DRAFT
ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual |
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MS-DRG Surgical Hierarchy by MDC and MS-DRG |
Surgical Hierarchy | MS-DRG |
---|---|
Pre-MDC | |
018 | Chimeric Antigen Receptor (CAR) T-cell and Other Immunotherapies |
001-002 | Heart transplant or implant of heart assist system |
003-004 | ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck |
005-006 | Liver or intestinal transplant |
014 | Allogeneic bone marrow transplant |
007 | Lung transplant |
019 | Simultaneous pancreas and kidney transplant with hemodialysis |
008 | Simultaneous pancreas and kidney transplant |
016-017 | Autologous bone marrow transplant |
010 | Pancreas transplant |
011-013 | Tracheostomy for face, mouth and neck diagnoses or laryngectomy |
MDC 01 Diseases and disorders of the nervous system | |
020-022 | Intracranial vascular procedures with principal diagnosis hemorrhage |
023-024 | Craniotomy with major device implant or acute complex CNS principal diagnosis |
025-027 | Craniotomy and endovascular intracranial procedures |
028-030 | Spinal procedures |
031-033 | Ventricular shunt procedures |
034-036 | Carotid artery stent procedures |
037-039 | Extracranial procedures |
040-042 | Peripheral, cranial nerve and other nervous system procedures |
MDC 02 Diseases and disorders of the eye | |
113-114 | Orbital procedures |
115 | Extraocular procedures except orbit |
116-117 | Intraocular procedures |
MDC 03 Diseases and disorders of the ear, nose, mouth and throat | |
140-142 | Major head and neck procedures |
143-145 | Other ear, nose, mouth and throat O.R. procedures |
135-136 | Sinus and mastoid procedures |
137-138 | Mouth procedures |
139 | Salivary gland procedures |
MDC 04 Diseases and disorders of the respiratory system | |
163-165 | Major chest procedures |
166-168 | Other respiratory system O.R. procedures |
MDC 05 Diseases and disorders of the circulatory system | |
215 | Other heart assist system implant |
216-221 | Cardiac valve and other major cardiothoracic procedures |
231-236 | Coronary bypass |
222-227 | Cardiac defibrillator implant |
266-267 | Endovascular cardiac valve replacement and supplement procedures |
268-269 | Aortic and heart assist procedures except pulsation balloon |
228-229 | Other cardiothoracic procedures |
319-320 | Other endovascular cardiac valve procedures |
270-272 | Other major cardiovascular procedures |
239-241 | Amputation for circulatory system disorders except upper limb and toe |
242-244 | Permanent cardiac pacemaker implant |
245 | AICD generator procedures |
265 | AICD lead procedures |
273-274 | Percutaneous intracardiac procedures |
246-247 | Percutaneous cardiovascular procedures with drug-eluting stent |
248-249 | Percutaneous cardiovascular procedures with non-drug-eluting stent |
250-251 | Percutaneous cardiovascular procedures without coronary artery stent |
252-254 | Other vascular procedures |
255-257 | Upper limb and toe amputation for circulatory system disorders |
258-259 | Cardiac pacemaker device replacement |
260-262 | Cardiac pacemaker revision except device replacement |
263 | Vein ligation and stripping |
264 | Other circulatory system O.R. procedures |
MDC 06 Diseases and disorders of the digestive system | |
326-328 | Stomach, esophageal and duodenal procedures |
329-331 | Major small and large bowel procedures |
332-334 | Rectal resection |
335-337 | Peritoneal adhesiolysis |
338-343 | Appendectomy |
344-346 | Minor small and large bowel procedures |
347-349 | Anal and stomal procedures |
350-355 | Hernia procedures |
356-358 | Other digestive system O.R. procedures |
MDC 07 Diseases and disorders of the hepatobiliary system and pancreas | |
405-407 | Pancreas, liver and shunt procedures |
408-410 | Biliary tract procedures except only cholecystectomy with or without C.D.E. |
411-419 | Cholecystectomy |
420-422 | Hepatobiliary diagnostic procedures |
423-425 | Other hepatobiliary or pancreas O.R. procedures |
MDC 08 Diseases and disorders of the musculoskeletal system and connective tissue | |
453-455 | Combined anterior and posterior spinal fusion |
456-458 | Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive fusions |
459-460 | Spinal fusion except cervical |
461-462 | Bilateral or multiple major joint procedures of lower extremity |
463-465 | Wound debridement and skin graft except hand for musculoskeletal and connective tissue disorders |
466-468 | Revision of hip or knee replacement |
521-522 | Hip replacement with principal diagnosis of hip fracture |
469-470 | Major hip and knee joint replacement or reattachment of lower extremity |
471-473 | Cervical spinal fusion |
474-476 | Amputation for musculoskeletal system and connective tissue disorders |
477-479 | Biopsies of musculoskeletal system and connective tissue |
480-482 | Hip and femur procedures except major joint |
483 | Major joint or limb reattachment procedures of upper extremities |
485-489 | Knee procedures |
518-520 | Back and neck procedures except spinal fusion |
492-494 | Lower extremity and humerus procedures except hip, foot and femur |
495-497 | Local excision and removal of internal fixation devices except hip and femur |
498-499 | Local excision and removal of internal fixation devices of hip and femur |
500-502 | Soft tissue procedures |
503-505 | Foot procedures |
506 | Major thumb or joint procedures |
507-508 | Major shoulder or elbow joint procedures |
509 | Arthroscopy |
510-512 | Shoulder, elbow or forearm procedures, except major joint procedures |
513-514 | Hand or wrist procedures, except major thumb or joint procedures |
515-517 | Other musculoskeletal system and connective tissue O.R. procedures |
MDC 09 Diseases and disorders of the skin, subcutaneous tissue and breast | |
573-578 | Skin graft |
570-572 | Skin debridement |
579-581 | Other skin, subcutaneous tissue and breast procedures |
582-583 | Mastectomy for malignancy |
584-585 | Breast biopsy, local excision and other breast procedures |
MDC 10 Endocrine, nutritional and metabolic diseases and disorders | |
616-618 | Amputation of lower limb for endocrine, nutritional and metabolic disorders |
619-621 | O.R. procedures for obesity |
614-615 | Adrenal and pituitary procedures |
622-624 | Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders |
625-627 | Thyroid, parathyroid and thyroglossal procedures |
628-630 | Other endocrine, nutritional and metabolic O.R. procedures |
MDC 11 Diseases and disorders of the kidney and urinary tract | |
650-651 | Kidney transplant with hemodialysis |
652 | Kidney transplant |
653-655 | Major bladder procedures |
656-661 | Kidney and ureter procedures |
662-664 | Minor bladder procedures |
665-667 | Prostatectomy |
668-670 | Transurethral procedures |
671-672 | Urethral procedures |
673-675 | Other kidney and urinary tract procedures |
MDC 12 Diseases and disorders of the male reproductive system | |
707-708 | Major male pelvic procedures |
709-710 | Penis procedures |
711-712 | Testes procedures |
713-714 | Transurethral prostatectomy |
715-718 | Other male reproductive system O.R. procedures |
MDC 13 Diseases and disorders of the female reproductive system | |
734-735 | Pelvic evisceration, radical hysterectomy and radical vulvectomy |
736-741 | Uterine and adnexa procedures |
742-743 | Uterine and adnexa procedures for non-malignancy |
744-745 | D&C, conization, laparoscopy and tubal interruption |
746-747 | Vagina, cervix and vulva procedures |
748 | Female reproductive system reconstructive procedures |
749-750 | Other female reproductive system O.R. procedures |
MDC 14 Pregnancy, childbirth and the puerperium | |
783-785 | Cesarean section with sterilization |
786-788 | Cesarean section without sterilization |
768 | Vaginal delivery with O.R. procedures except sterilization and/or D&C |
796-798 | Vaginal delivery with sterilization and/or D&C |
770 | Abortion with D&C, aspiration curettage or hysterotomy |
817-819 | Other antepartum diagnoses with O.R. procedures |
769 | Postpartum and post abortion diagnoses with O.R. procedures |
MDC 16 Diseases and disorders of blood, blood forming organs and immunologic disorders | |
799-801 | Splenectomy |
802-804 | Other O.R. procedures of the blood and blood forming organs |
MDC 17 Myeloproliferative diseases and disorders, poorly differentiated neoplasms | |
820-822 | Lymphoma and leukemia with major O.R. procedures |
823-825 | Lymphoma and non-acute leukemia with other procedures |
826-828 | Myeloproliferative disorders or poorly differentiated neoplasms with major O.R. procedures |
829-830 | Myeloproliferative disorders or poorly differentiated neoplasms with other procedures |
MDC 18 Infectious and parasitic diseases, systemic or unspecified sites | |
856-858 | Postoperative or post-traumatic infections with O.R. procedures |
853-855 | Infectious and parasitic diseases with O.R. procedures |
MDC 19 Mental diseases and disorders | |
876 | O.R. procedures with principal diagnosis of mental illness |
MDC 21 Injuries, poisonings and toxic effects of drugs | |
901-903 | Wound debridements for injuries |
904-905 | Skin grafts for injuries |
906 | Hand procedures for injuries |
907-909 | Other O.R. procedures for injuries |
MDC 22 Burns | |
927 | Extensive burns or full thickness burns with MV >96 hours |
928-929 | Full thickness burn |
MDC 23 Factors influencing health status and other contacts with health services | |
939-941 | O.R. procedures with diagnoses of other contact with health services |
MDC 24 Multiple significant trauma | |
955 | Craniotomy for multiple significant trauma |
956 | Limb reattachment, hip and femur procedures for multiple significant trauma |
957-959 | Other O.R. procedures for multiple significant trauma |
MDC 25 Human immunodeficiency virus infections | |
969-970 | HIV with extensive O.R. procedures |
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 17:08:13 CMS, code-revision=333, description-revision=1331 |