ICD-10-CM/PCS MS-DRG v38.0 Definitions Manual

Procedure Cluster/MS-DRG Index

Page 2 of 28

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

CODE COMBINATION	MDC	MS-DRG	SURGICAL CATEGORY
02H74KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH608Z

02HK0KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH608Z

02HK3KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH608Z

02HK4KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH608Z

02HL0KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH608Z

02HL3KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH608Z

02HL4KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH608Z

02H60KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02H63KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02H64KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02H70KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02H73KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02H74KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02HK0KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02HK3KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02HK4KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02HL0KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02HL3KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02HL4KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH638Z

02H60KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02H63KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02H64KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02H70KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02H73KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02H74KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02HK0KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02HK3KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02HK4KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02HL0KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02HL3KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02HL4KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH808Z

02H60KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02H63KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02H64KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02H70KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02H73KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02H74KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02HK0KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02HK3KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02HK4KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02HL0KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02HL3KZ	05	222-227	Cardiac Defibrillator Implant
and 0JH838Z

02HL4KZ	05	222-227	Cardiac Defibrillator Implant
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

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

One of	08	456-458	Spinal Fusion Except Cervical with Spinal Curvature / Malignancy / Infection or Extensive Fusions
0RG7070
0RG70A0
0RG70J0
0RG70K0
0RG7370
0RG73A0
0RG73J0
0RG73K0
0RG7470
0RG74A0
0RG74J0
0RG74K0
XRG70F3
with one of
0SG1070
0SG10A0
0SG10J0
0SG10K0
0SG1370
0SG13A0
0SG13J0
0SG13K0
0SG1470
0SG14A0
0SG14J0
0SG14K0
XRGC0F3

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14 Apr 2020 14:43:32
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