[Federal Register: May 19, 2003 (Volume 68, Number 96)] [Proposed Rules] [Page 27353-27402] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr19my03-21] [[pp. 27353-27402]] Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2004 Rates [[Continued from page 27352]] [[Page 27351]] 407............. 17 SURG MYELOPROLIF DISORD OR 1.2347 3.2 4.1 POORLY DIFF NEOPL W MAJ O.R.PROC W/O CC. 408............. 17 SURG MYELOPROLIF DISORD OR 2.1935 4.8 8.3 POORLY DIFF NEOPL W OTHER O.R.PROC. 409............. 17 MED RADIOTHERAPY............... 1.2333 4.6 6.2 410............. 17 MED CHEMOTHERAPY W/O ACUTE 1.0780 3.2 4.1 LEUKEMIA AS SECONDARY DIAGNOSIS. 411............. 17 MED *HISTORY OF MALIGNANCY W/O 0.3906 4.7 4.7 ENDOSCOPY. 412............. 17 MED HISTORY OF MALIGNANCY W 0.5721 2.5 3.7 ENDOSCOPY. 413............. 17 MED OTHER MYELOPROLIF DIS OR 1.3143 5.3 7.1 POORLY DIFF NEOPL DIAG W CC. 414............. 17 MED OTHER MYELOPROLIF DIS OR 0.7332 3.2 4.2 POORLY DIFF NEOPL DIAG W/O CC. 415............. 18 SURG O.R. PROCEDURE FOR 3.5998 10.4 14.4 INFECTIOUS & PARASITIC DISEASES. 416............. 18 MED SEPTICEMIA AGE17. 417............. 18 MED SEPTICEMIA AGE 0-17........ 0.9864 4.4 5.8 418............. 18 MED POSTOPERATIVE & POST- 1.0605 4.9 6.3 TRAUMATIC INFECTIONS. 419............. 18 MED FEVER OF UNKNOWN ORIGIN AGE 0.8404 3.6 4.6 17 W CC. 420............. 18 MED FEVER OF UNKNOWN ORIGIN AGE 0.6052 2.8 3.4 17 W/O CC. 421............. 18 MED VIRAL ILLNESS AGE 17. 422............. 18 MED VIRAL ILLNESS & FEVER OF 0.7271 2.5 3.7 UNKNOWN ORIGIN AGE 0-17. 423............. 18 MED OTHER INFECTIOUS & 1.8074 5.9 8.4 PARASITIC DISEASES DIAGNOSES. 424............. 19 SURG O.R. PROCEDURE W PRINCIPAL 2.3708 8.0 12.9 DIAGNOSES OF MENTAL ILLNESS. 425............. 19 MED ACUTE ADJUSTMENT REACTION & 0.6723 2.8 3.8 PSYCHOSOCIAL DYSFUNCTION. 426............. 19 MED DEPRESSIVE NEUROSES........ 0.5051 3.2 4.5 427............. 19 MED NEUROSES EXCEPT DEPRESSIVE. 0.5029 3.1 4.4 428............. 19 MED DISORDERS OF PERSONALITY & 0.7222 4.5 7.1 IMPULSE CONTROL. 429............. 19 MED ORGANIC DISTURBANCES & 0.8235 4.5 6.1 MENTAL RETARDATION. 430............. 19 MED PSYCHOSES.................. 0.6750 5.6 7.9 431............. 19 MED CHILDHOOD MENTAL DISORDERS. 0.6551 4.4 6.9 432............. 19 MED OTHER MENTAL DISORDER 0.6453 2.8 4.0 DIAGNOSES. 433............. 20 MED ALCOHOL/DRUG ABUSE OR 0.2876 2.2 3.1 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... 1.7409 5.1 8.1 440............. 21 SURG WOUND DEBRIDEMENTS FOR 1.8767 5.8 9.1 INJURIES. 441............. 21 SURG HAND PROCEDURES FOR 0.9595 2.1 3.1 INJURIES. 442............. 21 SURG OTHER O.R. PROCEDURES FOR 2.4020 5.6 8.6 INJURIES W CC. 443............. 21 SURG OTHER O.R. PROCEDURES FOR 0.9737 2.5 3.4 INJURIES W/O CC. 444............. 21 MED TRAUMATIC INJURY AGE 17 W CC. 445............. 21 MED TRAUMATIC INJURY AGE 17 W/O CC. 446............. 21 MED *TRAUMATIC INJURY AGE 0-17. 0.2951 2.4 2.4 447............. 21 MED ALLERGIC REACTIONS AGE 17. 448............. 21 MED *ALLERGIC REACTIONS AGE 0- 0.0971 2.9 2.9 17. 449............. 21 MED POISONING & TOXIC EFFECTS 0.8275 2.6 3.7 OF DRUGS AGE 17 W CC. 450............. 21 MED POISONING & TOXIC EFFECTS 0.4224 1.6 2.0 OF DRUGS AGE 17 W/O CC. 451............. 21 MED *POISONING & TOXIC EFFECTS 0.2621 2.1 2.1 OF DRUGS AGE 0-17. 452............. 21 MED COMPLICATIONS OF TREATMENT 1.0373 3.5 4.9 W CC. 453............. 21 MED COMPLICATIONS OF TREATMENT 0.5086 2.1 2.8 W/O CC. 454............. 21 MED OTHER INJURY, POISONING & 0.8121 3.0 4.2 TOXIC EFFECT DIAG W CC. 455............. 21 MED OTHER INJURY, POISONING & 0.4690 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 1.1855 2.1 3.6 OTHER CONTACT W HEALTH SERVICES. 462............. 23 MED REHABILITATION............. 1.0073 9.4 11.3 463............. 23 MED SIGNS & SYMPTOMS W CC...... 0.6795 3.1 4.1 464............. 23 MED SIGNS & SYMPTOMS W/O CC.... 0.4940 2.4 3.0 465............. 23 MED AFTERCARE W HISTORY OF 0.9078 2.0 4.0 MALIGNANCY AS SECONDARY DIAGNOSIS. [[Page 27352]] 466............. 23 MED AFTERCARE W/O HISTORY OF 0.7967 2.2 3.9 MALIGNANCY AS SECONDARY DIAGNOSIS. 467............. 23 MED OTHER FACTORS INFLUENCING 0.4916 1.9 3.0 HEALTH STATUS. 468............. ....... .................... EXTENSIVE O.R. PROCEDURE 3.7934 9.4 13.1 UNRELATED TO PRINCIPAL DIAGNOSIS. 469............. ....... .................... PRINCIPAL DIAGNOSIS INVALID 0.0000 0.0 0.0 AS DISCHARGE **DIAGNOSIS. 470............. ....... .................... **UNGROUPABLE.............. 0.0000 0.0 0.0 471............. 8 SURG BILATERAL OR MULTIPLE MAJOR 3.0380 4.7 5.4 JOINT PROCS OF LOWER EXTREMITY. 472............. 22 SURG NO LONGER VALID............ 0.0000 0.0 0.0 473............. 17 MED ACUTE LEUKEMIA W/O MAJOR 3.4644 7.4 12.7 O.R. PROCEDURE AGE 17. 474............. 4 SURG NO LONGER VALID............ 0.0000 0.0 0.0 475............. 4 MED RESPIRATORY SYSTEM 3.5767 8.0 11.3 DIAGNOSIS WITH VENTILATOR SUPPORT. 476............. ....... SURG PROSTATIC O.R. PROCEDURE 2.2299 8.0 11.1 UNRELATED TO PRINCIPAL DIAGNOSIS. 477............. ....... SURG NON-EXTENSIVE O.R. 1.8593 5.4 8.2 PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS. 478............. 5 SURG OTHER VASCULAR PROCEDURES W 2.3639 4.9 7.4 CC. 479............. 5 SURG OTHER VASCULAR PROCEDURES W/ 1.4223 2.4 3.2 O CC. 480............. PRE SURG LIVER TRANSPLANT........... 9.6510 14.0 21.1 481............. PRE SURG BONE MARROW TRANSPLANT..... 5.9571 19.1 21.7 482............. PRE SURG TRACHEOSTOMY FOR FACE,MOUTH 3.4598 9.6 12.5 & NECK DIAGNOSES. 483............. PRE SURG TRAC W MECH VENT 96+HRS OR 16.5997 34.1 41.3 PDX EXCEPT FACE,MOUTH & NECK DX OSES. 484............. 24 SURG CRANIOTOMY FOR MULTIPLE 5.3969 9.9 14.7 SIGNIFICANT TRAUMA. 485............. 24 SURG LIMB REATTACHMENT, HIP AND 3.1535 7.9 9.9 FEMUR PROC FOR MULTIPLE SIGNIFICANT TRA. 486............. 24 SURG OTHER O.R. PROCEDURES FOR 4.8552 8.8 12.9 MULTIPLE SIGNIFICANT TRAUMA. 487............. 24 MED OTHER MULTIPLE SIGNIFICANT 1.9609 5.3 7.3 TRAUMA. 488............. 25 SURG HIV W EXTENSIVE O.R. 4.7597 11.7 17.0 PROCEDURE. 489............. 25 MED HIV W MAJOR RELATED 1.8340 6.0 8.6 CONDITION. 490............. 25 MED HIV W OR W/O OTHER RELATED 1.0397 3.9 5.5 CONDITION. 491............. 8 SURG MAJOR JOINT & LIMB 1.7059 2.8 3.4 REATTACHMENT PROCEDURES OF UPPER EXTREMITY. 492............. 17 MED CHEMOTHERAPY W ACUTE 3.8083 9.3 14.9 LEUKEMIA OR W USE OF HIGH DOSE CHEMOAGENT. 493............. 7 SURG LAPAROSCOPIC 1.8169 4.4 6.0 CHOLECYSTECTOMY W/O C.D.E. W CC. 494............. 7 SURG LAPAROSCOPIC 0.9950 2.0 2.5 CHOLECYSTECTOMY W/O C.D.E. W/O CC. 495............. PRE SURG LUNG TRANSPLANT............ 8.3919 13.5 16.4 496............. 8 SURG COMBINED ANTERIOR/POSTERIOR 5.6730 6.8 8.9 SPINAL FUSION. 497............. 8 SURG SPINAL FUSION EXCEPT 3.3896 5.2 6.3 CERVICAL W CC. 498............. 8 SURG SPINAL FUSION EXCEPT 2.5213 3.6 4.0 CERVICAL W/O CC. 499............. 8 SURG BACK & NECK PROCEDURES 1.4186 3.3 4.5 EXCEPT SPINAL FUSION W CC. 500............. 8 SURG BACK & NECK PROCEDURES 0.9344 2.0 2.4 EXCEPT SPINAL FUSION W/O CC. 501............. 8 SURG KNEE PROCEDURES W PDX OF 2.6174 8.3 10.7 INFECTION W CC. 502............. 8 SURG KNEE PROCEDURES W PDX OF 1.4062 5.2 6.2 INFECTION W/O CC. 503............. 8 SURG KNEE PROCEDURES W/O PDX OF 1.2152 3.0 3.9 INFECTION. 504............. 22 SURG EXTENSIVE 3RD DEGREE BURNS 11.8123 20.1 27.7 W SKIN GRAFT. 505............. 22 MED EXTENSIVE 3RD DEGREE BURNS 2.0106 2.3 5.7 W/O SKIN GRAFT. 506............. 22 SURG FULL THICKNESS BURN W SKIN 4.0998 12.1 16.9 GRAFT OR INHAL INJ W CC OR SIG TRAUMA. 507............. 22 SURG FULL THICKNESS BURN W SKIN 1.8145 6.5 9.1 GRFT OR INHAL INJ W/O CC OR SIG TRAUMA. 508............. 22 MED FULL THICKNESS BURN W/O 1.3754 5.7 8.0 SKIN GRFT OR INHAL INJ W CC OR SIG TRAUMA. 509............. 22 MED FULL THICKNESS BURN W/O 0.6404 3.0 4.3 SKIN GRFT OR INH INJ W/O CC OR SIG TRAUMA. 510............. 22 MED NON-EXTENSIVE BURNS W CC OR 1.1762 4.6 6.8 SIGNIFICANT TRAUMA. 511............. 22 MED NON-EXTENSIVE BURNS W/O CC 0.6654 3.1 4.6 OR SIGNIFICANT TRAUMA. 512............. PRE SURG SIMULTANEOUS PANCREAS/ 5.3384 11.1 13.1 KIDNEY TRANSPLANT. 513............. PRE SURG PANCREAS TRANSPLANT........ 6.0851 8.5 9.8 514............. 5 SURG NO LONGER VALID............ 0.0000 0.0 0.0 515............. 5 SURG CARDIAC DEFIBRILLATOR 5.3127 3.0 5.2 IMPLANT W/O CARDIAC CATH. 516............. 5 SURG PERCUTANEOUS CARDIOVASC 2.6723 3.7 4.7 PROC W AMI. 517............. 5 SURG PERC CARDIO PROC W NON-DRUG 2.1245 1.8 2.6 ELUTING STENT W/O AMI. 518............. 5 SURG PERC CARDIO PROC W/O 1.8210 2.2 3.3 CORONARY ARTERY STENT OR AMI. [[Page 27353]] 519............. 8 SURG CERVICAL SPINAL FUSION W CC 2.4228 3.2 5.1 520............. 8 SURG CERVICAL SPINAL FUSION W/O 1.5749 1.7 2.1 CC. 521............. 20 MED ALCOHOL/DRUG ABUSE OR 0.7054 4.3 5.8 DEPENDENCE W CC. 522............. 20 MED ALC/DRUG ABUSE OR DEPEND W 0.5151 7.7 9.6 REHABILITATION THERAPY W/O CC. 523............. 20 MED ALC/DRUG ABUSE OR DEPEND W/ 0.3929 3.3 4.1 O REHABILITATION THERAPY W/ O CC. 524............. 1 MED TRANSIENT ISCHEMIA......... 0.7252 2.7 3.4 525............. 5 SURG HEART ASSIST SYSTEM IMPLANT 11.4482 9.0 17.6 526............. 5 SURG PERCUTNEOUS CARDIOVASULAR 2.9729 3.6 4.5 PROC W DRUG ELUTING STENT W AMI. 527............. 5 SURG PERCUTNEOUS CARDIOVASULAR 2.4342 1.8 2.6 PROC W DRUG ELUTING STENT W/O AMI. 528............. 1 SURG INTRACRANIAL VASCULAR PROC 7.0434 14.1 17.2 W PDX HEMORRHAGE. 529............. 1 SURG VENTRICULAR SHUNT 3.1094 6.6 10.6 PROCEDURES W CC. 530............. 1 SURG VENTRICULAR SHUNT 1.2664 2.9 3.9 PROCEDURES W/O CC. 531............. 1 SURG SPINAL PROCEDURES W CC..... 3.0474 6.8 10.0 532............. 1 SURG SPINAL PROCEDURES W/O CC... 1.4487 2.9 4.0 533............. 1 SURG EXTRACRANIAL PROCEDURES W 1.6578 2.7 4.1 CC. 534............. 1 SURG EXTRACRANIAL PROCEDURES W/O 1.0689 1.6 2.0 CC. 535............. 5 SURG CARDIAC DEFIB IMPLANT W 8.1344 8.1 11.0 CARDIAC CATH W AMI/HF/ SHOCK. 536............. 5 SURG CARDIAC DEFIB IMPLANT W 6.2536 3.9 5.8 CARDIAC CATH W/O AMI/HF/ SHOCK. 537............. 8 SURG LOCAL EXCIS & REMOV OF INT 1.8090 4.7 7.0 FIX DEV EXCEPT HIP & FEMUR W CC. 538............. 8 SURG LOCAL EXCIS & REMOV OF INT 0.9874 2.1 2.9 FIX DEV EXCEPT HIP & FEMUR W/O CC. 539............. 17 SURG LYMPHOMA & LEUKEMIA W MAJOR 3.3744 7.5 11.2 OR PROCEDURE W CC. 540............. 17 SURG LYMPHOMA & LEUKEMIA W MAJOR 1.2851 2.9 4.1 OR PROCEDURE W/O CC. ---------------------------------------------------------------------------------------------------------------- *Medicare data have been supplemented by data from 19 States for low volume DRGs. **DRGs 469 and 470 contain cases that could not be assigned to valid DRGs. [[Page 27353]] ----------------------------------------------------------------------- Table 6A.--New Diagnosis Codes ---------------------------------------------------------------------------------------------------------------- Diagnosis code Description CC MDC DRG ---------------------------------------------------------------------------------------------------------------- 255.10 Primary aldosteronism........ N 10 300, 301 255.11 Glucocorticoid-remediable N 10 300, 301 aldosteronism. 255.12 Conn's syndrome.............. N 10 300, 301 255.13 Bartter's syndrome........... N 10 300, 301 255.14 Other secondary aldosteronism N 10 300, 301 277.81 Primary carnitine deficiency. N 10 299 277.82 Carnitine deficiency due to N 10 299 inborn errors of metabolism. 277.83 Iatrogenic carnitine N 10 299 deficiency. 277.84 Other secondary carnitine N 10 299 deficiency. 277.89 Other specified disorders of N 10 299 metabolism. 282.41 Sickle-cell thalassemia Y 15 \1\ 387, \1\ 389 without crisis. 16 395, 396 282.42 Sickle-cell thalassemia with Y 15 \1\ 387, \1\ 389 crisis. 16 395, 396 282.49 Other thalassemia............ Y 15 \1\ 387, \1\ 389 16 395, 396 282.64 Sickle-cell/Hb-C disease with Y 16 395, 396 crisis. 282.68 Other sickle-cell disease Y 16 395, 396 without crisis. 289.52 Splenic sequestration........ N 16 398, 399 289.81 Primary hypercoagulable state Y 16 398, 399 289.82 Secondary hypercoagulable Y 16 398, 399 state. 289.89 Other specified diseases of N 16 398, 399 blood and blood-forming organs. 331.11 Pick's disease............... N 1 12 331.19 Other frontotemporal dementia N 1 12 331.82 Dementia with Lewy bodies.... N 1 12 348.30 Encephalopathy, unspecified.. N 1 16, 17 25 \2\ 489 348.31 Metabolic encephalopathy..... N 1 16, 17 25 \2\ 489 348.39 Other encephalopathy......... N 1 16, 17 25 \2\489 [[Page 27354]] 358.00 Myasthenia gravis without Y 1 12 (acute) exacerbation. 358.01 Myasthenia gravis with Y 1 12 (acute) exacerbation. 414.07 Coronary atherosclerosis, Of N 5 132,133 bypass graft (artery) (vein) of transplanted heart. 458.21 Hypotension of hemodialysis.. N 5 141, 142 458.29 Other iatrogenic hypotension. N 5 141,142 493.81 Exercise induced bronchospasm N 4 96, 97, 98 493.82 Cough variant asthma......... N 4 96, 97, 98 517.3 Acute chest syndrome......... N 4 92, 93 530.20 Ulcer of esophagus without N 6 176 bleeding. 530.21 Ulcer of esophagus with Y 6 176 bleeding. 530.85 Barrett's esophagus.......... N 6 176 600.00 Hypertrophy (benign) of N 12 348, 349 prostate without urinary obstruction. 600.01 Hypertrophy (benign) of N 12 348, 349 prostate with urinary obstruction. 600.10 Nodular prostate without N 12 348, 349 urinary obstruction. 600.11 Nodular prostate with urinary N 12 348, 349 obstruction. 600.20 Benign localized hyperplasia N 12 348, 349 of prostate without urinary obstruction. 600.21 Benign localized hyperplasia N 12 348, 349 of prostate with urinary obstruction. 600.90 Hyperplasia of prostate, N 12 348, 349 unspecified, without urinary obstruction. 600.91 Hyperplasia of prostate, N 12 348, 349 unspecified, with urinary obstruction. 607.85 Peyronie's disease........... N 12 352 674.50 Peripartum cardiomyopathy, Y 14 469 unspecified as to episode of care or not applicable. 674.51 Peripartum cardiomyopathy, Y 14 370, 371, 372, 374, 375 delivered, with or without mention of antepartum condition. 674.52 Peripartum cardiomyopathy, Y 14 370, 371, 372, 374, 375 delivered, with mention of postpartum condition. 674.53 Peripartum cardiomyopathy, Y 14 383, 384 antepartum condition or complication. 674.54 Peripartum cardiomyopathy, Y 14 376, 377 postpartum condition or complication. 719.7 Difficulty in walking........ N 8 247 728.87 Muscle weakness.............. N 8 247 728.88 Rhabdomyolysis............... Y 8 248 752.81 Scrotal transposition........ N 12 352 752.89 Other specified anomalies of N 12 352 genital organs. 766.21 Post-term infant............. N 15 391 766.22 Prolonged gestation of infant N 15 391 767.11 Epicranial subaponeurotic Y 15 389 hemorrhage (massive). 767.19 Other injuries to scalp...... N 15 391 779.83 Delayed separation of N 15 391 umbilical cord. 780.93 Memory loss.................. N 23 463, 464 780.94 Early satiety................ N 23 463, 464 781.94 Facial weakness.............. N 1 34, 35 785.52 Septic shock................. Y 18 416, 417 788.63 Urgency of urination......... N 11 325, 326, 327 790.21 Impaired fasting glucose..... N 10 296, 297, 298 790.22 Impaired glucose tolerance N 10 296, 297, 298 test (oral). 790.29 Other abnormal glucose....... N 10 296, 297, 298 799.81 Decreased libido............. N 23 467 799.89 Other ill-defined conditions. N 23 467 850.11 Concussion, with loss of Y 1 31, 32, 33 consciousness of 30 minutes 24 487 or less. 850.12 Concussion, with loss of Y 1 31, 32, 33 consciousness from 31 to 59 24 487 minutes. 959.11 Other injury of chest wall... N 21 444, 445, 446 24 487 959.12 Other injury of abdomen...... N 21 444, 445, 446 24 487 959.13 Fracture of corpus cavernosum N 21 444, 445, 446 penis. 24 487 959.14 Other injury of external N 21 444, 445, 446 genitals. 24 487 959.19 Other injury of other sites N 21 444, 445, 446 of trunk. 24 487 996.57 Complication, Due to insulin Y 21 452, 453 pump. V04.81 Need for prophylactic N 23 467 vaccination and inoculation, Influenza. V04.82 Need for prophylactic N 23 467 vaccination and inoculation, Respiratory synctial virus (RSV). V04.89 Need for prophylactic N 23 467 vaccination and inoculation, Other viral diseases. V15.87 History of Extracorporeal N 23 467 Membrance Oxygenation (ECMO). V25.03 Encounter for emergency N 23 467 contraceptive counseling and prescription. V43.21 Organ or tissue replaced by Y 5 144, 145 other means, Heart assist device. V43.22 Organ or tissue replaced by Y 5 144, 145 other means, Fully implantable artificial heart. V45.85 Insulin pump status.......... N 23 467 [[Page 27355]] V53.90 Fitting and adjustment, N 23 467 Unspecified device. V53.91 Fitting and adjustment of N 23 467 insulin pump. V53.99 Fitting and adjustment, Other N 23 467 device. V54.01 Encounter for removal of N 8 249 internal fixation device. V54.02 Encounter for lengthening/ N 8 249 adjustment of growth rod. V54.09 Other aftercare involving N 8 249 internal fixation device. V58.63 Long-term (current) use of N 23 465, 466 antiplatelet/antithrombotic. V58.64 Long-term (current) use of N 23 465, 466 nonsteriodal anti- inflammatories. V58.65 Long-term (current) use of N 23 465, 466 steroids. V64.41 Laparoscopic surgical N 23 467 procedure coverted to open procedure. V64.42 Thoracoscopic surgical N 23 467 procedure converted to open procedure. V64.43 Arthroscopic surgical N 23 467 procedure converted to open procedure. V65.11 Pediatric pre-birth visit for N 23 467 expectant mother. V65.19 Other person consulting on N 23 467 behalf of another person. V65.46 Encounter for insulin pump N 23 467 training. ---------------------------------------------------------------------------------------------------------------- \1\ Classified as a Major Problem. \2\ Classified as a Major Related Condition. ----------------------------------------------------------------------- Table 6B.--New Procedure Codes ---------------------------------------------------------------------------------------------------------------- Procedure Code Description OR MDC DRG ---------------------------------------------------------------------------------------------------------------- 00.15 High-dose infusion N* 17 492 interleukin-2 (IL-2). 37.51 Heart transplantation........ Y PRE 103 37.52 Implantation of total Y 5 525 replacement heart system. 37.53 Replacement or repair of Y 5 525 thoracic unit of total replacement heart system. 37.54 Replacement or repair of Y 5 525 other implantable component of total replacement heart system. 68.31 Laparoscopic supracervical Y 13 354, 355,357, hysterectomy (LSH). 358, 359 14 375 68.39 Other subtotal abdominal Y 13 354, 355, 357, hysterectomy, NOS. 358, 359 14 375 81.62 Fusion or refusion of 2-3 \1\ N vertebrae. 81.63 Fusion or refusion of 4-8 \1\ N vertebrae. 81.64 Fusion or refusion of 9 or \1\ N more vertebrae. ---------------------------------------------------------------------------------------------------------------- *Nonoperating room procedure, but affects DRG. \1\ Nonoperating room procedure code. The DRG assignment is made based on the specific fusion or refusion (81.00- 81.08, 81.30-81.39, 81.61). ----------------------------------------------------------------------- Table 6C.--Invalid Diagnosis Codes ---------------------------------------------------------------------------------------------------------------- Diagnosis code Description CC MDC DRG ---------------------------------------------------------------------------------------------------------------- 255.1 Hyperaldosteronism........... N 10 300, 301 277.8 Other specified disorders of N 10 299 metabolism. 282.4 Thalassemias................. Y 15 \1\1381, \1\389 16 395, 396 289.8 Other specified diseases of N 16 398, 399 blood and blood-forming organs. 331.1 Pick's disease............... N 1 12 348.3 Encephalopathy, unspecified.. N 1 16, 17 25 \2\489 358.0 Myasthenia gravis............ Y 1 12 458.2 Iatrogenic hypotension....... N 5 141, 142 530.2 Ulcer of esophagus........... N 6 176 600.0 Hypertrophy (benign) of N 12 348, 349 prostate. 600.1 Nodular prostate............. N 12 348, 349 600.2 Benign localized hyperplasia N 12 348, 349 of prostate. 600.9 Hyperplasia of prostate, N 12 348, 349 unspecified. 719.70 Difficulty in walking, site N 8 247 unspecified. 719.75 Difficulty in walking, pelvic N 8 247 region and thigh. 719.76 Difficulty in walking, lower N 8 247 leg. 719.77 Difficulty in walking, ankle N 8 247 and foot. 719.78 Difficulty in walking, other N 8 247 specified sites. 719.79 Difficulty in walking, N 8 247 multiple sites. 752.8 Other specified anomalies of N 12 352 genital organs. 13 358, 359, 369 [[Page 27356]] 766.2 Post term infant, not ``heavy N 15 391 for dates''. 767.1 Injuries to scalp............ N 15 391 790.2 Abnormal glucose tolerance N 10 296, 297, 298 test. 799.8 Other ill-defined conditions. N 23 467 850.1 Concussion, with brief loss Y 1 31, 32, 33 of consciousness. 24 487 959.1 Injury, trunk................ N 21 444, 445, 446 24 487 V04.8 Need for prophylactic N 23 467 vaccination and inoculation against certain viral disease, Influenza. V43.2 Organ or tissue replaced by Y 5 144, 145 other means, Heart. V53.9 Fitting and adjustment of N 23 467 other device, Other and unspecified device. V54.0 Aftercare involving removal N 8 249 of fracture plate or other internal fixation device. V64.4 Laparoscopic surgical N 23 467 procedure converted to open procedure. V65.1 Person consulting on behalf N 23 467 of another person. ---------------------------------------------------------------------------------------------------------------- \1\ Classified as a ``Major Problem.'' \2\ Classified as a ``Major Related Condition.'' ----------------------------------------------------------------------- TABLE 6D.--Invalid Procedure Codes ---------------------------------------------------------------------------------------------------------------- Procedure code Description OR MDC DRG ---------------------------------------------------------------------------------------------------------------- 37.5 Heart transplantation........ Y PRE 103 68.3 Subtotal abdominal Y 13 354, 355, 357, hysterectomy. 358, 359 14 375 ---------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------- Table 6E.--Revised Diagnosis Code Titles ---------------------------------------------------------------------------------------------------------------- Diagnosis code Description CC MDC DRG ---------------------------------------------------------------------------------------------------------------- 282.60 Sickle-cell disease, Y 16 395, 396 unspecified. 282.61 Hb-SS disease without crisis. Y 16 395, 396 282.62 Hb-SS disease with crisis.... Y 16 395, 396 282.63 Sickle-cell/Hb-C disease Y 16 395, 396 without crisis. 282.69 Other sickle-cell disease Y 16 395, 396 with crisis. 414.06 Of native coronary artery of N 5 132, 133 transplanted heart. 491.20 Obstructive chronic Y 4 88 bronchitis, without exacerbation. 491.21 Obstructive chronic Y 4 88 bronchitis, with (acute) exacerbation. 493.00 Extrinsic asthma, unspecified N 4 96, 97, 98 493.02 Extrinsic asthma, with Y 4 96, 97, 98 (acute) exacerbation. 493.10 Intrinsic asthma, unspecified N 4 96, 97, 98 493.12 Intrinsic asthma, with Y 4 96, 97, 98 (acute) exacerbation. 493.20 Chronic obstructive asthma, Y 4 88 unspecified. 493.22 Chronic obstructive asthma, Y 4 88 with (acute) exacerbation. 493.90 Asthma, unspecified, N 4 96, 97, 98 unspecified. 493.92 Asthma, unspecified, with Y 4 96, 97, 98 (acute) exacerbation. V06.1 Diphtheria-tetanus-pertussis, N 23 467 combined [DTP] [DtaP]. V06.5 Tetanus-diphtheria [Td][DT].. N 23 467 ---------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------- Table 6F.--Revised Procedure Code Titles ---------------------------------------------------------------------------------------------------------------- Procedure code Description OR MDC DRG ---------------------------------------------------------------------------------------------------------------- 37.33 Excision or destruction of Y 5 108 other lesion or tissue of heart, open approach. 37.34 Excision or destruction of Y 5 516, 517, 518 other lesion or tissue of heart, other approach. 39.79 Other endovascular repair (of Y 1 1, 2, 3 aneurysm) of other vessels. 5 110, 111 11 315 21 442, 443 24 486 ---------------------------------------------------------------------------------------------------------------- [[Page 27357]] ----------------------------------------------------------------------- Table 6G.--Additions to the CC Exclusions List [CCs that are added to the list are in Table 6G-Additions to the CC Exclusions List. Each of the principal diagnoses is shown with an asterisk, and the revisions to the CC Exclusions List are provided in an indented column immediately following the affected principal diagnosis.] ------------------------------------------------------------------------ ------------------------------------------------------------------------ *25060 *2800 28242 2848 28262 28249 28268 2860 35800 28241 28249 2849 28263 28264 *28522 2861 35801 28242 28264 2850 28264 28268 28241 2862 *25061 28249 28268 2851 28268 *28310 28242 2863 35800 28264 *2821 *28249 28269 28241 28249 2864 35801 28268 28241 2800 2830 28242 28264 2865 *25062 *2801 28242 2814 28310 28249 28268 2866 35800 28241 28249 2818 28311 28264 *28529 2867 35801 28242 28264 28241 28319 28268 28241 2869 *25063 28249 28268 28242 2832 *28311 28242 2870 35800 28264 *2822 28249 2839 28241 28249 2871 35801 28268 28241 28260 2840 28242 28264 2872 *25080 *2808 28242 28261 2848 28249 28268 2873 35800 28241 28249 28262 2849 28264 *2858 2874 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80176 80334 80351 80442 85123 85214 436 80086 80179 80335 80352 80443 85124 85215 78001 80089 80180 80336 80353 80444 85125 85216 78003 80090 80181 80339 80354 80445 85126 85219 80000 80091 80182 80340 80355 80446 85129 85220 80001 80092 80183 80341 80356 80449 85130 85221 80002 80093 80184 80342 80359 80450 85131 85222 80003 80094 80185 80343 80360 80451 85132 85223 80004 80095 80186 80344 80361 80452 85133 85224 80005 80096 80189 80345 80362 80453 85134 85225 80006 80099 80190 80346 80363 80454 85135 85226 80009 80100 80191 80349 80364 80455 85136 85229 80010 80101 80192 80350 80365 80456 85139 85230 80011 80102 80193 80351 80366 80459 85140 85231 80012 80103 80194 80352 80369 80460 85141 85232 80013 80104 80195 80353 80370 80461 85142 85233 80014 80105 80196 80354 80371 80462 85143 85234 80015 80106 80199 80355 80372 80463 85144 85235 80016 80109 8021 80356 80373 80464 85145 85236 80019 80110 80220 80359 80374 80465 85146 85239 80020 80111 80221 80360 80375 80466 85149 85240 80021 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80046 80139 8027 80386 80403 80494 85175 85306 80049 80140 8028 80389 80404 80495 85176 85309 80050 80141 8029 80390 80405 80496 85179 85310 80051 80142 80300 80391 80406 80499 85180 85311 80052 80143 80301 80392 80409 8500 85181 85312 80053 80144 80302 80393 80410 85011 85182 85313 80054 80145 80303 80394 [[Page 27363]] 80411 85012 85183 85314 80055 80146 80304 80395 80396 80489 85170 85301 *85111 85011 85012 *85202 80399 80490 85171 85302 85011 85012 *85172 85011 80400 80491 85172 85303 85012 *85142 85011 85012 80401 80492 85173 85304 *85112 85011 85012 *85203 80402 80493 85174 85305 85011 85012 *85173 85011 80403 80494 85175 85306 85012 *85143 85011 85012 80404 80495 85176 85309 *85113 85011 85012 *85204 80405 80496 85179 85310 85011 85012 *85174 85011 80406 80499 85180 85311 85012 *85144 85011 85012 80409 8500 85181 85312 *85114 85011 85012 *85205 80410 85011 85182 85313 85011 85012 *85175 85011 80411 85012 85183 85314 85012 *85145 85011 85012 80412 8502 85184 85315 *85115 85011 85012 *85206 80413 8503 85185 85316 85011 85012 *85176 85011 80414 8504 85186 85319 85012 *85146 85011 85012 80415 8505 85189 85400 *85116 85011 85012 *85209 80416 8509 85190 85401 85011 85012 *85179 85011 80419 85100 85191 85402 85012 *85149 85011 85012 80420 85101 85192 85403 *85119 85011 85012 *85210 80421 85102 85193 85404 85011 85012 *85180 85011 80422 85103 85194 85405 85012 *85150 85011 85012 80423 85104 85195 85406 *85120 85011 85012 *85211 80424 85105 85196 85409 85011 85012 *85181 85011 80425 85106 85199 85410 85012 *85151 85011 85012 80426 85109 85200 85411 *85121 85011 85012 *85212 80429 85110 85201 85412 85011 85012 *85182 85011 80430 85111 85202 85413 85012 *85152 85011 85012 80431 85112 85203 85414 *85122 85011 85012 *85213 80432 85113 85204 85415 85011 85012 *85183 85011 80433 85114 85205 85416 85012 *85153 85011 85012 80434 85115 85206 85419 *85123 85011 85012 *85214 80435 85116 85209 *8502 85011 85012 *85184 85011 80436 85119 85210 85011 85012 *85154 85011 85012 80439 85120 85211 85012 *85124 85011 85012 *85215 80440 85121 85212 *8503 85011 85012 *85185 85011 80441 85122 85213 85011 85012 *85155 85011 85012 80442 85123 85214 85012 *85125 85011 85012 *85216 80443 85124 85215 *8504 85011 85012 *85186 85011 80444 85125 85216 85011 85012 *85156 85011 85012 80445 85126 85219 85012 *85126 85011 85012 *85219 80446 85129 85220 *8505 85011 85012 *85189 85011 80449 85130 85221 85011 85012 *85159 85011 85012 80450 85131 85222 85012 *85129 85011 85012 *85221 80451 85132 85223 *8509 85011 85012 *85190 85011 80452 85133 85224 85011 85012 *85160 85011 85012 80453 85134 85225 85012 *85130 85011 85012 *85222 80454 85135 85226 *85100 85011 85012 *85191 85011 80455 85136 85229 85011 85012 *85161 85011 85012 80456 85139 85230 85012 *85131 85011 85012 *85223 80459 85140 85231 *85101 85011 85012 *85192 85011 80460 85141 85232 85011 85012 *85162 85011 85012 80461 85142 85233 85012 *85132 85011 85012 *85224 80462 85143 85234 *85102 85011 85012 *85193 85011 80463 85144 85235 85011 85012 *85163 85011 85012 80464 85145 85236 85012 *85133 85011 85012 *85225 80465 85146 85239 *85103 85011 85012 *85194 85011 80466 85149 85240 85011 85012 *85164 85011 85012 80469 85150 85241 85012 *85134 85011 85012 *85226 80470 85151 85242 *85104 85011 85012 *85195 85011 80471 85152 85243 85011 85012 *85165 85011 85012 80472 85153 85244 85012 *85135 85011 85012 *85229 80473 85154 85245 *85105 85011 85012 *85196 85011 80474 85155 85246 85011 85012 *85166 85011 85012 80475 85156 85249 85012 *85136 85011 85012 *85230 80476 85159 85250 *85106 85011 85012 *85199 85011 80479 85160 85251 85011 85012 *85169 85011 85012 80480 85161 85252 85012 *85139 85011 85012 *85231 80481 85162 85253 *85109 85011 85012 *85200 85011 80482 85163 85254 85011 85012 *85170 85011 85012 80483 85164 85255 85012 *85140 85011 85012 *85232 80484 85165 85256 *85110 85011 85012 *85201 85011 [[Page 27364]] 80485 85166 85259 85011 85012 *85171 85011 85012 80486 85169 85300 85012 *85141 85011 85012 *85233 85011 85012 *85414 8058 95219 8064 80609 80504 85012 *85304 85011 8059 9522 8065 80610 80505 *85234 85011 85012 80600 9523 80660 80611 80506 85011 85012 *85415 80601 9524 80661 80612 80507 85012 *85305 85011 80602 9528 80662 80613 80508 *85235 85011 85012 80603 9529 80669 80614 80510 85011 85012 *85416 80604 *95912 80670 80615 80511 85012 *85306 85011 80605 80500 80671 80616 80512 *85236 85011 85012 80606 80501 80672 80617 80513 85011 85012 *85419 80607 80502 80679 80618 80514 85012 *85309 85011 80608 80503 8068 80619 80515 *85239 85011 85012 80609 80504 8069 80620 80516 85011 85012 *8738 80610 80505 95200 80621 80517 85012 *85310 85011 80611 80506 95201 80622 80518 *85240 85011 85012 80612 80507 95202 80623 8052 85011 85012 *8739 80613 80508 95203 80624 8053 85012 *85311 85011 80614 80510 95204 80625 8054 *85241 85011 85012 80615 80511 95205 80626 8055 85011 85012 *8798 80616 80512 95206 80627 8056 85012 *85312 85011 80617 80513 95207 80628 8057 *85242 85011 85012 80618 80514 95208 80629 8058 85011 85012 *8799 80619 80515 95209 80630 8059 85012 *85313 85011 80620 80516 95210 80631 80600 *85243 85011 85012 80621 80517 95211 80632 80601 85011 85012 *9050 80622 80518 95212 80633 80602 85012 *85314 85011 80623 8052 95213 80634 80603 *85244 85011 85012 80624 8053 95214 80635 80604 85011 85012 *9251 80625 8054 95215 80636 80605 85012 *85315 85011 80626 8055 95216 80637 80606 *85245 85011 85012 80627 8056 95217 80638 80607 85011 85012 *9252 80628 8057 95218 80639 80608 85012 *85316 85011 80629 8058 95219 8064 80609 *85246 85011 85012 80630 8059 9522 8065 80610 85011 85012 *9290 80631 80600 9523 80660 80611 85012 *85319 85011 80632 80601 9524 80661 80612 *85249 85011 85012 80633 80602 9528 80662 80613 85011 85012 *9299 80634 80603 9529 80669 80614 85012 *85400 85011 80635 80604 *95913 80670 80615 *85250 85011 85012 80636 80605 80500 80671 80616 85011 85012 *9588 80637 80606 80501 80672 80617 85012 *85401 85011 80638 80607 80502 80679 80618 *85251 85011 85012 80639 80608 80503 8068 80619 85011 85012 *95901 8064 80609 80504 8069 80620 85012 *85402 85011 8065 80610 80505 95200 80621 *85252 85011 85012 80660 80611 80506 95201 80622 85011 85012 *95909 80661 80612 80507 95202 80623 85012 *85403 85011 80662 80613 80508 95203 80624 *85253 85011 85012 80669 80614 80510 95204 80625 85011 85012 *95911 80670 80615 80511 95205 80626 85012 *85404 80500 80671 80616 80512 95206 80627 *85254 85011 80501 80672 80617 80513 95207 80628 85011 85012 80502 80679 80618 80514 95208 80629 85012 *85405 80503 8068 80619 80515 95209 80630 *85255 85011 80504 8069 80620 80516 95210 80631 85011 85012 80505 95200 80621 80517 95211 80632 85012 *85406 80506 95201 80622 80518 95212 80633 *85256 85011 80507 95202 80623 8052 95213 80634 85011 85012 80508 95203 80624 8053 95214 80635 85012 *85409 80510 95204 80625 8054 95215 80636 *85259 85011 80511 95205 80626 8055 95216 80637 85011 85012 80512 95206 80627 8056 95217 80638 85012 *85410 80513 95207 80628 8057 95218 80639 *85300 85011 80514 95208 80629 8058 95219 8064 85011 85012 80515 95209 80630 8059 9522 8065 85012 *85411 80516 95210 80631 80600 9523 80660 *85301 85011 80517 95211 80632 80601 9524 80661 85011 85012 80518 95212 80633 80602 9528 80662 5012 *85412 8052 95213 80634 80603 9529 80669 *85302 85011 8053 95214 80635 80604 *95914 80670 85011 85012 8054 95215 80636 80605 80500 80671 [[Page 27365]] 85012 *85413 8055 95216 80637 80606 80501 80672 *85303 85011 8056 95217 80638 80607 80502 80679 85011 85012 8057 95218 80639 80608 80503 8068 8069 80620 *99609 *99671 95200 80621 99657 99657 95201 80622 *9961 *99672 95202 80623 99657 99657 95203 80624 *9962 *99673 95204 80625 99657 99657 95205 80626 *99630 *99674 95206 80627 99657 99657 95207 80628 *99639 *99675 95208 80629 99657 99657 95209 80630 *9964 *99676 95210 80631 99657 99657 95211 80632 *99651 *99677 95212 80633 99657 99657 95213 80634 *99652 *99678 95214 80635 99657 99657 95215 80636 *99653 *99679 95216 80637 99657 99657 95217 80638 *99654 *99680 95218 80639 99657 V4321 95219 8064 *99655 V4322 9522 8065 99657 *99683 9523 80660 *99656 V4321 9524 80661 99657 V4322 9528 80662 *99657 *99687 9529 80669 99655 V4321 *95919 80670 99656 V4322 80500 80671 99657 *99791 80501 80672 99659 99657 80502 80679 99660 *99799 80503 8068 99661 99657 80504 8069 99662 *99881 80505 95200 99663 99657 80506 95201 99664 *99883 80507 95202 99665 99657 80508 95203 99666 *99889 80510 95204 99667 99657 80511 95205 99668 *9989 80512 95206 99669 99657 80513 95207 99670 *V421 80514 95208 99671 V4321 80515 95209 99672 V4322 80516 95210 99673 *V4321 80517 95211 99674 V4321 80518 95212 99675 V4322 8052 95213 99676 *V4322 8053 95214 99677 V4321 8054 95215 99678 V4322 8055 95216 99679 8056 95217 *99659 8057 95218 99657 8058 95219 *99660 8059 9522 99657 80600 9523 *99661 80601 9524 99657 80602 9528 *99662 80603 9529 99657 80604 *9598 *99663 80605 85011 99657 80606 85012 *99664 80607 *9599 99657 80608 85011 *99665 80609 85012 99657 80610 *99600 *99666 80611 99657 99657 80612 *99601 *99667 80613 99657 99657 80614 *99602 *99668 80615 99657 99657 [[Page 27366]] 80616 *99603 *99669 80617 99657 99657 80618 *99604 *99670 80619 99657 99657 ------------------------------------------------------------------------ ----------------------------------------------------------------------- Table 6H.--Deletions From the CC Exclusions List [CCs that are deleted from the list are in Table 6H-Deletions to the CC Exclusions List. Each of the principal diagnoses is shown with an asterisk, and the revisions to the CC Exclusions List are provided in an indented column immediately following the affected principal diagnosis.] ------------------------------------------------------------------------ ------------------------------------------------------------------------ *25060 28263 28260 53201 6013 71169 6960 8501 3580 28269 28261 53210 6021 7141 71100 *80005 *25061 2830 28262 53211 78820 7142 71101 8501 3580 28310 28263 53220 78829 71430 71102 *80006 *25062 28311 28269 53221 *6001 71431 71103 8501 3580 28319 2830 53231 5960 71432 71104 *80009 *25063 2832 28310 53240 5996 71433 71105 8501 3580 2839 28311 53241 6010 *71976 71106 *80010 *25080 2840 28319 53250 6012 6960 71107 8501 3580 2848 2832 53251 6013 71100 71108 *80011 *25081 2849 2839 53260 6021 71106 71109 8501 3580 2850 2840 53261 78820 71108 71160 *80012 *25082 2851 2848 53271 78829 71109 71161 8501 3580 *2825 2849 53291 *6002 71160 71162 *80013 *25083 2824 2850 53300 5960 71166 71163 8501 3580 *28260 2851 53301 5996 71168 71164 *80014 *25090 2824 2860 53310 6010 71169 71165 8501 3580 *28261 2861 53311 6012 7141 71166 *80015 *25091 2824 2862 53320 6013 7142 71167 8501 3580 *28262 2863 53321 6021 71430 71168 *80016 *25092 2824 2864 53331 78820 71431 71169 8501 3580 *28263 2865 53340 78829 71432 7141 *80019 *25093 2824 2866 53341 *6009 71433 7142 8501 3580 *28269 2867 53350 5960 *71977 71430 *80020 *2551 2824 2869 53351 5996 6960 71431 8501 2550 *2827 2870 53360 6010 71100 71432 *80021 2580 2824 2871 53361 6012 71107 71433 8501 2581 *2828 2872 53371 6013 71108 *7528 *80022 2588 2824 2873 53391 6021 71109 5970 8501 2589 *2829 2874 53400 78820 71160 5994 *80023 *2800 2824 2875 53401 78829 71167 6140 8501 2824 *2830 2878 53410 *71970 71168 6143 *80024 *2801 2824 2879 53411 6960 71169 6145 8501 2824 *28310 2880 53420 71100 7141 6150 *80025 *2808 2824 2881 53421 71101 7142 6163 8501 2824 *28311 *2899 53431 71102 71430 6164 *80026 *2809 2824 2824 53440 71103 71431 6207 8501 2824 *28319 *3483 53441 71104 71432 *7998 *80029 *2810 2824 34982 53450 71105 71433 04082 8501 2824 *2832 *34989 53451 71106 *71978 44024 *80030 *2811 2824 3580 53460 71107 6960 78001 8501 2824 *2839 *3499 53461 71108 71100 78003 *80031 *2812 2824 3580 53471 71109 71101 7801 8501 2824 *2840 *3580 53491 71160 71102 78031 *80032 *2813 2824 3580 53501 71161 71103 78039 8501 2824 *2848 3581 53511 71162 71104 7817 *80033 *2814 2824 *3581 53521 71163 71105 7854 8501 2824 *2849 3580 53531 71164 71106 78550 *80034 *2818 2824 *5302 53541 71165 71107 78551 8501 2824 *2850 4560 53551 71166 71108 78559 *80035 *2819 2824 5307 53561 71167 71109 7863 8501 2824 *2851 53082 53783 71168 71160 78820 *80036 *2820 2824 53100 53784 71169 71161 78829 8501 2824 *28521 53101 56202 7141 71162 7895 *80039 *2821 2824 53110 56203 7142 71163 7907 8501 2824 *28522 53111 56212 71430 71164 7911 *80040 *2822 2824 53120 56213 71431 71165 7913 8501 2824 *28529 53121 5693 71432 71166 7991 *80041 *2823 2824 53131 56985 71433 71167 7994 8501 2824 *2858 53140 56986 *71975 71168 *80000 *80042 *2824 2824 53141 5780 6960 71169 8501 8501 2800 *2859 53150 5781 71100 7141 *80001 *80043 [[Page 27367]] 2814 2824 53151 5789 71105 7142 8501 8501 2818 *2898 53160 *6000 71108 71430 *80002 *80044 2824 2800 53161 5960 71109 71431 8501 8501 28260 2814 53171 5996 71160 71432 *80003 *80045 28261 2818 53191 6010 71165 71433 8501 8501 28262 2824 53200 6012 71168 *71979 *80004 *80046 8501 *80093 8501 *80184 8501 *80375 8501 *80466 *80049 8501 *80140 8501 *80331 8501 *80422 8501 8501 *80094 8501 *80185 8501 *80376 8501 *80469 *80050 8501 *80141 8501 *80332 8501 *80423 8501 8501 *80095 8501 *80186 8501 *80379 8501 *80470 *80051 8501 *80142 8501 *80333 8501 *80424 8501 8501 *80096 8501 *80189 8501 *80380 8501 *80471 *80052 8501 *80143 8501 *80334 8501 *80425 8501 8501 *80099 8501 *80190 8501 *80381 8501 *80472 *80053 8501 *80144 8501 *80335 8501 *80426 8501 8501 *80100 8501 *80191 8501 *80382 8501 *80473 *80054 8501 *80145 8501 *80336 8501 *80429 8501 8501 *80101 8501 *80192 8501 *80383 8501 *80474 *80055 8501 *80146 8501 *80339 8501 *80430 8501 8501 *80102 8501 *80193 8501 *80384 8501 *80475 *80056 8501 *80149 8501 *80340 8501 *80431 8501 8501 *80103 8501 *80194 8501 *80385 8501 *80476 *80059 8501 *80150 8501 *80341 8501 *80432 8501 8501 *80104 8501 *80195 8501 *80386 8501 *80479 *80060 8501 *80151 8501 *80342 8501 *80433 8501 8501 *80105 8501 *80196 8501 *80389 8501 *80480 *80061 8501 *80152 8501 *80343 8501 *80434 8501 8501 *80106 8501 *80199 8501 *80390 8501 *80481 *80062 8501 *80153 8501 *80344 8501 *80435 8501 8501 *80109 8501 *80300 8501 *80391 8501 *80482 *80063 8501 *80154 8501 *80345 8501 *80436 8501 8501 *80110 8501 *80301 8501 *80392 8501 *80483 *80064 8501 *80155 8501 *80346 8501 *80439 8501 8501 *80111 8501 *80302 8501 *80393 8501 *80484 *80065 8501 *80156 8501 *80349 8501 *80440 8501 8501 *80112 8501 *80303 8501 *80394 8501 *80485 *80066 8501 *80159 8501 *80350 8501 *80441 8501 8501 *80113 8501 *80304 8501 *80395 8501 *80486 *80069 8501 *80160 8501 *80351 8501 *80442 8501 8501 *80114 8501 *80305 8501 *80396 8501 *80489 *80070 8501 *80161 8501 *80352 8501 *80443 8501 8501 *80115 8501 *80306 8501 *80399 8501 *80490 *80071 8501 *80162 8501 *80353 8501 *80444 8501 8501 *80116 8501 *80309 8501 *80400 8501 *80491 *80072 8501 *80163 8501 *80354 8501 *80445 8501 8501 *80119 8501 *80310 8501 *80401 8501 *80492 *80073 8501 *80164 8501 *80355 8501 *80446 8501 8501 *80120 8501 *80311 8501 *80402 8501 *80493 *80074 8501 *80165 8501 *80356 8501 *80449 8501 8501 *80121 8501 *80312 8501 *80403 8501 *80494 *80075 8501 *80166 8501 *80359 8501 *80450 8501 8501 *80122 8501 *80313 8501 *80404 8501 *80495 *80076 8501 *80169 8501 *80360 8501 *80451 8501 8501 *80123 8501 *80314 8501 *80405 8501 *80496 *80079 8501 *80170 8501 *80361 8501 *80452 8501 8501 *80124 8501 *80315 8501 *80406 8501 *80499 *80080 8501 *80171 8501 *80362 8501 *80453 8501 8501 *80125 8501 *80316 8501 *80409 8501 *8500 *80081 8501 *80172 8501 *80363 8501 *80454 8501 8501 *80126 8501 *80319 8501 *80410 8501 *8501 *80082 8501 *80173 8501 *80364 8501 *80455 430 8501 *80129 8501 *80320 8501 *80411 8501 431 *80083 8501 *80174 8501 *80365 8501 *80456 4320 8501 *80130 8501 *80321 8501 *80412 8501 4321 *80084 8501 *80175 8501 *80366 8501 *80459 436 8501 *80131 8501 *80322 8501 *80413 8501 78001 *80085 8501 *80176 8501 *80369 8501 *80460 78003 8501 *80132 8501 *80323 8501 *80414 8501 80000 *80086 8501 *80179 8501 *80370 8501 *80461 80001 8501 *80133 8501 *80324 8501 *80415 8501 80002 *80089 8501 *80180 8501 *80371 8501 *80462 80003 [[Page 27368]] 8501 *80134 8501 *80325 8501 *80416 8501 80004 *80090 8501 *80181 8501 *80372 8501 *80463 80005 8501 *80135 8501 *80326 8501 *80419 8501 80006 *80091 8501 *80182 8501 *80373 8501 *80464 80009 8501 *80136 8501 *80329 8501 *80420 8501 80010 *80092 8501 *80183 8501 *80374 8501 *80465 80011 8501 *80139 8501 *80330 8501 *80421 8501 80012 80013 80104 80195 80353 80444 85126 85219 *8509 80014 80105 80196 80354 80445 85129 85220 8501 80015 80106 80199 80355 80446 85130 85221 *85100 80016 80109 8021 80356 80449 85131 85222 8501 80019 80110 80220 80359 80450 85132 85223 *85101 80020 80111 80221 80360 80451 85133 85224 8501 80021 80112 80222 80361 80452 85134 85225 *85102 80022 80113 80223 80362 80453 85135 85226 8501 80023 80114 80224 80363 80454 85136 85229 *85103 80024 80115 80225 80364 80455 85139 85230 8501 80025 80116 80226 80365 80456 85140 85231 *85104 80026 80119 80227 80366 80459 85141 85232 8501 80029 80120 80228 80369 80460 85142 85233 *85105 80030 80121 80229 80370 80461 85143 85234 8501 80031 80122 80230 80371 80462 85144 85235 *85106 80032 80123 80231 80372 80463 85145 85236 8501 80033 80124 80232 80373 80464 85146 85239 *85109 80034 80125 80233 80374 80465 85149 85240 8501 80035 80126 80234 80375 80466 85150 85241 *85110 80036 80129 80235 80376 80469 85151 85242 8501 80039 80130 80236 80379 80470 85152 85243 *85111 80040 80131 80237 80380 80471 85153 85244 8501 80041 80132 80238 80381 80472 85154 85245 *85112 80042 80133 80239 80382 80473 85155 85246 8501 80043 80134 8024 80383 80474 85156 85249 *85113 80044 80135 8025 80384 80475 85159 85250 8501 80045 80136 8026 80385 80476 85160 85251 *85114 80046 80139 8027 80386 80479 85161 85252 8501 80049 80140 8028 80389 80480 85162 85253 *85115 80050 80141 8029 80390 80481 85163 85254 8501 80051 80142 80300 80391 80482 85164 85255 *85116 80052 80143 80301 80392 80483 85165 85256 8501 80053 80144 80302 80393 80484 85166 85259 *85119 80054 80145 80303 80394 80485 85169 85300 8501 80055 80146 80304 80395 80486 85170 85301 *85120 80056 80149 80305 80396 80489 85171 85302 8501 80059 80150 80306 80399 80490 85172 85303 *85121 80060 80151 80309 80400 80491 85173 85304 8501 80061 80152 80310 80401 80492 85174 85305 *85122 80062 80153 80311 80402 80493 85175 85306 8501 80063 80154 80312 80403 80494 85176 85309 *85123 80064 80155 80313 80404 80495 85179 85310 8501 80065 80156 80314 80405 80496 85180 85311 *85124 80066 80159 80315 80406 80499 85181 85312 8501 80069 80160 80316 80409 8500 85182 85313 *85125 80070 80161 80319 80410 8501 85183 85314 8501 80071 80162 80320 80411 8502 85184 85315 *85126 80072 80163 80321 80412 8503 85185 85316 8501 80073 80164 80322 80413 8504 85186 85319 *85129 80074 80165 80323 80414 8505 85189 85400 8501 80075 80166 80324 80415 8509 85190 85401 *85130 80076 80169 80325 80416 85100 85191 85402 8501 80079 80170 80326 80419 85101 85192 85403 *85131 80080 80171 80329 80420 85102 85193 85404 8501 80081 80172 80330 80421 85103 85194 85405 *85132 80082 80173 80331 80422 85104 85195 85406 8501 80083 80174 80332 80423 85105 85196 85409 *85133 80084 80175 80333 80424 85106 85199 85410 8501 80085 80176 80334 80425 85109 85200 85411 *85134 80086 80179 80335 80426 85110 85201 85412 8501 80089 80180 80336 80429 85111 85202 85413 *85135 80090 80181 80339 80430 85112 85203 85414 8501 80091 80182 80340 80431 85113 85204 85415 *85136 80092 80183 80341 80432 85114 85205 85416 8501 80093 80184 80342 80433 85115 85206 85419 *85139 [[Page 27369]] 80094 80185 80343 80434 85116 85209 *8502 8501 80095 80186 80344 80435 85119 85210 8501 *85140 80096 80189 80345 80436 85120 85211 *8503 8501 80099 80190 80346 80439 85121 85212 8501 *85141 80100 80191 80349 80440 85122 85213 *8504 8501 80101 80192 80350 80441 85123 85214 8501 *85142 80102 80193 80351 80442 85124 85215 *8505 8501 80103 80194 80352 80443 85125 85216 8501 *85143 8501 *85190 8501 *85402 8054 95215 *85144 8501 *85236 8501 8055 95216 8501 *85191 8501 *85403 8056 95217 *85145 8501 *85239 8501 8057 95218 8501 *85192 8501 *85404 8058 95219 *85146 8501 *85240 8501 8059 9522 8501 *85193 8501 *85405 80600 9523 *85149 8501 *85241 8501 80601 9524 8501 *85194 8501 *85406 80602 9528 *85150 8501 *85242 8501 80603 9529 8501 *85195 8501 *85409 80604 *9598 *85151 8501 *85243 8501 80605 8501 8501 *85196 8501 *85410 80606 *9599 *85152 8501 *85244 8501 80607 8501 8501 *85199 8501 *85411 80608 *99680 *85153 8501 *85245 8501 80609 V432 8501 *85200 8501 *85412 80610 *99683 *85154 8501 *85246 8501 80611 V432 8501 *85201 8501 *85413 80612 *99687 *85155 8501 *85249 8501 80613 V432 8501 *85202 8501 *85414 80614 *V421 *85156 8501 *85250 8501 80615 V432 8501 *85203 8501 *85415 80616 *V432 *85159 8501 *85251 8501 80617 V432 8501 *85204 8501 *85416 80618 *85160 8501 *85252 8501 80619 8501 *85205 8501 *85419 80620 *85161 8501 *85253 8501 80621 8501 *85206 8501 *8738 80622 *85162 8501 *85254 8501 80623 8501 *85209 8501 *8739 80624 *85163 8501 *85255 8501 80625 8501 *85210 8501 *8798 80626 *85164 8501 *85256 8501 80627 8501 *85211 8501 *8799 80628 *85165 8501 *85259 8501 80629 8501 *85212 8501 *9050 80630 *85166 8501 *85300 8501 80631 8501 *85213 8501 *9251 80632 *85169 8501 *85301 8501 80633 8501 *85214 8501 *9252 80634 *85170 8501 *85302 8501 80635 8501 *85215 8501 *9290 80636 *85171 8501 *85303 8501 80637 8501 *85216 8501 *9299 80638 *85172 8501 *85304 8501 80639 8501 *85219 8501 *9588 8064 *85173 8501 *85305 8501 8065 8501 *85221 8501 *95901 80660 *85174 8501 *85306 8501 80661 8501 *85222 8501 *95909 80662 *85175 8501 *85309 8501 80669 8501 *85223 8501 *9591 80670 *85176 8501 *85310 80500 80671 8501 *85224 8501 80501 80672 *85179 8501 *85311 80502 80679 8501 *85225 8501 80503 8068 *85180 8501 *85312 80504 8069 8501 *85226 8501 80505 95200 *85181 8501 *85313 80506 95201 8501 *85229 8501 80507 95202 *85182 8501 *85314 80508 95203 8501 *85230 8501 80510 95204 *85183 8501 *85315 80511 95205 [[Page 27370]] 8501 *85231 8501 80512 95206 *85184 8501 *85316 80513 95207 8501 *85232 8501 80514 95208 *85185 8501 *85319 80515 95209 8501 *85233 8501 80516 95210 *85186 8501 *85400 80517 95211 8501 *85234 8501 80518 95212 *85189 8501 *85401 8052 95213 8501 *85235 8501 8053 95214 ------------------------------------------------------------------------ ----------------------------------------------------------------------- Table 7A.--Medicare Prospective Payment System Selected Percentile Lengths of Stay [FY 2002 MEDPAR Update December 2002 Grouper V20.0] -------------------------------------------------------------------------------------------------------------------------------------------------------- Arithmetic DRG Number of mean length of 10th 25th 50th 75th 90th discharges stay Percentile Percentile Percentile Percentile Percentile -------------------------------------------------------------------------------------------------------------------------------------------------------- 1....................................... 29,262 10.8505 3 5 8 14 22 2....................................... 14,769 5.0718 1 2 4 7 10 3....................................... 3 6.0000 1 1 4 13 13 4....................................... 6,712 7.3524 1 2 5 9 16 5....................................... 95,618 2.9596 1 1 2 3 7 6....................................... 356 3.0197 1 1 2 4 7 7....................................... 14,683 9.8438 2 4 7 12 20 8....................................... 4,106 2.8015 1 1 1 3 7 9....................................... 1,711 6.2402 1 3 5 8 12 10...................................... 18,655 6.3850 2 3 5 8 13 11...................................... 3,291 4.0413 1 2 3 5 8 12...................................... 52,512 5.7513 2 3 4 7 11 13...................................... 7,068 5.0035 2 3 4 6 9 14...................................... 237,027 5.9456 2 3 5 7 11 15...................................... 94,223 4.8529 2 3 4 6 9 16...................................... 9,938 6.3106 2 3 5 8 12 17...................................... 2,744 3.2172 1 2 2 4 6 18...................................... 29,701 5.4868 2 3 4 7 10 19...................................... 8,519 3.5184 1 2 3 5 7 20...................................... 6,207 10.1927 3 5 8 13 20 21...................................... 1,885 6.5963 2 3 5 9 13 22...................................... 2,785 5.1178 2 2 4 6 10 23...................................... 12,583 4.1677 1 2 3 5 8 24...................................... 59,102 4.8803 1 2 4 6 10 25...................................... 27,433 3.1776 1 2 3 4 6 26...................................... 18 4.2778 1 1 2 3 4 27...................................... 4,398 5.1719 1 1 3 7 11 28...................................... 13,919 6.0265 1 3 5 8 12 29...................................... 5,282 3.4924 1 2 3 5 7 30...................................... 2 6.5000 2 2 11 11 11 31...................................... 3,897 4.0429 1 2 3 5 8 32...................................... 1,895 2.4776 1 1 2 3 5 34...................................... 23,811 4.9368 1 2 4 6 9 35...................................... 7,451 3.1094 1 1 3 4 6 36...................................... 2,117 1.5328 1 1 1 1 2 37...................................... 1,382 3.7685 1 1 2 5 8 38...................................... ,97 2.8041 1 1 1 4 5 39...................................... 559 2.1163 1 1 1 2 4 40...................................... 1,549 3.8070 1 1 3 5 7 42...................................... 1,581 2.7381 1 1 1 3 6 43...................................... 94 3.3936 1 1 3 4 6 44...................................... 1,227 4.9935 2 3 4 6 9 45...................................... 2,668 3.1267 1 2 3 4 6 46...................................... 3,482 4.4730 1 2 3 6 8 47...................................... 1,402 3.0927 1 1 2 4 6 49...................................... 2,391 4.4676 1 2 3 6 9 50...................................... 2,429 1.8506 1 1 1 2 3 51...................................... 243 2.8354 1 1 1 3 8 52...................................... 223 1.8161 1 1 1 2 3 53...................................... 2,478 3.6186 1 1 2 4 8 55...................................... 1,481 2.9338 1 1 1 3 7 56...................................... 469 2.8955 1 1 1 3 6 57...................................... 711 3.6709 1 1 2 4 8 58...................................... 1 2.0000 2 2 2 2 2 [[Page 27371]] 59...................................... 116 2.6724 1 1 1 3 6 60...................................... 1 3.0000 3 3 3 3 3 61...................................... 254 5.1535 1 1 3 7 11 62...................................... 2 7.0000 1 1 13 13 13 63...................................... 3,000 4.3860 1 2 3 5 9 64...................................... 3,126 6.4997 1 2 4 8 14 65...................................... 40,407 2.8127 1 1 2 4 5 66...................................... 7,841 3.0778 1 1 2 4 6 67...................................... 385 3.6442 1 2 3 5 7 68...................................... 11,658 3.8813 1 2 3 5 7 69...................................... 3,769 3.0186 1 2 3 4 5 70...................................... 30 2.3333 1 1 2 3 4 71...................................... 80 3.4000 1 1 2 4 6 72...................................... 964 3.4035 1 1 3 4 6 73...................................... 7,697 4.4433 1 2 3 6 9 75...................................... 43,504 9.9907 3 5 7 12 20 76...................................... 44,508 11.1024 3 5 9 14 21 77...................................... 2,458 4.8031
