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DRG Expert a Comprehensive Guidebook to the MS-DRG Classification System

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DRG Expert a Comprehensive Guidebook to the MS-DRG Classification System DRG Expert A comprehensive guidebook to the MS-DRG classification system Changes effective with discharges on or after October 1, 2010 2011 27th Edition Contents Numeric Listing of DRGs ................................................ i MDC 16 Diseases And Disorders Of The Blood And Blood-Forming Organs And DRG Listing by Major Diagnostic Category ................ xiii Immunological Disorders ....................200 MDC 17 Myeloproliferative Diseases And Introduction ............................................................... xxv Pre MDC .................................................................. 1 Disorders And Poorly Differentiated Neoplasms ...........................................203 MDC 1 Diseases And Disorders Of The Nervous System ...................................... 5 MDC 18 Infectious And Parasitic Diseases ........210 MDC 2 Diseases And Disorders Of The Eye ..... 39 MDC 19 Mental Diseases And Disorders ...........214 MDC 3 Diseases And Disorders Of The Ear, MDC 20 Alcohol/Drug Use And Alcohol/ Nose, Mouth And Throat ..................... 46 Drug- Induced Organic Mental Disorders .............................................217 MDC 4 Diseases And Disorders Of The Respiratory System ............................... 55 MDC 21 Injury, Poisoning And Toxic Effects Of Drugs ..............................................219 MDC 5 Diseases And Disorders Of The Circulatory System ............................... 62 MDC 22 Burns ...................................................234 MDC 6 Diseases And Disorders Of The MDC 23 Factors Influencing Health Status Digestive System ................................... 79 And Other Contacts With Health Services ................................................240 MDC 7 Diseases And Disorders Of The Hepatobiliary System And Pancreas ..... 91 MDC 24 Multiple Significant Trauma ...............245 MDC 8 Diseases And Disorders Of The MDC 25 Human Immunodeficiency Virus Musculoskeletal System And Infections ............................................260 Connective Tissue ................................ 96 Alphabetic Index to Diseases ......................................269 MDC 9 Diseases And Disorders Of The Skin, Subcutaneous Tissue And Breast ........ 116 Numeric Index to Diseases .........................................337 MDC 10 Endocrine, Nutritional And Metabolic Diseases And Disorders ...................... 125 Alphabetic Index to Procedures ..................................405 MDC 11 Diseases And Disorders Of The Kidney Numeric Index to Procedures .....................................427 And Urinary Tract .............................. 131 MDC 12 Diseases And Disorders Of The Male Appendix A — Lists of CCs and MCCs .........Appendix-1 Reproductive System .......................... 138 MDC 13 Diseases And Disorders Of The Female Appendix B — List of Transfer and Reproductive System .......................... 143 Special Payment DRGs ........................Appendix-125 MDC 14 Pregnancy, Childbirth And The Appendix C — MS-DRG Surgical Puerperium ......................................... 151 Hierarchy Table ..................................Appendix-129 MDC 15 Newborns And Other Neonates With Conditions Originating In Appendix D — MS-LTC-DRG Crosswalk .Appendix-133 The Perinatal Period ........................... 187 Appendix E — National Average Payment Table ...................................................Appendix-151 MDC 1 Diseases And Disorders Of The Nervous System 003.21 013.96 063.9 227.5 324.9 334.3 341.1 346.02 351.0 006.5 036.0 064 227.6 325 334.4 341.20 346.03 351.1 013.00 036.1 066.2 228.02 326 334.8 341.21 346.10 351.8 013.01 045.00 071 237.1 327.21 334.9 341.22 346.11 351.9 013.02 045.01 072.1 237.3 327.25 335.0 341.8 346.12 352.0 013.03 045.02 072.2 237.5 327.27 335.10 341.9 346.13 352.1 013.04 045.03 072.72 237.6 327.30 335.11 342.00 346.20 352.2 013.05 045.10 078.81 237.70 327.31 335.19 342.01 346.21 352.3 013.06 045.11 090.40 237.71 327.32 335.20 342.02 346.22 352.4 MDC 1: Diseases And Disorder And Diseases 1: MDC 013.10 045.12 090.41 237.72 327.33 335.21 342.10 346.23 352.5 013.11 045.13 090.42 237.73 327.34 335.22 342.11 346.30 352.6 013.12 045.90 090.49 237.79 327.35 335.23 342.12 346.31 352.9 013.13 045.91 091.81 237.9 327.36 335.24 342.80 346.32 353.0 013.14 045.92 094.0 239.6 327.37 335.29 342.81 346.33 353.1 013.15 045.93 094.1 249.60 327.39 335.8 342.82 346.40 353.2 013.16 046.0 094.2 249.61 327.41 335.9 342.90 346.41 353.3 013.20 046.11 094.3 250.60 327.43 336.0 342.91 346.42 353.4 013.21 046.19 094.81 250.61 327.51 336.1 342.92 346.43 353.5 013.22 046.2 094.82 250.62 327.52 336.2 343.0 346.50 353.6 013.23 046.3 094.85 250.63 330.0 336.3 343.1 346.51 353.8 013.24 046.71 094.87 307.20 330.1 336.8 343.2 346.52 353.9 013.25 046.72 094.89 307.21 330.2 336.9 343.3 346.53 354.0 013.26 046.79 094.9 307.22 330.3 337.00 343.4 346.60 354.1 013.30 046.8 098.82 307.23 330.8 337.01 343.8 346.61 354.2 013.31 046.9 100.81 307.81 330.9 337.09 343.9 346.62 354.3 013.32 047.0 100.89 310.2 331.0 337.1 344.00 346.63 354.4 013.33 047.1 112.83 315.35 331.11 337.20 344.01 346.70 354.5 013.34 047.8 114.2 320.0 331.19 337.21 344.02 346.71 354.8 s Of The Nervous System—SURGICAL 013.35 047.9 115.01 320.1 331.2 337.22 344.03 346.72 354.9 013.36 048 115.11 320.2 331.3 337.29 344.04 346.73 355.0 013.40 049.0 115.91 320.3 331.4 337.3 344.09 346.80 355.1 013.41 049.1 130.0 320.7 331.5 337.9 344.1 346.81 355.2 013.42 049.8 137.1 320.81 331.7 338.0 344.2 346.82 355.3 013.43 049.9 138 320.82 331.81 338.21 344.30 346.83 355.4 013.44 052.0 139.0 320.89 331.82 338.22 344.31 346.90 355.5 013.45 052.2 191.0 320.9 331.83 338.28 344.32 346.91 355.6 013.46 053.0 191.1 321.0 331.89 338.29 344.40 346.92 355.71 013.50 053.10 191.2 321.1 331.9 338.4 344.41 346.93 355.79 013.51 053.11 191.3 321.2 332.0 339.00 344.42 347.00 355.8 013.52 053.12 191.4 321.3 332.1 339.01 344.5 347.01 355.9 013.53 053.13 191.5 321.4 333.0 339.02 344.60 347.10 356.0 013.54 053.14 191.6 321.8 333.1 339.03 344.81 347.11 356.1 013.55 053.19 191.7 322.0 333.2 339.04 344.89 348.0 356.2 013.56 054.3 191.8 322.1 333.3 339.05 344.9 348.1 356.3 013.60 054.72 191.9 322.2 333.4 339.09 345.00 348.2 356.4 013.61 054.74 192.0 322.9 333.5 339.10 345.01 348.30 356.8 013.62 055.0 192.1 323.01 333.6 339.11 345.10 348.31 356.9 013.63 056.00 192.2 323.02 333.71 339.12 345.11 348.39 357.0 013.64 056.01 192.3 323.1 333.72 339.20 345.2 348.4 357.1 013.65 056.09 192.8 323.2 333.79 339.21 345.3 348.5 357.2 013.66 058.21 192.9 323.41 333.82 339.22 345.40 348.81 357.3 013.80 058.29 194.4 323.42 333.83 339.3 345.41 348.89 357.4 013.81 062.0 194.5 323.51 333.84 339.41 345.50 348.9 357.5 013.82 062.1 194.6 323.52 333.85 339.42 345.51 349.0 357.6 013.83 062.2 198.3 323.61 333.89 339.43 345.60 349.1 357.7 013.84 062.3 198.4 323.62 333.90 339.44 345.61 349.2 357.81 013.85 062.4 225.0 323.63 333.91 339.81 345.70 349.81 357.82 013.86 062.5 225.1 323.71 333.92 339.82 345.71 349.82 357.89 013.90 062.8 225.2 323.72 333.93 339.83 345.80 349.89 357.9 013.91 062.9 225.3 323.81 333.94 339.84 345.81 349.9 358.00 013.92 063.0 225.4 323.82 333.99 339.85 345.90 350.1 358.01 013.93 063.1 225.8 323.9 334.0 339.89 345.91 350.2 358.1 013.94 063.2 225.9 324.0 334.1 340 346.00 350.8 358.2 013.95 063.8 227.4 324.1 334.2 341.0 346.01 350.9 358.8 © 2010 Ingenix 5 Diseases And Disorders Of The Digestive System—MDC 6 44.66 Other procedures for creation of esophagogastric SURGICAL sphincteric competence 44.67 Laparoscopic procedures for creation of DRGy 326 Stomach, Esophageal and Duodenal Procedures esophagogastric sphincteric competence swith y MCC 44.68 Laparoscopic gastroplasty GMLOS 12.6 AMLOS 16.2 RW 5.8142 T 44.69 Other repair of stomach 44.91 Ligation of gastric varices Operating Room Procedures 44.92 Intraoperative manipulation of stomach 29.3* Excision or destruction of lesion or tissue of pharynx 44.99 Other operations on stomach 31.73 Closure of other fistula of trachea 45.01 Incision of duodenum 38.05 Incision of other thoracic vessels 45.31 Other local excision of lesion of duodenum 38.35 Resection of other thoracic vessels with anastomosis 45.32 Other destruction of lesion of duodenum 38.45 Resection of other thoracic vessels with replacement 46.71 Suture of laceration of duodenum 38.65 Other excision of other thoracic vessel 46.72 Closure of fistula of duodenum MDC 6: Diseases And Disorders 38.85 Other surgical occlusion of other thoracic vessel 51.82 Pancreatic sphincterotomy 39.1 Intra-abdominal venous shunt 51.83 Pancreatic sphincteroplasty 42.01 Incision of esophageal web 52.7 Radical pancreaticoduodenectomy 42.09 Other incision of esophagus 53.7* Repair of diaphragmatic hernia, abdominal approach 42.1* Esophagostomy 53.8* Repair of diaphragmatic hernia, thoracic approach 42.21 Operative esophagoscopy by incision 42.25 Open biopsy of esophagus DRGy 327 Stomach, Esophageal and Duodenal Procedures 42.31 Local excision of esophageal diverticulum swith y CC 42.32 Local excision of other lesion or tissue of esophagus GMLOS 6.9 AMLOS 8.8 RW 2.7231 T4 42.39 Other destruction of lesion or tissue of esophagus 42.4* Excision of esophagus Select operating room procedures listed under DRG 326 42.5* Intrathoracic anastomosis of esophagus 42.6* Antesternal anastomosis of esophagus DRGy 328 Stomach, Esophageal and Duodenal Procedures 42.7 Esophagomyotomy without CC/MCC 42.82 Suture of laceration of esophagus GMLOS 2.9 AMLOS 3.8 RW 1.4298 T4 42.83 Closure of esophagostomy Of The Digestive System—SURGICAL Select operating room procedures listed under DRG
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