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.
To qualify for any subsection in MDC 12, the patient's primary diagnostic code must be included in this list.
| Code | Description |
|---|---|
| A18.14 |
Tuberculosis of prostate |
| A18.15 |
Tuberculosis of other male genital organs |
| A51.0 |
Primary genital syphilis |
| A54.00 |
Gonococcal infection of lower genitourinary tract, unspecified |
| A54.09 |
Other gonococcal infection of lower genitourinary tract |
| A54.1 |
Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess |
| A54.21 |
Gonococcal infection of kidney and ureter |
| A54.22 |
Gonococcal prostatitis |
| A54.23 |
Gonococcal infection of other male genital organs |
| A54.29 |
Other gonococcal genitourinary infections |
| A55 |
Chlamydial lymphogranuloma (venereum) |
| A56.00 |
Chlamydial infection of lower genitourinary tract, unspecified |
| A56.01 |
Chlamydial cystitis and urethritis |
| A56.09 |
Other chlamydial infection of lower genitourinary tract |
| A56.2 |
Chlamydial infection of genitourinary tract, unspecified |
| A56.8 |
Sexually transmitted chlamydial infection of other sites |
| A57 |
Chancroid |
| A58 |
Granuloma inguinale |
| A59.00 |
Urogenital trichomoniasis, unspecified |
| A59.02 |
Trichomonal prostatitis |
| A59.03 |
Trichomonal cystitis and urethritis |
| A59.09 |
Other urogenital trichomoniasis |
| A60.00 |
Herpesviral infection of urogenital system, unspecified |
| A60.01 |
Herpesviral infection of penis |
| A60.02 |
Herpesviral infection of other male genital organs |
| A60.09 |
Herpesviral infection of other urogenital tract |
| A60.1 |
Herpesviral infection of perianal skin and rectum |
| A60.9 |
Anogenital herpesviral infection, unspecified |
| A63.8 |
Other specified predominantly sexually transmitted diseases |
| A64 |
Unspecified sexually transmitted disease |
| B26.0 |
Mumps orchitis |
| B37.41 |
Candidal cystitis and urethritis |
| B37.42 |
Candidal balanitis |
| B37.49 |
Other urogenital candidiasis |
| C60.0 |
Malignant neoplasm of prepuce |
| C60.1 |
Malignant neoplasm of glans penis |
| C60.2 |
Malignant neoplasm of body of penis |
| C60.8 |
Malignant neoplasm of overlapping sites of penis |
| C60.9 |
Malignant neoplasm of penis, unspecified |
| C61 |
Malignant neoplasm of prostate |
| C62.00 |
Malignant neoplasm of unspecified undescended testis |
| C62.01 |
Malignant neoplasm of undescended right testis |
| C62.02 |
Malignant neoplasm of undescended left testis |
| C62.10 |
Malignant neoplasm of unspecified descended testis |
| C62.11 |
Malignant neoplasm of descended right testis |
| C62.12 |
Malignant neoplasm of descended left testis |
| C62.90 |
Malignant neoplasm of unspecified testis, unspecified whether descended or undescended |
| C62.91 |
Malignant neoplasm of right testis, unspecified whether descended or undescended |
| C62.92 |
Malignant neoplasm of left testis, unspecified whether descended or undescended |
| C63.00 |
Malignant neoplasm of unspecified epididymis |
| C63.01 |
Malignant neoplasm of right epididymis |
| C63.02 |
Malignant neoplasm of left epididymis |
| C63.10 |
Malignant neoplasm of unspecified spermatic cord |
| C63.11 |
Malignant neoplasm of right spermatic cord |
| C63.12 |
Malignant neoplasm of left spermatic cord |
| C63.2 |
Malignant neoplasm of scrotum |
| C63.7 |
Malignant neoplasm of other specified male genital organs |
| C63.8 |
Malignant neoplasm of overlapping sites of male genital organs |
| C63.9 |
Malignant neoplasm of male genital organ, unspecified |
| C76.3 |
Malignant neoplasm of pelvis |
| C79.82 |
Secondary malignant neoplasm of genital organs |
| D07.4 |
Carcinoma in situ of penis |
| D07.5 |
Carcinoma in situ of prostate |
| D07.60 |
Carcinoma in situ of unspecified male genital organs |
| D07.61 |
Carcinoma in situ of scrotum |
| D07.69 |
Carcinoma in situ of other male genital organs |
| D17.6 |
Benign lipomatous neoplasm of spermatic cord |
| D29.0 |
Benign neoplasm of penis |
| D29.1 |
Benign neoplasm of prostate |
| D29.20 |
Benign neoplasm of unspecified testis |
| D29.21 |
Benign neoplasm of right testis |
| D29.22 |
Benign neoplasm of left testis |
| D29.30 |
Benign neoplasm of unspecified epididymis |
| D29.31 |
Benign neoplasm of right epididymis |
| D29.32 |
Benign neoplasm of left epididymis |
| D29.4 |
Benign neoplasm of scrotum |
| D29.8 |
Benign neoplasm of other specified male genital organs |
| D29.9 |
Benign neoplasm of male genital organ, unspecified |
| D40.0 |
Neoplasm of uncertain behavior of prostate |
| D40.10 |
Neoplasm of uncertain behavior of unspecified testis |
| D40.11 |
Neoplasm of uncertain behavior of right testis |
| D40.12 |
Neoplasm of uncertain behavior of left testis |
| D40.8 |
Neoplasm of uncertain behavior of other specified male genital organs |
| D40.9 |
Neoplasm of uncertain behavior of male genital organ, unspecified |
| I86.1 |
Scrotal varices |
| I86.2 |
Pelvic varices |
| L29.1 |
Pruritus scroti |
| L29.3 |
Anogenital pruritus, unspecified |
| N34.1 |
Nonspecific urethritis |
| N40.0 |
Benign prostatic hyperplasia without lower urinary tract symptoms |
| N40.1 |
Benign prostatic hyperplasia with lower urinary tract symptoms |
| N40.2 |
Nodular prostate without lower urinary tract symptoms |
| N40.3 |
Nodular prostate with lower urinary tract symptoms |
| N41.0 |
Acute prostatitis |
| N41.1 |
Chronic prostatitis |
| N41.2 |
Abscess of prostate |
| N41.3 |
Prostatocystitis |
| N41.4 |
Granulomatous prostatitis |
| N41.8 |
Other inflammatory diseases of prostate |
| N41.9 |
Inflammatory disease of prostate, unspecified |
| N42.0 |
Calculus of prostate |
| N42.1 |
Congestion and hemorrhage of prostate |
| N42.30 |
Unspecified dysplasia of prostate |
| N42.31 |
Prostatic intraepithelial neoplasia |
| N42.32 |
Atypical small acinar proliferation of prostate |
| N42.39 |
Other dysplasia of prostate |
| N42.81 |
Prostatodynia syndrome |
| N42.82 |
Prostatosis syndrome |
| N42.83 |
Cyst of prostate |
| N42.89 |
Other specified disorders of prostate |
| N42.9 |
Disorder of prostate, unspecified |
| N43.0 |
Encysted hydrocele |
| N43.1 |
Infected hydrocele |
| N43.2 |
Other hydrocele |
| N43.3 |
Hydrocele, unspecified |
| N43.40 |
Spermatocele of epididymis, unspecified |
| N43.41 |
Spermatocele of epididymis, single |
| N43.42 |
Spermatocele of epididymis, multiple |
| N44.00 |
Torsion of testis, unspecified |
| N44.01 |
Extravaginal torsion of spermatic cord |
| N44.02 |
Intravaginal torsion of spermatic cord |
| N44.03 |
Torsion of appendix testis |
| N44.04 |
Torsion of appendix epididymis |
| N44.1 |
Cyst of tunica albuginea testis |
| N44.2 |
Benign cyst of testis |
| N44.8 |
Other noninflammatory disorders of the testis |
| N45.1 |
Epididymitis |
| N45.2 |
Orchitis |
| N45.3 |
Epididymo-orchitis |
| N45.4 |
Abscess of epididymis or testis |
| N46.01 |
Organic azoospermia |
| N46.021 |
Azoospermia due to drug therapy |
| N46.022 |
Azoospermia due to infection |
| N46.023 |
Azoospermia due to obstruction of efferent ducts |
| N46.024 |
Azoospermia due to radiation |
| N46.025 |
Azoospermia due to systemic disease |
| N46.029 |
Azoospermia due to other extratesticular causes |
| N46.11 |
Organic oligospermia |
| N46.121 |
Oligospermia due to drug therapy |
| N46.122 |
Oligospermia due to infection |
| N46.123 |
Oligospermia due to obstruction of efferent ducts |
| N46.124 |
Oligospermia due to radiation |
| N46.125 |
Oligospermia due to systemic disease |
| N46.129 |
Oligospermia due to other extratesticular causes |
| N46.8 |
Other male infertility |
| N46.9 |
Male infertility, unspecified |
| N47.0 |
Adherent prepuce, newborn |
| N47.1 |
Phimosis |
| N47.2 |
Paraphimosis |
| N47.3 |
Deficient foreskin |
| N47.4 |
Benign cyst of prepuce |
| N47.5 |
Adhesions of prepuce and glans penis |
| N47.6 |
Balanoposthitis |
| N47.7 |
Other inflammatory diseases of prepuce |
| N47.8 |
Other disorders of prepuce |
| N48.0 |
Leukoplakia of penis |
| N48.1 |
Balanitis |
| N48.21 |
Abscess of corpus cavernosum and penis |
| N48.22 |
Cellulitis of corpus cavernosum and penis |
| N48.29 |
Other inflammatory disorders of penis |
| N48.30 |
Priapism, unspecified |
| N48.31 |
Priapism due to trauma |
| N48.32 |
Priapism due to disease classified elsewhere |
| N48.33 |
Priapism, drug-induced |
| N48.39 |
Other priapism |
| N48.5 |
Ulcer of penis |
| N48.6 |
Induration penis plastica |
| N48.81 |
Thrombosis of superficial vein of penis |
| N48.82 |
Acquired torsion of penis |
| N48.83 |
Acquired buried penis |
| N48.89 |
Other specified disorders of penis |
| N48.9 |
Disorder of penis, unspecified |
| N49.0 |
Inflammatory disorders of seminal vesicle |
| N49.1 |
Inflammatory disorders of spermatic cord, tunica vaginalis and vas deferens |
| N49.2 |
Inflammatory disorders of scrotum |
| N49.3 |
Fournier gangrene |
| N49.8 |
Inflammatory disorders of other specified male genital organs |
| N49.9 |
Inflammatory disorder of unspecified male genital organ |
| N50.0 |
Atrophy of testis |
| N50.1 |
Vascular disorders of male genital organs |
| N50.3 |
Cyst of epididymis |
| N50.811 |
Right testicular pain |
| N50.812 |
Left testicular pain |
| N50.819 |
Testicular pain, unspecified |
| N50.82 |
Scrotal pain |
| N50.89 |
Other specified disorders of the male genital organs |
| N50.9 |
Disorder of male genital organs, unspecified |
| N51 |
Disorders of male genital organs in diseases classified elsewhere |
| N52.01 |
Erectile dysfunction due to arterial insufficiency |
| N52.02 |
Corporo-venous occlusive erectile dysfunction |
| N52.03 |
Combined arterial insufficiency and corporo-venous occlusive erectile dysfunction |
| N52.1 |
Erectile dysfunction due to diseases classified elsewhere |
| N52.2 |
Drug-induced erectile dysfunction |
| N52.31 |
Erectile dysfunction following radical prostatectomy |
| N52.32 |
Erectile dysfunction following radical cystectomy |
| N52.33 |
Erectile dysfunction following urethral surgery |
| N52.34 |
Erectile dysfunction following simple prostatectomy |
| N52.35 |
Erectile dysfunction following radiation therapy |
| N52.36 |
Erectile dysfunction following interstitial seed therapy |
| N52.37 |
Erectile dysfunction following prostate ablative therapy |
| N52.39 |
Other and unspecified postprocedural erectile dysfunction |
| N52.8 |
Other male erectile dysfunction |
| N52.9 |
Male erectile dysfunction, unspecified |
| N53.11 |
Retarded ejaculation |
| N53.12 |
Painful ejaculation |
| N53.13 |
Anejaculatory orgasm |
| N53.14 |
Retrograde ejaculation |
| N53.19 |
Other ejaculatory dysfunction |
| N53.8 |
Other male sexual dysfunction |
| N53.9 |
Unspecified male sexual dysfunction |
| Q53.00 |
Ectopic testis, unspecified |
| Q53.01 |
Ectopic testis, unilateral |
| Q53.02 |
Ectopic testes, bilateral |
| Q53.10 |
Unspecified undescended testicle, unilateral |
| Q53.111 |
Unilateral intraabdominal testis |
| Q53.112 |
Unilateral inguinal testis |
| Q53.12 |
Ectopic perineal testis, unilateral |
| Q53.13 |
Unilateral high scrotal testis |
| Q53.20 |
Undescended testicle, unspecified, bilateral |
| Q53.211 |
Bilateral intraabdominal testes |
| Q53.212 |
Bilateral inguinal testes |
| Q53.22 |
Ectopic perineal testis, bilateral |
| Q53.23 |
Bilateral high scrotal testes |
| Q53.9 |
Undescended testicle, unspecified |
| Q54.0 |
Hypospadias, balanic |
| Q54.1 |
Hypospadias, penile |
| Q54.2 |
Hypospadias, penoscrotal |
| Q54.3 |
Hypospadias, perineal |
| Q54.4 |
Congenital chordee |
| Q54.8 |
Other hypospadias |
| Q54.9 |
Hypospadias, unspecified |
| Q55.0 |
Absence and aplasia of testis |
| Q55.1 |
Hypoplasia of testis and scrotum |
| Q55.20 |
Unspecified congenital malformations of testis and scrotum |
| Q55.21 |
Polyorchism |
| Q55.22 |
Retractile testis |
| Q55.23 |
Scrotal transposition |
| Q55.29 |
Other congenital malformations of testis and scrotum |
| Q55.3 |
Atresia of vas deferens |
| Q55.4 |
Other congenital malformations of vas deferens, epididymis, seminal vesicles and prostate |
| Q55.5 |
Congenital absence and aplasia of penis |
| Q55.61 |
Curvature of penis (lateral) |
| Q55.62 |
Hypoplasia of penis |
| Q55.63 |
Congenital torsion of penis |
| Q55.64 |
Hidden penis |
| Q55.69 |
Other congenital malformation of penis |
| Q55.7 |
Congenital vasocutaneous fistula |
| Q55.8 |
Other specified congenital malformations of male genital organs |
| Q55.9 |
Congenital malformation of male genital organ, unspecified |
| Q56.0 |
Hermaphroditism, not elsewhere classified |
| Q56.1 |
Male pseudohermaphroditism, not elsewhere classified |
| Q56.3 |
Pseudohermaphroditism, unspecified |
| Q56.4 |
Indeterminate sex, unspecified |
| Q64.0 |
Epispadias |
| Q98.0 |
Klinefelter syndrome karyotype 47, XXY |
| Q98.1 |
Klinefelter syndrome, male with more than two X chromosomes |
| Q98.3 |
Other male with 46, XX karyotype |
| Q98.4 |
Klinefelter syndrome, unspecified |
| Q98.5 |
Karyotype 47, XYY |
| Q98.6 |
Male with structurally abnormal sex chromosome |
| Q98.7 |
Male with sex chromosome mosaicism |
| Q98.8 |
Other specified sex chromosome abnormalities, male phenotype |
| Q98.9 |
Sex chromosome abnormality, male phenotype, unspecified |
| Q99.0 |
Chimera 46, XX/46, XY |
| Q99.1 |
46, XX true hermaphrodite |
| Q99.8 |
Other specified chromosome abnormalities |
| R36.1 |
Hematospermia |
| R86.0 |
Abnormal level of enzymes in specimens from male genital organs |
| R86.1 |
Abnormal level of hormones in specimens from male genital organs |
| R86.2 |
Abnormal level of other drugs, medicaments and biological substances in specimens from male genital organs |
| R86.3 |
Abnormal level of substances chiefly nonmedicinal as to source in specimens from male genital organs |
| R86.4 |
Abnormal immunological findings in specimens from male genital organs |
| R86.5 |
Abnormal microbiological findings in specimens from male genital organs |
| R86.6 |
Abnormal cytological findings in specimens from male genital organs |
| R86.7 |
Abnormal histological findings in specimens from male genital organs |
| R86.8 |
Other abnormal findings in specimens from male genital organs |
| R86.9 |
Unspecified abnormal finding in specimens from male genital organs |
| R93.811 |
Abnormal radiologic findings on diagnostic imaging of right testicle |
| R93.812 |
Abnormal radiologic findings on diagnostic imaging of left testicle |
| R93.813 |
Abnormal radiologic findings on diagnostic imaging of testicles, bilateral |
| R93.819 |
Abnormal radiologic findings on diagnostic imaging of unspecified testicle |
| S30.201A |
Contusion of unspecified external genital organ, male, initial encounter |
| S30.21XA |
Contusion of penis, initial encounter |
| S30.22XA |
Contusion of scrotum and testes, initial encounter |
| S31.20XA |
Unspecified open wound of penis, initial encounter |
| S31.21XA |
Laceration without foreign body of penis, initial encounter |
| S31.22XA |
Laceration with foreign body of penis, initial encounter |
| S31.23XA |
Puncture wound without foreign body of penis, initial encounter |
| S31.24XA |
Puncture wound with foreign body of penis, initial encounter |
| S31.25XA |
Open bite of penis, initial encounter |
| S31.30XA |
Unspecified open wound of scrotum and testes, initial encounter |
| S31.31XA |
Laceration without foreign body of scrotum and testes, initial encounter |
| S31.32XA |
Laceration with foreign body of scrotum and testes, initial encounter |
| S31.33XA |
Puncture wound without foreign body of scrotum and testes, initial encounter |
| S31.34XA |
Puncture wound with foreign body of scrotum and testes, initial encounter |
| S31.35XA |
Open bite of scrotum and testes, initial encounter |
| S31.501A |
Unspecified open wound of unspecified external genital organs, male, initial encounter |
| S31.501S |
Unspecified open wound of unspecified external genital organs, male, sequela |
| S31.511A |
Laceration without foreign body of unspecified external genital organs, male, initial encounter |
| S31.511S |
Laceration without foreign body of unspecified external genital organs, male, sequela |
| S31.521A |
Laceration with foreign body of unspecified external genital organs, male, initial encounter |
| S31.521S |
Laceration with foreign body of unspecified external genital organs, male, sequela |
| S31.531A |
Puncture wound without foreign body of unspecified external genital organs, male, initial encounter |
| S31.531S |
Puncture wound without foreign body of unspecified external genital organs, male, sequela |
| S31.541A |
Puncture wound with foreign body of unspecified external genital organs, male, initial encounter |
| S31.541S |
Puncture wound with foreign body of unspecified external genital organs, male, sequela |
| S31.551A |
Open bite of unspecified external genital organs, male, initial encounter |
| S31.551S |
Open bite of unspecified external genital organs, male, sequela |
| S37.10XS |
Unspecified injury of ureter, sequela |
| S37.12XS |
Contusion of ureter, sequela |
| S37.13XS |
Laceration of ureter, sequela |
| S37.19XS |
Other injury of ureter, sequela |
| S37.20XS |
Unspecified injury of bladder, sequela |
| S37.22XS |
Contusion of bladder, sequela |
| S37.23XS |
Laceration of bladder, sequela |
| S37.29XS |
Other injury of bladder, sequela |
| S37.30XS |
Unspecified injury of urethra, sequela |
| S37.32XS |
Contusion of urethra, sequela |
| S37.33XS |
Laceration of urethra, sequela |
| S37.39XS |
Other injury of urethra, sequela |
| S37.812S |
Contusion of adrenal gland, sequela |
| S37.813S |
Laceration of adrenal gland, sequela |
| S37.818S |
Other injury of adrenal gland, sequela |
| S37.819S |
Unspecified injury of adrenal gland, sequela |
| S37.822A |
Contusion of prostate, initial encounter |
| S37.822S |
Contusion of prostate, sequela |
| S37.823A |
Laceration of prostate, initial encounter |
| S37.823S |
Laceration of prostate, sequela |
| S37.828A |
Other injury of prostate, initial encounter |
| S37.828S |
Other injury of prostate, sequela |
| S37.829A |
Unspecified injury of prostate, initial encounter |
| S37.829S |
Unspecified injury of prostate, sequela |
| S37.892A |
Contusion of other urinary and pelvic organ, initial encounter |
| S37.892S |
Contusion of other urinary and pelvic organ, sequela |
| S37.893A |
Laceration of other urinary and pelvic organ, initial encounter |
| S37.893S |
Laceration of other urinary and pelvic organ, sequela |
| S37.898A |
Other injury of other urinary and pelvic organ, initial encounter |
| S37.898S |
Other injury of other urinary and pelvic organ, sequela |
| S37.899A |
Unspecified injury of other urinary and pelvic organ, initial encounter |
| S37.899S |
Unspecified injury of other urinary and pelvic organ, sequela |
| S37.90XA |
Unspecified injury of unspecified urinary and pelvic organ, initial encounter |
| S37.90XS |
Unspecified injury of unspecified urinary and pelvic organ, sequela |
| S37.92XA |
Contusion of unspecified urinary and pelvic organ, initial encounter |
| S37.92XS |
Contusion of unspecified urinary and pelvic organ, sequela |
| S37.93XA |
Laceration of unspecified urinary and pelvic organ, initial encounter |
| S37.93XS |
Laceration of unspecified urinary and pelvic organ, sequela |
| S37.99XA |
Other injury of unspecified urinary and pelvic organ, initial encounter |
| S37.99XS |
Other injury of unspecified urinary and pelvic organ, sequela |
| S38.001A |
Crushing injury of unspecified external genital organs, male, initial encounter |
| S38.01XA |
Crushing injury of penis, initial encounter |
| S38.02XA |
Crushing injury of scrotum and testis, initial encounter |
| S38.221A |
Complete traumatic amputation of penis, initial encounter |
| S38.222A |
Partial traumatic amputation of penis, initial encounter |
| S38.231A |
Complete traumatic amputation of scrotum and testis, initial encounter |
| S38.232A |
Partial traumatic amputation of scrotum and testis, initial encounter |
| T19.4XXA |
Foreign body in penis, initial encounter |
| Z30.2 |
Encounter for sterilization |
| Z31.0 |
Encounter for reversal of previous sterilization |
| Z41.2 |
Encounter for routine and ritual male circumcision |
| Z90.79 |
Acquired absence of other genital organ(s) |
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.