COMPOSITION OF LOW-VOLUME QUINTILES FOR MS-LTC-DRGs FY 2021	
MS-LTC-DRG	MS-LTC-DRG Description
Quintile 1	
058	Multiple sclerosis and cerebellar ataxia with MCC
065	Intracranial hemorrhage or cerebral infarction with CC or tPA in 24 hours
066	Intracranial hemorrhage or cerebral infarction without CC/MCC
069	Transient ischemia without thrombolytic
081	Nontraumatic stupor and coma without MCC
084	Traumatic stupor and coma >1 hour without CC/MCC
096	Bacterial and tuberculous infections of nervous system without CC/MCC
140	Major head and neck procedures with MCC
148	"Ear, nose, mouth and throat malignancy without CC/MCC"
181	Respiratory neoplasms with CC
195	Simple pneumonia and pleurisy without CC/MCC
197	Interstitial lung disease with CC
203	Bronchitis and asthma without CC/MCC
281	"Acute myocardial infarction, discharged alive with CC"
282	"Acute myocardial infarction, discharged alive without CC/MCC"
284	"Acute myocardial infarction, expired with CC"
297	"Cardiac arrest, unexplained with CC"
307	Cardiac congenital and valvular disorders without MCC
310	Cardiac arrhythmia and conduction disorders without CC/MCC
369	Major esophageal disorders with CC
373	Major gastrointestinal disorders and peritoneal infections without CC/MCC
383	Uncomplicated peptic ulcer with MCC
384	Uncomplicated peptic ulcer without MCC
418	Laparoscopic cholecystectomy without C.D.E. with CC
424	Other hepatobiliary or pancreas O.R. procedures with CC
436	Malignancy of hepatobiliary system or pancreas with CC
440	Disorders of pancreas except malignancy without CC/MCC
443	"Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis without CC/MCC"
446	Disorders of the biliary tract without CC/MCC
502	Soft tissue procedures without CC/MCC
507	Major shoulder or elbow joint procedures with CC/MCC
536	Fractures of hip and pelvis without MCC
543	Pathological fractures and musculoskeletal and connective tissue malignancy with CC
546	Connective tissue disorders with CC
547	Connective tissue disorders without CC/MCC
581	"Other skin, subcutaneous tissue and breast procedures without CC/MCC"
596	Major skin disorders without MCC
639	Diabetes without CC/MCC
687	Kidney and urinary tract neoplasms with CC
693	Urinary stones with MCC
722	"Malignancy, male reproductive system with MCC"
809	Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with CC
812	Red blood cell disorders without MCC
836	Acute leukemia without major O.R. procedures without CC/MCC
838	Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapy agent
855	Infectious and parasitic diseases with O.R. procedures without CC/MCC
858	Postoperative or post-traumatic infections with O.R. procedures without CC/MCC
866	Viral illness without MCC
906	Hand procedures for injuries
964	Other multiple significant trauma with CC
Quintile 2	
041	"Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurostimulator"
055	Nervous system neoplasms without MCC
067	Nonspecific CVA and precerebral occlusion without infarction with MCC
072	Nonspecific cerebrovascular disorders without CC/MCC
075	Viral meningitis with CC/MCC
086	Traumatic stupor and coma <1 hour with CC
101	Seizures without MCC
147	"Ear, nose, mouth and throat malignancy with CC"
153	Otitis media and URI without MCC
155	"Other ear, nose, mouth and throat diagnoses with CC"
179	Respiratory infections and inflammations without CC/MCC
183	Major chest trauma with MCC
184	Major chest trauma with CC
187	Pleural effusion with CC
196	Interstitial lung disease with MCC
198	Interstitial lung disease without CC/MCC
201	Pneumothorax without CC/MCC
268	Aortic and heart assist procedures except pulsation balloon with MCC
296	"Cardiac arrest, unexplained with MCC"
316	Other circulatory system diagnoses without CC/MCC
375	Digestive malignancy with CC
378	Gastrointestinal hemorrhage with CC
414	Cholecystectomy except by laparoscope without C.D.E. with MCC
442	"Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CC"
465	Wound debridement and skin graft except hand for musculoskeletal and connective tissue disorders without CC/MCC
483	Major joint or limb reattachment procedures of upper extremities
510	"Shoulder, elbow or forearm procedures, except major joint procedures with MCC"
516	Other musculoskeletal system and connective tissue O.R. procedures with CC
541	Osteomyelitis without CC/MCC
550	Septic arthritis without CC/MCC
552	Medical back problems without MCC
556	Signs and symptoms of musculoskeletal system and connective tissue without MCC
561	"Aftercare, musculoskeletal system and connective tissue without CC/MCC"
597	Malignant breast disorders with MCC
605	"Trauma to the skin, subcutaneous tissue and breast without MCC"
644	Endocrine disorders with CC
665	Prostatectomy with MCC
684	Renal failure without CC/MCC
730	Other male reproductive system diagnoses without CC/MCC
758	"Infections, female reproductive system with CC"
759	"Infections, female reproductive system without CC/MCC"
813	Coagulation disorders
814	Reticuloendothelial and immunity disorders with MCC
841	Lymphoma and non-acute leukemia with CC
868	Other infectious and parasitic diseases diagnoses with CC
905	Skin grafts for injuries without CC/MCC
921	Complications of treatment without CC/MCC
934	Full thickness burn without skin graft or inhalation injury
948	Signs and symptoms without MCC
989	Non-extensive O.R. procedures unrelated to principal diagnosis without CC/MCC
Quintile 3	
031	Ventricular shunt procedures with MCC
059	Multiple sclerosis and cerebellar ataxia with CC
098	Non-bacterial infection of nervous system except viral meningitis with CC
099	Non-bacterial infection of nervous system except viral meningitis without CC/MCC
144	"Other ear, nose, mouth and throat O.R. procedures with CC"
146	"Ear, nose, mouth and throat malignancy with MCC"
150	Epistaxis with MCC
152	Otitis media and URI with MCC
158	Dental and oral diseases with CC
164	Major chest procedures with CC
180	Respiratory neoplasms with MCC
200	Pneumothorax with CC
206	Other respiratory system diagnoses without MCC
290	Acute and subacute endocarditis without CC/MCC
293	Heart failure and shock without CC/MCC
294	Deep vein thrombophlebitis with CC/MCC
303	Atherosclerosis without MCC
341	Appendectomy without complicated principal diagnosis with MCC
344	Minor small and large bowel procedures with MCC
357	Other digestive system O.R. procedures with CC
408	Biliary tract procedures except only cholecystectomy with or without C.D.E. with MCC
433	Cirrhosis and alcoholic hepatitis with CC
435	Malignancy of hepatobiliary system or pancreas with MCC
439	Disorders of pancreas except malignancy with CC
476	Amputation for musculoskeletal system and connective tissue disorders without CC/MCC
478	Biopsies of musculoskeletal system and connective tissue with CC
493	"Lower extremity and humerus procedures except hip, foot and femur with CC"
513	"Hand or wrist procedures, except major thumb or joint procedures with CC/MCC"
554	Bone diseases and arthropathies without MCC
572	Skin debridement without CC/MCC
577	Skin graft except for skin ulcer or cellulitis with CC
594	Skin ulcers without CC/MCC
595	Major skin disorders with MCC
600	Non-malignant breast disorders with CC/MCC
607	Minor skin disorders without MCC
643	Endocrine disorders with MCC
660	Kidney and ureter procedures for non-neoplasm with CC
707	Major male pelvic procedures with CC/MCC
729	Other male reproductive system diagnoses with CC/MCC
749	Other female reproductive system O.R. procedures with CC/MCC
834	Acute leukemia without major O.R. procedures with MCC
835	Acute leukemia without major O.R. procedures with CC
843	Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with MCC
854	Infectious and parasitic diseases with O.R. procedures with CC
908	Other O.R. procedures for injuries with CC
913	Traumatic injury with MCC
922	"Other injury, poisoning and toxic effect diagnoses with MCC"
923	"Other injury, poisoning and toxic effect diagnoses without MCC"
933	Extensive burns or full thickness burns with MV >96 hours without skin graft
935	Non-extensive burns
Quintile 4	
054	Nervous system neoplasms with MCC
074	Cranial and peripheral nerve disorders without MCC
121	Acute major eye infections with CC/MCC
157	Dental and oral diseases with MCC
176	Pulmonary embolism without MCC
192	Chronic obstructive pulmonary disease without CC/MCC
202	Bronchitis and asthma with CC/MCC
226	Cardiac defibrillator implant without cardiac catheterization with MCC
228	Other cardiothoracic procedures with MCC
243	Permanent cardiac pacemaker implant with CC
258	Cardiac pacemaker device replacement with MCC
271	Other major cardiovascular procedures with CC
287	"Circulatory disorders except AMI, with cardiac catheterization without MCC"
305	Hypertension without MCC
309	Cardiac arrhythmia and conduction disorders with CC
327	"Stomach, esophageal and duodenal procedures with CC"
353	Hernia procedures except inguinal and femoral with MCC
368	Major esophageal disorders with MCC
374	Digestive malignancy with MCC
386	Inflammatory bowel disease with CC
395	Other digestive system diagnoses without CC/MCC
420	Hepatobiliary diagnostic procedures with MCC
485	Knee procedures with principal diagnosis of infection with MCC
503	Foot procedures with MCC
533	Fractures of femur with MCC
535	Fractures of hip and pelvis with MCC
542	Pathological fractures and musculoskeletal and connective tissue malignancy with MCC
545	Connective tissue disorders with MCC
555	Signs and symptoms of musculoskeletal system and connective tissue with MCC
562	"Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCC"
566	Other musculoskeletal system and connective tissue diagnoses without CC/MCC
575	Skin graft for skin ulcer or cellulitis without CC/MCC
584	"Breast biopsy, local excision and other breast procedures with CC/MCC"
629	"Other endocrine, nutritional and metabolic O.R. procedures with CC"
642	Inborn and other disorders of metabolism
656	Kidney and ureter procedures for neoplasm with MCC
662	Minor bladder procedures with MCC
669	Transurethral procedures with CC
686	Kidney and urinary tract neoplasms with MCC
754	"Malignancy, female reproductive system with MCC"
802	Other O.R. procedures of the blood and blood forming organs with MCC
808	Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with MCC
815	Reticuloendothelial and immunity disorders with CC
846	Chemotherapy without acute leukemia as secondary diagnosis with MCC
864	Fever and inflammatory conditions
917	Poisoning and toxic effects of drugs with MCC
957	Other O.R. procedures for multiple significant trauma with MCC
963	Other multiple significant trauma with MCC
975	HIV with major related condition with CC
977	HIV with or without other related condition
988	Non-extensive O.R. procedures unrelated to principal diagnosis with CC
Quintile 5	
025	Craniotomy and endovascular intracranial procedures with MCC
028	Spinal procedures with MCC
037	Extracranial procedures with MCC
080	Nontraumatic stupor and coma with MCC
088	Concussion with MCC
093	Other disorders of nervous system without CC/MCC
154	"Other ear, nose, mouth and throat diagnoses with MCC"
204	Respiratory signs and symptoms
240	Amputation for circulatory system disorders except upper limb and toe with CC
242	Permanent cardiac pacemaker implant with MCC
246	Percutaneous cardiovascular procedures with drug-eluting stent with MCC or 4+ arteries or stents
255	Upper limb and toe amputation for circulatory system disorders with MCC
256	Upper limb and toe amputation for circulatory system disorders with CC
260	Cardiac pacemaker revision except device replacement with MCC
261	Cardiac pacemaker revision except device replacement with CC
270	Other major cardiovascular procedures with MCC
286	"Circulatory disorders except AMI, with cardiac catheterization with MCC"
304	Hypertension with MCC
312	Syncope and collapse
326	"Stomach, esophageal and duodenal procedures with MCC"
329	Major small and large bowel procedures with MCC
330	Major small and large bowel procedures with CC
335	Peritoneal adhesiolysis with MCC
405	"Pancreas, liver and shunt procedures with MCC"
417	Laparoscopic cholecystectomy without C.D.E. with MCC
423	Other hepatobiliary or pancreas O.R. procedures with MCC
453	Combined anterior and posterior spinal fusion with MCC
466	Revision of hip or knee replacement with MCC
475	Amputation for musculoskeletal system and connective tissue disorders with CC
477	Biopsies of musculoskeletal system and connective tissue with MCC
480	Hip and femur procedures except major joint with MCC
492	"Lower extremity and humerus procedures except hip, foot and femur with MCC"
498	Local excision and removal of internal fixation devices of hip and femur with CC/MCC
501	Soft tissue procedures with CC
504	Foot procedures with CC
518	Back and neck procedures except spinal fusion with MCC or disc device or neurostimulator
553	Bone diseases and arthropathies with MCC
574	Skin graft for skin ulcer or cellulitis with CC
576	Skin graft except for skin ulcer or cellulitis with MCC
582	Mastectomy for malignancy with CC/MCC
659	Kidney and ureter procedures for non-neoplasm with MCC
668	Transurethral procedures with MCC
700	Other kidney and urinary tract diagnoses without CC/MCC
709	Penis procedures with CC/MCC
711	Testes procedures with CC/MCC
717	Other male reproductive system O.R. procedures except malignancy with CC/MCC
904	Skin grafts for injuries with CC/MCC
928	Full thickness burn with skin graft or inhalation injury with CC/MCC
969	HIV with extensive O.R. procedures with MCC
983	Extensive O.R. procedures unrelated to principal diagnosis without CC/MCC
	
	
	
	
	
