Orange Regional Medical Center Average Charge Per Inpatient Case - based on MS DRG

Transcription

1 Per Inpatient Case - based on MS DRG 003 ECMO or trach w MV 96+ hrs or pdx exc face, mouth & neck w maj O.R. 737, Trach w MV 96+ hrs or pdx exc face, mouth & neck w/o maj O.R. 298, Tracheostomy for face,mouth & neck diagnoses w MCC 70, Tracheostomy for face,mouth & neck diagnoses w CC 59, Cranio w major dev impl/acute complex cns pdx w MCC or chemo implant 175, Craniotomy & endovascular intracranial procedures w MCC 63, Craniotomy & endovascular intracranial procedures w CC 106, Craniotomy & endovascular intracranial procedures w/o CC/MCC 60, Spinal procedures w MCC 55, Spinal procedures w CC or spinal neurostimulators 68, Spinal procedures w/o CC/MCC 60, Ventricular shunt procedures w CC 24, Carotid artery stent procedure w CC 29, Extracranial procedures w MCC 85, Extracranial procedures w CC 47, Extracranial procedures w/o CC/MCC 31, Periph/cranial nerve & other nerv syst proc w MCC 89, Periph/cranial nerve & other nerv syst proc w CC or periph neurostim 12, Spinal disorders & injuries w CC/MCC 26, Nervous system neoplasms w MCC 43, Nervous system neoplasms w/o MCC 36, Degenerative nervous system disorders w MCC 55, Degenerative nervous system disorders w/o MCC 34, Multiple sclerosis & cerebellar ataxia w MCC 25, Multiple sclerosis & cerebellar ataxia w CC 37, Multiple sclerosis & cerebellar ataxia w/o CC/MCC 17, Acute ischemic stroke w use of thrombolytic agent w MCC 117, Acute ischemic stroke w use of thrombolytic agent w CC 114, Acute ischemic stroke w use of thrombolytic agent w/o CC/MCC 43, Intracranial hemorrhage or cerebral infarction w MCC 64, Intracranial hemorrhage or cerebral infarction w CC 58, Intracranial hemorrhage or cerebral infarction w/o CC/MCC 36, Nonspecific cva & precerebral occlusion w/o infarct w MCC 32, Nonspecific cva & precerebral occlusion w/o infarct w/o MCC 28, Transient ischemia 26, Nonspecific cerebrovascular disorders w MCC 57, Nonspecific cerebrovascular disorders w CC 29, Nonspecific cerebrovascular disorders w/o CC/MCC 21, Cranial & peripheral nerve disorders w MCC 26, Cranial & peripheral nerve disorders w/o MCC 22, Viral meningitis w/o CC/MCC 20, Hypertensive encephalopathy w MCC 60, Hypertensive encephalopathy w CC 28, Nontraumatic stupor & coma w/o MCC 12, Traumatic stupor & coma, coma >1 hr w MCC 73, Traumatic stupor & coma, coma >1 hr w CC 72, Traumatic stupor & coma, coma >1 hr w/o CC/MCC 33, Traumatic stupor & coma, coma <1 hr w MCC 56, Traumatic stupor & coma, coma <1 hr w CC 45, Traumatic stupor & coma, coma <1 hr w/o CC/MCC 28, Concussion w CC 21, Concussion w/o CC/MCC 24, Other disorders of nervous system w MCC 58, Other disorders of nervous system w CC 35, Other disorders of nervous system w/o CC/MCC 27,490

2 Per Inpatient Case - based on MS DRG 095 Bacterial & tuberculous infections of nervous system w CC 95, Bacterial & tuberculous infections of nervous system w/o CC/MCC 71, Non-bacterial infect of nervous sys exc viral meningitis w MCC 51, Non-bacterial infect of nervous sys exc viral meningitis w CC 68, Non-bacterial infect of nervous sys exc viral meningitis w/o CC/MCC 19, Seizures w MCC 54, Seizures w/o MCC 19, Headaches w MCC 41, Headaches w/o MCC 22, Extraocular procedures except orbit 14, Acute major eye infections w CC/MCC 16, Neurological eye disorders 21, Other disorders of the eye w/o MCC 29, Major head & neck procedures w CC/MCC or major device 22, Cranial/facial procedures w CC/MCC 33, Cranial/facial procedures w/o CC/MCC 24, Other ear, nose, mouth & throat O.R. procedures w/o CC/MCC 12, Mouth procedures w CC/MCC 18, Mouth procedures w/o CC/MCC 23, Ear, nose, mouth & throat malignancy w MCC 5, Dysequilibrium 23, Epistaxis w/o MCC 24, Otitis media & URI w MCC 34, Otitis media & URI w/o MCC 21, Other ear, nose, mouth & throat diagnoses w CC 24, Other ear, nose, mouth & throat diagnoses w/o CC/MCC 16, Dental & oral diseases w MCC 34, Dental & oral diseases w CC 40, Major chest procedures w MCC 113, Major chest procedures w CC 59, Major chest procedures w/o CC/MCC 46, Other resp system O.R. procedures w MCC 104, Other resp system O.R. procedures w CC 114, Other resp system O.R. procedures w/o CC/MCC 35, Pulmonary embolism w MCC 49, Pulmonary embolism w/o MCC 32, Respiratory infections & inflammations w MCC 65, Respiratory infections & inflammations w CC 62, Respiratory infections & inflammations w/o CC/MCC 40, Respiratory neoplasms w MCC 62, Respiratory neoplasms w CC 31, Respiratory neoplasms w/o CC/MCC 18, Major chest trauma w MCC 58, Major chest trauma w CC 41, Major chest trauma w/o CC/MCC 26, Pleural effusion w MCC 65, Pleural effusion w CC 53, Pleural effusion w/o CC/MCC 53, Pulmonary edema & respiratory failure 41, Chronic obstructive pulmonary disease w MCC 43, Chronic obstructive pulmonary disease w CC 39, Chronic obstructive pulmonary disease w/o CC/MCC 25, Simple pneumonia & pleurisy w MCC 48, Simple pneumonia & pleurisy w CC 32, Simple pneumonia & pleurisy w/o CC/MCC 19,593

3 Per Inpatient Case - based on MS DRG 196 Interstitial lung disease w MCC 57, Interstitial lung disease w/o CC/MCC 10, Pneumothorax w MCC 57, Pneumothorax w CC 32, Pneumothorax w/o CC/MCC 28, Bronchitis & asthma w CC/MCC 36, Bronchitis & asthma w/o CC/MCC 20, Respiratory signs & symptoms 21, Other respiratory system diagnoses w MCC 46, Other respiratory system diagnoses w/o MCC 30, Respiratory system diagnosis w ventilator support 96+ hours 145, Respiratory system diagnosis w ventilator support <96 hours 80, Cardiac defib implant w cardiac cath w AMI/HF/shock w MCC 199, Cardiac defib implant w cardiac cath w AMI/HF/shock w/o MCC 178, Cardiac defib implant w cardiac cath w/o AMI/HF/shock w MCC 217, Cardiac defibrillator implant w/o cardiac cath w MCC 181, Cardiac defibrillator implant w/o cardiac cath w/o MCC 162, Major cardiovasc procedures w MCC 121, Major cardiovasc procedures w/o MCC 80, Amputation for circ sys disorders exc upper limb & toe w MCC 84, Amputation for circ sys disorders exc upper limb & toe w CC 78, Permanent cardiac pacemaker implant w MCC 100, Permanent cardiac pacemaker implant w CC 79, Permanent cardiac pacemaker implant w/o CC/MCC 73, Aicd generator procedures 156, Perc cardiovasc proc w drug-eluting stent w MCC or 4+ vessels/stents 104, Perc cardiovasc proc w drug-eluting stent w/o MCC 69, Perc cardiovasc proc w non-drug-eluting stent w MCC or 4+ ves/stents 83, Perc cardiovasc proc w non-drug-eluting stent w/o MCC 66, Perc cardiovasc proc w/o coronary artery stent w MCC 97, Perc cardiovasc proc w/o coronary artery stent w/o MCC 69, Other vascular procedures w MCC 107, Other vascular procedures w CC 70, Other vascular procedures w/o CC/MCC 40, Upper limb & toe amputation for circ system disorders w MCC 228, Upper limb & toe amputation for circ system disorders w/o CC/MCC 62, Cardiac pacemaker device replacement w/o MCC 135, Cardiac pacemaker revision except device replacement w MCC 62, Cardiac pacemaker revision except device replacement w CC 58, Cardiac pacemaker revision except device replacement w/o CC/MCC 51, Other circulatory system O.R. procedures 94, Aicd lead procedures 163, Acute myocardial infarction, discharged alive w MCC 59, Acute myocardial infarction, discharged alive w CC 43, Acute myocardial infarction, discharged alive w/o CC/MCC 28, Acute myocardial infarction, expired w MCC 67, Acute myocardial infarction, expired w CC 13, Circulatory disorders except AMI, w card cath w MCC 66, Circulatory disorders except AMI, w card cath w/o MCC 33, Acute & subacute endocarditis w MCC 91, Acute & subacute endocarditis w CC 27, Heart failure & shock w MCC 52, Heart failure & shock w CC 40, Heart failure & shock w/o CC/MCC 29, Deep vein thrombophlebitis w CC/MCC 19,391

4 Per Inpatient Case - based on MS DRG 296 Cardiac arrest, unexplained w MCC 23, Peripheral vascular disorders w MCC 47, Peripheral vascular disorders w CC 40, Peripheral vascular disorders w/o CC/MCC 35, Atherosclerosis w MCC 40, Atherosclerosis w/o MCC 23, Hypertension w MCC 52, Hypertension w/o MCC 30, Cardiac congenital & valvular disorders w/o MCC 33, Cardiac arrhythmia & conduction disorders w MCC 54, Cardiac arrhythmia & conduction disorders w CC 32, Cardiac arrhythmia & conduction disorders w/o CC/MCC 25, Angina pectoris 21, Syncope & collapse 30, Chest pain 21, Other circulatory system diagnoses w MCC 48, Other circulatory system diagnoses w CC 35, Other circulatory system diagnoses w/o CC/MCC 24, Stomach, esophageal & duodenal proc w MCC 120, Stomach, esophageal & duodenal proc w CC 96, Stomach, esophageal & duodenal proc w/o CC/MCC 32, Major small & large bowel procedures w MCC 145, Major small & large bowel procedures w CC 65, Major small & large bowel procedures w/o CC/MCC 47, Rectal resection w CC 51, Rectal resection w/o CC/MCC 24, Peritoneal adhesiolysis w MCC 170, Peritoneal adhesiolysis w CC 79, Peritoneal adhesiolysis w/o CC/MCC 39, Appendectomy w complicated principal diag w CC 33, Appendectomy w complicated principal diag w/o CC/MCC 31, Appendectomy w/o complicated principal diag w CC 19, Appendectomy w/o complicated principal diag w/o CC/MCC 20, Minor small & large bowel procedures w/o CC/MCC 39, Anal & stomal procedures w MCC 89, Anal & stomal procedures w CC 70, Anal & stomal procedures w/o CC/MCC 8, Inguinal & femoral hernia procedures w MCC 53, Inguinal & femoral hernia procedures w CC 24, Inguinal & femoral hernia procedures w/o CC/MCC 19, Hernia procedures except inguinal & femoral w MCC 91, Hernia procedures except inguinal & femoral w CC 47, Hernia procedures except inguinal & femoral w/o CC/MCC 41, Other digestive system O.R. procedures w MCC 41, Other digestive system O.R. procedures w CC 50, Other digestive system O.R. procedures w/o CC/MCC 37, Major esophageal disorders w CC 33, Major esophageal disorders w/o CC/MCC 38, Major gastrointestinal disorders & peritoneal infections w MCC 46, Major gastrointestinal disorders & peritoneal infections w CC 43, Major gastrointestinal disorders & peritoneal infections w/o CC/MCC 24, Digestive malignancy w MCC 59, Digestive malignancy w CC 48, Digestive malignancy w/o CC/MCC 8, G.I. hemorrhage w MCC 49,259

5 Per Inpatient Case - based on MS DRG 378 G.I. hemorrhage w CC 35, G.I. hemorrhage w/o CC/MCC 27, Complicated peptic ulcer w CC 44, Complicated peptic ulcer w/o CC/MCC 46, Uncomplicated peptic ulcer w MCC 49, Uncomplicated peptic ulcer w/o MCC 25, Inflammatory bowel disease w CC 27, Inflammatory bowel disease w/o CC/MCC 28, G.I. obstruction w MCC 67, G.I. obstruction w CC 30, G.I. obstruction w/o CC/MCC 24, Esophagitis, gastroent & misc digest disorders w MCC 44, Esophagitis, gastroent & misc digest disorders w/o MCC 23, Other digestive system diagnoses w MCC 55, Other digestive system diagnoses w CC 29, Other digestive system diagnoses w/o CC/MCC 24, Pancreas, liver & shunt procedures w MCC 108, Biliary tract proc except only cholecyst w or w/o c.d.e. w/o CC/MCC 17, Cholecystectomy except by laparoscope w/o c.d.e. w MCC 134, Cholecystectomy except by laparoscope w/o c.d.e. w CC 88, Cholecystectomy except by laparoscope w/o c.d.e. w/o CC/MCC 50, Laparoscopic cholecystectomy w/o c.d.e. w MCC 45, Laparoscopic cholecystectomy w/o c.d.e. w CC 43, Laparoscopic cholecystectomy w/o c.d.e. w/o CC/MCC 27, Other hepatobiliary or pancreas O.R. procedures w MCC 103, Other hepatobiliary or pancreas O.R. procedures w CC 134, Other hepatobiliary or pancreas O.R. procedures w/o CC/MCC 26, Cirrhosis & alcoholic hepatitis w MCC 48, Cirrhosis & alcoholic hepatitis w CC 45, Cirrhosis & alcoholic hepatitis w/o CC/MCC 23, Malignancy of hepatobiliary system or pancreas w MCC 51, Malignancy of hepatobiliary system or pancreas w CC 37, Disorders of pancreas except malignancy w MCC 48, Disorders of pancreas except malignancy w CC 27, Disorders of pancreas except malignancy w/o CC/MCC 21, Disorders of liver except malig,cirr,alc hepa w MCC 49, Disorders of liver except malig,cirr,alc hepa w CC 31, Disorders of liver except malig,cirr,alc hepa w/o CC/MCC 27, Disorders of the biliary tract w MCC 39, Disorders of the biliary tract w CC 34, Disorders of the biliary tract w/o CC/MCC 23, Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w CC 187, Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w/o CC/MCC 46, Spinal fusion except cervical w MCC 131, Spinal fusion except cervical w/o MCC 94, Bilateral or multiple major joint procs of lower extremity w/o MCC 57, Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w MCC 96, Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w CC 220, Revision of hip or knee replacement w MCC 62, Revision of hip or knee replacement w CC 58, Revision of hip or knee replacement w/o CC/MCC 53, Major joint replacement or reattachment of lower extremity w MCC 57, Major joint replacement or reattachment of lower extremity w/o MCC 46, Cervical spinal fusion w MCC 55, Cervical spinal fusion w CC 52,383

6 Per Inpatient Case - based on MS DRG 473 Cervical spinal fusion w/o CC/MCC 48, Amputation for musculoskeletal sys & conn tissue dis w MCC 126, Amputation for musculoskeletal sys & conn tissue dis w CC 89, Biopsies of musculoskeletal system & connective tissue w MCC 94, Biopsies of musculoskeletal system & connective tissue w CC 78, Biopsies of musculoskeletal system & connective tissue w/o CC/MCC 46, Hip & femur procedures except major joint w MCC 85, Hip & femur procedures except major joint w CC 59, Hip & femur procedures except major joint w/o CC/MCC 39, Major joint & limb reattachment proc of upper extremity w CC/MCC 67, Major joint & limb reattachment proc of upper extremity w/o CC/MCC 52, Knee procedures w pdx of infection w MCC 59, Knee procedures w pdx of infection w CC 37, Knee procedures w/o pdx of infection w CC/MCC 55, Knee procedures w/o pdx of infection w/o CC/MCC 40, Back & neck proc exc spinal fusion w CC/MCC or disc device/neurostim 49, Back & neck proc exc spinal fusion w/o CC/MCC 30, Lower extrem & humer proc except hip,foot,femur w CC 52, Lower extrem & humer proc except hip,foot,femur w/o CC/MCC 40, Local excision & removal int fix devices exc hip & femur w CC 31, Local excision & removal int fix devices exc hip & femur w/o CC/MCC 57, Local excision & removal int fix devices of hip & femur w CC/MCC 50, Soft tissue procedures w CC 33, Soft tissue procedures w/o CC/MCC 19, Major thumb or joint procedures 31, Major shoulder or elbow joint procedures w/o CC/MCC 18, Shoulder,elbow or forearm proc,exc major joint proc w CC 71, Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC 27, Hand or wrist proc, except major thumb or joint proc w CC/MCC 17, Hand or wrist proc, except major thumb or joint proc w/o CC/MCC 21, Other musculoskelet sys & conn tiss O.R. proc w MCC 114, Other musculoskelet sys & conn tiss O.R. proc w CC 60, Other musculoskelet sys & conn tiss O.R. proc w/o CC/MCC 39, Fractures of femur w MCC 44, Fractures of hip & pelvis w MCC 39, Fractures of hip & pelvis w/o MCC 21, Osteomyelitis w MCC 22, Osteomyelitis w CC 29, Osteomyelitis w/o CC/MCC 7, Pathological fractures & musculoskelet & conn tiss malig w MCC 38, Pathological fractures & musculoskelet & conn tiss malig w CC 47, Pathological fractures & musculoskelet & conn tiss malig w/o CC/MCC 19, Connective tissue disorders w CC 41, Connective tissue disorders w/o CC/MCC 22, Medical back problems w MCC 45, Medical back problems w/o MCC 27, Bone diseases & arthropathies w MCC 24, Bone diseases & arthropathies w/o MCC 23, Signs & symptoms of musculoskeletal system & conn tissue w MCC 54, Signs & symptoms of musculoskeletal system & conn tissue w/o MCC 29, Tendonitis, myositis & bursitis w MCC 67, Tendonitis, myositis & bursitis w/o MCC 24, Aftercare, musculoskeletal system & connective tissue w MCC 110, Aftercare, musculoskeletal system & connective tissue w CC 51, Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC 36,954

7 Per Inpatient Case - based on MS DRG 563 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC 30, Other musculoskeletal sys & connective tissue diagnoses w MCC 51, Other musculoskeletal sys & connective tissue diagnoses w CC 49, Skin debridement w CC 65, Skin debridement w/o CC/MCC 28, Skin graft for skin ulcer or cellulitis w MCC 31, Skin graft for skin ulcer or cellulitis w/o CC/MCC 115, Skin graft exc for skin ulcer or cellulitis w CC 58, Skin graft exc for skin ulcer or cellulitis w/o CC/MCC 28, Other skin, subcut tiss & breast proc w MCC 34, Other skin, subcut tiss & breast proc w CC 70, Other skin, subcut tiss & breast proc w/o CC/MCC 32, Mastectomy for malignancy w CC/MCC 21, Breast biopsy, local excision & other breast procedures w/o CC/MCC 56, Skin ulcers w MCC 34, Skin ulcers w CC 31, Skin ulcers w/o CC/MCC 14, Major skin disorders w MCC 48, Major skin disorders w/o MCC 27, Malignant breast disorders w CC 70, Malignant breast disorders w/o CC/MCC 47, Non-malignant breast disorders w CC/MCC 18, Non-malignant breast disorders w/o CC/MCC 24, Cellulitis w MCC 33, Cellulitis w/o MCC 26, Trauma to the skin, subcut tiss & breast w MCC 25, Trauma to the skin, subcut tiss & breast w/o MCC 26, Minor skin disorders w/o MCC 23, Amputat of lower limb for endocrine,nutrit,& metabol dis w MCC 86, Amputat of lower limb for endocrine,nutrit,& metabol dis w CC 127, O.R. procedures for obesity w MCC 25, O.R. procedures for obesity w CC 18, O.R. procedures for obesity w/o CC/MCC 19, Skin grafts & wound debrid for endoc, nutrit & metab dis w MCC 35, Thyroid, parathyroid & thyroglossal procedures w CC 46, Thyroid, parathyroid & thyroglossal procedures w/o CC/MCC 29, Other endocrine, nutrit & metab O.R. proc w MCC 52, Other endocrine, nutrit & metab O.R. proc w CC 102, Diabetes w MCC 43, Diabetes w CC 28, Diabetes w/o CC/MCC 19, Misc disorders of nutrition,metabolism,fluids/electrolytes w MCC 38, Misc disorders of nutrition,metabolism,fluids/electrolytes w/o MCC 21, Inborn and other disorders of metabolism 15, Endocrine disorders w MCC 36, Endocrine disorders w CC 27, Endocrine disorders w/o CC/MCC 31, Major bladder procedures w CC 74, Major bladder procedures w/o CC/MCC 92, Kidney & ureter procedures for neoplasm w MCC 105, Kidney & ureter procedures for neoplasm w CC 42, Kidney & ureter procedures for neoplasm w/o CC/MCC 32, Kidney & ureter procedures for non-neoplasm w CC 42, Kidney & ureter procedures for non-neoplasm w/o CC/MCC 30, Minor bladder procedures w/o CC/MCC 28,402

8 Per Inpatient Case - based on MS DRG 668 Transurethral procedures w MCC 43, Transurethral procedures w CC 34, Transurethral procedures w/o CC/MCC 19, Other kidney & urinary tract procedures w MCC 96, Other kidney & urinary tract procedures w CC 100, Other kidney & urinary tract procedures w/o CC/MCC 45, Renal failure w MCC 49, Renal failure w CC 35, Renal failure w/o CC/MCC 21, Admit for renal dialysis 16, Kidney & urinary tract neoplasms w CC 17, Kidney & urinary tract infections w MCC 37, Kidney & urinary tract infections w/o MCC 23, Urinary stones w/o esw lithotripsy w MCC 24, Urinary stones w/o esw lithotripsy w/o MCC 18, Kidney & urinary tract signs & symptoms w MCC 54, Kidney & urinary tract signs & symptoms w/o MCC 24, Other kidney & urinary tract diagnoses w MCC 39, Other kidney & urinary tract diagnoses w CC 36, Other kidney & urinary tract diagnoses w/o CC/MCC 30, Major male pelvic procedures w CC/MCC 40, Major male pelvic procedures w/o CC/MCC 34, Transurethral prostatectomy w CC/MCC 52, Transurethral prostatectomy w/o CC/MCC 17, Other male reproductive system O.R. proc exc malignancy w CC/MCC 32, Benign prostatic hypertrophy w/o MCC 21, Inflammation of the male reproductive system w/o MCC 21, Uterine & adnexa proc for non-malignancy w CC/MCC 49, Uterine & adnexa proc for non-malignancy w/o CC/MCC 25, D&C, conization, laparoscopy & tubal interruption w CC/MCC 47, Other female reproductive system O.R. procedures w CC/MCC 114, Malignancy, female reproductive system w MCC Malignancy, female reproductive system w CC 8, Infections, female reproductive system w MCC 23, Infections, female reproductive system w/o CC/MCC 21, Menstrual & other female reproductive system disorders w CC/MCC 23, Menstrual & other female reproductive system disorders w/o CC/MCC 27, Cesarean section w CC/MCC 38, Cesarean section w/o CC/MCC 31, Vaginal delivery w sterilization &/or D&C 30, Vaginal delivery w O.R. proc except steril &/or D&C 21, Postpartum & post abortion diagnoses w O.R. procedure 46, Abortion w D&C, aspiration curettage or hysterotomy 19, Vaginal delivery w complicating diagnoses 23, Vaginal delivery w/o complicating diagnoses 20, Postpartum & post abortion diagnoses w/o O.R. procedure 19, Ectopic pregnancy 28, Threatened abortion 9, Abortion w/o D&C 13, False labor 8, Other antepartum diagnoses w medical complications 16, Other antepartum diagnoses w/o medical complications 11, Neonates, died or transferred to another acute care facility 14, Extreme immaturity or respiratory distress syndrome, neonate 47, Prematurity w major problems 55,885

9 Per Inpatient Case - based on MS DRG 792 Prematurity w/o major problems 19, Full term neonate w major problems 21, Neonate w other significant problems 8, Normal newborn 6, Splenectomy w/o CC/MCC 26, Other O.R. proc of the blood & blood forming organs w MCC 121, Other O.R. proc of the blood & blood forming organs w/o CC/MCC 49, Major hematol/immun diag exc sickle cell crisis & coagul w MCC 102, Major hematol/immun diag exc sickle cell crisis & coagul w CC 34, Major hematol/immun diag exc sickle cell crisis & coagul w/o CC/MCC 31, Red blood cell disorders w MCC 40, Red blood cell disorders w/o MCC 33, Coagulation disorders 44, Reticuloendothelial & immunity disorders w MCC 32, Reticuloendothelial & immunity disorders w CC 28, Reticuloendothelial & immunity disorders w/o CC/MCC 15, Lymphoma & leukemia w major O.R. procedure w MCC 141, Lymphoma & leukemia w major O.R. procedure w CC 60, Lymphoma & non-acute leukemia w other O.R. proc w MCC 63, Lymphoma & non-acute leukemia w other O.R. proc w CC 129, Myeloprolif disord or poorly diff neopl w maj O.R. proc w/o CC/MCC 32, Acute leukemia w/o major O.R. procedure w MCC 58, Acute leukemia w/o major O.R. procedure w CC 56, Acute leukemia w/o major O.R. procedure w/o CC/MCC 29, Chemo w acute leukemia as sdx w CC or high dose chemo agent 60, Lymphoma & non-acute leukemia w MCC 80, Lymphoma & non-acute leukemia w CC 62, Lymphoma & non-acute leukemia w/o CC/MCC 56, Other myeloprolif dis or poorly diff neopl diag w MCC 59, Other myeloprolif dis or poorly diff neopl diag w CC 46, Other myeloprolif dis or poorly diff neopl diag w/o CC/MCC 21, Chemotherapy w/o acute leukemia as secondary diagnosis w MCC 78, Chemotherapy w/o acute leukemia as secondary diagnosis w CC 32, Radiotherapy 74, Infectious & parasitic diseases w O.R. procedure w MCC 131, Infectious & parasitic diseases w O.R. procedure w CC 71, Infectious & parasitic diseases w O.R. procedure w/o CC/MCC 32, Postoperative or post-traumatic infections w O.R. proc w MCC 72, Postoperative or post-traumatic infections w O.R. proc w CC 55, Postoperative & post-traumatic infections w MCC 74, Postoperative & post-traumatic infections w/o MCC 30, Fever 23, Viral illness w MCC 28, Viral illness w/o MCC 18, Other infectious & parasitic diseases diagnoses w MCC 23, Other infectious & parasitic diseases diagnoses w CC 36, Other infectious & parasitic diseases diagnoses w/o CC/MCC 15, Septicemia or severe sepsis w MV 96+ hours 180, Septicemia or severe sepsis w/o MV 96+ hours w MCC 60, Septicemia or severe sepsis w/o MV 96+ hours w/o MCC 37, Acute adjustment reaction & psychosocial dysfunction 23, Depressive neuroses 21, Neuroses except depressive 18, Disorders of personality & impulse control 31, Organic disturbances & mental retardation 32,060

10 Per Inpatient Case - based on MS DRG 885 Psychoses 37, Behavioral & developmental disorders 24, Alcohol/drug abuse or dependence, left ama 21, Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC 59, Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC 23, Hand procedures for injuries 13, Other O.R. procedures for injuries w MCC 124, Other O.R. procedures for injuries w CC 80, Other O.R. procedures for injuries w/o CC/MCC 31, Traumatic injury w MCC 39, Traumatic injury w/o MCC 14, Allergic reactions w MCC 90, Allergic reactions w/o MCC 18, Poisoning & toxic effects of drugs w MCC 42, Poisoning & toxic effects of drugs w/o MCC 24, Complications of treatment w MCC 87, Complications of treatment w CC 27, Complications of treatment w/o CC/MCC 25, Other injury, poisoning & toxic effect diag w/o MCC 25, Non-extensive burns 19, O.R. proc w diagnoses of other contact w health services w MCC 47, Rehabilitation w CC/MCC 63, Rehabilitation w/o CC/MCC 52, Signs & symptoms w MCC 20, Signs & symptoms w/o MCC 25, Aftercare w CC/MCC 81, Other multiple significant trauma w MCC 45, Other multiple significant trauma w CC 50, Other multiple significant trauma w/o CC/MCC 69, HIV w major related condition w MCC 71, HIV w major related condition w CC 157, HIV w major related condition w/o CC/MCC 66, HIV w or w/o other related condition 26, Extensive O.R. procedure unrelated to principal diagnosis w MCC 210, Extensive O.R. procedure unrelated to principal diagnosis w CC 85, Extensive O.R. procedure unrelated to principal diagnosis w/o CC/MCC 41, Non-extensive O.R. proc unrelated to principal diagnosis w MCC 87, Non-extensive O.R. proc unrelated to principal diagnosis w CC 44, Non-extensive O.R. proc unrelated to principal diagnosis w/o CC/MCC 26,948