MS-DRG v38 (FY 2021) MDC 02 Orbital Procedures | Turquoise Health MS-DRG Manual

Enhanced MS-DRG Definitions Manual

MS-DRG v38 (FY 2021) Definitions Manual • MDC 02 • Orbital Procedures

DRG Assignment Logic for Orbital Procedures

Patients who qualify for Orbital Procedures will be grouped into a DRG according to the logic below.

CC or MCC	DRG	Name	Type
Yes	113	ORBITAL PROCEDURES WITH CC/MCC	Medical
No	114	ORBITAL 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.

OPERATING ROOM PROCEDURES

Codes in OPERATING ROOM PROCEDURES
Code	Description
08B00ZX	Excision of Right Eye, Open Approach, Diagnostic
08B03ZX	Excision of Right Eye, Percutaneous Approach, Diagnostic
08B0XZX	Excision of Right Eye, External Approach, Diagnostic
08B10ZX	Excision of Left Eye, Open Approach, Diagnostic
08B13ZX	Excision of Left Eye, Percutaneous Approach, Diagnostic
08B1XZX	Excision of Left Eye, External Approach, Diagnostic
08P003Z	Removal of Infusion Device from Right Eye, Open Approach
08P00JZ	Removal of Synthetic Substitute from Right Eye, Open Approach
08P103Z	Removal of Infusion Device from Left Eye, Open Approach
08P10JZ	Removal of Synthetic Substitute from Left Eye, Open Approach
08Q0XZZ	Repair Right Eye, External Approach
08Q1XZZ	Repair Left Eye, External Approach
08R007Z	Replacement of Right Eye with Autologous Tissue Substitute, Open Approach
08R00JZ	Replacement of Right Eye with Synthetic Substitute, Open Approach
08R037Z	Replacement of Right Eye with Autologous Tissue Substitute, Percutaneous Approach
08R03KZ	Replacement of Right Eye with Nonautologous Tissue Substitute, Percutaneous Approach
08R107Z	Replacement of Left Eye with Autologous Tissue Substitute, Open Approach
08R10JZ	Replacement of Left Eye with Synthetic Substitute, Open Approach
08R137Z	Replacement of Left Eye with Autologous Tissue Substitute, Percutaneous Approach
08R13KZ	Replacement of Left Eye with Nonautologous Tissue Substitute, Percutaneous Approach
08T0XZZ	Resection of Right Eye, External Approach
08T1XZZ	Resection of Left Eye, External Approach
08W00JZ	Revision of Synthetic Substitute in Right Eye, Open Approach
08W03JZ	Revision of Synthetic Substitute in Right Eye, Percutaneous Approach
08W10JZ	Revision of Synthetic Substitute in Left Eye, Open Approach
08W13JZ	Revision of Synthetic Substitute in Left Eye, Percutaneous Approach
0J810ZZ	Division of Face Subcutaneous Tissue and Fascia, Open Approach
0J813ZZ	Division of Face Subcutaneous Tissue and Fascia, Percutaneous Approach
0JR107Z	Replacement of Face Subcutaneous Tissue and Fascia with Autologous Tissue Substitute, Open Approach
0JR10KZ	Replacement of Face Subcutaneous Tissue and Fascia with Nonautologous Tissue Substitute, Open Approach
0JR137Z	Replacement of Face Subcutaneous Tissue and Fascia with Autologous Tissue Substitute, Percutaneous Approach
0JR13KZ	Replacement of Face Subcutaneous Tissue and Fascia with Nonautologous Tissue Substitute, Percutaneous Approach
0N8P0ZZ	Division of Right Orbit, Open Approach
0N8P3ZZ	Division of Right Orbit, Percutaneous Approach
0N8P4ZZ	Division of Right Orbit, Percutaneous Endoscopic Approach
0N8Q0ZZ	Division of Left Orbit, Open Approach
0N8Q3ZZ	Division of Left Orbit, Percutaneous Approach
0N8Q4ZZ	Division of Left Orbit, Percutaneous Endoscopic Approach
0N9P00Z	Drainage of Right Orbit with Drainage Device, Open Approach
0N9P0ZX	Drainage of Right Orbit, Open Approach, Diagnostic
0N9P0ZZ	Drainage of Right Orbit, Open Approach
0N9P3ZX	Drainage of Right Orbit, Percutaneous Approach, Diagnostic
0N9P40Z	Drainage of Right Orbit with Drainage Device, Percutaneous Endoscopic Approach
0N9P4ZX	Drainage of Right Orbit, Percutaneous Endoscopic Approach, Diagnostic
0N9P4ZZ	Drainage of Right Orbit, Percutaneous Endoscopic Approach
0N9Q00Z	Drainage of Left Orbit with Drainage Device, Open Approach
0N9Q0ZX	Drainage of Left Orbit, Open Approach, Diagnostic
0N9Q0ZZ	Drainage of Left Orbit, Open Approach
0N9Q3ZX	Drainage of Left Orbit, Percutaneous Approach, Diagnostic
0N9Q40Z	Drainage of Left Orbit with Drainage Device, Percutaneous Endoscopic Approach
0N9Q4ZX	Drainage of Left Orbit, Percutaneous Endoscopic Approach, Diagnostic
0N9Q4ZZ	Drainage of Left Orbit, Percutaneous Endoscopic Approach
0NBP0ZX	Excision of Right Orbit, Open Approach, Diagnostic
0NBP0ZZ	Excision of Right Orbit, Open Approach
0NBP3ZX	Excision of Right Orbit, Percutaneous Approach, Diagnostic
0NBP3ZZ	Excision of Right Orbit, Percutaneous Approach
0NBP4ZX	Excision of Right Orbit, Percutaneous Endoscopic Approach, Diagnostic
0NBP4ZZ	Excision of Right Orbit, Percutaneous Endoscopic Approach
0NBQ0ZX	Excision of Left Orbit, Open Approach, Diagnostic
0NBQ0ZZ	Excision of Left Orbit, Open Approach
0NBQ3ZX	Excision of Left Orbit, Percutaneous Approach, Diagnostic
0NBQ3ZZ	Excision of Left Orbit, Percutaneous Approach
0NBQ4ZX	Excision of Left Orbit, Percutaneous Endoscopic Approach, Diagnostic
0NBQ4ZZ	Excision of Left Orbit, Percutaneous Endoscopic Approach
0NPW0JZ	Removal of Synthetic Substitute from Facial Bone, Open Approach
0NPW3JZ	Removal of Synthetic Substitute from Facial Bone, Percutaneous Approach
0NPW4JZ	Removal of Synthetic Substitute from Facial Bone, Percutaneous Endoscopic Approach
0NQP0ZZ	Repair Right Orbit, Open Approach
0NQP3ZZ	Repair Right Orbit, Percutaneous Approach
0NQP4ZZ	Repair Right Orbit, Percutaneous Endoscopic Approach
0NQQ0ZZ	Repair Left Orbit, Open Approach
0NQQ3ZZ	Repair Left Orbit, Percutaneous Approach
0NQQ4ZZ	Repair Left Orbit, Percutaneous Endoscopic Approach
0NRC0JZ	Replacement of Right Sphenoid Bone with Synthetic Substitute, Open Approach
0NRC3JZ	Replacement of Right Sphenoid Bone with Synthetic Substitute, Percutaneous Approach
0NRC4JZ	Replacement of Right Sphenoid Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRF0JZ	Replacement of Right Ethmoid Bone with Synthetic Substitute, Open Approach
0NRF3JZ	Replacement of Right Ethmoid Bone with Synthetic Substitute, Percutaneous Approach
0NRF4JZ	Replacement of Right Ethmoid Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRG0JZ	Replacement of Left Ethmoid Bone with Synthetic Substitute, Open Approach
0NRG3JZ	Replacement of Left Ethmoid Bone with Synthetic Substitute, Percutaneous Approach
0NRG4JZ	Replacement of Left Ethmoid Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRH0JZ	Replacement of Right Lacrimal Bone with Synthetic Substitute, Open Approach
0NRH3JZ	Replacement of Right Lacrimal Bone with Synthetic Substitute, Percutaneous Approach
0NRH4JZ	Replacement of Right Lacrimal Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRJ0JZ	Replacement of Left Lacrimal Bone with Synthetic Substitute, Open Approach
0NRJ3JZ	Replacement of Left Lacrimal Bone with Synthetic Substitute, Percutaneous Approach
0NRJ4JZ	Replacement of Left Lacrimal Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRK0JZ	Replacement of Right Palatine Bone with Synthetic Substitute, Open Approach
0NRK3JZ	Replacement of Right Palatine Bone with Synthetic Substitute, Percutaneous Approach
0NRK4JZ	Replacement of Right Palatine Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRL0JZ	Replacement of Left Palatine Bone with Synthetic Substitute, Open Approach
0NRL3JZ	Replacement of Left Palatine Bone with Synthetic Substitute, Percutaneous Approach
0NRL4JZ	Replacement of Left Palatine Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRM0JZ	Replacement of Right Zygomatic Bone with Synthetic Substitute, Open Approach
0NRM3JZ	Replacement of Right Zygomatic Bone with Synthetic Substitute, Percutaneous Approach
0NRM4JZ	Replacement of Right Zygomatic Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRN0JZ	Replacement of Left Zygomatic Bone with Synthetic Substitute, Open Approach
0NRN3JZ	Replacement of Left Zygomatic Bone with Synthetic Substitute, Percutaneous Approach
0NRN4JZ	Replacement of Left Zygomatic Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRP07Z	Replacement of Right Orbit with Autologous Tissue Substitute, Open Approach
0NRP0JZ	Replacement of Right Orbit with Synthetic Substitute, Open Approach
0NRP37Z	Replacement of Right Orbit with Autologous Tissue Substitute, Percutaneous Approach
0NRP3JZ	Replacement of Right Orbit with Synthetic Substitute, Percutaneous Approach
0NRP47Z	Replacement of Right Orbit with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0NRP4JZ	Replacement of Right Orbit with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRQ07Z	Replacement of Left Orbit with Autologous Tissue Substitute, Open Approach
0NRQ0JZ	Replacement of Left Orbit with Synthetic Substitute, Open Approach
0NRQ37Z	Replacement of Left Orbit with Autologous Tissue Substitute, Percutaneous Approach
0NRQ3JZ	Replacement of Left Orbit with Synthetic Substitute, Percutaneous Approach
0NRQ47Z	Replacement of Left Orbit with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0NRQ4JZ	Replacement of Left Orbit with Synthetic Substitute, Percutaneous Endoscopic Approach
0NRX0JZ	Replacement of Hyoid Bone with Synthetic Substitute, Open Approach
0NRX3JZ	Replacement of Hyoid Bone with Synthetic Substitute, Percutaneous Approach
0NRX4JZ	Replacement of Hyoid Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NSC04Z	Reposition Right Sphenoid Bone with Internal Fixation Device, Open Approach
0NSC0ZZ	Reposition Right Sphenoid Bone, Open Approach
0NSF04Z	Reposition Right Ethmoid Bone with Internal Fixation Device, Open Approach
0NSF0ZZ	Reposition Right Ethmoid Bone, Open Approach
0NSG04Z	Reposition Left Ethmoid Bone with Internal Fixation Device, Open Approach
0NSG0ZZ	Reposition Left Ethmoid Bone, Open Approach
0NSH04Z	Reposition Right Lacrimal Bone with Internal Fixation Device, Open Approach
0NSH0ZZ	Reposition Right Lacrimal Bone, Open Approach
0NSJ04Z	Reposition Left Lacrimal Bone with Internal Fixation Device, Open Approach
0NSJ0ZZ	Reposition Left Lacrimal Bone, Open Approach
0NSK04Z	Reposition Right Palatine Bone with Internal Fixation Device, Open Approach
0NSK0ZZ	Reposition Right Palatine Bone, Open Approach
0NSL04Z	Reposition Left Palatine Bone with Internal Fixation Device, Open Approach
0NSL0ZZ	Reposition Left Palatine Bone, Open Approach
0NSP04Z	Reposition Right Orbit with Internal Fixation Device, Open Approach
0NSP0ZZ	Reposition Right Orbit, Open Approach
0NSQ04Z	Reposition Left Orbit with Internal Fixation Device, Open Approach
0NSQ0ZZ	Reposition Left Orbit, Open Approach
0NSX04Z	Reposition Hyoid Bone with Internal Fixation Device, Open Approach
0NSX0ZZ	Reposition Hyoid Bone, Open Approach
0NUC0JZ	Supplement Right Sphenoid Bone with Synthetic Substitute, Open Approach
0NUC3JZ	Supplement Right Sphenoid Bone with Synthetic Substitute, Percutaneous Approach
0NUC4JZ	Supplement Right Sphenoid Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUF0JZ	Supplement Right Ethmoid Bone with Synthetic Substitute, Open Approach
0NUF3JZ	Supplement Right Ethmoid Bone with Synthetic Substitute, Percutaneous Approach
0NUF4JZ	Supplement Right Ethmoid Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUG0JZ	Supplement Left Ethmoid Bone with Synthetic Substitute, Open Approach
0NUG3JZ	Supplement Left Ethmoid Bone with Synthetic Substitute, Percutaneous Approach
0NUG4JZ	Supplement Left Ethmoid Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUH0JZ	Supplement Right Lacrimal Bone with Synthetic Substitute, Open Approach
0NUH3JZ	Supplement Right Lacrimal Bone with Synthetic Substitute, Percutaneous Approach
0NUH4JZ	Supplement Right Lacrimal Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUJ0JZ	Supplement Left Lacrimal Bone with Synthetic Substitute, Open Approach
0NUJ3JZ	Supplement Left Lacrimal Bone with Synthetic Substitute, Percutaneous Approach
0NUJ4JZ	Supplement Left Lacrimal Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUK0JZ	Supplement Right Palatine Bone with Synthetic Substitute, Open Approach
0NUK3JZ	Supplement Right Palatine Bone with Synthetic Substitute, Percutaneous Approach
0NUK4JZ	Supplement Right Palatine Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUL0JZ	Supplement Left Palatine Bone with Synthetic Substitute, Open Approach
0NUL3JZ	Supplement Left Palatine Bone with Synthetic Substitute, Percutaneous Approach
0NUL4JZ	Supplement Left Palatine Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUM0JZ	Supplement Right Zygomatic Bone with Synthetic Substitute, Open Approach
0NUM3JZ	Supplement Right Zygomatic Bone with Synthetic Substitute, Percutaneous Approach
0NUM4JZ	Supplement Right Zygomatic Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUN0JZ	Supplement Left Zygomatic Bone with Synthetic Substitute, Open Approach
0NUN3JZ	Supplement Left Zygomatic Bone with Synthetic Substitute, Percutaneous Approach
0NUN4JZ	Supplement Left Zygomatic Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUP0JZ	Supplement Right Orbit with Synthetic Substitute, Open Approach
0NUP3JZ	Supplement Right Orbit with Synthetic Substitute, Percutaneous Approach
0NUP4JZ	Supplement Right Orbit with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUQ0JZ	Supplement Left Orbit with Synthetic Substitute, Open Approach
0NUQ3JZ	Supplement Left Orbit with Synthetic Substitute, Percutaneous Approach
0NUQ4JZ	Supplement Left Orbit with Synthetic Substitute, Percutaneous Endoscopic Approach
0NUX0JZ	Supplement Hyoid Bone with Synthetic Substitute, Open Approach
0NUX3JZ	Supplement Hyoid Bone with Synthetic Substitute, Percutaneous Approach
0NUX4JZ	Supplement Hyoid Bone with Synthetic Substitute, Percutaneous Endoscopic Approach
0WQ2XZZ	Repair Face, External 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.