Table 6P.1h - List of ICD-10-CM diagnosis code and ICD-10-PCS procedure code combinations with data analysis by MS-DRG - Single Cases FY 2019 																
Single Cases in MS-DRG 515																
Case ID 	MS-DRG 	ICD-10-CM Code Reported as Principal Diagnosis 	Description 	ICD-10-PCS Code Reported for Procedure 	Description 	Case Count	Average Length of Stay 	Average Costs 	Procedure Count 	Length of Stay 	Cost 					
Single - A	515	S32.111A	"Minimally displaced Zone I fracture of sacrum, initial encounter for closed fracture"	0QS234Z	"Reposition right pelvic bone with internal fixation device, percutaneous approach"	1	3.0	"$8,433 "	1	3.0	"$8,433 "					
Single - B	515	S32.301A	"Unspecified fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"	1	7.0	"$14,724 "	1	7.0	"$14,724 "					
Single - C 	515	S32.302A	"Unspecified fracture of left ilium, initial encounter for closed fracture"	0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"	1	10.0	"$71,536 "	1	10.0	"$71,536 "					
Single - D	515	S32.391A	"Other fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1	7.0	"$30,438 "					
Single - E	515	S32.391A	"Other fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1	3.0	"$15,067 "					
						2	5.0	"$22,753"								
Single - F	515	S32.391A	"Other fracture of right ilium, initial encounter for closed fracture"	0QS234Z	"Reposition right pelvic bone with internal fixation device, percutaneous approach"	1	4.0	"$30,012 "	1	4.0	"$30,012 "					
Total Single	515					6	5.67	"$28,368"	6							
																
Single cases in MS-DRG 516																
Case ID 	MS-DRG 	ICD-10-CM Code Reported as Principal Diagnosis 	Description 	ICD-10-PCS Code Reported for Procedure 	Description 	Case Count	Average Length of Stay 	Average Costs 	Procedure Count 	Length of Stay 	Cost 					
Single - A	516	S32.111A	"Minimally displaced Zone I fracture of sacrum, initial encounter for closed fracture"	0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"	1	3.0	"$8,432 "	1	3.0	"$8,432 "					
Single - B	516	S32.119A	"Unspecified Zone I fracture of sacrum, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		"$7,151 "					
Single - C 	516	S32.119A	"Unspecified Zone I fracture of sacrum, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		"$7,275 "					
						2	5.50	"$7,213 "								
Single - D	516	S32.119A	"Unspecified Zone I fracture of sacrum, initial encounter for closed fracture"	0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"	1	2.0	"$8,113 "	1	2.0	"$8,113 "					
Single - E	516	S32.15XA	"Type 2 fracture of sacrum, initial encounter for closed fracture"	0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"	1	4.0		1							
Single - F	516	S32.301A	"Unspecified fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1							
Single - G	516	S32.301A	"Unspecified fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1							
Single - H	516	S32.301A	"Unspecified fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1							
						3	7.33									
Single - I	516	S32.302A	"Unspecified fracture of left ilium, initial encounter for closed fracture"	0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"		6.0		1		"$12,217 "					
Single - J	516	S32.302A	"Unspecified fracture of left ilium, initial encounter for closed fracture"	0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"		4.0		1		"$6,101 "					
Single - K	516	S32.302A	"Unspecified fracture of left ilium, initial encounter for closed fracture"	0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"		4.0		1		"$10,998 "					
						3	4.67	"$9,772 "								
Single - L	516	S32.302A	"Unspecified fracture of left ilium, initial encounter for closed fracture"	0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"	1	8.0	"$14,092 "	1	8.0	"$14,092 "					
Single - M	516	S32.309A	"Unspecified fracture of unspecified ilium, initial encounter for closed fracture"	0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"	1	7.0	"$9,223 "	1	7.0	"$9,223 "					
Single - N	516	S32.311A	"Displaced avulsion fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1	5	"$10,618 "					
Single - O	516	S32.311A	"Displaced avulsion fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1	10	"$11,870 "					
						2	7.50	"$11,244 "								
Single - P	516	S32.391A	"Other fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		"$8,510 "					
Single - Q	516	S32.391A	"Other fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		"$39,634 "					
Single - R	516	S32.391A	"Other fracture of right ilium, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		"$7,893 "					
						3	5.67	"$18,679 "								
Single - S	516	S32.391A	"Other fracture of right ilium, initial encounter for closed fracture"	0QS234Z	Reposition right pelvic bone with internal fixation device percutaneous approach	1	5.0	"$7,673 "	1	5.0	"$7,673 "					
Single - T	516	S32.392A	"Other fracture of left ilium, initial encounter for closed fracture"	0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"	1	8.0	"$23,264 "	1	8.0	"$23,264 "					
Total Single 	516					20	5.8	"$12,879 "	20							
																
Single cases in MS-DRG 517																
Case ID 	MS-DRG 	ICD-10-CM Code Reported as Principal Diagnosis 	Description 	ICD-10-PCS Code Reported for Procedure 	Description 	Case Count	Average Length of Stay 	Average Costs 	Procedure Count 	Length of Stay 	Cost 					
Single - A	517	S32.301A	"Unspecified fracture of right ilium, initial encounter for closed fracture"	0QS234Z	Reposition right pelvic bone with internal fixation device percutaneous approach	1	7.0	"$12,004 "	1	7.0	"$12,004 "					
Single - B	517	S32.301K	"Unspecified fracture of right ilium, subsequent encounter for fracture with nonunion"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"	1	4.0	"$12,766 "	1	4.0	"$12,766 "					
Single - C 	517	S32.302A	"Unspecified fracture of left ilium, initial encounter for closed fracture"	0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"	1	5.0	"$11,672 "	1	5.0	"$11,672 "					
Total Single 	517					3	5.33	"$12,147 "	3							
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
