ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual

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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 COMBINATIONMDCMS-DRGSURGICAL CATEGORY
02H74KZ05222-227Cardiac defibrillator implant
and 0JH608Z   
    
02HK0KZ05222-227Cardiac defibrillator implant
and 0JH608Z   
    
02HK3KZ05222-227Cardiac defibrillator implant
and 0JH608Z   
    
02HK4KZ05222-227Cardiac defibrillator implant
and 0JH608Z   
    
02HL0KZ05222-227Cardiac defibrillator implant
and 0JH608Z   
    
02HL3KZ05222-227Cardiac defibrillator implant
and 0JH608Z   
    
02HL4KZ05222-227Cardiac defibrillator implant
and 0JH608Z   
    
02H60KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02H63KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02H64KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02H70KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02H73KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02H74KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02HK0KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02HK3KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02HK4KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02HL0KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02HL3KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02HL4KZ05222-227Cardiac defibrillator implant
and 0JH638Z   
    
02H60KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02H63KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02H64KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02H70KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02H73KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02H74KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02HK0KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02HK3KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02HK4KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02HL0KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02HL3KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02HL4KZ05222-227Cardiac defibrillator implant
and 0JH808Z   
    
02H60KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02H63KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02H64KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02H70KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02H73KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02H74KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02HK0KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02HK3KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02HK4KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02HL0KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02HL3KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
02HL4KZ05222-227Cardiac defibrillator implant
and 0JH838Z   
    
0DQ80ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQ90ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQA0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQB0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQE0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQF0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQG0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQH0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQK0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQL0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQM0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DQN0ZZ06344-346Minor small and large bowel procedures
and 0WQFXZ2   
    
0DT90ZZ06326-328Stomach, esophageal and duodenal procedures
and 0FTG0ZZ   
    
0VT00ZZ11665-667Prostatectomy
and 0VT30ZZ12707-708Major male pelvic procedures
    
0VT00ZZ11665-667Prostatectomy
and 0VT34ZZ12707-708Major male pelvic procedures
    
0VT04ZZ11665-667Prostatectomy
and 0VT30ZZ12707-708Major male pelvic procedures
    
0VT04ZZ11665-667Prostatectomy
and 0VT34ZZ12707-708Major male pelvic procedures
    
0VT07ZZ11665-667Prostatectomy
and 0VT30ZZ12707-708Major male pelvic procedures
    
0VT07ZZ11665-667Prostatectomy
and 0VT34ZZ12707-708Major male pelvic procedures
    
0VT08ZZ11665-667Prostatectomy
and 0VT30ZZ12707-708Major male pelvic procedures
    
0VT08ZZ11665-667Prostatectomy
and 0VT34ZZ12707-708Major male pelvic procedures
    
0UT44ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT94ZZ   
and 0UTC4ZZ   
    
0UT40ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT90ZZ   
and 0UTC0ZZ   
    
0UT44ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT9FZZ   
and 0UTC4ZZ   
    
0UT47ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT97ZZ   
and 0UTC7ZZ   
    
0UT47ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT97ZZ   
and 0UTC8ZZ   
    
0UT48ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT97ZZ   
and 0UTC7ZZ   
    
0UT48ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT97ZZ   
and 0UTC8ZZ   
    
0UT47ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT98ZZ   
and 0UTC7ZZ   
    
0UT47ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT98ZZ   
and 0UTC8ZZ   
    
0UT48ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT98ZZ   
and 0UTC7ZZ   
    
0UT48ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UT98ZZ   
and 0UTC8ZZ   
    
0TTB0ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0TTD0ZZ   
and 0UT20ZZ   
and 0UT70ZZ   
and 0UT90ZZ   
and 0UTC0ZZ   
and 0UTG0ZZ   
    
07BH0ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UTM0ZZ   
    
07BH4ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UTM0ZZ   
    
07BJ0ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UTM0ZZ   
    
07BJ4ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UTM0ZZ   
    
07BH0ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UTMXZZ   
    
07BH4ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UTMXZZ   
    
07BJ0ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UTMXZZ   
    
07BJ4ZZ13734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
and 0UTMXZZ   
    
0PS33ZZ08515-517Other musculoskeletal system and connective tissue O.R. procedures
and 0PU33JZ   
    
0PS43ZZ08515-517Other musculoskeletal system and connective tissue O.R. procedures
and 0PU43JZ   
    
0QS03ZZ08515-517Other musculoskeletal system and connective tissue O.R. procedures
and 0QU03JZ   
    
0QS13ZZ08515-517Other musculoskeletal system and connective tissue O.R. procedures
and 0QU13JZ   
    
0QSS3ZZ08515-517Other musculoskeletal system and connective tissue O.R. procedures
and 0QUS3JZ   
    
07T50ZZ09582-583Mastectomy for malignancy
and 0HTT0ZZ09584-585Breast biopsy, local excision and other breast procedures
    
07T60ZZ09582-583Mastectomy for malignancy
and 0HTU0ZZ09584-585Breast biopsy, local excision and other breast procedures
    
07T50ZZ09582-583Mastectomy for malignancy
and 07T60ZZ09584-585Breast biopsy, local excision and other breast procedures
and 0HTV0ZZ   
    
07T50ZZ09582-583Mastectomy for malignancy
and 0HTT0ZZ09584-585Breast biopsy, local excision and other breast procedures
and 0KTH0ZZ   
    
07T60ZZ09582-583Mastectomy for malignancy
and 0HTU0ZZ09584-585Breast biopsy, local excision and other breast procedures
and 0KTJ0ZZ   
    
07T50ZZ09582-583Mastectomy for malignancy
and 07T60ZZ09584-585Breast biopsy, local excision and other breast procedures
and 0HTV0ZZ   
and 0KTH0ZZ   
and 0KTJ0ZZ   
    
07T50ZZ09582-583Mastectomy for malignancy
and 07T70ZZ09584-585Breast biopsy, local excision and other breast procedures
and 07T80ZZ   
and 0HTT0ZZ   
and 0KTH0ZZ   
    
07T60ZZ09582-583Mastectomy for malignancy
and 07T70ZZ09584-585Breast biopsy, local excision and other breast procedures
and 07T90ZZ   
and 0HTU0ZZ   
and 0KTJ0ZZ   
    
07T50ZZ09582-583Mastectomy for malignancy
and 07T60ZZ09584-585Breast biopsy, local excision and other breast procedures
and 07T70ZZ   
and 07T80ZZ   
and 07T90ZZ   
and 0HTV0ZZ   
and 0KTH0ZZ   
and 0KTJ0ZZ   
    
0HRT37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD63ZZ   
    
0HRT37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD73ZZ   
    
0HRT37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD83ZZ   
    
0HRT37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD93ZZ   
    
0HRT37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JDL3ZZ   
    
0HRT37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JDM3ZZ   
    
0HRU37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD63ZZ   
    
0HRU37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD73ZZ   
    
0HRU37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD83ZZ   
    
0HRU37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD93ZZ   
    
0HRU37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JDL3ZZ   
    
0HRU37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JDM3ZZ   
    
0HRV37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD63ZZ   
    
0HRV37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD73ZZ   
    
0HRV37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD83ZZ   
    
0HRV37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JD93ZZ   
    
0HRV37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JDL3ZZ   
    
0HRV37Z09584-585Breast biopsy, local excision and other breast procedures
and 0JDM3ZZ   
    
0TQB0ZZ11662-664Minor bladder procedures
and 0WQFXZ2   
    
0TQB0ZZ11662-664Minor bladder procedures
and 0WQFXZZ   
    
0TQB3ZZ11662-664Minor bladder procedures
and 0WQFXZ2   
    
0TQB3ZZ11662-664Minor bladder procedures
and 0WQFXZZ   
    
0TQB4ZZ11662-664Minor bladder procedures
and 0WQFXZ2   
    
0TQB4ZZ11662-664Minor bladder procedures
and 0WQFXZZ   
    
One of08456-458Spinal 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   
    



Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244
08 Mar 2021 20:13:49
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