ICD-10-CM/PCS MS-DRG v34.0 Definitions Manual |
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| Appendix I Hospital Acquired Conditions (HACS) List |
| Hospital Acquired Conditions |
| Page 11 of 15 |
HAC 08: SURGICAL SITE INFECTION, MEDIASTINITIS, FOLLOWING CORONARY ARTERY BYPASS GRAFT (CABG) (continued)
PROCEDURES
| 0213098 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Autologous Venous Tissue, Open Approach |
| 0213099 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Autologous Venous Tissue, Open Approach |
| 021309C | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Autologous Venous Tissue, Open Approach |
| 021309F | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Autologous Venous Tissue, Open Approach |
| 021309W | Bypass Coronary Artery, Four or More Arteries from Aorta with Autologous Venous Tissue, Open Approach |
| 02130A3 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Autologous Arterial Tissue, Open Approach |
| 02130A8 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Autologous Arterial Tissue, Open Approach |
| 02130A9 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Autologous Arterial Tissue, Open Approach |
| 02130AC | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Autologous Arterial Tissue, Open Approach |
| 02130AF | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Autologous Arterial Tissue, Open Approach |
| 02130AW | Bypass Coronary Artery, Four or More Arteries from Aorta with Autologous Arterial Tissue, Open Approach |
| 02130J3 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Synthetic Substitute, Open Approach |
| 02130J8 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Synthetic Substitute, Open Approach |
| 02130J9 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Synthetic Substitute, Open Approach |
| 02130JC | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Synthetic Substitute, Open Approach |
| 02130JF | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Synthetic Substitute, Open Approach |
| 02130JW | Bypass Coronary Artery, Four or More Arteries from Aorta with Synthetic Substitute, Open Approach |
| 02130K3 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Nonautologous Tissue Substitute, Open Approach |
| 02130K8 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Nonautologous Tissue Substitute, Open Approach |
| 02130K9 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Nonautologous Tissue Substitute, Open Approach |
| 02130KC | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Nonautologous Tissue Substitute, Open Approach |
| 02130KF | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Nonautologous Tissue Substitute, Open Approach |
| 02130KW | Bypass Coronary Artery, Four or More Arteries from Aorta with Nonautologous Tissue Substitute, Open Approach |
| 02130Z3 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery, Open Approach |
| 02130Z8 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary, Open Approach |
| 02130Z9 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary, Open Approach |
| 02130ZC | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery, Open Approach |
| 02130ZF | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery, Open Approach |
| 0213483 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach |
| 0213488 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach |
| 0213489 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach |
| 021348C | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach |
| 021348F | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach |
| 021348W | Bypass Coronary Artery, Four or More Arteries from Aorta with Zooplastic Tissue, Percutaneous Endoscopic Approach |
| 0213493 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 0213498 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 0213499 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 021349C | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 021349F | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 021349W | Bypass Coronary Artery, Four or More Arteries from Aorta with Autologous Venous Tissue, Percutaneous Endoscopic Approach |
| 02134A3 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 02134A8 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 02134A9 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 02134AC | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 02134AF | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 02134AW | Bypass Coronary Artery, Four or More Arteries from Aorta with Autologous Arterial Tissue, Percutaneous Endoscopic Approach |
| 02134J3 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 02134J8 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 02134J9 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 02134JC | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 02134JF | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 02134JW | Bypass Coronary Artery, Four or More Arteries from Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach |
| 02134K3 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 02134K8 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 02134K9 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 02134KC | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 02134KF | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 02134KW | Bypass Coronary Artery, Four or More Arteries from Aorta with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach |
| 02134Z3 | Bypass Coronary Artery, Four or More Arteries from Coronary Artery, Percutaneous Endoscopic Approach |
| 02134Z8 | Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary, Percutaneous Endoscopic Approach |
| 02134Z9 | Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary, Percutaneous Endoscopic Approach |
| 02134ZC | Bypass Coronary Artery, Four or More Arteries from Thoracic Artery, Percutaneous Endoscopic Approach |
| 02134ZF | Bypass Coronary Artery, Four or More Arteries from Abdominal Artery, Percutaneous Endoscopic Approach |
AND
SECONDARY DIAGNOSIS
| J9851 | Mediastinitis |
| J9859 | Other diseases of mediastinum, not elsewhere classified |
HAC 09: MANIFESTATIONS OF POOR GLYCEMIC CONTROL
SECONDARY DIAGNOSIS
| E0800 | Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| E0801 | Diabetes mellitus due to underlying condition with hyperosmolarity with coma |
| E0810 | Diabetes mellitus due to underlying condition with ketoacidosis without coma |
| E0900 | Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| E0901 | Drug or chemical induced diabetes mellitus with hyperosmolarity with coma |
| E0910 | Drug or chemical induced diabetes mellitus with ketoacidosis without coma |
| E1010 | Type 1 diabetes mellitus with ketoacidosis without coma |
| E1100 | Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| E1101 | Type 2 diabetes mellitus with hyperosmolarity with coma |
| E1300 | Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| E1301 | Other specified diabetes mellitus with hyperosmolarity with coma |
| E1310 | Other specified diabetes mellitus with ketoacidosis without coma |
| E15 | Nondiabetic hypoglycemic coma |
HAC 10: DEEP VEIN THROMBOSIS (DTV) / PULMONARY EMBOLISM (PE) WITH TOTAL KNEE OR HIP REPLACEMENT
PROCEDURES
| 0SR9019 | Replacement of Right Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach |
| 0SR901A | Replacement of Right Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach |
| 0SR901Z | Replacement of Right Hip Joint with Metal Synthetic Substitute, Open Approach |
| 0SR9029 | Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach |
| 0SR902A | Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Uncemented, Open Approach |
| 0SR902Z | Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Open Approach |
| 0SR9039 | Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Cemented, Open Approach |
| 0SR903A | Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Uncemented, Open Approach |
| 0SR903Z | Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Open Approach |
| 0SR9049 | Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Cemented, Open Approach |
| 0SR904A | Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach |
| 0SR904Z | Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Open Approach |
| 0SR907Z | Replacement of Right Hip Joint with Autologous Tissue Substitute, Open Approach |
| 0SR90J9 | Replacement of Right Hip Joint with Synthetic Substitute, Cemented, Open Approach |
| 0SR90JA | Replacement of Right Hip Joint with Synthetic Substitute, Uncemented, Open Approach |
| 0SR90JZ | Replacement of Right Hip Joint with Synthetic Substitute, Open Approach |
| 0SR90KZ | Replacement of Right Hip Joint with Nonautologous Tissue Substitute, Open Approach |
| 0SRA009 | Replacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Cemented, Open Approach |
| 0SRA00A | Replacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Uncemented, Open Approach |
| 0SRA00Z | Replacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Open Approach |
| 0SRA019 | Replacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Cemented, Open Approach |
| 0SRA01A | Replacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Uncemented, Open Approach |
| 0SRA01Z | Replacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Open Approach |
| 0SRA039 | Replacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Cemented, Open Approach |
| 0SRA03A | Replacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach |
| 0SRA03Z | Replacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Open Approach |
| 0SRA07Z | Replacement of Right Hip Joint, Acetabular Surface with Autologous Tissue Substitute, Open Approach |
| 0SRA0J9 | Replacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Cemented, Open Approach |
| 0SRA0JA | Replacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Uncemented, Open Approach |
| 0SRA0JZ | Replacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Open Approach |
| 0SRA0KZ | Replacement of Right Hip Joint, Acetabular Surface with Nonautologous Tissue Substitute, Open Approach |
| 0SRB019 | Replacement of Left Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach |
| 0SRB01A | Replacement of Left Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach |
| 0SRB01Z | Replacement of Left Hip Joint with Metal Synthetic Substitute, Open Approach |
| 0SRB029 | Replacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach |
| 0SRB02A | Replacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Uncemented, Open Approach |
| 0SRB02Z | Replacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Open Approach |
| 0SRB039 | Replacement of Left Hip Joint with Ceramic Synthetic Substitute, Cemented, Open Approach |
| 0SRB03A | Replacement of Left Hip Joint with Ceramic Synthetic Substitute, Uncemented, Open Approach |
| 0SRB03Z | Replacement of Left Hip Joint with Ceramic Synthetic Substitute, Open Approach |
| 0SRB049 | Replacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Cemented, Open Approach |
| 0SRB04A | Replacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 02 Nov 2016 09:53:07 PROD, CMS, code-revision=31, description-revision=86 |