ICD-10-CM/PCS MS-DRG v39.1 Definitions Manual
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ICD-10-CM/PCS MS-DRG v39.1 Definitions Manual |
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| MDC 06 Diseases and disorders of the digestive system |
| Stomach, esophageal and duodenal procedures |
| Page 1 of 3 |
| MCC | CC | DRG |
|---|---|---|
| Yes | n/a | 326 |
| No | Yes | 327 |
| No | No | 328 |
DRG 326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC
DRG 327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC
DRG 328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC
OPERATING ROOM PROCEDURES
| 008Q0ZZ | Division of Vagus Nerve, Open Approach |
| 008Q3ZZ | Division of Vagus Nerve, Percutaneous Approach |
| 008Q4ZZ | Division of Vagus Nerve, Percutaneous Endoscopic Approach |
| 02BP3ZZ | Excision of Pulmonary Trunk, Percutaneous Approach |
| 02BQ3ZZ | Excision of Right Pulmonary Artery, Percutaneous Approach |
| 02BR3ZZ | Excision of Left Pulmonary Artery, Percutaneous Approach |
| 02BS3ZZ | Excision of Right Pulmonary Vein, Percutaneous Approach |
| 02BT3ZZ | Excision of Left Pulmonary Vein, Percutaneous Approach |
| 02BV3ZZ | Excision of Superior Vena Cava, Percutaneous Approach |
| 02BW3ZZ | Excision of Thoracic Aorta, Descending, Percutaneous Approach |
| 02BX3ZZ | Excision of Thoracic Aorta, Ascending/Arch, Percutaneous Approach |
| 03B03ZZ | Excision of Right Internal Mammary Artery, Percutaneous Approach |
| 03B13ZZ | Excision of Left Internal Mammary Artery, Percutaneous Approach |
| 03B23ZZ | Excision of Innominate Artery, Percutaneous Approach |
| 03B33ZZ | Excision of Right Subclavian Artery, Percutaneous Approach |
| 03B43ZZ | Excision of Left Subclavian Artery, Percutaneous Approach |
| 03L20CZ | Occlusion of Innominate Artery with Extraluminal Device, Open Approach |
| 03L20DZ | Occlusion of Innominate Artery with Intraluminal Device, Open Approach |
| 03L20ZZ | Occlusion of Innominate Artery, Open Approach |
| 03L23CZ | Occlusion of Innominate Artery with Extraluminal Device, Percutaneous Approach |
| 03L23DZ | Occlusion of Innominate Artery with Intraluminal Device, Percutaneous Approach |
| 03L23ZZ | Occlusion of Innominate Artery, Percutaneous Approach |
| 03L24CZ | Occlusion of Innominate Artery with Extraluminal Device, Percutaneous Endoscopic Approach |
| 03L24DZ | Occlusion of Innominate Artery with Intraluminal Device, Percutaneous Endoscopic Approach |
| 03L24ZZ | Occlusion of Innominate Artery, Percutaneous Endoscopic Approach |
| 03L30CZ | Occlusion of Right Subclavian Artery with Extraluminal Device, Open Approach |
| 03L30DZ | Occlusion of Right Subclavian Artery with Intraluminal Device, Open Approach |
| 03L30ZZ | Occlusion of Right Subclavian Artery, Open Approach |
| 03L33CZ | Occlusion of Right Subclavian Artery with Extraluminal Device, Percutaneous Approach |
| 03L33DZ | Occlusion of Right Subclavian Artery with Intraluminal Device, Percutaneous Approach |
| 03L33ZZ | Occlusion of Right Subclavian Artery, Percutaneous Approach |
| 03L34CZ | Occlusion of Right Subclavian Artery with Extraluminal Device, Percutaneous Endoscopic Approach |
| 03L34DZ | Occlusion of Right Subclavian Artery with Intraluminal Device, Percutaneous Endoscopic Approach |
| 03L34ZZ | Occlusion of Right Subclavian Artery, Percutaneous Endoscopic Approach |
| 03L40CZ | Occlusion of Left Subclavian Artery with Extraluminal Device, Open Approach |
| 03L40DZ | Occlusion of Left Subclavian Artery with Intraluminal Device, Open Approach |
| 03L40ZZ | Occlusion of Left Subclavian Artery, Open Approach |
| 03L43CZ | Occlusion of Left Subclavian Artery with Extraluminal Device, Percutaneous Approach |
| 03L43DZ | Occlusion of Left Subclavian Artery with Intraluminal Device, Percutaneous Approach |
| 03L43ZZ | Occlusion of Left Subclavian Artery, Percutaneous Approach |
| 03L44CZ | Occlusion of Left Subclavian Artery with Extraluminal Device, Percutaneous Endoscopic Approach |
| 03L44DZ | Occlusion of Left Subclavian Artery with Intraluminal Device, Percutaneous Endoscopic Approach |
| 03L44ZZ | Occlusion of Left Subclavian Artery, Percutaneous Endoscopic Approach |
| 05L30CZ | Occlusion of Right Innominate Vein with Extraluminal Device, Open Approach |
| 05L30DZ | Occlusion of Right Innominate Vein with Intraluminal Device, Open Approach |
| 05L30ZZ | Occlusion of Right Innominate Vein, Open Approach |
| 05L33CZ | Occlusion of Right Innominate Vein with Extraluminal Device, Percutaneous Approach |
| 05L33DZ | Occlusion of Right Innominate Vein with Intraluminal Device, Percutaneous Approach |
| 05L33ZZ | Occlusion of Right Innominate Vein, Percutaneous Approach |
| 05L34CZ | Occlusion of Right Innominate Vein with Extraluminal Device, Percutaneous Endoscopic Approach |
| 05L34DZ | Occlusion of Right Innominate Vein with Intraluminal Device, Percutaneous Endoscopic Approach |
| 05L34ZZ | Occlusion of Right Innominate Vein, Percutaneous Endoscopic Approach |
| 05L40CZ | Occlusion of Left Innominate Vein with Extraluminal Device, Open Approach |
| 05L40DZ | Occlusion of Left Innominate Vein with Intraluminal Device, Open Approach |
| 05L40ZZ | Occlusion of Left Innominate Vein, Open Approach |
| 05L43CZ | Occlusion of Left Innominate Vein with Extraluminal Device, Percutaneous Approach |
| 05L43DZ | Occlusion of Left Innominate Vein with Intraluminal Device, Percutaneous Approach |
| 05L43ZZ | Occlusion of Left Innominate Vein, Percutaneous Approach |
| 05L44CZ | Occlusion of Left Innominate Vein with Extraluminal Device, Percutaneous Endoscopic Approach |
| 05L44DZ | Occlusion of Left Innominate Vein with Intraluminal Device, Percutaneous Endoscopic Approach |
| 05L44ZZ | Occlusion of Left Innominate Vein, Percutaneous Endoscopic Approach |
| 05L50CZ | Occlusion of Right Subclavian Vein with Extraluminal Device, Open Approach |
| 05L50DZ | Occlusion of Right Subclavian Vein with Intraluminal Device, Open Approach |
| 05L50ZZ | Occlusion of Right Subclavian Vein, Open Approach |
| 05L53CZ | Occlusion of Right Subclavian Vein with Extraluminal Device, Percutaneous Approach |
| 05L53DZ | Occlusion of Right Subclavian Vein with Intraluminal Device, Percutaneous Approach |
| 05L53ZZ | Occlusion of Right Subclavian Vein, Percutaneous Approach |
| 05L54CZ | Occlusion of Right Subclavian Vein with Extraluminal Device, Percutaneous Endoscopic Approach |
| 05L54DZ | Occlusion of Right Subclavian Vein with Intraluminal Device, Percutaneous Endoscopic Approach |
| 05L54ZZ | Occlusion of Right Subclavian Vein, Percutaneous Endoscopic Approach |
| 05L60CZ | Occlusion of Left Subclavian Vein with Extraluminal Device, Open Approach |
| 05L60DZ | Occlusion of Left Subclavian Vein with Intraluminal Device, Open Approach |
| 05L60ZZ | Occlusion of Left Subclavian Vein, Open Approach |
| 05L63CZ | Occlusion of Left Subclavian Vein with Extraluminal Device, Percutaneous Approach |
| 05L63DZ | Occlusion of Left Subclavian Vein with Intraluminal Device, Percutaneous Approach |
| 05L63ZZ | Occlusion of Left Subclavian Vein, Percutaneous Approach |
| 05L64CZ | Occlusion of Left Subclavian Vein with Extraluminal Device, Percutaneous Endoscopic Approach |
| 05L64DZ | Occlusion of Left Subclavian Vein with Intraluminal Device, Percutaneous Endoscopic Approach |
| 05L64ZZ | Occlusion of Left Subclavian Vein, Percutaneous Endoscopic Approach |
| 06100J5 | Bypass Inferior Vena Cava to Superior Mesenteric Vein with Synthetic Substitute, Open Approach |
| 06100J6 | Bypass Inferior Vena Cava to Inferior Mesenteric Vein with Synthetic Substitute, Open Approach |
| 06100JY | Bypass Inferior Vena Cava to Lower Vein with Synthetic Substitute, Open Approach |
| 06100Z5 | Bypass Inferior Vena Cava to Superior Mesenteric Vein, Open Approach |
| 06100Z6 | Bypass Inferior Vena Cava to Inferior Mesenteric Vein, Open Approach |
| 06100ZY | Bypass Inferior Vena Cava to Lower Vein, Open Approach |
| 06104J5 | Bypass Inferior Vena Cava to Superior Mesenteric Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06104J6 | Bypass Inferior Vena Cava to Inferior Mesenteric Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06104JY | Bypass Inferior Vena Cava to Lower Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06104Z5 | Bypass Inferior Vena Cava to Superior Mesenteric Vein, Percutaneous Endoscopic Approach |
| 06104Z6 | Bypass Inferior Vena Cava to Inferior Mesenteric Vein, Percutaneous Endoscopic Approach |
| 06104ZY | Bypass Inferior Vena Cava to Lower Vein, Percutaneous Endoscopic Approach |
| 06110J9 | Bypass Splenic Vein to Right Renal Vein with Synthetic Substitute, Open Approach |
| 06110JB | Bypass Splenic Vein to Left Renal Vein with Synthetic Substitute, Open Approach |
| 06110JY | Bypass Splenic Vein to Lower Vein with Synthetic Substitute, Open Approach |
| 06110Z9 | Bypass Splenic Vein to Right Renal Vein, Open Approach |
| 06110ZB | Bypass Splenic Vein to Left Renal Vein, Open Approach |
| 06110ZY | Bypass Splenic Vein to Lower Vein, Open Approach |
| 06114J9 | Bypass Splenic Vein to Right Renal Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06114JB | Bypass Splenic Vein to Left Renal Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06114JY | Bypass Splenic Vein to Lower Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06114Z9 | Bypass Splenic Vein to Right Renal Vein, Percutaneous Endoscopic Approach |
| 06114ZB | Bypass Splenic Vein to Left Renal Vein, Percutaneous Endoscopic Approach |
| 06114ZY | Bypass Splenic Vein to Lower Vein, Percutaneous Endoscopic Approach |
| 06180J9 | Bypass Portal Vein to Right Renal Vein with Synthetic Substitute, Open Approach |
| 06180JB | Bypass Portal Vein to Left Renal Vein with Synthetic Substitute, Open Approach |
| 06180JY | Bypass Portal Vein to Lower Vein with Synthetic Substitute, Open Approach |
| 06180Z9 | Bypass Portal Vein to Right Renal Vein, Open Approach |
| 06180ZB | Bypass Portal Vein to Left Renal Vein, Open Approach |
| 06180ZY | Bypass Portal Vein to Lower Vein, Open Approach |
| 06184J4 | Bypass Portal Vein to Hepatic Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06184J9 | Bypass Portal Vein to Right Renal Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06184JB | Bypass Portal Vein to Left Renal Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06184JY | Bypass Portal Vein to Lower Vein with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 06184Z9 | Bypass Portal Vein to Right Renal Vein, Percutaneous Endoscopic Approach |
| 06184ZB | Bypass Portal Vein to Left Renal Vein, Percutaneous Endoscopic Approach |
| 06184ZY | Bypass Portal Vein to Lower Vein, Percutaneous Endoscopic Approach |
| 06L20ZZ | Occlusion of Gastric Vein, Open Approach |
| 06L23ZZ | Occlusion of Gastric Vein, Percutaneous Approach |
| 06L24ZZ | Occlusion of Gastric Vein, Percutaneous Endoscopic Approach |
| 06L30ZZ | Occlusion of Esophageal Vein, Open Approach |
| 095N0ZZ | Destruction of Nasopharynx, Open Approach |
| 095N3ZZ | Destruction of Nasopharynx, Percutaneous Approach |
| 095N4ZZ | Destruction of Nasopharynx, Percutaneous Endoscopic Approach |
| 095N7ZZ | Destruction of Nasopharynx, Via Natural or Artificial Opening |
| 095N8ZZ | Destruction of Nasopharynx, Via Natural or Artificial Opening Endoscopic |
| 09BN0ZZ | Excision of Nasopharynx, Open Approach |
| 09BN3ZZ | Excision of Nasopharynx, Percutaneous Approach |
| 09BN4ZZ | Excision of Nasopharynx, Percutaneous Endoscopic Approach |
| 09BN7ZZ | Excision of Nasopharynx, Via Natural or Artificial Opening |
| 09BN8ZZ | Excision of Nasopharynx, Via Natural or Artificial Opening Endoscopic |
| 09TN0ZZ | Resection of Nasopharynx, Open Approach |
| 09TN4ZZ | Resection of Nasopharynx, Percutaneous Endoscopic Approach |
| 09TN7ZZ | Resection of Nasopharynx, Via Natural or Artificial Opening |
| 09TN8ZZ | Resection of Nasopharynx, Via Natural or Artificial Opening Endoscopic |
| 0BQT0ZZ | Repair Diaphragm, Open Approach |
| 0BQT3ZZ | Repair Diaphragm, Percutaneous Approach |
| 0BQT4ZZ | Repair Diaphragm, Percutaneous Endoscopic Approach |
| 0BRT07Z | Replacement of Diaphragm with Autologous Tissue Substitute, Open Approach |
| 0BRT0JZ | Replacement of Diaphragm with Synthetic Substitute, Open Approach |
| 0BRT0KZ | Replacement of Diaphragm with Nonautologous Tissue Substitute, Open Approach |
| 0BRT47Z | Replacement of Diaphragm with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0BRT4JZ | Replacement of Diaphragm with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0BRT4KZ | Replacement of Diaphragm with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0BUT07Z | Supplement Diaphragm with Autologous Tissue Substitute, Open Approach |
| 0BUT0JZ | Supplement Diaphragm with Synthetic Substitute, Open Approach |
| 0BUT0KZ | Supplement Diaphragm with Nonautologous Tissue Substitute, Open Approach |
| 0BUT47Z | Supplement Diaphragm with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0BUT4JZ | Supplement Diaphragm with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0BUT4KZ | Supplement Diaphragm with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0C5M0ZZ | Destruction of Pharynx, Open Approach |
| 0C5M3ZZ | Destruction of Pharynx, Percutaneous Approach |
| 0C5M4ZZ | Destruction of Pharynx, Percutaneous Endoscopic Approach |
| 0C5M7ZZ | Destruction of Pharynx, Via Natural or Artificial Opening |
| 0C5M8ZZ | Destruction of Pharynx, Via Natural or Artificial Opening Endoscopic |
| 0CBM0ZZ | Excision of Pharynx, Open Approach |
| 0CBM3ZZ | Excision of Pharynx, Percutaneous Approach |
| 0CBM4ZZ | Excision of Pharynx, Percutaneous Endoscopic Approach |
| 0CBM7ZZ | Excision of Pharynx, Via Natural or Artificial Opening |
| 0CBM8ZZ | Excision of Pharynx, Via Natural or Artificial Opening Endoscopic |
| 0CTM0ZZ | Resection of Pharynx, Open Approach |
| 0CTM4ZZ | Resection of Pharynx, Percutaneous Endoscopic Approach |
| 0CTM7ZZ | Resection of Pharynx, Via Natural or Artificial Opening |
| 0CTM8ZZ | Resection of Pharynx, Via Natural or Artificial Opening Endoscopic |
| 0D11074 | Bypass Upper Esophagus to Cutaneous with Autologous Tissue Substitute, Open Approach |
| 0D11076 | Bypass Upper Esophagus to Stomach with Autologous Tissue Substitute, Open Approach |
| 0D11079 | Bypass Upper Esophagus to Duodenum with Autologous Tissue Substitute, Open Approach |
| 0D1107A | Bypass Upper Esophagus to Jejunum with Autologous Tissue Substitute, Open Approach |
| 0D1107B | Bypass Upper Esophagus to Ileum with Autologous Tissue Substitute, Open Approach |
| 0D110J4 | Bypass Upper Esophagus to Cutaneous with Synthetic Substitute, Open Approach |
| 0D110J6 | Bypass Upper Esophagus to Stomach with Synthetic Substitute, Open Approach |
| 0D110J9 | Bypass Upper Esophagus to Duodenum with Synthetic Substitute, Open Approach |
| 0D110JA | Bypass Upper Esophagus to Jejunum with Synthetic Substitute, Open Approach |
| 0D110JB | Bypass Upper Esophagus to Ileum with Synthetic Substitute, Open Approach |
| 0D110K4 | Bypass Upper Esophagus to Cutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0D110K6 | Bypass Upper Esophagus to Stomach with Nonautologous Tissue Substitute, Open Approach |
| 0D110K9 | Bypass Upper Esophagus to Duodenum with Nonautologous Tissue Substitute, Open Approach |
| 0D110KA | Bypass Upper Esophagus to Jejunum with Nonautologous Tissue Substitute, Open Approach |
| 0D110KB | Bypass Upper Esophagus to Ileum with Nonautologous Tissue Substitute, Open Approach |
| 0D110Z4 | Bypass Upper Esophagus to Cutaneous, Open Approach |
| 0D110Z6 | Bypass Upper Esophagus to Stomach, Open Approach |
| 0D110Z9 | Bypass Upper Esophagus to Duodenum, Open Approach |
| 0D110ZA | Bypass Upper Esophagus to Jejunum, Open Approach |
| 0D110ZB | Bypass Upper Esophagus to Ileum, Open Approach |
| 0D113J4 | Bypass Upper Esophagus to Cutaneous with Synthetic Substitute, Percutaneous Approach |
| 0D11474 | Bypass Upper Esophagus to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D11476 | Bypass Upper Esophagus to Stomach with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D11479 | Bypass Upper Esophagus to Duodenum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D1147A | Bypass Upper Esophagus to Jejunum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D1147B | Bypass Upper Esophagus to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D114J4 | Bypass Upper Esophagus to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D114J6 | Bypass Upper Esophagus to Stomach with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D114J9 | Bypass Upper Esophagus to Duodenum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D114JA | Bypass Upper Esophagus to Jejunum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D114JB | Bypass Upper Esophagus to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D114K4 | Bypass Upper Esophagus to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D114K6 | Bypass Upper Esophagus to Stomach with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D114K9 | Bypass Upper Esophagus to Duodenum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D114KA | Bypass Upper Esophagus to Jejunum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D114KB | Bypass Upper Esophagus to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D114Z4 | Bypass Upper Esophagus to Cutaneous, Percutaneous Endoscopic Approach |
| 0D114Z6 | Bypass Upper Esophagus to Stomach, Percutaneous Endoscopic Approach |
| 0D114Z9 | Bypass Upper Esophagus to Duodenum, Percutaneous Endoscopic Approach |
| 0D114ZA | Bypass Upper Esophagus to Jejunum, Percutaneous Endoscopic Approach |
| 0D114ZB | Bypass Upper Esophagus to Ileum, Percutaneous Endoscopic Approach |
| 0D11874 | Bypass Upper Esophagus to Cutaneous with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D11876 | Bypass Upper Esophagus to Stomach with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D11879 | Bypass Upper Esophagus to Duodenum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D1187A | Bypass Upper Esophagus to Jejunum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D1187B | Bypass Upper Esophagus to Ileum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118J4 | Bypass Upper Esophagus to Cutaneous with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118J6 | Bypass Upper Esophagus to Stomach with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118J9 | Bypass Upper Esophagus to Duodenum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118JA | Bypass Upper Esophagus to Jejunum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118JB | Bypass Upper Esophagus to Ileum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118K4 | Bypass Upper Esophagus to Cutaneous with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118K6 | Bypass Upper Esophagus to Stomach with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118K9 | Bypass Upper Esophagus to Duodenum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118KA | Bypass Upper Esophagus to Jejunum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118KB | Bypass Upper Esophagus to Ileum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D118Z4 | Bypass Upper Esophagus to Cutaneous, Via Natural or Artificial Opening Endoscopic |
| 0D118Z6 | Bypass Upper Esophagus to Stomach, Via Natural or Artificial Opening Endoscopic |
| 0D118Z9 | Bypass Upper Esophagus to Duodenum, Via Natural or Artificial Opening Endoscopic |
| 0D118ZA | Bypass Upper Esophagus to Jejunum, Via Natural or Artificial Opening Endoscopic |
| 0D118ZB | Bypass Upper Esophagus to Ileum, Via Natural or Artificial Opening Endoscopic |
| 0D12074 | Bypass Middle Esophagus to Cutaneous with Autologous Tissue Substitute, Open Approach |
| 0D12076 | Bypass Middle Esophagus to Stomach with Autologous Tissue Substitute, Open Approach |
| 0D12079 | Bypass Middle Esophagus to Duodenum with Autologous Tissue Substitute, Open Approach |
| 0D1207A | Bypass Middle Esophagus to Jejunum with Autologous Tissue Substitute, Open Approach |
| 0D1207B | Bypass Middle Esophagus to Ileum with Autologous Tissue Substitute, Open Approach |
| 0D120J4 | Bypass Middle Esophagus to Cutaneous with Synthetic Substitute, Open Approach |
| 0D120J6 | Bypass Middle Esophagus to Stomach with Synthetic Substitute, Open Approach |
| 0D120J9 | Bypass Middle Esophagus to Duodenum with Synthetic Substitute, Open Approach |
| 0D120JA | Bypass Middle Esophagus to Jejunum with Synthetic Substitute, Open Approach |
| 0D120JB | Bypass Middle Esophagus to Ileum with Synthetic Substitute, Open Approach |
| 0D120K4 | Bypass Middle Esophagus to Cutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0D120K6 | Bypass Middle Esophagus to Stomach with Nonautologous Tissue Substitute, Open Approach |
| 0D120K9 | Bypass Middle Esophagus to Duodenum with Nonautologous Tissue Substitute, Open Approach |
| 0D120KA | Bypass Middle Esophagus to Jejunum with Nonautologous Tissue Substitute, Open Approach |
| 0D120KB | Bypass Middle Esophagus to Ileum with Nonautologous Tissue Substitute, Open Approach |
| 0D120Z4 | Bypass Middle Esophagus to Cutaneous, Open Approach |
| 0D120Z6 | Bypass Middle Esophagus to Stomach, Open Approach |
| 0D120Z9 | Bypass Middle Esophagus to Duodenum, Open Approach |
| 0D120ZA | Bypass Middle Esophagus to Jejunum, Open Approach |
| 0D120ZB | Bypass Middle Esophagus to Ileum, Open Approach |
| 0D123J4 | Bypass Middle Esophagus to Cutaneous with Synthetic Substitute, Percutaneous Approach |
| 0D12474 | Bypass Middle Esophagus to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D12476 | Bypass Middle Esophagus to Stomach with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D12479 | Bypass Middle Esophagus to Duodenum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D1247A | Bypass Middle Esophagus to Jejunum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D1247B | Bypass Middle Esophagus to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D124J4 | Bypass Middle Esophagus to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D124J6 | Bypass Middle Esophagus to Stomach with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D124J9 | Bypass Middle Esophagus to Duodenum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D124JA | Bypass Middle Esophagus to Jejunum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D124JB | Bypass Middle Esophagus to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D124K4 | Bypass Middle Esophagus to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D124K6 | Bypass Middle Esophagus to Stomach with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D124K9 | Bypass Middle Esophagus to Duodenum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D124KA | Bypass Middle Esophagus to Jejunum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D124KB | Bypass Middle Esophagus to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D124Z4 | Bypass Middle Esophagus to Cutaneous, Percutaneous Endoscopic Approach |
| 0D124Z6 | Bypass Middle Esophagus to Stomach, Percutaneous Endoscopic Approach |
| 0D124Z9 | Bypass Middle Esophagus to Duodenum, Percutaneous Endoscopic Approach |
| 0D124ZA | Bypass Middle Esophagus to Jejunum, Percutaneous Endoscopic Approach |
| 0D124ZB | Bypass Middle Esophagus to Ileum, Percutaneous Endoscopic Approach |
| 0D12874 | Bypass Middle Esophagus to Cutaneous with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D12876 | Bypass Middle Esophagus to Stomach with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D12879 | Bypass Middle Esophagus to Duodenum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D1287A | Bypass Middle Esophagus to Jejunum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D1287B | Bypass Middle Esophagus to Ileum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128J4 | Bypass Middle Esophagus to Cutaneous with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128J6 | Bypass Middle Esophagus to Stomach with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128J9 | Bypass Middle Esophagus to Duodenum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128JA | Bypass Middle Esophagus to Jejunum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128JB | Bypass Middle Esophagus to Ileum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128K4 | Bypass Middle Esophagus to Cutaneous with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128K6 | Bypass Middle Esophagus to Stomach with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128K9 | Bypass Middle Esophagus to Duodenum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128KA | Bypass Middle Esophagus to Jejunum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128KB | Bypass Middle Esophagus to Ileum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D128Z4 | Bypass Middle Esophagus to Cutaneous, Via Natural or Artificial Opening Endoscopic |
| 0D128Z6 | Bypass Middle Esophagus to Stomach, Via Natural or Artificial Opening Endoscopic |
| 0D128Z9 | Bypass Middle Esophagus to Duodenum, Via Natural or Artificial Opening Endoscopic |
| 0D128ZA | Bypass Middle Esophagus to Jejunum, Via Natural or Artificial Opening Endoscopic |
| 0D128ZB | Bypass Middle Esophagus to Ileum, Via Natural or Artificial Opening Endoscopic |
| 0D13074 | Bypass Lower Esophagus to Cutaneous with Autologous Tissue Substitute, Open Approach |
| 0D13076 | Bypass Lower Esophagus to Stomach with Autologous Tissue Substitute, Open Approach |
| 0D13079 | Bypass Lower Esophagus to Duodenum with Autologous Tissue Substitute, Open Approach |
| 0D1307A | Bypass Lower Esophagus to Jejunum with Autologous Tissue Substitute, Open Approach |
| 0D1307B | Bypass Lower Esophagus to Ileum with Autologous Tissue Substitute, Open Approach |
| 0D130J4 | Bypass Lower Esophagus to Cutaneous with Synthetic Substitute, Open Approach |
| 0D130J6 | Bypass Lower Esophagus to Stomach with Synthetic Substitute, Open Approach |
| 0D130J9 | Bypass Lower Esophagus to Duodenum with Synthetic Substitute, Open Approach |
| 0D130JA | Bypass Lower Esophagus to Jejunum with Synthetic Substitute, Open Approach |
| 0D130JB | Bypass Lower Esophagus to Ileum with Synthetic Substitute, Open Approach |
| 0D130K4 | Bypass Lower Esophagus to Cutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0D130K6 | Bypass Lower Esophagus to Stomach with Nonautologous Tissue Substitute, Open Approach |
| 0D130K9 | Bypass Lower Esophagus to Duodenum with Nonautologous Tissue Substitute, Open Approach |
| 0D130KA | Bypass Lower Esophagus to Jejunum with Nonautologous Tissue Substitute, Open Approach |
| 0D130KB | Bypass Lower Esophagus to Ileum with Nonautologous Tissue Substitute, Open Approach |
| 0D130Z4 | Bypass Lower Esophagus to Cutaneous, Open Approach |
| 0D130Z6 | Bypass Lower Esophagus to Stomach, Open Approach |
| 0D130Z9 | Bypass Lower Esophagus to Duodenum, Open Approach |
| 0D130ZA | Bypass Lower Esophagus to Jejunum, Open Approach |
| 0D130ZB | Bypass Lower Esophagus to Ileum, Open Approach |
| 0D133J4 | Bypass Lower Esophagus to Cutaneous with Synthetic Substitute, Percutaneous Approach |
| 0D13474 | Bypass Lower Esophagus to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D13476 | Bypass Lower Esophagus to Stomach with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D13479 | Bypass Lower Esophagus to Duodenum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D1347A | Bypass Lower Esophagus to Jejunum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D1347B | Bypass Lower Esophagus to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D134J4 | Bypass Lower Esophagus to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D134J6 | Bypass Lower Esophagus to Stomach with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D134J9 | Bypass Lower Esophagus to Duodenum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D134JA | Bypass Lower Esophagus to Jejunum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D134JB | Bypass Lower Esophagus to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D134K4 | Bypass Lower Esophagus to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D134K6 | Bypass Lower Esophagus to Stomach with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D134K9 | Bypass Lower Esophagus to Duodenum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D134KA | Bypass Lower Esophagus to Jejunum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D134KB | Bypass Lower Esophagus to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D134Z4 | Bypass Lower Esophagus to Cutaneous, Percutaneous Endoscopic Approach |
| 0D134Z6 | Bypass Lower Esophagus to Stomach, Percutaneous Endoscopic Approach |
| 0D134Z9 | Bypass Lower Esophagus to Duodenum, Percutaneous Endoscopic Approach |
| 0D134ZA | Bypass Lower Esophagus to Jejunum, Percutaneous Endoscopic Approach |
| 0D134ZB | Bypass Lower Esophagus to Ileum, Percutaneous Endoscopic Approach |
| 0D13874 | Bypass Lower Esophagus to Cutaneous with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D13876 | Bypass Lower Esophagus to Stomach with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D13879 | Bypass Lower Esophagus to Duodenum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D1387A | Bypass Lower Esophagus to Jejunum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D1387B | Bypass Lower Esophagus to Ileum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138J4 | Bypass Lower Esophagus to Cutaneous with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138J6 | Bypass Lower Esophagus to Stomach with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138J9 | Bypass Lower Esophagus to Duodenum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138JA | Bypass Lower Esophagus to Jejunum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138JB | Bypass Lower Esophagus to Ileum with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138K4 | Bypass Lower Esophagus to Cutaneous with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138K6 | Bypass Lower Esophagus to Stomach with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138K9 | Bypass Lower Esophagus to Duodenum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138KA | Bypass Lower Esophagus to Jejunum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138KB | Bypass Lower Esophagus to Ileum with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D138Z4 | Bypass Lower Esophagus to Cutaneous, Via Natural or Artificial Opening Endoscopic |
| 0D138Z6 | Bypass Lower Esophagus to Stomach, Via Natural or Artificial Opening Endoscopic |
| 0D138Z9 | Bypass Lower Esophagus to Duodenum, Via Natural or Artificial Opening Endoscopic |
| 0D138ZA | Bypass Lower Esophagus to Jejunum, Via Natural or Artificial Opening Endoscopic |
| 0D138ZB | Bypass Lower Esophagus to Ileum, Via Natural or Artificial Opening Endoscopic |
| 0D15074 | Bypass Esophagus to Cutaneous with Autologous Tissue Substitute, Open Approach |
| 0D15076 | Bypass Esophagus to Stomach with Autologous Tissue Substitute, Open Approach |
| 0D15079 | Bypass Esophagus to Duodenum with Autologous Tissue Substitute, Open Approach |
| 0D1507A | Bypass Esophagus to Jejunum with Autologous Tissue Substitute, Open Approach |
| 0D1507B | Bypass Esophagus to Ileum with Autologous Tissue Substitute, Open Approach |
| 0D150J4 | Bypass Esophagus to Cutaneous with Synthetic Substitute, Open Approach |
| 0D150J6 | Bypass Esophagus to Stomach with Synthetic Substitute, Open Approach |
| 0D150J9 | Bypass Esophagus to Duodenum with Synthetic Substitute, Open Approach |
| 0D150JA | Bypass Esophagus to Jejunum with Synthetic Substitute, Open Approach |
| 0D150JB | Bypass Esophagus to Ileum with Synthetic Substitute, Open Approach |
| 0D150K4 | Bypass Esophagus to Cutaneous with Nonautologous Tissue Substitute, Open Approach |
| 0D150K6 | Bypass Esophagus to Stomach with Nonautologous Tissue Substitute, Open Approach |
| 0D150K9 | Bypass Esophagus to Duodenum with Nonautologous Tissue Substitute, Open Approach |
| 0D150KA | Bypass Esophagus to Jejunum with Nonautologous Tissue Substitute, Open Approach |
| 0D150KB | Bypass Esophagus to Ileum with Nonautologous Tissue Substitute, Open Approach |
| 0D150Z4 | Bypass Esophagus to Cutaneous, Open Approach |
| 0D150Z6 | Bypass Esophagus to Stomach, Open Approach |
| 0D150Z9 | Bypass Esophagus to Duodenum, Open Approach |
| 0D150ZA | Bypass Esophagus to Jejunum, Open Approach |
| 0D150ZB | Bypass Esophagus to Ileum, Open Approach |
| 0D153J4 | Bypass Esophagus to Cutaneous with Synthetic Substitute, Percutaneous Approach |
| 0D15474 | Bypass Esophagus to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D15476 | Bypass Esophagus to Stomach with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D15479 | Bypass Esophagus to Duodenum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D1547A | Bypass Esophagus to Jejunum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D1547B | Bypass Esophagus to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D154J4 | Bypass Esophagus to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D154J6 | Bypass Esophagus to Stomach with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D154J9 | Bypass Esophagus to Duodenum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D154JA | Bypass Esophagus to Jejunum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D154JB | Bypass Esophagus to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 0D154K4 | Bypass Esophagus to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D154K6 | Bypass Esophagus to Stomach with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D154K9 | Bypass Esophagus to Duodenum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D154KA | Bypass Esophagus to Jejunum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D154KB | Bypass Esophagus to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 0D154Z4 | Bypass Esophagus to Cutaneous, Percutaneous Endoscopic Approach |
| 0D154Z6 | Bypass Esophagus to Stomach, Percutaneous Endoscopic Approach |
| 0D154Z9 | Bypass Esophagus to Duodenum, Percutaneous Endoscopic Approach |
| 0D154ZA | Bypass Esophagus to Jejunum, Percutaneous Endoscopic Approach |
| 0D154ZB | Bypass Esophagus to Ileum, Percutaneous Endoscopic Approach |
| 0D15874 | Bypass Esophagus to Cutaneous with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D15876 | Bypass Esophagus to Stomach with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D15879 | Bypass Esophagus to Duodenum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D1587A | Bypass Esophagus to Jejunum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D1587B | Bypass Esophagus to Ileum with Autologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic |
| 0D158J4 | Bypass Esophagus to Cutaneous with Synthetic Substitute, Via Natural or Artificial Opening Endoscopic |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 16:20:17 CMS, code-revision=332, description-revision=1327 |