MS-DRG v35 (FY 2018) MDC 03 Major Head and Neck Procedures

Enhanced MS-DRG Definitions Manual

MS-DRG v35 (FY 2018) Definitions Manual • MDC 03 • Major Head and Neck Procedures

DRG Assignment Logic for Major Head and Neck Procedures

Patients who qualify for Major Head and Neck Procedures will be grouped into a DRG according to the logic below.

Major Device	CC or MCC	DRG	Name	Type
No	Yes	129	MAJOR HEAD AND NECK PROCEDURES WITH CC/MCC OR MAJOR DEVICE	Medical
Yes	n/a	129	MAJOR HEAD AND NECK PROCEDURES WITH CC/MCC OR MAJOR DEVICE	Medical
No	No	130	MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC	Medical

Detailed Rules

The tables below list the codes required to qualify for this subsection according to the logic listed above. By matching the codes on a patient's account to those listed below, you can work out how a patient will be grouped by the MS-DRG grouper. However, sometimes this can be difficult to work out by hand. If you are looking for automated DRG grouping software that can be integrated into your workflow, please let us know.

HEAD AND NECK PROCEDURES OPERATING ROOM PROCEDURES

Codes in HEAD AND NECK PROCEDURES OPERATING ROOM PROCEDURES
Code	Description
07T00ZZ	Resection of Head Lymphatic, Open Approach
07T04ZZ	Resection of Head Lymphatic, Percutaneous Endoscopic Approach
07T10ZZ	Resection of Right Neck Lymphatic, Open Approach
07T14ZZ	Resection of Right Neck Lymphatic, Percutaneous Endoscopic Approach
07T20ZZ	Resection of Left Neck Lymphatic, Open Approach
07T24ZZ	Resection of Left Neck Lymphatic, Percutaneous Endoscopic Approach
07T30ZZ	Resection of Right Upper Extremity Lymphatic, Open Approach
07T34ZZ	Resection of Right Upper Extremity Lymphatic, Percutaneous Endoscopic Approach
07T40ZZ	Resection of Left Upper Extremity Lymphatic, Open Approach
07T44ZZ	Resection of Left Upper Extremity Lymphatic, Percutaneous Endoscopic Approach
07T70ZZ	Resection of Thorax Lymphatic, Open Approach
07T74ZZ	Resection of Thorax Lymphatic, Percutaneous Endoscopic Approach
07T80ZZ	Resection of Right Internal Mammary Lymphatic, Open Approach
07T84ZZ	Resection of Right Internal Mammary Lymphatic, Percutaneous Endoscopic Approach
07T90ZZ	Resection of Left Internal Mammary Lymphatic, Open Approach
07T94ZZ	Resection of Left Internal Mammary Lymphatic, Percutaneous Endoscopic Approach
07TB0ZZ	Resection of Mesenteric Lymphatic, Open Approach
07TB4ZZ	Resection of Mesenteric Lymphatic, Percutaneous Endoscopic Approach
07TF0ZZ	Resection of Right Lower Extremity Lymphatic, Open Approach
07TF4ZZ	Resection of Right Lower Extremity Lymphatic, Percutaneous Endoscopic Approach
07TG0ZZ	Resection of Left Lower Extremity Lymphatic, Open Approach
07TG4ZZ	Resection of Left Lower Extremity Lymphatic, Percutaneous Endoscopic Approach
09HD05Z	Insertion of Single Channel Cochlear Prosthesis into Right Inner Ear, Open Approach
09HD06Z	Insertion of Multiple Channel Cochlear Prosthesis into Right Inner Ear, Open Approach
09HD0SZ	Insertion of Hearing Device into Right Inner Ear, Open Approach
09HD35Z	Insertion of Single Channel Cochlear Prosthesis into Right Inner Ear, Percutaneous Approach
09HD36Z	Insertion of Multiple Channel Cochlear Prosthesis into Right Inner Ear, Percutaneous Approach
09HD3SZ	Insertion of Hearing Device into Right Inner Ear, Percutaneous Approach
09HD45Z	Insertion of Single Channel Cochlear Prosthesis into Right Inner Ear, Percutaneous Endoscopic Approach
09HD46Z	Insertion of Multiple Channel Cochlear Prosthesis into Right Inner Ear, Percutaneous Endoscopic Approach
09HD4SZ	Insertion of Hearing Device into Right Inner Ear, Percutaneous Endoscopic Approach
09HE05Z	Insertion of Single Channel Cochlear Prosthesis into Left Inner Ear, Open Approach
09HE06Z	Insertion of Multiple Channel Cochlear Prosthesis into Left Inner Ear, Open Approach
09HE0SZ	Insertion of Hearing Device into Left Inner Ear, Open Approach
09HE35Z	Insertion of Single Channel Cochlear Prosthesis into Left Inner Ear, Percutaneous Approach
09HE36Z	Insertion of Multiple Channel Cochlear Prosthesis into Left Inner Ear, Percutaneous Approach
09HE3SZ	Insertion of Hearing Device into Left Inner Ear, Percutaneous Approach
09HE45Z	Insertion of Single Channel Cochlear Prosthesis into Left Inner Ear, Percutaneous Endoscopic Approach
09HE46Z	Insertion of Multiple Channel Cochlear Prosthesis into Left Inner Ear, Percutaneous Endoscopic Approach
09HE4SZ	Insertion of Hearing Device into Left Inner Ear, Percutaneous Endoscopic Approach
09HH0YZ	Insertion of Other Device into Right Ear, Open Approach
09HJ0YZ	Insertion of Other Device into Left Ear, Open Approach
0CBS0ZZ	Excision of Larynx, Open Approach
0CBS3ZZ	Excision of Larynx, Percutaneous Approach
0CBS4ZZ	Excision of Larynx, Percutaneous Endoscopic Approach
0CBS7ZZ	Excision of Larynx, Via Natural or Artificial Opening
0CBS8ZZ	Excision of Larynx, Via Natural or Artificial Opening Endoscopic
0CT20ZZ	Resection of Hard Palate, Open Approach
0CT2XZZ	Resection of Hard Palate, External Approach
0CT70ZZ	Resection of Tongue, Open Approach
0CT7XZZ	Resection of Tongue, External Approach
0NBT0ZZ	Excision of Right Mandible, Open Approach
0NBT3ZZ	Excision of Right Mandible, Percutaneous Approach
0NBT4ZZ	Excision of Right Mandible, Percutaneous Endoscopic Approach
0NBV0ZZ	Excision of Left Mandible, Open Approach
0NBV3ZZ	Excision of Left Mandible, Percutaneous Approach
0NBV4ZZ	Excision of Left Mandible, Percutaneous Endoscopic Approach
0NRT07Z	Replacement of Right Mandible with Autologous Tissue Substitute, Open Approach
0NRT0JZ	Replacement of Right Mandible with Synthetic Substitute, Open Approach
0NRT0KZ	Replacement of Right Mandible with Nonautologous Tissue Substitute, Open Approach
0NRT37Z	Replacement of Right Mandible with Autologous Tissue Substitute, Percutaneous Approach
0NRT3JZ	Replacement of Right Mandible with Synthetic Substitute, Percutaneous Approach
0NRT3KZ	Replacement of Right Mandible with Nonautologous Tissue Substitute, Percutaneous Approach
0NRT47Z	Replacement of Right Mandible with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0NRT4JZ	Replacement of Right Mandible with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRT4KZ	Replacement of Right Mandible with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0NRV07Z	Replacement of Left Mandible with Autologous Tissue Substitute, Open Approach
0NRV0JZ	Replacement of Left Mandible with Synthetic Substitute, Open Approach
0NRV0KZ	Replacement of Left Mandible with Nonautologous Tissue Substitute, Open Approach
0NRV37Z	Replacement of Left Mandible with Autologous Tissue Substitute, Percutaneous Approach
0NRV3JZ	Replacement of Left Mandible with Synthetic Substitute, Percutaneous Approach
0NRV3KZ	Replacement of Left Mandible with Nonautologous Tissue Substitute, Percutaneous Approach
0NRV47Z	Replacement of Left Mandible with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0NRV4JZ	Replacement of Left Mandible with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRV4KZ	Replacement of Left Mandible with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0NTT0ZZ	Resection of Right Mandible, Open Approach
0NTV0ZZ	Resection of Left Mandible, Open Approach

MAJOR DEVICE IMPLANT OPERATING ROOM PROCEDURES

Codes in MAJOR DEVICE IMPLANT OPERATING ROOM PROCEDURES
Code	Description
09HD05Z	Insertion of Single Channel Cochlear Prosthesis into Right Inner Ear, Open Approach
09HD06Z	Insertion of Multiple Channel Cochlear Prosthesis into Right Inner Ear, Open Approach
09HD0SZ	Insertion of Hearing Device into Right Inner Ear, Open Approach
09HD35Z	Insertion of Single Channel Cochlear Prosthesis into Right Inner Ear, Percutaneous Approach
09HD36Z	Insertion of Multiple Channel Cochlear Prosthesis into Right Inner Ear, Percutaneous Approach
09HD3SZ	Insertion of Hearing Device into Right Inner Ear, Percutaneous Approach
09HD45Z	Insertion of Single Channel Cochlear Prosthesis into Right Inner Ear, Percutaneous Endoscopic Approach
09HD46Z	Insertion of Multiple Channel Cochlear Prosthesis into Right Inner Ear, Percutaneous Endoscopic Approach
09HD4SZ	Insertion of Hearing Device into Right Inner Ear, Percutaneous Endoscopic Approach
09HE05Z	Insertion of Single Channel Cochlear Prosthesis into Left Inner Ear, Open Approach
09HE06Z	Insertion of Multiple Channel Cochlear Prosthesis into Left Inner Ear, Open Approach
09HE0SZ	Insertion of Hearing Device into Left Inner Ear, Open Approach
09HE35Z	Insertion of Single Channel Cochlear Prosthesis into Left Inner Ear, Percutaneous Approach
09HE36Z	Insertion of Multiple Channel Cochlear Prosthesis into Left Inner Ear, Percutaneous Approach
09HE3SZ	Insertion of Hearing Device into Left Inner Ear, Percutaneous Approach
09HE45Z	Insertion of Single Channel Cochlear Prosthesis into Left Inner Ear, Percutaneous Endoscopic Approach
09HE46Z	Insertion of Multiple Channel Cochlear Prosthesis into Left Inner Ear, Percutaneous Endoscopic Approach
09HE4SZ	Insertion of Hearing Device into Left Inner Ear, Percutaneous Endoscopic Approach
09HH0YZ	Insertion of Other Device into Right Ear, Open Approach
09HJ0YZ	Insertion of Other Device into Left Ear, Open Approach

About the Turquoise Health MS-DRG Manual Browser

We build tools and machine learning systems that simplify healthcare revenue cycle operations. We were frustrated with the formatting of the MS-DRG rules, so we built our own solution.

MS-DRG rules and ICD-10 CM/PCS codes are automatically parsed from CMS's MS-DRG data files. All content is provided strictly “AS IS” and may contain parsing errors. If you spot an error, please let us know.

We have converted the MS-DRG logic into fully structured, machine-readable data. If you need structured data versions of the MS-DRG manuals, we would love to talk with you.