ICD-10-CM/PCS MS-DRG v39.1 Definitions Manual
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MDC 05 Diseases and disorders of the circulatory system
Upper limb and toe amputation for circulatory system disorders
MCC CC DRG
Yes n/a 255
No Yes 256
No No 257

DRG 255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC

DRG 256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC

DRG 257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC

OPERATING ROOM PROCEDURES

0X600ZZDetachment at Right Forequarter, Open Approach
0X610ZZDetachment at Left Forequarter, Open Approach
0X620ZZDetachment at Right Shoulder Region, Open Approach
0X630ZZDetachment at Left Shoulder Region, Open Approach
0X680Z1Detachment at Right Upper Arm, High, Open Approach
0X680Z2Detachment at Right Upper Arm, Mid, Open Approach
0X680Z3Detachment at Right Upper Arm, Low, Open Approach
0X690Z1Detachment at Left Upper Arm, High, Open Approach
0X690Z2Detachment at Left Upper Arm, Mid, Open Approach
0X690Z3Detachment at Left Upper Arm, Low, Open Approach
0X6B0ZZDetachment at Right Elbow Region, Open Approach
0X6C0ZZDetachment at Left Elbow Region, Open Approach
0X6D0Z1Detachment at Right Lower Arm, High, Open Approach
0X6D0Z2Detachment at Right Lower Arm, Mid, Open Approach
0X6D0Z3Detachment at Right Lower Arm, Low, Open Approach
0X6F0Z1Detachment at Left Lower Arm, High, Open Approach
0X6F0Z2Detachment at Left Lower Arm, Mid, Open Approach
0X6F0Z3Detachment at Left Lower Arm, Low, Open Approach
0X6J0Z0Detachment at Right Hand, Complete, Open Approach
0X6J0Z4Detachment at Right Hand, Complete 1st Ray, Open Approach
0X6J0Z5Detachment at Right Hand, Complete 2nd Ray, Open Approach
0X6J0Z6Detachment at Right Hand, Complete 3rd Ray, Open Approach
0X6J0Z7Detachment at Right Hand, Complete 4th Ray, Open Approach
0X6J0Z8Detachment at Right Hand, Complete 5th Ray, Open Approach
0X6J0Z9Detachment at Right Hand, Partial 1st Ray, Open Approach
0X6J0ZBDetachment at Right Hand, Partial 2nd Ray, Open Approach
0X6J0ZCDetachment at Right Hand, Partial 3rd Ray, Open Approach
0X6J0ZDDetachment at Right Hand, Partial 4th Ray, Open Approach
0X6J0ZFDetachment at Right Hand, Partial 5th Ray, Open Approach
0X6K0Z0Detachment at Left Hand, Complete, Open Approach
0X6K0Z4Detachment at Left Hand, Complete 1st Ray, Open Approach
0X6K0Z5Detachment at Left Hand, Complete 2nd Ray, Open Approach
0X6K0Z6Detachment at Left Hand, Complete 3rd Ray, Open Approach
0X6K0Z7Detachment at Left Hand, Complete 4th Ray, Open Approach
0X6K0Z8Detachment at Left Hand, Complete 5th Ray, Open Approach
0X6K0Z9Detachment at Left Hand, Partial 1st Ray, Open Approach
0X6K0ZBDetachment at Left Hand, Partial 2nd Ray, Open Approach
0X6K0ZCDetachment at Left Hand, Partial 3rd Ray, Open Approach
0X6K0ZDDetachment at Left Hand, Partial 4th Ray, Open Approach
0X6K0ZFDetachment at Left Hand, Partial 5th Ray, Open Approach
0X6L0Z0Detachment at Right Thumb, Complete, Open Approach
0X6L0Z1Detachment at Right Thumb, High, Open Approach
0X6L0Z2Detachment at Right Thumb, Mid, Open Approach
0X6L0Z3Detachment at Right Thumb, Low, Open Approach
0X6M0Z0Detachment at Left Thumb, Complete, Open Approach
0X6M0Z1Detachment at Left Thumb, High, Open Approach
0X6M0Z2Detachment at Left Thumb, Mid, Open Approach
0X6M0Z3Detachment at Left Thumb, Low, Open Approach
0X6N0Z0Detachment at Right Index Finger, Complete, Open Approach
0X6N0Z1Detachment at Right Index Finger, High, Open Approach
0X6N0Z2Detachment at Right Index Finger, Mid, Open Approach
0X6N0Z3Detachment at Right Index Finger, Low, Open Approach
0X6P0Z0Detachment at Left Index Finger, Complete, Open Approach
0X6P0Z1Detachment at Left Index Finger, High, Open Approach
0X6P0Z2Detachment at Left Index Finger, Mid, Open Approach
0X6P0Z3Detachment at Left Index Finger, Low, Open Approach
0X6Q0Z0Detachment at Right Middle Finger, Complete, Open Approach
0X6Q0Z1Detachment at Right Middle Finger, High, Open Approach
0X6Q0Z2Detachment at Right Middle Finger, Mid, Open Approach
0X6Q0Z3Detachment at Right Middle Finger, Low, Open Approach
0X6R0Z0Detachment at Left Middle Finger, Complete, Open Approach
0X6R0Z1Detachment at Left Middle Finger, High, Open Approach
0X6R0Z2Detachment at Left Middle Finger, Mid, Open Approach
0X6R0Z3Detachment at Left Middle Finger, Low, Open Approach
0X6S0Z0Detachment at Right Ring Finger, Complete, Open Approach
0X6S0Z1Detachment at Right Ring Finger, High, Open Approach
0X6S0Z2Detachment at Right Ring Finger, Mid, Open Approach
0X6S0Z3Detachment at Right Ring Finger, Low, Open Approach
0X6T0Z0Detachment at Left Ring Finger, Complete, Open Approach
0X6T0Z1Detachment at Left Ring Finger, High, Open Approach
0X6T0Z2Detachment at Left Ring Finger, Mid, Open Approach
0X6T0Z3Detachment at Left Ring Finger, Low, Open Approach
0X6V0Z0Detachment at Right Little Finger, Complete, Open Approach
0X6V0Z1Detachment at Right Little Finger, High, Open Approach
0X6V0Z2Detachment at Right Little Finger, Mid, Open Approach
0X6V0Z3Detachment at Right Little Finger, Low, Open Approach
0X6W0Z0Detachment at Left Little Finger, Complete, Open Approach
0X6W0Z1Detachment at Left Little Finger, High, Open Approach
0X6W0Z2Detachment at Left Little Finger, Mid, Open Approach
0X6W0Z3Detachment at Left Little Finger, Low, Open Approach
0Y6P0Z0Detachment at Right 1st Toe, Complete, Open Approach
0Y6P0Z1Detachment at Right 1st Toe, High, Open Approach
0Y6P0Z2Detachment at Right 1st Toe, Mid, Open Approach
0Y6P0Z3Detachment at Right 1st Toe, Low, Open Approach
0Y6Q0Z0Detachment at Left 1st Toe, Complete, Open Approach
0Y6Q0Z1Detachment at Left 1st Toe, High, Open Approach
0Y6Q0Z2Detachment at Left 1st Toe, Mid, Open Approach
0Y6Q0Z3Detachment at Left 1st Toe, Low, Open Approach
0Y6R0Z0Detachment at Right 2nd Toe, Complete, Open Approach
0Y6R0Z1Detachment at Right 2nd Toe, High, Open Approach
0Y6R0Z2Detachment at Right 2nd Toe, Mid, Open Approach
0Y6R0Z3Detachment at Right 2nd Toe, Low, Open Approach
0Y6S0Z0Detachment at Left 2nd Toe, Complete, Open Approach
0Y6S0Z1Detachment at Left 2nd Toe, High, Open Approach
0Y6S0Z2Detachment at Left 2nd Toe, Mid, Open Approach
0Y6S0Z3Detachment at Left 2nd Toe, Low, Open Approach
0Y6T0Z0Detachment at Right 3rd Toe, Complete, Open Approach
0Y6T0Z1Detachment at Right 3rd Toe, High, Open Approach
0Y6T0Z2Detachment at Right 3rd Toe, Mid, Open Approach
0Y6T0Z3Detachment at Right 3rd Toe, Low, Open Approach
0Y6U0Z0Detachment at Left 3rd Toe, Complete, Open Approach
0Y6U0Z1Detachment at Left 3rd Toe, High, Open Approach
0Y6U0Z2Detachment at Left 3rd Toe, Mid, Open Approach
0Y6U0Z3Detachment at Left 3rd Toe, Low, Open Approach
0Y6V0Z0Detachment at Right 4th Toe, Complete, Open Approach
0Y6V0Z1Detachment at Right 4th Toe, High, Open Approach
0Y6V0Z2Detachment at Right 4th Toe, Mid, Open Approach
0Y6V0Z3Detachment at Right 4th Toe, Low, Open Approach
0Y6W0Z0Detachment at Left 4th Toe, Complete, Open Approach
0Y6W0Z1Detachment at Left 4th Toe, High, Open Approach
0Y6W0Z2Detachment at Left 4th Toe, Mid, Open Approach
0Y6W0Z3Detachment at Left 4th Toe, Low, Open Approach
0Y6X0Z0Detachment at Right 5th Toe, Complete, Open Approach
0Y6X0Z1Detachment at Right 5th Toe, High, Open Approach
0Y6X0Z2Detachment at Right 5th Toe, Mid, Open Approach
0Y6X0Z3Detachment at Right 5th Toe, Low, Open Approach
0Y6Y0Z0Detachment at Left 5th Toe, Complete, Open Approach
0Y6Y0Z1Detachment at Left 5th Toe, High, Open Approach
0Y6Y0Z2Detachment at Left 5th Toe, Mid, Open Approach
0Y6Y0Z3Detachment at Left 5th Toe, Low, Open Approach



Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244
16 Mar 2022 16:20:17
CMS, code-revision=332, description-revision=1327