[Federal Register: August 1, 2002 (Volume 67, Number 148)] [Rules and Regulations] [Page 50231-50280] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr01au02-18] [[pp. 50231-50280]] Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2003 Rates [[Continued from page 50230]] [[Page 50230]] Table 5.--List of Diagnosis-Related Groups (DRGS), Relative Weighting Factors, Geometric and Arithmetic Mean Length of Stay (LOS)* [Explanation of footnotes: * Medicare Data Have Been Supplemented by Data From 19 States for Low Volume DRGS. ** DRGS 469 and 470 Contain Cases Which Could not be Assigned to Valid DRGS. Note: Geometric Mean is Used Only to Determine Payment for Transfer Cases. Note: Arithmetic Mean is Presented for Informational Purposes only. Note: Relative Weights are Based on Medicare Patient Data and May Not be Appropriate for Other Patients.] ---------------------------------------------------------------------------------------------------------------- Relative Geometric Arithmetic DRG MDC Type DRG Title weights mean LOS mean LOS ---------------------------------------------------------------------------------------------------------------- 1............... 01 SURG CRANIOTOMY AGE >17 W CC.... 3.7399 8.1 11.2 2............... 01 SURG CRANIOTOMY AGE >17 W/O CC.. 1.9730 4.0 5.2 3............... 01 SURG *CRANIOTOMY AGE 0-17....... 1.9504 12.7 12.7 4............... 01 SURG SPINAL PROCEDURES.......... 2.3184 4.5 7.2 5............... 01 SURG EXTRACRANIAL VASCULAR 1.3837 2.1 3.1 PROCEDURES. 6............... 01 SURG CARPAL TUNNEL RELEASE...... 0.8242 2.1 2.9 7............... 01 SURG PERIPH & CRANIAL NERVE & 2.5807 6.5 9.8 OTHER NERV SYST PROC W CC. 8............... 01 SURG PERIPH & CRANIAL NERVE & 1.4967 1.9 2.8 OTHER NERV SYST PROC W/O CC. 9............... 01 MED SPINAL DISORDERS & INJURIES 1.3769 4.6 6.6 10.............. 01 MED NERVOUS SYSTEM NEOPLASMS W 1.2598 4.8 6.6 CC. 11.............. 01 MED NERVOUS SYSTEM NEOPLASMS W/ 0.8689 3.0 4.0 O CC. 12.............. 01 MED DEGENERATIVE NERVOUS SYSTEM 0.8918 4.4 5.9 DISORDERS. 13.............. 01 MED MULTIPLE SCLEROSIS & 0.7968 4.1 5.0 CEREBELLAR ATAXIA. 14.............. 01 MED INTRACRANIAL HEMORRHAGE & 1.2943 4.8 6.2 STROKE W INFARCT. 15.............. 01 MED NONSPECIFIC CVA & 0.9858 4.0 5.0 PRECEREBRAL OCCLUSION W/O INFARCT. 16.............. 01 MED NONSPECIFIC CEREBROVASCULAR 1.2413 4.7 6.2 DISORDERS W CC. 17.............. 01 MED NONSPECIFIC CEREBROVASCULAR 0.6672 2.5 3.1 DISORDERS W/O CC. 18.............. 01 MED CRANIAL & PERIPHERAL NERVE 0.9727 4.2 5.4 DISORDERS W CC. 19.............. 01 MED CRANIAL & PERIPHERAL NERVE 0.6944 2.8 3.5 DISORDERS W/O CC. 20.............. 01 MED NERVOUS SYSTEM INFECTION 2.8156 8.0 10.7 EXCEPT VIRAL MENINGITIS. 21.............. 01 MED VIRAL MENINGITIS........... 1.5369 5.0 6.6 22.............. 01 MED HYPERTENSIVE ENCEPHALOPATHY 1.0343 3.9 5.0 23.............. 01 MED NONTRAUMATIC STUPOR & COMA. 0.8220 3.1 4.3 24.............. 01 MED SEIZURE & HEADACHE AGE >17 0.9978 3.6 4.9 W CC. 25.............. 01 MED SEIZURE & HEADACHE AGE >17 0.6085 2.5 3.2 W/O CC. 26.............. 01 MED SEIZURE & HEADACHE AGE 0-17 0.7847 2.5 4.6 27.............. 01 MED TRAUMATIC STUPOR & COMA, 1.3164 3.1 5.0 COMA >1 HR. 28.............. 01 MED TRAUMATIC STUPOR & COMA, 1.3447 4.5 6.3 COMA 1 HR AGE >17 W CC. 29.............. 01 MED TRAUMATIC STUPOR & COMA, 0.7086 2.7 3.6 COMA 1 HR AGE >17 W/O CC. 30.............. 01 MED *TRAUMATIC STUPOR & COMA, 0.3299 2.0 2.0 COMA 1 HR AGE 0-17. 31.............. 01 MED CONCUSSION AGE >17 W CC.... 0.8806 3.0 4.1 32.............. 01 MED CONCUSSION AGE >17 W/O CC.. 0.5336 1.9 2.4 33.............. 01 MED *CONCUSSION AGE 0-17....... 0.2072 1.6 1.6 34.............. 01 MED OTHER DISORDERS OF NERVOUS 0.9978 3.7 5.0 SYSTEM W CC. 35.............. 01 MED OTHER DISORDERS OF NERVOUS 0.6385 2.5 3.2 SYSTEM W/O CC. 36.............. 02 SURG RETINAL PROCEDURES......... 0.6830 1.2 1.5 37.............. 02 SURG ORBITAL PROCEDURES......... 1.0568 2.6 3.8 38.............. 02 SURG PRIMARY IRIS PROCEDURES.... 0.5418 1.9 2.5 39.............. 02 SURG LENS PROCEDURES WITH OR 0.5936 1.5 1.9 WITHOUT VITRECTOMY. 40.............. 02 SURG EXTRAOCULAR PROCEDURES 0.8756 2.5 3.6 EXCEPT ORBIT AGE >17. 41.............. 02 SURG *EXTRAOCULAR PROCEDURES 0.3358 1.6 1.6 EXCEPT ORBIT AGE 0-17. 42.............. 02 SURG INTRAOCULAR PROCEDURES 0.6593 1.7 2.4 EXCEPT RETINA, IRIS & LENS. 43.............. 02 MED HYPHEMA.................... 0.4992 2.4 3.0 44.............. 02 MED ACUTE MAJOR EYE INFECTIONS. 0.6409 4.1 5.1 45.............. 02 MED NEUROLOGICAL EYE DISORDERS. 0.7080 2.6 3.2 46.............. 02 MED OTHER DISORDERS OF THE EYE 0.7832 3.4 4.6 AGE >17 W CC. 47.............. 02 MED OTHER DISORDERS OF THE EYE 0.5209 2.5 3.2 AGE >17 W/O CC. 48.............. 02 MED *OTHER DISORDERS OF THE EYE 0.2958 2.9 2.9 AGE 0-17. 49.............. 03 SURG MAJOR HEAD & NECK 1.7796 3.3 4.6 PROCEDURES. 50.............. 03 SURG SIALOADENECTOMY............ 0.8332 1.5 1.8 51.............. 03 SURG SALIVARY GLAND PROCEDURES 0.9461 1.9 3.1 EXCEPT SIALOADENECTOMY. 52.............. 03 SURG CLEFT LIP & PALATE REPAIR.. 0.7983 1.5 1.9 53.............. 03 SURG SINUS & MASTOID PROCEDURES 1.2005 2.1 3.4 AGE >17. 54.............. 03 SURG *SINUS & MASTOID PROCEDURES 0.4795 3.2 3.2 AGE 0-17. 55.............. 03 SURG MISCELLANEOUS EAR, NOSE, 0.9595 1.9 3.1 MOUTH & THROAT PROCEDURES. 56.............. 03 SURG RHINOPLASTY................ 0.9666 2.0 3.0 57.............. 03 SURG T&A PROC, EXCEPT 0.9927 2.4 3.7 TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17. 58.............. 03 SURG *T&A PROC, EXCEPT 0.2722 1.5 1.5 TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0- 17. 59.............. 03 SURG TONSILLECTOMY &/OR 0.7528 1.8 2.6 ADENOIDECTOMY ONLY, AGE >17. 60.............. 03 SURG *TONSILLECTOMY &/OR 0.2073 1.5 1.5 ADENOIDECTOMY ONLY, AGE 0- 17. 61.............. 03 SURG MYRINGOTOMY W TUBE 1.3065 2.9 4.8 INSERTION AGE >17. 62.............. 03 SURG *MYRINGOTOMY W TUBE 0.2936 1.3 1.3 INSERTION AGE 0-17. 63.............. 03 SURG OTHER EAR, NOSE, MOUTH & 1.4363 3.0 4.5 THROAT O.R. PROCEDURES. 64.............. 03 MED EAR, NOSE, MOUTH & THROAT 1.3119 4.4 6.6 MALIGNANCY. [[Page 50231]] 65.............. 03 MED DYSEQUILIBRIUM............. 0.5484 2.3 2.8 66.............. 03 MED EPISTAXIS.................. 0.5653 2.4 3.1 67.............. 03 MED EPIGLOTTITIS............... 0.7774 2.8 3.6 68.............. 03 MED OTITIS MEDIA & URI AGE 0.6696 3.1 3.8 >17 W CC. 69.............. 03 MED OTITIS MEDIA & URI AGE 0.5025 2.4 3.0 >17 W/O CC. 70.............. 03 MED OTITIS MEDIA & URI AGE 0-17 0.4638 2.8 3.5 71.............. 03 MED LARYNGOTRACHEITIS.......... 0.6895 2.8 3.4 72.............. 03 MED NASAL TRAUMA & DEFORMITY... 0.7185 2.6 3.6 73.............. 03 MED OTHER EAR, NOSE, MOUTH & 0.7961 3.2 4.4 THROAT DIAGNOSES AGE >17. 74.............. 03 MED *OTHER EAR, NOSE, MOUTH & 0.3337 2.1 2.1 THROAT DIAGNOSES AGE 0-17. 75.............. 04 SURG MAJOR CHEST PROCEDURES..... 3.1077 7.7 10.1 76.............. 04 SURG OTHER RESP SYSTEM O.R. 2.8647 8.5 11.5 PROCEDURES W CC. 77.............. 04 SURG OTHER RESP SYSTEM O.R. 1.2097 3.5 4.9 PROCEDURES W/O CC. 78.............. 04 MED PULMONARY EMBOLISM......... 1.3022 5.7 6.7 79.............. 04 MED RESPIRATORY INFECTIONS & 1.6193 6.7 8.5 INFLAMMATIONS AGE >17 W CC. 80.............. 04 MED RESPIRATORY INFECTIONS & 0.8757 4.4 5.5 INFLAMMATIONS AGE >17 W/O CC. 81.............. 04 MED *RESPIRATORY INFECTIONS & 1.5107 6.1 6.1 INFLAMMATIONS AGE 0-17. 82.............. 04 MED RESPIRATORY NEOPLASMS...... 1.3943 5.2 7.0 83.............. 04 MED MAJOR CHEST TRAUMA W CC.... 0.9728 4.3 5.5 84.............. 04 MED MAJOR CHEST TRAUMA W/O CC.. 0.5125 2.6 3.2 85.............. 04 MED PLEURAL EFFUSION W CC...... 1.2145 4.8 6.4 86.............. 04 MED PLEURAL EFFUSION W/O CC.... 0.6963 2.9 3.8 87.............. 04 MED PULMONARY EDEMA & 1.3658 4.8 6.4 RESPIRATORY FAILURE. 88.............. 04 MED CHRONIC OBSTRUCTIVE 0.9028 4.1 5.1 PULMONARY DISEASE. 89.............. 04 MED SIMPLE PNEUMONIA & PLEURISY 1.0420 4.8 5.9 AGE >17 W CC. 90.............. 04 MED SIMPLE PNEUMONIA & PLEURISY 0.6262 3.4 4.0 AGE >17 W/O CC. 91.............. 04 MED SIMPLE PNEUMONIA & PLEURISY 0.7034 3.2 4.0 AGE 0-17. 92.............. 04 MED INTERSTITIAL LUNG DISEASE W 1.2273 5.0 6.4 CC. 93.............. 04 MED INTERSTITIAL LUNG DISEASE W/ 0.7306 3.3 4.1 O CC. 94.............. 04 MED PNEUMOTHORAX W CC.......... 1.1624 4.7 6.4 95.............. 04 MED PNEUMOTHORAX W/O CC........ 0.5940 2.9 3.7 96.............. 04 MED BRONCHITIS & ASTHMA AGE >17 0.7530 3.7 4.6 W CC. 97.............. 04 MED BRONCHITIS & ASTHMA AGE >17 0.5593 2.9 3.5 W/O CC. 98.............. 04 MED BRONCHITIS & ASTHMA AGE 0- 0.9540 3.7 5.1 17. 99.............. 04 MED RESPIRATORY SIGNS & 0.7034 2.4 3.2 SYMPTOMS W CC. 100............. 04 MED RESPIRATORY SIGNS & 0.5350 1.7 2.1 SYMPTOMS W/O CC. 101............. 04 MED OTHER RESPIRATORY SYSTEM 0.8592 3.3 4.4 DIAGNOSES W CC. 102............. 04 MED OTHER RESPIRATORY SYSTEM 0.5467 2.0 2.6 DIAGNOSES W/O CC. 103............. PRE SURG HEART TRANSPLANT........... 20.5419 30.5 52.1 104............. 05 SURG CARDIAC VALVE & OTH MAJOR 7.9916 12.3 14.4 CARDIOTHORACIC PROC W CARD CATH. 105............. 05 SURG CARDIAC VALVE & OTH MAJOR 5.8063 8.3 10.0 CARDIOTHORACIC PROC W/O CARD CATH. 106............. 05 SURG CORONARY BYPASS W PTCA..... 7.4425 9.6 11.4 107............. 05 SURG CORONARY BYPASS W CARDIAC 5.3850 9.2 10.5 CATH. 108............. 05 SURG OTHER CARDIOTHORACIC 5.4758 7.8 10.3 PROCEDURES. 109............. 05 SURG CORONARY BYPASS W/O PTCA OR 3.9795 6.8 7.7 CARDIAC CATH. 110............. 05 SURG MAJOR CARDIOVASCULAR 4.1218 6.5 9.1 PROCEDURES W CC. 111............. 05 SURG MAJOR CARDIOVASCULAR 2.4580 3.5 4.4 PROCEDURES W/O CC. 112............. 05 SURG NO LONGER VALID............ 0.0000 0.0 0.0 113............. 05 SURG AMPUTATION FOR CIRC SYSTEM 3.0261 10.4 13.4 DISORDERS EXCEPT UPPER LIMB & TOE. 114............. 05 SURG UPPER LIMB & TOE AMPUTATION 1.6551 6.2 8.5 FOR CIRC SYSTEM DISORDERS. 115............. 05 SURG PRM CARD PACEM IMPL W 3.4466 5.9 8.3 AMI,HRT FAIL OR SHK,OR AICD LEAD OR GN. 116............. 05 SURG OTHER PERMANENT CARDIAC 2.3078 3.2 4.5 PACEMAKER IMPLANT. 117............. 05 SURG CARDIAC PACEMAKER REVISION 1.3345 2.6 4.2 EXCEPT DEVICE REPLACEMENT. 118............. 05 SURG CARDIAC PACEMAKER DEVICE 1.5689 1.9 2.9 REPLACEMENT. 119............. 05 SURG VEIN LIGATION & STRIPPING.. 1.3045 3.0 5.1 120............. 05 SURG OTHER CIRCULATORY SYSTEM 2.2383 5.3 8.8 O.R. PROCEDURES. 121............. 05 MED CIRCULATORY DISORDERS W AMI 1.6216 5.3 6.6 & MAJOR COMP, DISCHARGED ALIVE. 122............. 05 MED CIRCULATORY DISORDERS W AMI 1.0679 3.0 3.8 W/O MAJOR COMP, DISCHARGED ALIVE. 123............. 05 MED CIRCULATORY DISORDERS W 1.5529 2.8 4.7 AMI, EXPIRED. [[Page 50232]] 124............. 05 MED CIRCULATORY DISORDERS 1.4415 3.3 4.4 EXCEPT AMI, W CARD CATH & COMPLEX DIAG. 125............. 05 MED CIRCULATORY DISORDERS 1.0844 2.1 2.7 EXCEPT AMI, W CARD CATH W/ O COMPLEX DIAG. 126............. 05 MED ACUTE & SUBACUTE 2.7280 9.5 12.2 ENDOCARDITIS. 127............. 05 MED HEART FAILURE & SHOCK...... 1.0039 4.1 5.3 128............. 05 MED DEEP VEIN THROMBOPHLEBITIS. 0.7230 4.7 5.5 129............. 05 MED CARDIAC ARREST, UNEXPLAINED 1.0767 1.8 2.8 130............. 05 MED PERIPHERAL VASCULAR 0.9439 4.5 5.7 DISORDERS W CC. 131............. 05 MED PERIPHERAL VASCULAR 0.5706 3.3 4.1 DISORDERS W/O CC. 132............. 05 MED ATHEROSCLEROSIS W CC....... 0.6564 2.3 2.9 133............. 05 MED ATHEROSCLEROSIS W/O CC..... 0.5353 1.8 2.3 134............. 05 MED HYPERTENSION............... 0.5877 2.5 3.2 135............. 05 MED CARDIAC CONGENITAL & 0.9011 3.3 4.5 VALVULAR DISORDERS AGE >17 W CC. 136............. 05 MED CARDIAC CONGENITAL & 0.5711 2.1 2.6 VALVULAR DISORDERS AGE >17 W/O CC. 137............. 05 MED *CARDIAC CONGENITAL & 0.8139 3.3 3.3 VALVULAR DISORDERS AGE 0- 17. 138............. 05 MED CARDIAC ARRHYTHMIA & 0.8274 3.1 4.0 CONDUCTION DISORDERS W CC. 139............. 05 MED CARDIAC ARRHYTHMIA & 0.5126 2.0 2.5 CONDUCTION DISORDERS W/O CC. 140............. 05 MED ANGINA PECTORIS............ 0.5382 2.1 2.6 141............. 05 MED SYNCOPE & COLLAPSE W CC.... 0.7296 2.8 3.6 142............. 05 MED SYNCOPE & COLLAPSE W/O CC.. 0.5613 2.1 2.6 143............. 05 MED CHEST PAIN................. 0.5391 1.7 2.1 144............. 05 MED OTHER CIRCULATORY SYSTEM 1.1992 3.8 5.5 DIAGNOSES W CC. 145............. 05 MED OTHER CIRCULATORY SYSTEM 0.5899 2.1 2.7 DIAGNOSES W/O CC. 146............. 06 SURG RECTAL RESECTION W CC...... 2.7203 8.8 10.2 147............. 06 SURG RECTAL RESECTION W/O CC.... 1.5562 5.8 6.4 148............. 06 SURG MAJOR SMALL & LARGE BOWEL 3.4503 10.2 12.3 PROCEDURES W CC. 149............. 06 SURG MAJOR SMALL & LARGE BOWEL 1.5251 5.9 6.5 PROCEDURES W/O CC. 150............. 06 SURG PERITONEAL ADHESIOLYSIS W 2.8484 9.1 11.2 CC. 151............. 06 SURG PERITONEAL ADHESIOLYSIS W/O 1.3296 4.5 5.7 CC. 152............. 06 SURG MINOR SMALL & LARGE BOWEL 1.9506 6.9 8.3 PROCEDURES W CC. 153............. 06 SURG MINOR SMALL & LARGE BOWEL 1.1770 4.8 5.4 PROCEDURES W/O CC. 154............. 06 SURG STOMACH, ESOPHAGEAL & 4.1533 9.8 13.3 DUODENAL PROCEDURES AGE >17 W CC. 155............. 06 SURG STOMACH, ESOPHAGEAL & 1.3082 3.0 4.0 DUODENAL PROCEDURES AGE >17 W/O CC. 156............. 06 SURG *STOMACH, ESOPHAGEAL & 0.8382 6.0 6.0 DUODENAL PROCEDURES AGE 0- 17. 157............. 06 SURG ANAL & STOMAL PROCEDURES W 1.2612 3.9 5.6 CC. 158............. 06 SURG ANAL & STOMAL PROCEDURES W/ 0.6503 2.0 2.5 O CC. 159............. 06 SURG HERNIA PROCEDURES EXCEPT 1.3612 3.7 5.1 INGUINAL & FEMORAL AGE >17 W CC. 160............. 06 SURG HERNIA PROCEDURES EXCEPT 0.8065 2.2 2.6 INGUINAL & FEMORAL AGE >17 W/O CC. 161............. 06 SURG INGUINAL & FEMORAL HERNIA 1.1264 2.8 4.2 PROCEDURES AGE >17 W CC. 162............. 06 SURG INGUINAL & FEMORAL HERNIA 0.6325 1.6 1.9 PROCEDURES AGE >17 W/O CC. 163............. 06 SURG *HERNIA PROCEDURES AGE 0-17 0.6877 2.1 2.1 164............. 06 SURG APPENDECTOMY W COMPLICATED 2.2962 7.0 8.3 PRINCIPAL DIAG W CC. 165............. 06 SURG APPENDECTOMY W COMPLICATED 1.2609 4.0 4.6 PRINCIPAL DIAG W/O CC. 166............. 06 SURG APPENDECTOMY W/O 1.4690 3.7 4.9 COMPLICATED PRINCIPAL DIAG W CC. 167............. 06 SURG APPENDECTOMY W/O 0.9088 2.1 2.5 COMPLICATED PRINCIPAL DIAG W/O CC. 168............. 03 SURG MOUTH PROCEDURES W CC...... 1.3038 3.3 4.9 169............. 03 SURG MOUTH PROCEDURES W/O CC.... 0.7444 1.8 2.3 170............. 06 SURG OTHER DIGESTIVE SYSTEM O.R. 2.8555 7.6 11.1 PROCEDURES W CC. 171............. 06 SURG OTHER DIGESTIVE SYSTEM O.R. 1.2025 3.1 4.3 PROCEDURES W/O CC. 172............. 06 MED DIGESTIVE MALIGNANCY W CC.. 1.3624 5.1 7.0 173............. 06 MED DIGESTIVE MALIGNANCY W/O CC 0.7540 2.7 3.7 174............. 06 MED G.I. HEMORRHAGE W CC....... 0.9952 3.9 4.8 175............. 06 MED G.I. HEMORRHAGE W/O CC..... 0.5551 2.5 2.9 176............. 06 MED COMPLICATED PEPTIC ULCER... 1.0826 4.1 5.3 177............. 06 MED UNCOMPLICATED PEPTIC ULCER 0.9170 3.7 4.5 W CC. 178............. 06 MED UNCOMPLICATED PEPTIC ULCER 0.6806 2.6 3.1 W/O CC. 179............. 06 MED INFLAMMATORY BOWEL DISEASE. 1.0786 4.6 6.0 180............. 06 MED G.I. OBSTRUCTION W CC...... 0.9443 4.1 5.4 181............. 06 MED G.I. OBSTRUCTION W/O CC.... 0.5331 2.8 3.4 [[Page 50233]] 182............. 06 MED ESOPHAGITIS, GASTROENT & 0.7986 3.3 4.4 MISC DIGEST DISORDERS AGE >17 W CC. 183............. 06 MED ESOPHAGITIS, GASTROENT & 0.5723 2.3 2.9 MISC DIGEST DISORDERS AGE >17 W/O CC. 184............. 06 MED ESOPHAGITIS, GASTROENT & 0.4836 2.3 2.8 MISC DIGEST DISORDERS AGE 0-17. 185............. 03 MED DENTAL & ORAL DIS EXCEPT 0.8986 3.3 4.7 EXTRACTIONS & RESTORATIONS, AGE >17. 186............. 03 MED *DENTAL & ORAL DIS EXCEPT 0.3195 2.9 2.9 EXTRACTIONS & RESTORATIONS, AGE 0-17. 187............. 03 MED DENTAL EXTRACTIONS & 0.8665 3.1 4.2 RESTORATIONS. 188............. 06 MED OTHER DIGESTIVE SYSTEM 1.0985 4.1 5.6 DIAGNOSES AGE >17 W CC. 189............. 06 MED OTHER DIGESTIVE SYSTEM 0.5825 2.4 3.1 DIAGNOSES AGE >17 W/O CC. 190............. 06 MED OTHER DIGESTIVE SYSTEM 0.7006 3.3 4.8 DIAGNOSES AGE 0-17. 191............. 07 SURG PANCREAS, LIVER & SHUNT 4.3282 9.8 13.8 PROCEDURES W CC. 192............. 07 SURG PANCREAS, LIVER & SHUNT 1.7144 4.7 6.1 PROCEDURES W/O CC. 193............. 07 SURG BILIARY TRACT PROC EXCEPT 3.4245 10.5 12.8 ONLY CHOLECYST W OR W/O C.D.E. W CC. 194............. 07 SURG BILIARY TRACT PROC EXCEPT 1.6033 5.5 6.9 ONLY CHOLECYST W OR W/O C.D.E. W/O CC. 195............. 07 SURG CHOLECYSTECTOMY W C.D.E. W 3.0071 8.6 10.4 CC. 196............. 07 SURG CHOLECYSTECTOMY W C.D.E. W/ 1.6046 4.6 5.4 O CC. 197............. 07 SURG CHOLECYSTECTOMY EXCEPT BY 2.4857 7.3 9.0 LAPAROSCOPE W/O C.D.E. W CC. 198............. 07 SURG CHOLECYSTECTOMY EXCEPT BY 1.2250 3.8 4.4 LAPAROSCOPE W/O C.D.E. W/O CC. 199............. 07 SURG HEPATOBILIARY DIAGNOSTIC 2.4345 7.0 9.9 PROCEDURE FOR MALIGNANCY. 200............. 07 SURG HEPATOBILIARY DIAGNOSTIC 2.9740 6.5 10.5 PROCEDURE FOR NON- MALIGNANCY. 201............. 07 SURG OTHER HEPATOBILIARY OR 3.7858 10.4 14.5 PANCREAS O.R. PROCEDURES. 202............. 07 MED CIRRHOSIS & ALCOHOLIC 1.2941 4.8 6.4 HEPATITIS. 203............. 07 MED MALIGNANCY OF HEPATOBILIARY 1.3555 5.0 6.8 SYSTEM OR PANCREAS. 204............. 07 MED DISORDERS OF PANCREAS 1.1858 4.4 5.8 EXCEPT MALIGNANCY. 205............. 07 MED DISORDERS OF LIVER EXCEPT 1.2003 4.6 6.2 MALIG,CIRR,ALC HEPA W CC. 206............. 07 MED DISORDERS OF LIVER EXCEPT 0.7061 3.0 3.9 MALIG,CIRR,ALC HEPA W/O CC. 207............. 07 MED DISORDERS OF THE BILIARY 1.1405 4.0 5.3 TRACT W CC. 208............. 07 MED DISORDERS OF THE BILIARY 0.6531 2.3 2.9 TRACT W/O CC. 209............. 08 SURG MAJOR JOINT & LIMB 2.0782 4.5 5.0 REATTACHMENT PROCEDURES OF LOWER EXTREMITY. 210............. 08 SURG HIP & FEMUR PROCEDURES 1.8622 6.1 7.0 EXCEPT MAJOR JOINT AGE >17 W CC. 211............. 08 SURG HIP & FEMUR PROCEDURES 1.2848 4.6 5.0 EXCEPT MAJOR JOINT AGE >17 W/O CC. 212............. 08 SURG *HIP & FEMUR PROCEDURES 0.8418 11.1 11.1 EXCEPT MAJOR JOINT AGE 0- 17. 213............. 08 SURG AMPUTATION FOR 1.8694 6.6 9.2 MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS. 214............. 08 SURG NO LONGER VALID............ 0.0000 0.0 0.0 215............. 08 SURG NO LONGER VALID............ 0.0000 0.0 0.0 216............. 08 SURG BIOPSIES OF MUSCULOSKELETAL 2.2225 6.6 9.6 SYSTEM & CONNECTIVE TISSUE. 217............. 08 SURG WND DEBRID & SKN GRFT 3.0272 9.1 13.5 EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS. 218............. 08 SURG LOWER EXTREM & HUMER PROC 1.5475 4.3 5.5 EXCEPT HIP,FOOT,FEMUR AGE >17 W CC. 219............. 08 SURG LOWER EXTREM & HUMER PROC 1.0266 2.7 3.2 EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC. 220............. 08 SURG *LOWER EXTREM & HUMER PROC 0.5807 5.3 5.3 EXCEPT HIP,FOOT,FEMUR AGE 0-17. 221............. 08 SURG NO LONGER VALID............ 0.0000 0.0 0.0 222............. 08 SURG NO LONGER VALID............ 0.0000 0.0 0.0 223............. 08 SURG MAJOR SHOULDER/ELBOW PROC, 1.0261 2.1 2.9 OR OTHER UPPER EXTREMITY PROC W CC. 224............. 08 SURG SHOULDER,ELBOW OR FOREARM 0.7859 1.6 1.9 PROC,EXC MAJOR JOINT PROC, W/O CC. 225............. 08 SURG FOOT PROCEDURES............ 1.1476 3.5 5.0 226............. 08 SURG SOFT TISSUE PROCEDURES W CC 1.5730 4.6 6.7 227............. 08 SURG SOFT TISSUE PROCEDURES W/O 0.8152 2.1 2.7 CC. [[Page 50234]] 228............. 08 SURG MAJOR THUMB OR JOINT 1.1379 2.6 4.1 PROC,OR OTH HAND OR WRIST PROC W CC. 229............. 08 SURG HAND OR WRIST PROC, EXCEPT 0.7004 1.7 2.2 MAJOR JOINT PROC, W/O CC. 230............. 08 SURG LOCAL EXCISION & REMOVAL OF 1.2763 3.3 5.1 INT FIX DEVICES OF HIP & FEMUR. 231............. 08 SURG LOCAL EXCISION & REMOVAL OF 1.4007 3.1 4.9 INT FIX DEVICES EXCEPT HIP & FEMUR. 232............. 08 SURG ARTHROSCOPY................ 1.0011 1.8 2.7 233............. 08 SURG OTHER MUSCULOSKELET SYS & 2.1159 5.1 7.8 CONN TISS O.R. PROC W CC. 234............. 08 SURG OTHER MUSCULOSKELET SYS & 1.2428 2.3 3.2 CONN TISS O.R. PROC W/O CC. 235............. 08 MED FRACTURES OF FEMUR......... 0.7692 3.8 5.1 236............. 08 MED FRACTURES OF HIP & PELVIS.. 0.7350 3.9 4.9 237............. 08 MED SPRAINS, STRAINS, & 0.5840 2.9 3.6 DISLOCATIONS OF HIP, PELVIS & THIGH. 238............. 08 MED OSTEOMYELITIS.............. 1.4039 6.6 8.9 239............. 08 MED PATHOLOGICAL FRACTURES & 1.0065 4.9 6.3 MUSCULOSKELETAL & CONN TISS MALIGNANCY. 240............. 08 MED CONNECTIVE TISSUE DISORDERS 1.3372 5.0 6.7 W CC. 241............. 08 MED CONNECTIVE TISSUE DISORDERS 0.6511 3.1 3.9 W/O CC. 242............. 08 MED SEPTIC ARTHRITIS........... 1.1281 5.1 6.7 243............. 08 MED MEDICAL BACK PROBLEMS...... 0.7418 3.7 4.7 244............. 08 MED BONE DISEASES & SPECIFIC 0.7072 3.7 4.7 ARTHROPATHIES W CC. 245............. 08 MED BONE DISEASES & SPECIFIC 0.4698 2.7 3.4 ARTHROPATHIES W/O CC. 246............. 08 MED NON-SPECIFIC ARTHROPATHIES. 0.5658 2.9 3.8 247............. 08 MED SIGNS & SYMPTOMS OF 0.5733 2.6 3.4 MUSCULOSKELETAL SYSTEM & CONN TISSUE. 248............. 08 MED TENDONITIS, MYOSITIS & 0.8357 3.8 4.9 BURSITIS. 249............. 08 MED AFTERCARE, MUSCULOSKELETAL 0.6902 2.5 3.7 SYSTEM & CONNECTIVE TISSUE. 250............. 08 MED FX, SPRN, STRN & DISL OF 0.6904 3.2 4.2 FOREARM, HAND, FOOT AGE >17 W CC. 251............. 08 MED FX, SPRN, STRN & DISL OF 0.4623 2.2 2.8 FOREARM, HAND, FOOT AGE >17 W/O CC. 252............. 08 MED *FX, SPRN, STRN & DISL OF 0.2521 1.8 1.8 FOREARM, HAND, FOOT AGE 0- 17. 253............. 08 MED FX, SPRN, STRN & DISL OF 0.7394 3.7 4.7 UPARM,LOWLEG EX FOOT AGE >17 W CC. 254............. 08 MED FX, SPRN, STRN & DISL OF 0.4440 2.6 3.1 UPARM,LOWLEG EX FOOT AGE >17 W/O CC. 255............. 08 MED *FX, SPRN, STRN & DISL OF 0.2937 2.9 2.9 UPARM,LOWLEG EX FOOT AGE 0- 17. 256............. 08 MED OTHER MUSCULOSKELETAL 0.8069 3.8 5.1 SYSTEM & CONNECTIVE TISSUE DIAGNOSES. 257............. 09 SURG TOTAL MASTECTOMY FOR 0.8994 2.1 2.7 MALIGNANCY W CC. 258............. 09 SURG TOTAL MASTECTOMY FOR 0.7101 1.6 1.8 MALIGNANCY W/O CC. 259............. 09 SURG SUBTOTAL MASTECTOMY FOR 0.9155 1.7 2.7 MALIGNANCY W CC. 260............. 09 SURG SUBTOTAL MASTECTOMY FOR 0.6827 1.2 1.4 MALIGNANCY W/O CC. 261............. 09 SURG BREAST PROC FOR NON- 0.9817 1.6 2.2 MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION. 262............. 09 SURG BREAST BIOPSY & LOCAL 0.9301 2.9 4.3 EXCISION FOR NON- MALIGNANCY. 263............. 09 SURG SKIN GRAFT &/OR DEBRID FOR 2.2854 9.3 12.5 SKN ULCER OR CELLULITIS W CC. 264............. 09 SURG SKIN GRAFT &/OR DEBRID FOR 1.1644 5.5 7.2 SKN ULCER OR CELLULITIS W/ O CC. 265............. 09 SURG SKIN GRAFT &/OR DEBRID 1.6039 4.2 6.8 EXCEPT FOR SKIN ULCER OR CELLULITIS W CC. 266............. 09 SURG SKIN GRAFT &/OR DEBRID 0.8590 2.2 3.1 EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC. 267............. 09 SURG PERIANAL & PILONIDAL 0.9394 2.5 4.2 PROCEDURES. 268............. 09 SURG SKIN, SUBCUTANEOUS TISSUE & 1.1026 2.3 3.6 BREAST PLASTIC PROCEDURES. 269............. 09 SURG OTHER SKIN, SUBCUT TISS & 1.7172 5.8 8.4 BREAST PROC W CC. 270............. 09 SURG OTHER SKIN, SUBCUT TISS & 0.7693 2.4 3.4 BREAST PROC W/O CC. 271............. 09 MED SKIN ULCERS................ 1.0303 5.6 7.3 272............. 09 MED MAJOR SKIN DISORDERS W CC.. 1.0050 4.6 6.1 273............. 09 MED MAJOR SKIN DISORDERS W/O CC 0.5587 3.0 3.9 274............. 09 MED MALIGNANT BREAST DISORDERS 1.1927 4.8 6.8 W CC. 275............. 09 MED MALIGNANT BREAST DISORDERS 0.5526 2.2 3.0 W/O CC. 276............. 09 MED NON-MALIGANT BREAST 0.6805 3.5 4.5 DISORDERS. 277............. 09 MED CELLULITIS AGE >17 W CC.... 0.8593 4.7 5.8 278............. 09 MED CELLULITIS AGE >17 W/O CC.. 0.5495 3.6 4.3 [[Page 50235]] 279............. 09 MED *CELLULITIS AGE 0-17....... 0.6601 4.2 4.2 280............. 09 MED TRAUMA TO THE SKIN, SUBCUT 0.6981 3.2 4.2 TISS & BREAST AGE >17 W CC. 281............. 09 MED TRAUMA TO THE SKIN, SUBCUT 0.4644 2.3 2.9 TISS & BREAST AGE >17 W/O CC. 282............. 09 MED *TRAUMA TO THE SKIN, SUBCUT 0.2553 2.2 2.2 TISS & BREAST AGE 0-17. 283............. 09 MED MINOR SKIN DISORDERS W CC.. 0.7221 3.5 4.7 284............. 09 MED MINOR SKIN DISORDERS W/O CC 0.4311 2.4 3.1 285............. 10 SURG AMPUTAT OF LOWER LIMB FOR 2.0499 8.0 10.7 ENDOCRINE,NUTRIT,& METABOL DISORDERS. 286............. 10 SURG ADRENAL & PITUITARY 2.0937 4.5 5.9 PROCEDURES. 287............. 10 SURG SKIN GRAFTS & WOUND DEBRID 1.8722 7.7 10.6 FOR ENDOC, NUTRIT & METAB DISORDERS. 288............. 10 SURG O.R. PROCEDURES FOR OBESITY 2.2239 4.3 5.4 289............. 10 SURG PARATHYROID PROCEDURES..... 0.9773 1.8 2.8 290............. 10 SURG THYROID PROCEDURES......... 0.8951 1.7 2.2 291............. 10 SURG THYROGLOSSAL PROCEDURES.... 0.6331 1.4 1.6 292............. 10 SURG OTHER ENDOCRINE, NUTRIT & 2.6826 7.3 10.7 METAB O.R. PROC W CC. 293............. 10 SURG OTHER ENDOCRINE, NUTRIT & 1.3164 3.4 5.1 METAB O.R. PROC W/O CC. 294............. 10 MED DIABETES AGE >35........... 0.7571 3.4 4.5 295............. 10 MED DIABETES AGE 0-35.......... 0.7928 3.0 4.0 296............. 10 MED NUTRITIONAL & MISC 0.8471 3.9 5.1 METABOLIC DISORDERS AGE >17 W CC. 297............. 10 MED NUTRITIONAL & MISC 0.5043 2.7 3.4 METABOLIC DISORDERS AGE >17 W/O CC. 298............. 10 MED NUTRITIONAL & MISC 0.5814 2.9 4.3 METABOLIC DISORDERS AGE 0- 17. 299............. 10 MED INBORN ERRORS OF METABOLISM 0.9420 3.8 5.4 300............. 10 MED ENDOCRINE DISORDERS W CC... 1.0940 4.7 6.2 301............. 10 MED ENDOCRINE DISORDERS W/O CC. 0.6319 2.8 3.7 302............. 11 SURG KIDNEY TRANSPLANT.......... 3.3000 7.4 8.7 303............. 11 SURG KIDNEY,URETER & MAJOR 2.4282 6.7 8.3 BLADDER PROCEDURES FOR NEOPLASM. 304............. 11 SURG KIDNEY,URETER & MAJOR 2.3343 6.2 8.7 BLADDER PROC FOR NON-NEOPL W CC. 305............. 11 SURG KIDNEY,URETER & MAJOR 1.2016 2.9 3.6 BLADDER PROC FOR NON-NEOPL W/O CC. 306............. 11 SURG PROSTATECTOMY W CC......... 1.2709 3.6 5.5 307............. 11 SURG PROSTATECTOMY W/O CC....... 0.6323 1.8 2.2 308............. 11 SURG MINOR BLADDER PROCEDURES W 1.6387 4.0 6.3 CC. 309............. 11 SURG MINOR BLADDER PROCEDURES W/ 0.8959 1.7 2.2 O CC. 310............. 11 SURG TRANSURETHRAL PROCEDURES W 1.1270 2.9 4.3 CC. 311............. 11 SURG TRANSURETHRAL PROCEDURES W/ 0.6262 1.5 1.8 O CC. 312............. 11 SURG URETHRAL PROCEDURES, AGE 1.0623 3.0 4.5 >17 W CC. 313............. 11 SURG URETHRAL PROCEDURES, AGE 0.6703 1.7 2.1 >17 W/O CC. 314............. 11 SURG *URETHRAL PROCEDURES, AGE 0- 0.4921 2.3 2.3 17. 315............. 11 SURG OTHER KIDNEY & URINARY 2.1046 3.9 7.2 TRACT O.R. PROCEDURES. 316............. 11 MED RENAL FAILURE.............. 1.3284 4.9 6.6 317............. 11 MED ADMIT FOR RENAL DIALYSIS... 0.6629 2.0 3.1 318............. 11 MED KIDNEY & URINARY TRACT 1.1868 4.4 6.1 NEOPLASMS W CC. 319............. 11 MED KIDNEY & URINARY TRACT 0.6017 2.1 2.8 NEOPLASMS W/O CC. 320............. 11 MED KIDNEY & URINARY TRACT 0.8551 4.3 5.3 INFECTIONS AGE >17 W CC. 321............. 11 MED KIDNEY & URINARY TRACT 0.5638 3.1 3.8 INFECTIONS AGE >17 W/O CC. 322............. 11 MED KIDNEY & URINARY TRACT 0.4987 3.2 3.7 INFECTIONS AGE 0-17. 323............. 11 MED URINARY STONES W CC, &/OR 0.8041 2.4 3.1 ESW LITHOTRIPSY. 324............. 11 MED URINARY STONES W/O CC...... 0.4638 1.5 1.8 325............. 11 MED KIDNEY & URINARY TRACT 0.6517 2.9 3.8 SIGNS & SYMPTOMS AGE >17 W CC. 326............. 11 MED KIDNEY & URINARY TRACT 0.4446 2.2 2.7 SIGNS & SYMPTOMS AGE >17 W/ O CC. 327............. 11 MED *KIDNEY & URINARY TRACT 0.3680 3.1 3.1 SIGNS & SYMPTOMS AGE 0-17. 328............. 11 MED URETHRAL STRICTURE AGE >17 0.7321 2.8 3.8 W CC. 329............. 11 MED URETHRAL STRICTURE AGE >17 0.4904 1.7 2.2 W/O CC. 330............. 11 MED *URETHRAL STRICTURE AGE 0- 0.3170 1.6 1.6 17. 331............. 11 MED OTHER KIDNEY & URINARY 1.0597 4.2 5.6 TRACT DIAGNOSES AGE >17 W CC. 332............. 11 MED OTHER KIDNEY & URINARY 0.6023 2.4 3.2 TRACT DIAGNOSES AGE >17 W/ O CC. 333............. 11 MED OTHER KIDNEY & URINARY 0.7795 3.3 4.7 TRACT DIAGNOSES AGE 0-17. 334............. 12 SURG MAJOR MALE PELVIC 1.5207 4.0 4.8 PROCEDURES W CC. 335............. 12 SURG MAJOR MALE PELVIC 1.1255 2.9 3.2 PROCEDURES W/O CC. 336............. 12 SURG TRANSURETHRAL PROSTATECTOMY 0.8707 2.6 3.4 W CC. 337............. 12 SURG TRANSURETHRAL PROSTATECTOMY 0.6033 1.8 2.1 W/O CC. 338............. 12 SURG TESTES PROCEDURES, FOR 1.2293 3.5 5.6 MALIGNANCY. 339............. 12 SURG TESTES PROCEDURES, NON- 1.1074 2.9 4.6 MALIGNANCY AGE >17. [[Page 50236]] 340............. 12 SURG *TESTES PROCEDURES, NON- 0.2817 2.4 2.4 MALIGNANCY AGE 0-17. 341............. 12 SURG PENIS PROCEDURES........... 1.2142 1.9 3.1 342............. 12 SURG CIRCUMCISION AGE >17....... 0.7922 2.4 3.2 343............. 12 SURG *CIRCUMCISION AGE 0-17..... 0.1531 1.7 1.7 344............. 12 SURG OTHER MALE REPRODUCTIVE 1.2658 1.6 2.4 SYSTEM O.R. PROCEDURES FOR MALIGNANCY. 345............. 12 SURG OTHER MALE REPRODUCTIVE 1.1852 2.9 4.8 SYSTEM O.R. PROC EXCEPT FOR MALIGNANCY. 346............. 12 MED MALIGNANCY, MALE 1.0468 4.5 6.0 REPRODUCTIVE SYSTEM, W CC. 347............. 12 MED MALIGNANCY, MALE 0.5649 2.0 2.7 REPRODUCTIVE SYSTEM, W/O CC. 348............. 12 MED BENIGN PROSTATIC 0.7106 3.2 4.2 HYPERTROPHY W CC. 349............. 12 MED BENIGN PROSTATIC 0.3974 1.9 2.5 HYPERTROPHY W/O CC. 350............. 12 MED INFLAMMATION OF THE MALE 0.7182 3.6 4.5 REPRODUCTIVE SYSTEM. 351............. 12 MED *STERILIZATION, MALE....... 0.2349 1.3 1.3 352............. 12 MED OTHER MALE REPRODUCTIVE 0.7283 2.9 4.0 SYSTEM DIAGNOSES. 353............. 13 SURG PELVIC EVISCERATION, 1.8769 5.0 6.5 RADICAL HYSTERECTOMY & RADICAL VULVECTOMY. 354............. 13 SURG UTERINE,ADNEXA PROC FOR NON- 1.5499 4.8 5.8 OVARIAN/ADNEXAL MALIG W CC. 355............. 13 SURG UTERINE,ADNEXA PROC FOR NON- 0.9144 3.0 3.2 OVARIAN/ADNEXAL MALIG W/O CC. 356............. 13 SURG FEMALE REPRODUCTIVE SYSTEM 0.7657 1.9 2.2 RECONSTRUCTIVE PROCEDURES. 357............. 13 SURG UTERINE & ADNEXA PROC FOR 2.3330 6.7 8.4 OVARIAN OR ADNEXAL MALIGNANCY. 358............. 13 SURG UTERINE & ADNEXA PROC FOR 1.2295 3.5 4.3 NON-MALIGNANCY W CC. 359............. 13 SURG UTERINE & ADNEXA PROC FOR 0.8345 2.4 2.6 NON-MALIGNANCY W/O CC. 360............. 13 SURG VAGINA, CERVIX & VULVA 0.8851 2.3 2.8 PROCEDURES. 361............. 13 SURG LAPAROSCOPY & INCISIONAL 1.1095 2.3 3.6 TUBAL INTERRUPTION. 362............. 13 SURG *ENDOSCOPIC TUBAL 0.3003 1.4 1.4 INTERRUPTION. 363............. 13 SURG D&C, CONIZATION & RADIO- 0.8840 2.6 3.6 IMPLANT, FOR MALIGNANCY. 364............. 13 SURG D&C, CONIZATION EXCEPT FOR 0.8391 2.7 3.9 MALIGNANCY. 365............. 13 SURG OTHER FEMALE REPRODUCTIVE 1.9491 5.2 7.7 SYSTEM O.R. PROCEDURES. 366............. 13 MED MALIGNANCY, FEMALE 1.2885 4.9 6.9 REPRODUCTIVE SYSTEM W CC. 367............. 13 MED MALIGNANCY, FEMALE 0.5416 2.3 3.0 REPRODUCTIVE SYSTEM W/O CC. 368............. 13 MED INFECTIONS, FEMALE 1.2032 5.2 6.7 REPRODUCTIVE SYSTEM. 369............. 13 MED MENSTRUAL & OTHER FEMALE 0.5950 2.4 3.2 REPRODUCTIVE SYSTEM DISORDERS. 370............. 14 SURG CESAREAN SECTION W CC...... 0.9848 4.4 5.7 371............. 14 SURG CESAREAN SECTION W/O CC.... 0.6745 3.2 3.6 372............. 14 MED VAGINAL DELIVERY W 0.6259 2.6 3.7 COMPLICATING DIAGNOSES. 373............. 14 MED VAGINAL DELIVERY W/O 0.3934 2.0 2.3 COMPLICATING DIAGNOSES. 374............. 14 SURG VAGINAL DELIVERY W 0.7727 2.5 2.9 STERILIZATION &/OR D&C. 375............. 14 SURG *VAGINAL DELIVERY W O.R. 0.5733 4.4 4.4 PROC EXCEPT STERIL &/OR D&C. 376............. 14 MED POSTPARTUM & POST ABORTION 0.4851 2.6 3.5 DIAGNOSES W/O O.R. PROCEDURE. 377............. 14 SURG POSTPARTUM & POST ABORTION 1.4354 3.0 4.2 DIAGNOSES W O.R. PROCEDURE. 378............. 14 MED ECTOPIC PREGNANCY.......... 0.8368 2.0 2.5 379............. 14 MED THREATENED ABORTION........ 0.3916 2.1 3.0 380............. 14 MED ABORTION W/O D&C........... 0.3631 1.6 2.0 381............. 14 SURG ABORTION W D&C, ASPIRATION 0.5896 1.6 2.1 CURETTAGE OR HYSTEROTOMY. 382............. 14 MED FALSE LABOR................ 0.1683 1.2 1.3 383............. 14 MED OTHER ANTEPARTUM DIAGNOSES 0.5474 2.7 4.0 W MEDICAL COMPLICATIONS. 384............. 14 MED OTHER ANTEPARTUM DIAGNOSES 0.4204 1.8 2.8 W/O MEDICAL COMPLICATIONS. 385............. 15 MED *NEONATES, DIED OR 1.3680 1.8 1.8 TRANSFERRED TO ANOTHER ACUTE CARE FACILITY. 386............. 15 MED *EXTREME IMMATURITY........ 4.5111 17.9 17.9 387............. 15 MED *PREMATURITY W MAJOR 3.0810 13.3 13.3 PROBLEMS. 388............. 15 MED *PREMATURITY W/O MAJOR 1.8590 8.6 8.6 PROBLEMS. 389............. 15 MED *FULL TERM NEONATE W MAJOR 3.1648 4.7 4.7 PROBLEMS. 390............. 15 MED *NEONATE W OTHER 1.1201 3.4 3.4 SIGNIFICANT PROBLEMS. 391............. 15 MED *NORMAL NEWBORN............ 0.1517 3.1 3.1 392............. 16 SURG SPLENECTOMY AGE >17........ 3.1665 6.9 9.5 393............. 16 SURG *SPLENECTOMY AGE 0-17...... 1.3400 9.1 9.1 [[Page 50237]] 394............. 16 SURG OTHER O.R. PROCEDURES OF 1.8110 4.3 7.1 THE BLOOD AND BLOOD FORMING ORGANS. 395............. 16 MED RED BLOOD CELL DISORDERS 0.8156 3.2 4.4 AGE >17. 396............. 16 MED RED BLOOD CELL DISORDERS 0.6591 2.4 3.8 AGE 0-17. 397............. 16 MED COAGULATION DISORDERS...... 1.2421 3.7 5.2 398............. 16 MED RETICULOENDOTHELIAL & 1.2700 4.6 5.9 IMMUNITY DISORDERS W CC. 399............. 16 MED RETICULOENDOTHELIAL & 0.6890 2.8 3.6 IMMUNITY DISORDERS W/O CC. 400............. 17 SURG LYMPHOMA & LEUKEMIA W MAJOR 2.6787 5.5 9.0 O.R. PROCEDURE. 401............. 17 SURG LYMPHOMA & NON-ACUTE 2.7850 8.0 11.3 LEUKEMIA W OTHER O.R. PROC W CC. 402............. 17 SURG LYMPHOMA & NON-ACUTE 1.1248 2.7 3.9 LEUKEMIA W OTHER O.R. PROC W/O CC. 403............. 17 MED LYMPHOMA & NON-ACUTE 1.7709 5.7 8.0 LEUKEMIA W CC. 404............. 17 MED LYMPHOMA & NON-ACUTE 0.8587 3.0 4.2 LEUKEMIA W/O CC. 405............. 17 MED *ACUTE LEUKEMIA W/O MAJOR 1.8998 4.9 4.9 O.R. PROCEDURE AGE 0-17. 406............. 17 SURG MYELOPROLIF DISORD OR 2.8059 6.9 9.7 POORLY DIFF NEOPL W MAJ O.R.PROC W CC. 407............. 17 SURG MYELOPROLIF DISORD OR 1.2905 3.3 4.1 POORLY DIFF NEOPL W MAJ O.R.PROC W/O CC. 408............. 17 SURG MYELOPROLIF DISORD OR 2.0623 4.7 7.9 POORLY DIFF NEOPL W OTHER O.R.PROC. 409............. 17 MED RADIOTHERAPY............... 1.2077 4.5 6.1 410............. 17 MED CHEMOTHERAPY W/O ACUTE 1.0456 3.1 4.0 LEUKEMIA AS SECONDARY DIAGNOSIS. 411............. 17 MED HISTORY OF MALIGNANCY W/O 0.3898 2.2 2.9 ENDOSCOPY. 412............. 17 MED HISTORY OF MALIGNANCY W 0.2792 1.6 2.0 ENDOSCOPY. 413............. 17 MED OTHER MYELOPROLIF DIS OR 1.3696 5.3 7.3 POORLY DIFF NEOPL DIAG W CC. 414............. 17 MED OTHER MYELOPROLIF DIS OR 0.6931 3.0 4.0 POORLY DIFF NEOPL DIAG W/O CC. 415............. 18 SURG O.R. PROCEDURE FOR 3.6798 10.4 14.5 INFECTIOUS & PARASITIC DISEASES. 416............. 18 MED SEPTICEMIA AGE >17......... 1.5985 5.6 7.5 417............. 18 MED SEPTICEMIA AGE 0-17........ 1.1847 4.5 6.2 418............. 18 MED POSTOPERATIVE & POST- 1.0459 4.8 6.2 TRAUMATIC INFECTIONS. 419............. 18 MED FEVER OF UNKNOWN ORIGIN AGE 0.8674 3.6 4.7 >17 W CC. 420............. 18 MED FEVER OF UNKNOWN ORIGIN AGE 0.5908 2.8 3.4 >17 W/O CC. 421............. 18 MED VIRAL ILLNESS AGE >17...... 0.7062 2.9 3.8 422............. 18 MED VIRAL ILLNESS & FEVER OF 0.4381 2.4 3.0 UNKNOWN ORIGIN AGE 0-17. 423............. 18 MED OTHER INFECTIOUS & 1.7896 5.9 8.3 PARASITIC DISEASES DIAGNOSES. 424............. 19 SURG O.R. PROCEDURE W PRINCIPAL 2.3048 8.1 13.0 DIAGNOSES OF MENTAL ILLNESS. 425............. 19 MED ACUTE ADJUSTMENT REACTION & 0.6822 2.9 3.9 PSYCHOSOCIAL DYSFUNCTION. 426............. 19 MED DEPRESSIVE NEUROSES........ 0.5167 3.2 4.5 427............. 19 MED NEUROSES EXCEPT DEPRESSIVE. 0.5188 3.1 4.4 428............. 19 MED DISORDERS OF PERSONALITY & 0.7408 4.4 7.4 IMPULSE CONTROL. 429............. 19 MED ORGANIC DISTURBANCES & 0.8448 4.7 6.3 MENTAL RETARDATION. 430............. 19 MED PSYCHOSES.................. 0.7128 5.7 8.0 431............. 19 MED CHILDHOOD MENTAL DISORDERS. 0.5940 4.2 5.9 432............. 19 MED OTHER MENTAL DISORDER 0.6348 2.9 4.6 DIAGNOSES. 433............. 20 MED ALCOHOL/DRUG ABUSE OR 0.2755 2.2 3.0 DEPENDENCE, LEFT AMA. 434............. 20 MED NO LONGER VALID............ 0.0000 0.0 0.0 435............. 20 MED NO LONGER VALID............ 0.0000 0.0 0.0 436............. 20 MED NO LONGER VALID............ 0.0000 0.0 0.0 437............. 20 MED NO LONGER VALID............ 0.0000 0.0 0.0 438............. 20 .................... NO LONGER VALID............ 0.0000 0.0 0.0 439............. 21 SURG SKIN GRAFTS FOR INJURIES... 1.6965 5.4 8.5 440............. 21 SURG WOUND DEBRIDEMENTS FOR 1.9156 5.7 9.1 INJURIES. 441............. 21 SURG HAND PROCEDURES FOR 0.9314 2.1 3.1 INJURIES. 442............. 21 SURG OTHER O.R. PROCEDURES FOR 2.4136 5.6 8.6 INJURIES W CC. 443............. 21 SURG OTHER O.R. PROCEDURES FOR 1.0679 2.6 3.5 INJURIES W/O CC. 444............. 21 MED TRAUMATIC INJURY AGE >17 W 0.7614 3.2 4.3 CC. 445............. 21 MED TRAUMATIC INJURY AGE >17 W/ 0.4881 2.3 2.9 O CC. 446............. 21 MED *TRAUMATIC INJURY AGE 0-17. 0.2945 2.4 2.4 447............. 21 MED ALLERGIC REACTIONS AGE >17. 0.4992 1.8 2.4 448............. 21 MED *ALLERGIC REACTIONS AGE 0- 0.0969 2.9 2.9 17. 449............. 21 MED POISONING & TOXIC EFFECTS 0.8267 2.6 3.7 OF DRUGS AGE >17 W CC. 450............. 21 MED POISONING & TOXIC EFFECTS 0.4260 1.6 2.0 OF DRUGS AGE >17 W/O CC. 451............. 21 MED *POISONING & TOXIC EFFECTS 0.2615 2.1 2.1 OF DRUGS AGE 0-17. 452............. 21 MED COMPLICATIONS OF TREATMENT 1.0433 3.5 5.0 W CC. [[Page 50238]] 453............. 21 MED COMPLICATIONS OF TREATMENT 0.5146 2.1 2.8 W/O CC. 454............. 21 MED OTHER INJURY, POISONING & 0.8281 3.0 4.3 TOXIC EFFECT DIAG W CC. 455............. 21 MED OTHER INJURY, POISONING & 0.4582 1.8 2.4 TOXIC EFFECT DIAG W/O CC. 456............. 22 .................... NO LONGER VALID............ 0.0000 0.0 0.0 457............. 22 MED NO LONGER VALID............ 0.0000 0.0 0.0 458............. 22 SURG NO LONGER VALID............ 0.0000 0.0 0.0 459............. 22 SURG NO LONGER VALID............ 0.0000 0.0 0.0 460............. 22 MED NO LONGER VALID............ 0.0000 0.0 0.0 461............. 23 SURG O.R. PROC W DIAGNOSES OF 1.2060 2.2 4.1 OTHER CONTACT W HEALTH SERVICES. 462............. 23 MED REHABILITATION............. 1.1298 9.3 11.5 463............. 23 MED SIGNS & SYMPTOMS W CC...... 0.6957 3.2 4.2 464............. 23 MED SIGNS & SYMPTOMS W/O CC.... 0.4959 2.4 3.0 465............. 23 MED AFTERCARE W HISTORY OF 0.6786 1.8 2.9 MALIGNANCY AS SECONDARY DIAGNOSIS. 466............. 23 MED AFTERCARE W/O HISTORY OF 0.7500 2.2 4.1 MALIGNANCY AS SECONDARY DIAGNOSIS. 467............. 23 MED OTHER FACTORS INFLUENCING 0.6012 2.1 8.5 HEALTH STATUS. 468............. ....... .................... EXTENSIVE O.R. PROCEDURE 3.7267 9.2 13.0 UNRELATED TO PRINCIPAL DIAGNOSIS. 469............. ....... .................... **PRINCIPAL DIAGNOSIS 0.0000 0.0 0.0 INVALID AS DISCHARGE DIAGNOSIS. 470............. ....... .................... **UNGROUPABLE.............. 0.0000 0.0 0.0 471............. 08 SURG BILATERAL OR MULTIPLE MAJOR 3.1053 4.8 5.5 JOINT PROCS OF LOWER EXTREMITY. 472............. 22 SURG NO LONGER VALID............ 0.0000 0.0 0.0 473............. 17 SURG ACUTE LEUKEMIA W/O MAJOR 3.5411 7.3 12.6 O.R. PROCEDURE AGE >17. 474............. 04 SURG NO LONGER VALID............ 0.0000 0.0 0.0 475............. 04 MED RESPIRATORY SYSTEM 3.6632 8.0 11.4 DIAGNOSIS WITH VENTILATOR SUPPORT. 476............. ....... SURG PROSTATIC O.R. PROCEDURE 2.2592 8.0 11.3 UNRELATED TO PRINCIPAL DIAGNOSIS. 477............. ....... SURG NON-EXTENSIVE O.R. 1.8618 5.3 8.2 PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS. 478............. 05 SURG OTHER VASCULAR PROCEDURES W 2.3725 4.9 7.4 CC. 479............. 05 SURG OTHER VASCULAR PROCEDURES W/ 1.4321 2.5 3.3 O CC. 480............. PRE SURG LIVER TRANSPLANT........... 10.3805 15.7 21.8 481............. PRE SURG BONE MARROW TRANSPLANT..... 7.1307 19.3 22.1 482............. PRE SURG TRACHEOSTOMY FOR FACE,MOUTH 3.5614 9.7 12.6 & NECK DIAGNOSES. 483............. PRE SURG TRAC W MECH VENT 96+HRS OR 17.0510 34.8 42.2 PDX EXCEPT FACE,MOUTH & NECK DX. 484............. 24 SURG CRANIOTOMY FOR MULTIPLE 5.5768 8.8 13.1 SIGNIFICANT TRAUMA. 485............. 24 SURG LIMB REATTACHMENT, HIP AND 3.0493 7.7 9.5 FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA. 486............. 24 SURG OTHER O.R. PROCEDURES FOR 4.8153 8.3 12.3 MULTIPLE SIGNIFICANT TRAUMA. 487............. 24 MED OTHER MULTIPLE SIGNIFICANT 2.0055 5.5 7.8 TRAUMA. 488............. 25 SURG HIV W EXTENSIVE O.R. 4.6556 11.4 16.9 PROCEDURE. 489............. 25 MED HIV W MAJOR RELATED 1.7997 6.0 8.6 CONDITION. 490............. 25 MED HIV W OR W/O OTHER RELATED 1.0261 3.7 5.3 CONDITION. 491............. 08 SURG MAJOR JOINT & LIMB 1.7037 2.9 3.5 REATTACHMENT PROCEDURES OF UPPER EXTREMITY. 492............. 17 MED CHEMOTHERAPY W ACUTE 3.9528 9.2 15.0 LEUKEMIA AS SECONDARY DIAGNOSIS. 493............. 07 SURG LAPAROSCOPIC 1.8152 4.3 5.9 CHOLECYSTECTOMY W/O C.D.E. W CC. 494............. 07 SURG LAPAROSCOPIC 1.0107 1.9 2.5 CHOLECYSTECTOMY W/O C.D.E. W/O CC. 495............. PRE SURG LUNG TRANSPLANT............ 9.2016 14.4 17.3 496............. 08 SURG COMBINED ANTERIOR/POSTERIOR 5.7988 7.1 9.5 SPINAL FUSION. 497............. 08 SURG SPINAL FUSION EXCEPT 3.3938 5.4 6.5 CERVICAL W CC. 498............. 08 SURG SPINAL FUSION EXCEPT 2.4738 3.7 4.1 CERVICAL W/O CC. 499............. 08 SURG BACK & NECK PROCEDURES 1.4399 3.3 4.6 EXCEPT SPINAL FUSION W CC. 500............. 08 SURG BACK & NECK PROCEDURES 0.9489 2.0 2.5 EXCEPT SPINAL FUSION W/O CC. 501............. 08 SURG KNEE PROCEDURES W PDX OF 2.5922 8.4 10.6 INFECTION W CC. 502............. 08 SURG KNEE PROCEDURES W PDX OF 1.5368 5.2 6.4 INFECTION W/O CC. 503............. 08 SURG KNEE PROCEDURES W/O PDX OF 1.2128 2.9 3.9 INFECTION. 504............. 22 SURG EXTENSIVE 3RD DEGREE BURNS 14.6542 26.7 34.9 W SKIN GRAFT. 505............. 22 MED EXTENSIVE 3RD DEGREE BURNS 2.0178 2.2 3.7 W/O SKIN GRAFT. 506............. 22 SURG FULL THICKNESS BURN W SKIN 4.6725 12.7 17.3 GRAFT OR INHAL INJ W CC OR SIG TRAUMA. [[Page 50239]] 507............. 22 SURG FULL THICKNESS BURN W SKIN 1.7246 6.5 9.0 GRFT OR INHAL INJ W/O CC OR SIG TRAUMA. 508............. 22 MED FULL THICKNESS BURN W/O 1.4330 5.8 8.4 SKIN GRFT OR INHAL INJ W CC OR SIG TRAUMA. 509............. 22 MED FULL THICKNESS BURN W/O 0.9691 4.1 5.7 SKIN GRFT OR INH INJ W/O CC OR SIG TRAUMA. 510............. 22 MED NON-EXTENSIVE BURNS W CC OR 1.2301 4.6 6.7 SIGNIFICANT TRAUMA. 511............. 22 MED NON-EXTENSIVE BURNS W/O CC 0.7006 3.0 4.4 OR SIGNIFICANT TRAUMA. 512............. PRE SURG SIMULTANEOUS PANCREAS/ 5.8613 11.9 14.5 KIDNEY TRANSPLANT. 513............. PRE SURG PANCREAS TRANSPLANT........ 6.3271 9.4 10.8 514............. 05 SURG CARDIAC DEFIBRILLATOR 6.3376 5.0 7.3 IMPLANT W CARDIAC CATH. 515............. 05 SURG CARDIAC DEFIBRILLATOR 5.0562 3.3 5.5 IMPLANT W/O CARDIAC CATH. 516............. 05 SURG PERCUTANEOUS CARDIOVASCULAR 2.7273 3.7 4.8 PROC W AMI. 517............. 05 SURG PERC CARDIO PROC W NON-DRUG 2.1789 1.9 2.6 ELUTING STENT W/O AMI. 518............. 05 SURG PERC CARDIO PROC W/O 1.7297 2.3 3.4 CORONARY ARTERY STENT OR AMI. 519............. 08 SURG CERVICAL SPINAL FUSION W CC 2.3551 3.2 5.2 520............. 08 SURG CERVICAL SPINAL FUSION W/O 1.5389 1.7 2.1 CC. 521............. 20 MED ALCOHOL/DRUG ABUSE OR 0.7300 4.3 5.8 DEPENDENCE W CC. 522............. 20 MED ALC/DRUG ABUSE OR DEPEND W 0.5818 7.5 9.5 REHABILITATION THERAPY W/O CC. 523............. 20 MED ALC/DRUG ABUSE OR DEPEND W/ 0.3999 3.3 4.1 O REHABILITATION THERAPY W/ O CC. 524............. 01 MED TRANSIENT ISCHEMIA......... 0.7238 2.7 3.4 525............. 05 SURG HEART ASSIST SYSTEM IMPLANT 11.6479 9.4 16.6 526............. 05 SURG PERCUTANEOUS CARDIOVASCULAR 3.1176 3.7 4.7 PROC W DRUG ELUTING STENT W AMI. 527............. 05 SURG PERCUTANEOUS CARDIOVASCULAR 2.5342 1.9 2.6 PROC W DRUG ELUTING STENT W/O AMI. ---------------------------------------------------------------------------------------------------------------- Table 6A.--New Diagnosis Codes ---------------------------------------------------------------------------------------------------------------- Diagnosis code Description CC MDC DRG ---------------------------------------------------------------------------------------------------------------- 040.82 Toxic shock syndrome......... Y 18 423 066.4 West Nile fever.............. N 18 421, 422 277.02 Cystic fibrosis with Y 4 79, 80, 81 pulmonary manifestations. 277.03 Cystic fibrosis with Y 6 188, 189, 190 gastrointestinal manifestations. 277.09 Cystic fibrosis with other Y 10 296, 297, 298 manifestations. 357.81 Chronic inflammatory N 1 18, 19 demyelinating polyneuritis. 357.82 Critical illness N 1 18, 19 polyneuropathy. 357.89 Other inflammatory and toxic N 1 18, 19 neuropathy. 359.81 Critical illness myopathy.... N 1 34, 35 359.89 Other myopathies............. N 1 34, 35 365.83 Aqueous misdirection......... N 2 46, 47, 48 414.06 Coronary atherosclerosis of N 5 132, 133 coronary artery of transplanted heart. 414.12 Dissection of coronary artery N 5 121, 144, 145 428.20 Unspecified systolic heart Y 5 115, 121, 124, 127 failure. 428.21 Acute systolic heart failure. Y 5 115, 121, 124, 127 428.22 Chronic systolic heart Y 5 115, 121, 124, 127 failure. 428.23 Acute on chronic systolic Y 5 115, 121, 124, 127 heart failure. 428.30 Unspecified diastolic heart Y 5 115, 121, 124, 127 failure. 428.31 Acute diastolic heart failure Y 5 115, 121, 124, 127 428.32 Chronic diastolic heart Y 5 115, 121, 124, 127 failure. 428.33 Acute on chronic diastolic Y 5 115, 121, 124, 127 heart failure. 428.40 Unspecified combined systolic Y 5 115, 121, 124, 127 and diastolic heart failure. 428.41 Acute combined systolic and Y 5 115, 121, 124, 127 diastolic heart failure. 428.42 Chronic combined systolic and Y 5 115, 121, 124, 127 diastolic heart failure. 428.43 Acute on chronic combined Y 5 115, 121, 124, 127 systolic and diastolic heart failure. 438.6 Alterations of sensations.... N 1 12 438.7 Disturbances of vision....... N 1 12 438.83 Facial weakness.............. N 1 12 438.84 Ataxia....................... N 1 12 438.85 Vertigo...................... N 1 12 443.21 Dissection of carotid artery. N 5 130, 131 [[Page 50240]] 443.22 Dissection of iliac artery... N 5 130, 131 443.23 Dissection of renal artery... N 11 331, 332, 333 443.24 Dissection of vertebral N 5 130, 131 artery. 443.29 Dissection of other artery... N 5 130, 131 445.01 Atheroembolism, upper Y 5 130, 131 extremity. 445.02 Atheroembolism, lower Y 5 130, 131 extremity. 445.81 Atheroembolism, kidney....... Y 11 331, 332, 333 445.89 Atheroembolism, other site... Y 5 130, 131 454.8 Varicose veins of the lower N 5 130, 131 extremities, with other complications. 459.10 Postphlebetic syndrome N 5 130, 131 without complications. 459.11 Postphlebetic syndrome with N 5 130, 131 ulcer. 459.12 Postphlebetic syndrome with N 5 130, 131 inflammation. 459.13 Postphlebetic syndrome with N 5 130, 131 ulcer and inflammation. 459.19 Postphlebetic syndrome with N 5 130, 131 other complication. 459.30 Chronic venous hypertension N 5 130, 131 without complications. 459.31 Chronic venous hypertension N 5 130, 131 with ulcer. 459.32 Chronic venous hypertension N 5 130, 131 with inflammation. 459.33 Chronic venous hypertension N 5 130, 131 with ulcer and inflammation. 459.39 Chronic venous hypertension N 5 130, 131 with other complication. 537.84 Dielulafoy lesion Y 6 174, 175 (hemorrhagic) of stomach and duodenum. 569.86 Dieulafoy lesion Y 6 188, 189, 190 (hemorrhagic) of intestine. 633.00 Abdominal pregnancy without N 14 378 intrauterine pregnancy. 633.01 Abdominal pregnancy with N 14 378 intrauterine pregnancy. 633.10 Tubal pregnancy without N 14 378 intrauterine pregnancy. 633.11 Tubal pregnancy with N 14 378 intrauterine pregnancy. 633.20 Ovarian pregnancy without N 14 378 intrauterine pregnancy. 633.21 Ovarian pregnancy with N 14 378 intrauterine pregnancy. 633.80 Other ectopic pregnancy N 14 378 without intrauterine pregnancy. 633.81 Other ectopic pregnancy with N 14 378 intrauterine pregnancy. 633.90 Unspecified ectopic pregnancy N 14 378 without intrauterine pregnancy. 633.91 Unspecified ectopic pregnancy N 14 378 with intrauterine pregnancy. 747.83 Persistent fetal circulation. N 15 387, 389 765.20 Unspecified weeks of N 15 391 gestation. 765.21 Less than 24 completed weeks N 15 386 of gestation. 765.22 24 completed weeks of N 15 386 gestation. 765.23 25-26 completed weeks of N 15 386 gestation. 765.24 27-28 completed weeks of N 15 387, 388 gestation. 765.25 29-30 completed weeks of N 15 387, 388 gestation. 765.26 31-32 completed weeks of N 15 387, 388 gestation. 765.27 33-34 completed weeks of N 15 387, 388 gestation. 765.28 35-36 completed weeks of N 15 387, 388 gestation. 765.29 37 or more completed weeks of N 15 391 gestation. 770.81 Primary apnea of newborn..... N 15 390 770.82 Other apnea of newborn....... N 15 390 770.83 Cyanotic attacks of newborn.. N 15 390 770.84 Respiratory failure of Y 15 387, 389 newborn. 770.89 Other respiratory problems N 15 390 after birth. 771.81 Septicemia [sepsis] of Y 15 387, 389 newborn. 771.82 Urinary tract infection of N 15 387, 389 newborn. 771.83 Bacteremia of newborn........ Y 15 387, 389 771.89 Other infections specific to N 15 387, 389 the perinatal period. 779.81 Neonatal bradycardia......... N 15 390 779.82 Neonatal tachycardia......... N 15 390 779.89 Other specified conditions N 15 390 originating in the perinatal period. 780.91 Fussy infant (baby).......... N 23 463,464 780.92 Excessive crying of infant N 23 463,464 (baby). 780.99 Other general symptoms....... N 23 463,464 781.93 Ocular torticollis........... N 8 243 795.00 Nonspecific abnormal N 13 358, 359, 369 Papanicolaou smear of cervix, unspecified. 795.01 Atypical squamous cell N 13 358, 359, 369 changes of undetermined significance favor benign (ASCUS favor benign). 795.02 Atypical squamous cell N 13 358, 359, 369 changes of undetermined significance favor dysplasia (ASCUS favor dysplasia). 795.09 Other nonspecific abnormal N 13 358, 359, 369 Papanicolaou smear of cervix. 795.31 Nonspecific positive findings N 18 423 for anthrax. 795.39 Other nonspecific positive N 18 423 culture findings. 813.45 Torus fracture of radius..... N 8 250, 251, 252 24 487 823.40 Torus fracture, tibia alone.. N 8 253, 254, 255 24 487 823.41 Torus fracture, fibula alone. N 8 253, 254, 255 24 487 [[Page 50241]] 823.42 Torus fracture, fibula with N 8 253, 254, 255 tibia. 24 487 995.90 Systemic inflammatory Y 18 416, 417 response syndrome, unspecified. 995.91 Systemic inflammatory Y 18 416, 417 response syndrome due to infectious process without organ dysfunction. 995.92 Systemic inflammatory Y 18 416, 417 response syndrome due to infectious process with organ dysfunction. 995.93 Systemic inflammatory Y 18 416, 417 response syndrome due to non- infectious process without organ dysfunction. 995.94 Systemic inflammatory Y 18 416, 417 response syndrome due to non- infectious process with organ dysfunction. 998.31 Disruption of internal Y 21 452, 453 operation wound. 998.32 Disruption of external Y 21 452, 453 operation wound. V01.81 Contact with or exposure to N 15 391 \1\ communicable diseases, 23 467 anthrax. V01.89 Contact with or exposure to N 15 391 \1\ communicable diseases, other 23 467 communicable diseases. V13.21 Personal history of pre-term N 23 467 labor. V13.29 Personal history of other N 23 467 genital system and obstetric disorders. V23.41 Pregnancy with history of pre- N 14 469 term labor. V23.49 Pregnancy with other poor N 14 469 obstetric history. V46.2 Other dependence on machines, N 23 467 supplemental oxygen. V54.10 Aftercare for healing N 8 249 traumatic fracture of arm, unspecified. V54.11 Aftercare for healing N 8 249 traumatic fracture of upper arm. V54.12 Aftercare for healing N 8 249 traumatic fracture of lower arm. V54.13 Aftercare for healing N 8 249 traumatic fracture of hip. V54.14 Aftercare for healing N 8 249 traumatic fracture of leg, unspecified. V54.15 Aftercare for healing N 8 249 traumatic fracture of upper leg. V54.16 Aftercare for healing N 8 249 traumatic fracture of lower leg. V54.17 Aftercare for healing N 8 249 traumatic fracture of vertebrae. V54.19 Aftercare for healing N 8 249 traumatic fracture of other bone. V54.20 Aftercare for healing N 8 249 pathologic fracture of arm, unspecified. V54.21 Aftercare for healing N 8 249 pathologic fracture of upper arm. V54.22 Aftercare for healing N 8 249 pathologic fracture of lower arm. V54.23 Aftercare for healing N 8 249 pathologic fracture of hip. V54.24 Aftercare for healing N 8 249 pathologic fracture of leg, unspecified. V54.25 Aftercare for healing N 8 249 pathologic fracture of upper leg. V54.26 Aftercare for healing N 8 249 pathologic fracture of lower leg. V54.27 Aftercare for healing N 8 249 pathologic fracture of vertebrae. V54.29 Aftercare for healing N 8 249 pathologic fracture of other bone. V54.81 Aftercare following joint N 8 249 replacement. V54.89 Other orthopedic aftercare... N 8 249 V58.42 Aftercare following surgery N 23 465, 466 for neoplasm. V58.43 Aftercare following surgery N 23 465, 466 for injury and trauma. V58.71 Aftercare following surgery N 23 465, 466 of the sense organs, NEC. V58.72 Aftercare following surgery N 23 465, 466 of the nervous system, NEC. V58.73 Aftercare following surgery N 23 465, 466 of the circulatory system, NEC. V58.74 Aftercare following surgery N 23 465, 466 of the respiratory system, NEC. V58.75 Aftercare following surgery N 23 465, 466 of the teeth, oral cavity and digestive system, NEC. V58.76 Aftercare following surgery N 23 465, 466 of the genitourinary system, NEC. V58.77 Aftercare following surgery N 23 465, 466 of the skin and subcutaneous tissue, NEC. V58.78 Aftercare following surgery N 23 465, 466 of the musculoskeletal system, NEC. V71.82 Observation and evaluation N 23 467 for suspected exposure to anthrax. V71.83 Observation and evaluation N 23 467 for suspected exposure to other biological agent. V83.81 Cystic fibrosis gene carrier. N 23 467 V83.89 Other genetic carrier status. N 23 467 ---------------------------------------------------------------------------------------------------------------- \1\ Classified as an ``only secondary diagnosis'' in this DRG. Table 6B.--New Procedure Codes ---------------------------------------------------------------------------------------------------------------- Procedure code Description OR MDC DRG ---------------------------------------------------------------------------------------------------------------- 00.01 Therapeutic ultrasound of N vessels of head and neck. 00.02 Therapeutic ultrasound of N heart. 00.03 Therapeutic ultrasound of N peripheral vascular vessels. 00.09 Other therapeutic ultrasound. N 00.10 Implantation of N chemotherapeutic agent. 00.11 Infusion of drotrecogin alfa N (activated). 00.12 Administration of inhaled N nitric oxide. [[Page 50242]] 00.13 Injection or infusion of N nesiritide. 00.14 Injection or infusion of N oxazolidinone class of antibiotics. 00.50 Implantation of cardiac Y 5 115 \1\, 116 \1\ resynchronization pacemaker without mention of defibrillation, total system [CRT-P]. 00.51 Implantation of cardiac Y 5 514 \1\, 515 \1\ resynchronization defibrillator, total system [CRT-D]. 00.52 Implantation or replacement Y 5 115 \2\, 116 \3\, 514 \4\, 515 \4\ of transvenous lead (electrode) into left ventricular coronary venous system. 00.53 Implantation or replacement Y 5 115 \2\, 116 \3\, 118 of cardiac resynchronization pacemaker pulse generator only [CRT-P]. 00.54 Implantation or replacement Y 5 115 \1\, 514 \4\, 515 \4\ of cardiac resynchronization defibrillator pulse generator only [CRT-D]. 00.55 Insertion of drug-eluting non- N coronary artery stent(s). 36.07 Insertion of drug-eluting N \*\ 5 526, 527 coronary artery stents(s). 39.72 Endovascular repair or Y 1 1,2,3 occlusion of head and neck 5 110, 111 vessels. 11 315 21 442, 443 24 486 49.75 Implantation or revision of Y 6 157, 158 artificial anal sphincter. 9 267 21 442, 443 24 486 49.76 Removal of artificial anal Y 6 157, 158 sphincter. 9 267 21 442, 443 24 486 81.61 360 degree spinal fusion, Y 1 4 single incision approach. 8 496 21 442, 443 24 486 84.51 Insertion of interbody spinal N fusion device. 84.52 Insertion of recombinant bone N morphogenetic protein. 88.96 Other intraoperative magnetic N resonance imaging. 89.60 \5\ Continuous intra-arterial N blood gas monitoring. 99.76 Extracorporeal N immunoadsorption. 99.77 Application or administration N of an adhesion barrier substance. ---------------------------------------------------------------------------------------------------------------- * Nonoperating room procedure, but affects DRG. \1\ Classified under ``operating room procedures''. \2\ Classified under ``operating room procedure'' and under ``as any of the following procedure combinations'' as 00.52 and 00.53. \3\ Classified under ``any of the following procedure combinations'' as 00.52 and 00.53. \4\ Classified under ``any of the following procedure combinations'' as 00.52 and 00.54. \5\ This code was discussed at the April 18, 2002 meeting of the ICD-9-CM Coordination and Maintenance Committee and included in the final addendum for ICD-9-CM. Table 6C.--Invalid Diagnosis Codes ---------------------------------------------------------------------------------------------------------------- Diagnosis code Description CC MDC DRG ---------------------------------------------------------------------------------------------------------------- 357.8 Other inflammatory and toxic N 1 18, 19 neuropathy. 359.8 Other myopathies............. N 1 34, 35 459.1 Postphlebetic syndrome....... N 5 130, 131 633.0 Abdominal pregnancy.......... N 14 378 633.1 Tubal pregnancy.............. N 14 378 633.2 Ovarian pregnancy............ N 14 378 633.8 Other ectopic pregnancy...... N 14 378 633.9 Unspecified ectopic pregnancy N 14 378 770.8 Other respiratory problems N 15 387, 389 after birth. 771.8 Other infections specific to Y 15 387, 389 the perinatal period. 779.8 Other specified conditions N 15 390 originating in the perinatal period. 780.9 Other general symptoms....... N 23 463, 464 795.0 Nonspecific abnormal N 13 358, 359, 369 Papanicolaou smear of cervix. 795.3 Nonspecific positive culture N 18 423 findings. 998.3 Disruption of operation wound Y 21 452, 453 V01.8 Other communicable diseases.. N 23 467 V13.2 Other genital system and N 23 467 obstetric disorders. V23.4 Pregnancy with other poor N 14 469 obstetric history. V54.8 Other orthopedic aftercare... N 8 249 ---------------------------------------------------------------------------------------------------------------- [[Page 50243]] Table 6D.--Invalid Procedure Codes ------------------------------------------------------------------------ ------------------------------------------------------------------------- Note: There are no invalid procedure codes for FY 2003. ------------------------------------------------------------------------ Table 6E.--Revised Diagnosis Code Titles ---------------------------------------------------------------------------------------------------------------- Diagnosis code Description CC MDC DRG ---------------------------------------------------------------------------------------------------------------- 402.00 Hypertensive heart disease, Y 5 134 malignant, without heart failure. 402.01 Hypertensive heart disease, Y 5 115, 121, 124, 127 malignant, with heart failure. 402.10 Hypertensive heart disease, N 5 134 benign, without heart failure. 402.11 Hypertensive heart disease, Y 5 115, 121, 124, 127 benign, with heart failure. 402.90 Hypertensive heart disease, N 5 134 unspecified, without heart failure. 402.91 Hypertensive heart disease, Y 5 115, 121, 124, 127 unspecified, with heart failure. 404.00 Hypertensive heart and renal Y 5 134 disease, malignant, without mention of heart failure or renal failure. 404.01 Hypertensive heart and renal Y 5 115, 121, 124, 127 disease, malignant, with heart failure. 404.03 Hypertensive heart and renal Y 5 115, 121, 124, 127 disease, malignant, with heart failure and renal failure. 404.10 Hypertensive heart and renal N 5 134 disease, benign, without mention of heart failure or renal failure. 404.11 Hypertensive heart and renal Y 5 115, 121, 124, 127 disease, benign, with heart failure. 404.13 Hypertensive heart and renal Y 5 115, 121, 124, 127 disease, benign, with heart failure and renal failure. 404.90 Hypertensive heart and renal N 5 134 disease, unspecified, without mention of heart failure or renal failure. 404.91 Hypertensive heart and renal Y 5 115, 121, 124, 127 disease, unspecified, with heart failure. 404.93 Hypertensive heart and renal Y 5 115, 121, 124, 127 disease, unspecified, with heart failure and renal failure. 414.10 Aneurysm of heart............ N 5 121, 144, 145 414.11 Aneurysm of coronary vessels. N 5 121, 144, 145 414.19 Other aneurysm of heart...... N 5 121, 144, 145 428.0 Congestive heart failure, Y 5 115, 121, 124, 127 unspecified. 454.9 Asymptomatic varicose veins.. N 5 130, 131 627.2 Symptomatic menopausal or N 13 358, 359, 369 female climacteric states. 627.4 Symptomatic states associated N 13 358, 359, 369 with artificial menopause. V49.81 Asymptomatic postmenopausal N 23 467 status (age-related) (natural). ------------------
