PROPOSED 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, 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"		
296	"Cardiac arrest, unexplained with MCC"		
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, 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. procedure 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. procedure without CC/MCC		
858	Postoperative or post-traumatic infections with O.R. procedure without CC/MCC		
866	Viral illness without MCC		
906	Hand procedures for injuries		
964	Other multiple significant trauma with CC		
934	Full thickness burn w/o skin graft or inhal inj		
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 infarct with MCC		
072	Nonspecific cerebrovascular disorders without CC/MCC		
075	Viral meningitis with CC/MCC		
086	"Traumatic stupor and coma, 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		
303	Atherosclerosis without 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, alcoholic hepatitis with CC"		
465	"Wound debridement and skin graft except hand, for musculoskeletal and connective tissue disorders without CC/MCC"		
478	Biopsies of musculoskeletal system and connective tissue with CC		
483	Major joint/limb reattachment procedure 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"		
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. procedure 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 infections of nervous system except viral meningitis with CC		
099	Non-bacterial infections 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		
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		
493	"Lower extremity and humerus procedures except hip, foot, 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		
813	Coagulation disorders		
834	Acute leukemia without major O.R. procedure with MCC		
835	Acute leukemia without major O.R. procedure with CC		
840	Lymphoma and non-acute leukemia with MCC		
843	Other myeloproliferative disorders or poorly differentiated neoplasms diagnoses with MCC		
854	Infectious and parasitic diseases with O.R. procedure 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		
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. procedure 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, femur with MCC"		
498	Local excision and removal 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		
754	"Malignancy, female reproductive system with 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. procedure with MCC		
983	Extensive O.R. procedure unrelated to principal diagnosis without CC/MCC		
			
			
			
