS MS-DRG v36.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v36.0 Definitions Manual |
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| MDC 03 Diseases & Disorders of the Ear, Nose, Mouth & Throat |
| Dental and Oral Diseases |
| Page 1 of 2 |
| MCC | CC | DRG |
|---|---|---|
| Yes | n/a | 157 |
| No | Yes | 158 |
| No | No | 159 |
DRG 157 DENTAL AND ORAL DISEASES WITH MCC
DRG 158 DENTAL AND ORAL DISEASES WITH CC
DRG 159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC
PRINCIPAL DIAGNOSIS
| A690 | Necrotizing ulcerative stomatitis |
| B002 | Herpesviral gingivostomatitis and pharyngotonsillitis |
| B370 | Candidal stomatitis |
| B3783 | Candidal cheilitis |
| D100 | Benign neoplasm of lip |
| D101 | Benign neoplasm of tongue |
| D102 | Benign neoplasm of floor of mouth |
| D1030 | Benign neoplasm of unspecified part of mouth |
| D1039 | Benign neoplasm of other parts of mouth |
| D165 | Benign neoplasm of lower jaw bone |
| K000 | Anodontia |
| K001 | Supernumerary teeth |
| K002 | Abnormalities of size and form of teeth |
| K003 | Mottled teeth |
| K004 | Disturbances in tooth formation |
| K005 | Hereditary disturbances in tooth structure, not elsewhere classified |
| K006 | Disturbances in tooth eruption |
| K007 | Teething syndrome |
| K008 | Other disorders of tooth development |
| K009 | Disorder of tooth development, unspecified |
| K010 | Embedded teeth |
| K011 | Impacted teeth |
| K023 | Arrested dental caries |
| K0251 | Dental caries on pit and fissure surface limited to enamel |
| K0252 | Dental caries on pit and fissure surface penetrating into dentin |
| K0253 | Dental caries on pit and fissure surface penetrating into pulp |
| K0261 | Dental caries on smooth surface limited to enamel |
| K0262 | Dental caries on smooth surface penetrating into dentin |
| K0263 | Dental caries on smooth surface penetrating into pulp |
| K027 | Dental root caries |
| K029 | Dental caries, unspecified |
| K030 | Excessive attrition of teeth |
| K031 | Abrasion of teeth |
| K032 | Erosion of teeth |
| K033 | Pathological resorption of teeth |
| K034 | Hypercementosis |
| K035 | Ankylosis of teeth |
| K036 | Deposits [accretions] on teeth |
| K037 | Posteruptive color changes of dental hard tissues |
| K0381 | Cracked tooth |
| K0389 | Other specified diseases of hard tissues of teeth |
| K039 | Disease of hard tissues of teeth, unspecified |
| K0401 | Reversible pulpitis |
| K0402 | Irreversible pulpitis |
| K041 | Necrosis of pulp |
| K042 | Pulp degeneration |
| K043 | Abnormal hard tissue formation in pulp |
| K044 | Acute apical periodontitis of pulpal origin |
| K045 | Chronic apical periodontitis |
| K046 | Periapical abscess with sinus |
| K047 | Periapical abscess without sinus |
| K048 | Radicular cyst |
| K0490 | Unspecified diseases of pulp and periapical tissues |
| K0499 | Other diseases of pulp and periapical tissues |
| K0500 | Acute gingivitis, plaque induced |
| K0501 | Acute gingivitis, non-plaque induced |
| K0510 | Chronic gingivitis, plaque induced |
| K0511 | Chronic gingivitis, non-plaque induced |
| K0520 | Aggressive periodontitis, unspecified |
| K05211 | Aggressive periodontitis, localized, slight |
| K05212 | Aggressive periodontitis, localized, moderate |
| K05213 | Aggressive periodontitis, localized, severe |
| K05219 | Aggressive periodontitis, localized, unspecified severity |
| K05221 | Aggressive periodontitis, generalized, slight |
| K05222 | Aggressive periodontitis, generalized, moderate |
| K05223 | Aggressive periodontitis, generalized, severe |
| K05229 | Aggressive periodontitis, generalized, unspecified severity |
| K0530 | Chronic periodontitis, unspecified |
| K05311 | Chronic periodontitis, localized, slight |
| K05312 | Chronic periodontitis, localized, moderate |
| K05313 | Chronic periodontitis, localized, severe |
| K05319 | Chronic periodontitis, localized, unspecified severity |
| K05321 | Chronic periodontitis, generalized, slight |
| K05322 | Chronic periodontitis, generalized, moderate |
| K05323 | Chronic periodontitis, generalized, severe |
| K05329 | Chronic periodontitis, generalized, unspecified severity |
| K054 | Periodontosis |
| K055 | Other periodontal diseases |
| K056 | Periodontal disease, unspecified |
| K06010 | Localized gingival recession, unspecified |
| K06011 | Localized gingival recession, minimal |
| K06012 | Localized gingival recession, moderate |
| K06013 | Localized gingival recession, severe |
| K06020 | Generalized gingival recession, unspecified |
| K06021 | Generalized gingival recession, minimal |
| K06022 | Generalized gingival recession, moderate |
| K06023 | Generalized gingival recession, severe |
| K061 | Gingival enlargement |
| K062 | Gingival and edentulous alveolar ridge lesions associated with trauma |
| K063 | Horizontal alveolar bone loss |
| K068 | Other specified disorders of gingiva and edentulous alveolar ridge |
| K069 | Disorder of gingiva and edentulous alveolar ridge, unspecified |
| K080 | Exfoliation of teeth due to systemic causes |
| K08101 | Complete loss of teeth, unspecified cause, class I |
| K08102 | Complete loss of teeth, unspecified cause, class II |
| K08103 | Complete loss of teeth, unspecified cause, class III |
| K08104 | Complete loss of teeth, unspecified cause, class IV |
| K08109 | Complete loss of teeth, unspecified cause, unspecified class |
| K08111 | Complete loss of teeth due to trauma, class I |
| K08112 | Complete loss of teeth due to trauma, class II |
| K08113 | Complete loss of teeth due to trauma, class III |
| K08114 | Complete loss of teeth due to trauma, class IV |
| K08119 | Complete loss of teeth due to trauma, unspecified class |
| K08121 | Complete loss of teeth due to periodontal diseases, class I |
| K08122 | Complete loss of teeth due to periodontal diseases, class II |
| K08123 | Complete loss of teeth due to periodontal diseases, class III |
| K08124 | Complete loss of teeth due to periodontal diseases, class IV |
| K08129 | Complete loss of teeth due to periodontal diseases, unspecified class |
| K08131 | Complete loss of teeth due to caries, class I |
| K08132 | Complete loss of teeth due to caries, class II |
| K08133 | Complete loss of teeth due to caries, class III |
| K08134 | Complete loss of teeth due to caries, class IV |
| K08139 | Complete loss of teeth due to caries, unspecified class |
| K08191 | Complete loss of teeth due to other specified cause, class I |
| K08192 | Complete loss of teeth due to other specified cause, class II |
| K08193 | Complete loss of teeth due to other specified cause, class III |
| K08194 | Complete loss of teeth due to other specified cause, class IV |
| K08199 | Complete loss of teeth due to other specified cause, unspecified class |
| K0820 | Unspecified atrophy of edentulous alveolar ridge |
| K0821 | Minimal atrophy of the mandible |
| K0822 | Moderate atrophy of the mandible |
| K0823 | Severe atrophy of the mandible |
| K0824 | Minimal atrophy of maxilla |
| K0825 | Moderate atrophy of the maxilla |
| K0826 | Severe atrophy of the maxilla |
| K083 | Retained dental root |
| K08401 | Partial loss of teeth, unspecified cause, class I |
| K08402 | Partial loss of teeth, unspecified cause, class II |
| K08403 | Partial loss of teeth, unspecified cause, class III |
| K08404 | Partial loss of teeth, unspecified cause, class IV |
| K08409 | Partial loss of teeth, unspecified cause, unspecified class |
| K08411 | Partial loss of teeth due to trauma, class I |
| K08412 | Partial loss of teeth due to trauma, class II |
| K08413 | Partial loss of teeth due to trauma, class III |
| K08414 | Partial loss of teeth due to trauma, class IV |
| K08419 | Partial loss of teeth due to trauma, unspecified class |
| K08421 | Partial loss of teeth due to periodontal diseases, class I |
| K08422 | Partial loss of teeth due to periodontal diseases, class II |
| K08423 | Partial loss of teeth due to periodontal diseases, class III |
| K08424 | Partial loss of teeth due to periodontal diseases, class IV |
| K08429 | Partial loss of teeth due to periodontal diseases, unspecified class |
| K08431 | Partial loss of teeth due to caries, class I |
| K08432 | Partial loss of teeth due to caries, class II |
| K08433 | Partial loss of teeth due to caries, class III |
| K08434 | Partial loss of teeth due to caries, class IV |
| K08439 | Partial loss of teeth due to caries, unspecified class |
| K08491 | Partial loss of teeth due to other specified cause, class I |
| K08492 | Partial loss of teeth due to other specified cause, class II |
| K08493 | Partial loss of teeth due to other specified cause, class III |
| K08494 | Partial loss of teeth due to other specified cause, class IV |
| K08499 | Partial loss of teeth due to other specified cause, unspecified class |
| K0850 | Unsatisfactory restoration of tooth, unspecified |
| K0851 | Open restoration margins of tooth |
| K0852 | Unrepairable overhanging of dental restorative materials |
| K08530 | Fractured dental restorative material without loss of material |
| K08531 | Fractured dental restorative material with loss of material |
| K08539 | Fractured dental restorative material, unspecified |
| K0854 | Contour of existing restoration of tooth biologically incompatible with oral health |
| K0855 | Allergy to existing dental restorative material |
| K0856 | Poor aesthetic of existing restoration of tooth |
| K0859 | Other unsatisfactory restoration of tooth |
| K0881 | Primary occlusal trauma |
| K0882 | Secondary occlusal trauma |
| K0889 | Other specified disorders of teeth and supporting structures |
| K089 | Disorder of teeth and supporting structures, unspecified |
| K090 | Developmental odontogenic cysts |
| K091 | Developmental (nonodontogenic) cysts of oral region |
| K098 | Other cysts of oral region, not elsewhere classified |
| K099 | Cyst of oral region, unspecified |
| K120 | Recurrent oral aphthae |
| K121 | Other forms of stomatitis |
| K122 | Cellulitis and abscess of mouth |
| K1230 | Oral mucositis (ulcerative), unspecified |
| K1231 | Oral mucositis (ulcerative) due to antineoplastic therapy |
| K1232 | Oral mucositis (ulcerative) due to other drugs |
| K1233 | Oral mucositis (ulcerative) due to radiation |
| K1239 | Other oral mucositis (ulcerative) |
| K130 | Diseases of lips |
| K131 | Cheek and lip biting |
| K1321 | Leukoplakia of oral mucosa, including tongue |
| K1322 | Minimal keratinized residual ridge mucosa |
| K1323 | Excessive keratinized residual ridge mucosa |
| K1324 | Leukokeratosis nicotina palati |
| K1329 | Other disturbances of oral epithelium, including tongue |
| K133 | Hairy leukoplakia |
| K134 | Granuloma and granuloma-like lesions of oral mucosa |
| K135 | Oral submucous fibrosis |
| K136 | Irritative hyperplasia of oral mucosa |
| K1370 | Unspecified lesions of oral mucosa |
| K1379 | Other lesions of oral mucosa |
| K140 | Glossitis |
| K141 | Geographic tongue |
| K142 | Median rhomboid glossitis |
| K143 | Hypertrophy of tongue papillae |
| K144 | Atrophy of tongue papillae |
| K145 | Plicated tongue |
| K146 | Glossodynia |
| K148 | Other diseases of tongue |
| K149 | Disease of tongue, unspecified |
| M2600 | Unspecified anomaly of jaw size |
| M2601 | Maxillary hyperplasia |
| M2602 | Maxillary hypoplasia |
| M2603 | Mandibular hyperplasia |
| M2604 | Mandibular hypoplasia |
| M2605 | Macrogenia |
| M2606 | Microgenia |
| M2607 | Excessive tuberosity of jaw |
| M2609 | Other specified anomalies of jaw size |
| M2610 | Unspecified anomaly of jaw-cranial base relationship |
| M2611 | Maxillary asymmetry |
| M2612 | Other jaw asymmetry |
| M2619 | Other specified anomalies of jaw-cranial base relationship |
| M2620 | Unspecified anomaly of dental arch relationship |
| M26211 | Malocclusion, Angle's class I |
| M26212 | Malocclusion, Angle's class II |
| M26213 | Malocclusion, Angle's class III |
| M26219 | Malocclusion, Angle's class, unspecified |
| M26220 | Open anterior occlusal relationship |
| M26221 | Open posterior occlusal relationship |
| M2623 | Excessive horizontal overlap |
| M2624 | Reverse articulation |
| M2625 | Anomalies of interarch distance |
| M2629 | Other anomalies of dental arch relationship |
| M2630 | Unspecified anomaly of tooth position of fully erupted tooth or teeth |
| M2631 | Crowding of fully erupted teeth |
| M2632 | Excessive spacing of fully erupted teeth |
| M2633 | Horizontal displacement of fully erupted tooth or teeth |
| M2634 | Vertical displacement of fully erupted tooth or teeth |
| M2635 | Rotation of fully erupted tooth or teeth |
| M2636 | Insufficient interocclusal distance of fully erupted teeth (ridge) |
| M2637 | Excessive interocclusal distance of fully erupted teeth |
| M2639 | Other anomalies of tooth position of fully erupted tooth or teeth |
| M264 | Malocclusion, unspecified |
| M2650 | Dentofacial functional abnormalities, unspecified |
| M2651 | Abnormal jaw closure |
| M2652 | Limited mandibular range of motion |
| M2653 | Deviation in opening and closing of the mandible |
| M2654 | Insufficient anterior guidance |
| M2655 | Centric occlusion maximum intercuspation discrepancy |
| M2656 | Non-working side interference |
| M2657 | Lack of posterior occlusal support |
| M2659 | Other dentofacial functional abnormalities |
| M26601 | Right temporomandibular joint disorder, unspecified |
| M26602 | Left temporomandibular joint disorder, unspecified |
| M26603 | Bilateral temporomandibular joint disorder, unspecified |
| M26609 | Unspecified temporomandibular joint disorder, unspecified side |
| M26611 | Adhesions and ankylosis of right temporomandibular joint |
| M26612 | Adhesions and ankylosis of left temporomandibular joint |
| M26613 | Adhesions and ankylosis of bilateral temporomandibular joint |
| M26619 | Adhesions and ankylosis of temporomandibular joint, unspecified side |
| M26621 | Arthralgia of right temporomandibular joint |
| M26622 | Arthralgia of left temporomandibular joint |
| M26623 | Arthralgia of bilateral temporomandibular joint |
| M26629 | Arthralgia of temporomandibular joint, unspecified side |
| M26631 | Articular disc disorder of right temporomandibular joint |
| M26632 | Articular disc disorder of left temporomandibular joint |
| M26633 | Articular disc disorder of bilateral temporomandibular joint |
| M26639 | Articular disc disorder of temporomandibular joint, unspecified side |
| M2669 | Other specified disorders of temporomandibular joint |
| M2670 | Unspecified alveolar anomaly |
| M2671 | Alveolar maxillary hyperplasia |
| M2672 | Alveolar mandibular hyperplasia |
| M2673 | Alveolar maxillary hypoplasia |
| M2674 | Alveolar mandibular hypoplasia |
| M2679 | Other specified alveolar anomalies |
| M2681 | Anterior soft tissue impingement |
| M2682 | Posterior soft tissue impingement |
| M2689 | Other dentofacial anomalies |
| M269 | Dentofacial anomaly, unspecified |
| M270 | Developmental disorders of jaws |
| M271 | Giant cell granuloma, central |
| M272 | Inflammatory conditions of jaws |
| M273 | Alveolitis of jaws |
| M2740 | Unspecified cyst of jaw |
| M2749 | Other cysts of jaw |
| M2751 | Perforation of root canal space due to endodontic treatment |
| M2752 | Endodontic overfill |
| M2753 | Endodontic underfill |
| M2759 | Other periradicular pathology associated with previous endodontic treatment |
| M2761 | Osseointegration failure of dental implant |
| M2762 | Post-osseointegration biological failure of dental implant |
| M2763 | Post-osseointegration mechanical failure of dental implant |
| M2769 | Other endosseous dental implant failure |
| M278 | Other specified diseases of jaws |
| M279 | Disease of jaws, unspecified |
| Q184 | Macrostomia |
| Q185 | Microstomia |
| Q186 | Macrocheilia |
| Q187 | Microcheilia |
| Q351 | Cleft hard palate |
| Q353 | Cleft soft palate |
| Q355 | Cleft hard palate with cleft soft palate |
| Q357 | Cleft uvula |
| Q359 | Cleft palate, unspecified |
| Q360 | Cleft lip, bilateral |
| Q361 | Cleft lip, median |
| Q369 | Cleft lip, unilateral |
| Q370 | Cleft hard palate with bilateral cleft lip |
| Q371 | Cleft hard palate with unilateral cleft lip |
| Q372 | Cleft soft palate with bilateral cleft lip |
| Q373 | Cleft soft palate with unilateral cleft lip |
| Q374 | Cleft hard and soft palate with bilateral cleft lip |
| Q375 | Cleft hard and soft palate with unilateral cleft lip |
| Q378 | Unspecified cleft palate with bilateral cleft lip |
| Q379 | Unspecified cleft palate with unilateral cleft lip |
| Q380 | Congenital malformations of lips, not elsewhere classified |
| Q381 | Ankyloglossia |
| Q382 | Macroglossia |
| Q383 | Other congenital malformations of tongue |
| Q386 | Other congenital malformations of mouth |
| R6884 | Jaw pain |
| S01501A | Unspecified open wound of lip, initial encounter |
| S01502A | Unspecified open wound of oral cavity, initial encounter |
| S01511A | Laceration without foreign body of lip, initial encounter |
| S01512A | Laceration without foreign body of oral cavity, initial encounter |
| S01521A | Laceration with foreign body of lip, initial encounter |
| S01522A | Laceration with foreign body of oral cavity, initial encounter |
| S01531A | Puncture wound without foreign body of lip, initial encounter |
| S01532A | Puncture wound without foreign body of oral cavity, initial encounter |
| S01541A | Puncture wound with foreign body of lip, initial encounter |
| S01542A | Puncture wound with foreign body of oral cavity, initial encounter |
| S01551A | Open bite of lip, initial encounter |
| S01552A | Open bite of oral cavity, initial encounter |
| S02400A | Malar fracture, unspecified side, initial encounter for closed fracture |
| S02400B | Malar fracture, unspecified side, initial encounter for open fracture |
| S02401A | Maxillary fracture, unspecified side, initial encounter for closed fracture |
| S02401B | Maxillary fracture, unspecified side, initial encounter for open fracture |
| S02402A | Zygomatic fracture, unspecified side, initial encounter for closed fracture |
| S02402B | Zygomatic fracture, unspecified side, initial encounter for open fracture |
| S0240AA | Malar fracture, right side, initial encounter for closed fracture |
| S0240AB | Malar fracture, right side, initial encounter for open fracture |
| S0240BA | Malar fracture, left side, initial encounter for closed fracture |
| S0240BB | Malar fracture, left side, initial encounter for open fracture |
| S0240CA | Maxillary fracture, right side, initial encounter for closed fracture |
| S0240CB | Maxillary fracture, right side, initial encounter for open fracture |
| S0240DA | Maxillary fracture, left side, initial encounter for closed fracture |
| S0240DB | Maxillary fracture, left side, initial encounter for open fracture |
| S0240EA | Zygomatic fracture, right side, initial encounter for closed fracture |
| S0240EB | Zygomatic fracture, right side, initial encounter for open fracture |
| S0240FA | Zygomatic fracture, left side, initial encounter for closed fracture |
| S0240FB | Zygomatic fracture, left side, initial encounter for open fracture |
| S02411A | LeFort I fracture, initial encounter for closed fracture |
| S02411B | LeFort I fracture, initial encounter for open fracture |
| S02412A | LeFort II fracture, initial encounter for closed fracture |
| S02412B | LeFort II fracture, initial encounter for open fracture |
| S02413A | LeFort III fracture, initial encounter for closed fracture |
| S02413B | LeFort III fracture, initial encounter for open fracture |
| S025XXA | Fracture of tooth (traumatic), initial encounter for closed fracture |
| S025XXB | Fracture of tooth (traumatic), initial encounter for open fracture |
| S02600A | Fracture of unspecified part of body of mandible, unspecified side, initial encounter for closed fracture |
| S02600B | Fracture of unspecified part of body of mandible, unspecified side, initial encounter for open fracture |
| S02601A | Fracture of unspecified part of body of right mandible, initial encounter for closed fracture |
| S02601B | Fracture of unspecified part of body of right mandible, initial encounter for open fracture |
| S02602A | Fracture of unspecified part of body of left mandible, initial encounter for closed fracture |
| S02602B | Fracture of unspecified part of body of left mandible, initial encounter for open fracture |
| S02609A | Fracture of mandible, unspecified, initial encounter for closed fracture |
| S02609B | Fracture of mandible, unspecified, initial encounter for open fracture |
| S02610A | Fracture of condylar process of mandible, unspecified side, initial encounter for closed fracture |
| S02610B | Fracture of condylar process of mandible, unspecified side, initial encounter for open fracture |
| S02611A | Fracture of condylar process of right mandible, initial encounter for closed fracture |
| S02611B | Fracture of condylar process of right mandible, initial encounter for open fracture |
| S02612A | Fracture of condylar process of left mandible, initial encounter for closed fracture |
| S02612B | Fracture of condylar process of left mandible, initial encounter for open fracture |
| S02620A | Fracture of subcondylar process of mandible, unspecified side, initial encounter for closed fracture |
| S02620B | Fracture of subcondylar process of mandible, unspecified side, initial encounter for open fracture |
| S02621A | Fracture of subcondylar process of right mandible, initial encounter for closed fracture |
| S02621B | Fracture of subcondylar process of right mandible, initial encounter for open fracture |
| S02622A | Fracture of subcondylar process of left mandible, initial encounter for closed fracture |
| S02622B | Fracture of subcondylar process of left mandible, initial encounter for open fracture |
| S02630A | Fracture of coronoid process of mandible, unspecified side, initial encounter for closed fracture |
| S02630B | Fracture of coronoid process of mandible, unspecified side, initial encounter for open fracture |
| S02631A | Fracture of coronoid process of right mandible, initial encounter for closed fracture |
| S02631B | Fracture of coronoid process of right mandible, initial encounter for open fracture |
| S02632A | Fracture of coronoid process of left mandible, initial encounter for closed fracture |
| S02632B | Fracture of coronoid process of left mandible, initial encounter for open fracture |
| S02640A | Fracture of ramus of mandible, unspecified side, initial encounter for closed fracture |
| S02640B | Fracture of ramus of mandible, unspecified side, initial encounter for open fracture |
| S02641A | Fracture of ramus of right mandible, initial encounter for closed fracture |
| S02641B | Fracture of ramus of right mandible, initial encounter for open fracture |
| S02642A | Fracture of ramus of left mandible, initial encounter for closed fracture |
| S02642B | Fracture of ramus of left mandible, initial encounter for open fracture |
| S02650A | Fracture of angle of mandible, unspecified side, initial encounter for closed fracture |
| S02650B | Fracture of angle of mandible, unspecified side, initial encounter for open fracture |
| S02651A | Fracture of angle of right mandible, initial encounter for closed fracture |
| S02651B | Fracture of angle of right mandible, initial encounter for open fracture |
| S02652A | Fracture of angle of left mandible, initial encounter for closed fracture |
| S02652B | Fracture of angle of left mandible, initial encounter for open fracture |
| S0266XA | Fracture of symphysis of mandible, initial encounter for closed fracture |
| S0266XB | Fracture of symphysis of mandible, initial encounter for open fracture |
| S02670A | Fracture of alveolus of mandible, unspecified side, initial encounter for closed fracture |
| S02670B | Fracture of alveolus of mandible, unspecified side, initial encounter for open fracture |
| S02671A | Fracture of alveolus of right mandible, initial encounter for closed fracture |
| S02671B | Fracture of alveolus of right mandible, initial encounter for open fracture |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 04 Oct 2018 16:21:08 CMS, code-revision=145, description-revision=1114 |