TABLE 13A. PROPOSED COMPOSITION OF LOW-VOLUME QUINTILES FOR MS-LTC-DRGs FY 2018			
MS-LTC-DRG	MS-LTC-DRG Description		
Quintile 1			
055	Nervous system neoplasms w/o MCC		
065	Intracranial hemorrhage or cerebral infarction w CC or tPA in 24 hrs		
066	Intracranial hemorrhage or cerebral infarction w/o CC/MCC		
068	Nonspecific cva & precerebral occlusion w/o infarct w/o MCC		
072	Nonspecific cerebrovascular disorders w/o CC/MCC		
083	"Traumatic stupor & coma, coma >1 hr w CC"		
084	"Traumatic stupor & coma, coma >1 hr w/o CC/MCC"		
087	"Traumatic stupor & coma, coma <1 hr w/o CC/MCC"		
103	Headaches w/o MCC		
121	Acute major eye infections w CC/MCC		
123	Neurological eye disorders		
124	Other disorders of the eye w MCC		
125	Other disorders of the eye w/o MCC		
148	"Ear, nose, mouth & throat malignancy w/o CC/MCC"		
153	Otitis media & URI w/o MCC		
155	"Other ear, nose, mouth & throat diagnoses w CC"		
159	Dental & Oral Diseases w/o CC/MCC		
185	Major chest trauma w/o CC/MCC		
198	Interstitial lung disease w/o CC/MCC		
200	Pneumothorax w CC		
206	Other respiratory system diagnoses w/o MCC		
257	Upper limb & toe amputation for circ system disorders w/o CC/MCC		
265	AICD lead procedures		
282	"Acute myocardial infarction, discharged alive w/o CC/MCC"		
293	Heart failure & shock w/o CC/MCC		
294	Deep vein thrombophlebitis w CC/MCC		
301	Peripheral vascular disorders w/o CC/MCC		
303	Atherosclerosis w/o MCC		
310	Cardiac arrhythmia & conduction disorders w/o CC/MCC		
379	G.I. hemorrhage w/o CC/MCC		
381	Complicated peptic ulcer w CC		
446	Disorders of the biliary tract 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		
535	Fractures of hip & pelvis w MCC		
546	Connective tissue disorders w CC		
556	Signs & symptoms of musculoskeletal system & conn tissue w/o MCC		
562	"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC"		
581	"Other skin, subcut tiss & breast proc w/o CC/MCC"		
600	Non-malignant breast disorders w CC/MCC		
684	Renal failure w/o CC/MCC		
696	Kidney & urinary tract signs & symptoms w/o MCC		
697	Urethral stricture		
755	"Malignancy, female reproductive system w CC"		
756	"Malignancy, female reproductive system w/o CC/MCC"		
759	"Infections, female reproductive system w/o CC/MCC"		
841	Lymphoma & non-acute leukemia w CC		
914	Traumatic injury w/o MCC		
918	Poisoning & toxic effects of drugs w/o MCC		
928	Full thickness burn w skin graft or inhal inj w CC/MCC		
948	Signs & symptoms w/o MCC		
976	HIV w major related condition w/o CC/MCC		
Quintile 2			
059	Multiple sclerosis & cerebellar ataxia w CC		
077	Hypertensive encephalopathy w MCC		
093	Other disorders of nervous system w/o CC/MCC		
096	Bacterial & tuberculous infections of nervous system w/o CC/MCC		
098	Non-bacterial infect of nervous sys exc viral meningitis w CC		
099	Non-bacterial infect of nervous sys exc viral meningitis w/o CC/MCC		
101	Seizures w/o MCC		
176	Pulmonary embolism w/o MCC		
181	Respiratory neoplasms w CC		
187	Pleural effusion w CC		
192	Chronic obstructive pulmonary disease w/o CC/MCC		
195	Simple pneumonia & pleurisy w/o CC/MCC		
197	Interstitial lung disease w CC		
204	Respiratory signs & symptoms		
284	"Acute myocardial infarction, expired w CC"		
287	"Circulatory disorders except AMI, w card cath w/o MCC"		
290	Acute & subacute endocarditis w/o CC/MCC		
305	Hypertension w/o MCC		
309	Cardiac arrhythmia & conduction disorders w CC		
373	Major gastrointestinal disorders & peritoneal infections w/o CC/MCC		
383	Uncomplicated peptic ulcer w MCC		
406	"Pancreas, liver & shunt procedures w CC"		
408	Biliary tract proc except only cholecyst w or w/o c.d.e. w MCC		
424	Other hepatobiliary or pancreas O.R. procedures w CC		
440	Disorders of pancreas except malignancy w/o CC/MCC		
533	Fractures of femur w MCC		
534	Fractures of femur w/o MCC		
543	Pathological fractures & musculoskelet & conn tiss malig w CC		
553	Bone diseases & arthropathies w MCC		
554	Bone diseases & arthropathies w/o MCC		
563	"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC"		
575	Skin graft for skin ulcer or cellulitis w/o CC/MCC		
594	Skin ulcers w/o CC/MCC		
596	Major skin disorders w/o MCC		
605	"Trauma to the skin, subcut tiss & breast w/o MCC"		
607	Minor skin disorders w/o MCC		
642	Inborn and other disorders of metabolism		
644	Endocrine disorders w CC		
694	Urinary stones w/o esw lithotripsy w/o MCC		
723	"Malignancy, male reproductive system w CC"		
776	Postpartum & post abortion diagnoses w/o O.R. procedure		
812	Red blood cell disorders w/o MCC		
834	Acute leukemia w/o major O.R. procedure w MCC		
835	Acute leukemia w/o major O.R. procedure w CC		
837	Chemo w acute leukemia as sdx or w high dose chemo agent w MCC		
844	Other myeloprolif dis or poorly diff neopl diag w CC		
864	Fever		
866	Viral illness w/o MCC		
869	Other infectious & parasitic diseases diagnoses w/o CC/MCC		
921	Complications of treatment w/o CC/MCC		
934	Full thickness burn w/o skin grft or inhal inj		
935	Non-extensive burns		
941	O.R. proc w diagnoses of other contact w health services w/o CC/MCC		
Quintile 3			
041	Periph/cranial nerve & other nerv syst proc w CC or periph neurostim		
054	Nervous system neoplasms w MCC		
074	Cranial & peripheral nerve disorders w/o MCC		
075	Viral meningitis w CC/MCC		
102	Headaches w MCC		
147	"Ear, nose, mouth & throat malignancy w CC"		
154	"Other ear, nose, mouth & throat diagnoses w MCC"		
158	Dental & Oral Diseases w CC		
183	Major chest trauma w MCC		
201	Pneumothorax w/o CC/MCC		
258	Cardiac pacemaker device replacement w MCC		
307	Cardiac congenital & valvular disorders w/o MCC		
375	Digestive malignancy w CC		
378	G.I. hemorrhage w CC		
389	G.I. obstruction w CC		
395	Other digestive system diagnoses w/o CC/MCC		
405	"Pancreas, liver & shunt procedures w MCC"		
417	Laparoscopic cholecystectomy w/o c.d.e. w MCC		
433	Cirrhosis & alcoholic hepatitis w CC		
439	Disorders of pancreas except malignancy w CC		
445	Disorders of the biliary tract 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		
501	Soft tissue procedures w CC		
504	Foot procedures w CC		
516	Other musculoskelet sys & conn tiss O.R. proc w CC		
550	Septic arthritis w/o CC/MCC		
552	Medical back problems w/o MCC		
555	Signs & symptoms of musculoskeletal system & conn tissue w MCC		
571	Skin debridement w CC		
572	Skin debridement w/o CC/MCC		
580	"Other skin, subcut tiss & breast proc w CC"		
595	Major skin disorders w MCC		
643	Endocrine disorders w MCC		
685	Admit for renal dialysis		
686	Kidney & urinary tract neoplasms w MCC		
746	"Vagina, cervix & vulva procedures w CC/MCC"		
758	"Infections, female reproductive system w CC"		
802	Other O.R. proc of the blood & blood forming organs w MCC		
814	Reticuloendothelial & immunity disorders w MCC		
815	Reticuloendothelial & immunity disorders w CC		
843	Other myeloprolif dis or poorly diff neopl diag w MCC		
854	Infectious & parasitic diseases w O.R. procedure w CC		
868	Other infectious & parasitic diseases diagnoses w CC		
903	Wound debridements for injuries w/o CC/MCC		
906	Hand procedures for injuries		
913	Traumatic injury w MCC		
922	"Other injury, poisoning & toxic effect diag w MCC"		
933	Extensive burns or full thickness burns w MV >96 hrs w/o skin graft		
947	Signs & symptoms w MCC		
975	HIV w major related condition w CC		
977	HIV w or w/o other related condition		
Quintile 4			
069	Transient ischemia w/o thrombolytic		
129	Major head & neck procedures w CC/MCC or major device		
152	Otitis media & URI w MCC		
157	Dental & Oral Diseases w MCC		
164	Major chest procedures w CC		
240	Amputation for circ sys disorders exc upper limb & toe w CC		
242	Permanent cardiac pacemaker implant w MCC		
246	Percutaneous cardiovascular procedures w drug-eluting stent w MCC or 4+ arteries or stents		
255	Upper limb & toe amputation for circ system disorders w MCC		
256	Upper limb & toe amputation for circ system disorders w CC		
260	Cardiac pacemaker revision except device replacement w MCC		
263	Vein ligation & stripping		
271	Other major cardiovascular procedures w CC		
286	"Circulatory disorders except AMI, w card cath w MCC"		
312	Syncope & collapse		
330	Major small & large bowel procedures w CC		
357	Other digestive system O.R. procedures w CC		
368	Major esophageal disorders w MCC		
385	Inflammatory bowel disease w MCC		
386	Inflammatory bowel disease w CC		
471	Cervical spinal fusion w MCC		
475	Amputation for musculoskeletal sys & conn tissue dis w CC		
480	Hip & femur procedures except major joint w MCC		
492	"Lower extrem & humer proc except hip,foot,femur w MCC"		
493	"Lower extrem & humer proc except hip,foot,femur w CC"		
495	Local excision & removal int fix devices exc hip & femur w MCC		
503	Foot procedures w 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"		
545	Connective tissue disorders w MCC		
566	Other musculoskeletal sys & connective tissue diagnoses w/o CC/MCC		
574	Skin graft for skin ulcer or cellulitis w CC		
576	Skin graft exc for skin ulcer or cellulitis w MCC		
577	Skin graft exc for skin ulcer or cellulitis w CC		
629	"Other endocrine, nutrit & metab O.R. proc w CC"		
674	Other kidney & urinary tract procedures w CC		
687	Kidney & urinary tract neoplasms w CC		
693	Urinary stones w/o esw lithotripsy w MCC		
700	Other kidney & urinary tract diagnoses w/o CC/MCC		
717	Other male reproductive system O.R. proc exc malignancy w CC/MCC		
729	Other male reproductive system diagnoses w CC/MCC		
749	Other female reproductive system O.R. procedures w CC/MCC		
808	Major hematol/immun diag exc sickle cell crisis & coagul w MCC		
809	Major hematol/immun diag exc sickle cell crisis & coagul w CC		
813	Coagulation disorders		
849	Radiotherapy		
908	Other O.R. procedures for injuries w CC		
915	Allergic reactions w MCC		
923	"Other injury, poisoning & toxic effect diag w/o MCC"		
951	Other factors influencing health status		
964	Other multiple significant trauma w CC		
Quintile 5			
028	Spinal procedures w MCC		
031	Ventricular shunt procedures w MCC		
037	Extracranial procedures w MCC		
058	Multiple sclerosis & cerebellar ataxia w MCC		
073	Cranial & peripheral nerve disorders w MCC		
080	Nontraumatic stupor & coma w MCC		
133	"Other ear, nose, mouth & throat O.R. procedures w CC/MCC"		
168	Other resp system O.R. procedures w/o CC/MCC		
226	Cardiac defibrillator implant w/o cardiac cath w MCC		
245	AICD generator procedures		
248	Percutaneous cardiovascular procedures w non-drug-eluting stent w MCC or 4+ arteries or stents		
250	Perc cardiovasc proc w/o coronary artery stent w MCC		
253	Other vascular procedures w CC		
270	Other major cardiovascular procedures w MCC		
296	"Cardiac arrest, unexplained w MCC"		
304	Hypertension w MCC		
316	Other circulatory system diagnoses w/o CC/MCC		
326	"Stomach, esophageal & duodenal proc w MCC"		
329	Major small & large bowel procedures w MCC		
335	Peritoneal adhesiolysis w MCC		
341	Appendectomy w/o complicated principal diag w MCC		
344	Minor small & large bowel procedures w MCC		
347	Anal & stomal procedures w MCC		
354	Hernia procedures except inguinal & femoral w CC		
369	Major esophageal disorders w CC		
414	Cholecystectomy except by laparoscope w/o c.d.e. w MCC		
423	Other hepatobiliary or pancreas O.R. procedures w MCC		
435	Malignancy of hepatobiliary system or pancreas w MCC		
459	Spinal fusion except cervical w MCC		
477	Biopsies of musculoskeletal system & connective tissue w MCC		
478	Biopsies of musculoskeletal system & connective tissue w CC		
485	Knee procedures w pdx of infection w MCC		
486	Knee procedures w pdx of infection w CC		
518	Back & neck proc exc spinal fusion w MCC or disc device/neurostim		
542	Pathological fractures & musculoskelet & conn tiss malig w MCC		
616	"Amputat of lower limb for endocrine,nutrit,& metabol dis w MCC"		
617	"Amputat of lower limb for endocrine,nutrit,& metabol dis w CC"		
659	Kidney & ureter procedures for non-neoplasm w MCC		
660	Kidney & ureter procedures for non-neoplasm w CC		
665	Prostatectomy w MCC		
668	Transurethral procedures w MCC		
669	Transurethral procedures w CC		
695	Kidney & urinary tract signs & symptoms w MCC		
709	Penis procedures w CC/MCC		
754	"Malignancy, female reproductive system w MCC"		
846	Chemotherapy w/o acute leukemia as secondary diagnosis w MCC		
847	Chemotherapy w/o acute leukemia as secondary diagnosis w CC		
904	Skin grafts for injuries w CC/MCC		
957	Other O.R. procedures for multiple significant trauma w MCC		
963	Other multiple significant trauma w MCC		
969	HIV w extensive O.R. procedure w MCC		
988	Non-extensive O.R. proc unrelated to principal diagnosis w CC		
