Table 6P.1j - List of ICD-10-CM diagnosis code and ICD-10-PCS procedure code combinations with data analysis by MS-DRG - Bilateral Cases FY 2019 											
Bilateral Cases in MS-DRG 515 - (Percutaneous Approaches )											
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 
Bilateral - A	515	S32.119A	"Unspecified Zone I fracture of sacrum, initial encounter for closed fracture"	0QS234Z	Reposition right pelvic bone with internal fixation device percutaneous approach				1		
				0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"				1		
						1	10.0	"$21,539 "	2		
Bilateral - B 	515	S32.19XA	"Other fracture of sacrum, initial encounter for closed fracture"	0QS234Z	Reposition right pelvic bone with internal fixation device percutaneous approach				1		
				0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"				1		
						1	8.0	"$13,143 "	2		
Total Bilateral	515					2	9.0	"17,341"	4		
											
Bilateral Cases in MS-DRG 517 - (Percutaneous Approaches )											
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 
Bilateral - A	517	S32.10XA	"Unspecified fracture of sacrum, initial encounter for closed fracture"	0QS234Z	Reposition right pelvic bone with internal fixation device percutaneous approach				1		
				0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"				1		
						1	4.0	"$24,258 "	2		
Total Bilateral	517					1	4.0	"$24,258 "	2		
											
Bilateral Cases in MS-DRG 515 - (Open Approaches )											
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 
Bilateral - A	515	S32.129A	"Unspecified Zone II fracture of sacrum, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		
				0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"				1		
						1	16.0	"$44,349 "	2		
Bilateral - B 	515	S32.129K	"Unspecified Zone II fracture of sacrum, subsequent encounter for fracture with nonunion"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		
				0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"				1		
						1	6	"$14,470 "	2		
Total Bilateral	515					2	11.0	"$29,409"	4		
											
Bilateral Cases in MS-DRG 516 - (Open Approaches )											
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 
Bilateral - A	516	S32.10XA	"Unspecified fracture of sacrum, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		
				0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"				1		
						1	4.0	"$15,273 "	2		
Bilateral - B	516	S32.120A	"Nondisplaced Zone II fracture of sacrum, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		
				0QS304Z	"Reposition left pelvic bone with internal fixation device, open approach"				1		
						1					
						2	7.0	"$27,717 "	2		
Total Bilateral	516					2	5.5	"21,495"	4		
											
Bilateral Cases in MS-DRG 515 - (Percutaneous and Open Approaches )											
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 
Bilateral - A	515	S32.129A	"Unspecified Zone II fracture of sacrum, initial encounter for closed fracture"	0QS204Z	"Reposition right pelvic bone with internal fixation device, open approach"				1		
				0QS334Z	"Reposition left pelvic bone with internal fixation device, percutaneous approach"				1		
						1	16.0	"$44,349 "	2		
Total Bilateral	515					1	16.0	"$44,349 "	2		
											
