MDC 1 DISEASES AND DISORDERS OF THE NERVOUS SYSTEM Implantation of chemotherapeutic agent Intracranial stents
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1 To assist the readers in identifying all changes that were made to the MS-DRGs as a result of comments, we developed the attached table that summaries those changes. MS-DRG Summary Table PRE-MDC Intestinal Transplant Proposed titles: MS-DRG 005 Liver transplant and/or intestinal transplant w MCC MS-DRG 006 Liver transplant and/or intestinal transplant w/o MCC MS-DRG 005 Liver transplant w MCC or intestinal transplant MS-DRG 006 Liver transplant w/o MCC 1. Reassign cases with procedure code 46.97, Transplant of intestine, from MS- DRG 006 to MS-DRG 005. MDC 1 DISEASES AND DISORDERS OF THE NERVOUS SYSTEM Implantation of chemotherapeutic agent Intracranial stents Proposed titles: MS-DRG 23 Craniotomy w major device implant or acute complex central nervous system principal diagnosis w MCC MS-DRG 24 Craniotomy w major device implant or acute complex central nervous system principal diagnosis w/o MCC Final titles: MS-DRG 023 Cranio w major dev impl/acute complex CNS PDX w MCC or chemo implant MS-DRG 024 Cranio w major dev impl/acute complex CNS PDX w/o MCC 1. Reassign cases with procedure code 00.10, Implantation of chemotherapeutic agent, from MS-DRG 24 to MS-DRG Reassign cases with procedure code 00.62, Percutaneous angioplasty or atherectomy of intracranial vessel(s), from MS-DRGs to MS-DRGs Intracranial stents MS-DRG 025 Craniotomy & endovascular intracranial procedures w MCC MS-DRG 026 Craniotomy & endovascular intracranial procedures w CC MS-DRG 027 Craniotomy & endovascular intracranial procedures w/o CC/MCC 1. Reassign cases with procedure code 00.62, Percutaneous angioplasty or atherectomy of intracranial vessel(s), from MS-DRGs to MS-DRGs
2 Spinal Neurostimulators MS-DRG 028 Spinal procedures w MCC MS-DRG 029 Spinal procedures w CC MS-DRG 030 Spinal procedures w/o CC/MCC MS-DRG 028 Spinal procedures w MCC MS-DRG 029 Spinal procedures w CC or spinal neurostimulators MS-DRG 030 Spinal procedures w/o CC/MCC 1. Reassign full system spinal cord non-rechargeable and rechargeable neurostimulator cases in MS-DRG 30 to MS-DRG 29 in MDC 1. ICD-9-CM procedure codes 03.93, Implantation or replacement of spinal neurostimulator lead(s) and 86.94, Insertion or replacement of single array neurostimulator pulse generator, not specified as rechargeable or 86.95, Insertion or replacement of dual array neurostimulator pulse generator, not specified as rechargeable, or 86.97, Insertion or replacement of single array rechargeable neurostimulator pulse generator or 86.98, Insertion or replacement of dual array rechargeable neurostimulator pulse generator, must be reported in order for the spinal neurostimulator cases to be assigned to MS-DRG 29. Intracranial stents MS-DRG 037 Extracranial procedures w MCC MS-DRG 038 Extracranial procedures w CC MS-DRG 039 Extracranial procedures w/o CC/MCC 1. Reassign cases with procedure code 00.62, Percutaneous angioplasty or atherectomy of intracranial vessel(s), from MS-DRGs to MS-DRG Peripheral Neurostimulators MS-DRG 40 Periph & cranial nerve & other nerv syst proc w MCC MS-DRG 41 Periph/cranial nerve & other nerv syst proc w CC MS-DRG 42 Periph/cranial nerve & other nerv syst proc w/o CC/MCC MS-DRG 40 Periph & cranial nerve & other nerv syst proc w MCC MS-DRG 41 Periph/cranial nerve & other nerv syst proc w CC or periph neurostim MS-DRG 42 Periph/cranial nerve & other nerv syst proc w/o CC/MCC
3 1. Reassign full system peripheral non-rechargeable and rechargeable neurostimulator cases in MS-DRG 42 to MS-DRG 41. ICD-9-CM procedure codes 04.92, Implantation or replacement of peripheral neurostimulator lead(s) and 86.94, Insertion or replacement of single array neurostimulator pulse generator, not specified as rechargeable or 86.95, Insertion or replacement of dual array neurostimulator pulse generator, not specified as rechargeable, or 86.97, Insertion or replacement of single array rechargeable neurostimulator pulse generator or 86.98, Insertion or replacement of dual array rechargeable neurostimulator pulse generator, must be reported in order for the peripheral neurostimulator cases to be assigned to MS-DRG 41. Pain Codes MS-DRG 091 Other disorders of nervous system w MCC MS-DRG 092 Other disorders of nervous system w CC MS-DRG 093 Other disorders of nervous system w/o CC/MCC 1. Reassign cases with a principal diagnosis of code 338.0, Central pain syndrome, or , Chronic pain due to trauma, or code , Chronic post-thoracotomy pain, or code , Other chronic postoperative pain, or code , Other chronic pain, or code 338.4, Chronic pain syndrome from MDC 23, MS-DRGs to MS-DRGs MDC 3 DISEASE AND DISORDERS OF THE EAR, NOSE, MOUTH AND THROAT Cochlear Implants MS-DRG 129 Major head & neck procedures w CC/MCC MS-DRG 130 Major head & neck procedures w/o CC/MCC MS-DRG 129 Major head & neck procedures w CC/MCC or major device MS-DRG 130 Major head & neck procedures w/o CC/MCC 1. Reassign cochlear implant cases from MS-DRG 130 to MS-DRG 129. The ICD- 9-CM procedure codes for cochlear implants are: 20.96, Implantation or replacement of cochlear prosthetic device, not otherwise specified, or 20.97, Implantation or replacement of cochlear prosthetic device, single channel or 20.98, Implantation or replacement of cochlear prosthetic device, multiple channel. MDC 5 DISEASE AND DISORDERS OF THE CIRCULATORY SYSTEM
4 Endovascular implantation of graft in thoracic aorta MS-DRG 237 Major Cardiovascular Procedures w MCC MS-DRG 238 Major Cardiovascular Procedures w/o MCC MS-DRG 237 Major cardiovasc procedures w MCC or thoracic aortic aneurysm repair MS-DRG 238 Major cardiovasc procedures w/o MCC 1. Reassign cases with procedure code 39.73, Endovascular implantation of graft in thoracic aorta, from MS-DRG 238 to MS-DRG 237. Multiple Vessels, Multiple Coronary Stents MS-DRG 246 Percutaneous cardiovascular proc w drug-eluting stent w MCC MS-DRG 247 Percutaneous cardiovascular proc w drug-eluting stent w/o MCC MS-DRG 246 Perc cardiovasc proc w drug-eluting stent w MCC or 4+ vessels/stents MS-DRG 247 Perc cardiovasc proc w drug-eluting stent w/o MCC 1. Reassign cases in MS-DRG 247 with procedure codes 00.66, Percutaneous transluminal coronary angioplasty [PTCA] or coronary atherectomy and code 36.07, Insertion of drug-eluting coronary artery stent(s) and code 00.43, Procedure on four or more vessels or code 00.48, Insertion of four or more vascular stents, to MS-DRG 246. MS-DRG 248 Percutaneous cardiovascular proc w non-drug-eluting stent w MCC MS-DRG 249 Percutaneous cardiovascular proc w non-drug-eluting stent w/o MCC MS-DRG 248 Perc cardiovasc proc w non-drug-eluting stent w MCC or 4+ ves/stents MS-DRG 249 Perc cardiovasc proc w non-drug-eluting stent w/o MCC 1.Reassign cases in MS-DRG 249 with procedure codes 00.66, Percutaneous transluminal coronary angioplasty [PTCA] or coronary atherectomy and code 36.06, Insertion of non-drug-eluting coronary artery stent(s) and code 00.43, Procedure on four or more vessels or code 00.48, Insertion of four or more vascular stents, to MS-DRG 248. MDC 8 DISEASES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE
5 Spinal Fusions MS-DRG 456 Spinal fusion exc cerv w spinal curv, malig or 9+ fusions w MCC MS-DRG 457 Spinal fusion exc cerv w spinal curv, malig or 9+ fusions w CC MS-DRG 458 Spinal fusion exc cerv w spinal curv, malig or 9+ fusions w/o CC/MCC MS-DRG 456 Spinal fusion exc cerv w spinal curv/malig/infec or 9+ fusions w MCC MS-DRG 457 Spinal fusion exc cerv w spinal curv/malig/infec or 9+ fusions w CC MS-DRG 458 Spinal fusion exc cerv w spinal curv/malign/infec or 9+ fusions w/o CC/MCC 1. Add the following diagnoses to the principal diagnosis list for MS-DRGs : , Tuberculosis of bones and joints, vertebral column, bacteriological or histological examination unknown (at present) , Tuberculosis of bones and joints, vertebral column, tubercle bacilli not found (in sputum) by microscopy, but found by bacterial culture , Tuberculosis of bones and joints, vertebral column, tubercle bacilli not found by bacteriological examination, but tuberculosis confirmed histologically , Acute osteomyelitis of other specified sites , Chronic osteomyelitis of other specified sites , Unspecified osteomyelitis of other specified sites 2. Add procedure code 81.64, Fusion or refusion of 9 or more vertebrae, to the list of procedures for MS-DRGs Hip and Knee Replacements MS-DRG 466 Revision of hip or knee replacement w MCC MS-DRG 467 Revision of hip or knee replacement w CC MS-DRG 468 Revision of hip or knee replacement w/o CC/MCC MS-DRG 485 Knee procedures w pdx of infection w MCC MS-DRG 486 Knee procedures w pdx of infection w CC MS-DRG 487 Knee procedures w pdx of infection w/o CC/MCC MS-DRG 488 Knee procedures w/o pdx of infection w CC/MCC MS-DRG 489 Knee procedures w/o pdx of infection w/o CC/MCC 1. Reassign cases with procedure code 00.83, Revision of knee replacement, patellar component, or code 00.84, Revision of total knee replacement, tibial insert (liner), from MS-DRGs to MS-DRGs Spinal Procedures Spinal Neurostimulators
6 MS-DRG 490 Back & neck procedures except spinal fusion w CC/MCC or disc devices MS-DRG 491 Back & neck procedures except spinal fusion w/o CC/MCC MS-DRG 490 Back & neck proc exc spinal fusion w CC/MCC or disc device/neurostim MS-DRG 491 Back & neck proc exc spinal fusion w/o CC/MCC 1. Reassign cases with procedure codes 84.59, Insertion of other spinal devices, or code 84.62, Insertion of total spinal disc prosthesis, cervical or code 84.65, Insertion of total spinal disc prosthesis, lumbosacral, or code 84.80, Insertion or replacement of interspinous process device(s) or code 84.82, Insertion or replacement of pedicle-based dynamic stabilization device(s) or code 84.84, Insertion or replacement of facet replacement devices, from MS-DRG 491 to MS DRG Reassign full system spinal cord non-rechargeable and rechargeable neurostimulator cases in MS-DRG 491 to MS-DRG 490 in MDC 8. ICD-9- CM procedure codes 03.93, Implantation or replacement of spinal neurostimulator lead(s) and 86.94, Insertion or replacement of single array neurostimulator pulse generator, not specified as rechargeable or 86.95, Insertion or replacement of dual array neurostimulator pulse generator, not specified as rechargeable, or 86.97, Insertion or replacement of single array rechargeable neurostimulator pulse generator or 86.98, Insertion or replacement of dual array rechargeable neurostimulator pulse generator, must be reported in order for the spinal neurostimulator cases to be assigned to MS-DRG 490. MDC 17 MYELOPROLIFERATIVE DISEASES AND DISORDERS, POORLY DIFFERENTIATED NEOPLASM High-dose infusion interleukin-2 [IL-2] Proposed DRG Titles: MS-DRG 837 Chemo w acute leukemia as sdx or w high dose chemo agent w MCC MS-DRG 838 Chemo w acute leukemia as sdx or w high dose chemo agent w CC MS-DRG 839 Chemo w acute leukemia as sdx or w high dose chemo agent w/o CC/MCC Final DRG Titles: MS-DRG 837 Chemo w acute leukemia as sdx or w high dose chemo agent w MCC MS-DRG 838 Chemo w acute leukemia as sdx w CC or high dose chemo agent MS-DRG 839 Chemo w acute leukemia as sdx w/o CC/MCC
7 1 Reassign cases with procedure code 00.15, High-dose infusion interleukin-2 [IL-2] from MS-DRG 839 to MS-DRG 838. MDC 23 FACTORS INFLUENCING HEALTH STATUS AND OTHER CONTACTS WITH HEALTH STATUS Pain codes MS-DRG 947 Signs & symptoms w MCC MS-DRG 948 Signs & symptoms w/o MCC 1. Reassign cases with a principal diagnosis of code 338.0, Central pain syndrome, or , Chronic pain due to trauma, or code , Chronic post-thoracotomy pain, or code , Other chronic postoperative pain, or code , Other chronic pain, or code 338.4, Chronic pain syndrome from MDC 23, MS-DRGs to MS-DRGs in MDC 1.
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