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DRG Detail - Tricare

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					                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments
103        001      PR S        001       Heart transplant or implant of heart
                                          assist system w MCC
           002                  002       Heart transplant or implant of heart
                                          assist system w/o MCC


541        003      PR   S      003       ECMO or trach w MV 96+ hrs or PDX
                                          exc face, mouth & neck w maj O.R.



542        004      PR   S      004       Trach w MV 96+ hrs or PDX exc face,
                                          mouth & neck w/o maj O.R.


480        005      PR   S      005       Liver transplant w MCC or intestinal
                                          transplant
           006                  006       Liver transplant w/o MCC


495        007      PR   S      007       Lung transplant


512        008      PR   S      008       Simultaneous pancreas/kidney
                                          transplant



481        009      PR   S      009       Bone marrow transplant



513        010      PR   S      010       Pancreas transplant



482        011      PR   S      011       Tracheostomy for face,mouth & neck
                                          diagnoses w MCC
           012                  012       Tracheostomy for face,mouth & neck
                                          diagnoses w CC
           013                  013       Tracheostomy for face,mouth & neck
                                          diagnoses w/o CC/MCC


528        020      01   S      020       Intracranial vascular procedures w
                                          PDX hemorrhage w MCC



      5/16/2012                                                                                        1
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments
           021                  021       Intracranial vascular procedures w
                                          PDX hemorrhage w CC
           022                  022       Intracranial vascular procedures w
                                          PDX hemorrhage w/o CC/MCC

543        023      01   S      023       Cranio w major dev impl/acute
                                          complex CNS PDX w MCC or chemo
                                          implant
           024                  024       Cranio w major dev impl/acute
                                          complex CNS PDX w/o MCC


001        025      01   S      025       Craniotomy & endovascular             age split
                                          intracranial procedures age >17 w
                                          MCC
002        026                  026       Craniotomy & endovascular             age split
                                          intracranial procedures age >17 w
                                          CC
           027                  027       Craniotomy & endovascular             age split
                                          intracranial procedures age >17 w/o
                                          CC/MCC

003        025      01   S      104       Craniotomy, ventricular shunt &       age split
                                          endovasc intracranial proc age 0-17
           026                                                                  New TRIS-DRG 104 will be below TRIS-DRGs
                                                                                023/024 and above TRIS-DRG 028-030 in the surgical
                                                                                hierarchy
           027
           031
           032
           033


531        028      01   S      028       Spinal procedures w MCC
532        029                  029       Spinal procedures w CC or spinal
                                          neurostimulators
           030                  030       Spinal procedures w/o CC/MCC

529        031      01   S      031       Ventricular shunt procedures age >17 age split
                                          w MCC
530        032                  032       Ventricular shunt procedures age >17 age split
                                          w CC
           033                  033       Ventricular shunt procedures age >17 age split
                                          w/o CC/MCC




      5/16/2012                                                                                                                      2
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                     Comments
577        034      01  S       034       Carotid artery stent procedure w
                                          MCC
           035                  035       Carotid artery stent procedure w CC

           036                  036       Carotid artery stent procedure w/o
                                          CC/MCC

533        037      01   S      037       Extracranial procedures w MCC
534        038                  038       Extracranial procedures w CC
           039                  039       Extracranial procedures w/o CC/MCC


006        040      01   S      040       Periph/cranial nerve & other nerv syst
                                          proc w MCC
007        041                  041       Periph/cranial nerve & other nerv syst
                                          proc w CC or periph neurostim
008        042                  042       Periph/cranial nerve & other nerv syst
                                          proc w/o CC/MCC

009        052      01   M      052       Spinal disorders & injuries w
                                          CC/MCC
           053                  053       Spinal disorders & injuries w/o
                                          CC/MCC


010        054      01   M      054       Nervous system neoplasms w MCC
011        055                  055       Nervous system neoplasms w/o MCC



012        056      01   M      056       Degenerative nervous system
                                          disorders w MCC
           057                  057       Degenerative nervous system
                                          disorders w/o MCC


013        058      01   M      058       Multiple sclerosis & cerebellar ataxia
                                          w MCC
           059                  059       Multiple sclerosis & cerebellar ataxia
                                          w CC
           060                  060       Multiple sclerosis & cerebellar ataxia
                                          w/o CC/MCC

559        061      01   M      061       Acute ischemic stroke w use of
                                          thrombolytic agent w MCC




      5/16/2012                                                                                         3
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments
           062                  062       Acute ischemic stroke w use of
                                          thrombolytic agent w CC
           063                  063       Acute ischemic stroke w use of
                                          thrombolytic agent w/o CC/MCC

014        064      01   M      064       Intracranial hemorrhage or cerebral
                                          infarction w MCC
           065                  065       Intracranial hemorrhage or cerebral
                                          infarction w CC
           066                  066       Intracranial hemorrhage or cerebral
                                          infarction w/o CC/MCC

015        067      01   M      067       Nonspecific cva & precerebral
                                          occlusion w/o infarct w MCC
           068                  068       Nonspecific cva & precerebral
                                          occlusion w/o infarct w/o MCC


524        069      01   M      069       Transient ischemia



016        070      01   M      070       Nonspecific cerebrovascular
                                          disorders w MCC
017        071                  071       Nonspecific cerebrovascular
                                          disorders w CC
           072                  072       Nonspecific cerebrovascular
                                          disorders w/o CC/MCC

018        073      01   M      073       Cranial & peripheral nerve disorders
                                          w MCC
019        074                  074       Cranial & peripheral nerve disorders
                                          w/o MCC


021        075      01   M      075       Viral meningitis w CC/MCC
           076                  076       Viral meningitis w/o CC/MCC


022        077      01   M      077       Hypertensive encephalopathy w MCC

           078                  078       Hypertensive encephalopathy w CC
           079                  079       Hypertensive encephalopathy w/o
                                          CC/MCC




      5/16/2012                                                                                       4
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions             Comments
023        080      01  M       080       Nontraumatic stupor & coma w MCC

           081                  081       Nontraumatic stupor & coma w/o
                                          MCC


027        082      01   M      082       Traumatic stupor & coma, coma >1
                                          hr w MCC
           083                  083       Traumatic stupor & coma, coma >1
                                          hr w CC
           084                  084       Traumatic stupor & coma, coma >1
                                          hr w/o CC/MCC

028        085      01   M      085       Traumatic stupor & coma, coma <1        age split
                                          hr age >17 w MCC
029        086                  086       Traumatic stupor & coma, coma <1        age split
                                          hr age >17 w CC
           087                  087       Traumatic stupor & coma, coma <1        age split
                                          hr age >17 w/o CC/MCC

030        085      01   M      105       Traumatic stupor & coma, coma <1        age split
                                          hr age 0-17
           086
           087


031        088      01   M      088       Concussion age >17 w MCC                age split
032        089                  089       Concussion age >17 w CC                 age split
           090                  090       Concussion age >17 w/o CC/MCC           age split

033        088      01   M      106       Concussion age 0-17                     age split
           089
           090


034        091      01   M      091       Other disorders of nervous system w
                                          MCC
035        092                  092       Other disorders of nervous system w
                                          CC
           093                  093       Other disorders of nervous system
                                          w/o CC/MCC

560        094      01   M      094       Bacterial & tuberculous infections of
                                          nervous system w MCC
           095                  095       Bacterial & tuberculous infections of
                                          nervous system w CC



      5/16/2012                                                                                        5
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments
           096                  096       Bacterial & tuberculous infections of
                                          nervous system w/o CC/MCC

561        097      01   M      097       Non-bacterial infect of nervous sys
                                          exc viral meningitis w MCC
           098                  098       Non-bacterial infect of nervous sys
                                          exc viral meningitis w CC
           099                  099       Non-bacterial infect of nervous sys
                                          exc viral meningitis w/o CC/MCC

562        100      01   M      100       Seizures age >17 w MCC                  age split
563        101                  101       Seizures age >17 w/o MCC                age split


564        102      01   M      102       Headaches age >17 w MCC                 age split
           103                  103       Headaches age >17 w/o MCC               age split


026        100      01   M      107       Seizures & headaches age 0-17           age split
           101
           102
           103


037        113      02   S      113       Orbital procedures w CC/MCC
           114                  114       Orbital procedures w/o CC/MCC


040        115      02   S      115       Extraocular procedures except orbit     age split
                                          age >17


041        115      02   S      108       Extraocular procedures except orbit     age split
                                          age 0-17


036        116      02   S      116       Intraocular procedures w CC/MCC
038        117                  117       Intraocular procedures w/o CC/MCC

039
042


044        121      02   M      121       Acute major eye infections w
                                          CC/MCC




      5/16/2012                                                                                        6
                                                                       TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments
           122                  122       Acute major eye infections w/o
                                          CC/MCC


045        123      02   M      123       Neurological eye disorders



043        124      02   M      124       Other disorders of the eye age >17 w age split
                                          MCC
046        125                  125       Other disorders of the eye age >17   age split
                                          w/o MCC
047
048

043        124      02   M      109       Other disorders of the eye age 0-17   age split
046        125
047
048

049        129      03   S      129       Major head & neck procedures w
                                          CC/MCC or major device
           130                  130       Major head & neck procedures w/o
                                          CC/MCC


580        131      03   S      131       Cranial/facial procedures w CC/MCC

           132                  132       Cranial/facial procedures w/o
                                          CC/MCC


052        133      03   S      133       Other ear, nose, mouth & throat O.R. age split
                                          procedures age >17 w CC/MCC

055        134                  134       Other ear, nose, mouth & throat O.R. age split
                                          procedures age >17 w/o CC/MCC

056
057
058
059
060
061
062
063



      5/16/2012                                                                                          7
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                 Comments


052        133      03   S      110       Other ear, nose, mouth & throat O.R. age split
                                          procedures age 0-17
055        134
056
057
058
059
060
061
062
063




053        135      03   S      135       Sinus & mastoid procedures age >17 age split
                                          w CC/MCC
           136                  136       Sinus & mastoid procedures age >17 age split
                                          w/o CC/MCC


054        135      03   S      111       Sinus & mastoid procedures age 0-    age split
                                          17
           136


168        137      03   S      137       Mouth procedures w CC/MCC
169        138                  138       Mouth procedures w/o CC/MCC


050        139      03   S      139       Salivary gland procedures
051


064        146      03   M      146       Ear, nose, mouth & throat
                                          malignancy w MCC
           147                  147       Ear, nose, mouth & throat
                                          malignancy w CC
           148                  148       Ear, nose, mouth & throat
                                          malignancy w/o CC/MCC



      5/16/2012                                                                                         8
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                Comments

065        149      03   M      149       Dysequilibrium



066        150      03   M      150       Epistaxis w MCC
           151                  151       Epistaxis w/o MCC


067        152      03   M      152       Otitis media & URI age >17 w MCC age split
068        153                  153       Otitis media & URI age >17 w/o MCC age split

069
070
071


067        152      03   M      112       Otitis media & URI age 0-17         age split
068        153
069
070
071


72         154      03   M      154       Other ear, nose, mouth & throat     age split
                                          diagnoses age >17 w MCC
73         155                  155       Other ear, nose, mouth & throat     age split
                                          diagnoses age >17 w CC
74         156                  156       Other ear, nose, mouth & throat     age split
                                          diagnoses age >17 w/o CC/MCC


72         154      03   M      118       Other ear, nose, mouth & throat     age split
                                          diagnoses age 0-17
73         155
74         156


185        157      03   M      157       Dental & Oral Diseases age >17 w   age split
                                          MCC
186        158                  158       Dental & Oral Diseases age >17 w   age split
                                          CC
187        159                  159       Dental & Oral Diseases age >17 w/o age split
                                          CC/MCC




      5/16/2012                                                                                       9
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                Comments
185        157      03  M       119       Dental & Oral Diseases age 0-17     age split
186        158
187        159

075        163      04   S      163       Major chest procedures w MCC
           164                  164       Major chest procedures w CC
           165                  165       Major chest procedures w/o CC/MCC



076        166      04   S      166       Other resp system O.R. procedures
                                          w MCC
077        167                  167       Other resp system O.R. procedures
                                          w CC
           168                  168       Other resp system O.R. procedures
                                          w/o CC/MCC


078        175      04   M      175       Pulmonary embolism w MCC
           176                  176       Pulmonary embolism w/o MCC


079        177      04   M      177       Respiratory infections &         age split
                                          inflammations age >17 w MCC
080        178                  178       Respiratory infections &         age split
                                          inflammations age >17 w CC
           179                  179       Respiratory infections &         age split
                                          inflammations age >17 w/o CC/MCC



081        177      04   M      120       Respiratory infections &            age split
                                          inflammations age 0-17
           178
           179


082        180      04   M      180       Respiratory neoplasms w MCC
           181                  181       Respiratory neoplasms w CC
           182                  182       Respiratory neoplasms w/o CC/MCC



083        183      04   M      183       Major chest trauma w MCC
084        184                  184       Major chest trauma w CC
           185                  185       Major chest trauma w/o CC/MCC



      5/16/2012                                                                                        10
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments


085        186      04   M      186       Pleural effusion w MCC
086        187                  187       Pleural effusion w CC
           188                  188       Pleural effusion w/o CC/MCC


087        189      04   M      189       Pulmonary edema & respiratory
                                          failure



088        190      04   M      190       Chronic obstructive pulmonary
                                          disease w MCC
           191                  191       Chronic obstructive pulmonary
                                          disease w CC
           192                  192       Chronic obstructive pulmonary
                                          disease w/o CC/MCC


089        193      04   M      193       Simple pneumonia & pleurisy age        age split
                                          >17 w MCC
090        194                  194       Simple pneumonia & pleurisy age        age split
                                          >17 w CC
           195                  195       Simple pneumonia & pleurisy age        age split
                                          >17 w/o CC/MCC


091        193      04   M      140       Simple pneumonia & pleurisy age 0-     age split
                                          17
           194
           195



092        196      04   M      196       Interstitial lung disease w MCC
093        197                  197       Interstitial lung disease w CC
           198                  198       Interstitial lung disease w/o CC/MCC



094        199      04   M      199       Pneumothorax w MCC
095        200                  200       Pneumothorax w CC
           201                  201       Pneumothorax w/o CC/MCC




      5/16/2012                                                                                       11
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments
096        202      04  M       202       Bronchitis & asthma age >17 w          age split
                                          CC/MCC
097        203                  203       Bronchitis & asthma age >17 w/o        age split
                                          CC/MCC


098        202      04    M     141       Bronchitis & asthma age 0-17           age split
           203


099        204      04    M     204       Respiratory signs & symptoms
100


101        205      04    M     205       Other respiratory system diagnoses
                                          w MCC
102        206                  206       Other respiratory system diagnoses
                                          w/o MCC


565        207      04    M     207       Respiratory system diagnosis w
                                          ventilator support 96+ hours


566        208      04    M     208       Respiratory system diagnosis w
                                          ventilator support <96 hours


631                      4 M    608       BPD & oth chronic respiratory          age split
                                          diseases arising in perinatal period


632                      4 M    609       Other respiratory problems after birth age split



525        215      05    S     215       Other heart assist system implant


104        216      05    S     216       Cardiac valve & oth maj
                                          cardiothoracic proc w card cath w
                                          MCC
           217                  217       Cardiac valve & oth maj
                                          cardiothoracic proc w card cath w CC




      5/16/2012                                                                                        12
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments
           218                  218       Cardiac valve & oth maj
                                          cardiothoracic proc w card cath w/o
                                          CC/MCC

105        219      05   S      219       Cardiac valve & oth maj
                                          cardiothoracic proc w/o card cath w
                                          MCC
           220                  220       Cardiac valve & oth maj
                                          cardiothoracic proc w/o card cath w
                                          CC
           221                  221       Cardiac valve & oth maj
                                          cardiothoracic proc w/o card cath w/o
                                          CC/MCC


535        222      05   S      222       Cardiac defib implant w cardiac cath
                                          w AMI/HF/shock w MCC
           223                  223       Cardiac defib implant w cardiac cath
                                          w AMI/HF/shock w/o MCC


536        224      05   S      224       Cardiac defib implant w cardiac cath
                                          w/o AMI/HF/shock w MCC
           225                  225       Cardiac defib implant w cardiac cath
                                          w/o AMI/HF/shock w/o MCC


515        226      05   S      226       Cardiac defibrillator implant w/o
                                          cardiac cath w MCC
           227                  227       Cardiac defibrillator implant w/o
                                          cardiac cath w/o MCC


108        228      05   S      228       Other cardiothoracic procedures w
                                          MCC
           229                  229       Other cardiothoracic procedures w
                                          CC
           230                  230       Other cardiothoracic procedures w/o
                                          CC/MCC

106        231      05   S      231       Coronary bypass w PTCA w MCC
           232                  232       Coronary bypass w PTCA w/o MCC


547        233      05   S      233       Coronary bypass w cardiac cath w
                                          MCC



      5/16/2012                                                                                         13
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments
548        234                  234       Coronary bypass w cardiac cath w/o
                                          MCC


549        235      05    S     235       Coronary bypass w/o cardiac cath w
                                          MCC
550        236                  236       Coronary bypass w/o cardiac cath
                                          w/o MCC


110        237      05    S     237       Major cardiovasc procedures w MCC
                                          or thoracic aortic aneurysm repair

111        238                  238       Major cardiovasc procedures w/o
                                          MCC


113        239      05    S     239       Amputation for circ sys disorders exc
                                          upper limb & toe w MCC
           240                  240       Amputation for circ sys disorders exc
                                          upper limb & toe w CC
           241                  241       Amputation for circ sys disorders exc
                                          upper limb & toe w/o CC/MCC


551        242      05    S     242       Permanent cardiac pacemaker
                                          implant w MCC
552        243                  243       Permanent cardiac pacemaker
                                          implant w CC
           244                  244       Permanent cardiac pacemaker
                                          implant w/o CC/MCC

551        245      05    S     245       AICD generator procedures               This DRG is carved out of TRICARE 551


551        265           5 S    265       AICD lead procedures                    This DRG is carved out of TRICARE 551


557        246      05    S     246       Perc cardiovasc proc w drug-eluting
                                          stent w MCC or 4+ vessels/stents
558        247                  247       Perc cardiovasc proc w drug-eluting
                                          stent w/o MCC




      5/16/2012                                                                                                           14
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                 Comments
555        248      05  S       248       Perc cardiovasc proc w non-drug-
                                          eluting stent w MCC or 4+ ves/stents

556        249                  249       Perc cardiovasc proc w non-drug-
                                          eluting stent w/o MCC


518        250      05   S      250       Perc cardiovasc proc w/o coronary
                                          artery stent w MCC
           251                  251       Perc cardiovasc proc w/o coronary
                                          artery stent w/o MCC


479        252      05   S      252       Other vascular procedures w MCC
553        253                  253       Other vascular procedures w CC
554        254                  254       Other vascular procedures w/o
                                          CC/MCC


114        255      05   S      255       Upper limb & toe amputation for circ
                                          system disorders w MCC
           256                  256       Upper limb & toe amputation for circ
                                          system disorders w CC
           257                  257       Upper limb & toe amputation for circ
                                          system disorders w/o CC/MCC


118        258      05   S      258       Cardiac pacemaker device
                                          replacement w MCC
           259                  259       Cardiac pacemaker device
                                          replacement w/o MCC


117        260      05   S      260       Cardiac pacemaker revision except
                                          device replacement w MCC
           261                  261       Cardiac pacemaker revision except
                                          device replacement w CC
           262                  262       Cardiac pacemaker revision except
                                          device replacement w/o CC/MCC

119        263      05   S      263       Vein ligation & stripping


120        264      05   S      264       Other circulatory system O.R.
                                          procedures




      5/16/2012                                                                                         15
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments

121        280      05   M      280       Acute myocardial infarction,
                                          discharged alive w MCC
122        281                  281       Acute myocardial infarction,
                                          discharged alive w CC
           282                  282       Acute myocardial infarction,
                                          discharged alive w/o CC/MCC


123        283      05   M      283       Acute myocardial infarction, expired
                                          w MCC
           284                  284       Acute myocardial infarction, expired
                                          w CC
           285                  285       Acute myocardial infarction, expired
                                          w/o CC/MCC


124        286      05   M      286       Circulatory disorders except AMI, w
                                          card cath w MCC
125        287                  287       Circulatory disorders except AMI, w
                                          card cath w/o MCC


126        288      05   M      288       Acute & subacute endocarditis w
                                          MCC
           289                  289       Acute & subacute endocarditis w CC

           290                  290       Acute & subacute endocarditis w/o
                                          CC/MCC


127        291      05   M      291       Heart failure & shock w MCC
           292                  292       Heart failure & shock w CC
           293                  293       Heart failure & shock w/o CC/MCC

128        294      05   M      294       Deep vein thrombophlebitis w
                                          CC/MCC
           295                  295       Deep vein thrombophlebitis w/o
                                          CC/MCC


129        296      05   M      296       Cardiac arrest, unexplained w MCC
           297                  297       Cardiac arrest, unexplained w CC
           298                  298       Cardiac arrest, unexplained w/o
                                          CC/MCC




      5/16/2012                                                                                        16
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments

130        299      05   M      299       Peripheral vascular disorders w MCC

131        300                  300       Peripheral vascular disorders w CC
           301                  301       Peripheral vascular disorders w/o
                                          CC/MCC


132        302      05   M      302       Atherosclerosis w MCC
133        303                  303       Atherosclerosis w/o MCC


134        304      05   M      304       Hypertension w MCC
           305                  305       Hypertension w/o MCC


135        306      05   M      306       Cardiac congenital & valvular         age split
                                          disorders age >17 w MCC
136        307                  307       Cardiac congenital & valvular         age split
                                          disorders age >17 w/o MCC


137        306      05   M      142       Cardiac congenital & valvular         age split
                                          disorders age 0-17
           307


138        308      05   M      308       Cardiac arrhythmia & conduction
                                          disorders w MCC
139        309                  309       Cardiac arrhythmia & conduction
                                          disorders w CC
           310                  310       Cardiac arrhythmia & conduction
                                          disorders w/o CC/MCC


140        311      05   M      311       Angina pectoris


141        312      05   M      312       Syncope & collapse
142


143        313      05   M      313       Chest pain




      5/16/2012                                                                                       17
                                                                   TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                 Comments
144        314      05  M       314       Other circulatory system diagnoses w
                                          MCC
145        315                  315       Other circulatory system diagnoses w
                                          CC
           316                  316       Other circulatory system diagnoses
                                          w/o CC/MCC


155        326      06   S      326       Stomach, esophageal & duodenal         age split
                                          proc age >17 w MCC
567        327                  327       Stomach, esophageal & duodenal         age split
                                          proc age >17 w CC
568        328                  328       Stomach, esophageal & duodenal         age split
                                          proc age >17 w/o CC/MCC


156        326      06   S      143       Stomach, esophageal & duodenal         age split
                                          proc age 0-17
           327
           328


149        329      06   S      329       Major small & large bowel procedures
                                          w MCC
569        330                  330       Major small & large bowel procedures
                                          w CC
570        331                  331       Major small & large bowel procedures
                                          w/o CC/MCC


146        332      06   S      332       Rectal resection w MCC
147        333                  333       Rectal resection w CC
           334                  334       Rectal resection w/o CC/MCC


150        335      06   S      335       Peritoneal adhesiolysis w MCC
151        336                  336       Peritoneal adhesiolysis w CC
           337                  337       Peritoneal adhesiolysis w/o CC/MCC



164        338      06   S      338       Appendectomy w complicated
                                          principal diag w MCC
165        339                  339       Appendectomy w complicated
                                          principal diag w CC




      5/16/2012                                                                                      18
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments
           340                  340       Appendectomy w complicated
                                          principal diag w/o CC/MCC


166        341      06   S      341       Appendectomy w/o complicated
                                          principal diag w MCC
167        342                  342       Appendectomy w/o complicated
                                          principal diag w CC
           343                  343       Appendectomy w/o complicated
                                          principal diag w/o CC/MCC


152        344      06   S      344       Minor small & large bowel procedures
                                          w MCC
153        345                  345       Minor small & large bowel procedures
                                          w CC
           346                  346       Minor small & large bowel procedures
                                          w/o CC/MCC


157        347      06   S      347       Anal & stomal procedures w MCC
158        348                  348       Anal & stomal procedures w CC
           349                  349       Anal & stomal procedures w/o
                                          CC/MCC


161        350      06   S      350       Inguinal & femoral hernia procedures age split
                                          age >17 w MCC
162        351                  351       Inguinal & femoral hernia procedures age split
                                          age >17 w CC
           352                  352       Inguinal & femoral hernia procedures age split
                                          age >17 w/o CC/MCC


159        353      06   S      353       Hernia procedures except inguinal &    age split
                                          femoral age >17 w MCC
160        354                  354       Hernia procedures except inguinal &    age split
                                          femoral age >17 w CC
           355                  355       Hernia procedures except inguinal &    age split
                                          femoral age >17 w/o CC/MCC


163        350      06   S      144       Hernia procedures age 0-17             age split
           351
           352
           353



      5/16/2012                                                                                       19
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                 Comments
           354
           355


170        356      06   S      356       Other digestive system O.R.
                                          procedures w MCC
171        357                  357       Other digestive system O.R.
                                          procedures w CC
           358                  358       Other digestive system O.R.
                                          procedures w/o CC/MCC


571        368      06   M      368       Major esophageal disorders w MCC
           369                  369       Major esophageal disorders w CC
           370                  370       Major esophageal disorders w/o
                                          CC/MCC


572        371      06   M      371       Major gastrointestinal disorders &
                                          peritoneal infections w MCC
           372                  372       Major gastrointestinal disorders &
                                          peritoneal infections w CC
           373                  373       Major gastrointestinal disorders &
                                          peritoneal infections w/o CC/MCC


172        374      06   M      374       Digestive malignancy w MCC
173        375                  375       Digestive malignancy w CC
           376                  376       Digestive malignancy w/o CC/MCC


174        377      06   M      377       G.I. hemorrhage w MCC
175        378                  378       G.I. hemorrhage w CC
           379                  379       G.I. hemorrhage w/o CC/MCC


176        380      06   M      380       Complicated peptic ulcer w MCC
           381                  381       Complicated peptic ulcer w CC
           382                  382       Complicated peptic ulcer w/o
                                          CC/MCC


177        383      06   M      383       Uncomplicated peptic ulcer w MCC
178        384                  384       Uncomplicated peptic ulcer w/o MCC




      5/16/2012                                                                                        20
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments

179        385      06   M      385       Inflammatory bowel disease w MCC
           386                  386       Inflammatory bowel disease w CC
           387                  387       Inflammatory bowel disease w/o
                                          CC/MCC


180        388      06   M      388       G.I. obstruction w MCC
181        389                  389       G.I. obstruction w CC
           390                  390       G.I. obstruction w/o CC/MCC


182        391      06   M      391       Esophagitis, gastroent & misc digest age split
                                          disorders age >17 w MCC
183        392                  392       Esophagitis, gastroent & misc digest age split
                                          disorders age >17 w/o MCC


184        391      06   M      145       Esophagitis, gastroent & misc digest age split
                                          disorders age 0-17
           392


188        393      06   M      393       Other digestive system diagnoses       age split
                                          age >17 w MCC
189        394                  394       Other digestive system diagnoses       age split
                                          age >17 w CC
           395                  395       Other digestive system diagnoses       age split
                                          age >17 w/o CC/MCC


190        393      06   M      160       Other digestive system diagnoses       age split
                                          age 0-17
           394
           395


191        405      07   S      405       Pancreas, liver & shunt procedures w
                                          MCC
192        406                  406       Pancreas, liver & shunt procedures w
                                          CC
           407                  407       Pancreas, liver & shunt procedures
                                          w/o CC/MCC




      5/16/2012                                                                                       21
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments
193        408      07  S       408       Biliary tract proc except only
                                          cholecyst w or w/o c.d.e. w MCC
194        409                  409       Biliary tract proc except only
                                          cholecyst w or w/o c.d.e. w CC
           410                  410       Biliary tract proc except only
                                          cholecyst w or w/o c.d.e. w/o
                                          CC/MCC


195        411      07   S      411       Cholecystectomy w c.d.e. w MCC
196        412                  412       Cholecystectomy w c.d.e. w CC
           413                  413       Cholecystectomy w c.d.e. w/o
                                          CC/MCC


197        414      07   S      414       Cholecystectomy except by
                                          laparoscope w/o c.d.e. w MCC
198        415                  415       Cholecystectomy except by
                                          laparoscope w/o c.d.e. w CC
           416                  416       Cholecystectomy except by
                                          laparoscope w/o c.d.e. w/o CC/MCC



493        417      07   S      417       Laparoscopic cholecystectomy w/o
                                          c.d.e. w MCC
494        418                  418       Laparoscopic cholecystectomy w/o
                                          c.d.e. w CC
           419                  419       Laparoscopic cholecystectomy w/o
                                          c.d.e. w/o CC/MCC


199        420      07   S      420       Hepatobiliary diagnostic procedures
                                          w MCC
200        421                  421       Hepatobiliary diagnostic procedures
                                          w CC
           422                  422       Hepatobiliary diagnostic procedures
                                          w/o CC/MCC


201        423      07   S      423       Other hepatobiliary or pancreas O.R.
                                          procedures w MCC
           424                  424       Other hepatobiliary or pancreas O.R.
                                          procedures w CC
           425                  425       Other hepatobiliary or pancreas O.R.
                                          procedures w/o CC/MCC



      5/16/2012                                                                                       22
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                       Comments


202        432      07   M      432       Cirrhosis & alcoholic hepatitis w MCC

           433                  433       Cirrhosis & alcoholic hepatitis w CC

           434                  434       Cirrhosis & alcoholic hepatitis w/o
                                          CC/MCC


203        435      07   M      435       Malignancy of hepatobiliary system or
                                          pancreas w MCC
           436                  436       Malignancy of hepatobiliary system or
                                          pancreas w CC
           437                  437       Malignancy of hepatobiliary system or
                                          pancreas w/o CC/MCC


204        438      07   M      438       Disorders of pancreas except
                                          malignancy w MCC
           439                  439       Disorders of pancreas except
                                          malignancy w CC
           440                  440       Disorders of pancreas except
                                          malignancy w/o CC/MCC


205        441      07   M      441       Disorders of liver except malig,cirr,alc
                                          hepa w MCC
206        442                  442       Disorders of liver except malig,cirr,alc
                                          hepa w CC
           443                  443       Disorders of liver except malig,cirr,alc
                                          hepa w/o CC/MCC


207        444      07   M      444       Disorders of the biliary tract w MCC
208        445                  445       Disorders of the biliary tract w CC
           446                  446       Disorders of the biliary tract w/o
                                          CC/MCC


496        453      08   S      453       Combined anterior/posterior spinal
                                          fusion w MCC
           454                  454       Combined anterior/posterior spinal
                                          fusion w CC
           455                  455       Combined anterior/posterior spinal
                                          fusion w/o CC/MCC



      5/16/2012                                                                                         23
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                      Comments


546        456      08   S      456       Spinal fus exc cerv w spinal
                                          curv/malig/infec or 9+ fus w MCC
           457                  457       Spinal fus exc cerv w spinal
                                          curv/malig/infec or 9+ fus w CC
           458                  458       Spinal fus exc cerv w spinal
                                          curv/malig/infec or 9+ fus w/o
                                          CC/MCC


497        459      08   S      459       Spinal fusion except cervical w MCC

498        460                  460       Spinal fusion except cervical w/o
                                          MCC


471        461      08   S      461       Bilateral or multiple major joint procs
                                          of lower extremity w MCC
           462                  462       Bilateral or multiple major joint procs
                                          of lower extremity w/o MCC


217        463      08   S      463       Wnd debrid & skn grft exc hand, for
                                          musculo-conn tiss dis w MCC
           464                  464       Wnd debrid & skn grft exc hand, for
                                          musculo-conn tiss dis w CC
           465                  465       Wnd debrid & skn grft exc hand, for
                                          musculo-conn tiss dis w/o CC/MCC


545        466      08   S      466       Revision of hip or knee replacement
                                          w MCC
           467                  467       Revision of hip or knee replacement
                                          w CC
           468                  468       Revision of hip or knee replacement
                                          w/o CC/MCC


544        469      08   S      469       Major joint replacement or
                                          reattachment of lower extremity w
                                          MCC
           470                  470       Major joint replacement or
                                          reattachment of lower extremity w/o
                                          MCC




      5/16/2012                                                                                         24
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments

519        471      08   S      471       Cervical spinal fusion w MCC
520        472                  472       Cervical spinal fusion w CC
           473                  473       Cervical spinal fusion w/o CC/MCC


213        474      08   S      474       Amputation for musculoskeletal sys &
                                          conn tissue dis w MCC
           475                  475       Amputation for musculoskeletal sys &
                                          conn tissue dis w CC
           476                  476       Amputation for musculoskeletal sys &
                                          conn tissue dis w/o CC/MCC


216        477      08   S      477       Biopsies of musculoskeletal system
                                          & connective tissue w MCC
           478                  478       Biopsies of musculoskeletal system
                                          & connective tissue w CC
           479                  479       Biopsies of musculoskeletal system
                                          & connective tissue w/o CC/MCC



210        480      08   S      480       Hip & femur procedures except major age split
                                          joint age >17 w MCC
211        481                  481       Hip & femur procedures except major age split
                                          joint age >17 w CC
           482                  482       Hip & femur procedures except major age split
                                          joint age >17 w/o CC/MCC


212                             161       Hip & femur procedures except major age split
                                          joint age 0-17


491        483      08   S      483       Major joint & limb reattachment proc
                                          of upper extremity w CC/MCC
           484                  484       Major joint & limb reattachment proc
                                          of upper extremity w/o CC/MCC



501        485      08   S      485       Knee procedures w pdx of infection w
                                          MCC
502        486                  486       Knee procedures w pdx of infection w
                                          CC



      5/16/2012                                                                                       25
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments
           487                  487       Knee procedures w pdx of infection
                                          w/o CC/MCC


503        488      08   S      488       Knee procedures w/o pdx of infection
                                          w CC/MCC
           489                  489       Knee procedures w/o pdx of infection
                                          w/o CC/MCC


499        490      08   S      490       Back & neck proc exc spinal fusion w
                                          CC/MCC or disc device/neurostim

500        491                  491       Back & neck proc exc spinal fusion
                                          w/o CC/MCC


218        492      08   S      492       Lower extrem & humer proc except  age split
                                          hip,foot,femur age >17 w MCC
219        493                  493       Lower extrem & humer proc except  age split
                                          hip,foot,femur age >17 w CC
           494                  494       Lower extrem & humer proc except  age split
                                          hip,foot,femur age >17 w/o CC/MCC



220                 08   S      162       Lower extrem & humer proc except       age split
                                          hip,foot,femur age 0-17


537        495      08   S      495       Local excision & removal int fix
                                          devices exc hip & femur w MCC
538        496                  496       Local excision & removal int fix
                                          devices exc hip & femur w CC
           497                  497       Local excision & removal int fix
                                          devices exc hip & femur w/o CC/MCC


230        498      08   S      498       Local excision & removal int fix
                                          devices of hip & femur w CC/MCC
           499                  499       Local excision & removal int fix
                                          devices of hip & femur w/o CC/MCC


226        500      08   S      500       Soft tissue procedures w MCC
227        501                  501       Soft tissue procedures w CC



      5/16/2012                                                                                       26
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments
           502                  502       Soft tissue procedures w/o CC/MCC



225        503      08   S      503       Foot procedures w MCC
           504                  504       Foot procedures w CC
           505                  505       Foot procedures w/o CC/MCC


228        506      08   S      506       Major thumb or joint procedures


223        507      08   S      507       Major shoulder or elbow joint
                                          procedures w CC/MCC
           508                  508       Major shoulder or elbow joint
                                          procedures w/o CC/MCC


232        509      08   S      509       Arthroscopy



224        510      08   S      510       Shoulder,elbow or forearm proc,exc
                                          major joint proc w MCC
           511                  511       Shoulder,elbow or forearm proc,exc
                                          major joint proc w CC
           512                  512       Shoulder,elbow or forearm proc,exc
                                          major joint proc w/o CC/MCC


229        513      08   S      513       Hand or wrist proc, except major
                                          thumb or joint proc w CC/MCC
           514                  514       Hand or wrist proc, except major
                                          thumb or joint proc w/o CC/MCC


233        515      08   S      515       Other musculoskelet sys & conn tiss
                                          O.R. proc w MCC
234        516                  516       Other musculoskelet sys & conn tiss
                                          O.R. proc w CC
           517                  517       Other musculoskelet sys & conn tiss
                                          O.R. proc w/o CC/MCC


235        533      08   M      533       Fractures of femur w MCC
           534                  534       Fractures of femur w/o MCC



      5/16/2012                                                                                        27
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                       Comments


236        535      08   M      535       Fractures of hip & pelvis w MCC
           536                  536       Fractures of hip & pelvis w/o MCC


237        537      08   M      537       Sprains, strains, & dislocations of hip,
                                          pelvis & thigh w CC/MCC
           538                  538       Sprains, strains, & dislocations of hip,
                                          pelvis & thigh w/o CC/MCC


238        539      08   M      539       Osteomyelitis w MCC
           540                  540       Osteomyelitis w CC
           541                  541       Osteomyelitis w/o CC/MCC


239        542      08   M      542       Pathological fractures &
                                          musculoskelet & conn tiss malig w
                                          MCC
           543                  543       Pathological fractures &
                                          musculoskelet & conn tiss malig w
                                          CC
           544                  544       Pathological fractures &
                                          musculoskelet & conn tiss malig w/o
                                          CC/MCC


240        545      08   M      545       Connective tissue disorders w MCC
241        546                  546       Connective tissue disorders w CC
           547                  547       Connective tissue disorders w/o
                                          CC/MCC


242        548      08   M      548       Septic arthritis w MCC
           549                  549       Septic arthritis w CC
           550                  550       Septic arthritis w/o CC/MCC


243        551      08   M      551       Medical back problems w MCC
           552                  552       Medical back problems w/o MCC


244        553      08   M      553       Bone diseases & arthropathies w
                                          MCC




      5/16/2012                                                                                         28
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments
245        554                  554       Bone diseases & arthropathies w/o
                                          MCC
246


247        555      08   M      555       Signs & symptoms of
                                          musculoskeletal system & conn
                                          tissue w MCC
           556                  556       Signs & symptoms of
                                          musculoskeletal system & conn
                                          tissue w/o MCC


248        557      08   M      557       Tendonitis, myositis & bursitis w
                                          MCC
           558                  558       Tendonitis, myositis & bursitis w/o
                                          MCC


249        559      08   M      559       Aftercare, musculoskeletal system &
                                          connective tissue w MCC
           560                  560       Aftercare, musculoskeletal system &
                                          connective tissue w CC
           561                  561       Aftercare, musculoskeletal system &
                                          connective tissue w/o CC/MCC


250        562      08   M      562       Fx, sprn, strn & disl except femur, age split
                                          hip, pelvis & thigh age >17 w MCC
251        563                  563       Fx, sprn, strn & disl except femur, age split
                                          hip, pelvis & thigh age >17 w/o MCC

253
254

252                 08   M      169       Fx, sprn, strn & disl except femur,   age split
                                          hip, pelvis & thigh age 0-17
255


256        564      08   M      564       Other musculoskeletal sys &
                                          connective tissue diagnoses w MCC

           565                  565       Other musculoskeletal sys &
                                          connective tissue diagnoses w CC




      5/16/2012                                                                                         29
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                      Comments
           566                  566       Other musculoskeletal sys &
                                          connective tissue diagnoses w/o
                                          CC/MCC

263        573      09   S      573       Skin graft &/or debrid for skn ulcer or
                                          cellulitis w MCC
264        574                  574       Skin graft &/or debrid for skn ulcer or
                                          cellulitis w CC
           575                  575       Skin graft &/or debrid for skn ulcer or
                                          cellulitis w/o CC/MCC


265        576      09   S      576       Skin graft &/or debrid exc for skin
                                          ulcer or cellulitis w MCC
266        577                  577       Skin graft &/or debrid exc for skin
                                          ulcer or cellulitis w CC
           578                  578       Skin graft &/or debrid exc for skin
                                          ulcer or cellulitis w/o CC/MCC


267        579      09   S      579       Other skin, subcut tiss & breast proc
                                          w MCC
268        580                  580       Other skin, subcut tiss & breast proc
                                          w CC
269        581                  581       Other skin, subcut tiss & breast proc
                                          w/o CC/MCC
270


257        582      09   S      582       Mastectomy for malignancy w
                                          CC/MCC
258        583                  583       Mastectomy for malignancy w/o
                                          CC/MCC


259        584      09   S      584       Breast biopsy, local excision & other
                                          breast procedures w CC/MCC
260        585                  585       Breast biopsy, local excision & other
                                          breast procedures w/o CC/MCC

261
262


271        592      09   M      592       Skin ulcers w MCC
           593                  593       Skin ulcers w CC



      5/16/2012                                                                                         30
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                 Comments
           594                  594       Skin ulcers w/o CC/MCC


272        595      09   M      595       Major skin disorders w MCC
273        596                  596       Major skin disorders w/o MCC


274        597      09   M      597       Malignant breast disorders w MCC
275        598                  598       Malignant breast disorders w CC
           599                  599       Malignant breast disorders w/o
                                          CC/MCC


276        600      09   M      600       Non-malignant breast disorders w
                                          CC/MCC
           601                  601       Non-malignant breast disorders w/o
                                          CC/MCC


277        602      09   M      602       Cellulitis age >17 w MCC             age split
278        603                  603       Cellulitis age >17 w/o MCC


279        602      09   M      170       Cellulitis age 0-17                  age split
           603


280        604      09   M      604       Trauma to the skin, subcut tiss &    age split
                                          breast age >17 w MCC
281        605                  605       Trauma to the skin, subcut tiss &    age split
                                          breast age >17 w/o MCC


282        604      09   M      171       Trauma to the skin, subcut tiss &    age split
                                          breast age 0-17
           605


283        606      09   M      606       Minor skin disorders w MCC
284        607                  607       Minor skin disorders w/o MCC


286        614      10   S      614       Adrenal & pituitary procedures w
                                          CC/MCC
           615                  615       Adrenal & pituitary procedures w/o
                                          CC/MCC



      5/16/2012                                                                                        31
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments


285        616      10   S      616       Amputat of lower limb for
                                          endocrine,nutrit,& metabol dis w
                                          MCC
           617                  617       Amputat of lower limb for
                                          endocrine,nutrit,& metabol dis w CC

           618                  618       Amputat of lower limb for
                                          endocrine,nutrit,& metabol dis w/o
                                          CC/MCC


288        619      10   S      619       O.R. procedures for obesity w MCC
           620                  620       O.R. procedures for obesity w CC
           621                  621       O.R. procedures for obesity w/o
                                          CC/MCC


287        622      10   S      622       Skin grafts & wound debrid for endoc,
                                          nutrit & metab dis w MCC
           623                  623       Skin grafts & wound debrid for endoc,
                                          nutrit & metab dis w CC
           624                  624       Skin grafts & wound debrid for endoc,
                                          nutrit & metab dis w/o CC/MCC



289        625      10   S      625       Thyroid, parathyroid & thyroglossal
                                          procedures w MCC
290        626                  626       Thyroid, parathyroid & thyroglossal
                                          procedures w CC
291        627                  627       Thyroid, parathyroid & thyroglossal
                                          procedures w/o CC/MCC


292        628      10   S      628       Other endocrine, nutrit & metab O.R.
                                          proc w MCC
293        629                  629       Other endocrine, nutrit & metab O.R.
                                          proc w CC
           630                  630       Other endocrine, nutrit & metab O.R.
                                          proc w/o CC/MCC


294        637      10   M      637       Diabetes w MCC
295        638                  638       Diabetes w CC



      5/16/2012                                                                                        32
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments
           639                  639       Diabetes w/o CC/MCC


296        640      10   M      640       Nutritional & misc metabolic          age split
                                          disorders age >17 w MCC
297        641                  641       Nutritional & misc metabolic          age split
                                          disorders age >17 w/o MCC


298        640      10   M      172       Nutritional & misc metabolic          age split
                                          disorders age 0-17
           641


299        642      10   M      642       Inborn errors of metabolism


300        643      10   M      643       Endocrine disorders w MCC
301        644                  644       Endocrine disorders w CC
           645                  645       Endocrine disorders w/o CC/MCC


302        652      11   S      652       Kidney transplant


573        653      11   S      653       Major bladder procedures w MCC
           654                  654       Major bladder procedures w CC
           655                  655       Major bladder procedures w/o
                                          CC/MCC


303        656      11   S      656       Kidney & ureter procedures for
                                          neoplasm w MCC
           657                  657       Kidney & ureter procedures
                                          forneoplasm w CC
           658                  658       Kidney & ureter procedures for
                                          neoplasm w/o CC/MCC


304        659      11   S      659       Kidney & ureter procedures for non-
                                          neoplasm w MCC
305        660                  660       Kidney & ureter procedures for non-
                                          neoplasm w CC
           661                  661       Kidney & ureter procedures for non-
                                          neoplasm w/o CC/MCC




      5/16/2012                                                                                       33
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                Comments

308        662      11   S      662       Minor bladder procedures w MCC
309        663                  663       Minor bladder procedures w CC
           664                  664       Minor bladder procedures w/o
                                          CC/MCC


306        665      11   S      665       Prostatectomy w MCC
307        666                  666       Prostatectomy w CC
           667                  667       Prostatectomy w/o CC/MCC


310        668      11   S      668       Transurethral procedures w MCC
311        669                  669       Transurethral procedures w CC
           670                  670       Transurethral procedures w/o
                                          CC/MCC


312        671      11   S      671       Urethral procedures age >17 w       age split
                                          CC/MCC
313        672                  672       Urethral procedures age >17 w/o     age split
                                          CC/MCC


314        671      11   S      173       Urethral procedures age 0-17        age split
           672


315        673      11   S      673       Other kidney & urinary tract        Use logic from TRICARE v25 which excludes criteria
                                          procedures w MCC                    of PDX of 25041 or 25043 with Non-OR 5284 or 5285
           674                  674       Other kidney & urinary tract
                                          procedures w CC
           675                  675       Other kidney & urinary tract
                                          procedures w/o CC/MCC


316        682      11   M      682       Renal failure w MCC
           683                  683       Renal failure w CC
           684                  684       Renal failure w/o CC/MCC


317        685      11   M      685       Admit for renal dialysis




      5/16/2012                                                                                                                    34
                                                                       TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                 Comments
318        686      11  M       686       Kidney & urinary tract neoplasms w
                                          MCC
319        687                  687       Kidney & urinary tract neoplasms w
                                          CC
           688                  688       Kidney & urinary tract neoplasms w/o
                                          CC/MCC


320        689      11   M      689       Kidney & urinary tract infections age    age split
                                          >17 w MCC
321        690                  690       Kidney & urinary tract infections age    age split
                                          >17 w/o MCC


322        689      11   M      174       Kidney & urinary tract infections age    age split
                                          0-17
           690


323        691      11   M      691       Urinary stones w esw lithotripsy w
                                          CC/MCC
           692                  692       Urinary stones w esw lithotripsy w/o
                                          CC/MCC


324        693      11   M      693       Urinary stones w/o esw lithotripsy w
                                          MCC
           694                  694       Urinary stones w/o esw lithotripsy w/o
                                          MCC


325        695      11   M      695       Kidney & urinary tract signs &           age split
                                          symptoms age >17 w MCC
326        696                  696       Kidney & urinary tract signs &           age split
                                          symptoms age >17 w/o MCC


327        695      11   M      209       Kidney & urinary tract signs &           age split
                                          symptoms age 0-17
           696


328        697      11   M      697       Urethral stricture age >17               age split
329




      5/16/2012                                                                                          35
                                                                        TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments
330        697      11  M       210       Urethral stricture age 0-17            age split


331        698      11   M      698       Other kidney & urinary tract           age split
                                          diagnoses age >17 w MCC
332        699                  699       Other kidney & urinary tract           age split
                                          diagnoses age >17 w CC
           700                  700       Other kidney & urinary tract           age split
                                          diagnoses age >17 w/o CC/MCC


333        698      11   M      211       Other kidney & urinary tract           age split
                                          diagnoses age 0-17
           699
           700


334        707      12   S      707       Major male pelvic procedures w
                                          CC/MCC
335        708                  708       Major male pelvic procedures w/o
                                          CC/MCC


341        709      12   S      709       Penis procedures w CC/MCC
           710                  710       Penis procedures w/o CC/MCC


338        711      12   S      711       Testes procedures age >17 w            age split
                                          CC/MCC
339        712                  712       Testes procedures age >17 w/o          age split
                                          CC/MCC


340        711      12   S      212       Testes procedures age 0-17             age split
           712


336        713      12   S      713       Transurethral prostatectomy w
                                          CC/MCC
337        714                  714       Transurethral prostatectomy w/o
                                          CC/MCC


344        715      12   S      715       Other male reproductive system O.R.
                                          proc for malignancy w CC/MCC




      5/16/2012                                                                                           36
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                Comments
           716                  716       Other male reproductive system O.R.
                                          proc for malignancy w/o CC/MCC



345        717      12   S      717       Other male reproductive system O.R.
                                          proc exc malignancy w CC/MCC

           718                  718       Other male reproductive system O.R.
                                          proc exc malignancy w/o CC/MCC



346        722      12   M      722       Malignancy, male reproductive
                                          system w MCC
347        723                  723       Malignancy, male reproductive
                                          system w CC
           724                  724       Malignancy, male reproductive
                                          system w/o CC/MCC


348        725      12   M      725       Benign prostatic hypertrophy w MCC

349        726                  726       Benign prostatic hypertrophy w/o
                                          MCC


350        727      12   M      727       Inflammation of the male
                                          reproductive system w MCC
           728                  728       Inflammation of the male
                                          reproductive system w/o MCC


351        729      12   M      729       Other male reproductive system
                                          diagnoses w CC/MCC
352        730                  730       Other male reproductive system
                                          diagnoses w/o CC/MCC


353        734      13   S      734       Pelvic evisceration, rad hysterectomy
                                          & rad vulvectomy w CC/MCC

           735                  735       Pelvic evisceration, rad hysterectomy
                                          & rad vulvectomy w/o CC/MCC




      5/16/2012                                                                                       37
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments

357        736      13   S      736       Uterine & adnexa proc for ovarian or
                                          adnexal malignancy w MCC
           737                  737       Uterine & adnexa proc for ovarian or
                                          adnexal malignancy w CC
           738                  738       Uterine & adnexa proc for ovarian or
                                          adnexal malignancy w/o CC/MCC


354        739      13   S      739       Uterine,adnexa proc for non-
                                          ovarian/adnexal malig w MCC
355        740                  740       Uterine,adnexa proc for non-
                                          ovarian/adnexal malig w CC
           741                  741       Uterine,adnexa proc for non-
                                          ovarian/adnexal malig w/o CC/MCC


358        742      13   S      742       Uterine & adnexa proc for non-
                                          malignancy w CC/MCC
359        743                  743       Uterine & adnexa proc for non-
                                          malignancy w/o CC/MCC


361        744      13   S      744       D&C, conization, laparoscopy & tubal
                                          interruption w CC/MCC
362        745                  745       D&C, conization, laparoscopy & tubal
                                          interruption w/o CC/MCC
363
364


360        746      13   S      746       Vagina, cervix & vulva procedures w
                                          CC/MCC
           747                  747       Vagina, cervix & vulva procedures
                                          w/o CC/MCC


356        748      13   S      748       Female reproductive system
                                          reconstructive procedures



365        749      13   S      749       Other female reproductive system
                                          O.R. procedures w CC/MCC
           750                  750       Other female reproductive system
                                          O.R. procedures w/o CC/MCC



      5/16/2012                                                                                       38
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments


366        754      13   M      754       Malignancy, female reproductive
                                          system w MCC
367        755                  755       Malignancy, female reproductive
                                          system w CC
           756                  756       Malignancy, female reproductive
                                          system w/o CC/MCC


368        757      13   M      757       Infections, female reproductive
                                          system w MCC
           758                  758       Infections, female reproductive
                                          system w CC
           759                  759       Infections, female reproductive
                                          system w/o CC/MCC


369        760      13   M      760       Menstrual & other female
                                          reproductive system disorders w
                                          CC/MCC
           761                  761       Menstrual & other female
                                          reproductive system disorders w/o
                                          CC/MCC


370        765      14   S      765       Cesarean section w CC/MCC
371        766                  766       Cesarean section w/o CC/MCC


374        767      14   S      767       Vaginal delivery w sterilization &/or
                                          D&C


375        768      14   S      768       Vaginal delivery w O.R. proc except
                                          steril &/or D&C


377        769      14   S      769       Postpartum & post abortion
                                          diagnoses w O.R. procedure


381        770      14   S      770       Abortion w D&C, aspiration curettage
                                          or hysterotomy




      5/16/2012                                                                                         39
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments
372        774      14  M       774       Vaginal delivery w complicating
                                          diagnoses


373        775      14   M      775       Vaginal delivery w/o complicating
                                          diagnoses


376        776      14   M      776       Postpartum & post abortion
                                          diagnoses w/o O.R. procedure


378        777      14   M      777       Ectopic pregnancy


379        778      14   M      778       Threatened abortion


380        779      14   M      779       Abortion w/o D&C


382        780      14   M      780       False labor


383        781      14   M      781       Other antepartum diagnoses w
                                          medical complications


384        782      14   M      782       Other antepartum diagnoses w/o
                                          medical complications


600                 15   M      610       Neonate, died w/in one day of birth


601                 15   M      611       Neonate, transferred <5 days old


602                 15   M      612       Neonate, birthwt <750g, discharged
                                          alive


603                 15   M      613       Neonate, birthwt <750g, died




      5/16/2012                                                                                        40
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments
604                 15  M       631       Neonate, birthwt 750-999g,
                                          discharged alive


605                 15   M      632       Neonate, birthwt 750-999g, died


606                 15   S      633       Neonate, birthwt 1000-1499g, w
                                          signif O.R. proc, discharged alive


607                 15   M      634       Neonate, birthwt 1000-1499g, w/o
                                          signif O.R. proc, discharged alive


608                 15   M      635       Neonate, birthwt 1000-1499g, died


609                 15   S      636       Neonate, birthwt 1500-1999g, w
                                          signif O.R. proc, w mult major prob


610                 15   S      646       Neonate, birthwt 1500-1999g, w
                                          signif O.R. proc, w/o mult major prob



611                 15   M      647       Neonate, birthwt 1500-1999g, w/o
                                          signif O.R. proc, w mult major prob


612                 15   M      648       Neonate, birthwt 1500-1999g, w/o
                                          signif O.R. proc, w major prob


613                 15   M      649       Neonate, birthwt 1500-1999g, w/o
                                          signif O.R. proc, w minor prob


                    15   M      650       Neonate, birthwt 1500-1999g, w/o
614                                       signif O.R. proc, w other prob


                    15   S      651       Neonate, birthwt 2000-2499g, w
615                                       signif O.R. proc, w mult major prob




      5/16/2012                                                                                        41
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments

                    15   S      676
                                          Neonate, birthwt 2000-2499g, w
616                                       signif O.R. proc, w/o mult major prob



                    15   M      677       Neonate, birthwt 2000-2499g, w/o
617                                       signif O.R. proc, w mult major prob


                    15   M      678       Neonate, birthwt 2000-2499g, w/o
618                                       signif O.R. proc, w major prob


                    15   M      679       Neonate, birthwt 2000-2499g, w/o
619                                       signif O.R. proc, w minor prob


                    15   M      680       Neonate, birthwt 2000-2499g, w/o
621                                       signif O.R. proc, w other prob


                    15   S      681       Neonate, birthwt >2499g, w signif
622                                       O.R. proc, w mult major prob


                    15   S      787       Neonate, birthwt >2499g, w signif
623                                       O.R. proc, w/o mult major prob


                    15   S      788       Neonate, birthwt >2499g, w minor
624                                       abdom procedure


                    15   M      789       Neonate, birthwt >2499g, w/o signif
626                                       O.R. proc, w mult major prob


                    15   M      790       Neonate, birthwt >2499g, w/o signif
627                                       O.R. proc, w major prob


                    15   M      791       Neonate, birthwt >2499g, w/o signif
628                                       O.R. proc, w minor prob




      5/16/2012                                                                                        42
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments

                    15   M      792       Neonate, birthwt >2499g, w/o signif
630                                       O.R. proc, w other prob


635                 15   M      793       Neonatal aftercare for weight gain


636                 15   M      794       Neonatal diagnosis, age > 28 days


391        795      15   M      795       Normal newborn



392        799      16   S      799       Splenectomy age >17 w MCC              age split
           800                  800       Splenectomy age >17 w CC               age split
           801                  801       Splenectomy age >17 w/o CC/MCC         age split


393        799      16   S      213       Splenectomy age 0-17                   age split
           800
           801


394        802      16   S      802       Other O.R. proc of the blood & blood
                                          forming organs w MCC
           803                  803       Other O.R. proc of the blood & blood
                                          forming organs w CC
           804                  804       Other O.R. proc of the blood & blood
                                          forming organs w/o CC/MCC


574        808      16   M      808       Major hematol/immun diag exc sickle
                                          cell crisis & coagul w MCC
           809                  809       Major hematol/immun diag exc sickle
                                          cell crisis & coagul w CC
           810                  810       Major hematol/immun diag exc sickle
                                          cell crisis & coagul w/o CC/MCC



395        811      16   M      811       Red blood cell disorders age >17 w age split
                                          MCC
           812                  812       Red blood cell disorders age >17 w/o age split
                                          MCC



      5/16/2012                                                                                        43
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                      Comments


396        811      16   M      214       Red blood cell disorders age 0-17         age split
           812


397        813      16   M      813       Coagulation disorders


398        814      16   M      814       Reticuloendothelial & immunity
                                          disorders w MCC
399        815                  815       Reticuloendothelial & immunity
                                          disorders w CC
           816                  816       Reticuloendothelial & immunity
                                          disorders w/o CC/MCC


539        820      17   S      820       Lymphoma & leukemia w major O.R.
                                          procedure w MCC
540        821                  821       Lymphoma & leukemia w major O.R.
                                          procedure w CC
           822                  822       Lymphoma & leukemia w major O.R.
                                          procedure w/o CC/MCC


401        823      17   S      823       Lymphoma & non-acute leukemia w
                                          other O.R. proc w MCC
402        824                  824       Lymphoma & non-acute leukemia w
                                          other O.R. proc w CC
           825                  825       Lymphoma & non-acute leukemia w
                                          other O.R. proc w/o CC/MCC


406        826      17   S      826       Myeloprolif disord or poorly diff neopl
                                          w maj O.R. proc w MCC
407        827                  827       Myeloprolif disord or poorly diff neopl
                                          w maj O.R. proc w CC
           828                  828       Myeloprolif disord or poorly diff neopl
                                          w maj O.R. proc w/o CC/MCC



408        829      17   S      829       Myeloprolif disord or poorly diff neopl
                                          w other O.R. proc w CC/MCC




      5/16/2012                                                                                         44
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments
           830                  830       Myeloprolif disord or poorly diff neopl
                                          w other O.R. proc w/o CC/MCC



473        834      17   M      834       Acute leukemia w/o major O.R.          age split
                                          procedure age >17 w MCC
           835                  835       Acute leukemia w/o major O.R.          age split
                                          procedure age >17 w CC
           836                  836       Acute leukemia w/o major O.R.          age split
                                          procedure age >17 w/o CC/MCC


405        834      17   M      266       Acute leukemia w/o major O.R.          age split
                                          procedure age 0-17
           835
           836


492        837      17   M      837       Chemo w acute leukemia as sdx or w
                                          high dose chemo agent w MCC
           838                  838       Chemo w acute leukemia as sdx w
                                          CC or high dose chemo agent
           839                  839       Chemo w acute leukemia as sdx w/o
                                          CC/MCC


403        840      17   M      840       Lymphoma & non-acute leukemia w
                                          MCC
404        841                  841       Lymphoma & non-acute leukemia w
                                          CC
           842                  842       Lymphoma & non-acute leukemia
                                          w/o CC/MCC


411        843      17   M      843       Other myeloprolif dis or poorly diff
                                          neopl diag w MCC
412        844                  844       Other myeloprolif dis or poorly diff
                                          neopl diag w CC
413        845                  845       Other myeloprolif dis or poorly diff
                                          neopl diag w/o CC/MCC
414


410        846      17   M      846       Chemotherapy w/o acute leukemia
                                          as secondary diagnosis w MCC



      5/16/2012                                                                                         45
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions              Comments
           847                  847       Chemotherapy w/o acute leukemia
                                          as secondary diagnosis w CC
           848                  848       Chemotherapy w/o acute leukemia
                                          as secondary diagnosis w/o CC/MCC



409        849      17   M      849       Radiotherapy


578        853      18   S      853       Infectious & parasitic diseases w
                                          O.R. procedure w MCC
           854                  854       Infectious & parasitic diseases w
                                          O.R. procedure w CC
           855                  855       Infectious & parasitic diseases w
                                          O.R. procedure w/o CC/MCC


579        856      18   S      856       Postoperative or post-traumatic
                                          infections w O.R. proc w MCC
           857                  857       Postoperative or post-traumatic
                                          infections w O.R. proc w CC
           858                  858       Postoperative or post-traumatic
                                          infections w O.R. proc w/o CC/MCC



418        862      18   M      862       Postoperative & post-traumatic
                                          infections w MCC
           863                  863       Postoperative & post-traumatic
                                          infections w/o MCC


419        864      18   M      864       Fever age >17                        age split
420


421        865      18   M      865       Viral illness age >17 w MCC          age split
           866                  866       Viral illness age >17 w/o MCC        age split


422        864      18   M      267       Viral illness & fever age 0-17       age split
           865
           866




      5/16/2012                                                                                         46
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments
423        867      18  M       867       Other infectious & parasitic diseases
                                          diagnoses w MCC
           868                  868       Other infectious & parasitic diseases
                                          diagnoses w CC
           869                  869       Other infectious & parasitic diseases
                                          diagnoses w/o CC/MCC

575        870      18   M      870       Septicemia or severe sepsis w MV       age split
                                          96+ hours age >17


576        871      18   M      871       Septicemia or severe sepsis w/o MV age split
                                          96+ hours age >17 w MCC
           872                  872       Septicemia or severe sepsis w/o MV age split
                                          96+ hours age >17 w/o MCC


417        870      18   M      268       Septicemia or severe sepsis age 0-     age split
                                          17
           871
           872


424        876      19   S      876       O.R. procedure w principal diagnoses
                                          of mental illness


425        880      19   M      880       Acute adjustment reaction &
                                          psychosocial dysfunction


426        881      19   M      881       Depressive neuroses


427        882      19   M      882       Neuroses except depressive


428        883      19   M      883       Disorders of personality & impulse
                                          control


429        884      19   M      884       Organic disturbances & mental
                                          retardation


430        885      19   M      885       Psychoses



      5/16/2012                                                                                       47
                                                                    TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                  Comments


431        886      19   M      886       Behavioral & developmental
                                          disorders


432        887      19   M      887       Other mental disorder diagnoses


433        894      20   M      894       Alcohol/drug abuse or dependence,
                                          left AMA


521        895      20   M      895       Alcohol/drug abuse or dependence w
                                          rehabilitation therapy
522


521        896      20   M      896       Alcohol/drug abuse or dependence
                                          w/o rehabilitation therapy w MCC


900        897      20   M      898       Alcohol/drug abuse or dependence      age split
                                          w/o rehabilitation therapy age >21
                                          w/o MCC
901                             899       Alcohol/drug abuse or dependence
                                          w/o rehabilitation therapy age <=21
                                          w/o MCC


440        901      21   S      901       Wound debridements for injuries w
                                          MCC
           902                  902       Wound debridements for injuries w
                                          CC
           903                  903       Wound debridements for injuries w/o
                                          CC/MCC


439        904      21   S      904       Skin grafts for injuries w CC/MCC
           905                  905       Skin grafts for injuries w/o CC/MCC


441        906      21   S      906       Hand procedures for injuries




      5/16/2012                                                                                       48
                                                                        TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                     Comments
442        907      21  S       907       Other O.R. procedures for injuries w
                                          MCC
443        908                  908       Other O.R. procedures for injuries w
                                          CC
           909                  909       Other O.R. procedures for injuries
                                          w/o CC/MCC


444        913      21   M      913       Traumatic injury age >17 w MCC           age split
445        914                  914       Traumatic injury age >17 w/o MCC         age split


446        913      21   M      269       Traumatic injury age 0-17                age split
           914


447        915      21   M      915       Allergic reactions age >17 w MCC         age split
           916                  916       Allergic reactions age >17 w/o MCC       age split



448        915      21   M      270       Allergic reactions age 0-17              age split
           916


449        917      21   M      917       Poisoning & toxic effects of drugs       age split
                                          age >17 w MCC
450        918                  918       Poisoning & toxic effects of drugs       age split
                                          age >17 w/o MCC


451        917      21   M      271       Poisoning & toxic effects of drugs       age split
                                          age 0-17
           918


452        919      21   M      919       Complications of treatment w MCC
453        920                  920       Complications of treatment w CC
           921                  921       Complications of treatment w/o
                                          CC/MCC


454        922      21   M      922       Other injury, poisoning & toxic effect
                                          diag w MCC
455        923                  923       Other injury, poisoning & toxic effect
                                          diag w/o MCC



      5/16/2012                                                                                           49
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                   Comments


504        927      22   S      927       Extensive burns or full thickness
                                          burns w MV 96+ hrs w skin graft


506        928      22   S      928       Full thickness burn w skin graft or
                                          inhal inj w CC/MCC
507        929                  929       Full thickness burn w skin graft or
                                          inhal inj w/o CC/MCC


505        933      22   M      933       Extensive burns or full thickness
                                          burns w MV 96+ hrs w/o skin graft


508        934      22   M      934       Full thickness burn w/o skin grft or
                                          inhal inj
509


510        935      22   M      935       Non-extensive burns
511


461        939      23   S      939       O.R. proc w diagnoses of other
                                          contact w health services w MCC
           940                  940       O.R. proc w diagnoses of other
                                          contact w health services w CC
           941                  941       O.R. proc w diagnoses of other
                                          contact w health services w/o
                                          CC/MCC


462        945      23   M      945       Rehabilitation w CC/MCC
           946                  946       Rehabilitation w/o CC/MCC


463        947      23   M      947       Signs & symptoms w MCC
464        948                  948       Signs & symptoms w/o MCC


465        949      23   M      949       Aftercare w CC/MCC
466        950                  950       Aftercare w/o CC/MCC




      5/16/2012                                                                                         50
                                                                     TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments
467        951      23  M       951       Other factors influencing health
                                          status


633                      23 M   796       Multiple, other and unspecified         TRICARE specific DRG
                                          congenital anomalies, w CC/MCC
634                      23 M   797       Multiple, other and unspecified         TRICARE specific DRG
                                          congenital anomalies, w/o CC/MCC


484        955      24     S    955       Craniotomy for multiple significant
                                          trauma


485        956      24     S    956       Limb reattachment, hip & femur proc
                                          for multiple significant trauma


486        957      24     S    957       Other O.R. procedures for multiple
                                          significant trauma w MCC
           958                  958       Other O.R. procedures for multiple
                                          significant trauma w CC
           959                  959       Other O.R. procedures for multiple
                                          significant trauma w/o CC/MCC


487        963      24     M    963       Other multiple significant trauma w
                                          MCC
           964                  964       Other multiple significant trauma w
                                          CC
           965                  965       Other multiple significant trauma w/o
                                          CC/MCC


488        969      25     S    969       HIV w extensive O.R. procedure w
                                          MCC
           970                  970       HIV w extensive O.R. procedure w/o
                                          MCC


489        974      25     M    974       HIV w major related condition w MCC

           975                  975       HIV w major related condition w CC
           976                  976       HIV w major related condition w/o
                                          CC/MCC




      5/16/2012                                                                                          51
                                                                      TRICARE DRG to MS-DRG Crosswalk



TRI v25    MS v25   mdc medsurg TRI v26   TRI-DRG Descriptions                    Comments

490        977      25   M      977       HIV w or w/o other related condition



468        981           S      981       Extensive O.R. procedure unrelated
                                          to principal diagnosis w MCC
           982                  982       Extensive O.R. procedure unrelated
                                          to principal diagnosis w CC
           983                  983       Extensive O.R. procedure unrelated
                                          to principal diagnosis w/o CC/MCC


476        984           S      984       Prostatic O.R. procedure unrelated to
                                          principal diagnosis w MCC
           985                  985       Prostatic O.R. procedure unrelated to
                                          principal diagnosis w CC
           986                  986       Prostatic O.R. procedure unrelated to
                                          principal diagnosis w/o CC/MCC


477        987           S      987       Non-extensive O.R. proc unrelated to
                                          principal diagnosis w MCC
           988                  988       Non-extensive O.R. proc unrelated to
                                          principal diagnosis w CC
           989                  989       Non-extensive O.R. proc unrelated to
                                          principal diagnosis w/o CC/MCC


469        998           *      998       Principal diagnosis invalid as
                                          discharge diagnosis


470        999           *      999       Ungroupable




      5/16/2012                                                                                         52

				
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