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ICD-10-CM/PCS MS-DRGv33 Definitions Manual

The first section of the Procedure Code/MS-DRG Index is a reference source of all ICD-10-PCS procedure codes that affect MS-DRG assignment, the MDCs and MS-DRGs to which they are assigned, and a description of the surgical categories. The procedure codes are listed in code order with an * indicating the non-operating room procedures. All procedures without an * are considered OPERATING ROOM PROCEDURES by the MS-DRGs. A + beside a procedure indicates that it is also a member of a Procedure Code Combination, also called a 'Procedure Cluster'. These are combinations of procedures, which, when found on a patient record, are treated differently than their consituent codes.

The second section of this Appendix lists each procedure cluster and the surgical categories to which it is assigned.

The third section of this Appendix lists a few procedure combinations for which the combination is designated non-OR even though one or more of the procedures in the combination are considered O.R. These are defined to allow the ICD-10-CM/PCS MS-DRGs to replicate the ICD-9-CM MS-DRGs where a non-OR ICD-9-CM code can only be represented by a combination of ICD-10-PCS codes.