COMPOSITION OF LOW-VOLUME QUINTILES FOR MS-LTC-DRGS FY 2025	
MS-LTC-DRG	MS-LTC-DRG Description
Quintile 1	
055	Nervous system neoplasms without MCC
058	Multiple sclerosis and cerebellar ataxia with MCC
060	Multiple sclerosis and cerebellar ataxia without CC/MCC
066	Intracranial hemorrhage or cerebral infarction without CC/MCC
074	Cranial and peripheral nerve disorders without MCC
093	Other disorders of nervous system without CC/MCC
099	Non-bacterial infection of nervous system except viral meningitis without CC/MCC
121	Acute major eye infections with CC/MCC
150	Epistaxis with MCC
180	Respiratory neoplasms with MCC
183	Major chest trauma with MCC
195	Simple pneumonia and pleurisy without CC/MCC
244	Permanent cardiac pacemaker implant without CC/MCC
282	"Acute myocardial infarction, discharged alive without CC/MCC"
293	Heart failure and shock without CC/MCC
301	Peripheral vascular disorders without CC/MCC
303	Atherosclerosis without MCC
309	Cardiac arrhythmia and conduction disorders with CC
310	Cardiac arrhythmia and conduction disorders without CC/MCC
316	Other circulatory system diagnoses without CC/MCC
370	Major esophageal disorders without CC/MCC
375	Digestive malignancy with CC
384	Uncomplicated peptic ulcer without MCC
390	Gastrointestinal obstruction without CC/MCC
395	Other digestive system diagnoses without CC/MCC
434	Cirrhosis and alcoholic hepatitis without CC/MCC
442	"Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CC"
494	"Lower extremity and humerus procedures except hip, foot and femur without CC/MCC"
513	"Hand or wrist procedures, except major thumb or joint procedures with CC/MCC"
516	Other musculoskeletal system and connective tissue O.R. procedures with CC
542	Pathological fractures and musculoskeletal and connective tissue malignancy with MCC
554	Bone diseases and arthropathies without MCC
594	Skin ulcers without CC/MCC
642	Inborn and other disorders of metabolism
644	Endocrine disorders with CC
684	Renal failure without CC/MCC
686	Kidney and urinary tract neoplasms with MCC
700	Other kidney and urinary tract diagnoses without CC/MCC
725	Benign prostatic hypertrophy with MCC
802	Other O.R. procedures of the blood and blood forming organs with MCC
835	Acute leukemia with CC
841	Lymphoma and non-acute leukemia with CC
909	Other O.R. procedures for injuries without CC/MCC
914	Traumatic injury without MCC
935	Non-extensive burns
948	Signs and symptoms without MCC
950	Aftercare without CC/MCC
Quintile 2	
067	Nonspecific CVA and precerebral occlusion without infarction with MCC
072	Nonspecific cerebrovascular disorders without CC/MCC
075	Viral meningitis with CC/MCC
083	Traumatic stupor and coma >1 hour with CC
086	Traumatic stupor and coma <1 hour with CC
098	Non-bacterial infection of nervous system except viral meningitis with CC
146	"Ear, nose, mouth and throat malignancy with MCC"
153	Otitis media and URI without MCC
176	Pulmonary embolism without MCC
181	Respiratory neoplasms with CC
187	Pleural effusion with CC
204	Respiratory signs and symptoms
206	Other respiratory system diagnoses without MCC
243	Permanent cardiac pacemaker implant with CC
281	"Acute myocardial infarction, discharged alive with CC"
302	Atherosclerosis with MCC
307	Cardiac congenital and valvular disorders without MCC
330	Major small and large bowel procedures with CC
335	Peritoneal adhesiolysis with MCC
373	Major gastrointestinal disorders and peritoneal infections without CC/MCC
378	Gastrointestinal hemorrhage with CC
433	Cirrhosis and alcoholic hepatitis with CC
436	Malignancy of hepatobiliary system or pancreas with CC
446	Disorders of the biliary tract without CC/MCC
504	Foot procedures with CC
535	Fractures of hip and pelvis with MCC
546	Connective tissue disorders with CC
550	Septic arthritis without CC/MCC
555	Signs and symptoms of musculoskeletal system and connective tissue with MCC
556	Signs and symptoms of musculoskeletal system and connective tissue without MCC
561	"Aftercare, musculoskeletal system and connective tissue without CC/MCC"
596	Major skin disorders without MCC
600	Non-malignant breast disorders with CC/MCC
607	Minor skin disorders without MCC
696	Kidney and urinary tract signs and symptoms without MCC
718	Other male reproductive system O.R. procedures except malignancy without CC/MCC
729	Other male reproductive system diagnoses with CC/MCC
809	Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with CC
812	Red blood cell disorders without MCC
814	Reticuloendothelial and immunity disorders with MCC
855	Infectious and parasitic diseases with O.R. procedures without CC/MCC
913	Traumatic injury with MCC
915	Allergic reactions 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
947	Signs and symptoms with MCC
964	Other multiple significant trauma with CC
Quintile 3	
065	Intracranial hemorrhage or cerebral infarction with CC or tPA in 24 hours
080	Nontraumatic stupor and coma with MCC
085	Traumatic stupor and coma <1 hour with MCC
100	Seizures with MCC
101	Seizures without MCC
147	"Ear, nose, mouth and throat malignancy with CC"
158	Dental and oral diseases with CC
179	Respiratory infections and inflammations without CC/MCC
191	Chronic obstructive pulmonary disease with CC
199	Pneumothorax with MCC
200	Pneumothorax with CC
265	AICD lead procedures
286	"Circulatory disorders except AMI, with cardiac catheterization with MCC"
290	Acute and subacute endocarditis without CC/MCC
305	Hypertension without MCC
357	Other digestive system O.R. procedures with CC
368	Major esophageal disorders with MCC
381	Complicated peptic ulcer with CC
383	Uncomplicated peptic ulcer with MCC
389	Gastrointestinal obstruction with CC
406	"Pancreas, liver and shunt procedures with CC"
439	Disorders of pancreas except malignancy with CC
475	Amputation for musculoskeletal system and connective tissue disorders with CC
480	Hip and femur procedures except major joint with MCC
496	Local excision and removal of internal fixation devices except hip and femur with CC
543	Pathological fractures and musculoskeletal and connective tissue malignancy with CC
549	Septic arthritis with CC
552	Medical back problems without MCC
553	Bone diseases and arthropathies with MCC
595	Major skin disorders with MCC
597	Malignant breast disorders with MCC
601	Non-malignant breast disorders without CC/MCC
605	"Trauma to the skin, subcutaneous tissue and breast without MCC"
629	"Other endocrine, nutritional and metabolic O.R. procedures with CC"
645	Endocrine disorders without CC/MCC
694	Urinary stones without MCC
723	"Malignancy, male reproductive system with CC"
758	"Infections, female reproductive system with CC"
813	Coagulation disorders
834	Acute leukemia with MCC
840	Lymphoma and non-acute leukemia with MCC
865	Viral illness with MCC
866	Viral illness without MCC
868	Other infectious and parasitic diseases diagnoses with CC
921	Complications of treatment without CC/MCC
977	HIV with or without other related condition
983	Extensive O.R. procedures unrelated to principal diagnosis without CC/MCC
Quintile 4	
078	Hypertensive encephalopathy with CC
084	Traumatic stupor and coma >1 hour without CC/MCC
095	Bacterial and tuberculous infections of nervous system with CC
143	"Other ear, nose, mouth and throat O.R. procedures with MCC"
152	Otitis media and URI with MCC
154	"Other ear, nose, mouth and throat diagnoses with MCC"
155	"Other ear, nose, mouth and throat diagnoses with CC"
157	Dental and oral diseases with MCC
196	Interstitial lung disease with MCC
260	Cardiac pacemaker revision except device replacement with MCC
276	Cardiac defibrillator implant with MCC or carotid sinus neurostimulator
277	Cardiac defibrillator implant without MCC
278	Ultrasound accelerated and other thrombolysis of peripheral vascular structures with MCC
283	"Acute myocardial infarction, expired with MCC"
304	Hypertension with MCC
306	Cardiac congenital and valvular disorders with MCC
312	Syncope and collapse
326	"Stomach, esophageal and duodenal procedures with MCC"
374	Digestive malignancy with MCC
376	Digestive malignancy without CC/MCC
386	Inflammatory bowel disease with CC
435	Malignancy of hepatobiliary system or pancreas with MCC
445	Disorders of the biliary tract with CC
488	Knee procedures without principal diagnosis of infection with CC/MCC
501	Soft tissue procedures with CC
541	Osteomyelitis without CC/MCC
545	Connective tissue disorders with MCC
572	Skin debridement without CC/MCC
574	Skin graft for skin ulcer or cellulitis with CC
576	Skin graft except for skin ulcer or cellulitis with MCC
604	"Trauma to the skin, subcutaneous tissue and breast with MCC"
606	Minor skin disorders with MCC
616	"Amputation of lower limb for endocrine, nutritional and metabolic disorders with MCC"
617	"Amputation of lower limb for endocrine, nutritional and metabolic disorders with CC"
628	"Other endocrine, nutritional and metabolic O.R. procedures with MCC"
659	Kidney and ureter procedures for non-neoplasm with MCC
717	Other male reproductive system O.R. procedures except malignancy with CC/MCC
815	Reticuloendothelial and immunity disorders with CC
854	Infectious and parasitic diseases with O.R. procedures with CC
902	Wound debridements for injuries with CC
904	Skin grafts for injuries with CC/MCC
922	"Other injury, poisoning and toxic effect diagnoses with MCC"
928	Full thickness burn with skin graft or inhalation injury with CC/MCC
934	Full thickness burn without skin graft or inhalation injury
940	O.R. procedures with diagnoses of other contact with health services with CC
975	HIV with major related condition with CC
988	Non-extensive O.R. procedures unrelated to principal diagnosis with CC
Quintile 5	
023	Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC or chemotherapy implant or epilepsy with neurostimulator
037	Extracranial procedures with MCC
041	"Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurostimulator"
054	Nervous system neoplasms with MCC
073	Cranial and peripheral nerve disorders with MCC
096	Bacterial and tuberculous infections of nervous system without CC/MCC
197	Interstitial lung disease with CC
202	Bronchitis and asthma with CC/MCC
239	Amputation for circulatory system disorders except upper limb and toe with MCC
242	Permanent cardiac pacemaker implant with MCC
252	Other vascular procedures with MCC
255	Upper limb and toe amputation for circulatory system disorders with MCC
270	Other major cardiovascular procedures with MCC
271	Other major cardiovascular procedures with CC
329	Major small and large bowel procedures with MCC
344	Minor small and large bowel procedures with MCC
353	Hernia procedures except inguinal and femoral with MCC
369	Major esophageal disorders with CC
385	Inflammatory bowel disease with MCC
405	"Pancreas, liver and shunt procedures with MCC"
423	Other hepatobiliary or pancreas O.R. procedures with MCC
465	Wound debridement and skin graft except hand for musculoskeletal and connective tissue disorders without CC/MCC
466	Revision of hip or knee replacement with MCC
474	Amputation for musculoskeletal system and connective tissue disorders with MCC
477	Biopsies of musculoskeletal system and connective tissue 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
519	Back and neck procedures except spinal fusion with CC
562	"Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCC"
577	Skin graft except for skin ulcer or cellulitis with CC
643	Endocrine disorders with MCC
660	Kidney and ureter procedures for non-neoplasm with CC
675	Other kidney and urinary tract procedures without CC/MCC
693	Urinary stones with MCC
749	Other female reproductive system O.R. procedures with CC/MCC
754	"Malignancy, female reproductive system with MCC"
808	Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with MCC
820	Lymphoma and leukemia with major O.R. procedures with MCC
823	Lymphoma and non-acute leukemia with other procedures with MCC
843	Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with MCC
850	Acute leukemia with other procedures
857	Postoperative or post-traumatic infections with O.R. procedures with CC
908	Other O.R. procedures for injuries with CC
917	Poisoning and toxic effects of drugs with MCC
963	Other multiple significant trauma with MCC
969	HIV with extensive O.R. procedures with MCC
976	HIV with major related condition without CC/MCC
