KMAP MS-DRG/CMS-DRG Crosswalk

Transcription

1 KMAP MS-DRG/CMS-DRG and 103 PR S 001 Heart transplant or implant of heart assist system w Heart transplant or implant of heart assist system w/o 541 PR S 003 ECMO or trach w MV 96+ hrs or PDX exc face, mouth & neck w maj O.R. 542 PR S 004 Trach w MV 96+ hrs or PDX exc face, mouth & neck w/o maj O.R. 480 PR S 005 Liver transplant w or intestinal transplant Liver transplant w/o Procedure 4697 (Transplant of intestine) is always assigned to MS-DRG 005 regardless of severity level 495 PR S 007 Lung transplant 512 PR S 008 Simultaneous pancreas/kidney transplant 481 PR S 009 Bone marrow transplant 513 PR S 010 Pancreas transplant 482 PR S 011 Tracheostomy for face,mouth & neck diagnoses w Tracheostomy for face,mouth & neck diagnoses w Tracheostomy for face,mouth & neck diagnoses w/o S 020 Intracranial vascular procedures w PDX hemorrhage w Intracranial vascular procedures w PDX hemorrhage w Intracranial vascular procedures w PDX hemorrhage w/o S 023 Cranio w major dev impl/acute complex CNS PDX w or chemo implant Non-or procedure 0010(Implant chemothera agent) is always assigned to MS-DRG 023 regardless of severity level; Added procedure 0062 to MS-DRG Revised 12/07/2007 Page: 1

2 KMAP MS-DRG/CMS-DRG and Cranio w major dev impl/acute complex CNS PDX w/o S 025 Craniotomy & endovascular intracranial procedures w Craniotomy & endovascular intracranial procedures w 003* 027 Craniotomy & endovascular intracranial procedures w/o *CMS v24 DRG 003 procedures are split between MS-DRGs 025,026,027,031,032,033; Added procedure 0062 to MS-DRG S 028 Spinal procedures w Spinal procedures w or spinal Combination of 0393 with (8694 or 8695 or neurostimulators 8697 or 8698) is always assigned to MS-DRG 029 regardless of severity level Spinal procedures w/o S 031 Ventricular shunt procedures w Ventricular shunt procedures w Ventricular shunt procedures w/o S 034 Carotid artery stent procedure w Carotid artery stent procedure w Carotid artery stent procedure w/o S 037 Extracranial procedures w Extracranial procedures w Extracranial procedures w/o S 040 Periph & cranial nerve & other nerv syst proc w Periph/cranial nerve & other nerv Combination of 0492 with (8694 or 8695 or syst proc w or periph neurostim 8697 or 8698) is always assigned to MS-DRG 041 regardless of severity Periph & cranial nerve & other nerv syst proc w/o M 052 Spinal disorders & injuries w Spinal disorders & injuries w/o M 054 Nervous system neoplasms w Nervous system neoplasms w/o Revised 12/07/2007 Page: 2

3 KMAP MS-DRG/CMS-DRG and M 056 Degenerative nervous system disorders w Degenerative nervous system disorders w/o M 058 Multiple sclerosis & cerebellar ataxia w Multiple sclerosis & cerebellar ataxia w Multiple sclerosis & cerebellar ataxia w/o M 061 Acute ischemic stroke w use of thrombolytic agent w Acute ischemic stroke w use of thrombolytic agent w Acute ischemic stroke w use of thrombolytic agent w/o M 064 Intracranial hemorrhage or cerebral infarction w Intracranial hemorrhage or cerebral infarction w Intracranial hemorrhage or cerebral infarction w/o M 067 Nonspecific cva & precerebral occlusion w/o infarct w Nonspecific cva & precerebral occlusion w/o infarct w/o M 069 Transient ischemia M 070 Nonspecific cerebrovascular disorders w Nonspecific cerebrovascular disorders w Nonspecific cerebrovascular disorders w/o M 073 Cranial & peripheral nerve disorders w Cranial & peripheral nerve disorders w/o M 075 Viral meningitis w Viral meningitis w/o M 077 Hypertensive encephalopathy w Hypertensive encephalopathy w Hypertensive encephalopathy w/o Revised 12/07/2007 Page: 3

4 KMAP MS-DRG/CMS-DRG and M 080 Nontraumatic stupor & coma w Nontraumatic stupor & coma w/o M 082 Traumatic stupor & coma, coma >1 hr w Traumatic stupor & coma, coma >1 hr w Traumatic stupor & coma, coma >1 hr w/o M 085 Traumatic stupor & coma, coma <1 hr w Traumatic stupor & coma, coma <1 hr w Traumatic stupor & coma, coma <1 hr w/o M 088 Concussion w Concussion w Concussion w/o M 091 Other disorders of nervous system w Other disorders of nervous system w Other disorders of nervous system w/o M 094 Bacterial & tuberculous infections of nervous system w Bacterial & tuberculous infections of nervous system w Bacterial & tuberculous infections of nervous system w/o M 097 Non-bacterial infect of nervous sys exc viral meningitis w Non-bacterial infect of nervous sys exc viral meningitis w Non-bacterial infect of nervous sys exc viral meningitis w/o 026* 01 M 100 Seizures w * CMS v24 DRG 026 PDX are split between MS-DRGs 100,101,102, Seizures w/o M 102 Headaches w Headaches w/o S 113 Orbital procedures w Revised 12/07/2007 Page: 4

5 KMAP MS-DRG/CMS-DRG and Orbital procedures w/o S 115 Extraocular procedures except orbit S 116 Intraocular procedures w Intraocular procedures w/o M 121 Acute major eye infections w Acute major eye infections w/o M 123 Neurological eye disorders M 124 Other disorders of the eye w Other disorders of the eye w/o S 129 Major head & neck procedures w or major device Major head & neck procedures w/o Procedures 2096,2097,2098 (cochlear implants) are always assigned to MS-DRG 129 regardless of severity level S 131 Cranial/facial procedures w Cranial/facial procedures w/o S 133 Other ear, nose, mouth & throat O.R. procedures w Other ear, nose, mouth & throat O.R. procedures w/o Revised 12/07/2007 Page: 5

6 KMAP MS-DRG/CMS-DRG and S 135 Sinus & mastoid procedures w Sinus & mastoid procedures w/o S 137 Mouth procedures w Mouth procedures w/o S 139 Salivary gland procedures M 146 Ear, nose, mouth & throat malignancy w Ear, nose, mouth & throat malignancy w Ear, nose, mouth & throat malignancy w/o M 149 Dysequilibrium M 150 Epistaxis w Epistaxis w/o M 152 Otitis media & URI w Otitis media & URI w/o M 154 Nasal trauma & deformity w Nasal trauma & deformity w Nasal trauma & deformity w/o M 157 Dental & Oral Diseases w Dental & Oral Diseases w Dental & Oral Diseases w/o S 163 Major chest procedures w Major chest procedures w Major chest procedures w/o S 166 Other resp system O.R. procedures w Other resp system O.R. procedures w Other resp system O.R. procedures w/o Revised 12/07/2007 Page: 6

7 KMAP MS-DRG/CMS-DRG and M 175 Pulmonary embolism w Pulmonary embolism w/o M 177 Respiratory infections & inflammations w Respiratory infections & inflammations w Respiratory infections & inflammations w/o M 180 Respiratory neoplasms w Respiratory neoplasms w Respiratory neoplasms w/o M 183 Major chest trauma w Major chest trauma w Major chest trauma w/o M 186 Pleural effusion w Pleural effusion w Pleural effusion w/o M 189 Pulmonary edema & respiratory failure M 190 Chronic obstructive pulmonary disease w Chronic obstructive pulmonary disease w Chronic obstructive pulmonary disease w/o M 193 Simple pneumonia & pleurisy w Simple pneumonia & pleurisy w Simple pneumonia & pleurisy w/o M 196 Interstitial lung disease w Interstitial lung disease w Interstitial lung disease w/o M 199 Pneumothorax w Pneumothorax w Pneumothorax w/o M 202 Bronchitis & asthma w Bronchitis & asthma w/o M 204 Respiratory signs & symptoms 100 Revised 12/07/2007 Page: 7

8 KMAP MS-DRG/CMS-DRG and M 205 Other respiratory system diagnoses w Other respiratory system diagnoses w/o M 207 Respiratory system diagnosis w ventilator support 96+ hours M 208 Respiratory system diagnosis w ventilator support <96 hours S 215 Other heart assist system implant S 216 Cardiac valve & oth maj cardiothoracic proc w card cath w Cardiac valve & oth maj cardiothoracic proc w card cath w Cardiac valve & oth maj cardiothoracic proc w card cath w/o S 219 Cardiac valve & oth maj cardiothoracic proc w/o card cath w Cardiac valve & oth maj cardiothoracic proc w/o card cath w Cardiac valve & oth maj cardiothoracic proc w/o card cath w/o S 222 Cardiac defib implant w cardiac cath w AMI/HF/shock w Cardiac defib implant w cardiac cath w AMI/HF/shock w/o S 224 Cardiac defib implant w cardiac cath w/o AMI/HF/shock w Cardiac defib implant w cardiac cath w/o AMI/HF/shock w/o S 226 Cardiac defibrillator implant w/o cardiac cath w Cardiac defibrillator implant w/o cardiac cath w/o Revised 12/07/2007 Page: 8

9 KMAP MS-DRG/CMS-DRG and S 228 Other cardiothoracic procedures w Other cardiothoracic procedures w Other cardiothoracic procedures w/o S 231 Coronary bypass w PTCA w Coronary bypass w PTCA w/o S 233 Coronary bypass w cardiac cath w Coronary bypass w cardiac cath w/o S 235 Coronary bypass w/o cardiac cath w Coronary bypass w/o cardiac cath w/o S 237 Major cardiovasc procedures w Procedure code 3973 (Endovascular or thoracic aortic anuerysm implantation of graft in thoracic aorta) is repair always assigned to MS-DRG 237 regardless of severity level Major cardiovascular procedures w/o S 239 Amputation for circ sys disorders exc upper limb & toe w Amputation for circ sys disorders exc upper limb & toe w Amputation for circ sys disorders exc upper limb & toe w/o S 242 Permanent cardiac pacemaker implant w Permanent cardiac pacemaker implant w Permanent cardiac pacemaker implant w/o S 245 AICD lead & generator procedures S 246 Perc cardiovasc proc w drugeluting stent w or 4+ vessels/stents Perc cardiovasc proc w drugeluting stent w/o Combination procedures (0066 and 3607) with 0043 or 0048 is always assigned to MS- DRG 246 regardless of severity level Revised 12/07/2007 Page: 9

10 KMAP MS-DRG/CMS-DRG and S 248 Perc cardiovasc proc w non-drugeluting Combination procedures (0066 and 3606) stent w or 4+ with 0043 or 0048 is always assigned to MS- ves/stents DRG 248 regardless of severity level Perc cardiovasc proc w non-drugeluting stent w/o S 250 Perc cardiovasc proc w/o coronary artery stent or AMI w Perc cardiovasc proc w/o coronary artery stent or AMI w/o S 252 Other vascular procedures w Other vascular procedures w Other vascular procedures w/o S 255 Upper limb & toe amputation for circ system disorders w Upper limb & toe amputation for circ system disorders w Upper limb & toe amputation for circ system disorders w/o S 258 Cardiac pacemaker device replacement w Cardiac pacemaker device replacement w/o S 260 Cardiac pacemaker revision except device replacement w Cardiac pacemaker revision except device replacement w Cardiac pacemaker revision except device replacement w/o S 263 Vein ligation & stripping S 264 Other circulatory system O.R. procedures M 280 Acute myocardial infarction, discharged alive w Acute myocardial infarction, discharged alive w Acute myocardial infarction, discharged alive w/o Revised 12/07/2007 Page: 10

11 KMAP MS-DRG/CMS-DRG and M 283 Acute myocardial infarction, expired w Acute myocardial infarction, expired w Acute myocardial infarction, expired w/o M 286 Circulatory disorders except AMI, w card cath w Circulatory disorders except AMI, w card cath w/o M 288 Acute & subacute endocarditis w Acute & subacute endocarditis w Acute & subacute endocarditis w/o M 291 Heart failure & shock w Heart failure & shock w Heart failure & shock w/o M 294 Deep vein thrombophlebitis w Deep vein thrombophlebitis w/o M 296 Cardiac arrest, unexplained w Cardiac arrest, unexplained w Cardiac arrest, unexplained w/o M 299 Peripheral vascular disorders w Peripheral vascular disorders w Peripheral vascular disorders w/o M 302 Atherosclerosis w Atherosclerosis w/o M 304 Hypertension w Hypertension w/o M 306 Cardiac congenital & valvular disorders w Cardiac congenital & valvular disorders w/o M 308 Cardiac arrhythmia & conduction disorders w Revised 12/07/2007 Page: 11

12 KMAP MS-DRG/CMS-DRG and Cardiac arrhythmia & conduction disorders w Cardiac arrhythmia & conduction disorders w/o M 311 Angina pectoris M 312 Syncope & collapse M 313 Chest pain M 314 Other circulatory system diagnoses w Other circulatory system diagnoses w Other circulatory system diagnoses w/o S 326 Stomach, esophageal & duodenal proc w Stomach, esophageal & duodenal proc w Stomach, esophageal & duodenal proc w/o S 329 Major small & large bowel procedures w Major small & large bowel procedures w Major small & large bowel procedures w/o S 332 Rectal resection w Rectal resection w Rectal resection w/o S 335 Peritoneal adhesiolysis w Peritoneal adhesiolysis w Peritoneal adhesiolysis w/o S 338 Appendectomy w complicated principal diag w Appendectomy w complicated principal diag w Appendectomy w complicated principal diag w/o S 341 Appendectomy w/o complicated principal diag w Appendectomy w/o complicated principal diag w Revised 12/07/2007 Page: 12

13 KMAP MS-DRG/CMS-DRG and Appendectomy w/o complicated principal diag w/o S 344 Minor small & large bowel procedures w Minor small & large bowel procedures w Minor small & large bowel procedures w/o S 347 Anal & stomal procedures w Anal & stomal procedures w Anal & stomal procedures w/o S 350 Inguinal & femoral hernia procedures w *CMS v24 DRG 163 procedures are split between MS-DRGs 350,351,352,353,354, Inguinal & femoral hernia procedures w 163* 352 Inguinal & femoral hernia procedures w/o S 353 Hernia procedures except inguinal & femoral w Hernia procedures except inguinal & femoral w Hernia procedures except inguinal & femoral w/o S 356 Other digestive system O.R. procedures w Other digestive system O.R. procedures w Other digestive system O.R. procedures w/o M 368 Major esophageal disorders w Major esophageal disorders w Major esophageal disorders w/o M 371 Major gastrointestinal disorders & peritoneal infections w Major gastrointestinal disorders & peritoneal infections w Major gastrointestinal disorders & peritoneal infections w/o M 374 Digestive malignancy w Digestive malignancy w Digestive malignancy w/o Revised 12/07/2007 Page: 13

14 KMAP MS-DRG/CMS-DRG and M 377 G.I. hemorrhage w G.I. hemorrhage w G.I. hemorrhage w/o M 380 Complicated peptic ulcer w Complicated peptic ulcer w Complicated peptic ulcer w/o M 383 Uncomplicated peptic ulcer w Uncomplicated peptic ulcer w/o M 385 Inflammatory bowel disease w Inflammatory bowel disease w Inflammatory bowel disease w/o M 388 G.I. obstruction w G.I. obstruction w G.I. obstruction w/o M 391 Esophagitis, gastroent & misc digest disorders w Esophagitis, gastroent & misc digest disorders w/o M 393 Other digestive system diagnoses w Other digestive system diagnoses w Other digestive system diagnoses w/o S 405 Pancreas, liver & shunt procedures w Pancreas, liver & shunt procedures w Pancreas, liver & shunt procedures w/o S 408 Biliary tract proc except only cholecyst w or w/o c.d.e. w Biliary tract proc except only cholecyst w or w/o c.d.e. w Biliary tract proc except only cholecyst w or w/o c.d.e. w/o S 411 Cholecystectomy w c.d.e. w Cholecystectomy w c.d.e. w Revised 12/07/2007 Page: 14

15 KMAP MS-DRG/CMS-DRG and Cholecystectomy w c.d.e. w/o S 414 Cholecystectomy except by laparoscope w/o c.d.e. w Cholecystectomy except by laparoscope w/o c.d.e. w Cholecystectomy except by laparoscope w/o c.d.e. w/o S 417 Laparoscopic cholecystectomy w/o c.d.e. w Laparoscopic cholecystectomy w/o c.d.e. w Laparoscopic cholecystectomy w/o c.d.e. w/o S 420 Hepatobiliary diagnostic procedures w Hepatobiliary diagnostic procedures w Hepatobiliary diagnostic procedures w/o S 423 Other hepatobiliary or pancreas O.R. procedures w Other hepatobiliary or pancreas O.R. procedures w Other hepatobiliary or pancreas O.R. procedures w/o M 432 Cirrhosis & alcoholic hepatitis w Cirrhosis & alcoholic hepatitis w Cirrhosis & alcoholic hepatitis w/o M 435 Malignancy of hepatobiliary system or pancreas w Malignancy of hepatobiliary system or pancreas w Malignancy of hepatobiliary system or pancreas w/o M 438 Disorders of pancreas except malignancy w Disorders of pancreas except malignancy w Disorders of pancreas except malignancy w/o M 441 Disorders of liver except malig,cirr,alc hepa w Disorders of liver except malig,cirr,alc hepa w Revised 12/07/2007 Page: 15

16 KMAP MS-DRG/CMS-DRG and Disorders of liver except malig,cirr,alc hepa w/o M 444 Disorders of the biliary tract w Disorders of the biliary tract w Disorders of the biliary tract w/o S 453 Combined anterior/posterior spinal fusion w Combined anterior/posterior spinal fusion w Combined anterior/posterior spinal fusion w/o S 456 Spinal fus exc cerv w spinal Addition of infections to PDX list and criteria curv/malig/infec or 9+ fus w of spinal fusion with non-or procedure 8164 will assign to MS-DRGs Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w/o S 459 Spinal fusion except cervical w Spinal fusion except cervical w/o S 461 Bilateral or multiple major joint procs of lower extremity w Bilateral or multiple major joint procs of lower extremity w/o S 463 Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w/o S 466 Revision of hip or knee replacement w Revision of hip or knee replacement w Revision of hip or knee replacement w/o S 469 Major joint replacement or reattachment of lower extremity w Revised 12/07/2007 Page: 16

17 KMAP MS-DRG/CMS-DRG and Major joint replacement or reattachment of lower extremity w/o S 471 Cervical spinal fusion w Cervical spinal fusion w Cervical spinal fusion w/o S 474 Amputation for musculoskeletal sys & conn tissue dis w Amputation for musculoskeletal sys & conn tissue dis w Amputation for musculoskeletal sys & conn tissue dis w/o S 477 Biopsies of musculoskeletal system & connective tissue w Biopsies of musculoskeletal system & connective tissue w Biopsies of musculoskeletal system & connective tissue w/o S 480 Hip & femur procedures except major joint w Hip & femur procedures except major joint w Hip & femur procedures except major joint w/o S 483 Major joint & limb reattachment proc of upper extremity w Major joint & limb reattachment proc of upper extremity w/o S 485 Knee procedures w pdx of infection w Knee procedures w pdx of infection w Knee procedures w pdx of infection w/o S 488 Knee procedures w/o pdx of infection w Knee procedures w/o pdx of infection w/o Added procedure codes 0083 and 0084 to MS-DRGs Added procedure codes 0083 and 0084 to MS-DRGs Revised 12/07/2007 Page: 17

18 KMAP MS-DRG/CMS-DRG and S 490 Back & neck proc exc spinal Procedures 8459, 8462, 8465, 8480, 8482, fusion w or disc 8484 are always assigned to MS-DRG 490 device/neurostim regardless of severity level; Combination 0393 with (8694 or 8695 or 8697 or 8698) is always assigned to MS-DRG 490 regardless of severity level Back & neck proc exc spinal fusion w/o S 492 Lower extrem & humer proc except hip,foot,femur w Lower extrem & humer proc except hip,foot,femur w Lower extrem & humer proc except hip,foot,femur w/o S 495 Local excision & removal int fix devices exc hip & femur w Local excision & removal int fix devices exc hip & femur w Local excision & removal int fix devices exc hip & femur w/o S 498 Local excision & removal int fix devices of hip & femur w Local excision & removal int fix devices of hip & femur w/o S 500 Soft tissue procedures w Soft tissue procedures w Soft tissue procedures w/o S 503 Foot procedures w Foot procedures w Foot procedures w/o S 506 Major thumb or joint procedures S 507 Major shoulder or elbow joint procedures w Major shoulder or elbow joint procedures w/o S 509 Arthroscopy S 510 Shoulder,elbow or forearm proc,exc major joint proc w Revised 12/07/2007 Page: 18

19 KMAP MS-DRG/CMS-DRG and Shoulder,elbow or forearm proc,exc major joint proc w Shoulder,elbow or forearm proc,exc major joint proc w/o S 513 Hand or wrist proc, except major thumb or joint proc w Hand or wrist proc, except major thumb or joint proc w/o S 515 Other musculoskelet sys & conn tiss O.R. proc w Other musculoskelet sys & conn tiss O.R. proc w Other musculoskelet sys & conn tiss O.R. proc w/o M 533 Fractures of femur w Fractures of femur w/o M 535 Fractures of hip & pelvis w Fractures of hip & pelvis w/o M 537 Sprains, strains, & dislocations of hip, pelvis & thigh w Sprains, strains, & dislocations of hip, pelvis & thigh w/o M 539 Osteomyelitis w Osteomyelitis w Osteomyelitis w/o M 542 Pathological fractures & musculoskelet & conn tiss malig w Pathological fractures & musculoskelet & conn tiss malig w Pathological fractures & musculoskelet & conn tiss malig w/o M 545 Connective tissue disorders w Connective tissue disorders w Connective tissue disorders w/o M 548 Septic arthritis w Revised 12/07/2007 Page: 19

20 KMAP MS-DRG/CMS-DRG and Septic arthritis w Septic arthritis w/o M 551 Medical back problems w Medical back problems w/o M 553 Bone diseases & arthropathies w Bone diseases & arthropathies w/o M 555 Signs & symptoms of musculoskeletal system & conn tissue w Signs & symptoms of musculoskeletal system & conn tissue w/o M 557 Tendonitis, myositis & bursitis w Tendonitis, myositis & bursitis w/o M 559 Aftercare, musculoskeletal system & connective tissue w Aftercare, musculoskeletal system & connective tissue w Aftercare, musculoskeletal system & connective tissue w/o M 562 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o M 564 Other musculoskeletal sys & connective tissue diagnoses w Other musculoskeletal sys & connective tissue diagnoses w Other musculoskeletal sys & connective tissue diagnoses w/o S 573 Skin graft &/or debrid for skn ulcer or cellulitis w Revised 12/07/2007 Page: 20

21 KMAP MS-DRG/CMS-DRG and Skin graft &/or debrid for skn ulcer or cellulitis w Skin graft &/or debrid for skn ulcer or cellulitis w/o S 576 Skin graft &/or debrid exc for skin ulcer or cellulitis w Skin graft &/or debrid exc for skin ulcer or cellulitis w Skin graft &/or debrid exc for skin ulcer or cellulitis w/o S 579 Other skin, subcut tiss & breast proc w Other skin, subcut tiss & breast proc w Other skin, subcut tiss & breast proc w/o S 582 Mastectomy for malignancy w Mastectomy for malignancy w/o S 584 Breast biopsy, local excision & other breast procedures w Breast biopsy, local excision & other breast procedures w/o M 592 Skin ulcers w Skin ulcers w Skin ulcers w/o M 595 Major skin disorders w Major skin disorders w/o M 597 Malignant breast disorders w Malignant breast disorders w Malignant breast disorders w/o M 600 Non-malignant breast disorders w Non-malignant breast disorders w/o M 602 Cellulitis w Cellulitis w/o 262 Revised 12/07/2007 Page: 21

22 KMAP MS-DRG/CMS-DRG and M 604 Trauma to the skin, subcut tiss & breast w Trauma to the skin, subcut tiss & breast w/o M 606 Minor skin disorders w Minor skin disorders w/o S 614 Adrenal & pituitary procedures w Adrenal & pituitary procedures w/o S 616 Amputat of lower limb for endocrine,nutrit,& metabol dis w Amputat of lower limb for endocrine,nutrit,& metabol dis w Amputat of lower limb for endocrine,nutrit,& metabol dis w/o S 619 O.R. procedures for obesity w O.R. procedures for obesity w O.R. procedures for obesity w/o S 622 Skin grafts & wound debrid for endoc, nutrit & metab dis w Skin grafts & wound debrid for endoc, nutrit & metab dis w Skin grafts & wound debrid for endoc, nutrit & metab dis w/o S 625 Thyroid, parathyroid & thyroglossal procedures w Thyroid, parathyroid & thyroglossal procedures w Thyroid, parathyroid & thyroglossal procedures w/o S 628 Other endocrine, nutrit & metab O.R. proc w Other endocrine, nutrit & metab O.R. proc w Other endocrine, nutrit & metab O.R. proc w/o M 637 Diabetes w Diabetes w Diabetes w/o Revised 12/07/2007 Page: 22

23 KMAP MS-DRG/CMS-DRG and M 640 Nutritional & misc metabolic disorders w Nutritional & misc metabolic disorders w/o M 642 Inborn errors of metabolism M 643 Endocrine disorders w Endocrine disorders w Endocrine disorders w/o S 652 Kidney transplant S 653 Major bladder procedures w Major bladder procedures w Major bladder procedures w/o S 656 Kidney & ureter procedures for neoplasm w Kidney & ureter procedures forneoplasm w Kidney & ureter procedures for neoplasm w/o S 659 Kidney & ureter procedures for non-neoplasm w Kidney & ureter procedures for non-neoplasm w Kidney & ureter procedures for non-neoplasm w/o S 662 Minor bladder procedures w Minor bladder procedures w Minor bladder procedures w/o S 665 Prostatectomy w Prostatectomy w Prostatectomy w/o S 668 Transurethral procedures w Transurethral procedures w Transurethral procedures w/o S 671 Urethral procedures w Urethral procedures w/o Revised 12/07/2007 Page: 23

24 KMAP MS-DRG/CMS-DRG and S 673 Other kidney & urinary tract procedures w Other kidney & urinary tract procedures w Other kidney & urinary tract procedures w/o M 682 Renal failure w Renal failure w Renal failure w/o M 685 Admit for renal dialysis M 686 Kidney & urinary tract neoplasms w Kidney & urinary tract neoplasms w Kidney & urinary tract neoplasms w/o M 689 Kidney & urinary tract infections w Kidney & urinary tract infections w/o M 691 Urinary stones w esw lithotripsy w Urinary stones w esw lithotripsy w/o M 693 Urinary stones w/o esw lithotripsy w Urinary stones w/o esw lithotripsy w/o M 695 Kidney & urinary tract signs & symptoms w Kidney & urinary tract signs & symptoms w/o M 697 Urethral stricture M 698 Other kidney & urinary tract diagnoses w Other kidney & urinary tract diagnoses w Other kidney & urinary tract diagnoses w/o S 707 Major male pelvic procedures w Revised 12/07/2007 Page: 24

25 KMAP MS-DRG/CMS-DRG and Major male pelvic procedures w/o S 709 Penis procedures w Penis procedures w/o S 711 Testes procedures w Testes procedures w/o S 713 Transurethral prostatectomy w Transurethral prostatectomy w/o S 715 Other male reproductive system O.R. proc for malignancy w Other male reproductive system O.R. proc for malignancy w/o S 717 Other male reproductive system O.R. proc exc malignancy w Other male reproductive system O.R. proc exc malignancy w/o 342 CMS v24 DRG 342/343 deleted. OR procedure 640 (Circumcision) changed to Non-OR M 722 Malignancy, male reproductive system w Malignancy, male reproductive system w Malignancy, male reproductive system w/o M 725 Benign prostatic hypertrophy w Benign prostatic hypertrophy w/o M 727 Inflammation of the male reproductive system w Inflammation of the male reproductive system w/o M 729 Other male reproductive system diagnoses w Revised 12/07/2007 Page: 25

26 KMAP MS-DRG/CMS-DRG and Other male reproductive system diagnoses w/o S 734 Pelvic evisceration, rad hysterectomy & rad vulvectomy w Pelvic evisceration, rad hysterectomy & rad vulvectomy w/o S 736 Uterine & adnexa proc for ovarian or adnexal malignancy w Uterine & adnexa proc for ovarian or adnexal malignancy w Uterine & adnexa proc for ovarian or adnexal malignancy w/o S 739 Uterine,adnexa proc for nonovarian/adnexal malig w Uterine,adnexa proc for nonovarian/adnexal malig w Uterine,adnexa proc for nonovarian/adnexal malig w/o S 742 Uterine & adnexa proc for nonmalignancy w Uterine & adnexa proc for nonmalignancy w/o S 744 D&C, conization, laparoscopy & tubal interruption w D&C, conization, laparoscopy & tubal interruption w/o S 746 Vagina, cervix & vulva procedures w Vagina, cervix & vulva procedures w/o S 748 Female reproductive system reconstructive procedures S 749 Other female reproductive system O.R. procedures w Other female reproductive system O.R. procedures w/o Revised 12/07/2007 Page: 26

27 KMAP MS-DRG/CMS-DRG and M 754 Malignancy, female reproductive system w Malignancy, female reproductive system w Malignancy, female reproductive system w/o M 757 Infections, female reproductive system w Infections, female reproductive system w Infections, female reproductive system w/o M 760 Menstrual & other female reproductive system disorders w Menstrual & other female reproductive system disorders w/o S 765 Cesarean section w Cesarean section w/o S 767 Vaginal delivery w sterilization &/or D&C S 768 Vaginal delivery w O.R. proc except steril &/or D&C S 769 Postpartum & post abortion diagnoses w O.R. procedure S 770 Abortion w D&C, aspiration curettage or hysterotomy M 774 Vaginal delivery w complicating diagnoses M 775 Vaginal delivery w/o complicating diagnoses M 776 Postpartum & post abortion diagnoses w/o O.R. procedure Revised 12/07/2007 Page: 27

28 KMAP MS-DRG/CMS-DRG and M 777 Ectopic pregnancy M 778 Threatened abortion M 779 Abortion w/o D&C M 780 False labor M 781 Other antepartum diagnoses w medical complications M 782 Other antepartum diagnoses w/o medical complications M 789 Neonates, died or transferred to another acute care facility M 790 Extreme immaturity or respiratory distress syndrome, neonate M 791 Prematurity w major problems M 792 Prematurity w/o major problems M 793 Full term neonate w major problems M 794 Neonate w other significant problems M 795 Normal newborn Revised 12/07/2007 Page: 28

29 KMAP MS-DRG/CMS-DRG and S 799 Splenectomy w Splenectomy w Splenectomy w/o S 802 Other O.R. proc of the blood & blood forming organs w Other O.R. proc of the blood & blood forming organs w Other O.R. proc of the blood & blood forming organs w/o M 808 Major hematol/immun diag exc sickle cell crisis & coagul w Major hematol/immun diag exc sickle cell crisis & coagul w Major hematol/immun diag exc sickle cell crisis & coagul w/o M 811 Red blood cell disorders w Red blood cell disorders w/o M 813 Coagulation disorders M 814 Reticuloendothelial & immunity disorders w Reticuloendothelial & immunity disorders w Reticuloendothelial & immunity disorders w/o S 820 Lymphoma & leukemia w major O.R. procedure w Lymphoma & leukemia w major O.R. procedure w Lymphoma & leukemia w major O.R. procedure w/o S 823 Lymphoma & non-acute leukemia w other O.R. proc w Lymphoma & non-acute leukemia w other O.R. proc w Lymphoma & non-acute leukemia w other O.R. proc w/o S 826 Myeloprolif disord or poorly diff neopl w maj O.R. proc w Myeloprolif disord or poorly diff neopl w maj O.R. proc w Revised 12/07/2007 Page: 29

30 KMAP MS-DRG/CMS-DRG and Myeloprolif disord or poorly diff neopl w maj O.R. proc w/o S 829 Myeloprolif disord or poorly diff neopl w other O.R. proc w Myeloprolif disord or poorly diff neopl w other O.R. proc w/o M 834 Acute leukemia w/o major O.R. procedure w Acute leukemia w/o major O.R. procedure w Acute leukemia w/o major O.R. procedure w/o M 837 Chemo w acute leukemia as sdx or w high dose chemo agent w Chemo w acute leukemia as sdx w or high dose chemo agent Chemo w acute leukemia as sdx w/o M 840 Lymphoma & non-acute leukemia w Lymphoma & non-acute leukemia w Lymphoma & non-acute leukemia w/o Non-or procedure 0015 will minimally be assigned to 838 with or without the presence of a M 843 Other myeloprolif dis or poorly diff neopl diag w Other myeloprolif dis or poorly diff neopl diag w Other myeloprolif dis or poorly diff neopl diag w/o M 846 Chemotherapy w/o acute leukemia as secondary diagnosis w Chemotherapy w/o acute leukemia as secondary diagnosis w Chemotherapy w/o acute leukemia as secondary diagnosis w/o M 849 Radiotherapy S 853 Infectious & parasitic diseases w O.R. procedure w Infectious & parasitic diseases w O.R. procedure w Revised 12/07/2007 Page: 30

31 KMAP MS-DRG/CMS-DRG and Infectious & parasitic diseases w O.R. procedure w/o S 856 Postoperative or post-traumatic infections w O.R. proc w Postoperative or post-traumatic infections w O.R. proc w Postoperative or post-traumatic infections w O.R. proc w/o M 862 Postoperative & post-traumatic infections w Postoperative & post-traumatic infections w/o M 864 Fever of unknown origin M 865 Viral illness w *CMS v PDX split between MS-DRGs 864,865, * 866 Viral illness w/o M 867 Other infectious & parasitic diseases diagnoses w Other infectious & parasitic diseases diagnoses w Other infectious & parasitic diseases diagnoses w/o M 870 Septicemia w MV 96+ hours M 871 Septicemia w/o MV 96+ hours w Septicemia w/o MV 96+ hours w/o S 876 O.R. procedure w principal diagnoses of mental illness M 880 Acute adjustment reaction & psychosocial dysfunction M 881 Depressive neuroses M 882 Neuroses except depressive Revised 12/07/2007 Page: 31

32 KMAP MS-DRG/CMS-DRG and M 883 Disorders of personality & impulse control M 884 Organic disturbances & mental retardation M 885 Psychoses M 886 Behavioral & developmental disorders M 887 Other mental disorder diagnoses M 894 Alcohol/drug abuse or dependence, left ama M 895 Alcohol/drug abuse or dependence w rehabilitation therapy M 896 Alcohol/drug abuse or dependence w/o rehabilitation therapy w Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o S 901 Wound debridements for injuries w Wound debridements for injuries w Wound debridements for injuries w/o S 904 Skin grafts for injuries w Skin grafts for injuries w/o S 906 Hand procedures for injuries S 907 Other O.R. procedures for injuries w Revised 12/07/2007 Page: 32

33 KMAP MS-DRG/CMS-DRG and Other O.R. procedures for injuries w Other O.R. procedures for injuries w/o M 913 Traumatic injury w Traumatic injury w/o M 915 Allergic reactions w Allergic reactions w/o M 917 Poisoning & toxic effects of drugs w Poisoning & toxic effects of drugs w/o M 919 Complications of treatment w Complications of treatment w Complications of treatment w/o M 922 Other injury, poisoning & toxic effect diag w Other injury, poisoning & toxic effect diag w/o S 927 Extensive burns or full thickness burns w MV 96+ hrs w skin graft S 928 Full thickness burn w skin graft or inhal inj w Full thickness burn w skin graft or inhal inj w/o M 933 Extensive burns or full thickness burns w MV 96+ hrs w/o skin graft M 934 Full thickness burn w/o skin grft or inhal inj M 935 Non-extensive burns S 939 O.R. proc w diagnoses of other contact w health services w O.R. proc w diagnoses of other contact w health services w O.R. proc w diagnoses of other contact w health services w/o Revised 12/07/2007 Page: 33

34 KMAP MS-DRG/CMS-DRG and M 945 Rehabilitation w 946 Rehabilitation w/o M 947 Signs & symptoms w Signs & symptoms w/o M 949 Aftercare w Aftercare w/o M 951 Other factors influencing health status S 955 Craniotomy for multiple significant trauma S 956 Limb reattachment, hip & femur proc for multiple significant trauma S 957 Other O.R. procedures for multiple significant trauma w Other O.R. procedures for multiple significant trauma w Other O.R. procedures for multiple significant trauma w/o M 963 Other multiple significant trauma w Other multiple significant trauma w Other multiple significant trauma w/o S 969 HIV w extensive O.R. procedure w HIV w extensive O.R. procedure w/o M 974 HIV w major related condition w HIV w major related condition w HIV w major related condition w/o M 977 HIV w or w/o other related condition 468 S 981 Extensive O.R. procedure unrelated to principal diagnosis w Extensive O.R. procedure unrelated to principal diagnosis w Extensive O.R. procedure unrelated to principal diagnosis w/o Revised 12/07/2007 Page: 34

35 KMAP MS-DRG/CMS-DRG and 476 S 984 Prostatic O.R. procedure unrelated to principal diagnosis w Prostatic O.R. procedure unrelated to principal diagnosis w Prostatic O.R. procedure unrelated to principal diagnosis w/o 477 S 987 Non-extensive O.R. proc unrelated to principal diagnosis w Non-extensive O.R. proc unrelated to principal diagnosis w Non-extensive O.R. proc unrelated to principal diagnosis w/o 469 * 998 Principal diagnosis invalid as discharge diagnosis 470 * 999 Ungroupable Revised 12/07/2007 Page: 35