MS-DRG v37 (FY 2020) MDC 08 Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity

Enhanced MS-DRG Definitions Manual

MS-DRG v37 (FY 2020) Definitions Manual • MDC 08 • Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity

DRG Assignment Logic for Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity

Patients who qualify for Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity will be grouped into a DRG according to the logic below.

MCC	Total Ankle Replacement	DRG	Name	Type
Yes	n/a	469	MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT	Medical
n/a	Yes	469	MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT	Medical
No	No	470	MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT 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.

OPERATING ROOM PROCEDURES

Codes in OPERATING ROOM PROCEDURES
Code	Description
0SR9019	Replacement of Right Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach
0SR901A	Replacement of Right Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach
0SR901Z	Replacement of Right Hip Joint with Metal Synthetic Substitute, Open Approach
0SR9029	Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SR902A	Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SR902Z	Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Open Approach
0SR9039	Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Cemented, Open Approach
0SR903A	Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SR903Z	Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Open Approach
0SR9049	Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SR904A	Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SR904Z	Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Open Approach
0SR9069	Replacement of Right Hip Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SR906A	Replacement of Right Hip Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SR906Z	Replacement of Right Hip Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Open Approach
0SR907Z	Replacement of Right Hip Joint with Autologous Tissue Substitute, Open Approach
0SR90J9	Replacement of Right Hip Joint with Synthetic Substitute, Cemented, Open Approach
0SR90JA	Replacement of Right Hip Joint with Synthetic Substitute, Uncemented, Open Approach
0SR90JZ	Replacement of Right Hip Joint with Synthetic Substitute, Open Approach
0SR90KZ	Replacement of Right Hip Joint with Nonautologous Tissue Substitute, Open Approach
0SRA009	Replacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRA00A	Replacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRA00Z	Replacement of Right Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Open Approach
0SRA019	Replacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Cemented, Open Approach
0SRA01A	Replacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Uncemented, Open Approach
0SRA01Z	Replacement of Right Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Open Approach
0SRA039	Replacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRA03A	Replacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRA03Z	Replacement of Right Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Open Approach
0SRA07Z	Replacement of Right Hip Joint, Acetabular Surface with Autologous Tissue Substitute, Open Approach
0SRA0J9	Replacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Cemented, Open Approach
0SRA0JA	Replacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Uncemented, Open Approach
0SRA0JZ	Replacement of Right Hip Joint, Acetabular Surface with Synthetic Substitute, Open Approach
0SRA0KZ	Replacement of Right Hip Joint, Acetabular Surface with Nonautologous Tissue Substitute, Open Approach
0SRB019	Replacement of Left Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach
0SRB01A	Replacement of Left Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach
0SRB01Z	Replacement of Left Hip Joint with Metal Synthetic Substitute, Open Approach
0SRB029	Replacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRB02A	Replacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRB02Z	Replacement of Left Hip Joint with Metal on Polyethylene Synthetic Substitute, Open Approach
0SRB039	Replacement of Left Hip Joint with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRB03A	Replacement of Left Hip Joint with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRB03Z	Replacement of Left Hip Joint with Ceramic Synthetic Substitute, Open Approach
0SRB049	Replacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRB04A	Replacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRB04Z	Replacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Open Approach
0SRB069	Replacement of Left Hip Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRB06A	Replacement of Left Hip Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRB06Z	Replacement of Left Hip Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Open Approach
0SRB07Z	Replacement of Left Hip Joint with Autologous Tissue Substitute, Open Approach
0SRB0J9	Replacement of Left Hip Joint with Synthetic Substitute, Cemented, Open Approach
0SRB0JA	Replacement of Left Hip Joint with Synthetic Substitute, Uncemented, Open Approach
0SRB0JZ	Replacement of Left Hip Joint with Synthetic Substitute, Open Approach
0SRB0KZ	Replacement of Left Hip Joint with Nonautologous Tissue Substitute, Open Approach
0SRC069	Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRC06A	Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRC06Z	Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Open Approach
0SRC07Z	Replacement of Right Knee Joint with Autologous Tissue Substitute, Open Approach
0SRC0J9	Replacement of Right Knee Joint with Synthetic Substitute, Cemented, Open Approach
0SRC0JA	Replacement of Right Knee Joint with Synthetic Substitute, Uncemented, Open Approach
0SRC0JZ	Replacement of Right Knee Joint with Synthetic Substitute, Open Approach
0SRC0KZ	Replacement of Right Knee Joint with Nonautologous Tissue Substitute, Open Approach
0SRC0L9	Replacement of Right Knee Joint with Unicondylar Synthetic Substitute, Cemented, Open Approach
0SRC0LA	Replacement of Right Knee Joint with Unicondylar Synthetic Substitute, Uncemented, Open Approach
0SRC0LZ	Replacement of Right Knee Joint with Unicondylar Synthetic Substitute, Open Approach
0SRC0M9	Replacement of Right Knee Joint with Lateral Unicondylar Synthetic Substitute, Cemented, Open Approach
0SRC0MA	Replacement of Right Knee Joint with Lateral Unicondylar Synthetic Substitute, Uncemented, Open Approach
0SRC0MZ	Replacement of Right Knee Joint with Lateral Unicondylar Synthetic Substitute, Open Approach
0SRC0N9	Replacement of Right Knee Joint with Patellofemoral Synthetic Substitute, Cemented, Open Approach
0SRC0NA	Replacement of Right Knee Joint with Patellofemoral Synthetic Substitute, Uncemented, Open Approach
0SRC0NZ	Replacement of Right Knee Joint with Patellofemoral Synthetic Substitute, Open Approach
0SRD069	Replacement of Left Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRD06A	Replacement of Left Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRD06Z	Replacement of Left Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Open Approach
0SRD07Z	Replacement of Left Knee Joint with Autologous Tissue Substitute, Open Approach
0SRD0J9	Replacement of Left Knee Joint with Synthetic Substitute, Cemented, Open Approach
0SRD0JA	Replacement of Left Knee Joint with Synthetic Substitute, Uncemented, Open Approach
0SRD0JZ	Replacement of Left Knee Joint with Synthetic Substitute, Open Approach
0SRD0KZ	Replacement of Left Knee Joint with Nonautologous Tissue Substitute, Open Approach
0SRD0L9	Replacement of Left Knee Joint with Unicondylar Synthetic Substitute, Cemented, Open Approach
0SRD0LA	Replacement of Left Knee Joint with Unicondylar Synthetic Substitute, Uncemented, Open Approach
0SRD0LZ	Replacement of Left Knee Joint with Unicondylar Synthetic Substitute, Open Approach
0SRD0M9	Replacement of Left Knee Joint with Lateral Unicondylar Synthetic Substitute, Cemented, Open Approach
0SRD0MA	Replacement of Left Knee Joint with Lateral Unicondylar Synthetic Substitute, Uncemented, Open Approach
0SRD0MZ	Replacement of Left Knee Joint with Lateral Unicondylar Synthetic Substitute, Open Approach
0SRD0N9	Replacement of Left Knee Joint with Patellofemoral Synthetic Substitute, Cemented, Open Approach
0SRD0NA	Replacement of Left Knee Joint with Patellofemoral Synthetic Substitute, Uncemented, Open Approach
0SRD0NZ	Replacement of Left Knee Joint with Patellofemoral Synthetic Substitute, Open Approach
0SRE009	Replacement of Left Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Cemented, Open Approach
0SRE00A	Replacement of Left Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Uncemented, Open Approach
0SRE00Z	Replacement of Left Hip Joint, Acetabular Surface with Polyethylene Synthetic Substitute, Open Approach
0SRE019	Replacement of Left Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Cemented, Open Approach
0SRE01A	Replacement of Left Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Uncemented, Open Approach
0SRE01Z	Replacement of Left Hip Joint, Acetabular Surface with Metal Synthetic Substitute, Open Approach
0SRE039	Replacement of Left Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRE03A	Replacement of Left Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRE03Z	Replacement of Left Hip Joint, Acetabular Surface with Ceramic Synthetic Substitute, Open Approach
0SRE07Z	Replacement of Left Hip Joint, Acetabular Surface with Autologous Tissue Substitute, Open Approach
0SRE0J9	Replacement of Left Hip Joint, Acetabular Surface with Synthetic Substitute, Cemented, Open Approach
0SRE0JA	Replacement of Left Hip Joint, Acetabular Surface with Synthetic Substitute, Uncemented, Open Approach
0SRE0JZ	Replacement of Left Hip Joint, Acetabular Surface with Synthetic Substitute, Open Approach
0SRE0KZ	Replacement of Left Hip Joint, Acetabular Surface with Nonautologous Tissue Substitute, Open Approach
0SRF07Z	Replacement of Right Ankle Joint with Autologous Tissue Substitute, Open Approach
0SRF0KZ	Replacement of Right Ankle Joint with Nonautologous Tissue Substitute, Open Approach
0SRG07Z	Replacement of Left Ankle Joint with Autologous Tissue Substitute, Open Approach
0SRG0KZ	Replacement of Left Ankle Joint with Nonautologous Tissue Substitute, Open Approach
0SRR019	Replacement of Right Hip Joint, Femoral Surface with Metal Synthetic Substitute, Cemented, Open Approach
0SRR01A	Replacement of Right Hip Joint, Femoral Surface with Metal Synthetic Substitute, Uncemented, Open Approach
0SRR01Z	Replacement of Right Hip Joint, Femoral Surface with Metal Synthetic Substitute, Open Approach
0SRR039	Replacement of Right Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRR03A	Replacement of Right Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRR03Z	Replacement of Right Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Open Approach
0SRR07Z	Replacement of Right Hip Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach
0SRR0J9	Replacement of Right Hip Joint, Femoral Surface with Synthetic Substitute, Cemented, Open Approach
0SRR0JA	Replacement of Right Hip Joint, Femoral Surface with Synthetic Substitute, Uncemented, Open Approach
0SRR0JZ	Replacement of Right Hip Joint, Femoral Surface with Synthetic Substitute, Open Approach
0SRR0KZ	Replacement of Right Hip Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach
0SRS019	Replacement of Left Hip Joint, Femoral Surface with Metal Synthetic Substitute, Cemented, Open Approach
0SRS01A	Replacement of Left Hip Joint, Femoral Surface with Metal Synthetic Substitute, Uncemented, Open Approach
0SRS01Z	Replacement of Left Hip Joint, Femoral Surface with Metal Synthetic Substitute, Open Approach
0SRS039	Replacement of Left Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Cemented, Open Approach
0SRS03A	Replacement of Left Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Uncemented, Open Approach
0SRS03Z	Replacement of Left Hip Joint, Femoral Surface with Ceramic Synthetic Substitute, Open Approach
0SRS07Z	Replacement of Left Hip Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach
0SRS0J9	Replacement of Left Hip Joint, Femoral Surface with Synthetic Substitute, Cemented, Open Approach
0SRS0JA	Replacement of Left Hip Joint, Femoral Surface with Synthetic Substitute, Uncemented, Open Approach
0SRS0JZ	Replacement of Left Hip Joint, Femoral Surface with Synthetic Substitute, Open Approach
0SRS0KZ	Replacement of Left Hip Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach
0SRT07Z	Replacement of Right Knee Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach
0SRT0J9	Replacement of Right Knee Joint, Femoral Surface with Synthetic Substitute, Cemented, Open Approach
0SRT0JA	Replacement of Right Knee Joint, Femoral Surface with Synthetic Substitute, Uncemented, Open Approach
0SRT0JZ	Replacement of Right Knee Joint, Femoral Surface with Synthetic Substitute, Open Approach
0SRT0KZ	Replacement of Right Knee Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach
0SRU07Z	Replacement of Left Knee Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach
0SRU0J9	Replacement of Left Knee Joint, Femoral Surface with Synthetic Substitute, Cemented, Open Approach
0SRU0JA	Replacement of Left Knee Joint, Femoral Surface with Synthetic Substitute, Uncemented, Open Approach
0SRU0JZ	Replacement of Left Knee Joint, Femoral Surface with Synthetic Substitute, Open Approach
0SRU0KZ	Replacement of Left Knee Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach
0SRV07Z	Replacement of Right Knee Joint, Tibial Surface with Autologous Tissue Substitute, Open Approach
0SRV0J9	Replacement of Right Knee Joint, Tibial Surface with Synthetic Substitute, Cemented, Open Approach
0SRV0JA	Replacement of Right Knee Joint, Tibial Surface with Synthetic Substitute, Uncemented, Open Approach
0SRV0JZ	Replacement of Right Knee Joint, Tibial Surface with Synthetic Substitute, Open Approach
0SRV0KZ	Replacement of Right Knee Joint, Tibial Surface with Nonautologous Tissue Substitute, Open Approach
0SRW07Z	Replacement of Left Knee Joint, Tibial Surface with Autologous Tissue Substitute, Open Approach
0SRW0J9	Replacement of Left Knee Joint, Tibial Surface with Synthetic Substitute, Cemented, Open Approach
0SRW0JA	Replacement of Left Knee Joint, Tibial Surface with Synthetic Substitute, Uncemented, Open Approach
0SRW0JZ	Replacement of Left Knee Joint, Tibial Surface with Synthetic Substitute, Open Approach
0SRW0KZ	Replacement of Left Knee Joint, Tibial Surface with Nonautologous Tissue Substitute, Open Approach
0SU90BZ	Supplement Right Hip Joint with Resurfacing Device, Open Approach
0SUA0BZ	Supplement Right Hip Joint, Acetabular Surface with Resurfacing Device, Open Approach
0SUB0BZ	Supplement Left Hip Joint with Resurfacing Device, Open Approach
0SUE0BZ	Supplement Left Hip Joint, Acetabular Surface with Resurfacing Device, Open Approach
0SUR0BZ	Supplement Right Hip Joint, Femoral Surface with Resurfacing Device, Open Approach
0SUS0BZ	Supplement Left Hip Joint, Femoral Surface with Resurfacing Device, Open Approach
0YM70ZZ	Reattachment of Right Femoral Region, Open Approach
0YM80ZZ	Reattachment of Left Femoral Region, Open Approach
0YMC0ZZ	Reattachment of Right Upper Leg, Open Approach
0YMD0ZZ	Reattachment of Left Upper Leg, Open Approach
0YMF0ZZ	Reattachment of Right Knee Region, Open Approach
0YMG0ZZ	Reattachment of Left Knee Region, Open Approach
0YMH0ZZ	Reattachment of Right Lower Leg, Open Approach
0YMJ0ZZ	Reattachment of Left Lower Leg, Open Approach
0YMK0ZZ	Reattachment of Right Ankle Region, Open Approach
0YML0ZZ	Reattachment of Left Ankle Region, Open Approach
0YMM0ZZ	Reattachment of Right Foot, Open Approach
0YMN0ZZ	Reattachment of Left Foot, Open Approach

TOTAL ANKLE REPLACEMENT

Codes in TOTAL ANKLE REPLACEMENT
Code	Description
0SRF0J9	Replacement of Right Ankle Joint with Synthetic Substitute, Cemented, Open Approach
0SRF0JA	Replacement of Right Ankle Joint with Synthetic Substitute, Uncemented, Open Approach
0SRF0JZ	Replacement of Right Ankle Joint with Synthetic Substitute, Open Approach
0SRG0J9	Replacement of Left Ankle Joint with Synthetic Substitute, Cemented, Open Approach
0SRG0JA	Replacement of Left Ankle Joint with Synthetic Substitute, Uncemented, Open Approach
0SRG0JZ	Replacement of Left Ankle Joint with Synthetic Substitute, Open Approach

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