TABLE 13A.PROPOSED COMPOSITION OF LOW-VOLUME QUINTILES FOR MS-LTC-DRGsFY 2015	
MS-LTC-DRG	MS-LTC-DRG Description
 Quintile 1	
060	Multiple sclerosis & cerebellar ataxia w/o CC/MCC
069	Transient ischemia
072	Nonspecific cerebrovascular disorders w/o CC/MCC
076	Viral meningitis w/o CC/MCC
078	Hypertensive encephalopathy w CC
080	Nontraumatic stupor & coma w MCC
081	Nontraumatic stupor & coma w/o MCC
087	"Traumatic stupor & coma, coma <1 hr w/o CC/MCC"
125	Other disorders of the eye w/o MCC
182	Respiratory neoplasms w/o CC/MCC
183	Major chest trauma w MCC
184	Major chest trauma w CC
188	Pleural effusion 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
259	Cardiac pacemaker device replacement w/o MCC
282	"Acute myocardial infarction, discharged alive w/o CC/MCC"
284	"Acute myocardial infarction, expired w CC"
310	Cardiac arrhythmia & conduction disorders w/o CC/MCC
311	Angina pectoris
376	Digestive malignancy w/o CC/MCC
379	G.I. hemorrhage w/o CC/MCC
382	Complicated peptic ulcer w/o CC/MCC
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
446	Disorders of the biliary tract w/o CC/MCC
534	Fractures of femur w/o MCC
536	Fractures of hip & pelvis w/o MCC
544	Pathological fractures & musculoskelet & conn tiss malig w/o CC/MCC
547	Connective tissue disorders w/o CC/MCC
556	Signs & symptoms of musculoskeletal system & conn tissue w/o MCC
572	Skin debridement w/o CC/MCC
598	Malignant breast disorders w CC
601	Non-malignant breast disorders w/o CC/MCC
618	"Amputat of lower limb for endocrine,nutrit,& metabol dis w/o CC/MCC"
639	Diabetes w/o CC/MCC
645	Endocrine disorders w/o CC/MCC
663	Minor bladder procedures w CC
675	Other kidney & urinary tract procedures w/o CC/MCC
684	Renal failure w/o CC/MCC
687	Kidney & urinary tract neoplasms w CC
694	Urinary stones w/o esw lithotripsy w/o MCC
696	Kidney & urinary tract signs & symptoms w/o MCC
697	Urethral stricture
700	Other kidney & urinary tract diagnoses w/o CC/MCC
730	Other male reproductive system diagnoses w/o CC/MCC
836	Acute leukemia w/o major O.R. procedure w/o CC/MCC
869	Other infectious & parasitic diseases diagnoses w/o CC/MCC
880	Acute adjustment reaction & psychosocial dysfunction
886	Behavioral & developmental disorders
894	"Alcohol/drug abuse or dependence, left ama"
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
918	Poisoning & toxic effects of drugs w/o MCC
983	Extensive O.R. procedure unrelated to principal diagnosis w/o CC/MCC
 Quintile 2	
055	Nervous system neoplasms w/o MCC
059	Multiple sclerosis & cerebellar ataxia w CC
084	"Traumatic stupor & coma, coma >1 hr w/o CC/MCC"
093	Other disorders of nervous system w/o CC/MCC
096	Bacterial & tuberculous infections of nervous system w/o CC/MCC
099	Non-bacterial infect of nervous sys exc viral meningitis w/o CC/MCC
101	Seizures w/o MCC
103	Headaches w/o MCC
121	Acute major eye infections w CC/MCC
153	Otitis media & URI w/o MCC
156	"Other ear, nose, mouth & throat diagnoses w/o CC/MCC"
158	Dental & Oral Diseases w CC
181	Respiratory neoplasms w CC
187	Pleural effusion w CC
200	Pneumothorax w CC
241	Amputation for circ sys disorders exc upper limb & toe w/o CC/MCC
290	Acute & subacute endocarditis w/o CC/MCC
301	Peripheral vascular disorders w/o CC/MCC
304	Hypertension w MCC
305	Hypertension w/o MCC
307	Cardiac congenital & valvular disorders w/o MCC
312	Syncope & collapse
316	Other circulatory system diagnoses w/o CC/MCC
373	Major gastrointestinal disorders & peritoneal infections w/o CC/MCC
375	Digestive malignancy w CC
384	Uncomplicated peptic ulcer w/o MCC
386	Inflammatory bowel disease w CC
440	Disorders of pancreas except malignancy w/o CC/MCC
476	Amputation for musculoskeletal sys & conn tissue dis w/o CC/MCC
506	Major thumb or joint procedures
535	Fractures of hip & pelvis w MCC
543	Pathological fractures & musculoskelet & conn tiss malig w CC
554	Bone diseases & arthropathies w/o 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
585	"Breast biopsy, local excision & other breast procedures w/o CC/MCC"
594	Skin ulcers w/o CC/MCC
597	Malignant breast disorders w MCC
624	"Skin grafts & wound debrid for endoc, nutrit & metab dis w/o CC/MCC"
642	Inborn and other disorders of metabolism
644	Endocrine disorders w CC
660	Kidney & ureter procedures for non-neoplasm w CC
669	Transurethral procedures w CC
686	Kidney & urinary tract neoplasms w MCC
693	Urinary stones w/o esw lithotripsy w MCC
695	Kidney & urinary tract signs & symptoms w MCC
726	Benign prostatic hypertrophy w/o MCC
759	"Infections, female reproductive system w/o CC/MCC"
835	Acute leukemia w/o major O.R. procedure w CC
866	Viral illness w/o MCC
881	Depressive neuroses
882	Neuroses except depressive
883	Disorders of personality & impulse control
897	Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC
915	Allergic reactions w MCC
921	Complications of treatment w/o CC/MCC
923	"Other injury, poisoning & toxic effect diag w/o MCC"
976	HIV w major related condition w/o CC/MCC
986	Prostatic O.R. procedure unrelated to principal diagnosis w/o CC/MCC
 Quintile 3	
038	Extracranial procedures w CC
054	Nervous system neoplasms w MCC
058	Multiple sclerosis & cerebellar ataxia w MCC
066	Intracranial hemorrhage or cerebral infarction w/o CC/MCC
075	Viral meningitis w CC/MCC
083	"Traumatic stupor & coma, coma >1 hr w CC"
102	Headaches w MCC
124	Other disorders of the eye w MCC
129	Major head & neck procedures w CC/MCC or major device
131	Cranial/facial procedures w CC/MCC
147	"Ear, nose, mouth & throat malignancy w CC"
148	"Ear, nose, mouth & throat malignancy w/o CC/MCC"
149	Dysequilibrium
168	Other resp system O.R. procedures w/o CC/MCC
238	Major cardiovasc procedures w/o MCC
243	Permanent cardiac pacemaker implant w CC
244	Permanent cardiac pacemaker implant w/o CC/MCC
249	Perc cardiovasc proc w non-drug-eluting stent w/o MCC
251	Perc cardiovasc proc w/o coronary artery stent w/o MCC
257	Upper limb & toe amputation for circ system disorders w/o CC/MCC
263	Vein ligation & stripping
294	Deep vein thrombophlebitis w CC/MCC
313	Chest pain
327	"Stomach, esophageal & duodenal proc w CC"
347	Anal & stomal procedures w MCC
369	Major esophageal disorders w CC
381	Complicated peptic ulcer w CC
418	Laparoscopic cholecystectomy w/o c.d.e. w CC
435	Malignancy of hepatobiliary system or pancreas w MCC
443	"Disorders of liver except malig,cirr,alc hepa w/o CC/MCC"
465	"Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w/o CC/MCC"
488	Knee procedures w/o pdx of infection w CC/MCC
493	"Lower extrem & humer proc except hip,foot,femur w CC"
502	Soft tissue procedures w/o CC/MCC
505	Foot procedures w/o CC/MCC
513	"Hand or wrist proc, except major thumb or joint proc w CC/MCC"
519	Back & neck proc exc spinal fusion w CC
546	Connective tissue disorders w CC
555	Signs & symptoms of musculoskeletal system & conn tissue w MCC
577	Skin graft exc for skin ulcer or cellulitis w CC
581	"Other skin, subcut tiss & breast proc w/o CC/MCC"
630	"Other endocrine, nutrit & metab O.R. proc w/o CC/MCC"
691	Urinary stones w esw lithotripsy w CC/MCC
725	Benign prostatic hypertrophy w MCC
754	"Malignancy, female reproductive system w MCC"
803	Other O.R. proc of the blood & blood forming organs w CC
809	Major hematol/immun diag exc sickle cell crisis & coagul w CC
815	Reticuloendothelial & immunity disorders w CC
841	Lymphoma & non-acute leukemia w CC
844	Other myeloprolif dis or poorly diff neopl diag w CC
858	Postoperative or post-traumatic infections w O.R. proc w/o CC/MCC
864	Fever
876	O.R. procedure w principal diagnoses of mental illness
896	Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC
917	Poisoning & toxic effects of drugs w MCC
928	Full thickness burn w skin graft or inhal inj w CC/MCC
941	O.R. proc w diagnoses of other contact w health services w/o CC/MCC
965	Other multiple significant trauma w/o CC/MCC
970	HIV w extensive O.R. procedure w/o MCC
 Quintile 4	
016	Autologous bone marrow transplant w CC/MCC
025	Craniotomy & endovascular intracranial procedures w MCC
029	Spinal procedures w CC or spinal neurostimulators
077	Hypertensive encephalopathy w MCC
082	"Traumatic stupor & coma, coma >1 hr w MCC"
133	"Other ear, nose, mouth & throat O.R. procedures w CC/MCC"
216	Cardiac valve & oth maj cardiothoracic proc w card cath w MCC
248	Perc cardiovasc proc w non-drug-eluting stent w MCC or 4+ ves/stents
256	Upper limb & toe amputation for circ system disorders w CC
287	"Circulatory disorders except AMI, w card cath w/o MCC"
328	"Stomach, esophageal & duodenal proc w/o CC/MCC"
330	Major small & large bowel procedures w CC
348	Anal & stomal procedures w CC
358	Other digestive system O.R. procedures w/o CC/MCC
368	Major esophageal disorders w MCC
383	Uncomplicated peptic ulcer w MCC
456	Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w MCC
469	Major joint replacement or reattachment of lower extremity w MCC
483	Major joint/limb reattachment procedure of upper extremities
487	Knee procedures w pdx of infection w/o CC/MCC
509	Arthroscopy
516	Other musculoskelet sys & conn tiss O.R. proc w CC
517	Other musculoskelet sys & conn tiss O.R. proc w/o CC/MCC
553	Bone diseases & arthropathies w MCC
575	Skin graft for skin ulcer or cellulitis w/o CC/MCC
584	"Breast biopsy, local excision & other breast procedures w CC/MCC"
662	Minor bladder procedures w MCC
666	Prostatectomy w CC
668	Transurethral procedures w MCC
671	Urethral procedures w CC/MCC
685	Admit for renal dialysis
688	Kidney & urinary tract neoplasms w/o CC/MCC
709	Penis procedures w CC/MCC
711	Testes procedures w CC/MCC
712	Testes procedures w/o CC/MCC
713	Transurethral prostatectomy w CC/MCC
717	Other male reproductive system O.R. proc exc malignancy w CC/MCC
722	"Malignancy, male reproductive system w MCC"
723	"Malignancy, male reproductive system w CC"
749	Other female reproductive system O.R. procedures w CC/MCC
755	"Malignancy, female reproductive system w CC"
760	Menstrual & other female reproductive system disorders w CC/MCC
769	Postpartum & post abortion diagnoses w O.R. procedure
776	Postpartum & post abortion diagnoses w/o O.R. procedure
802	Other O.R. proc of the blood & blood forming organs w MCC
814	Reticuloendothelial & immunity disorders w MCC
829	Myeloprolif disord or poorly diff neopl w other O.R. proc w CC/MCC
834	Acute leukemia w/o major O.R. procedure w MCC
837	Chemo w acute leukemia as sdx or w high dose chemo agent w MCC
838	Chemo w acute leukemia as sdx w CC or high dose chemo agent
843	Other myeloprolif dis or poorly diff neopl diag w MCC
855	Infectious & parasitic diseases w O.R. procedure w/o CC/MCC
906	Hand procedures for injuries
922	"Other injury, poisoning & toxic effect diag w MCC"
933	Extensive burns or full thickness burns w MV 96+ hrs w/o skin graft
957	Other O.R. procedures for multiple significant trauma w MCC
958	Other O.R. procedures for multiple significant trauma w CC
964	Other multiple significant trauma w CC
989	Non-extensive O.R. proc unrelated to principal diagnosis w/o CC/MCC
 Quintile 5	
011	"Tracheostomy for face,mouth & neck diagnoses w MCC"
012	"Tracheostomy for face,mouth & neck diagnoses w CC"
027	Craniotomy & endovascular intracranial procedures w/o CC/MCC
028	Spinal procedures w MCC
031	Ventricular shunt procedures w MCC
037	Extracranial procedures w MCC
053	Spinal disorders & injuries w/o CC/MCC
113	Orbital procedures w CC/MCC
137	Mouth procedures w CC/MCC
159	Dental & Oral Diseases w/o CC/MCC
164	Major chest procedures w CC
226	Cardiac defibrillator implant w/o cardiac cath w MCC
227	Cardiac defibrillator implant w/o cardiac cath w/o MCC
237	Major cardiovasc procedures w MCC
242	Permanent cardiac pacemaker implant w MCC
250	Perc cardiovasc proc w/o coronary artery stent w MCC
260	Cardiac pacemaker revision except device replacement w MCC
286	"Circulatory disorders except AMI, w card cath w MCC"
329	Major small & large bowel procedures w MCC
335	Peritoneal adhesiolysis w MCC
336	Peritoneal adhesiolysis w CC
344	Minor small & large bowel procedures 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
411	Cholecystectomy w c.d.e. w MCC
414	Cholecystectomy except by laparoscope w/o c.d.e. w MCC
417	Laparoscopic cholecystectomy w/o c.d.e. w MCC
420	Hepatobiliary diagnostic procedures w MCC
423	Other hepatobiliary or pancreas O.R. procedures w MCC
436	Malignancy of hepatobiliary system or pancreas w CC
453	Combined anterior/posterior spinal fusion w MCC
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
472	Cervical spinal fusion w CC
478	Biopsies of musculoskeletal system & connective tissue w CC
479	Biopsies of musculoskeletal system & connective tissue w/o CC/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
486	Knee procedures w pdx of infection w CC
492	"Lower extrem & humer proc except hip,foot,femur w MCC"
497	Local excision & removal int fix devices exc hip & 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"
518	Back & neck proc exc spinal fusion w MCC or disc device/neurostim
533	Fractures of femur w MCC
576	Skin graft exc for skin ulcer or cellulitis w MCC
619	O.R. procedures for obesity w MCC
659	Kidney & ureter procedures for non-neoplasm w MCC
665	Prostatectomy w MCC
744	"D&C, conization, laparoscopy & tubal interruption w CC/MCC"
746	"Vagina, cervix & vulva procedures w CC/MCC"
823	Lymphoma & non-acute leukemia w other O.R. proc w MCC
963	Other multiple significant trauma w MCC
969	HIV w extensive O.R. procedure w MCC
984	Prostatic O.R. procedure unrelated to principal diagnosis w MCC
985	Prostatic O.R. procedure unrelated to principal diagnosis w CC
