TABLE 13A.COMPOSITION OF PROPOSED LOW-VOLUME QUINTILES FOR          MS-LTC-DRGsFY 2012		
Proposed MS-LTC-DRG	Proposed MS-LTC-DRG Description	
Quintile 1		
60	Multiple sclerosis & cerebellar ataxia w/o CC/MCC	
68	Nonspecific cva & precerebral occlusion w/o infarct w/o MCC	
81	Nontraumatic stupor & coma w/o MCC	
87	"Traumatic stupor & coma, coma <1 hr w/o CC/MCC"	
90	Concussion w/o CC/MCC	
93	Other disorders of nervous system w/o CC/MCC	
99	Non-bacterial infect of nervous sys exc viral meningitis w/o CC/MCC	
101	Seizures w/o MCC	
103	Headaches w/o MCC	
148	"Ear, nose, mouth & throat malignancy w/o CC/MCC"	
149	Dysequilibrium	
156	"Other ear, nose, mouth & throat diagnoses w/o CC/MCC"	
182	Respiratory neoplasms w/o CC/MCC	
185	Major chest trauma w/o CC/MCC	
198	Interstitial lung disease w/o CC/MCC	
201	Pneumothorax w/o CC/MCC	
203	Bronchitis & asthma w/o CC/MCC	
248	Perc cardiovasc proc w non-drug-eluting stent w MCC or 4+ ves/stents	
282	"Acute myocardial infarction, discharged alive w/o CC/MCC"	
305	Hypertension w/o MCC	
373	Major gastrointestinal disorders & peritoneal infections w/o CC/MCC	
376	Digestive malignancy w/o CC/MCC	
379	G.I. hemorrhage w/o CC/MCC	
381	Complicated peptic ulcer w CC	
387	Inflammatory bowel disease w/o CC/MCC	
390	G.I. obstruction w/o CC/MCC	
395	Other digestive system diagnoses w/o CC/MCC	
433	Cirrhosis & alcoholic hepatitis w CC	
440	Disorders of pancreas except malignancy w/o CC/MCC	
446	Disorders of the biliary tract w/o CC/MCC	
517	Other musculoskelet sys & conn tiss O.R. proc w/o CC/MCC	
534	Fractures of femur w/o MCC	
536	Fractures of hip & pelvis w/o MCC	
547	Connective tissue disorders w/o CC/MCC	
554	Bone diseases & arthropathies w/o MCC	
556	Signs & symptoms of musculoskeletal system & conn tissue w/o MCC	
639	Diabetes w/o CC/MCC	
642	Inborn and other disorders of metabolism	
645	Endocrine disorders w/o CC/MCC	
694	Urinary stones w/o esw lithotripsy w/o MCC	
696	Kidney & urinary tract signs & symptoms w/o MCC	
700	Other kidney & urinary tract diagnoses w/o CC/MCC	
707	Major male pelvic procedures w CC/MCC	
726	Benign prostatic hypertrophy w/o MCC	
730	Other male reproductive system diagnoses w/o CC/MCC	
759	"Infections, female reproductive system w/o CC/MCC"	
760	Menstrual & other female reproductive system disorders w CC/MCC	
781	Other antepartum diagnoses w medical complications	
830	Myeloprolif disord or poorly diff neopl w other O.R. proc w/o CC/MCC	
876	O.R. procedure w principal diagnoses of mental illness	
880	Acute adjustment reaction & psychosocial dysfunction	
881	Depressive neuroses	
886	Behavioral & developmental disorders	
894	"Alcohol/drug abuse or dependence, left ama"	
948	Signs & symptoms w/o MCC	
976	HIV w major related condition w/o CC/MCC	
Quintile 2		
55	Nervous system neoplasms w/o MCC	
59	Multiple sclerosis & cerebellar ataxia w CC	
66	Intracranial hemorrhage or cerebral infarction w/o CC/MCC	
72	Nonspecific cerebrovascular disorders w/o CC/MCC	
96	Bacterial & tuberculous infections of nervous system w/o CC/MCC	
122	Acute major eye infections w/o CC/MCC	
124	Other disorders of the eye w MCC	
135	Sinus & mastoid procedures w CC/MCC	
183	Major chest trauma w MCC	
188	Pleural effusion w/o CC/MCC	
234	Coronary bypass w cardiac cath w/o MCC	
241	Amputation for circ sys disorders exc upper limb & toe w/o CC/MCC	
284	"Acute myocardial infarction, expired w CC "	
287	"Circulatory disorders except AMI, w card cath w/o MCC"	
294	Deep vein thrombophlebitis w CC/MCC	
303	Atherosclerosis w/o MCC	
310	Cardiac arrhythmia & conduction disorders w/o CC/MCC	
327	"Stomach, esophageal & duodenal proc w CC"	
369	Major esophageal disorders w CC	
384	Uncomplicated peptic ulcer w/o MCC	
436	Malignancy of hepatobiliary system or pancreas w CC	
443	"Disorders of liver except malig,cirr,alc hepa w/o CC/MCC"	
472	Cervical spinal fusion w CC	
488	Knee procedures w/o pdx of infection w CC/MCC	
497	Local excision & removal int fix devices exc hip & femur w/o CC/MCC	
505	Foot procedures w/o CC/MCC	
509	Arthroscopy	
533	Fractures of femur w MCC	
544	Pathological fractures & musculoskelet & conn tiss malig w/o CC/MCC	
553	Bone diseases & arthropathies w MCC	
562	"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC"	
563	"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC"	
566	Other musculoskeletal sys & connective tissue diagnoses w/o CC/MCC	
578	Skin graft exc for skin ulcer or cellulitis w/o CC/MCC 	
581	"Other skin, subcut tiss & breast proc w/o CC/MCC"	
620	O.R. procedures for obesity w CC	
624	"Skin grafts & wound debrid for endoc, nutrit & metab dis w/o CC/MCC"	
644	Endocrine disorders w CC	
663	Minor bladder procedures w CC	
709	Penis procedures w CC/MCC	
722	"Malignancy, male reproductive system w MCC"	
746	"Vagina, cervix & vulva procedures w CC/MCC"	
755	"Malignancy, female reproductive system w CC"	
815	Reticuloendothelial & immunity disorders w CC	
836	Acute leukemia w/o major O.R. procedure w/o CC/MCC	
842	Lymphoma & non-acute leukemia w/o CC/MCC	
844	Other myeloprolif dis or poorly diff neopl diag w CC	
864	Fever 	
869	Other infectious & parasitic diseases diagnoses w/o CC/MCC	
882	Neuroses except depressive	
895	Alcohol/drug abuse or dependence w rehabilitation therapy	
918	Poisoning & toxic effects of drugs w/o MCC	
941	O.R. proc w diagnoses of other contact w health services w/o CC/MCC	
983	Extensive O.R. procedure unrelated to principal diagnosis w/o CC/MCC	
989	Non-extensive O.R. proc unrelated to principal diagnosis w/o CC/MCC	
Quintile 3		
23	Cranio w major dev impl/acute complex cns pdx w MCC or chemo implant	
32	Ventricular shunt procedures w CC	
34	Carotid artery stent procedure w MCC	
58	Multiple sclerosis & cerebellar ataxia w MCC	
69	Transient ischemia	
75	Viral meningitis w CC/MCC	
78	Hypertensive encephalopathy w CC	
80	Nontraumatic stupor & coma w MCC	
98	Non-bacterial infect of nervous sys exc viral meningitis w CC	
115	Extraocular procedures except orbit	
121	Acute major eye infections w CC/MCC	
125	Other disorders of the eye w/o MCC	
147	"Ear, nose, mouth & throat malignancy w CC"	
153	Otitis media & URI w/o MCC	
257	Upper limb & toe amputation for circ system disorders w/o CC/MCC	
260	Cardiac pacemaker revision except device replacement w MCC	
304	Hypertension w MCC	
312	Syncope & collapse	
348	Anal & stomal procedures w CC	
358	Other digestive system O.R. procedures w/o CC/MCC	
386	Inflammatory bowel disease w CC	
465	"Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w/o CC/MCC"	
476	Amputation for musculoskeletal sys & conn tissue dis w/o CC/MCC	
502	Soft tissue procedures w/o CC/MCC	
535	Fractures of hip & pelvis w MCC	
555	Signs & symptoms of musculoskeletal system & conn tissue w MCC	
582	Mastectomy for malignancy w CC/MCC	
584	"Breast biopsy, local excision & other breast procedures w CC/MCC"	
597	Malignant breast disorders w MCC	
598	Malignant breast disorders w CC	
600	Non-malignant breast disorders w CC/MCC	
618	"Amputat of lower limb for endocrine,nutrit,& metabol dis w/o CC/MCC"	
668	Transurethral procedures w MCC	
669	Transurethral procedures w CC	
685	Admit for renal dialysis	
686	Kidney & urinary tract neoplasms w MCC	
687	Kidney & urinary tract neoplasms w CC	
691	Urinary stones w esw lithotripsy w CC/MCC	
711	Testes procedures w CC/MCC	
723	"Malignancy, male reproductive system w CC"	
749	Other female reproductive system O.R. procedures w CC/MCC	
776	Postpartum & post abortion diagnoses w/o O.R. procedure	
809	Major hematol/immun diag exc sickle cell crisis & coagul w CC	
810	Major hematol/immun diag exc sickle cell crisis & coagul w/o CC/MCC	
835	Acute leukemia w/o major O.R. procedure w CC	
843	Other myeloprolif dis or poorly diff neopl diag w MCC	
858	Postoperative or post-traumatic infections w O.R. proc w/o CC/MCC	
866	Viral illness w/o MCC	
883	Disorders of personality & impulse control	
903	Wound debridements for injuries w/o CC/MCC	
905	Skin grafts for injuries w/o CC/MCC	
909	Other O.R. procedures for injuries w/o CC/MCC	
917	Poisoning & toxic effects of drugs w MCC	
923	"Other injury, poisoning & toxic effect diag w/o MCC"	
933	Extensive burns or full thickness burns w MV 96+ hrs w/o skin graft	
Quintile 4		
25	Craniotomy & endovascular intracranial procedures w MCC	
29	Spinal procedures w CC or spinal neurostimulators 	
38	Extracranial procedures w CC	
67	Nonspecific cva & precerebral occlusion w/o infarct w MCC	
77	Hypertensive encephalopathy w MCC	
82	"Traumatic stupor & coma, coma >1 hr w MCC"	
83	"Traumatic stupor & coma, coma >1 hr w CC"	
159	Dental & Oral Diseases w/o CC/MCC	
164	Major chest procedures w CC	
237	Major cardiovasc procedures w MCC	
238	Major cardiovasc procedures w/o MCC	
242	Permanent cardiac pacemaker implant w MCC	
243	Permanent cardiac pacemaker implant w CC	
250	Perc cardiovasc proc w/o coronary artery stent w MCC	
254	Other vascular procedures w/o CC/MCC	
311	Angina pectoris	
330	Major small & large bowel procedures w CC	
383	Uncomplicated peptic ulcer w MCC	
406	"Pancreas, liver & shunt procedures w CC"	
417	Laparoscopic cholecystectomy w/o c.d.e. w MCC	
423	Other hepatobiliary or pancreas O.R. procedures w MCC	
424	Other hepatobiliary or pancreas O.R. procedures w CC	
471	Cervical spinal fusion w MCC	
478	Biopsies of musculoskeletal system & connective tissue w CC	
483	Major joint & limb reattachment proc of upper extremity w CC/MCC	
486	Knee procedures w pdx of infection w CC	
490	Back & neck proc exc spinal fusion w CC/MCC or disc device/neurostim	
493	"Lower extrem & humer proc except hip,foot,femur w CC"	
494	"Lower extrem & humer proc except hip,foot,femur w/o CC/MCC"	
498	Local excision & removal int fix devices of hip & femur w CC/MCC	
507	Major shoulder or elbow joint procedures w CC/MCC	
510	"Shoulder,elbow or forearm proc,exc major joint proc w MCC"	
513	"Hand or wrist proc, except major thumb or joint proc w CC/MCC"	
516	Other musculoskelet sys & conn tiss O.R. proc w CC	
537	"Sprains, strains, & dislocations of hip, pelvis & thigh w CC/MCC"	
575	Skin graft for skin ulcer or cellulitis w/o CC/MCC	
577	Skin graft exc for skin ulcer or cellulitis w CC 	
630	"Other endocrine, nutrit & metab O.R. proc w/o CC/MCC"	
653	Major bladder procedures w MCC	
656	Kidney & ureter procedures for neoplasm w MCC	
659	Kidney & ureter procedures for non-neoplasm w MCC	
660	Kidney & ureter procedures for non-neoplasm w CC	
662	Minor bladder procedures w MCC	
665	Prostatectomy w MCC	
675	Other kidney & urinary tract procedures w/o CC/MCC	
693	Urinary stones w/o esw lithotripsy w MCC	
802	Other O.R. proc of the blood & blood forming organs w MCC	
808	Major hematol/immun diag exc sickle cell crisis & coagul w MCC	
824	Lymphoma & non-acute leukemia w other O.R. proc w CC	
847	Chemotherapy w/o acute leukemia as secondary diagnosis w CC	
855	Infectious & parasitic diseases w O.R. procedure w/o CC/MCC	
922	"Other injury, poisoning & toxic effect diag w MCC"	
928	Full thickness burn w skin graft or inhal inj w CC/MCC	
963	Other multiple significant trauma w MCC	
964	Other multiple significant trauma w CC	
985	Prostatic O.R. procedure unrelated to principal diagnosis w CC	
Quintile 5		
11	"Tracheostomy for face,mouth & neck diagnoses w MCC"	
28	Spinal procedures w MCC	
31	Ventricular shunt procedures w MCC	
37	Extracranial procedures w MCC	
53	Spinal disorders & injuries w/o CC/MCC	
165	Major chest procedures w/o CC/MCC	
168	Other resp system O.R. procedures w/o CC/MCC	
226	Cardiac defibrillator implant w/o cardiac cath w MCC	
227	Cardiac defibrillator implant w/o cardiac cath w/o MCC	
245	AICD generator procedures	
246	Perc cardiovasc proc w drug-eluting stent w MCC or 4+ vessels/stents	
251	Perc cardiovasc proc w/o coronary artery stent w/o MCC	
258	Cardiac pacemaker device replacement w MCC	
259	Cardiac pacemaker device replacement w/o MCC	
261	Cardiac pacemaker revision except device replacement w CC	
286	"Circulatory disorders except AMI, w card cath w MCC"	
326	"Stomach, esophageal & duodenal proc w MCC"	
332	Rectal resection w MCC	
335	Peritoneal adhesiolysis w MCC	
336	Peritoneal adhesiolysis w CC	
338	Appendectomy w complicated principal diag w MCC	
344	Minor small & large bowel procedures w MCC	
347	Anal & stomal procedures w MCC	
353	Hernia procedures except inguinal & femoral w MCC	
405	"Pancreas, liver & shunt procedures w MCC"	
408	Biliary tract proc except only cholecyst w or w/o c.d.e. w MCC	
414	Cholecystectomy except by laparoscope w/o c.d.e. w MCC	
453	Combined anterior/posterior spinal fusion w MCC	
454	Combined anterior/posterior spinal fusion w CC	
459	Spinal fusion except cervical w MCC	
460	Spinal fusion except cervical w/o MCC	
466	Revision of hip or knee replacement w MCC	
467	Revision of hip or knee replacement w CC	
468	Revision of hip or knee replacement w/o CC/MCC	
469	Major joint replacement or reattachment of lower extremity w MCC	
470	Major joint replacement or reattachment of lower extremity w/o MCC	
480	Hip & femur procedures except major joint w MCC	
481	Hip & femur procedures except major joint w CC	
485	Knee procedures w pdx of infection w MCC	
492	"Lower extrem & humer proc except hip,foot,femur w MCC"	
576	Skin graft exc for skin ulcer or cellulitis w MCC	
619	O.R. procedures for obesity w MCC	
671	Urethral procedures w CC/MCC	
695	Kidney & urinary tract signs & symptoms w MCC	
713	Transurethral prostatectomy w CC/MCC	
717	Other male reproductive system O.R. proc exc malignancy w CC/MCC	
799	Splenectomy w MCC	
803	Other O.R. proc of the blood & blood forming organs w CC	
823	Lymphoma & non-acute leukemia w other O.R. proc w MCC	
827	Myeloprolif disord or poorly diff neopl w maj O.R. proc w CC	
829	Myeloprolif disord or poorly diff neopl w other O.R. proc w CC/MCC	
906	Hand procedures for injuries	
958	Other O.R. procedures for multiple significant trauma w CC	
969	HIV w extensive O.R. procedure w MCC	
984	Prostatic O.R. procedure unrelated to principal diagnosis w MCC	
		
*  Initial composition of proposed low-volume quintiles prior to adjusting for nonmonotonicity (as discussed in step 6 in section VII.B.3.g. of the preamble of this proposed rule).  Any adjustments to the proposed low-volume quintile assignments to address nonmonotonicity are identified in Table 11 of the Addendum of this proposed rule.		
		
		
		
		
		
		
