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dhs16 147985 - Minnesota Department of Human Services

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					Minnesota Administrative Rules
9500. Assistance Payments Programs (Department of Human Services)

9500.1100 DEFINITIONS (Hospital MA & GA Reimbursement)

Subp. 20g. Additional DRG requirements.
A. Version 23 of the Medicare grouper and DRG assignment to the diagnostic category must be used uniformly for all determinations of
   rates and payments.

B. The discharge status will be changed to "discharge to home" for DRG 433.

C. A diagnosis with the prefix "v57" will be excluded when grouping under subpart 20e.

D. The discharge status will be changed to "discharge to home" when grouping under subparts 20b and 20d for a transfer to a Medicare
   rehabilitation distinct part.

E. A transfer from subpart 20b or 20d, which included ICD-9-CM procedure code 86.06 (implantation of a totally implantable infusion
   pump) for the treatment of spasticity, to a Medicare rehabilitation distinct part must include ICD-9-CM diagnosis code 781.0 when
   grouping under subpart e.

F. Neonates transferred into a neonatal intensive care unit with a DRG assignment of DRG 482, 541, or 542, age less than one year,
   will be grouped under subpart 20f.

G. The discharge status will be changed to "discharge to home" for all neonates in DRG 385, except for neonates that expire at the birth
   hospital and the discharge date is the same as the date of birth.

H. For payment of admissions that result from a home health nurse being unavailable, and there is one or more acute episodes of
   illness during the admission resulting in changes in physician orders and the treatment plan, the principal diagnoses V58.89, other
   specified aftercare and V63.1, mmedical services in home not available, will be excluded.

I.   For neonates transferred into a neonatal intensive care unit within 28 days of birth, with a principal diagnosis of congenital anomaly
     (ICD-9-CM code 740-759) and a secondary diagnosis of conditions originating in the perinatal period (ICD-9-CM code 760-779), the
     principal diagnosis and the first sequenced secondary diagnosis in the range 760-779 will be interchanged when grouping under
     subpart 20f.

J. The admission source will be changed to "admitted as a transfer from another hospital" for neonates born before admission to the
   hospital and admitted directly to a Level IV neonatal intensive care unit.
K. For patients in DRG 386-390 and the age is greater than zero, the principal diagnosis from ICD-9-CM Chapter 15, certain conditions
   originating in the perinatal period (diagnoses codes 760-779), will be excluded when grouping under subparts 20b and 20d.


L. For payment under DRG 521, alcohol/drug abuse or dependence with complications or comorbidities, payment shall not be made for
   patients engaged in alcohol and/or drug rehabilitation.
M. The patient age will be changed to 18 years for DRG 003. If the admission subsequently groups to DRG 529 or 530, that DRG will be
   assigned. Otherwise the admission will remain in DRG 003.

N. The admission source will be changed to "admitted as a transfer from a different acute care hospital" for all newborns admitted to the
   hospital within the first 28 days after birth with a principal diagnosis of V29.0-V29.9.
O. The prematurity subcategory diagnosis codes 765.20 and 765.26 through 765.29 will be ignored when assigning a DRG if a
   diagnosis code from 764, 765.0, or 765.1 is not included on the claim.

         Statutory Authority: MS s 256.9685; 256.969; 256.9695
        https://www.revisor.mn.gov/rules/?id=9500.1100




Ann Gjerstad, 651.431.2541                                                                                         Minnesota Dept of Human Services
ann.gjerstad@state.mn.us                                                                                             Inpatient Hospital Payment Policy
2007-2010 Crosswalk from Federal DRGs to Mn Diag Categories in MMIS to MnDC published in State Register
        Column F. Alpha-numeric codes in Column F.indicate the Minnesota Diagnsotic Category found in the State Register on Jan. 2, 2007.
                                                                                          Grper
                                                                                                      State Reg.
DRG #      DRG NUMBER and DESCRIPTOR                                                       23                        Comment
                                                                                                     Designation
                                                                                          MnDC
  1     Craniotomy, Age >17 w/ CC                                                          A3             ok
  2     Craniotomy, Age >17 w/o CC                                                         A6             ok
  3     Craniotomy, Age 0-17                                                               A5             ok
  6     006 Carpal Tunnel Release (see Ortho-hand & wrist)                                 H9             ok
  7     Peripheral & Cranial Nerve & Other Nervous System Procedures w/ CC                 A6             ok
  8     Peripheral & Cranial Nerve & Other Nervous System Procedures w/o CC                A7             ok
  9     Spinal Disorders & Injuries                                                        A8             ok
  10    Nervous System Neoplasms w/ CC                                                     A10            ok
  11    011 Nervous System Neoplasms w/o CC                                                A14            ok
  12    Degenerative Nervous System disorders                                              A10            ok
  13    013 Multiple Sclerosis & Cerebral Ataxia                                           A14            ok
  14    Intracranial Hemorrhage or Cerebral Infarction                                     A9             ok
  15    015 Non-specific CVA & Precerebral Occlusion w/o Infarct                           A12            ok
  16    016 Nonspecif Cerebrovasc Disorder w/ CC                                           A11            ok
  17    017 Nonspecific Cerebralvasc Disorders w/o CC                                      A15            ok
  18    018 Cranial & Peripheral Nerve Disorders w/ CC                                     A12            ok
  19    019 Cranial & Peripheral Nerve Disorders w/o CC                                    A15            ok
  20    Nervous system infection except viral meningitis                                   A8             ok
  21    021 Viral Meningitis                                                               A15            ok
  22    Hypertensive Encephalopathy                                                        A8             ok
  23    023 Nontraumatic Stupor & Coma                                                     A12            ok
  24    024 Seizure & Headache Age >17 w/ CC                                               A13            ok
  25    025 Seizure & Headache age >17 w/o CC                                              A16            ok
  26    026 Seizure and Headache, age 0-17                                                 A15            ok
  27    027 Traumatic Stupor & Coma, Coma >1 Hr                                            A10            ok
  28    028 Traumatic Stupor & Coma, <1 Hr, age >17 w/ CC                                  A11            ok
  29    029 Traumatic Stupor & Coma, <1 Hr, age >17, w/o CC                                A15            ok
  30    030 Trauma, Stupor, Coma <1 Hr, age 0-17                                           A12            ok
  31    031 Concussion, age >17 w/ CC                                                      A16            ok
  32    032 Concussion, age >17 w/o CC                                                     A16            ok
  33    033 Concussion, age 0-17                                                           A15            ok
  34    034 Other Disorders of Nervous System w/ CC                                        A11            ok
  35    035 Other Disorders of Nervous System w/o CC                                       A11            ok
  36    036 Retinal Procedures                                                             B1             ok
  37    037 Orbital Procedures                                                             B1             ok
  38    038 PRIMARY IRIS Procedures                                                        B1             ok
  39    039 Lens Procedures w/ or w/o Vitrectomy                                           B1             ok
  40    040 Extraocul Procedure except Orbit, age >17                                      B1             ok
  41    041 Extraocul Procedure except Orbit, age 0-17                                     B1             ok
  42    042 Intraocular Procedure except Retina, Iris, Lens                                B1             ok
  43    043 Hyphema                                                                        B2             ok
  44    044 Acute Major Eye Infections                                                     B2             ok
  45    045 Neurological Eye Disorders                                                     B2             ok
  46    046 Other Disorder of Eye, age >17 w/ CC                                           B2             ok
  47    047 Other Disorder of Eye, age >17 w/o CC                                          B2             ok
  48    048 Other Disorders of Eye, age 0-17                                               B2             ok
  49    049-2 Major Head & Neck Procedures (cochlear implant)                               C6            ok
  49    049 Major Head & Neck Procedures (cochlear implants removed)                        C7            ok
  50    050 Sialoadenectomy                                                                C8             ok
  51    051 Salivary Gland Procedure except Sialoadenectomy                                C9             ok
  52    052 Cleft Lip & Palate Repair                                                      C10            ok
  53    053 Sinus & Mastoid Procedures, age >17                                            C8             ok
  54    054 Sinus & Mastoid Procedures, age 0-17                                           C8             ok
  55    055 Miscellaneous Ear, Nose, Mouth, & Throat Procedures                            C7             ok
  56    056 Rhinoplasty                                                                    C8             ok
  57    057 T&A Proc, except T & A Only, age >17                                           C9             ok
  58    058 T&A Proc, except T & A Only, age 0-17                                          C10            ok
  59    059 Tonsillectomy, Adenoidectomy Only, age >17                                     C10            ok
  60    060 Tonsillectomy, Adenoidectomy Only, age 0-17                                    C9             ok
  61    061 Myringotomy W/ Tube Insertion, age >17                                         C9             ok
  62    062 Myringotomy W/ Tube Insertion, age 0-17                                        C9             ok
  63    063 Other Ear, Nose Mouth, & Throat O.R. Procedures                                C8             ok
  64    064 Ear, Nose, Mouth & Throat Malignancy                                           C11            ok
  65    065 Dysequilibrium                                                                 C13            ok
  66    066 Epistaxis                                                                      C12            ok
  67    067 Epiglottitis                                                                   C11            ok

                                                                                                                                            2
                                                                                 Grper
                                                                                          State Reg.
DRG #     DRG NUMBER and DESCRIPTOR                                                23                  Comment
                                                                                         Designation
                                                                                 MnDC
 68     068   Otitis Media & URI, age >17 w/ CC                                   C12        ok
 69     069   Otitis Media & URI, age >17 w/o CC                                  C13        ok
 70     070   Otitis Media & URI, age 0-17                                        C13        ok
 71     071   Laryngotracheitis                                                   C13        ok
 72     072   Nasal Trauma & Deformity                                            C11        ok
 73     073   Other Ear, Nose, Mouth, Throat Dx, age >17                          C11        ok
 74     074   Other Ear, Nose, Mouth, Throat Dx, age 0-17                         C12        ok
 75     075   Major Chest Procedures                                              D75       D19         State Register alpha-numeric
 76     076   Other Resp System O.R. Procedure w/ CC                              D76       D20         State Register alpha-numeric
 77     077   Other Resp System O.R. Procedure w/o CC                             D77       D21         State Register alpha-numeric
 78     078   Pulmonary Embolism                                                  D13        ok
 79     079   Respiratory Infection, Inflammation, age >17 w/ CC                  D12        ok
 80     080   Resp Infection, Inflammation, age >17 w/o CC                        D15        ok
 81     081   Respiratory Infection, Inflammation, age 0-17                       D15        ok
 82     082   Respiratory Neoplasms                                               D6         ok
 83     083   Major Chest Trauma w/ CC                                            D15        ok
 84     084   Major Chest Trauma w/o CC                                           D9         ok
 85     085   Pleural Effusion w/ CC                                              D12        ok
 86     086   Pleural Effusion w/o CC                                             D16        ok
 87     087   Pulmonary Edema & Respiratory Failure                               D12        ok
 88     088   Chronic Obstructive Pulmonary Disease                               D9         ok
 89     089   Simple Pneumonia & Pleurisy, age >17 w/ CC                          D9         ok
 90     090   Simple Pneumonia & Pleurisy, age >17 w/o CC                         D11        ok
 91     091   Simple Pneumonia & Pleurisy, age 0-17                               D11        ok
 92     092   Interstitial Lung Disease w/ CC                                     D15        ok
 93     093   Interstitial Lung Disease w/o CC                                    D9         ok
 94     094   Pneumothorax w/ CC                                                  D9         ok
 95     095   Pneumothorax w/o CC                                                 D16        ok
 96     096   Bronchitis & Asthma, age >17 w/ CC                                  D11        ok
 97     097   Bronchitis & Asthma, age >17 w/o CC                                 D16        ok
 98     098   Bronchitis & Asthma, age 0-17                                       D16        ok
 99     099   Respiratory Signs & Symptoms w/ CC                                  D9         ok
 100    100   Respiratory Signs & Symptoms w/o CC                                 D16        ok
 101    101   Other Respiratory System Dx w/ CC                                   D13        ok
 102    102   Other Respiratory System Dx w/o CC                                  D16        ok
 103    103   Heart Transplant or Implant of Heart Assist System                  UU1        ok
 104    104   Cardiac Valve Procedure w/ Cardiac Cath                              E4        ok
 105    105   Cardiac Valve Procedure w/o Cardiac Cath                             E1        ok
 106    106   Coronary Bypass with PTCA                                            E1        ok
 108    108   Other Cardiothoracic Procedures                                      E1        ok
 110    110   Major Cardiovascular Procedure w/ CC                                 E1        ok
 111    111   Major Cardiovascular Procedure w/o CC                               E14        ok
 113    113   Amputation for Circulatory System Disease except Upper Limb, Toe     E6        ok
 114    114   Upper Limb, Toe Amputation for Circulatory System Disease            E3        ok
 117    117   Cardiac Pacemaker Revision except Device Replacement                 E3        ok
 118    118   Cardiac Pacemaker Device Replacement                                 E5        ok
 119    119   Vein Ligation & Stripping                                           E12        ok
 120    120   Other Circulatory System O.R. Procedures                             E5        ok
 121    121   Circulatory Disorder with AMI & with Maj Compl                      E11        ok
 122    122   Circulatory Disorder with AMI w/o Maj Complic, discharged alive      E9        ok
 123    123   Circulatory Disorders with AMI, Expired                             E14        ok
 124    124   Circulatory disorders w/ cardiac cath & complex diagnosis           E14        ok
 125    125   Circulatory disorders w/ cardiac cath, w/o complex diagnosis         E9        ok
 126    126   Acute & Subacute Endocarditis                                       E11        ok
 127    127   Heart Failure & Shock                                                E8        ok
 128    128   Deep Vein Thrombophlebitis                                          E13        ok
 129    129   Cardiac Arrest, Unexplained                                          E8        ok
 130    130   Peripheral Vascular Disorders w/ CC                                 E10        ok
 131    131   Peripheral Vascular Disorders w/o CC                                E13        ok
 132    132   Atherosclerosis w/ CC                                               E12        ok
 133    133   Atherosclerosis w/o CC                                              E16        ok
 134    134   Hypertension                                                         E9        ok
 135    135   Cardiac Congenital & Valvular Disorders, age >17 w/ CC              E13        ok
 136    136   Cardiac Congenital & Valvular Disorders, age >17 w/o CC             E13        ok
 137    137   Cardiac Congenital & Valvular Disorders, age 0-17                   E16        ok
 138    138   Cardiac Arrhythmia & Conduction Disease w/ CC                       E13        ok
 139    139   Cardiac Arrhythmia & Conduction Disease w/o CC                      E12        ok
 140    140   Angina Pectoris                                                     E12        ok
 141    141   Syncope & Collapse w/ CC                                            E15        ok
 142    142   Syncope & Collapse w/o CC                                           E15        ok
                                                                                                                                       3
                                                                                         Grper
                                                                                                  State Reg.
DRG #     DRG NUMBER and DESCRIPTOR                                                       23                   Comment
                                                                                                 Designation
                                                                                         MnDC
 143    143   Chest Pain                                                                  E12        ok
 144    144   Other Circulatory System Dx w/ CC                                           E11        ok
 145    145   Other Circulatory System Dx w/o CC                                          E12        ok
 146    146   Rectal Resection w/ CC                                                      F6         ok
 147    147   Rectal Resection w/o CC                                                     F3         ok
 148    148   Major Small & Large Bowel Procedures w/ CC                                  F6         ok
 149    149   Major Small, Large Bowel Procedure w/o CC                                   F4         ok
 150    150   Peritoneal Adhesiolysis w/ CC                                               F6         ok
 151    151   Peritoneal Adhesiolysis w/o CC                                              F3         ok
 152    152   Minor Small & Large Bowel Procedure w/ CC                                   F5         ok
 153    153   Minor Small, Large Bowel Procedure w/o CC                                   F3         ok
 154    154   Stomach, Esophageal, & Duodenal Procedures, age >17 w/ CC                   F6         ok
 155    155   Stomach, Esophageal, & Duodenal Procedure, age >17 w/o CC                   F3         ok
 156    156   Stomach, Esophageal, & Duodenal Procedures, age 0-17                        F4         ok
 157    157   Anal & Stomal Procedures w/ CC                                              F3         ok
 158    158   Anal & Stomal Procedures w/o CC                                             F1         ok
 159    159   Hernia except Inguinal, Femoral, age >17 w/ CC                              F3         ok
 160    160   Hernia except Inguinal, Femoral, age >17 w/o CC                             F2         ok
 161    161   Inguinal, Femoral Hernia, age >17 w/ CC                                     F2         ok
 162    162   Inguinal, Femoral Hernia age >17 w/o CC                                     F1         ok
 163    163   Hernia Procedures age 0-17                                                  F1         ok
 164    164   Appendectomy w/ Complicated Principal Dx w/ CC                              F4         ok
 165    165   Appendectomy w/ Complicated Principal Dx w/o CC                             F3         ok
 166    166   Appendectomy w/o Complicated Principal Dx w/ CC                             F2         ok
 167    167   Appendectomy w/o Complicated Principal Dx w/o CC                            F1         ok
 168    168   Mouth Procedures w/ CC                                                      C12        ok
 169    169   Mouth Procedures w/o CC                                                     C12        ok
 170    170   Other Digestive Sys O.R. Procedure w/ CC                                    F5         ok
 171    171   Other Digestive Sys O.R. Procedure w/o CC                                   F3         ok
 172    172   Digestive Malignancy w/ CC                                                  F4         ok
 173    173   Digestive Malignancy w/o CC                                                 F7         ok
 174    174   G.I. Hemorrhage w/ CC                                                       F7         ok
 175    175   G.I. Hemorrhage w/o CC                                                      F9         ok
 176    176   Complicated Peptic Ulcer                                                    F8         ok
 177    177   Uncomplicated Peptic Ulcer w/ CC                                            F8         ok
 178    178   Uncomplicated Peptic Ulcer w/o CC                                           F9         ok
 179    179   Inflammatory Bowel Disease                                                  F8         ok
 180    180   G.I. Obstruction w/ CC                                                      F7         ok
 181    181   G.I. Obstruction w/o CC                                                     F9         ok
 182    182   Misc Digest Disord age >17 w/ CC                                            F8         ok
 183    183   Misc Digest Disord age >17 w/o CC                                           F9         ok
 184    184   Miscellaneous Digestive Disorders, age 0-17                                 F9         ok
 185    185   Dental, Oral Disease except Extraction/Restoration, age >17                 C12        ok
 186    186   Dental, Oral Disease except Extraction/Restoration, age 0-17                C13        ok
 187    187   Dental Extractions and Restorations                                         C12        ok
 188    188   Other Digest System Dx, age >17 w/ CC                                       F7         ok
 189    189   Other Digest System Dx, age >17 w/o CC                                      F8         ok
 190    190   Other Digestive System Dx, age 0-17                                         F4         ok
 191    191   Pancreas, Liver & Shunt Procedure w/ CC                                     G8         ok
 192    192   Pancreas, Liver & Shunt Procedure w/o CC                                    G7         ok
 193    193   Biliary Proced Except Only Cholecyst w/ CC                                  G8         ok
 194    194   Biliary Proced Except Only Cholecyst w/o CC                                 G5         ok
 195    195   Cholecystectomy except lap, w/ C.D.E. w/ CC                                 G7         ok
 196    196   Cholecystectomy except lap, w/ C.D.E. w/o CC                                G6         ok
 197    197   Cholecystectomy except lap, w/o C.D.E. w/ CC                                G7         ok
 198    198   Cholecystectomy except lap, w/o C.D.E. w/o CC                               G6         ok
 199    199   Hepatobiliary Diagnostic Procedure for Malignancy                           G7         ok
 200    200   Hepatobiliary Diagnostic Procedure for Non-Malignancy                       G7         ok
 201    201   Other Hepatobiliary or Pancreas O.R. Proc                                   G8         ok
 202    202   Cirrhosis & Alcoholic Hepatitis                                             G4         ok
 203    203   Malignancy of Hepatobiliary System/ Pancreas                                G4         ok
 204    204   Disorders of the Pancreas except Malignancy                                 G2         ok
 205    205   Liver Disorders except Malignancy, Cirrhosis, Alcoholic Hepatitis w/ CC     G3         ok
 206    206   Liver Disorders except Malignancy, Cirrhosis, Alcoholic Hepatitis w/o CC    G1         ok
 207    207   Disorders of the Biliary Tract w/ CC                                        G5         ok
 208    208   Disorders of Biliary Tract w/o CC                                           G1         ok
 210    210   Hip & Femur Procedures except Major Joint, age >17 w/ CC                    H3         ok
 211    211   Hip & Femur Procedures except Major Joint, age >17 w/o CC                   H5         ok
 212    212   Hip & Femur Procedures except Major Joint, age 0-17                         H4         ok
 213    213   Amputation for Musculoskel System & Connective Tissue Disorders             H4         ok
                                                                                                                         4
                                                                                            Grper
                                                                                                     State Reg.
DRG #         DRG NUMBER and DESCRIPTOR                                                      23                   Comment
                                                                                                    Designation
                                                                                            MnDC
 216    216    Biopsies of Musculoskeletal System & Connective Tissue                        H4         ok
 217    217    Wnd Debrdmnt & Skn Grft excpt Hnd for Musculoskel/ Connec Tissue Disease      H3         ok
 218    218    Lower Extremity Procedure, age >17 w/ CC                                      H5         ok
 219    219    Lower Extremity Procedure, age >17 w/o CC                                     H7         ok
 220    220    Lower Extremity Procedure, age 0-17                                           H5         ok
 223    223    Major Shoulder, Elbow or Other Upper Extremity Procedure w/ CC                H8         ok
 224    224    Shoulder, Elbow, or Forearm Procedure except Major Joint w/o CC               H9         ok
 225    225    Foot Procedures                                                               H7         ok
 226    226    Soft Tissue Procedures w/ CC                                                  H6         ok
 227    227    Soft Tissue Procedures w/o CC                                                 H6         ok
 228    228    Major Thumb, Joint, or Other Hand or Wrist Procedure w/ CC                    H5         ok
 229    229    Hand or Wrist Procedure except Major Joint Procedure w/o CC                   H9         ok
 230    230   Local excision & removal Internal fixation devices of hip & femur              H7         ok
 232    232    Arthroscopy                                                                   H9         ok
 233    233    Other Muscular System/ Connective Tissue O.R. Procedure w/ CC                 H3         ok
 234    234    Other Muscular System/ Connective Tissue O.R. Procedure w/o CC                H5         ok
 235    235    Fractures of Femur                                                            H12        ok
 236    236    Fractures of Hip & Pelvis                                                     H12        ok
 237    237    Sprains, Strains, & Dislocation of Hip, Pelvis, & Thigh                       H12        ok
 238    238    Osteomyelitis                                                                 H12        ok
 239    239    Pathological Fracture & Musculoskeletal & Connective Tissue Malignancy        H11        ok
 240    240    Connective Tissue Disorders w/ CC                                             H10        ok
 241    241    Connective Tissue Disorders w/o CC                                            H12        ok
 242    242    Septic Arthritis                                                              H11        ok
 243    243    Medical Back Problems                                                         H12        ok
 244    244    Bone Disease & Specific Arthropathies w/ CC                                   H10        ok
 245    245    Bone Disease & Specific Arthropathies w/o CC                                  H12        ok
 246    246    Non-Specific Arthropathies                                                    H13        ok
 247    247    Signs & Symptoms of Musculoskeletal System/ Connective Tissue                 H13        ok
 248    248    Tendonitis, Myositis & Bursitis                                               H12        ok
 249    249    Aftercare Musculoskeletal System & Connective Tissue                          H13        ok
 250    250    Injury to Forearm, Hand, Foot, age >17 w/ CC                                  H12        ok
 251    251    Injury to Forearm, Hand, Foot, age >17 w/o CC                                 H13        ok
 252    252    Injury Forearm, Hand, Foot, age 0-17                                          H13        ok
 253    253    Injury Upper Arm, Lower Leg except Foot, age >17 w/ CC                        H12        ok
 254    254    Injury Upper Arm, Lower Leg except Foot, age >17 w/o CC                       H13        ok
 255    255    Injury Upper Arm, Lower Leg except Foot, age 0-17                             H12        ok
 256    256    Other Musculoskeletal Symptoms & Connective Tissue Dx                         H12        ok
 257    257    Total Mastectomy for Malignancy w/ CC                                          I3        ok
 258    258    Total Mastectomy for Malignancy w/o CC                                         I3        ok
 259    259    Subtotal Mastectomy for Malignancy w/ CC                                       I4        ok
 260    260    Subtotal Mastectomy for Malignancy w/o CC                                      I4        ok
 261    261    Breast Procedure for Non-Malignancy except Biopsy                              I3        ok
 262    262    Breast Biopsy & Local Excision Non-Malignancy                                  I2        ok
 263    263    Skin Graft &/or Debridement of Skin Ulcer/ Cellulitis w/ CC                    I1        ok
 264    264    Skin Graft &/or Debridement of Skin Ulcer/ Cellulitis w/o CC                   I2        ok
 265    265    Skin Graft &/or Debridement except Skin Ulcer/ Cellulitis w/ CC                I1        ok
 266    266    Skin Graft &/or Debridement except Skin Ulcer/ Cellulitis w/o CC               I2        ok
 267    267    Perianal & Pilonidal Procedures                                                I3        ok
 268    268    Skin/Subcutaneous Tissue & Breast Plastic Procedure                            I4        ok
 269    269    Other Skin/Subcutaneous Tissue/Breast Procedure w/ CC                          I2        ok
 270    270    Other Skin/Subcutaneous Tissue/Breast Procedure w/o CC                         I3        ok
 271    271    Skin Ulcers                                                                    I2        ok
 272    272    Major Skin Disorders w/ CC                                                     I3        ok
 273    273    Major Skin Disorders w/o CC                                                    I3        ok
 274    274    Malignant Breast Disorders w/ CC                                               I1        ok
 275    275    Malignant Breast Disorders w/o CC                                              I3        ok
 276    276    Non-Malignant Breast Disorders                                                 I5        ok
 277    277    Cellulitis, age >17 w/ CC                                                      I3        ok
 278    278    Cellulitis, age >17 w/o CC                                                     I4        ok
 279    279    Cellulitis, age 0-17                                                           I4        ok
 280    280    Trauma to Skin, Subq Tissue & Breast, age >17 w/ CC                            I4        ok
 281    281    Trauma to Skin, Subq Tissue, & Breast, age>17 w/o CC                           I5        ok
 282    282    Trauma to Skin, Subq Tissue & Breast, age 0-17                                 I4        ok
 283    283    Minor Skin Disorders w/ CC                                                     I4        ok
 284    284    Minor Skin Disorders w/o CC                                                    I5        ok
 285    285    Amputation of Lower Limb for Endocrine, Nutritional & Metabolic Disorder       J1        ok
 286    286    Adrenal & Pituitary Procedures                                                 J1        ok
 287    287    Skin Graft & Wnd Debridement for Endocrine, Nutritional & Metabolic Disorders J1         ok
 288    288    O.R. Procedures for Obesity                                                    J1        ok
                                                                                                                            5
                                                                                     Grper
                                                                                              State Reg.
DRG #         DRG NUMBER and DESCRIPTOR                                                23                  Comment
                                                                                             Designation
                                                                                     MnDC
 289    289    Parathyroid Procedures                                                  J6        ok
 290    290    Thyroid Procedures                                                      J6        ok
 291    291    Thyroglossal Procedures                                                 J6        ok
 292    292    Other Endocrine, Nutritional, & Metabolic O.R. Procedure w/ CC          J1        ok
 293    293    Other O.R. Procedure w/o CC                                             J1        ok
 294    294    Diabetes, age >35                                                       J2        ok
 295    295    Diabetes, age 0-35                                                      J4        ok
 296    296    Nutritional & Metabolic Disorders, age >17 w/ CC                        J3        ok
 297    297    Nutritional & Miscellaneous Metabolic Disorders, age >17 w/o CC         J5        ok
 298    298    Nutritional & Miscellaneous Metabolic Disorders, age 0-17               J4        ok
 299    299    Inborn Errors of Metabolism                                             J3        ok
 300    300    Endocrine Disorders w/ CC                                               J6        ok
 301    301    Endocrine Disorders w/o CC                                              J5        ok
 302    302    Kidney Transplant                                                      UU3        ok
 303    303    Kidney, Ureter, & Major Bladder Procedure for Neoplasm                  K1        ok
 304    304    Kidney, Ureter, & Major Bladder Procedure for Non-Neoplasm w/ CC        K1        ok
 305    305    Kidney, Ureter, Major Bladder Procedure for Non-Neoplasm w/o CC         K2        ok
 306    306    Prostatectomy w/ CC                                                     K2        ok
 307    307    Prostatectomy w/o CC                                                    K7        ok
 308    308    Minor Bladder Procedures w/ CC                                          K2        ok
 309    309    Minor Bladder Procedures w/o CC                                         K7        ok
 310    310    Transurethral Procedures w/ CC                                          K7        ok
 311    311    Transurethral Procedures w/o CC                                         K7        ok
 312    312    Urethral Procedures, age >17 w/ CC                                      K2        ok
 313    313    Urethral Procedures, age >17 w/o CC                                     K7        ok
 314    314    Urethral Procedures, age 0-17                                           K7        ok
 315    315    Other Kidney & Urinary Tract O.R. Procedure                             K1        ok
 316    316    Renal Failure                                                           K4        ok
 317    317    Admit for Renal Dialysis                                                K5        ok
 318    318    Kidney & Urinary Tract Neoplasms w/ CC                                  K3        ok
 319    319    Kidney & Urinary Tract Neoplasms w/o CC                                 K6        ok
 320    320    Kidney/Urinary Tract Infection, age >17 w/ CC                           K5        ok
 321    321    Kidney/Urinary Tract Infection, age >17 w/o CC                          K5        ok
 322    322    Kidney/Urinary Tract Infection, age 0-17                                K5        ok
 323    323    Urinary Stones w/ CC, ESW Lithotripsy                                   K7        ok
 324    324    Urinary Stones w/o CC                                                   K6        ok
 325    325    Kidney/Urinary Signs/Symptoms, age >17 w/ CC                            K5        ok
 326    326    Kidney/ Urinary Signs/Symptoms, age >17 w/o CC                          K6        ok
 327    327    Kidney/ Urinary Signs/Symptoms, age 0-17                                K6        ok
 328    328    Urethral Stricture, age >17 w/ CC                                       K5        ok
 329    329    Urethral Stricture, age >17 w/o CC                                      K6        ok
 330    330    Urethral Stricture, age 0-17                                            K6        ok
 331    331    Other Kidney & Urinary Tract Diagnoses, age >17 w/ CC                   K3        ok
 332    332    Other Kidney & Urinary Tract Diagnoses, age >17 w/o CC                  K5        ok
 333    333    Other Kidney & Urinary Tract Diagnoses, age 0-17                        K3        ok
 334    334    Major Male Pelvic Procedures w/ CC                                      L1        ok
 335    335    Major Male Pelvic Procedures w/o CC                                     L2        ok
 336    336    Transurethral Prostatectomy w/ CC                                       L1        ok
 337    337    Transurethral Prostatectomy w/o CC                                      L2        ok
 338    338    Testes Procedures for Malignancy                                        L1        ok
 339    339    Testes Proc, Non-Malignancy, age >17                                    L2        ok
 340    340    Testes Proc, Non-Malignancy, age 0-17                                   L1        ok
 341    341    Penis Procedures                                                        L1        ok
 342    342    Circumcision, age >17                                                   L2        ok
 343    343    Circumcision, age 0-17                                                  L2        ok
 344    344    Other Male Reproductive O.R. Procedure for Malignancy                   L1        ok
 345    345    Other Male Reproductive O.R. Procedure except for Malignancy            L2        ok
 346    346    Malignancy, Male Reproductive System w/ CC                              L3        ok
 347    347    Malignancy, Male Reproductive System w/o CC                             L3        ok
 348    348    Benign Prostatic Hypertrophy w/ CC                                      L3        ok
 349    349    Benign Prostatic Hypertrophy w/o CC                                     L3        ok
 350    350    Inflammation of the Male Reproductive System                            L3        ok
 351    351    Sterilization, Male                                                     L3        ok
 352    352    Other Male Reproductive System Diagnoses                                L3        ok
 353    353    Pelvic Evisceration, Radical Hysterectomy                              M6         ok
 354    354    Uterine, Adnexa Procedure for Non-Ovarian/Adnexal Malignancy w/ CC     M6         ok
 355    355    Uterine, Adnexa Procedure for Non-Ovarian/Adnexal Malignancy w/o CC    M2         ok
 356    356    Female Reproductive System Reconstructive Procedures                   M1         ok
 357    357    Uterine, Adnexa Procedure for Ovarian & Adnexal Malignancy             M6         ok
 358    358    Uterine, Adnexa Procedure for Non-Malignancy w/ CC                     M5         ok
                                                                                                                     6
                                                                                          Grper
                                                                                                       State Reg.
DRG #      DRG NUMBER and DESCRIPTOR                                                        23                      Comment
                                                                                                      Designation
                                                                                          MnDC
 359    359 Uterine, Adnexa Procedure for Non-Malignancy w/o CC                            M2             ok
 360    360 Vagina, Cervix & Vulva Procedures                                              M5             ok
 361    361 Laparoscopy & Incisional Tubal Interruption                                    M1             ok
 362    362 Endoscopic Tubal Interruption                                                  M1             ok
 363    363 D&C, Conization, Radio-Implant w/ Malignancy                                   M2             ok
 364    364 D&C, Conization except for Malignancy                                          M1             ok
 365    365 Other Female Reproductive System O.R. Procedure                                M5             ok
 366    366 Malignancy, Female Reproductive System w/ CC                                   M6             ok
 367    367 Malignancy, Female Reproductive System w/o CC                                  M2             ok
 368    368 Infection, Female Reproductive System                                          M3             ok
 369    369 Menstrual & Other Female Reproductive System Disorders                         M3             ok
 370    370 Cesarean Section w/ CC                                                         CC1            ok
 371    371 Cesarean Section w/o CC                                                        CC2            ok
 372    372 Vaginal Delivery w/ Complicating Diagnoses                                     DD1            ok
 373    373 Vaginal Delivery w/o Complicating Diagnoses                                    DD2            ok
 374    374 Vaginal Delivery w/ Sterilization &/ or D&C                                    DD3            ok
 375    375 Vaginal Delivery w/ O.R. Procedure except Sterilization/ D&C                   DD3            ok
 376    376 Postpartum & Post Abortion Diagnoses w/o O.R. Procedure                        N3             ok
 377    377 Postpartum/Post Abortion Diagnoses w/ O.R. Procedure                           N1             ok
 378    378 Ectopic Pregnancy                                                              N2             ok
 379    379 Threatened Abortion                                                            N6             ok
 380    380 Abortion w/o D&C                                                               N7             ok
 381    381 Abortion w/ D&C, Aspiration Curettage or Hysterotomy                           N4             ok
 382    382 False Labor                                                                    N7             ok
 383    383 Other Antepartum Diagnoses w/ Medical Complications                            N7             ok
 384    384 Other Antepartum Diagnoses w/o Medical Complications                           N2             ok
 385    385 -2 Neonates Died or Transferred to Another Hospital                              MM           ok
 385    385-1 Neonates Died or Transferred to Another Hospital
 386    386 -1 Extreme Immaturity & Neonatal Respiratory Distress Syndrome (wt <750Gms) KK1               ok
 386    386 -4 Extreme Immaturity & Neonatal Resp Distress Syndrome (wt 750-1499 Gms)        KK4          ok
 386    386 -5 Extreme Immaturity & Neonatal Resp Distress Syndrome (all Dx exc those in KK1 KK5
                                                                                             & KK4)       ok
 387    387- 1 Prematurity w/ Major Problems (Wt <1250 Gms)                                  LL1          ok
 387    387 -2 Prematurity w/ Major Problems (Wt 1250-1749 Gms)                              LL2          ok
 387    387 -3 Prematurity w/ Major Problems (Wt >1749 Gms)                                  LL3          ok
 387    387 -4 Prematurity w/ Major Problems (Dx 765.00 only)                                KK4          ok
 387    387- 1 Prematurity w/ Major Problems (Wt <1250 Gms)                                  LL1          ok
 387    387 -2 Prematurity w/ Major Problems (Wt 1250-1749 Gms)                              LL2          ok
 387    387 -3 Prematurity w/ Major Problems (Wt >1749 Gms)                                  LL3          ok
 388    388 Prematurity w/o Major Problems                                                   MM           ok
 389    389 Full Term Neonates w/ Major Problems                                            NN1           ok
 390    390 Full Term Neonates w/ Other Significant Problems                                NN2           ok
 391    391 Normal Newborn                                                                   QQ           ok
 392    392 Splenectomy, age >17                                                             P1           ok
 393    393 Splenectomy, age 0-17                                                            P1           ok
 394    394 Other O.R. Procedure of Blood & Blood Forming Organs                             P1           ok
 395    395 Red Blood Cell Disorders, age >17                                                P3           ok
 396    396 Red Blood Cell Disorders, age 0-17                                               P4           ok
 397    397 Coagulation Disorders                                                            P5           ok
 398    398 Reticuloendothelial & Immunity Disorders w/ CC                                   P5           ok
 399    399 Reticuloendothelial & Immunity Disorders w/o CC                                  P6           ok
 401    401 Lymphoma & Non-Acute Leukemia w/ O.R. Procedure w/ CC                            Q6           ok
 402    402 Lymphoma & Non-Acute Leukemia w/ O.R. Procedure w/o CC                           Q6           ok
 403    403 Lymphoma & Non-Acute Leukemia w/ CC                                              Q7           ok
 404    404 Lymphoma & Non-Acute Leukemia w/o CC                                             Q7           ok
 405    405 Acute Leukemia w/o Major O.R. Procedure, age 0-17                                Q7           ok
 406    406 Myeloproliferative Disord/ Prly Differentiated Neopl w/ Maj O.R w/ CC            Q6           ok
 407    407 Myeloproliferative Disord/Prly Differentiated Neopl w/ Maj O.R w/o CC            Q6           ok
 408    408 Myeloproliferative Disord/Prly Differentiated Neopl w/ Oth O.R.                  Q6           ok
 409    409 Radiotherapy                                                                     Q4           ok
 410    410 Chemotherapy w/o Acute Leukemia as 2nd Dx                                        Q4           ok
 411    411 History of Malignancy w/o Endoscopy                                              Q7           ok
 412    412 History of Malignancy w/ Endoscopy                                               Q7           ok
 413    413 Oth Myeloproliferative Dis/Prly Differentiated Neoplasm w/ CC                    Q7           ok
 414    414 Oth Myeloproliferative Dis/Prly Differentiated Neoplasm w/o CC                   Q7           ok
 415    415 O.R. Procedure for Infection & Parasitic Diseases                                R1           ok
 416    416 Septicemia, age >17                                                              R3           ok
 417    417 Septicemia, age 0-17                                                             R4           ok
 418    418 Postop & Post-Traumatic Infections                                               R5           ok
 419    419 Fever of Unknown Origin, age >17 w/ CC                                           R5           ok
 420    420 Fever of Unknown Origin, age >17 w/o CC                                          R7           ok
                                                                                                                              7
                                                                                   Grper
                                                                                            State Reg.
DRG #      DRG NUMBER and DESCRIPTOR                                                 23                  Comment
                                                                                           Designation
                                                                                   MnDC
 421    421 Viral Illness, age >17                                                   R7        ok
 422    422 Viral Illness & Fever of Unknown Origin, age 0-17                        R6        ok
 423    423 Other Infection & Parasitic Diseases Diagnoses                           R2        ok
 424    424 O.R. Procedure w/ PDx of Mental Illness                                  S1        ok
 425    425 -2 Acute Adjustment Reaction/ Psychological Dysfunction                  S2        ok
 425    425 -3 Acute Adjustment Reaction/Psychological Dysfunction                   S3        ok
 426    426    Depressive Neuroses                                                   FF        ok
 427    427 -2 Neuroses except Depressive                                            S2        ok
 427    427 -3 Neuroses except Depressive                                            S3        ok
 428    428 -2 Disorders of Personality & Impulse Control                            S2        ok
 428    428 -3 Disorders of Personality & Impulse Control                            S3        ok
 429    429 -2 Organic Disturbance/ Mental Retardation                               S2        ok
 429    429 -3 Organic Disturbance/ Mental Retardation                               S3        ok
 430    430 -1 Psychoses                                                            GG1        ok
 430    430 -2 Psychoses                                                            GG2        ok
 431    431 Childhood Mental Disorders                                              HH         ok
 432    432 -2 Other Mental Disorder Diagnoses                                       S2        ok
 432    432 -3 Other Mental Disorder Diagnoses                                       S3        ok
 433    433 Alcohol/Drug Abuse or Dependence, Left AMA
 439    439 Skin Grafts for Injuries                                                V1         ok
 440    440 Wound Debridements for Injuries                                         V1         ok
 441    441 Hand Procedures for Injuries                                            V2         ok
 442    442 Other O.R. Procedure for Injury w/ CC                                   V1         ok
 443    443 Other O.R. Procedure for Injury w/o CC                                  V2         ok
 444    444 Traumatic Injury, age >17 w/ CC                                         V6         ok
 445    445 Traumatic Injury, age >17 w/o CC                                        V6         ok
 446    446 Traumatic Injury, age 0-17                                              V4         ok
 447    447 Allergic Reactions, age >17                                             V4         ok
 448    448 Allergic Reactions, age 0-17                                            V4         ok
 449    449 Poison & Toxic Effects of Drugs, age >17 w/ CC                          V5         ok
 450    450 Poisoning & Toxic Effects of Drugs, age >17 w/o CC                      V6         ok
 451    451 Poisoning & Toxic Effects of Drugs, age 0-17                            V4         ok
 452    452 Complications of Treatment w/ CC                                        V5         ok
 453    453 Complications of Treatment w/o CC                                       V4         ok
 454    454 Other Injury, Poisoning, & Toxic Effect Diagnoses w/ CC                 V5         ok
 455    455 Other Injury, Poisoning, & Toxic Effect Diagnoses w/o CC                V4         ok
 461    461 O.R. Procedure w/ Diagnoses of Other Contact w/ Health Services         X1         ok
 462    462 Rehabilitation                                                          X2         ok
 463    463 Signs & Symptoms w/ CC                                                  X2         ok
 464    464 Signs & Symptoms w/o CC                                                 X2         ok
 465    465 Aftercare w/ History of Malignancy as Secondary Diagnosis               X2         ok
 466    466 Aftercare w/o History of Malignancy as Secondary Diagnosis              X2         ok
 467    467 Other Factors Influencing Health Status                                 X2         ok
 468    468 Extensive O.R. Procedure Unrelated to Principal Diagnosis               II1        ok
 469    469 Principal Diagnosis Invalid as Discharge Diagnosis
 470    470 Ungroupable
 471    471 Bilateral or Multiple Major Joint Procedures of Lower Extremity         H3         ok
 473    473 Acute Leukemia w/o Major O.R. Procedure, age >17                       Q7          ok
 475    475-1 Respiratory System Diagnosis w/ Ventilator Support, < 96 hr          D1          ok
 475    475-3 Respiratory System Diagnosis w/ Ventilator Support, 96+ hr            D2         ok
 476    476 Prostatic O.R. Procedure Unrelated to Principal Diagnosis               II2        ok
 477    477 Non-Extensive O.R. Procedure Unrelated to Principal Diagnosis           II2        ok
 479    479 Other Vascular Procedures w/o CC                                        E5         ok
 480    480 Liver Transplant &/or Intestinal Transplant                            UU2         ok
 481    481 Bone Marrow Transplant                                                 UU2         ok
 482    482 Tracheostomy for Face, Mouth, & Neck Diagnoses                         D10         ok
 482    482 Tracheostomy for Face, Mouth, & Neck Diagnoses                         D10         ok
 484    484 Craniotomy for Multiple Significant Trauma                              A2         ok
 484    484 Craniotomy for Multiple Significant Trauma                              A2         ok
 485    485 Limb Reattachment, Hip & Femur Procedures for Multiple Signif Trauma   OO1         ok
 486    486 Other O.R. Procedures for Multiple Significant Trauma                  OO3         ok
 487    487 Other Multiple Significant Trauma w/o OR                               OO2         ok
 488    488 HIV w/ Extensive O.R. Procedure                                        HV1        WW1         State Register alpha-numeric
 489    489 HIV w/ Major Related Condition                                         HV2        WW2         State Register alpha-numeric
 490    490 HIV with or without Other Related Conditions                           HV3        WW3         State Register alpha-numeric
 491    491 Major Joint/Limb Reattachment of Upper Extremity                        H5         ok
 492    492 CHEMOTHERAPY w/ Acute Leukemia as 2nd Dx                               Q2          ok
 493    493 Laparoscopic Cholecystectomy w/o C.D.E. w/ CC                           G6         ok
 494    494 Laparoscopic Cholecystectomy w/o C.D.E. w/o CC                          G5         ok
 495    495 Lung Transplant                                                        UU2         ok
                                                                                                                                         8
                                                                                    Grper
                                                                                             State Reg.
DRG #      DRG NUMBER and DESCRIPTOR                                                  23                  Comment
                                                                                            Designation
                                                                                    MnDC
 496    496 Combined Anterior/Posterior Spinal Fusion                                 H1        ok
 497    497 Spinal Fusion except Cervical w/ CC                                       H2        ok
 498    498 Spinal Fusion except Cervical w/o CC                                      H3        ok
 499    499 Back & Neck Procedures except fusion w/ CC                                H5        ok
 500    500 Back & Neck Procedures except fusion w/o CC                               H8        ok
 501    501 KNEE Procedures w/ PDx of Infection w/ CC                                 H3        ok
 502    502 KNEE Procedures w/ PDx of Infection w/o CC                                H7        ok
 503    503 KNEE Procedures w/o PDx of Infection                                      H7        ok
 504    504 Extensive or full thickness burns with MV 96+ hrs with Skin Graft        D19       D17         State Register alpha-numeric
 505    505 Extensive or full thickness burns with MV 96+ hrs w/o Skin Graft         W3         ok
 506    506 Full Thick Burn with Skin Graft or Inhal Inj with CC or Signif Trauma    OO3        ok
 507    507 Full Thick Burn with Skin Graft or Inhal Inj w/o CC or Signif Trauma     W3         ok
 508    508 Full Thick Burn w/o Sk Graft or Inh Inj w CC or Sign Trauma              W3         ok
 509    509 Full Thick Burn w/o Sk Graft or Inh Inj w/o CC or Signif Trauma          W4         ok
 510    510 Non-extensive Burns with CC or Signif Trauma                             W4         ok
 511    511 Non-extensive Burns w/o CC or Signif Trauma                              W4         ok
 512    512 Simultaneous Pancreas/ Kidney Transplant                                 UU2        ok
 513    513 Pancreas Transplant                                                      UU2        ok
 515    515 Cardiac Defibrillator Implant w/o Cardiac Cath                            E4        ok
 518    518 Percutaneous Cardiovascular Proc w/o Stent w/o AMI                        E5        ok
 519    519 Cervical Spinal Fusion w/ CC                                              H4        ok
 520    520 Cervical Spinal Fusion w/o CC                                             H6        ok
 521    521 -1 Alcohol/Drug Abuse or Dependence with CC (age 0-20)                    T1        ok
 521    521 -2 Alcohol/Drug Abuse or Dependence with CC (age > 20)                    T2        ok
 522    522 Alcohol/Drug Abuse or Dependence with Rehab without CC
 523    523 -1 Alcohol/Drug Abuse or Dependence w/o Rehab w/o CC (age 0-20)          T3         ok
 523    523 -2 Alcohol/Drug Abuse or Dependence w/o Rehab w/o CC (age > 20)          T4         ok
 524      Transient Ischemia (cerebral )                                            A15         ok
 525    525 Heart Assist System Implant                                             UU2         ok
 528      Intracranial Vascular Procedure w/ PDx of Hemorrhage                       A1         ok
 529      Ventricular Shunt Procedures w/ CC                                         A3         ok
 530    Ventricular Shunt Procedures w/o CC                                          A7         ok
 531      Spinal Procedures w/ CC                                                    A4         ok
 532      Spinal Procedures w/o CC                                                   A4         ok
 533      Extracranial Procedures w/ CC                                              A4         ok
 534    Extracranial Procedures w/o CC                                               A7         ok
 535    535 Cardiac Defibrillator Implant with Cath with AMI, HF, or Shock           E4         ok
 536    536 Cardiac Defibrillator Implant w/o Cath with AMI, HF, or Shock            E4         ok
 537    537 Local Excis & Remov Intern Fixation Dev Exc Hip & Femur w/ CC           H6          ok
 538    538 Local Excis & Remov Intern Fixation Dev Exc Hip & Femur w/o CC          H8          ok
 539    539 Lymphoma & Leukemia w/ Maj OR Procedure w/ CC                            Q6         ok
 540    540 Lymphoma & Leukemia w/ Maj OR Procedure w/o CC                           Q6         ok
 541    541 Trach w/ Mech Vent 96+hr or PDx exc Fce, Mth & Nck w/ Maj O.R.          D19        D17         State Register alpha-numeric
 541    Trach w/ Mech Ventilation 96+hr or PDx exc Face, Mouth & Neck w/ Maj O.R.   D19        D17         State Register alpha-numeric
 542    542 Trach w/ Mech Vent 96+hr or PDx exc Face, Mth & Nck w/o Maj O.R.        D20        D18         State Register alpha-numeric
 542    Trach w/ Mech Ventilaton 96+hr Exc Face, Mouth & Neck w/o Maj O.R.          D20        D18         State Register alpha-numeric
 543    Crani w/ Implant of Chemotherapeutic Agent or Acute Complex CNS PDx         A2          ok
 544    Major Joint Replacement or Reattachment of Lower Extremity                  H4          ok
 545    Revision of Hip or Knee Replacement                                         H4          ok
 546    Spinal Fusion Except Cervical w/ Curvature of Spine or Malignancy           H1          ok
 547    547 Coronary Bypass with Cardiac Cath with Maj Cardiovascular Dx            E1          ok
 548    548 Coronary Bypass with Cardiac Cath w/o Maj Cardiovascular Dx             E17         ok
 549    549 Coronary Bypass w/o Cardiac Cath with Maj Cardiovascular Dx             E1          ok
 550    550 Coronary Bypass w/o Cardiac Cath w/o Maj Cardiovascular Dx              E17         ok
 551    551 Perm Cardiac PPM Implant with Maj CV Dx, or AICD Lead or Generator      E7          ok
 552    552 Other Permanent Cardiac Pacemaker Implant w/o Major CV Dx               E3          ok
 553    553 Other Vascular Procedures with CC with Maj CV Diagnosis                 E7          ok
 554    554 Other Vascular Procedures with CC w/o Maj CV Diagnosis                  E5          ok
 555    555 Perc Cardiovasc Procedures with Major CV Diagnosis                      E18         ok
 556    556 Perc Cardiovasc Proc with Non-Drug-Eluding Stent w/o Maj CV Dx          E5          ok
 557    557 Perc Cardiovasc Procedures with Drug Eluding Stent with Maj CV Dx       E7          ok
 558    558 Perc Cardiovasc Procedures with Drug Eluding Stent w/o Maj CV Dx        E7          ok
 559    Acute Ischemic Stroke w/ Use of a Thrombolytic Agent                        A4          ok




                                                                                                                                          9
          MnDHS Mn Health Care Programs                                                         MA 2007-2010                                                                      Sort by DRG
* Minnesota Diagnostic Categories must be determined in conjunction with Mn Rule 9500.1100 Subp. 20g. Other DRG Requirements, A.-O.
                                                                                                                                                                           MA      Additions/
    Fed     Grp 23       MA                                                                                 MA Comment                                  MA Rel     MA
                                    MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                               Trim     Corrections/
    MDC     MnDC        DRG #                                                                               Mn Rule 9500.1100 Subp. 20b.                Value     ALOS
                                                                                                                                                                          Point    Comments
0         Rehab only       0     Lt effects of specific injuries with bilateral paraplegia (Y)                       not used in acute care -
0         Rehab only       0     Lt effects of specific injuries with Quadri/Hemiplegia (Z)                          not used in acute care -
     1       A3            1     001 Craniotomy, Age >17 w/ CC                                                                                          3.70241    9.88    36
     1       A6            2     002 Craniotomy, Age >17 w/o CC                                                                                         2.61046    5.66    22
     1       A5            3     003-1 Craniotomy, Age 0-17 (all cases in DRG 3 without V-shunt as PProc)   Excludes cases if Vent-shunt is the PProc   4.99114   14.55    51
     1       A3            3     003-2 Craniotomy, Age 0-17 (cases with V-shunt w/ CC as PProc)                       Groups to DRG 529                 3.70241    9.88    36
     1       A7            3     003-3 Craniotomy, Age 0-17 (cases with V-shunt w/o CC as PProc)                      Groups to DRG 530                 1.45979    2.87     8
     1                     4             No Longer Valid (see DRG 531-532)
     1                     5             No Longer Valid (see DRG 533-544)
     1        H9           6     006 Carpal Tunnel Release (see Ortho-hand & wrist)                           DRG 006 w/ ortho DRG 224, 229,232         0.64604    1.40     3
     1        A6           7     007 Peripheral & Cranial Nerve & Other Nervous System Procedures w/ CC                                                 2.61046    5.66    22
     1        A7           8     008 Peripheral & Cranial Nerve & Other Nervous System Procedures w/o CC                                                1.45979    2.87     8
     1        A8           9     009 Spinal Disorders & Injuries                                                                                        2.80242   10.56    31
     1        A10          10    010 Nervous System Neoplasms w/ CC                                                                                     1.42914    6.20    23
     1        A14          11    011 Nervous System Neoplasms w/o CC                                                                                    0.81369    4.34    12
     1        A10          12    012 Degenerative Nervous System disorders                                                                              1.42914    6.20    23
     1        A14          13    013 Multiple Sclerosis & Cerebral Ataxia                                                                               0.81369    4.34    12
     1        A9           14    014 Intracranial Hemorrhage or Cerebral Infarction                                                                     1.70822    6.63    19
     1        A12          15    015 Non-specific CVA & Precerebral Occlusion w/o Infarct                                                               0.91685    3.76    12
     1        A11          16    016 Nonspecif Cerebrovasc Disorder w/ CC                                                                               1.06541    4.40    16
     1        A15          17    017 Nonspecific Cerebralvasc Disorders w/o CC                                                                          0.75287    3.01    12
     1        A12          18    018 Cranial & Peripheral Nerve Disorders w/ CC                                                                         0.91685    3.76    12
     1        A15          19    019 Cranial & Peripheral Nerve Disorders w/o CC                                                                        0.75287    3.01    12
     1        A8           20    020 Nervous system infection except viral meningitis                                                                   2.80242   10.56    31
     1        A15          21    021 Viral Meningitis                                                                                                   0.75287    3.01    12
     1        A8           22    022 Hypertensive Encephalopathy                                                                                        2.80242   10.56    31
     1        A12          23    023 Nontraumatic Stupor & Coma                                                                                         0.91685    3.76    12
     1        A13          24    024 Seizure & Headache, age >17 w/ CC                                                                                  0.91025    3.81    13
     1        A16          25    025 Seizure & Headache, age >17 w/o CC                                                                                 0.58373    3.23     9
     1        A15          26    026 Seizure and Headache, age 0-17                                                                                     0.75287    3.01    12
     1        A10          27    027 Traumatic Stupor & Coma, Coma >1 Hr                                                                                1.42914    6.20    23
     1        A11          28    028 Traumatic Stupor & Coma, <1 Hr, age >17 w/ CC                                                                      1.06541    4.40    16
     1        A15          29    029 Traumatic Stupor & Coma, <1 Hr, age >17, w/o CC                                                                    0.75287    3.01    12
     1        A12          30    030 Trauma, Stupor, Coma <1 Hr, age 0-17                                                                               0.91685    3.76    12
     1        A16          31    031 Concussion, age >17 w/ CC                                                                                          0.58373    3.23     9
     1        A16          32    032 Concussion, age >17 w/o CC                                                                                         0.58373    3.23     9
     1        A15          33    033 Concussion, age 0-17                                                                                               0.75287    3.01    12
     1        A11          34    034 Other Disorders of Nervous System w/ CC                                                                            1.06541    4.40    16
     1        A11          35    035 Other Disorders of Nervous System w/o CC                                                                           1.06541    4.40    16
     2        B1           36    036 Retinal Procedures                                                                                                 0.96902    2.40    10
     2        B1           37    037 Orbital Procedures                                                                                                 0.96902    2.40    10
     2        B1           38    038 Primary Iris Procedures                                                                                            0.96902    2.40    10
     2        B1           39    039 Lens Procedures w/ or w/o Vitrectomy                                                                               0.96902    2.40    10
     2        B1           40    040 Extraocul Procedure except Orbit, age >17                                                                          0.96902    2.40    10

          Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                  MA      10
      MnDHS Mn Health Care Programs                                                       MA 2007-2010                                                            Sort by DRG
                                                                                                                                                           MA      Additions/
Fed     Grp 23       MA                                                                           MA Comment                            MA Rel     MA
                                MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                   Trim     Corrections/
MDC     MnDC        DRG #                                                                         Mn Rule 9500.1100 Subp. 20b.          Value     ALOS
                                                                                                                                                          Point    Comments
 2        B1           41    041 Extraocul Procedure except Orbit, age 0-17                                                             0.96902    2.40    10
 2        B1           42    042 Intraocular Procedure except Retina, Iris, Lens                                                        0.96902    2.40    10
 2        B2           43    043 Hyphema                                                                                                0.68057    3.19     9
 2        B2           44    044 Acute Major Eye Infections                                                                             0.68057    3.19     9
 2        B2           45    045 Neurological Eye Disorders                                                                             0.68057    3.19     9
 2        B2           46    046 Other Disorder of Eye, age >17 w/ CC                                                                   0.68057    3.19     9
 2        B2           47    047 Other Disorder of Eye, age >17 w/o CC                                                                  0.68057    3.19     9
 2        B2           48    048 Other Disorders of Eye, age 0-17                                                                       0.68057    3.19     9
 3        C6           49    049-1 Major Head & Neck Procedures (w/o cochlear implants)               Excludes Procedures 20.96-20.98   1.85915    4.38    14
 3        C7           49    049-2 Major Head & Neck Procedures (cochlear implant)                    Includes proc 20.96-20.98 ONLY    6.53584    1.00     1
 3        C8           50    050 Sialoadenectomy                                                                                        1.02787    2.44     7
 3        C9           51    051 Salivary Gland Procedure except Sialoadenectomy                                                        0.78382    2.27     7
 3        C10          52    052 Cleft Lip & Palate Repair                                                                              0.61481    1.85     4
 3        C8           53    053 Sinus & Mastoid Procedures, age >17                                                                    1.02787    2.44     7
 3        C8           54    054 Sinus & Mastoid Procedures, age 0-17                                                                   1.02787    2.44     7
 3        C6           55    055 Miscellaneous Ear, Nose, Mouth, & Throat Procedures                                                    1.85915    4.38    14
 3        C8           56    056 Rhinoplasty                                                                                            1.02787    2.44     7
 3        C9           57    057 T&A Proc, except T & A Only, age >17                                                                   0.78382    2.27     7
 3        C10          58    058 T&A Proc, except T & A Only, age 0-17                                                                  0.61481    1.85     4
 3        C10          59    059 Tonsillectomy, Adenoidectomy Only, age >17                                                             0.61481    1.85     4
 3        C9           60    060 Tonsillectomy, Adenoidectomy Only, age 0-17                                                            0.78382    2.27     7
 3        C9           61    061 Myringotomy W/ Tube Insertion, age >17                                                                 0.78382    2.27     7
 3        C9           62    062 Myringotomy W/ Tube Insertion, age 0-17                                                                0.78382    2.27     7
 3        C5           63    063 Other Ear, Nose Mouth, & Throat O.R. Procedures                                                        1.49914    3.37    12
 3        C11          64    064 Ear, Nose, Mouth & Throat Malignancy                                                                   0.89346    3.64    13
 3        C13          65    065 Dysequilibrium                                                                                         0.46910    2.20     6
 3        C12          66    066 Epistaxis                                                                                              0.63190    2.51     7
 3        C11          67    067 Epiglottitis                                                                                           0.89346    3.64    13
 3        C12          68    068 Otitis Media & URI, age >17 w/ CC                                                                      0.63190    2.51     7
 3        C13          69    069 Otitis Media & URI, age >17 w/o CC                                                                     0.46910    2.20     6
 3        C13          70    070 Otitis Media & URI, age 0-17                                                                           0.46910    2.20     6
 3        C13          71    071 Laryngotracheitis                                                                                      0.46910    2.20     6
 3        C11          72    072 Nasal Trauma & Deformity                                                                               0.89346    3.64    13
 3        C11          73    073 Other Ear, Nose, Mouth, Throat Dx, age >17                                                             0.89346    3.64    13
 3        C12          74    074 Other Ear, Nose, Mouth, Throat Dx, age 0-17                                                            0.63190    2.51     7
 4        D75          75    075 Major Chest Procedures                                                                                 3.80628   11.96    39
 4        D76          76    076 Other Resp System O.R. Procedure w/ CC                                                                 2.22299    7.48    20
 4        D77          77    077 Other Resp System O.R. Procedure w/o CC                                                                0.91570    3.09     6
 4        D13          78    078 Pulmonary Embolism                                                                                     1.02577    4.30    11
 4        D12          79    079 Respiratory Infection, Inflammation, age >17 w/ CC                                                     1.73507    7.54    20
 4        D15          80    080 Resp Infection, Inflammation, age >17 w/o CC                                                           1.47534    6.33    17
 4        D15          81    081 Respiratory Infection, Inflammation, age 0-17                                                          1.47534    6.33    17
 4        D6           82    082 Respiratory Neoplasms                                                                                  1.15294    5.68    16
 4        D15          83    083 Major Chest Trauma w/ CC                                                                               1.47534    6.33    17
 4        D9           84    084 Major Chest Trauma w/o CC                                                                              0.80255    3.93    10

      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                      MA      11
         MnDHS Mn Health Care Programs                                                           MA 2007-2010                                                      Sort by DRG
                                                                                                                                                            MA      Additions/
 Fed       Grp 23       MA                                                                               MA Comment                     MA Rel      MA
                                   MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                 Trim     Corrections/
 MDC       MnDC        DRG #                                                                             Mn Rule 9500.1100 Subp. 20b.   Value      ALOS
                                                                                                                                                           Point    Comments
   4         D12          85    085   Pleural Effusion w/ CC                                                                            1.73507     7.54    20
   4         D16          86    086   Pleural Effusion w/o CC                                                                           0.53481     2.64     8
   4         D12          87    087   Pulmonary Edema & Respiratory Failure                                                             1.73507     7.54    20
   4         D9           88    088   Chronic Obstructive Pulmonary Disease                                                             0.80255     3.93    10
   4         D9           89    089   Simple Pneumonia & Pleurisy, age >17 w/ CC                                                        0.80255     3.93    10
   4         D11          90    090   Simple Pneumonia & Pleurisy, age >17 w/o CC                                                       0.63319     3.05     8
   4         D11          91    091   Simple Pneumonia & Pleurisy, age 0-17                                                             0.63319     3.05     8
   4         D15          92    092   Interstitial Lung Disease w/ CC                                                                   1.47534     6.33    17
   4         D9           93    093   Interstitial Lung Disease w/o CC                                                                  0.80255     3.93    10
   4         D9           94    094   Pneumothorax w/ CC                                                                                0.80255     3.93    10
   4         D16          95    095   Pneumothorax w/o CC                                                                               0.53481     2.64     8
   4         D11          96    096   Bronchitis & Asthma, age >17 w/ CC                                                                0.63319     3.05     8
   4         D16          97    097   Bronchitis & Asthma, age >17 w/o CC                                                               0.53481     2.64     8
   4         D16          98    098   Bronchitis & Asthma, age 0-17                                                                     0.53481     2.64     8
   4         D9           99    099   Respiratory Signs & Symptoms w/ CC                                                                0.80255     3.93    10
   4         D16         100    100   Respiratory Signs & Symptoms w/o CC                                                               0.53481     2.64     8
   4         D13         101    101   Other Respiratory System Dx w/ CC                                                                 1.02577     4.30    11
   4         D16         102    102   Other Respiratory System Dx w/o CC                                                                0.53481     2.64     8
PreMDC       UU1         103    103   Heart Transplant or Implant of Heart Assist System                                                23.31413   34.33    109
   5          E4         104    104   Cardiac Valve Procedure w/ Cardiac Cath                                                           7.45945    10.90    30
   5          E1         105    105   Cardiac Valve Procedure w/o Cardiac Cath                                                          5.72356    11.92    35
   5          E1         106    106   Coronary Bypass with PTCA                                                                         5.72356    11.92    35
   5          E1         108    108   Other Cardiothoracic Procedures                                                                   5.72356    11.92    35
   5          E1         110    110   Major Cardiovascular Procedure w/ CC                                                              5.72356    11.92    35
   5         E14         111    111   Major Cardiovascular Procedure w/o CC                                                             1.40917     4.28    11
   5          E6         113    113   Amputation for Circulatory System Disease except Upper Limb, Toe                                  3.91015    14.33    45
   5          E3         114    114   Upper Limb, Toe Amputation for Circulatory System Disease                                         2.29256     5.41    14
   5          E3         117    117   Cardiac Pacemaker Revision except Device Replacement                                              2.29256     5.41    14
   5          E5         118    118   Cardiac Pacemaker Device Replacement                                                              1.56546     3.37    10
   5         E12         119    119   Vein Ligation & Stripping                                                                         0.49738     1.74     6
   5          E5         120    120   Other Circulatory System O.R. Procedures                                                          1.56546     3.37    10
   5         E11         121    121   Circulatory Disorder with AMI & with Maj Compl                                                    1.97326     6.99    25
   5          E9         122    122   Circulatory Disorder with AMI w/o Maj Complic, discharged alive                                   0.87728     2.77     9
   5         E14         123    123   Circulatory Disorders with AMI, Expired                                                           1.40917     4.28    11
   5         E14         124    124   Circulatory disorders w/ cardiac cath & complex diagnosis                                         1.40917     4.28    11
   5          E9         125    125   Circulatory disorders w/ cardiac cath, w/o complex diagnosis                                      0.87728     2.77     9
   5         E11         126    126   Acute & Subacute Endocarditis                                                                     1.97326     6.99    25
   5          E8         127    127   Heart Failure & Shock                                                                             1.05888     4.66    15
   5         E13         128    128   Deep Vein Thrombophlebitis                                                                        0.87333     3.44    10
   5          E8         129    129   Cardiac Arrest, Unexplained                                                                       1.05888     4.66    15
   5         E10         130    130   Peripheral Vascular Disorders w/ CC                                                               1.18680     4.81    15
   5         E13         131    131   Peripheral Vascular Disorders w/o CC                                                              0.87333     3.44    10
   5         E12         132    132   Atherosclerosis w/ CC                                                                             0.49738     1.74     6
   5         E16         133    133   Atherosclerosis w/o CC                                                                            0.36432     1.25     2
   5          E9         134    134   Hypertension                                                                                      0.87728     2.77     9

         Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                    MA      12
      MnDHS Mn Health Care Programs                                                         MA 2007-2010                                                     Sort by DRG
                                                                                                                                                      MA      Additions/
Fed     Grp 23       MA                                                                             MA Comment                     MA Rel     MA
                                MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                              Trim     Corrections/
MDC     MnDC        DRG #                                                                           Mn Rule 9500.1100 Subp. 20b.   Value     ALOS
                                                                                                                                                     Point    Comments
 5        E13         135    135    Cardiac Congenital & Valvular Disorders, age >17 w/ CC                                         0.87333    3.44    10
 5        E13         136    136    Cardiac Congenital & Valvular Disorders, age >17 w/o CC                                        0.87333    3.44    10
 5        E16         137    137    Cardiac Congenital & Valvular Disorders, age 0-17                                              0.36432    1.25     2
 5        E13         138    138    Cardiac Arrhythmia & Conduction Disease w/ CC                                                  0.87333    3.44    10
 5        E12         139    139    Cardiac Arrhythmia & Conduction Disease w/o CC                                                 0.49738    1.74     6
 5        E12         140    140    Angina Pectoris                                                                                0.49738    1.74     6
 5        E15         141    141    Syncope & Collapse w/ CC                                                                       0.52777    2.11     6
 5        E15         142    142    Syncope & Collapse w/o CC                                                                      0.52777    2.11     6
 5        E12         143    143    Chest Pain                                                                                     0.49738    1.74     6
 5        E11         144    144    Other Circulatory System Dx w/ CC                                                              1.97326    6.99    25
 5        E12         145    145    Other Circulatory System Dx w/o CC                                                             0.49738    1.74     6
 6         F6         146    146    Rectal Resection w/ CC                                                                         3.75626   13.29    38
 6         F3         147    147    Rectal Resection w/o CC                                                                        1.10763    4.13    10
 6         F6         148    148    Major Small & Large Bowel Procedures w/ CC                                                     3.75626   13.29    38
 6         F4         149    149    Major Small, Large Bowel Procedure w/o CC                                                      1.57189    6.01    17
 6         F6         150    150    Peritoneal Adhesiolysis w/ CC                                                                  3.75626   13.29    38
 6         F3         151    151    Peritoneal Adhesiolysis w/o CC                                                                 1.10763    4.13    10
 6         F5         152    152    Minor Small & Large Bowel Procedure w/ CC                                                      2.58025    8.82    22
 6         F3         153    153    Minor Small, Large Bowel Procedure w/o CC                                                      1.10763    4.13    10
 6         F6         154    154    Stomach, Esophageal, & Duodenal Procedures, age >17 w/ CC                                      3.75626   13.29    38
 6         F3         155    155    Stomach, Esophageal, & Duodenal Procedure, age >17 w/o CC                                      1.10763    4.13    10
 6         F4         156    156    Stomach, Esophageal, & Duodenal Procedures, age 0-17                                           1.57189    6.01    17
 6         F3         157    157    Anal & Stomal Procedures w/ CC                                                                 1.10763    4.13    10
 6         F1         158    158    Anal & Stomal Procedures w/o CC                                                                0.60582    1.63     3
 6         F3         159    159    Hernia except Inguinal, Femoral, age >17 w/ CC                                                 1.10763    4.13    10
 6         F2         160    160    Hernia except Inguinal, Femoral, age >17 w/o CC                                                0.86465    2.70     6
 6         F2         161    161    Inguinal, Femoral Hernia, age >17 w/ CC                                                        0.86465    2.70     6
 6         F1         162    162    Inguinal, Femoral Hernia age >17 w/o CC                                                        0.60582    1.63     3
 6         F1         163    163    Hernia Procedures age 0-17                                                                     0.60582    1.63     3
 6         F4         164    164    Appendectomy w/ Complicated Principal Dx w/ CC                                                 1.57189    6.01    17
 6         F3         165    165    Appendectomy w/ Complicated Principal Dx w/o CC                                                1.10763    4.13    10
 6         F2         166    166    Appendectomy w/o Complicated Principal Dx w/ CC                                                0.86465    2.70     6
 6         F1         167    167    Appendectomy w/o Complicated Principal Dx w/o CC                                               0.60582    1.63     3
 6        C12         168    168    Mouth Procedures w/ CC                                                                         0.63190    2.51     7
 6        C12         169    169    Mouth Procedures w/o CC                                                                        0.63190    2.51     7
 6         F5         170    170    Other Digestive Sys O.R. Procedure w/ CC                                                       2.58025    8.82    22
 6         F3         171    171    Other Digestive Sys O.R. Procedure w/o CC                                                      1.10763    4.13    10
 6         F4         172    172    Digestive Malignancy w/ CC                                                                     1.57189    6.01    17
 6         F7         173    173    Digestive Malignancy w/o CC                                                                    1.09567    4.54    13
 6         F7         174    174    G.I. Hemorrhage w/ CC                                                                          1.09567    4.54    13
 6         F9         175    175    G.I. Hemorrhage w/o CC                                                                         0.52709    2.43     7
 6         F8         176    176    Complicated Peptic Ulcer                                                                       0.75238    3.39    11
 6         F8         177    177    Uncomplicated Peptic Ulcer w/ CC                                                               0.75238    3.39    11
 6         F9         178    178    Uncomplicated Peptic Ulcer w/o CC                                                              0.52709    2.43     7
 6         F8         179    179    Inflammatory Bowel Disease                                                                     0.75238    3.39    11

      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                 MA      13
      MnDHS Mn Health Care Programs                                                            MA 2007-2010                                                                         Sort by DRG
                                                                                                                                                                             MA      Additions/
Fed     Grp 23       MA                                                                                        MA Comment                                 MA Rel     MA
                                MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                                     Trim     Corrections/
MDC     MnDC        DRG #                                                                                      Mn Rule 9500.1100 Subp. 20b.               Value     ALOS
                                                                                                                                                                            Point    Comments
 6         F7         180    180    G.I. Obstruction w/ CC                                                                                                1.09567    4.54    13
 6         F9         181    181    G.I. Obstruction w/o CC                                                                                               0.52709    2.43     7
 6         F8         182    182    Misc Digest Disord age >17 w/ CC                                                                                      0.75238    3.39    11
 6         F9         183    183    Misc Digest Disord age >17 w/o CC                                                                                     0.52709    2.43     7
 6         F9         184    184    Miscellaneous Digestive Disorders, age 0-17                                                                           0.52709    2.43     7
 3        C12         185    185    Dental, Oral Disease except Extraction/Restoration, age >17                                                           0.63190    2.51     7
 3        C13         186    186    Dental, Oral Disease except Extraction/Restoration, age 0-17                                                          0.46910    2.20     6
 3        C12         187    187    Dental Extractions and Restorations                                                                                   0.63190    2.51     7
 6         F7         188    188    Other Digest System Dx, age >17 w/ CC                                                                                 1.09567    4.54    13
 6         F8         189    189    Other Digest System Dx, age >17 w/o CC                                                                                0.75238    3.39    11
 6         F4         190    190    Other Digestive System Dx, age 0-17                                                                                   1.57189    6.01    17
 7        G8          191    191    Pancreas, Liver & Shunt Procedure w/ CC                                                                               5.66869   16.50    53
 7        G7          192    192    Pancreas, Liver & Shunt Procedure w/o CC                                                                              2.26875    8.55    18
 7        G8          193    193    Biliary Proced Except Only Cholecyst w/ CC                                                                            5.66869   16.50    53
 7        G5          194    194    Biliary Proced Except Only Cholecyst w/o CC                                                                           0.79440    2.35     5
 7        G7          195    195    Cholecystectomy except lap, w/ C.D.E. w/ CC                                                                           2.26875    8.55    18
 7        G6          196    196    Cholecystectomy except lap, w/ C.D.E. w/o CC                                                                          1.18966    3.91    14
 7        G7          197    197    Cholecystectomy except lap, w/o C.D.E. w/ CC                                                                          2.26875    8.55    18
 7        G6          198    198    Cholecystectomy except lap, w/o C.D.E. w/o CC                                                                         1.18966    3.91    14
 7        G7          199    199    Hepatobiliary Diagnostic Procedure for Malignancy                                                                     2.26875    8.55    18
 7        G7          200    200    Hepatobiliary Diagnostic Procedure for Non-Malignancy                                                                 2.26875    8.55    18
 7        G8          201    201    Other Hepatobiliary or Pancreas O.R. Proc                                                                             5.66869   16.50    53
 7        G4          202    202    Cirrhosis & Alcoholic Hepatitis                                                                                       1.49773    6.27    18
 7        G4          203    203    Malignancy of Hepatobiliary System/ Pancreas                                                                          1.49773    6.27    18
 7        G2          204    204    Disorders of the Pancreas except Malignancy                                                                           1.11590    4.99    16
 7        G3          205    205    Liver Disorders except Malignancy, Cirrhosis, Alcoholic Hepatitis w/ CC                                               1.37367    5.83    19
 7        G1          206    206    Liver Disorders except Malignancy, Cirrhosis, Alcoholic Hepatitis w/o CC                                              0.50298    1.82     4
 7        G5          207    207    Disorders of the Biliary Tract w/ CC                                                                                  0.79440    2.35     5
 7        G1          208    208    Disorders of Biliary Tract w/o CC                                                                                     0.50298    1.82     4
 7                    209           No Longer Valid; See 544
 8         H3         210    210    Hip & Femur Procedures except Major Joint, age >17 w/ CC                                                              2.46485   7.57     21
 8         H5         211    211    Hip & Femur Procedures except Major Joint, age >17 w/o CC                                                             1.36905   3.90     13
 8         H4         212    212    Hip & Femur Procedures except Major Joint, age 0-17                                                                   1.78485   4.99     11
 8         H4         213    213    Amputation for Musculoskeletal System & Connective Tissue Disorders                                                   1.78485   4.99     11
 8         H4         216    216    Biopsies of Musculoskeletal System & Connective Tissue                                                                1.78485   4.99     11
 8         H3         217    217    Wound Debridement & Skin Graft except Hand for Musculoskeletal/ Connective Tissue Disease                             2.46485   7.57     21
 8         H5         218    218    Lower Extremity Procedure, age >17 w/ CC                                                                              1.36905   3.90     13
 8         H7         219    219    Lower Extremity Procedure, age >17 w/o CC                                                                             0.91774   2.37      7
 8         H5         220    220    Lower Extremity Procedure, age 0-17                                                                                   1.36905   3.90     13
 8         H8         223    223    Major Shoulder, Elbow or Other Upper Extremity Procedure w/ CC                                                        0.76070   2.25      5
 8         H9         224    224    Shoulder, Elbow, or Forearm Procedure except Major Joint w/o CC              includes DRG 6 (carpal tunnel release)   0.64604   1.40      3
 8         H7         225    225    Foot Procedures                                                                                                       0.91774   2.37      7
 8         H6         226    226    Soft Tissue Procedures w/ CC                                                                                          1.13915   2.80      8
 8         H6         227    227    Soft Tissue Procedures w/o CC                                                                                         1.13915   2.80      8
 8         H5         228    228    Major Thumb, Joint, or Other Hand or Wrist Procedure w/ CC                                                            1.36905   3.90     13

      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                        MA      14
      MnDHS Mn Health Care Programs                                                          MA 2007-2010                                                                      Sort by DRG
                                                                                                                                                                        MA      Additions/
Fed     Grp 23       MA                                                                                   MA Comment                                 MA Rel     MA
                                MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                                Trim     Corrections/
MDC     MnDC        DRG #                                                                                 Mn Rule 9500.1100 Subp. 20b.               Value     ALOS
                                                                                                                                                                       Point    Comments
 8         H9         229    229 Hand or Wrist Procedure except Major Joint Procedure w/o CC                includes DRG 6 (carpal tunnel release)   0.64604   1.40      3
 8         H7         230    230 Local excision & removal Internal fixation devices of hip & femur                                                   0.91774   2.37      7
 8                    231         No Longer Valid; See DRG 537-538
 8        H9          232    232 Arthroscopy                                                                includes DRG 6 (carpal tunnel release)   0.64604    1.40     3
 8        H3          233    233 Other Muscular System/ Connective Tissue O.R. Procedure w/ CC                                                       2.46485    7.57    21
 8        H5          234    234 Other Muscular System/ Connective Tissue O.R. Procedure w/o CC                                                      1.36905    3.90    13
 8        H12         235    235 Fractures of Femur                                                                                                  0.69932    3.50    10
 8        H12         236    236 Fractures of Hip & Pelvis                                                                                           0.69932    3.50    10
 8        H12         237    237 Sprains, Strains, & Dislocation of Hip, Pelvis, & Thigh                                                             0.69932    3.50    10
 8        H12         238    238 Osteomyelitis                                                                                                       0.69932    3.50    10
 8        H11         239    239 Pathological Fracture & Musculoskeletal & Connective Tissue Malignancy                                              1.16140    5.61    15
 8        H10         240    240 Connective Tissue Disorders w/ CC                                                                                   2.12659    7.76    23
 8        H12         241    241 Connective Tissue Disorders w/o CC                                                                                  0.69932    3.50    10
 8        H11         242    242 Septic Arthritis                                                                                                    1.16140    5.61    15
 8        H12         243    243 Medical Back Problems                                                                                               0.69932    3.50    10
 8        H10         244    244 Bone Disease & Specific Arthropathies w/ CC                                                                         2.12659    7.76    23
 8        H12         245    245 Bone Disease & Specific Arthropathies w/o CC                                                                        0.69932    3.50    10
 8        H13         246    246 Non-Specific Arthropathies                                                                                          0.49642    2.18     6
 8        H13         247    247 Signs & Symptoms of Musculoskeletal System/ Connective Tissue                                                       0.49642    2.18     6
 8        H12         248    248 Tendonitis, Myositis & Bursitis                                                                                     0.69932    3.50    10
 8        H13         249    249 Aftercare Musculoskeletal System & Connective Tissue                                                                0.49642    2.18     6
 8        H12         250    250 Injury to Forearm, Hand, Foot, age >17 w/ CC                                                                        0.69932    3.50    10
 8        H13         251    251 Injury to Forearm, Hand, Foot, age >17 w/o CC                                                                       0.49642    2.18     6
 8        H13         252    252 Injury Forearm, Hand, Foot, age 0-17                                                                                0.49642    2.18     6
 8        H12         253    253 Injury Upper Arm, Lower Leg except Foot, age >17 w/ CC                                                              0.69932    3.50    10
 8        H13         254    254 Injury Upper Arm, Lower Leg except Foot, age >17 w/o CC                                                             0.49642    2.18     6
 8        H12         255    255 Injury Upper Arm, Lower Leg except Foot, age 0-17                                                                   0.69932    3.50    10
 8        H12         256    256 Other Musculoskeletal Symptoms & Connective Tissue Dx                                                               0.69932    3.50    10
 9         I3         257    257 Total Mastectomy for Malignancy w/ CC                                                                               0.80462    3.58    10
 9         I3         258    258 Total Mastectomy for Malignancy w/o CC                                                                              0.80462    3.58    10
 9         I4         259    259 Subtotal Mastectomy for Malignancy w/ CC                                                                            0.58630    2.92     7
 9         I4         260    260 Subtotal Mastectomy for Malignancy w/o CC                                                                           0.58630    2.92     7
 9         I3         261    261 Breast Procedure for Non-Malignancy except Biopsy                                                                   0.80462    3.58    10
 9         I2         262    262 Breast Biopsy & Local Excision Non-Malignancy                                                                       1.23251    5.30    13
 9         I1         263    263 Skin Graft &/or Debridement of Skin Ulcer/ Cellulitis w/ CC                                                         2.03905   10.16    31
 9         I2         264    264 Skin Graft &/or Debridement of Skin Ulcer/ Cellulitis w/o CC                                                        1.23251    5.30    13
 9         I1         265    265 Skin Graft &/or Debridement except Skin Ulcer/ Cellulitis w/ CC                                                     2.03905   10.16    31
 9         I2         266    266 Skin Graft &/or Debridement except Skin Ulcer/ Cellulitis w/o CC                                                    1.23251    5.30    13
 9         I3         267    267 Perianal & Pilonidal Procedures                                                                                     0.80462    3.58    10
 9         I4         268    268 Skin/Subcutaneous Tissue & Breast Plastic Procedure                                                                 0.58630    2.92     7
 9         I2         269    269 Other Skin/Subcutaneous Tissue/Breast Procedure w/ CC                                                               1.23251    5.30    13
 9         I3         270    270 Other Skin/Subcutaneous Tissue/Breast Procedure w/o CC                                                              0.80462    3.58    10
 9         I2         271    271 Skin Ulcers                                                                                                         1.23251    5.30    13
 9         I3         272    272 Major Skin Disorders w/ CC                                                                                          0.80462    3.58    10
 9         I3         273    273 Major Skin Disorders w/o CC                                                                                         0.80462    3.58    10

      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                   MA      15
      MnDHS Mn Health Care Programs                                                             MA 2007-2010                                                             Sort by DRG
                                                                                                                                                                  MA      Additions/
Fed     Grp 23       MA                                                                                         MA Comment                     MA Rel     MA
                                MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                          Trim     Corrections/
MDC     MnDC        DRG #                                                                                       Mn Rule 9500.1100 Subp. 20b.   Value     ALOS
                                                                                                                                                                 Point    Comments
 9         I1         274    274    Malignant Breast Disorders w/ CC                                                                           2.03905   10.16    31
 9         I3         275    275    Malignant Breast Disorders w/o CC                                                                          0.80462    3.58    10
 9         I5         276    276    Non-Malignant Breast Disorders                                                                             0.41567    1.83     4
 9         I3         277    277    Cellulitis, age >17 w/ CC                                                                                  0.80462    3.58    10
 9         I4         278    278    Cellulitis, age >17 w/o CC                                                                                 0.58630    2.92     7
 9         I4         279    279    Cellulitis, age 0-17                                                                                       0.58630    2.92     7
 9         I4         280    280    Trauma to Skin, Subq Tissue & Breast, age >17 w/ CC                                                        0.58630    2.92     7
 9         I5         281    281    Trauma to Skin, Subq Tissue, & Breast, age>17 w/o CC                                                       0.41567    1.83     4
 9         I4         282    282    Trauma to Skin, Subq Tissue & Breast, age 0-17                                                             0.58630    2.92     7
 9         I4         283    283    Minor Skin Disorders w/ CC                                                                                 0.58630    2.92     7
 9         I5         284    284    Minor Skin Disorders w/o CC                                                                                0.41567    1.83     4
10         J1         285    285    Amputation of Lower Limb for Endocrine, Nutritional & Metabolic Disorder                                   2.07315    6.65    23
10         J1         286    286    Adrenal & Pituitary Procedures                                                                             2.07315    6.65    23
10         J1         287    287    Skin Graft & Wound Debridement for Endocrine, Nutritional & Metabolic Disorders                            2.07315    6.65    23
10         J1         288    288    O.R. Procedures for Obesity                                                                                2.07315    6.65    23
10         J6         289    289    Parathyroid Procedures                                                                                     0.66343    2.40     6
10         J6         290    290    Thyroid Procedures                                                                                         0.66343    2.40     6
10         J6         291    291    Thyroglossal Procedures                                                                                    0.66343    2.40     6
10         J1         292    292    Other Endocrine, Nutritional, & Metabolic O.R. Procedure w/ CC                                             2.07315    6.65    23
10         J1         293    293    Other O.R. Procedure w/o CC                                                                                2.07315    6.65    23
10         J2         294    294    Diabetes, age >35                                                                                          0.77549    3.53    10
10         J4         295    295    Diabetes, age 0-35                                                                                         0.61164    2.94     9
10         J3         296    296    Nutritional & Metabolic Disorders, age >17 w/ CC                                                           0.88916    4.27    14
10         J5         297    297    Nutritional & Miscellaneous Metabolic Disorders, age >17 w/o CC                                            0.41988    2.13     5
10         J4         298    298    Nutritional & Miscellaneous Metabolic Disorders, age 0-17                                                  0.61164    2.94     9
10         J3         299    299    Inborn Errors of Metabolism                                                                                0.88916    4.27    14
10         J6         300    300    Endocrine Disorders w/ CC                                                                                  0.66343    2.40     6
10         J5         301    301    Endocrine Disorders w/o CC                                                                                 0.41988    2.13     5
11        UU3         302    302    Kidney Transplant                                                                                          9.70936   10.71    26
11         K1         303    303    Kidney, Ureter, & Major Bladder Procedure for Neoplasm                                                     2.64106    8.39    27
11         K1         304    304    Kidney, Ureter, & Major Bladder Procedure for Non-Neoplasm w/ CC                                           2.64106    8.39    27
11         K2         305    305    Kidney, Ureter, Major Bladder Procedure for Non-Neoplasm w/o CC                                            1.44304    4.07    10
11         K2         306    306    Prostatectomy w/ CC                                                                                        1.44304    4.07    10
11         K7         307    307    Prostatectomy w/o CC                                                                                       0.77656    2.57     7
11         K2         308    308    Minor Bladder Procedures w/ CC                                                                             1.44304    4.07    10
11         K7         309    309    Minor Bladder Procedures w/o CC                                                                            0.77656    2.57     7
11         K7         310    310    Transurethral Procedures w/ CC                                                                             0.77656    2.57     7
11         K7         311    311    Transurethral Procedures w/o CC                                                                            0.77656    2.57     7
11         K2         312    312    Urethral Procedures, age >17 w/ CC                                                                         1.44304    4.07    10
11         K7         313    313    Urethral Procedures, age >17 w/o CC                                                                        0.77656    2.57     7
11         K7         314    314    Urethral Procedures, age 0-17                                                                              0.77656    2.57     7
11         K1         315    315    Other Kidney & Urinary Tract O.R. Procedure                                                                2.64106    8.39    27
11         K4         316    316    Renal Failure                                                                                              1.47279    5.47    16
11         K5         317    317    Admit for Renal Dialysis                                                                                   0.63753    3.15     8
11         K3         318    318    Kidney & Urinary Tract Neoplasms w/ CC                                                                     0.92880    3.98     9

      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                             MA      16
      MnDHS Mn Health Care Programs                                                           MA 2007-2010                                                        Sort by DRG
                                                                                                                                                           MA      Additions/
Fed     Grp 23       MA                                                                                   MA Comment                     MA Rel     MA
                                MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                   Trim     Corrections/
MDC     MnDC        DRG #                                                                                 Mn Rule 9500.1100 Subp. 20b.   Value     ALOS
                                                                                                                                                          Point    Comments
11         K6         319    319    Kidney & Urinary Tract Neoplasms w/o CC                                                              0.39182   1.61     4
11         K5         320    320    Kidney/Urinary Tract Infection, age >17 w/ CC                                                        0.63753   3.15     8
11         K5         321    321    Kidney/Urinary Tract Infection, age >17 w/o CC                                                       0.63753   3.15     8
11         K5         322    322    Kidney/Urinary Tract Infection, age 0-17                                                             0.63753   3.15     8
11         K7         323    323    Urinary Stones w/ CC, ESW Lithotripsy                                                                0.77656   2.57     7
11         K6         324    324    Urinary Stones w/o CC                                                                                0.39182   1.61     4
11         K5         325    325    Kidney/ Urinary Signs/ Symptoms, age >17 w/ CC                                                       0.63753   3.15     8
11         K6         326    326    Kidney/ Urinary Signs/ Symptoms, age >17 w/o CC                                                      0.39182   1.61     4
11         K6         327    327    Kidney/ Urinary Signs/Symptoms, age 0-17                                                             0.39182   1.61     4
11         K5         328    328    Urethral Stricture, age >17 w/ CC                                                                    0.63753   3.15     8
11         K6         329    329    Urethral Stricture, age >17 w/o CC                                                                   0.39182   1.61     4
11         K6         330    330    Urethral Stricture, age 0-17                                                                         0.39182   1.61     4
11         K3         331    331    Other Kidney & Urinary Tract Diagnoses, age >17 w/ CC                                                0.92880   3.98     9
11         K5         332    332    Other Kidney & Urinary Tract Diagnoses, age >17 w/o CC                                               0.63753   3.15     8
11         K3         333    333    Other Kidney & Urinary Tract Diagnoses, age 0-17                                                     0.92880   3.98     9
12         L1         334    334    Major Male Pelvic Procedures w/ CC                                                                   1.01686   3.22     8
12         L2         335    335    Major Male Pelvic Procedures w/o CC                                                                  0.62700   2.55     7
12         L1         336    336    Transurethral Prostatectomy w/ CC                                                                    1.01686   3.22     8
12         L2         337    337    Transurethral Prostatectomy w/o CC                                                                   0.62700   2.55     7
12         L1         338    338    Testes Procedures for Malignancy                                                                     1.01686   3.22     8
12         L2         339    339    Testes Proc, Non-Malignancy, age >17                                                                 0.62700   2.55     7
12         L1         340    340    Testes Proc, Non-Malignancy, age 0-17                                                                1.01686   3.22     8
12         L1         341    341    Penis Procedures                                                                                     1.01686   3.22     8
12         L2         342    342    Circumcision, age >17                                                                                0.62700   2.55     7
12         L2         343    343    Circumcision, age 0-17                                                                               0.62700   2.55     7
12         L1         344    344    Other Male Reproductive O.R. Procedure for Malignancy                                                1.01686   3.22     8
12         L2         345    345    Other Male Reproductive O.R. Procedure except for Malignancy                                         0.62700   2.55     7
12         L3         346    346    Malignancy, Male Reproductive System w/ CC                                                           0.83328   4.20    13
12         L3         347    347    Malignancy, Male Reproductive System w/o CC                                                          0.83328   4.20    13
12         L3         348    348    Benign Prostatic Hypertrophy w/ CC                                                                   0.83328   4.20    13
12         L3         349    349    Benign Prostatic Hypertrophy w/o CC                                                                  0.83328   4.20    13
12         L3         350    350    Inflammation of the Male Reproductive System                                                         0.83328   4.20    13
12         L3         351    351    Sterilization, Male                                                                                  0.83328   4.20    13
12         L3         352    352    Other Male Reproductive System Diagnoses                                                             0.83328   4.20    13
13         M6         353    353    Pelvic Evisceration, Radical Hysterectomy                                                            2.57974   7.54    33
13         M6         354    354    Uterine, Adnexa Procedure for Non-Ovarian/Adnexal Malignancy w/ CC                                   2.57974   7.54    33
13         M2         355    355    Uterine, Adnexa Procedure for Non-Ovarian/Adnexal Malignancy w/o CC                                  0.73443   2.59     5
13         M1         356    356    Female Reproductive System Reconstructive Procedures                                                 0.55518   1.70     3
13         M6         357    357    Uterine, Adnexa Procedure for Ovarian & Adnexal Malignancy                                           2.57974   7.54    33
13         M5         358    358    Uterine, Adnexa Procedure for Non-Malignancy w/ CC                                                   0.96401   3.56     8
13         M2         359    359    Uterine, Adnexa Procedure for Non-Malignancy w/o CC                                                  0.73443   2.59     5
13         M5         360    360    Vagina, Cervix & Vulva Procedures                                                                    0.96401   3.56     8
13         M1         361    361    Laparoscopy & Incisional Tubal Interruption                                                          0.55518   1.70     3
13         M1         362    362    Endoscopic Tubal Interruption                                                                        0.55518   1.70     3
13         M2         363    363    D&C, Conization, Radio-Implant w/ Malignancy                                                         0.73443   2.59     5

      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                      MA      17
      MnDHS Mn Health Care Programs                                                         MA 2007-2010                                                                         Sort by DRG
                                                                                                                                                                          MA      Additions/
Fed     Grp 23       MA                                                                                   MA Comment                                 MA Rel      MA
                                MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                                  Trim     Corrections/
MDC     MnDC        DRG #                                                                                 Mn Rule 9500.1100 Subp. 20b.               Value      ALOS
                                                                                                                                                                         Point    Comments
13        M1          364    364 D&C, Conization except for Malignancy                                                                               0.55518     1.70      3
13        M5          365    365 Other Female Reproductive System O.R. Procedure                                                                     0.96401     3.56      8
13        M6          366    366 Malignancy, Female Reproductive System w/ CC                                                                        2.57974     7.54     33
13        M2          367    367 Malignancy, Female Reproductive System w/o CC                                                                       0.73443     2.59      5
13        M3          368    368 Infection, Female Reproductive System                                                                               0.48209     2.16      5
13        M3          369    369 Menstrual & Other Female Reproductive System Disorders                                                              0.48209     2.16      5
14        CC1         370    370 Cesarean Section w/ CC                                                                                              1.03654     4.66     13
14        CC2         371    371 Cesarean Section w/o CC                                                                                             0.78351     3.77     10
14        DD1         372    372 Vaginal Delivery w/ Complicating Diagnoses                                                                          0.56235     2.58      7
14        DD2         373    373 Vaginal Delivery w/o Complicating Diagnoses                                                                         0.42700     2.08      4
14        DD3         374    374 Vaginal Delivery w/ Sterilization &/ or D&C                                                                         0.73702     2.71      9
14        DD3         375    375 Vaginal Delivery w/ O.R. Procedure except Sterilization/ D&C                                                        0.73702     2.71      9
14        N3          376    376 Postpartum & Post Abortion Diagnoses w/o O.R. Procedure                                                             0.58249     2.78     11
14        N1          377    377 Postpartum/Post Abortion Diagnoses w/ O.R. Procedure                                                                1.17587     4.64     13
14        N2          378    378 Ectopic Pregnancy                                                                                                   0.69288     2.43      9
14        N6          379    379 Threatened Abortion                                                                                                 0.54380     2.89     10
14        N7          380    380 Abortion w/o D&C                                                                                                    0.53437     2.80      9
14        N4          381    381 Abortion w/ D&C, Aspiration Curettage or Hysterotomy                                                                0.58935     2.19     10
14        N7          382    382 False Labor                                                                                                         0.53437     2.80      9
14        N7          383    383 Other Antepartum Diagnoses w/ Medical Complications                                                                 0.53437     2.80      9
14        N2          384    384 Other Antepartum Diagnoses w/o Medical Complications                                                                0.69288     2.43      9
15                    385    385-1 Neonates Died or Transferred to Another Hospital                     DC destination changed to "home" except MM
15        MM          385    385-2 Neonates Died or Transferred to Another Hospital                             Expired: birth hosp on birth date    0.73799     6.85     14
15        KK1         386    386 -1 Extreme Immaturity & Neonatal RDS (wt <750Gms)                                   Includes 765.01, 765.02         25.51705   113.86    211
15        KK4         386    386 -4 Extreme Immaturity & Neonatal RDS (wt 750-1499 Gms)                             Includes 765.03 -765.05          14.26799   81.73     109
15        KK5         386    386 -5 Extreme Immaturity & Neonatal RDS (all Dx exc those in KK1 & KK4)                Excludes 765.01-765.05          6.47557    33.49     66
15        KK4         387    387 -4 Prematurity w/ Major Problems (Dx 765.00 only)                                       Includes 765.00             14.26799   81.73     109
15        LL1         387    387- 1 Prematurity w/ Major Problems (Wt <1250 Gms)                                     Includes 765.11-765.14          6.25091    42.57     62
15        LL2         387    387 -2 Prematurity w/ Major Problems (Wt 1250-1749 Gms)                         Incl 765.06, 765.10, 765.15, 765.16     4.60752    28.83     41
15        LL3         387    387 -3 Prematurity w/ Major Problems (Wt >1749 Gms)                             Excl 765.00, 765.06, 765.10-765.16      1.90841    12.40     21
15        MM          388    388 Prematurity w/o Major Problems                                                                                      0.73799     6.85     14
15        NN1         389    389 Full Term Neonate w/ Major Problems                                                        age 0                    0.88603     5.19     12
15        NN2         390    390 Neonate w/ Other Significant Problems                                                                               0.23455     2.71      5
15        QQ          391    391 Normal Newborn                                                                                                      0.14278     2.08      3
16         P1         392    392 Splenectomy, age >17                                                                                                1.39849     4.12      9
16         P1         393    393 Splenectomy, age 0-17                                                                                               1.39849     4.12      9
16         P1         394    394 Other O.R. Procedure of Blood & Blood Forming Organs                                                                1.39849     4.12      9
16         P3         395    395 Red Blood Cell Disorders, age >17                                                                                   0.95974     4.46     13
16         P4         396    396 Red Blood Cell Disorders, age 0-17                                                                                  0.89082     3.26     10
16         P5         397    397 Coagulation Disorders                                                                                               2.71045     4.48     21
16         P5         398    398 Reticuloendothelial & Immunity Disorders w/ CC                                                                      2.71045     4.48     21
16         P6         399    399 Reticuloendothelial & Immunity Disorders w/o CC                                                                     0.59944     2.67      7
17                    400          No Longer Valid; See DRG 539-540
17         Q6         401    401 Lymphoma & Non-Acute Leukemia w/ O.R. Procedure w/ CC                                                               2.06411     6.54     20
17         Q6         402    402 Lymphoma & Non-Acute Leukemia w/ O.R. Procedure w/o CC                                                              2.06411     6.54     20

      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                     MA      18
      MnDHS Mn Health Care Programs                                                               MA 2007-2010                                                           Sort by DRG
                                                                                                                                                                  MA      Additions/
Fed     Grp 23       MA                                                                                     MA Comment                         MA Rel     MA
                                MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                          Trim     Corrections/
MDC     MnDC        DRG #                                                                                   Mn Rule 9500.1100 Subp. 20b.       Value     ALOS
                                                                                                                                                                 Point    Comments
17        Q7          403    403    Lymphoma & Non-Acute Leukemia w/ CC                                                                        2.53472    8.94    25
17        Q7          404    404    Lymphoma & Non-Acute Leukemia w/o CC                                                                       2.53472    8.94    25
17        Q7          405    405    Acute Leukemia w/o Major O.R. Procedure, age 0-17                                                          2.53472    8.94    25
17        Q6          406    406    Myeloproliferative Disord/ Prly Differentiated Neopl w/ Maj O.R w/ CC                                      2.06411    6.54    20
17        Q6          407    407    Myeloproliferative Disord/Prly Differentiated Neopl w/ Maj O.R w/o CC                                      2.06411    6.54    20
17        Q6          408    408   Myeloproliferative Disord/Prly Differentiated Neopl w/ Oth O.R.                                             2.06411    6.54    20
17        Q4          409    409    Radiotherapy                                                                                               1.36167    4.33    15
17        Q4          410    410    Chemotherapy w/o Acute Leukemia as 2nd Dx                                                                  1.36167    4.33    15
17        Q7          411    411    History of Malignancy w/o Endoscopy                                                                        2.53472    8.94    25
17        Q7          412    412    History of Malignancy w/ Endoscopy                                                                         2.53472    8.94    25
17        Q7          413    413    Oth Myeloproliferative Dis/Prly Differentiated Neoplasm w/ CC                                              2.53472    8.94    25
17        Q7          414    414    Oth Myeloproliferative Dis/Prly Differentiated Neoplasm w/o CC                                             2.53472    8.94    25
18         R1         415    415    O.R. Procedure for Infection & Parasitic Diseases                                                          3.73674   12.45    41
18         R3         416    416    Septicemia, age >17                                                                                        1.24646    5.03    12
18         R4         417    417    Septicemia, age 0-17                                                                                       1.52201    6.38    18
18         R5         418    418    Postop & Post-Traumatic Infections                                                                         0.90608    4.11    11
18         R5         419    419    Fever of Unknown Origin, age >17 w/ CC                                                                     0.90608    4.11    11
18         R7         420    420    Fever of Unknown Origin, age >17 w/o CC                                                                    0.53104    2.55     6
18         R7         421    421    Viral Illness, age >17                                                                                     0.53104    2.55     6
18         R6         422    422    Viral Illness & Fever of Unknown Origin, age 0-17                                                          0.97437    3.87    35
18         R2         423    423    Other Infection & Parasitic Diseases Diagnoses                                                             4.30589   15.30    53
19         S1         424    424    O.R. Procedure w/ PDx of Mental Illness                                                                    2.71302   20.70    39
19         S2         425    425   -2 Acute Adjustment Reaction/ Psychological Dysfunction (0-17)                          age 0-17            0.86020    6.67    18
19         S3         425    425   -3 Acute Adjustment Reaction/Psychological Dysfunction (>17)                            age >17             0.86379    6.58    23
19         FF         426    426      Depressive Neuroses                                                                                      0.76040    6.18    18
19         S2         427    427   -2 Neuroses except Depressive (0-17)                                                    age 0-17            0.86020    6.67    18
19         S3         427    427   -3 Neuroses except Depressive (>17)                                                     age >17             0.86379    6.58    23
19         S2         428    428   -2 Disorders of Personality & Impulse Control (0-17)                                    age 0-17            0.86020    6.67    18
19         S3         428    428   -3 Disorders of Personality & Impulse Control (>17)                                     age >17             0.86379    6.58    23
19         S2         429    429   -2 Organic Disturbance/ Mental Retardation (0-17)                                       age 0-17            0.86020    6.67    18
19         S3         429    429   -3 Organic Disturbance/ Mental Retardation (>17)                                        age >17             0.86379    6.58    23
19        GG1         430    430   -1 Psychoses (0-17)                                                                     age 0-17            1.14291   10.04    31
19        GG2         430    430   -2 Psychoses (>17)                                                                      age >17             1.18412   10.04    29
19        HH          431    431    Childhood Mental Disorders                                                                                 1.06262    8.51    24
19         S2         432    432   -2 Other Mental Disorder Diagnoses (0-17)                                                age 0-17           0.86020    6.67    18
19         S3         432    432   -3 Other Mental Disorder Diagnoses (>17)                                                 age >17            0.86379    6.58    23
20                    433    433    Alcohol/Drug Abuse or Dependence, Left AMA                                      D/C dest. change to home
21         V1         439    439    Skin Grafts for Injuries                                                                                   3.31854   10.57    38
21         V1         440    440    Wound Debridements for Injuries                                                                            3.31854   10.57    38
21         V2         441    441    Hand Procedures for Injuries                                                                               0.73394    2.04     5
21         V1         442    442    Other O.R. Procedure for Injury w/ CC                                                                      3.31854   10.57    38
21         V2         443    443    Other O.R. Procedure for Injury w/o CC                                                                     0.73394    2.04     5
21         V6         444    444    Traumatic Injury, age >17 w/ CC                                                                            0.65670    3.46    14
21         V6         445    445    Traumatic Injury, age >17 w/o CC                                                                           0.65670    3.46    14
21         V4         446    446    Traumatic Injury, age 0-17                                                                                 0.47458    2.09     6

      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                             MA      19
        MnDHS Mn Health Care Programs                                                         MA 2007-2010                                                                           Sort by DRG
                                                                                                                                                                              MA      Additions/
 Fed        Grp 23     MA                                                                                   MA Comment                                    MA Rel      MA
                                  MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                                    Trim     Corrections/
 MDC        MnDC      DRG #                                                                                 Mn Rule 9500.1100 Subp. 20b.                  Value      ALOS
                                                                                                                                                                             Point    Comments
   21        V4         447    447 Allergic Reactions, age >17                                                                                            0.47458    2.09      6
   21        V4         448    448 Allergic Reactions, age 0-17                                                                                           0.47458    2.09      6
   21        V5         449    449 Poison & Toxic Effects of Drugs, age >17 w/ CC                                                                         1.25048    5.81     21
   21        V6         450    450 Poisoning & Toxic Effects of Drugs, age >17 w/o CC                                                                     0.65670    3.46     14
   21        V4         451    451 Poisoning & Toxic Effects of Drugs, age 0-17                                                                           0.47458    2.09      6
   21        V5         452    452 Complications of Treatment w/ CC                                                                                       1.25048    5.81     21
   21        V4         453    453 Complications of Treatment w/o CC                                                                                      0.47458    2.09      6
   21        V5         454    454 Other Injury, Poisoning, & Toxic Effect Diagnoses w/ CC                                                                1.25048    5.81     21
   21        V4         455    455 Other Injury, Poisoning, & Toxic Effect Diagnoses w/o CC                                                               0.47458    2.09      6
   22                   456    456-460 No Longer Valid
   23        X1         461    461 O.R. Procedure w/ Diagnoses of Other Contact w/ Health Services                                                        1.88387     5.48    36
   23        X2         462    462 Rehabilitation                                                                                                         1.36136     5.61    22
   23        X2         463    463 Signs & Symptoms w/ CC                                                                                                 1.36136     5.61    22
   23        X2         464    464 Signs & Symptoms w/o CC                                                                                                1.36136     5.61    22
   23        X2         465    465 Aftercare w/ History of Malignancy as Secondary Diagnosis                                                              1.36136     5.61    22
   23        X2         466    466 Aftercare w/o History of Malignancy as Secondary Diagnosis                      See 9500.1100 Subp.20g. H.             1.36136     5.61    22
   23        X2         467    467 Other Factors Influencing Health Status                                                                                1.36136     5.61    22
Unrelated    II1        468    468 Extensive O.R. Procedure Unrelated to Principal Diagnosis                                                              3.41079    10.99    31
   14                   469    469 Principal Diagnosis Invalid as Discharge Diagnosis
   15                   470    470 Ungroupable
    8         H3        471    471 Bilateral or Multiple Major Joint Procedures of Lower Extremity                                                        2.46485     7.57    21
   17        Q7         473    473 Acute Leukemia w/o Major O.R. Procedure, age >17                                                                       2.53472     8.94    25
    4        D1         475    475-1 Respiratory System Diagnosis w/ Ventilator Support, < 96 hr                        Excludes 96.72                    2.39197     6.97    21
    4         D2        475    475-2 Respiratory System Diagnosis w/ Ventilator Support, 96+ hr                         Includes 96.72                    7.71555    21.12    100
Unrelated    II2        476    476 Prostatic O.R. Procedure Unrelated to Principal Diagnosis                                                              2.37438     8.96    35
Unrelated    II2        477    477 Non-Extensive O.R. Procedure Unrelated to Principal Diagnosis                                                          2.37438     8.96    35
    5         E5        479    479 Other Vascular Procedures w/o CC                                                                                       1.56546     3.37    10
PreMDC       UU2        480    480 Liver Transplant &/or Intestinal Transplant                                   DRG 480 included w/ DRG 525              15.75514   25.89    73
PreMDC       UU2        481    481 Bone Marrow Transplant                                                                                                 15.75514   25.89    73
PreMDC       D10        482    482 Tracheostomy for Face, Mouth, & Neck Diagnoses                                                                         3.05931     9.50    22
   24         A2        484    484 Craniotomy for Multiple Significant Trauma                                                                             6.04648
                                                                                                          DRG 484 w/ 543: crani w/ implnt chemo agt/compl CNS Dx     15.74    32
   24        OO1        485    485 Limb Reattachment, Hip & Femur Procedures for Multiple Signif Trauma                                                   8.50337    20.00    49
   24        OO3        486    486 Other O.R. Procedures for Multiple Significant Trauma                    DRG 486 w/ DRG 506 (full thickness burn)      4.44862    11.56    22
   24        OO2        487    487 Other Multiple Significant Trauma                                                                                      1.95908     6.74    18
   25        HV1        488    488 HIV w/ Extensive O.R. Procedure                                                                                       9.99510     21.80    83
   25        HV2        489    489 HIV w/ Major Related Condition                                                                                        1.88926      7.15    21
   25        HV3        490    490 HIV with or without Other Related Conditions                                                                          1.04831      4.03    13
    8         H5        491    491 Major Joint/Limb Reattachment of Upper Extremity                                                                      1.36905      3.90    13
   17        Q2         492    492 CHEMOTHERAPY w/ Acute Leukemia as 2nd Dx                                                                              4.92819     15.33    51
    7         G6        493    493 Laparoscopic Cholecystectomy w/o C.D.E. w/ CC                                                                         1.18966      3.91    14
    7         G5        494    494 Laparoscopic Cholecystectomy w/o C.D.E. w/o CC                                                                        0.79440      2.35     5
PreMDC       UU2        495    495 Lung Transplant                                                                                                       15.75514    25.89    73
    8         H1        496    496 Combined Anterior/Posterior Spinal Fusion                                                                             4.33357      7.27    17
    8         H2        497    497 Spinal Fusion except Cervical w/ CC                                                                                   3.13460      7.03    19
    8         H3        498    498 Spinal Fusion except Cervical w/o CC                                                                                  2.46485      7.57    21

        Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                       MA      20
         MnDHS Mn Health Care Programs                                                           MA 2007-2010                                                                       Sort by DRG
                                                                                                                                                                             MA      Additions/
 Fed       Grp 23       MA                                                                                    MA Comment                                 MA Rel      MA
                                   MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                                  Trim     Corrections/
 MDC       MnDC        DRG #                                                                                  Mn Rule 9500.1100 Subp. 20b.               Value      ALOS
                                                                                                                                                                            Point    Comments
    8         H5         499    499 Back & Neck Procedures except fusion w/ CC                                                                           1.36905     3.90    13
    8         H8         500    500 Back & Neck Procedures except fusion w/o CC                                                                          0.76070     2.25     5
    8         H3         501    501 KNEE Procedures w/ PDx of Infection w/ CC                                                                            2.46485     7.57    21
    8         H7         502    502 KNEE Procedures w/ PDx of Infection w/o CC                                                                           0.91774     2.37     7
    8         H7         503    503 KNEE Procedures w/o PDx of Infection                                                                                 0.91774     2.37     7
   22        D19         504    504 Extensive or full thickness burns with MV 96+ hrs with Skin Graft         DRG 504 w/ 541 (Trach w/ CMV or Maj OR)    16.87970   49.54    96
   22        W3          505    505 Extensive or full thickness burns with MV 96+ hrs w/o Skin Graft                                                     3.27218    15.60    25
   22        OO3         506    506 Full Thick Burn with Skin Graft or Inhal Inj with CC or Signif Trauma   DRG 506 w/ 486 (OR for mult signif trauma)   4.44862    11.56    22
   22        W3          507    507 Full Thick Burn with Skin Graft or Inhal Inj w/o CC or Signif Trauma                                                 3.27218    15.60    25
   22        W3          508    508 Full Thick Burn w/o Sk Graft or Inh Inj with CC or Sign Trauma                                                       3.27218    15.60    25
   22        W4          509    509 Full Thick Burn w/o Sk Graft or Inh Inj w/o CC or Signif Trauma                                                      0.77473     3.23     6
   22        W4          510    510 Non-extensive Burns with CC or Signif Trauma                                                                         0.77473     3.23     6
   22        W4          511    511 Non-extensive Burns w/o CC or Signif Trauma                                                                          0.77473     3.23     6
PreMDC       UU2         512    512 Simultaneous Pancreas/ Kidney Transplant                                                                             15.75514   25.89    73
PreMDC       UU2         513    513 Pancreas Transplant                                                                                                  15.75514   25.89    73
    5         E4         515    515 Cardiac Defibrillator Implant w/o Cardiac Cath                                                                       7.45945    10.90    30
    5         E5         518    518 Percutaneous Cardiovascular Proc w/o Stent w/o AMI                                                                   1.56546     3.37    10
    8         H4         519    519 Cervical Spinal Fusion w/ CC                                                                                         1.78485     4.99    11
    8         H6         520    520 Cervical Spinal Fusion w/o CC                                                                                        1.13915     2.80     8
   20         T1         521    521-1 Alcohol/Drug Abuse or Dependence with CC (age 0-20)                        age 0-20; Excludes rehab Proc codes     1.27638     8.25    21
   20         T2         521    521-2 Alcohol/Drug Abuse or Dependence with CC (age > 20)                        age >20; Excludes rehab Proc codes      1.14053     5.83    19
   20                    522    522 Alcohol/Drug Abuse or Dependence with Rehab without CC                  Non-covered under FFS (see CCDTF)
   20         T3         523    523-1 Alcohol/Drug Abuse or Dependence w/o Rehab w/o CC (age 0-20)                            age 0-20                   0.79037     4.47    13
   20         T4         523    523-2 Alcohol/Drug Abuse or Dependence w/o Rehab w/o CC (age> 20)                              age >20                   0.97813     5.79    19
    1        A15         524     524 Transient Ischemia (cerebral )                                                                                      0.75287     3.01    12
    5        UU2         525    525 Heart Assist System Implant                                             DRG 525 w/transplants except DRG 103 & 302   15.75514   25.89    73
    5                    526         No Longer Valid; See DRG 555-558
    5                    527         No Longer Valid; See DRG 555-558
    1        A1          528    528 Intracranial Vascular Procedure w/ PDx of Hemorrhage                                                                 8.03832    16.88    27
    1        A3          529    529 Ventricular Shunt Procedure w/ CC                                       Includes DRG 3 when Ventr-shunt is PProc     3.70241     9.88    36
    1        A7          530    530 Ventricular Shunt Procedure w/o CC                                      Includes DRG 3 when Ventr-shunt is PProc     1.45979     2.87     8
    1        A4          531    531 Spinal Procedure w/ CC                                                                                               3.58635    11.67    43
    1        A4          532    532 Spinal Procedure w/o CC                                                                                              3.58635    11.67    43
    1        A4          533    533 Extracranial Procedure w/ CC                                                                                         3.58635    11.67    43
    1        A7          534    534 Extracranial Procedure w/o CC                                                                                        1.45979     2.87     8
    5        E4          535    535 ICD Implant with Cath with AMI, HF, or Shock                                                                         7.45945    10.90    30
    5        E4          536    536 Cardiac Defib Implant w/o Cath with AMI, HF, or Shock                                                                7.45945    10.90    30
    8        H6          537    537 Local Excis & Remov Intern Fxtn Dev Exc Hip & Femur w/ CC                                                            1.13915     2.80     8
    8        H8          538    538 Local Excis & Remov Intern Fxtn Dev Exc Hip & Femur w/o CC                                                           0.76070     2.25     5
   17        Q6          539    539 Lymphoma & Leukemia w/ Maj OR Procedure w/ CC                                                                        2.06411     6.54    20
   17        Q6          540    540 Lymphoma & Leukemia w/ Maj OR Procedure w/o CC                                                                       2.06411     6.54    20
PreMDC       D19         541    541 ECMO/ Trach w/ MV 96+ hr or PDx except Fce, Mth & Nck w/ Maj O.R.            DRG 541 w/ 504 (burn w/ CMV 96+h)       16.87970   49.54    96
PreMDC       D20         542    542 Trach w/ MV 96+hr or PDx except Face, Mouth & Neck w/o Maj O.R.                                                      10.53772   26.50    75
    1        A2          543    543 Crani w/Implnt Chemotherap Agnt or Ac Cmplx CNS PDx                                                                  6.04648    15.74    32
    8        H4          544    544 Maj Joint Replacement or Reattachment of Lower Extremity                                                             1.78485     4.99    11

         Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                     MA      21
         MnDHS Mn Health Care Programs                                                                     MA 2007-2010                                                                                         Sort by DRG
                                                                                                                                                                                                         MA       Additions/
  Fed       Grp 23      MA                                                                                              MA Comment                                              MA Rel         MA
                                   MA Grouper V.23 DRG NUMBER & DESCRIPTOR                                                                                                                              Trim      Corrections/
  MDC       MnDC       DRG #                                                                                            Mn Rule 9500.1100 Subp. 20b.                            Value         ALOS
                                                                                                                                                                                                        Point     Comments
    8         H4       545 545 Revision of Hip or Knee Replacement                                                                                                              1.78485        4.99        11
    8         H1       546 546 Spinal Fusion Except Cervical w/ Curvature of Spine or Malignancy                                                                                4.33357        7.27        17
    5          E1      547 547 Coronary Bypass with Cardiac Cath with Maj CV Dx                                                                                                 5.72356       11.92        35
    5         E17      548 548 Coronary Bypass with Cardiac Cath w/o Maj CV Diagnosis                                                                                           3.34875        7.84        17
    5          E1      549 549 Coronary Bypass w/o Cardiac Cath with Maj CV Dx                                                                                                  5.72356       11.92        35
    5         E17      550 550 Coronary Bypass w/o Cardiac Cath w/o Maj CV Diagnosis                                                                                            3.34875        7.84        17
    5          E7      551 551 PPM Implant with Maj CV Dx, or AICD Lead or Generator                                                                                            2.53423        5.48        15
    5          E3      552 552 Oth Cardiac PPM Implant w/o Maj CV Dx                                                                                                            2.29256        5.41        14
    5          E7      553 553 Oth Vascular Procedure with CC with Maj CV Dx                                                                                                    2.53423        5.48        15
    5          E5      554 554 Oth Vascular Procedure with CC w/o Maj CV Dx                                                                                                     1.56546        3.37        10
    5         E18      555 555 Perc Cardiovascular Procedure with Maj CV Diagnosis                                                                                              2.00783        3.96        12
    5          E5      556 556 Perc CV Procedure with Non-Drug-Eluding Stent w/o Maj CV Dx                                                                                      1.56546        3.37        10
    5          E7      557 557 Perc CV Procedure with Drug Eluding Stent with Maj CV Dx                                                                                         2.53423        5.48        15
    5          E7      558 558 Perc CV Procedure with Drug Eluding Stent w/o Maj CV Dx                                                                                          2.53423        5.48        15
    1         A4       559 559 Acute Ischemic Stroke w/ Use of a Thrombolytic Agent                                                                                             3.58635       11.67        43
          Grouper Version 27 MS-DRGs effective Oct. 1, 2009 (DHS uses V. 23 through 12/31/2010)
           To determine a Grouper 23 DRG, enter a test claim with a discharge between 10/1/2005 and 9/31/2006 for discharges between 1/1/07 & 12/31/10.
          * ICD-9 Conversion Table:
                             http://www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/ftpicd9.htm
          * V.24 to V. 25 Crosswalk: http://www.cms.hhs.gov/AcuteInpatientPPS/FFD/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=2&sortOrder=ascending&itemID=CMS1198678&intNumPerPage=10
                              DRGs new w/ Grouper Version 24 effective Oct. 1, 2006 (DHS does not use DRG 560-579.)
predicted ** IMPORTANT The predicted Grouper V. 23 DRG & the actual Grouper V. 23 DRG that is paid has the potential to vary. The creator of the crosswalk does not have the algorithms developed by Medicare.
                                The newer DRGs are included to assist providers with their payment audits.
                         560    Bacterial and tuberculous infections of the nervous system                           DRG 20?
                         561    Nonbacterial infections of nervous system except viral meningitis                    DRG 20?
                         562    Seizure age>17 w/ CC                                                                 DRG 24
                         563    Seizure age>17 w/o CC                                                                DRG 25
                         564    Headaches, age >17                                                                   DRG 24 (Minn Dx Cat A13) & 25 (MnDC A16)
                         565    Respiratory system diagnosis with ventilator support 96+ hours                       475-2 D2
                         566    Respiratory system diagnosis with ventilator support <96 hours                       475-1     D1
                         567    Stomach, esophageal and duodenal proc age >17 w/ CC w/ major GI Dx                   DRG 154
                         568    Stomach, esophageal and duodenal proc age >17 w/ CC w/o major GI Dx                  DRG 155
                         569    Major small and large bowel procedures w/CC w/ major GI Dx                           DRG 148
                         570    Major small and large bowel procedures w/ CC w/o major GI Dx                         DRG 149
                         571    Major esophageal disorders                                                           DRG 182-184 or 188-190 (guesstimate - need to test with your grouper)
                         572    Major gastrointestinal disorders and peritoneal infections                           DRG 182-184 or 188-190 (guesstimate - need to test with your grouper)
                         573    Major bladder procedures                                                             DRG 303 & 304
                         574    Major hematologic/immunologicDx except sickle cell crisis & coagulation disorders    395, 396, 398, 399
                         575    Septicemia w/ MV 96+ hours, age >17                                                  416 Septicemia w/vent support pays in regular septicemia DRG unless respiratory condition is PDx.
                         576    Septicemia w/o MV 96+hours, age >17                                                  416     Septicemia w/vent support pays in regular septicemia DRG unless respiratory condition is PDx.
                         577    Carotid artery stent                                                                 Version 23: DRG 533 & 534
                         578    Infectious and parasitic diseases w/ OR procedure                                    415
                         579    Postoperative or post-traumatic infections w/ OR procedure                           415




         Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                                                   MA      22
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    23
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    24
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    25
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    26
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    27
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    28
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    29
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    30
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    31
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    32
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    33
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    34
MnDHS Mn Health Care Programs                               MA 2007-2010   Sort by DRG




Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                     MA    35
          DHS, MN Health Care Programs                                          2007-2012 DRG MnDC Crosswalk                                                       Sort by DRG

* Minnesota Diagnostic Categories must be determined in conjunction with Mn Rule 9500.1100 Subp. 20g. Other DRG Requirements, A.-O.
    Fed     Grp 23        GA                                                                               GA Comment                   GA Rel     GA    GA Trim Additions/ Corrections/
                                  GA Grouper V.23 DRG NUMBER & DESCRIPTOR
    MDC     MnDC         DRG #                                                                      Mn Rule 9500.1100 Subp. 20d.        Value     ALOS    Point Comments
0           Rehab only     0     Lt effects of specific injuries with bilateral paraplegia (Y)          not used in acute care -
0           Rehab only     0     Lt effects of specific injuries with Quadri/Hemiplegia (Z)             not used in acute care -
     1         A2          1     001 Craniotomy, Age >17 with CC                                  DRG 01 w/ DRG 484, Crani for trauma   3.49553   9.96     23
     1         A4          2     002 Craniotomy, Age >17 w/o CC                                                                         1.32492   4.56     12
     1         A2          3     003 Craniotomy, Age 0-17                                                                               3.49553   9.96     23
     1                     4            No Longer Valid (see DRG 531-532)
     1                     5            No Longer Valid (see DRG 533-544)
     1        H19          6     006 Carpal Tunnel Release                                            DRG 006 w/ DRG 229 & 441          0.64339   1.71      4
     1        A4           7     007 Peripheral & Cranial Nerve & Oth Nerv Sx Procedure w/ CC                                           1.32492   4.56     12
     1        A4           8     008 Peripheral & Cranial Nrv & Oth Nervous Sx Procedure w/o CC                                         1.32492   4.56     12
     1        A5           9     009 Spinal Disorders and Injuries                                                                      1.14773   4.04     11
     1        A6          10     010 Nervous System Neopls w/ CC                                                                        0.89407   3.94     11
     1        A8          11     011 Nervous System Neopls w/o CC                                                                       0.50286   2.56      7
     1        A6          12     012 Degenerative Nervous System D/Os                                                                   0.89407   3.94     11
     1        A8          13     013 Mult Sclerosis & Cerebral Ataxia                                                                   0.50286   2.56      7
     1        A4          14     014 Intracranial Hemorrhage or Cerebral Infarction                                                     1.32492   4.56     12
     1        A6          15     015 Non-specific CVA & Precerebral Occlusion w/o Infarct                                               0.89407   3.94     11
     1        A5          16     016 Nonspecif Cerebrovasc D/O w/ CC                                                                    1.14773   4.04     11
     1        A7          17     017 Nonspecific Cerebralvasc D/Os w/o CC                                                               0.74715   2.99      8
     1        A8          18     018 Cranial & Peripheral Nerve D/Os w/ CC                                                              0.50286   2.56      7
     1        A8          19     019 Cranial & Peripheral Nerve D/Os w/o CC                                                             0.50286   2.56      7
     1        A4          20     020 Nervous system infection except viral meningitis                                                   1.32492   4.56     12
     1        A6          21     021 Viral Meningitis                                                                                   0.89407   3.94     11
     1        A5          22     022 Hypertensive Encephalopathy                                                                        1.14773   4.04     11
     1        A7          23     023 Nontraumatic Stupor & Coma                                                                         0.74715   2.99      8
     1        A7          24     024 Seizure & Headache Age >17 w/ CC                                                                   0.74715   2.99      8
     1        A8          25     025 Seizure & Headache age >17 w/o CC                                                                  0.50286   2.56      7
     1        A7          26     026 Seizure and Headache, age 0-17                                                                     0.74715   2.99      8
     1        A6          27     027 Traumatic Stupor & Coma, Coma >1 Hr                                                                0.89407   3.94     11
     1        A5          28     028 Traumatic Stupor & Coma, <1 Hr, age >17 w/ CC                                                      1.14773   4.04     11
     1        A7          29     029 Traumatic Stupor & Coma, <1 Hr, age >17, w/o CC                                                    0.74715   2.99      8
     1        A7          30     030 Traumaic Stupor & Coma, Coma <1h, age 0-17                                                         0.74715   2.99      8
     1        A8          31     031 Concussion, age >17 w/ CC                                                                          0.50286   2.56      7
     1        A8          32     032 Concussion, age >17 w/o CC                                                                         0.50286   2.56      7
     1        A8          33     033 Concussion, age 0-17                                                                               0.50286   2.56      7
     1        A6          34     034 Oth Disorders of Nervous System w/ CC                                                              0.89407   3.94     11
     1        A8          35     035 Oth D/Os of Nervous System w/o CC                                                                  0.50286   2.56      7
     2         B          36     036 Retinal Procedure                                                                                  0.72209   2.94     12
     2         B          37     037 Orbital Procedure                                                                                  0.72209   2.94     12
     2         B          38     038 PRIMARY IRIS Procedure                                                                             0.72209   2.94     12
     2         B          39     039 Lens Procdures w/ or w/o Vitrectomy                                                                0.72209   2.94     12
     2         B          40     040 Extraocul Procedure except Orbit, age >17                                                          0.72209   2.94     12
     2         B          41     041 Extraocul Procedure except Orbit, age 0-17                                                         0.72209   2.94     12
     2         B          42     042 Intraocular Procedure except Retina, Iris, Lens                                                    0.72209   2.94     12
     2         B          43     043 Hyphema                                                                                            0.72209   2.94     12
     2         B          44     044 Acute Maj Eye Infections                                                                           0.72209   2.94     12
     2         B          45     045 Neurological Eye D/Os                                                                              0.72209   2.94     12

          Ann Gjerstad, MnDHS 651-431-2541                                                                                                                            GA   pg 36
      DHS, MN Health Care Programs                                         2007-2012 DRG MnDC Crosswalk                                                  Sort by DRG

Fed     Grp 23      GA                                                                                GA Comment              GA Rel     GA    GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC     MnDC       DRG #                                                                       Mn Rule 9500.1100 Subp. 20d.   Value     ALOS    Point Comments

 2         B         46     046 Oth D/O of Eye, age >17 w/ CC                                                                 0.72209   2.94     12
 2         B         47     047 Oth D/O of Eye, age >17 w/o CC                                                                0.72209   2.94     12
 2         B         48     048 Oth D/Os of Eye, age 0-17                                                                     0.72209   2.94     12
 3         C1        49     049-1 Major Head & Neck Procedures                                                                1.00297   2.13      5
 3                   49     049-2 Major Head & Neck Procedures                                      No split under GA
 3         C1        50     050 Sialoadenectomy                                                                               1.00297   2.13      5
 3         C2        51     051 Salivary Gland Procedure except Sialoadenectomy                                               0.56335   2.37      6
 3         C2        52     052 Cleft Lip & Palate Repair                                                                     0.56335   2.37      6
 3         C1        53     053 Sinus & Mastoid Procs, age >17                                                                1.00297   2.13      5
 3         C1        54     054 Sinus & Mastoid Procs, age 0-17                                                               1.00297   2.13      5
 3         C2        55     055 Miscellaneous Ear, Nose, Mouth, & Throat Procs                                                0.56335   2.37      6
 3         C1        56     056 Rhinoplasty                                                                                   1.00297   2.13      5
 3         C2        57     057 T&A Proc, except T & A Only, age >17                                                          0.56335   2.37      6
 3         C2        58     058 T&A Proc, except T & A Only, age 0-17                                                         0.56335   2.37      6
 3         C1        59     059 Tonsillectomy, Adenoidectomy Only, age >17                                                    1.00297   2.13      5
 3         C2        60     060 Tonsillectomy, Adenoidectomy Only, age 0-17                                                   0.56335   2.37      6
 3         C2        61     061 Myringotomy W/ Tube Insertion, age >17                                                        0.56335   2.37      6
 3         C2        62     062 Myringotomy W/ Tube Insertion, age 0-17                                                       0.56335   2.37      6
 3         C1        63     063 Oth Ear, Nose Mouth, & Throat O.R. Procs                                                      1.00297   2.13      5
 3         C2        64     064 Ear, Nose, Mouth & Throat Malignancy                                                          0.56335   2.37      6
 3         C4        65     065 Dysequilibrium                                                                                0.40975   2.00      5
 3         C4        66     066 Epistaxis                                                                                     0.40975   2.00      5
 3         C3        67     067 Epiglottitis                                                                                  0.53542   2.71      8
 3         C4        68     068 Otitis Media & URI, age >17 w/ CC                                                             0.40975   2.00      5
 3         C3        69     069 Otitis Media & URI, age >17 w/o CC                                                            0.53542   2.71      8
 3         C4        70     070 Otitis Media & URI, age 0-17                                                                  0.40975   2.00      5
 3         C3        71     071 Laryngotracheitis                                                                             0.53542   2.71      8
 3         C3        72     072 Nasal Trauma & Deformity                                                                      0.53542   2.71      8
 3         C3        73     073 Oth Ear, Nose, Mouth, Throat Dx, age >17                                                      0.53542   2.71      8
 3         C4        74     074 Oth Ear, Nose, Mouth, Throat Dx, age 0-17                                                     0.40975   2.00      5
 4         D8        75     075 Maj Chest Procedure                                                                           2.79594   9.91     26
 4         D8        76     076 Oth Resp System O.R. Procedure w/ CC                                                          2.79594   9.91     26
 4         D8        77     077 Oth Resp System O.R. Procedure w/o CC                                                         2.79594   9.91     26
 4         D4        78     078 Pulmonary Embolism                                                                            1.04039   5.19     14
 4         D4        79     079 Respiratory Infection, Inflammation, age >17 w/ CC                                            1.04039   5.19     14
 4         D4        80     080 Resp Infection, Inflammation, age >17 w/o CC                                                  1.04039   5.19     14
 4         D4        81     081 Respiratory Infection, Inflammation, age 0-17                                                 1.04039   5.19     14
 4         D4        82     082 Respiratory Neoplasms                                                                         1.04039   5.19     14
 4         D4        83     083 Maj Chest Trauma w/ CC                                                                        1.04039   5.19     14
 4         D6        84     084 Maj Chest Trauma w/o CC                                                                       0.33023   1.32      3
 4         D4        85     085 Pleural Effusion w/ CC                                                                        1.04039   5.19     14
 4         D5        86     086 Pleural Effusion w/o CC                                                                       0.55424   2.87      7
 4         D4        87     087 Pulmonary Edema & Respiratory Failure                                                         1.04039   5.19     14
 4         D5        88     088 Chronic Obstructive Pulmonary Disease                                                         0.55424   2.87      7
 4         D5        89     089 Simple Pneumonia & Pleurisy, age >17 w/ CC                                                    0.55424   2.87      7
 4         D5        90     090 Simple Pneumonia & Pleurisy, age >17 w/o CC                                                   0.55424   2.87      7
 4         D5        91     091 Simple Pneumonia & Pleurisy, age 0-17                                                         0.55424   2.87      7
 4         D4        92     092 Interstitial Lung Disease w/ CC                                                               1.04039   5.19     14


      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                      GA   pg 37
      DHS, MN Health Care Programs                                            2007-2012 DRG MnDC Crosswalk                                                    Sort by DRG

Fed      Grp 23     GA                                                                                   GA Comment              GA Rel      GA     GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC      MnDC      DRG #                                                                          Mn Rule 9500.1100 Subp. 20d.   Value      ALOS     Point Comments

  4       D5          93    093   Interstitial Lung Disease w/o CC                                                                0.55424    2.87      7
  4       D4          94    094   Pneumothorax w/ CC                                                                              1.04039    5.19     14
  4       D5          95    095   Pneumothorax w/o CC                                                                             0.55424    2.87      7
  4       D5          96    096   Bronchitis & Asthma, age >17 w/ CC                                                              0.55424    2.87      7
  4       D5          97    097   Bronchitis & Asthma, age >17 w/o CC                                                             0.55424    2.87      7
  4       D5          98    098   Bronchitis & Asthma, age 0-17                                         494 cases in MA           0.55424    2.87      7
  4       D5          99    099   Respiratory Signs & Symptoms w/ CC                                                              0.55424    2.87      7
  4       D6         100    100   Respiratory Signs & Symptoms w/o CC                                                             0.33023    1.32      3
  4       D4         101    101   Oth Respiratory System Dx w/ CC                                                                 1.04039    5.19     14
  4       D5         102    102   Oth Respiratory System Dx w/o CC                                                                0.55424    2.87      7
PreMDC    UU         103    103   Heart Transplant or Implant of Heart Assist System                                             13.97639   34.80     54
  5       E4         104    104   Cardiac Valve Procedure w/ Cardiac Cath                                                         6.17659   13.12     35
  5       E5         105    105   Cardiac Valve Procedure w/o Cardiac Cath                                                        4.12602    9.50     25
  5       E4         106    106   Coronary Bypass with PTCA                                                                       6.17659   13.12     35
  5       E5         108    108   Oth Cardiothoracic Procedure                                                                    4.12602    9.50     25
  5       E5         110    110   Maj Cardiovascular Procedure w/ CC                                                              4.12602    9.50     25
  5       E6         111    111   Maj Cardiovascular Procedure w/o CC                                                             1.82340    4.17     11
  5       E5         113    113   Amputation for Circ Sx Dz excpt Upper Limb, Toe                                                 4.12602    9.50     25
  5       E7         114    114   Upper Limb, Toe Amputation for Circ System Disease                                              1.19648    3.17      9
  5       E7         117    117   Cardiac PM Revision except Device Replacement                                                   1.19648    3.17      9
  5       E7         118    118   Cardiac Pacemaker Device Replacement                                                            1.19648    3.17      9
  5       E9         119    119   Vein Ligation & Stripping                                                                       0.77769    2.26      6
  5       E6         120    120   Oth Circulatory System O.R. Procs                                                               1.82340    4.17     11
  5       E7         121    121   Circulatory Disorders with AMI & with C.V. Comp                                                 1.19648    3.17      9
  5       E10        122    122   Circulatory D/O w/ AMI w/o Maj Complic, discharged alive                                        0.69254    2.47      5
  5       E7         123    123   Circulatory Disorders with AMI, Expired                                                         1.19648    3.17      9
  5       E7         124    124   Circulatory Disorders w/ cardiac cath & complex Dx                                              1.19648    3.17      9
  5       E9         125    125   Circulatory D/Os w/ cardiac cath, w/o complex Dx                                                0.77769    2.26      6
  5       E7         126    126   Acute & Subacute Endocarditis                                                                   1.19648    3.17      9
  5       E8         127    127   Heart Failure & Shock                                                                           0.86291    3.67     10
  5       E12        128    128   Deep Vein Thrombophlebitis                                                                      0.40316    1.74      4
  5       E8         129    129   Cardiac Arrest, Unexplained                                                                     0.86291    3.67     10
  5       E8         130    130   Peripheral Vascular D/Os w/ CC                                                                  0.86291    3.67     10
  5       E11        131    131   Peripheral Vascular D/Os w/o CC                                                                 0.68085    2.69      7
  5       E12        132    132   Atherosclerosis w/ CC                                                                           0.40316    1.74      4
  5       E12        133    133   Atherosclerosis w/o CC                                                                          0.40316    1.74      4
  5       E11        134    134   Hypertension                                                                                    0.68085    2.69      7
  5       E11        135    135   Cardiac Congenital & Valvular D/Os, age >17 w/ CC                                               0.68085    2.69      7
  5       E11        136    136   Cardiac Congenital & Valvular D/Os, age >17 w/o CC                                              0.68085    2.69      7
  5       E11        137    137   Cardiac Congenital & Valvular D/Os, age 0-17                                                    0.68085    2.69      7
  5       E11        138    138   Cardiac Arrhythmia & Conduction Disease w/ CC                                                   0.68085    2.69      7
  5       E12        139    139   Cardiac Arrhythmia & Conduction Disease w/o CC                                                  0.40316    1.74      4
  5       E12        140    140   Angina Pectoris                                                                                 0.40316    1.74      4
  5       E12        141    141   Syncope & Collapse w/ CC                                                                        0.40316    1.74      4
  5       E12        142    142   Syncope & Collapse w/o CC                                                                       0.40316    1.74      4
  5       E13        143    143   Chest Pain                                                                                      0.39943    1.47      4
  5       E8         144    144   Oth Circulatory System Dx w/ CC                                                                 0.86291    3.67     10
  5       E10        145    145   Oth Circulatory System Dx w/o CC                                                                0.69254    2.47      5


      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                           GA   pg 38
      DHS, MN Health Care Programs                                         2007-2012 DRG MnDC Crosswalk                                                   Sort by DRG

Fed     Grp 23      GA                                                                                GA Comment              GA Rel     GA     GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC     MnDC       DRG #                                                                       Mn Rule 9500.1100 Subp. 20d.   Value     ALOS     Point Comments

 6         F1        146    146 Rectal resection with CC                                                                      2.50967   11.35     27
 6         F3        147    147 Rectal Resection w/o CC                                                                       1.23461    6.03     15
 6         F1        148    148 Maj Small & Large Bowel Procedure w/ CC                                                       2.50967   11.35     27
 6         F3        149    149 Maj Small, Large Bowel Procedure w/o CC                                                       1.23461    6.03     15
 6         F2        150    150 Peritoneal Adhesiolysis w/ CC                                                                 1.70597    7.35     15
 6         F5        151    151 Peritoneal Adhesiolysis w/o CC                                                                0.90781    3.82      8
 6         F2        152    152 Minor Small & Large Bowel Procedure w/ CC                                                     1.70597    7.35     15
 6         F5        153    153 Minor Small, Large Bowel Procedure w/o CC                                                     0.90781    3.82      8
 6         F1        154    154 Stomach, Esophageal, & Duodenal Procs, age >17 w/ CC                                          2.50967   11.35     27
 6         F5        155    155 Stomach, Esophageal, & Duodenal Proc, age >17 w/o CC                                          0.90781    3.82      8
 6         F2        156    156 Stomach, Esophageal, & Duodenal Procs, age 0-17                                               1.70597    7.35     15
 6         F3        157    157 Anal & Stomal Procedure w/ CC                                                                 1.23461    6.03     15
 6         F4        158    158 Anal & Stomal Procedure w/o CC                                                                0.59722    1.79      4
 6         F5        159    159 Hernia except Inguinal, Femoral, age >17 w/ CC                                                0.90781    3.82      8
 6         F4        160    160 Hernia except Inguinal, Femoral, age >17 w/o CC                                               0.59722    1.79      4
 6         F4        161    161 Inguinal, Femoral Hernia, age >17 w/ CC                                                       0.59722    1.79      4
 6         F4        162    162 Inguinal, Femoral Hernia age >17 w/o CC                                                       0.59722    1.79      4
 6         F4        163    163 Hernia Procedure age 0-17                                                                     0.59722    1.79      4
 6         F3        164    164 Appendectomy w/ Complicated PDx w/ CC                                                         1.23461    6.03     15
 6         F5        165    165 Appendectomy w/ Complicated PDx w/o CC                                                        0.90781    3.82      8
 6         F4        166    166 Appendectomy w/o Complicated PDx w/ CC                                                        0.59722    1.79      4
 6         F4        167    167 Appendectomy w/o Complicated PDx w/o CC                                                       0.59722    1.79      4
 6         F4        168    168 Mouth Procedure w/ CC                                                                         0.59722    1.79      4
 6         F4        169    169 Mouth Procedure w/o CC                                                                        0.59722    1.79      4
 6         F2        170    170 Oth Digestive Sys O.R. Procedure w/ CC                                                        1.70597    7.35     15
 6         F5        171    171 Oth Digestive Sys O.R. Procedure w/o CC                                                       0.90781    3.82      8
 6         F7        172    172 Digestive Malignancy w/ CC                                                                    0.65587    3.82      9
 6         F8        173    173 Digestive Malignancy w/o CC                                                                   0.53167    2.77      7
 6         F6        174    174 G.I. Hemorrhage w/ CC                                                                         0.80219    3.25     10
 6         F9        175    175 G.I. Hemorrhage w/o CC                                                                        0.42537    2.19      5
 6         F9        176    176 Complicated Peptic Ulcer                                                                      0.42537    2.19      5
 6         F7        177    177 Uncomplicated Peptic Ulcer w/ CC                                                              0.65587    3.82      9
 6         F7        178    178 Uncomplicated Peptic Ulcer w/o CC                                                             0.65587    3.82      9
 6         F7        179    179 Inflammatory Bowel Disease                                                                    0.65587    3.82      9
 6         F7        180    180 G.I. Obstruction w/ CC                                                                        0.65587    3.82      9
 6         F9        181    181 G.I. Obstruction w/o CC                                                                       0.42537    2.19      5
 6         F8        182    182 Misc Digest Disord age >17 w/ CC                                                              0.53167    2.77      7
 6         F9        183    183 Misc Digest Disord age >17 w/o CC                                                             0.42537    2.19      5
 6         F9        184    184 Miscellaneous Digestive D/Os, age 0-17                                                        0.42537    2.19      5
 3         C2        185    185 Dental, Oral Dz excpt Extract/Restoration, age >17                                            0.56335    2.37      6
 3         C2        186    186 Dental, Oral Dz excpt Extraction/Restoration, age 0-17                                        0.56335    2.37      6
 3         C2        187    187 Dental Extractions and Restorations                                                           0.56335    2.37      6
 6         F3        188    188 Oth Digest System Dx, age >17 w/ CC                                                           1.23461    6.03     15
 6         F7        189    189 Oth Digest System Dx, age >17 w/o CC                                                          0.65587    3.82      9
 6         F6        190    190 Oth Digestive System Dx, age 0-17                                                             0.80219    3.25     10
 7         G1        191    191 Pancreas, Liver & Shunt Procedure w/ CC                                                       3.20356   10.00     25
 7         G4        192    192 Pancreas, Liver & Shunt Procedure w/o CC                                                      1.09881    4.60     12
 7         G1        193    193 Biliary Proced Except Only Cholecyst w/ CC                                                    3.20356   10.00     25


      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                       GA   pg 39
      DHS, MN Health Care Programs                                              2007-2012 DRG MnDC Crosswalk                                                             Sort by DRG

Fed     Grp 23      GA                                                                                               GA Comment              GA Rel     GA     GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC     MnDC       DRG #                                                                                      Mn Rule 9500.1100 Subp. 20d.   Value     ALOS     Point Comments

 7         G2        194    194    Biliary Proced Except Only Cholecyst w/o CC                                                               1.35729    5.50     11
 7         G2        195    195    Cholecystectomy except lap, w/ C.D.E. w/ CC                                                               1.35729    5.50     11
 7         G4        196    196    Cholecystectomy except lap, w/ C.D.E. w/o CC                                                              1.09881    4.60     12
 7         G2        197    197    Cholecystectomy except lap, w/o C.D.E. w/ CC                                                              1.35729    5.50     11
 7         G2        198    198    Cholecystectomy except lap, w/o C.D.E. w/o CC                                                             1.35729    5.50     11
 7         G1        199    199    Hepatobiliary Diagnostic Procedure for Malignancy                                                         3.20356   10.00     25
 7         G2        200    200    Hepatobiliary Diagnostic Procedure for Non-Malignancy                                                     1.35729    5.50     11
 7         G1        201    201    Oth Hepatobiliary or Pancreas O.R. Proc                                                                   3.20356   10.00     25
 7         G3        202    202    Cirrhosis & Alcoholic Hepatitis                                                                           1.54519    6.92     19
 7         G6        203    203    Malignancy of Hepatobiliary System/ Pancreas                                                              1.10394    5.27     15
 7         G6        204    204    Disorders of the Pancreas except Malignancy                                                               1.10394    5.27     15
 7         G3        205    205    Liver Disorders except Malignancy, Cirrhosis, Alcoholic Hepatitis w/ CC                                   1.54519    6.92     19
 7         G6        206    206    Liver Disorders except Malignancy, Cirrhosis, Alcoholic Hepatitis w/o CC                                  1.10394    5.27     15
 7         G7        207    207    Disorders of the Biliary Tract w/ CC                                                                      0.61905    2.47      6
 7         G7        208    208    Disorders of the Biliary Tract w/o CC                                                                     0.61905    2.47      6
 8                   209           No Longer Valid; See 544
 8        H2         210    210    Hip & Femur Procedure except Maj Joint, age >17 w/ CC                                                     2.39525   6.58      16
 8        H7         211    211    Hip & Femur Procedure except Maj Joint, age >17 w/o CC                                                    0.91230   2.77       7
 8        H4         212    212    Hip & Femur Procedure except Maj Joint, age 0-17                                                          1.69545   4.97      13
 8        H5         213    213    Amputation for Musculoskeletal System & Connective Tissue D/Os                                            1.49097   4.87      14
 8        H5         216    216    Biopsies of Musculoskeletal System & Connective Tissue                                                    1.49097   4.87      14
 8        H3         217    217    Wnd Debrdmnt, Skn Grft exc Hand for Musculoskel/ Connec Tiss Dz                                           2.26257   7.31      19
 8        H5         218    218    Lower Extremity Proc, age >17 w/ CC                                                                       1.49097   4.87      14
 8        H7         219    219    Lower Extremity Proc, age >17 w/o CC                                                                      0.91230   2.77       7
 8        H8         220    220    Lower Extremity Proc, age 0-17                                                                            0.80803   2.07       6
 8        H7         223    223    Maj Shoulder, Elbow or Oth Upper Extremity Procedure w/ CC                                                0.91230   2.77       7
 8        H8         224    224    Shoulder, Elbow, or Forearm Procedure except Maj Joint w/o CC                                             0.80803   2.07       6
 8        H6         225    225    Foot Procedures                                                                                           1.17254   3.52      12
 8        H4         226    226    Soft Tissue Procedure w/ CC                                                                               1.69545   4.97      13
 8        H11        227    227    Soft Tissue Procedure w/o CC                                                                              0.66601   2.55       6
 8        H7         228    228    Maj Thumb, Joint, or Oth Hand or Wrist Procedure w/ CC                                                    0.91230   2.77       7
 8        H19        229    229    Hand or Wrist Procedure except Maj Joint Procedure w/o CC                    DRG 229 w/ DRG 6 & 441       0.64339   1.71       4
 8        H6         230    230   Local excis & removal Intern fixation device, hip & femur                                                  1.17254   3.52      12
 8                   231           No Longer Valid; See DRG 537-538
 8        H9         232    232    Arthroscopy                                                                                               0.67442   2.11       7
 8        H3         233    233    Oth Muscular System/ Connective Tissue O.R. Procedure w/ CC                                               2.26257   7.31      19
 8        H7         234    234    Oth Muscular System/ Connective Tiss O.R. Procedure w/o CC                                                0.91230   2.77       7
 8        H11        235    235    Fractures of Femur                                                                                        0.66601   2.55       6
 8        H11        236    236    Fractures of Hip & Pelvis                                                                                 0.66601   2.55       6
 8        H12        237    237    Sprains, Strains, & Dislocation of Hip, Pelvis, & Thigh                                                   0.62000   3.36       9
 8        H10        238    238    Osteomyelitis                                                                                             1.01511   3.71      11
 8        H10        239    239    Path Fx & Musculoskeletal & Connective Tissue Malig                                                       1.01511   3.71      11
 8        H9         240    240    Connective Tissue Disorders w/ CC                                                                         0.67442   2.11       7
 8        H9         241    241    Connective Tissue Disorders w/o CC                                                                        0.67442   2.11       7
 8        H12        242    242    Septic Arthritis                                                                                          0.62000   3.36       9
 8        H12        243    243    Medical Back Problems                                                                                     0.62000   3.36       9
 8        H11        244    244    Bone Disease & Specific Arthropathies w/ CC                                                               0.66601   2.55       6
 8        H12        245    245    Bone Disease & Specific Arthropathies w/o CC                                                              0.62000   3.36       9


      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                                      GA   pg 40
      DHS, MN Health Care Programs                                         2007-2012 DRG MnDC Crosswalk                                                         Sort by DRG

Fed     Grp 23      GA                                                                                 GA Comment                    GA Rel     GA    GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC     MnDC       DRG #                                                                        Mn Rule 9500.1100 Subp. 20d.         Value     ALOS    Point Comments

 8        H12        246    246   Non-Specific Arthropathies                                                                         0.62000   3.36      9
 8        H12        247    247   S & S of Musculoskeletal Sx/Connective Tissue                                                      0.62000   3.36      9
 8        H12        248    248   Tendonitis, Myositis & Bursitis                                                                    0.62000   3.36      9
 8        H13        249    249   Aftercare Musculoskeletal System & Connective Tissue                                               0.46632   2.20      5
 8        H11        250    250   Injury to Forearm, Hand, Foot, age >17 w/ CC                                                       0.66601   2.55      6
 8        H14        251    251   Injury to Forearm, Hand, Foot, age >17 w/o CC                                                      0.32131   1.55      3
 8        H13        252    252   Injury Forearm, Hand, Foot, age 0-17                                                               0.46632   2.20      5
 8        H13        253    253   Injury Upper Arm, Lower Leg except Foot, age >17 w/ CC                                             0.46632   2.20      5
 8        H14        254    254   Injury Upper Arm, Lower Leg except Foot, age >17 w/o CC                                            0.32131   1.55      3
 8        H11        255    255   Injury Upper Arm, Lower Leg except Foot, age 0-17                                                  0.66601   2.55      6
 8        H10        256    256   Oth Musculoskeletal Symptoms & Connective Tissue Dx                                                1.01511   3.71     11
 9         I4        257    257   Total Mastectomy for Malignancy w/ CC                                                              0.73114   3.58      9
 9         I4        258    258   Total Mastectomy for Malignancy w/o CC                                                             0.73114   3.58      9
 9         I4        259    259   Subtotal Mastectomy for Malignancy w/ CC                                                           0.73114   3.58      9
 9         I4        260    260   Subtotal Mastectomy for Malignancy w/o CC                                                          0.73114   3.58      9
 9         I5        261    261   Breast Procedure for Non-Malignancy except Biopsy                                                  0.59795   2.42      7
 9         I4        262    262   Breast Biopsy & Local Excision Non-Malignancy                                                      0.73114   3.58      9
 9         I1        263    263   Skn Grft&/or Debridement of Skin Ulcer/ Cellulitis w/ CC                                           1.46251   8.37     25
 9         I3        264    264   Skn Grft&/or Debridement of Skin Ulcer/ Cellulitis w/o CC                                          0.93212   4.29     10
 9         I1        265    265   Skn Grft&/or Debrdemnt excpt Skn Ulcer/ Cellulitis w/ CC                                           1.46251   8.37     25
 9         I2        266    266   Skn Grft&/or Debrdemnt excpt Skn Ulcer/ Cellulitis w/o CC                                          1.08271   4.19     11
 9         I5        267    267   Perianal & Pilonidal Procedure                                                                     0.59795   2.42      7
 9         I2        268    268   Skin/Subcutaneous Tissue & Breast Plastic Proc                                                     1.08271   4.19     11
 9         I3        269    269   Oth Skin/Subcutaneous Tissue/Breast Procedure w/ CC                                                0.93212   4.29     10
 9         I2        270    270   Oth Skin/Subcutaneous Tissue/Breast Procedure w/o CC                                               1.08271   4.19     11
 9         I6        271    271   Skin Ulcers                                                                                        0.57439   2.26      6
 9         I5        272    272   Maj Skin D/Os w/ CC                                                                                0.59795   2.42      7
 9         I7        273    273   Maj Skin D/Os w/o CC                                                                               0.54042   3.00      6
 9         I2        274    274   Malignant Breast D/Os w/ CC                                                                        1.08271   4.19     11
 9         I7        275    275   Malignant Breast D/Os w/o CC                                                                       0.54042   3.00      6
 9         I5        276    276   Non-Malignant Breast D/Os                                                                          0.59795   2.42      7
 9         I4        277    277   Cellulitis, age >17 w/ CC                                                                          0.73114   3.58      9
 9         I7        278    278   Cellulitis, age >17 w/o CC                                                                         0.54042   3.00      6
 9         I6        279    279   Cellulitis, age 0-17                                                                               0.57439   2.26      6
 9         I6        280    280   Trauma to Skin, Subq Tissue & Breast, age >17 w/ CC                                                0.57439   2.26      6
 9         I5        281    281   Trauma to Skin, Subq Tissue, & Breast, age>17 w/o CC                                               0.59795   2.42      7
 9         I6        282    282   Trauma to Skin, Subq Tissue & Breast, age 0-17                                                     0.57439   2.26      6
 9         I5        283    283   Minor Skin D/Os w/ CC                                                                              0.59795   2.42      7
 9         I7        284    284   Minor Skin D/Os w/o CC                                                                             0.54042   3.00      6
10        H5         285    285   Amput of LL for Endocrine, Nutritional & Metabolic D/O       w/ DRG 544 Jt replc & limb reattach   1.49097   4.87     14
10        J1         286    286   Adrenal & Pituitary Procedure                                                                      1.21464   4.05      9
10         I1        287    287   Skn Grft& Wnd Debrdemnt for Endocrine, Nutrit & Metab D/Os                                         1.46251   8.37     25
10        J1         288    288   O.R. Procedure for Obesity                                                                         1.21464   4.05      9
10        J4         289    289   Parathyroid Procedure                                                                              0.61569   3.42      9

      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                             GA   pg 41
      DHS, MN Health Care Programs                                           2007-2012 DRG MnDC Crosswalk                                                   Sort by DRG

Fed     Grp 23      GA                                                                                  GA Comment              GA Rel     GA     GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC     MnDC       DRG #                                                                         Mn Rule 9500.1100 Subp. 20d.   Value     ALOS     Point Comments

10         J1        290    290   Thyroid Procedures                                                                            1.21464    4.05      9
10         J1        291    291   Thyroglossal Procedure                                                                        1.21464    4.05      9
10         J1        292    292   Oth Endocrine, Nutritional, & Metabolic O.R. Procedure w/ CC                                  1.21464    4.05      9
10         J1        293    293   Oth O.R. Procedure w/o CC                                                                     1.21464    4.05      9
10         J2        294    294   Diabetes, age >35                                                                             0.63541    2.82      7
10         J3        295    295   Diabetes, age 0-35                                                                            0.53284    2.49      6
10         J4        296    296   Nutritional & Metabolic D/Os, age >17 w/ CC                                                   0.61569    3.42      9
10         J6        297    297   Nutritional & Misc Metabolic D/Os, age >17 w/o CC                                             0.38803    2.24      5
10         J6        298    298   Nutritional & Miscellaneous Metabolic D/Os, age 0-17                                          0.38803    2.24      5
10         J2        299    299   Inborn Errors of Metabolism                                                                   0.63541    2.82      7
10         J5        300    300   Endocrine Disorders w/ CC                                                                     0.97086    4.54     13
10         J6        301    301   Endocrine Disorders w/o CC                                                                    0.38803    2.24      5
11         H1        302    302   Kidney Transplant                                               DRG 302 w/ DRG 485 & 546      4.75312   11.13     27
11         K1        303    303   Kidney, Ureter, & Maj Bladder Procedure for Neopl                                             2.09753    7.59     17
11         K1        304    304   Kidney, Ureter, & Maj Bladder Procedure for Non-Neopl w/ CC                                   2.09753    7.59     17
11         K3        305    305   Kidney, Ureter, Maj Bladder Procedure for Non-Neopl w/o CC                                    1.11816    2.69      5
11         K3        306    306   Prostatectomy w/ CC                                                                           1.11816    2.69      5
11         K4        307    307   Prostatectomy w/o CC                                                                          0.75927    3.43      9
11         K1        308    308   Minor Bladder Procedure w/ CC                                                                 2.09753    7.59     17
11         K4        309    309   Minor Bladder Procedure w/o CC                                                                0.75927    3.43      9
11         K4        310    310   Transurethral Procedure w/ CC                                                                 0.75927    3.43      9
11         K5        311    311   Transurethral Procedure w/o CC                                                                0.48716    2.07      4
11         K5        312    312   Urethral Procs, age >17 w/ CC                                                                 0.48716    2.07      4
11         K5        313    313   Urethral Procs, age >17 w/o CC                                                                0.48716    2.07      4
11         K5        314    314   Urethral Procs, age 0-17                                                                      0.48716    2.07      4
11         K1        315    315   Oth Kidney & Urinary Tract O.R. Proc                                                          2.09753    7.59     17
11         K6        316    316   Renal Failure                                                                                 1.31170    5.50     14
11         K4        317    317   Admit for Renal Dialysis                                                                      0.75927    3.43      9
11         K6        318    318   Kidney & Urinary Tract Neopls w/ CC                                                           1.31170    5.50     14
11         K4        319    319   Kidney & Urinary Tract Neopls w/o CC                                                          0.75927    3.43      9
11         K4        320    320   Kidney/Urinary Tract Infection, age >17 w/ CC                                                 0.75927    3.43      9
11         K5        321    321   Kidney/Urinary Tract Infection, age >17 w/o CC                                                0.48716    2.07      4
11         K5        322    322   Kidney/Urinary Tract Infection, age 0-17                                                      0.48716    2.07      4
11         K5        323    323   Urinary Stones w/ CC, ESW Lithotripsy                                                         0.48716    2.07      4
11         K7        324    324   Urinary Stones w/o CC                                                                         0.39205    1.82      4
11         K7        325    325   Kidney/Urinary Signs/Symptoms, age >17 w/ CC                                                  0.39205    1.82      4
11         K7        326    326   Kidney/ Urinary Signs/Symptoms, age >17 w/o CC                                                0.39205    1.82      4
11         K7        327    327   Kidney/ Urinary Signs/Symptoms, age 0-17                                                      0.39205    1.82      4
11         K6        328    328   Urethral Stricture, age >17 w/ CC                                                             1.31170    5.50     14
11         K7        329    329   Urethral Stricture, age >17 w/o CC                                                            0.39205    1.82      4
11         K7        330    330   Urethral Stricture, age 0-17                                                                  0.39205    1.82      4
11         K4        331    331   Oth Kidney & Urinary Tract Dx, age >17 w/ CC                                                  0.75927    3.43      9
11         K7        332    332   Oth Kidney & Urinary Tract Dx, age >17 w/o CC                                                 0.39205    1.82      4
11         K6        333    333   Oth Kidney & Urinary Tract Dx, age 0-17                                                       1.31170    5.50     14
12         L1        334    334   Maj Male Pelvic Procedure w/ CC                                                               1.06108    3.92      9
12         L1        335    335   Maj Male Pelvic Procedure w/o CC                                                              1.06108    3.92      9
12         L2        336    336   Transurethral Prostatectomy w/ CC                                                             0.62061    2.76      7
12         L2        337    337   Transurethral Prostatectomy w/o CC                                                            0.62061    2.76      7


      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                         GA   pg 42
      DHS, MN Health Care Programs                                        2007-2012 DRG MnDC Crosswalk                                                                Sort by DRG

Fed     Grp 23      GA                                                                                        GA Comment                   GA Rel     GA    GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC     MnDC       DRG #                                                                               Mn Rule 9500.1100 Subp. 20d.        Value     ALOS    Point Comments

12        L1         338    338 Testes Procedure for Malignancy                                                                            1.06108   3.92      9
12        L1         339    339 Testes Proc, Non-Malignancy, age >17                                                                       1.06108   3.92      9
12        L1         340    340 Testes Proc, Non-Malignancy, age 0-17                                                                      1.06108   3.92      9
12        L2         341    341 Penis Procedures                                                                                           0.62061   2.76      7
12        L2         342    342 Circumcision, age >17                                                                                      0.62061   2.76      7
12        L2         343    343 Circumcision, age 0-17                                                                                     0.62061   2.76      7
12        L1         344    344 Oth Male Reproductive O.R. Procedure for Malignancy                                                        1.06108   3.92      9
12        L1         345    345 Oth Male Reproductive O.R. Procedure except for Malignancy                                                 1.06108   3.92      9
12        L2         346    346 Malignancy, Male Reproductive System w/ CC                                                                 0.62061   2.76      7
12        L2         347    347 Malignancy, Male Reproductive System w/o CC                                                                0.62061   2.76      7
12        L2         348    348 Benign Prostatic Hypertrophy w/ CC                                                                         0.62061   2.76      7
12        L2         349    349 Benign Prostatic Hypertrophy w/o CC                                                                        0.62061   2.76      7
12        L2         350    350 Inflammation of the Male Reproductive System                                                               0.62061   2.76      7
12        L2         351    351 Sterilization, Male                                                                                        0.62061   2.76      7
12        L2         352    352 Oth Male Reproductive System Dx                                                                            0.62061   2.76      7
13        M5         353    353 Pelvic Evisceration, Radical Hysterectomy                                                                  1.82290   7.00     22
13        M6         354    354 Uterine, Adnexa Procedure for Non-Ovarian/Adnexal Malignancy w/ CC                                         0.99039   3.74      8
13        M6         355    355 Uterine, Adnexa Procedure for Non-Ovarian/Adnexal Malignancy w/o CC                                        0.99039   3.74      8
13        M4         356    356 Female Reproductive System Reconstructive Procs                                                            0.69124   2.93      9
13        M5         357    357 Uterine, Adnexa Procedure for Ovarian & Adnexal Malignancy                                                 1.82290   7.00     22
13        M6         358    358 Uterine, Adnexa Procedure for Non-Malignancy w/ CC                                                         0.99039   3.74      8
13        M4         359    359 Uterine, Adnexa Procedure for Non-Malignancy w/o CC                                                        0.69124   2.93      9
13        M6         360    360 Vagina, Cervix & Vulva Procedures                                                                          0.99039   3.74      8
13        M6         361    361 Laparoscopy & Incisional Tubal Interruption                                                                0.99039   3.74      8
13        M1         362    362 Endoscopic Tubal Interruption                                                                              0.50938   2.87      6
13        M6         363    363 D&C, Conization, Radio-Implant w/ Malignancy                                                               0.99039   3.74      8
13        M1         364    364 D&C, Conization except for Malignancy                                                                      0.50938   2.87      6
13        M6         365    365 Oth Female Reproductive System O.R. Proc                                                                   0.99039   3.74      8
13        M4         366    366 Malignancy, Female Reproductive System w/ CC                                                               0.69124   2.93      9
13        M1         367    367 Malignancy, Female Reproductive System w/o CC                                                              0.50938   2.87      6
13        M1         368    368 Infection, Female Reproductive System                                                                      0.50938   2.87      6
13        M4         369    369 Menstrual & Oth Female Reproductive System D/Os                                                            0.69124   2.93      9
14        N1         370    370 Cesarean Section w/ CC                                                Deliveries should be covered under   0.96655   4.50      6
14        N1         371    371 Cesarean Section w/o CC                                               a FFP program. Contact county for    0.96655   4.50      6
14        N2         372    372 Vaginal Delivery w/ Complicating Dx                                             eligibilty change          0.52031   2.36      5
14        N2         373    373 Vaginal Delivery w/o Complicating Dx                                  Deliveries should be covered under   0.52031   2.36      5
14        N2         374    374 Vaginal Delivery w/ Sterilization &/ or D&C                           a FFP program. Contact county for    0.52031   2.36      5
14        N2         375    375 Vaginal Delivery w/ O.R. Procedure except Sterilization/ D&C                    eligibilty change          0.52031   2.36      5
14        N2         376    376 Postpartum & Post Abortion Dx w/o O.R. Proc                           Pregnancy related stays should be    0.52031   2.36      5
14        N1         377    377 Postpartum/Post Abortion Dx w/ O.R. Proc                                   covered under FFP (MA)          0.96655   4.50      6
14        N2         378    378 Ectopic Pregnancy                                                     Pregnancy should be covered under    0.52031   2.36      5
14        N2         379    379 Threatened Abortion                                                   a FFP program. Contact county for    0.52031   2.36      5
14        N2         380    380 Abortion w/o D&C                                                                eligibilty change          0.52031   2.36      5
14        N2         381    381 Abortion w/ D&C, Aspiration Curettage or Hysterotomy                  Pregnancy should be covered under    0.52031   2.36      5
14        N2         382    382 False Labor                                                             a FFP program. Contact county      0.52031   2.36      5
14        N2         383    383 Oth Antepartum Dx w/ Medical Complications                            Pregnancy related stays should be    0.52031   2.36      5
14        N2         384    384 Oth Antepartum Dx w/o Medical Complications                                covered under FFP (MA)          0.52031   2.36      5
15                   385    385-1 Neonates Died or Transferred to Another Hospital                    Neonates should be covered under


      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                                   GA   pg 43
      DHS, MN Health Care Programs                                           2007-2012 DRG MnDC Crosswalk                                                                Sort by DRG

Fed     Grp 23      GA                                                                                             GA Comment                GA Rel     GA     GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC     MnDC       DRG #                                                                                    Mn Rule 9500.1100 Subp. 20d.     Value     ALOS     Point Comments

15                   385    385-2 Neonates Died or Transferred to Another Hospital                       a FFP program. Contact county for
15                   386    386-1 Extreme Immaturity & Neonatal Respiratory Distress Syndrome                     eligibilty change
15                   386    386-4 Extreme Immaturity & Neonatal Resp Distress Syndrome
15                   386    386-5 Extreme Immaturity & Neonatal Resp Distress Syndrome                   Neonates should be covered under
15                   387    387-1 Prematurity w/ Major Problems (Wt <1250 Gms)                           a FFP program. Contact county for
15                   387    387-2 Prematurity w/ Major Problems (Wt 1250-1749 Gms)                                eligibilty change
15                   387    387-3 Prematurity w/ Major Problems (Wt >1749 Gms)
15                   387    387-4 Prematurity w/ Major Problems (Dx 765.00 only)                         Neonates should be covered under
15                   388    388   Prematurity w/o Maj Problems                                           a FFP program. Contact county for
15                   389    389   Full Term Neonate w/ Maj Problems                                               eligibilty change
15                   390    390   Neonate w/ Oth Significant Problems
15                   391    391   Normal Newborn                                                         Neonates should be covered w/ FFP
16         P1        392    392 Splenectomy, age >17                                                                                         1.79602   6.85      20
16         P1        393    393 Splenectomy, age 0-17                                                                                        1.79602   6.85      20
16         P1        394    394 Oth O.R. Procedure of Blood & Blood Forming Organs                                                           1.79602   6.85      20
16         P2        395    395 Red Blood Cell D/Os, age >17                                                                                 0.67997   3.41      10
16         P2        396    396 Red Blood Cell Disorders, age 0-17                                                                           0.67997   3.41      10
16         P1        397    397 Coagulation D/Os                                                                                             1.79602   6.85      20
16         P2        398    398 Reticuloendothelial & Immunity D/Os w/ CC                                                                    0.67997   3.41      10
16         P2        399    399 Reticuloendothelial & Immunity D/Os w/o CC                                                                   0.67997   3.41      10
17                   400         No Longer Valid; See DRG 539-540
17         Q3        401    401 Lymphoma & Non-Acute Leukemia w/ O.R. Procedure w/ CC                                                        1.88847    6.87     23
17         Q3        402    402 Lymphoma & Non-Acute Leukemia w/ O.R. Procedure w/o CC                                                       1.88847    6.87     23
17         Q3        403    403 Lymphoma & Non-Acute Leukemia w/ CC                                                                          1.88847    6.87     23
17         Q4        404    404 Lymphoma & Non-Acute Leukemia w/o CC                                                                         1.03999    4.90     15
17         Q3        405    405 Acute Leukemia w/o Maj O.R. Proc, age 0-17                                                                   1.88847    6.87     23
17         Q3        406    406 Myeloprolif D/O or Prly Differentiated Neopl w/ Maj O.R. Procedure w/ CC                                     1.88847    6.87     23
17         Q4        407    407 Myeloprolif D/o or Prly Different'd Neopl w/ Maj OR Procedure w/o CC                                         1.03999    4.90     15
17         Q3        408    408 Myeloprolif D/O or Prly Different'd Neopl w/ Oth O.R. Proc                                                   1.88847    6.87     23
17         Q4        409    409 Radiotherapy                                                                                                 1.03999    4.90     15
17         Q4        410    410 Chemotherapy w/o Acute Leukemia as a secondary Dx                                                            1.03999    4.90     15
17         Q4        411    411 Hx of Malignancy w/o Endoscopy                                                                               1.03999    4.90     15
17         Q4        412    412 Hx of Malignancy w/ Endoscopy                                                                                1.03999    4.90     15
17         Q4        413    413 Oth Myeloproliferative Dz or Prly Differentiated Neopl w/ CC                                                 1.03999    4.90     15
17         Q4        414    414 Oth Myeloproliferative Dz or Prly Differentiated Neopl w/o CC                                                1.03999    4.90     15
18         R1        415    415 O.R. Procedure for Infection & Parasitic Diseases                                                            1.96341    8.96     23
18         R2        416    416 Septicemia, age >17                                                                                          1.03883    5.23     13
18         R2        417    417 Septicemia, age 0-17                                                                                         1.03883    5.23     13
18         R3        418    418 Postop & Post-Traumatic Infections                                                                           0.90928    4.67     10
18         R4        419    419 Fever of Unknown Origin, age >17 w/ CC                                                                       0.61261    3.13      8
18         R4        420    420 Fever of Unknown Origin, age >17 w/o CC                                                                      0.61261    3.13      8
18         R4        421    421 Viral Illness, age >17                                                                                       0.61261    3.13      8
18         R4        422    422 Viral Illness & Fever of Unknown Origin, age 0-17                                                            0.61261    3.13      8
18         R2        423    423 Oth Infection & Parasitic Diseases Dx                                                                        1.03883    5.23     13
19         S1        424    424 O.R. Procedure w/ PDx of Mental Illness                                                                      1.76391   12.50     34
19         S2        425    42 Acute Adjustment Reaction/ Psychological Dysfunction                                                          0.66973    5.38     20
19                   425    425 Acute Adjustment Reaction/ Psychological Dysfunction                            No age split in GA
19         S3        426    426    Depressive Neuroses                                                                                       0.58204   5.48      15


      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                                      GA   pg 44
       DHS, MN Health Care Programs                                           2007-2012 DRG MnDC Crosswalk                                                        Sort by DRG

 Fed        Grp 23    GA                                                                                 GA Comment                  GA Rel      GA     GA Trim Additions/ Corrections/
                              GA Grouper V.23 DRG NUMBER & DESCRIPTOR
 MDC        MnDC     DRG #                                                                        Mn Rule 9500.1100 Subp. 20d.       Value      ALOS     Point Comments

  19         S4       427    427 Neuroses except Depressive                                                                          0.57775    5.46      20
  19                  427    427 Neuroses except Depressive                                             No age split in GA
  19         S4       428    428 Disorders of Personality & Impulse Control                                                          0.57775    5.46      20
  19                  428    428 Disorders of Personality & Impulse Control                             No age split in GA
  19         S4       429    429 Organic Disturbance/ Mental Retardation                                                             0.57775    5.46      20
  19                  429    429 Organic Disturbance/ Mental Retardation                                No age split in GA
  19         S5       430    430 Psychoses                                                                                           0.95843    9.43      26
  19                  430    430 Psychoses                                                              No age split in GA
  19         S3       431    431 Childhood Mental Disorders                                                                          0.58204    5.48      15
  19         S2       432    432-1 Other Mental Disorder Diagnoses                                                                   0.66973    5.38      20
  19                  432    432-2 Other Mental Disorder Diagnoses                                       No age split in GA
  20                  433    433 Alcohol/Drug Abuse or Dependence, Left AMA                      Disch destination changed to home
  21         V1       439    439 Skin Grafts for Injuries                                                                            1.71373    7.36      21
  21         V2       440    440 Wound Debridements for Injuries                                                                     1.09531    5.09      20
  21         H19      441    441 Hand Procedure for Injuries                                             w/ DRG 6 & 229              0.64339    1.71       4
  21         V1       442    442 Oth O.R. Procedure for Injury w/ CC                                                                 1.71373    7.36      21
  21         V2       443    443 Oth O.R. Procedure for Injury w/o CC                                                                1.09531    5.09      20
  21         V3       444    444 Traumatic Injury, age >17 w/ CC                                                                     0.48469    2.00       4
  21         V3       445    445 Traumatic Injury, age >17 w/o CC                                                                    0.48469    2.00       4
  21         V3       446    446 Traumatic Injury, age 0-17                                                                          0.48469    2.00       4
  21         V4       447    447 Allergic Reactions, age >17                                                                         0.41419    1.88       4
  21         V4       448    448 Allergic Reactions, age 0-17                                                                        0.41419    1.88       4
  21         V5       449    449 Poison & Toxic Effects of Drugs, age >17 w/ CC                                                      1.19037    4.97      18
  21         V6       450    450 Poisoning & Toxic Effects of Drugs, age >17 w/o CC                                                  0.51304    2.56       8
  21         V6       451    451 Poisoning & Toxic Effects of Drugs, age 0-17                                                        0.51304    2.56       8
  21         V8       452    452 Complications of Treatment w/ CC                                                                    0.94946    4.78      15
  21         V4       453    453 Complications of Treatment w/o CC                                                                   0.41419    1.88       4
  21         V8       454    454 Oth Injury, Poisoning, & Toxic Effect Dx w/ CC                                                      0.94946    4.78      15
  21         V8       455    455 Oth Injury, Poisoning, & Toxic Effect Dx w/o CC                                                     0.94946    4.78      15
  23         X1       461    461 O.R. Procedure w/ Dx of Oth Contact w/ Health Services                                              0.89869    2.25       9
  23         X2       462    462 Rehabilitation                                                                                      0.93449    6.50      18
  23         X2       463    463 Signs & Symptoms w/ CC                                                                              0.93449    6.50      18
  23         X2       464    464 Signs & Symptoms w/o CC                                                                             0.93449    6.50      18
  23         X2       465    465 Aftercare w/ Hx of Malignancy as Secondary Dx                                                       0.93449    6.50      18
  23         X2       466    466 Aftercare w/o Hx of Malignancy as Secondary Dx                                                      0.93449    6.50      18
  23         X2       467    467 Oth Factors Influencing Health Status                                                               0.93449    6.50      18
Unrelated    II1      468    468 Extensive O.R. Procedure Unrelated to PDx                                                           1.70818    6.52      18
  14                  469    469 Principal Diagnosis Invalid as Discharge Diagnosis
  15                  470    470 Ungroupable
   8         H2       471    471 Bilateral or Mult Maj Joint Procedure of Lower Extremity                                             2.39525    6.58     16
  17         Q3       473    473 Acute Leukemia w/o Maj O.R. Proc, age >17                                                            1.88847    6.87     23
   4         D1       475    475-1 Respiratory System Dx w/ Ventilator Support, < 96 hrs                  excludes 96.72              1.58247    4.70     13
   4         D2       475    475-2 Respiratory System Dx w/ Ventilator Support, 96+ hrs                   includes 96.72              5.15680   15.25     33
Unrelated    II2      476    476 Prostatic O.R. Procedure Unrelated to PDx                                                            1.14830    5.33     15
Unrelated    II2      477    477 Non-Extensive O.R. Procedure Unrelated to PDx                                                        1.14830    5.33     15
   5         E8       479    479 Oth Vascular Procedures w/o CC                                                                       0.86291    3.67     10
PreMDC       UU       480    480 Liver Transplant &/or Intestinal Transplant                                                         13.97639   34.80     54
PreMDC       UU       481    481 Bone Marrow Transplant                                                                              13.97639   34.80     54


       Ann Gjerstad, MnDHS 651-431-2541                                                                                                                              GA   pg 45
      DHS, MN Health Care Programs                                            2007-2012 DRG MnDC Crosswalk                                                            Sort by DRG

Fed      Grp 23     GA                                                                                        GA Comment                 GA Rel      GA     GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC      MnDC      DRG #                                                                               Mn Rule 9500.1100 Subp. 20d.      Value      ALOS     Point Comments

PreMDC     D7        482    482 Tracheostomy for Face, Mouth, & Neck Dx                                                                   1.98798    9.36     14
 24        A2        484    484 Craniotomy for Mult Significant Trauma                                 DRG 484 w/ DRG 1, 3, 531, 543      3.49553    9.96     23
 24        H1        485    485 Limb Reattchmt, Hip & Femur Procedure for Mult Signif Trauma            DRG 485 w/ DRG 302 & 546          4.75312   11.13     27
 24       OO1        486    486 Oth O.R. Procedure for Mult Significant Trauma                            DRG 486 w/ DRG 506              3.40969   11.18     21
 24       OO2        487    487 Oth Mult Significant Trauma                                                                               1.52210    4.80     11
 25       WW         488    488 HIV w/ Extensive O.R. Proc                                                                                2.73460   10.95     39
 25       WW         489    489 HIV w/ Maj Related Condition                                                                              2.73460   10.95     39
 25       WW         490    490 HIV with or without Oth Related Conditions                                                                2.73460   10.95     39
  8        H6        491    491 Maj Joint/Limb Reattachment of Upper Extremity                                                            1.17254    3.52     12
 17        Q3        492    492 Chemotherapy w/ Acute Leukemia as 2nd Dx                                                                  1.88847    6.87     23
  7        G4        493    493 Laparoscopic Cholecystectomy w/o C.D.E. w/ CC                                                             1.09881    4.60     12
  7        G5        494    494 Laparoscopic Cholecystectomy w/o C.D.E. w/o CC                                                            0.82634    2.64      8
PreMDC    UU         495    495 Lung Transplant                                                                                          13.97639   34.80     54
  8        H2        496    496 Combined Anterior/Posterior Spinal Fusion                                                                 2.39525    6.58     16
  8        H2        497    497 Spinal Fusion except Cervical w/ CC                                                                       2.39525    6.58     16
  8        H4        498    498 Spinal Fusion except Cervical w/o CC                                                                      1.69545    4.97     13
  8        H9        499    499 Back & Neck Procedure except fusion w/ CC                                                                 0.67442    2.11      7
  8        H9        500    500 Back & Neck Procedure except fusion w/o CC                                                                0.67442    2.11      7
  8        H2        501    501 KNEE Procedure w/ PDx of Infection w/ CC                                                                  2.39525    6.58     16
  8        H6        502    502 KNEE Procedure w/ PDx of Infection w/o CC                                                                 1.17254    3.52     12
  8        H8        503    503 KNEE Procedure w/o PDx of Infection                                                                       0.80803    2.07      6
 22       UU         504    504 Extensive or full thickness burns with MV 96+ hrs with Skin Graft      DRG 504 w/ Tranplants & Trach     13.97639   34.80     54
 22       W3         505    505 Extensive or full thickness burns with MV 96+ hrs w/o Skin Graft                                          2.26673   10.00     12
 22       OO1        506    506 Full Thick Burn with Skn Grftor Inhal Inj with CC or Signif Trauma         DRG 506 w/ DRG 486             3.40969   11.18     21
 22       W3         507    507 Full Thick Burn with Skn Grftor Inhal Inj w/o CC or Signif Trauma                                         2.26673   10.00     12
 22        D7        508    508 Full Thick Burn w/o Sk Graft or Inh Inj w CC or Sign Trauma                                               1.98798    9.36     14
 22       W1         509    509 Full Thick Burn w/o Sk Graft or Inh Inj w/o CC or Signif Trauma                                           1.10899    5.13      9
 22       W1         510    510 Non-extensive Burns with CC or Signif Trauma                                                              1.10899    5.13      9
 22       W1         511    511 Non-extensive Burns w/o CC or Signif Trauma                                                               1.10899    5.13      9
PreMDC    UU         512    512 Simultaneous Pancreas/ Kidney Transplant                                                                 13.97639   34.80     54
PreMDC    UU         513    513 Pancreas Transplant                                                                                      13.97639   34.80     54
  5        E5        515    515 Cardiac Defibrillator Implant w/o Cardiac Cath                                                            4.12602    9.50     25
  5        E7        518    518 Percutaneous Cardiovascular Procedure w/o Stent w/o AMI                                                   1.19648    3.17      9
  8        H4        519    519 Cervical Spinal Fusion w/ CC                                                                              1.69545    4.97     13
  8        H6        520    520 Cervical Spinal Fusion w/o CC                                                                             1.17254    3.52     12
 20        T1        521    521 -1 Alcohol/Drug Abuse or Dependence with CC                          Excludes CD rehab procedure codes    0.90619    4.88     14
 20                  521    521 -2 Alcohol/Drug Abuse or Dependence with CC                                  No age split in GA
 20                  522    522 Alcohol/Drug Abuse or Dependence with Rehab without CC                       Not paid under FFS
 20        T2        523    523 -1 Alcohol/Drug Abuse or Dependence w/o Rehab w/o CC                                                     0.60727    4.05      11
 20                  523    523 -2 Alcohol/Drug Abuse or Dependence w/o Rehab w/o CC                         No age split in GA
  1       A8         524    524 Transient Ischemia                                                                                        0.50286    2.56      7
  5       UU         525    525 Heart Assist System Implant                                                                              13.97639   34.80     54
  1       A1         528    528 Intracranial Vascular Procedure w/ PDx of Hemorrhage                                                      6.50219   13.20     25
  1       A3         529    529 Ventricular Shunt Procedure w/ CC                                                                         2.03130    6.22     10
  1       A4         530    530 Ventricular Shunt Procedure w/o CC                                                                        1.32492    4.56     12
  1       A2         531    531 Spinal Procedure w/ CC                                                                                    3.49553    9.96     23
  1       A4         532    532 Spinal Procedure w/o CC                                                                                   1.32492    4.56     12
  1       A3         533    533 Extracranial Procedure w/ CC                                                                              2.03130    6.22     10


      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                                   GA   pg 46
       DHS, MN Health Care Programs                                                  2007-2012 DRG MnDC Crosswalk                                                                             Sort by DRG

 Fed      Grp 23      GA                                                                                                     GA Comment                     GA Rel       GA      GA Trim Additions/ Corrections/
                               GA Grouper V.23 DRG NUMBER & DESCRIPTOR
 MDC      MnDC       DRG #                                                                                            Mn Rule 9500.1100 Subp. 20d.          Value       ALOS      Point Comments

   1        A4         534    534   Extracranial Procedure w/o CC                                                                                       1.32492          4.56        12
   5        E4         535    535   ICD Implant with Cath with AMI, HF, or Shock                                                                        6.17659         13.12        35
   5        E4         536    536   Cardiac Defib Implant w/o Cath with AMI, HF, or Shock                                                               6.17659         13.12        35
   8        H4         537    537    Local Excis & Remov Intern Fxtn Dev Exc Hip & Femur w/ CC                                                          1.69545          4.97        13
   8        H8         538    538    Local Excis & Remov Intern Fxtn Dev Exc Hip & Femur w/o CC                                                         0.80803          2.07         6
  17        Q3         539    539    Lymphoma & Leukemia w/ Maj OR Procedure w/ CC                                                                      1.88847          6.87        23
  17        Q3         540    540    Lymphoma & Leukemia w/ Maj OR Procedure w/o CC                                                                     1.88847          6.87        23
PreMDC      UU         541    541    Trach w/ MV 96+ hr or PDx exc Fce, Mth & Nck w/ Maj O.R.                                                          13.97639         34.80        54
PreMDC      UU         542    542    Trach w/ MV 96+hr Exc Face, Mouth & Neck w/o Maj O.R.                                                             13.97639         34.80        54
   1        A2         543    543   Crani w/Implnt Chemotherap Agnt or Ac Cmplx CNS PDx                                                                 3.49553          9.96        23
   8        H5         544    544   Maj Joint Replacement or Reattachment of Lower Extremity                      DRG 544 w/ DRG 285 Amp for endocrine 1.49097           4.87        14
   8        H4         545    545   Revision of Hip or Knee Replacement                                                                                 1.69545          4.97        13
   8        H1         546    546   Spinal Fusion Except Cervical w/ Curvature of Spine or Malignancy                 DRG 546 w/ DRG 485 & 302          4.75312         11.13        27
   5        E5         547    547   Coronary Bypass with Cardiac Cath with Maj CV Dx                                                                    4.12602          9.50        25
   5        E6         548    548   Coronary Bypass with Cardiac Cath w/o Maj CV Dx                                                                     1.82340          4.17        11
   5        E6         549    549   Coronary Bypass w/o Cardiac Cath with Maj CV Dx                                                                     1.82340          4.17        11
   5        E6         550    550   Coronary Bypass w/o Cardiac Cath w/o Maj CV Dx                                                                      1.82340          4.17        11
   5        E6         551    551    PPM Implant with Maj CV Dx, or AICD Lead or Generator                                                              1.82340          4.17        11
   5        E6         552    552   Oth Cardiac PPM Implant w/o Maj CV Dx                                                                               1.82340          4.17        11
   5        E5         553    553   Oth Vascular Procedure with CC with Maj CV Dx                                                                       4.12602          9.50        25
   5        E6         554    554   Oth Vascular Procedure with CC w/o Maj CV Dx                                                                        1.82340          4.17        11
   5        E6         555    555   Perc CV Procedure with Maj CV Dx                                                                                    1.82340          4.17        11
   5        E7         556    556   Perc CV Procedure with Non-Drug-Eluding Stent w/o Maj CV Dx                                                         1.19648          3.17         9
   5        E6         557    557   Perc CV Procedure with Drug Eluding Stent with Maj CV Dx                                                            1.82340          4.17        11
   5        E6         558    558   Perc CV Procedure with Drug Eluding Stent w/o Maj CV Dx                                                             1.82340          4.17        11
   1        A3         559    559   Acute Ischemic Stroke w/ Use of a Thrombolytic Agent                                                                2.03130          6.22        10

                              Effective for admission on or after January 1, 2007

                              DRGs new w/ Grouper Version 24 effective Oct. 1, 2006 (DHS does not use DRG 560-579.)
                              To determine a Grouper 23 DRG, enter a test claim with a discharge between 10/1/2005 and 9/31/2006 for discharges between 1/1/07 & 12/31/10.
predicted ** IMPORTANT The predicted Grouper V. 23 DRG & the actual Grouper V. 23 DRG that is paid has the potential to vary. The creator of the crosswalk does not have the algorithms developed by Medicare.
                              The newer DRGs are included to assist providers with their payment audits.
                       560    Bacterial and tuberculous infections of the nervous system                          DRG 20?
                       561    Nonbacterial infections of nervous system except viral meningitis                   DRG 20?
                       562    Seizure age>17 w/ CC                                                                DRG 24
                       563    Seizure age>17 w/o CC                                                               DRG 25
                       564    Headaches, age >17                                                                  DRG 24 (Minn Dx Cat A13) & 25 (MnDC A16)
                       565    Respiratory system diagnosis with ventilator support 96+ hours                      475-2 D2
                       566    Respiratory system diagnosis with ventilator support <96 hours                      475-1 D1
                       567    Stomach, esophageal and duodenal proc age >17 w/ CC w/ major GI Dx                  DRG 154
                       568    Stomach, esophageal and duodenal proc age >17 w/ CC w/o major GI Dx                 DRG 155
                       569    Major small and large bowel procedures w/CC w/ major GI Dx                          DRG 148
                       570    Major small and large bowel procedures w/ CC w/o major GI Dx                        DRG 149
                       571    Major esophageal disorders                                                          DRG 182-184 or 188-190 (guesstimate - need to test with your grouper)
                       572    Major gastrointestinal disorders and peritoneal infections                          DRG 182-184 or 188-190 (guesstimate - need to test with your grouper)
                       573    Major bladder procedures                                                            DRG 303 & 304
                       574    Major hematologic/immunologicDx except sickle cell crisis & coagulation disorders   395, 396, 398, 399
                       575    Septicemia w/ MV 96+ hours, age >17                                                 416 Septicemia w/vent support pays in regular septicemia DRG unless respiratory condition is PDx.

       Ann Gjerstad, MnDHS 651-431-2541                                                                                                                                                           GA    pg 47
      DHS, MN Health Care Programs                                           2007-2012 DRG MnDC Crosswalk                                                                 Sort by DRG

Fed     Grp 23      GA                                                                                    GA Comment                    GA Rel       GA       GA Trim Additions/ Corrections/
                             GA Grouper V.23 DRG NUMBER & DESCRIPTOR
MDC     MnDC       DRG #                                                                           Mn Rule 9500.1100 Subp. 20d.         Value       ALOS       Point Comments

                     576    Septicemia w/o MV 96+hours, age >17                                416 Septicemia w/vent support pays in regular septicemia DRG unless respiratory condition is PDx.
                     577    Carotid artery stent                                               Version 23: DRG 533 & 534
                     578    Infectious and parasitic diseases w/ OR procedure                  415
                     579    Postoperative or post-traumatic infections w/ OR procedure         415




      Ann Gjerstad, MnDHS 651-431-2541                                                                                                                                        GA     pg 48
      Mn DHS, Minn Health Care Programs                                        Acute Physical Rehab                    2007-2010                                                    Sort by DRG

* Minnesota Diagnostic Categories must be determined in conjunction with Mn Rule 9500.1100 Subp. 20g. Other DRG Requirements, A.-O.
                                                                                                                                                   Rehab                    Rehab
      Rehab                                                                                                                                              Rehab Rel Rehab
                  REHAB
Fed
MDC                                Grouper V.23 DRG NUMBER & DESCRIPTOR                                       Rehab Comments                        V.23                     Trim Additions/ Corrections/
      DRG #                                                                                                                                                 Val    ALOS
                                                                                                                                                   MnDC                     Point Comments
                                                                                                                                                                                    Dx Code Definitions
                                                                                               Dx 344.1, 806.21, 806.26, 806.31, 806.36, 952.11,                                    781.0: abn invol mvmt;
                Specific late effects or conditions secondary to spinal cord or intracranial
         0                                                                                     952.16 WITH 905.0, 907.0, or 907.2, excluding         Y    1.61347   28.20     56    781.2: abnormal gait;
                injury or skull fracture resulting in paraplegia                               cases w/ 781.0, 781.2, 781.3, & 781.4                                                781.3: lack of coordination;
                                                                                                                                                                                    781.4: transient limb paralysis
                                                                                               Dx 344.01-344.04, 344.09, 806.0x, 806.1x, or                                         Dx Code Definitions
                                                                                               952.0x WITH 907.2, excluding 781.0, 781.2, &                                         781.0: abn involuntary mvmnt;
                Specific late effects or conditions secondary to spinal cord or intracranial   780.03;                or                                                            781.2: abnormal gait;
         0                                                                                                                                           Z    2.58347   35.25     97
                injury or skull fracture resulting in quadriplegia or hemiplegia               Dx 344.00-344.04, 344.09, 342.01, 342.81, or                                         781.3: lack of coordination;
                                                                                               342.91 WITH 907.0 or 905.0, excluding 781.0,                                         780.03: Persistent vegetative
                                                                                               781.3, & 780.03                                                                      state
 1       1      001 Craniotomy, Age >17 with CC                                                                                                      A    0.93042   14.46     37
 1       2      002 Craniotomy, Age >17 w/o CC                                                                                                       A    0.93042   14.46     37
 1       3      003 Craniotomy, Age 0-17                                                                                                             A    0.93042   14.46     37
         4          No Longer Valid (see DRG 531-532)                                                                                                     0.93042   14.46     37
         5          No Longer Valid (see DRG 533-544)                                                                                                     0.93042   14.46     37
 1       6      006 Carpal Tunnel Release                                                                                                            A    0.93042   14.46     37
 1       7      007 Periph & cranial nerve & Other nervous Sx Procedure w/ CC                                                                        A    0.93042   14.46     37
 1       8      008 Peripheral & cranial nerve & Other nerv Sx Procedure w/o CC                                                                      A    0.93042   14.46     37
 1       9      009 Spinal Disorders & Injuries                                                                                                      A    0.93042   14.46     37
 1      10      010 Nervous System Neoplasms w/ CC                                                                                                   A    0.93042   14.46     37
 1      11      011 Nervous System Neoplasms w/o CC                                                                                                  A    0.93042   14.46     37
 1      12      012 Degenerative Nervous System Disorders                                                                                            A    0.93042   14.46     37
 1      13      013 Multiple Sclerosis & Cerebral Ataxia                                                                                             A    0.93042   14.46     37
 1      14      014 Specif Cerebrovasc Disorders Except TIA                                                                                          A    0.93042   14.46     37
 1      15      015 Transient Ischemic Attack, Precerebral Occlusion                                                                                 A    0.93042   14.46     37
 1      16      016 Nonspecific Cerebrovascular Disorders w/ CC                                                                                      A    0.93042   14.46     37
 1      17      017 Nonspecific Cerebrovascular Disorders w/o CC                                                                                     A    0.93042   14.46     37
 1      18      018 Cranial & Peripheral Nerve Disorders w/ CC                                                                                       A    0.93042   14.46     37
 1      19      019 Cranial & Peripheral Nerve Disorders w/o CC                                                                                      A    0.93042   14.46     37
 1      20      020 Nervous System Infection Except Viral Meningitis                                                                                 A    0.93042   14.46     37
 1      21      021 Viral Meningitis                                                                                                                 A    0.93042   14.46     37
 1      22      022 Hypertensive Encephalopathy                                                                                                      A    0.93042   14.46     37
 1      23      023 Nontraumatic Stupor & Coma                                                                                                       A    0.93042   14.46     37
 1      24      024 Seizure & Headache Age >17 w/ CC                                                                                                 A    0.93042   14.46     37
 1      25      025 Seizure & Headache Age >17 w/o CC                                                                                                A    0.93042   14.46     37
 1      26      026 Seizure & Headache Age 0-17                                                                                                      A    0.93042   14.46     37
 1      27      027 Traumatic Stupor & Coma, Coma >1 Hr                                                                                              A    0.93042   14.46     37
 1      28      028 Traumatic Stupor & Coma, Coma <1 Hr, age >17 w/ CC                                                                               A    0.93042   14.46     37
 1      29      029 Traumatic Stupor & Coma, Coma <1 Hr, age >17 w/o CC                                                                              A    0.93042   14.46     37
 1      30      030 Traumatic Stupor & Coma, Coma <1 Hr, age 0-17                                                                                    A    0.93042   14.46     37
 1      31      031 Concussion, age >17 w/ CC                                                                                                        A    0.93042   14.46     37
 1      32      032 Concussion, age >17 w/o CC                                                                                                       A    0.93042   14.46     37
 1      33      033 Concussion, age 0-17                                                                                                             A    0.93042   14.46     37
 1      34      034 Other Disorders of the Nervous System w/ CC                                                                                      A    0.93042   14.46     37
 1      35      035 Other Disorders of the Nervous System w/o CC                                                                                     A    0.93042   14.46     37
 2      36      036 RETINAL Procedures                                                                                                               T    0.99455   14.44     37
 2      37      037 ORBITAL Procedures                                                                                                               T    0.99455   14.44     37


      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                    Rehab         pg 49
      Mn DHS, Minn Health Care Programs                                   Acute Physical Rehab   2007-2010                                  Sort by DRG
                                                                                                             Rehab                   Rehab
      Rehab                                                                                                        Rehab Rel Rehab
                  REHAB
Fed
                                   Grouper V.23 DRG NUMBER & DESCRIPTOR                    Rehab Comments     V.23                    Trim Additions/ Corrections/
MDC   DRG #                                                                                                           Val    ALOS
                                                                                                             MnDC                    Point Comments
 2      38      038 PRIMARY IRIS Procedures                                                                    T    0.99455  14.44     37
 2      39      039 LENS PROCDURES w/ or w/o VITRECTOMY                                                        T    0.99455  14.44     37
 2      40      040 EXTRAOCUL Procedure except ORBIT age >17                                                   T    0.99455  14.44     37
 2      41      041 EXTRAOCUL Procedure except ORBIT age 0-17                                                  T    0.99455  14.44     37
 2      42      042 Intraocular Procedure except Retina, Iris, Lens                                            T    0.99455  14.44     37
 2      43      043 HYPHEMA                                                                                    T    0.99455  14.44     37
 2      44      044 Acute Major Eye Infections                                                                 T    0.99455  14.44     37
 2      45      045 Neurological Eye Disorders                                                                 T    0.99455  14.44     37
 2      46      046 Other Disorder of Eye, age >17 w/ CC                                                       T    0.99455  14.44     37
 2      47      047 Other Disorder of Eye, age >17 w/o CC                                                      T    0.99455  14.44     37
 2      48      048 Other Disorders of Eye, age 0-17                                                           T    0.99455  14.44     37
 3      49      049-1 Major Head & Neck Procedures                                                             T    0.99455  14.44     37
 3      50      050 SIALOADENECTOMY                                                                            T    0.99455  14.44     37
 3      51      051 Salivary Gland Procedure except Sialoadenectomy                                            T    0.99455  14.44     37
 3      52      052 CLEFT LIP & PALATE REPAIR                                                                  T    0.99455  14.44     37
 3      53      053 SINUS & MASTOID Procedures age >17                                                         T    0.99455  14.44     37
 3      54      054 SINUS & MASTOID Procedures age 0-17                                                        T    0.99455  14.44     37
 3      55      055 Miscellaneous ear, nose, mouth, & throat procedures                                        T    0.99455  14.44     37
 3      56      056 RHINOPLASTY                                                                                T    0.99455  14.44     37
 3      57      057 T&A Procedures, except T & A Only, age >17                                                 T    0.99455  14.44     37
 3      58      058 T&A Procedures Except T & A Only, age 0-17                                                 T    0.99455  14.44     37
 3      59      059 Tonsillectomy, Adenoidectomy Only, age >17                                                 T    0.99455  14.44     37
 3      60      060 Tonsillectomy, Adenoidectomy Only, age 0-17                                                T    0.99455  14.44     37
 3      61      061 MYRINGOTOMY w/ tube insertion, age >17                                                     T    0.99455  14.44     37
 3      62      062 MYRINGOTOMY w/ tube insertion, age 0-17                                                    T    0.99455  14.44     37
 3      63      063 Other ear, nose mouth, & throat O.R. procedures                                            T    0.99455  14.44     37
 3      64      064 EAR, NOSE, MOUTH & Throat MALIGNCY                                                         T    0.99455  14.44     37
 3      65      065 DYSEQUILIBRIUM                                                                             T    0.99455  14.44     37
 3      66      066 EPISTAXIS                                                                                  T    0.99455  14.44     37
 3      67      067 EPIGLOTTITIS                                                                               T    0.99455  14.44     37
 3      68      068 OTITIS MEDIA & URI age >17 w/ CC                                                           T    0.99455  14.44     37
 3      69      069 OTITIS MEDIA & URI age >17 w/o CC                                                          T    0.99455  14.44     37
 3      70      070 OTITIS MEDIA & URI age 0-17                                                                T    0.99455  14.44     37
 3      71      071 LARYNGOTRACHEITIS                                                                          T    0.99455  14.44     37
 3      72      072 Nasal Trauma & Deformity                                                                   T    0.99455  14.44     37
 3      73      073 Other EAR,NOSE,MOUTH,Throat Dx age >17                                                     T    0.99455  14.44     37
 3      74      074 Other EAR,NOSE,MOUTH,Throat Dx, age 0-17                                                   T    0.99455  14.44     37
 4      75      075 MAJOR CHEST Procedures                                                                     T    0.99455  14.44     37
 4      76      076 Other RESP SYSTEM O.R. Procedure w/ CC                                                     T    0.99455  14.44     37
 4      77      077 Other RESP SYSTEM O.R. Procedure w/o CC                                                    T    0.99455  14.44     37
 4      78      078 PULMONARY EMBOLISM                                                                         T    0.99455  14.44     37
 4      79      079 Respiratory Infection, Inflammation, age >17 w/ CC                                         T    0.99455  14.44     37
 4      80      080 Resp Infection, Inflammation, age >17 w/o CC                                               T    0.99455  14.44     37
 4      81      081 Respiratory Infection, Inflammation, age 0-17                                              T    0.99455  14.44     37
 4      82      082 RESPIRATORY NEOPLASMS                                                                      T    0.99455  14.44     37
 4      83      083 MAJOR CHEST TRAUMA w/ CC                                                                   T    0.99455  14.44     37
 4      84      084 MAJOR CHEST TRAUMA w/o CC                                                                  T    0.99455  14.44     37
 4      85      085 PLEURAL EFFUSION w/ CC                                                                     T    0.99455  14.44     37
 4      86      086 PLEURAL EFFUSION w/o CC                                                                    T    0.99455  14.44     37
 4      87      087 PULMONARY EDEMA & RESPIR FAILURE                                                           T    0.99455  14.44     37


      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                           Rehab      pg 50
           Mn DHS, Minn Health Care Programs                                     Acute Physical Rehab   2007-2010                                    Sort by DRG
                                                                                                                    Rehab                    Rehab
        Rehab                                                                                                             Rehab Rel Rehab
                       REHAB
  Fed
                                        Grouper V.23 DRG NUMBER & DESCRIPTOR                      Rehab Comments     V.23                     Trim Additions/ Corrections/
  MDC   DRG #                                                                                                                Val    ALOS
                                                                                                                    MnDC                     Point Comments
     4       88      088   Chronic Obstructive Pulmonary Disease                                                      T    0.99455  14.44      37
     4       89      089   SIMP PNEUMON, PLEURSY age >17 w/ CC                                                        T    0.99455  14.44      37
     4       90      090   SIMP PNEUMON, PLEURSY age >17 w/o CC                                                       T    0.99455  14.44      37
     4       91      091   SIMP PNEUMON, PLEURSY age 0-17                                                             T    0.99455  14.44      37
     4       92      092   INTERSTITIAL LUNG DISEASE w/ CC                                                            T    0.99455  14.44      37
     4       93      093   INTERSTITIAL LUNG DISEASE w/o CC                                                           T    0.99455  14.44      37
     4       94      094   PNEUMOTHORAX w/ CC                                                                         T    0.99455  14.44      37
     4       95      095   PNEUMOTHORAX w/o CC                                                                        T    0.99455  14.44      37
     4       96      096   BRONCHITIS & ASTHMA age >17 w/ CC                                                          T    0.99455  14.44      37
     4       97      097   BRONCHITIS & ASTHMA age >17 w/o CC                                                         T    0.99455  14.44      37
     4       98      098   BRONCHITIS & ASTHMA, age 0-17                                                              T    0.99455  14.44      37
     4       99      099   RESPIRATORY Signs & Symptoms w/ CC                                                         T    0.99455  14.44      37
     4      100      100   RESPIRATORY Signs & Symptoms w/o CC                                                        T    0.99455  14.44      37
     4      101      101    Other RESPIRATORY SYSTEM Dx w/ CC                                                         T    0.99455  14.44      37
     4      102      102   Other RESPIRATORY SYSTEM Dx w/o CC                                                         T    0.99455  14.44      37
0 PreMDC    103      103   HEART TRANSPLANT                                                                           T    0.99455  14.44      37
     5      104      104   CARDIAC VALVE Procedure w/ CARDIAC CATH                                                    T    0.99455  14.44      37
     5      105      105   CARDIAC VALVE Procedure w/o CARDIAC CATH                                                   T    0.99455  14.44      37
     5      106      106   CORONARY BYPASS with PTCA                                                                  T    0.99455  14.44      37
     5      108      108   Other CARDIOTHORACIC Procedures                                                            T    0.99455  14.44      37
     5      109            No Longer Valid; see DRG 547-548
     5      110      110   MAJOR CARDIOVASCULAR Procedure w/ CC                                                       T    0.99455   14.44     37
     5      111      111   MAJOR CARDIOVASCULAR Procedure w/o CC                                                      T    0.99455   14.44     37
     5      113      113   AMPUTAT CIRC Dz except UPPER LIMB,TOE                                                      T    0.99455   14.44     37
     5      114      114   UPPER LIMB, TOE AMPUT CIRCU SYS DIS                                                        T    0.99455   14.44     37
     5      117      117   CARD PACEMKR REVIS except DEVIC REPL                                                       T    0.99455   14.44     37
     5      118      118   CARDIAC PACEMAKER DEVICE REPLACEMNT                                                        T    0.99455   14.44     37
     5      119      119   VEIN LIGATION & STRIPPING                                                                  T    0.99455   14.44     37
     5      120      120   Other CIRCULATORY SYSTEM O.R. PROC                                                         T    0.99455   14.44     37
     5      121      121   CIRCUL DISORD w/ AMI & C.V. COMP                                                           T    0.99455   14.44     37
     5      122      122   CIRCUL DISORD w/ AMI w/o C.V. COMP                                                         T    0.99455   14.44     37
     5      123      123   Circulatory Disorders w/ AMI, Expired                                                      T    0.99455   14.44     37
     5      124      124   Circulatory disorders w/ cardiac cath & complex diagnosis                                  T    0.99455   14.44     37
     5      125      125   Circulatory disorders w/ cardiac cath, w/o complex diagnosis                               T    0.99455   14.44     37
     5      126      126   ACUTE & SUBACUTE ENDOCARDITIS                                                              T    0.99455   14.44     37
     5      127      127   HEART FAILURE & SHOCK                                                                      T    0.99455   14.44     37
     5      128      128   DEEP VEIN THROMBOPHLEBITIS                                                                 T    0.99455   14.44     37
     5      129      129   CARDIAC ARREST, UNEXPLAINED                                                                T    0.99455   14.44     37
     5      130      130   PERIPHERAL VASCULAR DISORDERS w/ CC                                                        T    0.99455   14.44     37
     5      131      131   PERIPHERAL VASCULAR DISORD w/o CC                                                          T    0.99455   14.44     37
     5      132      132   ATHEROSCLEROSIS w/ CC                                                                      T    0.99455   14.44     37
     5      133      133   ATHEROSCLEROSIS w/o CC                                                                     T    0.99455   14.44     37
     5      134      134   HYPERTENSION                                                                               T    0.99455   14.44     37
     5      135      135   Cardiac Congenital Valve Disease, age >17 w/ CC                                            T    0.99455   14.44     37
     5      136      136   Cardiac Congenital Valve Disease age >17 w/o CC                                            T    0.99455   14.44     37
     5      137      137   Cardiac Congenital Valve Disease age 0-17                                                  T    0.99455   14.44     37
     5      138      138   CARD ARRHYTHMIA & CONDCTN Dz w/ CC                                                         T    0.99455   14.44     37
     5      139      139   CARD ARRHYTHMIA & CONDCTN Dz w/o CC                                                        T    0.99455   14.44     37
     5      140      140   ANGINA PECTORIS                                                                            T    0.99455   14.44     37
     5      141      141   SYNCOPE & COLLAPSE w/ CC                                                                   T    0.99455   14.44     37


           Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                Rehab    pg 51
      Mn DHS, Minn Health Care Programs                             Acute Physical Rehab   2007-2010                                  Sort by DRG
                                                                                                       Rehab                   Rehab
      Rehab                                                                                                  Rehab Rel Rehab
                  REHAB
Fed
                                   Grouper V.23 DRG NUMBER & DESCRIPTOR              Rehab Comments     V.23                    Trim Additions/ Corrections/
MDC   DRG #                                                                                                     Val    ALOS
                                                                                                       MnDC                    Point Comments
 5     142      142   SYNCOPE & COLLAPSE w/o CC                                                          T    0.99455  14.44     37
 5     143      143   CHEST PAIN                                                                         T    0.99455  14.44     37
 5     144      144   Other CIRCULATORY SYSTEM Dx w/ CC                                                  T    0.99455  14.44     37
 5     145      145   Other CIRCULATORY SYSTEM Dx w/o CC                                                 T    0.99455  14.44     37
 6     146      146   RECTAL RESECTION w/ CC                                                             T    0.99455  14.44     37
 6     147      147   RECTAL RESECTION w/o CC                                                            T    0.99455  14.44     37
 6     148      148   MAJOR SMALL & LARGE Bowel Procedure w/ CC                                          T    0.99455  14.44     37
 6     149      149   MAJOR SMALL, LARGE Bowel Procedure w/o CC                                          T    0.99455  14.44     37
 6     150      150   PERITONEAL ADHESIOLYSIS w/ CC                                                      T    0.99455  14.44     37
 6     151      151   PERITONEAL ADHESIOLYSIS w/o CC                                                     T    0.99455  14.44     37
 6     152      152   MINOR SMALL & LARGE Bowel Procedure w/ CC                                          T    0.99455  14.44     37
 6     153      153   MINOR SMALL, LARGE Bowel Procedure w/o CC                                          T    0.99455  14.44     37
 6     154      154   STOM,ESOPHAG,DUOD Procedure age >17 w/ CC                                          T    0.99455  14.44     37
 6     155      155   STOM,ESOPHAG,DUOD Proc, age >17 w/o CC                                             T    0.99455  14.44     37
 6     156      156   STOM,ESOPHAG,DUOD Procedure age 0-17                                               T    0.99455  14.44     37
 6     157      157   ANAL & STOMAL Procedures w/ CC                                                     T    0.99455  14.44     37
 6     158      158   ANAL & STOMAL Procedures w/o CC                                                    T    0.99455  14.44     37
 6     159      159   HERNIA except INGN,FEMOR, age >17 w/ CC                                            T    0.99455  14.44     37
 6     160      160   HERNIA except INGN,FEMOR, age >17 w/o CC                                           T    0.99455  14.44     37
 6     161      161   Inguinal, Femoral Hernia, age >17 w/ CC                                            T    0.99455  14.44     37
 6     162      162   INGNAL,FEMORL HERNIA age >17 w/o CC                                                T    0.99455  14.44     37
 6     163      163   HERNIA Procedures age 0-17                                                         T    0.99455  14.44     37
 6     164      164   APPENDECTOMY w/ COMPLIC PRN Dx w/ CC                                               T    0.99455  14.44     37
 6     165      165   APPENDECTOMY w/ COMPLIC PRN Dx w/o CC                                              T    0.99455  14.44     37
 6     166      166   APPENDECTOMY w/o COMPLIC PRN Dx w/ CC                                              T    0.99455  14.44     37
 6     167      167   APPENDECTMY w/o COMPLIC PRN Dx w/o CC                                              T    0.99455  14.44     37
 6     168      168   MOUTH Procedures w/ CC                                                             T    0.99455  14.44     37
 6     169      169   MOUTH Procedures w/o CC                                                            T    0.99455  14.44     37
 6     170      170   Other DIGESTIVE SYS O.R. Procedure w/ CC                                           T    0.99455  14.44     37
 6     171      171   Other DIGESTIVE SYS O.R. Procedure w/o CC                                          T    0.99455  14.44     37
 6     172      172   DIGESTIVE MALIGNANCY w/ CC                                                         T    0.99455  14.44     37
 6     173      173   DIGESTIVE MALIGNANCY w/o CC                                                        T    0.99455  14.44     37
 6     174      174   G.I. Hemorrhage w/ CC                                                              T    0.99455  14.44     37
 6     175      175   G.I. Hemorrhage w/o CC                                                             T    0.99455  14.44     37
 6     176      176   COMPLICATED PEPTIC ULCER                                                           T    0.99455  14.44     37
 6     177      177   UNCOMPLICATED PEPTIC ULCER w/ CC                                                   T    0.99455  14.44     37
 6     178      178   UNCOMPLICATED PEPTIC ULCER w/o CC                                                  T    0.99455  14.44     37
 6     179      179   INFLAMMATORY Bowel DISEASE                                                         T    0.99455  14.44     37
 6     180      180   G.I. OBSTRUCTION w/ CC                                                             T    0.99455  14.44     37
 6     181      181   G.I. OBSTRUCTION w/o CC                                                            T    0.99455  14.44     37
 6     182      182   MISC DIGEST DISORD age >17 w/ CC                                                   T    0.99455  14.44     37
 6     183      183   MISC DIGEST DISORD age >17 w/o CC                                                  T    0.99455  14.44     37
 6     184      184   Miscellaneous Digestive Disorders, age 0-17                                        T    0.99455  14.44     37
 3     185      185   DENT,ORAL Dz except EXTR/RST age >17                                               T    0.99455  14.44     37
 3     186      186   DENT,ORAL Dz except EXTR/RST age 0-17                                              T    0.99455  14.44     37
 3     187      187   DENTAL EXTRACTIONS & RESTORATIONS                                                  T    0.99455  14.44     37
 6     188      188   Other DIGEST SYS Dx age >17 w/ CC                                                  T    0.99455  14.44     37
 6     189      189   Other DIGEST SYS Dx age >17 w/o CC                                                 T    0.99455  14.44     37
 6     190      190   Other DIGEST SYS Dx age 0-17                                                       T    0.99455  14.44     37
 7     191      191   PANCREAS, LIVER & SHUNT Procedure w/ CC                                            T    0.99455  14.44     37


      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                     Rehab      pg 52
      Mn DHS, Minn Health Care Programs                                    Acute Physical Rehab   2007-2010                                   Sort by DRG
                                                                                                              Rehab                   Rehab
      Rehab                                                                                                         Rehab Rel Rehab
                  REHAB
Fed
                                   Grouper V.23 DRG NUMBER & DESCRIPTOR                     Rehab Comments     V.23                    Trim Additions/ Corrections/
MDC   DRG #                                                                                                            Val    ALOS
                                                                                                              MnDC                    Point Comments
 7     192      192   PANCREAS, LIVER & SHUNT Procedure w/o CC                                                  T    0.99455  14.44     37
 7     193      193   Biliary Proced Except Only Cholecyst w/ CC                                                T    0.99455  14.44     37
 7     194      194   Biliary Proced Except Only Cholecyst w/o CC                                               T    0.99455  14.44     37
 7     195      195   Cholecystectomy Exc lap, w/ C.D.E. w/ CC                                                  T    0.99455  14.44     37
 7     196      196   Cholecystectomy Exc. lap, w/ C.D.E. w/o CC                                                T    0.99455  14.44     37
 7     197      197   Cholecystectomy Exc. lap, w/o C.D.E. w/ CC                                                T    0.99455  14.44     37
 7     198      198   Cholecystectomy Exc. lap, w/o C.D.E. w/o CC                                               T    0.99455  14.44     37
 7     199      199   HEPATOBILIARY Dx Procedure for MALIGNCY                                                   T    0.99455  14.44     37
 7     200      200   HEPATOBILIARY Dx Procedure for NON-MALIG                                                  T    0.99455  14.44     37
 7     201      201   Other hepatobiliary or pancreas O.R. proc                                                 T    0.99455  14.44     37
 7     202      202   CIRRHOSIS & ALCOHOLIC HEPATITIS                                                           T    0.99455  14.44     37
 7     203      203   MALIG of HEPATOBILIARY SYS/PANCREAS                                                       T    0.99455  14.44     37
 7     204      204   DISORD of PANCREAS except MALIGNANCY                                                      T    0.99455  14.44     37
 7     205      205   LIVER Dz except MAL,CIRR,ALC HEPA w/ CC                                                   T    0.99455  14.44     37
 7     206      206   LIVER Dz except MAL,CIRR,ALC HEP w/o CC                                                   T    0.99455  14.44     37
 7     207      207   DISORDERS of THE BILIARY TRACT w/ CC                                                      T    0.99455  14.44     37
 7     208      208   DISORDERS of BILIARY TRACT w/o CC                                                         T    0.99455  14.44     37
 8     209             No Longer Valid; See DRG 544
 8     210      210   HIP/FEMUR except MAJ JOINT age >17 w/ CC                                                 H     0.52712   9.00     20
 8     211      211   HIP/FEMUR except MAJ JOINT age>17 w/o CC                                                 H     0.52712   9.00     20
 8     212      212   HIP/FEMUR except MAJ JOINT age 0-17                                                      H     0.52712   9.00     20
 8     213      213   AMPUT for MUSCULO SYS/CONN TISS DIS                                                      H     0.52712   9.00     20
 8     216      216   Bx of musculoskeletal system /connective tissue                                          H     0.52712   9.00     20
 8     217      217   Wound debrid/skin graft for musculoskel/ conn tiss Dz                                    H     0.52712   9.00     20
 8     218      218   Lower extremity procedure, age >17 w/ CC                                                 H     0.52712   9.00     20
 8     219      219   Lower extremity procedure, age >17 w/o CC                                                H     0.52712   9.00     20
 8     220      220   Lower extremity procedure, age 0-17                                                      H     0.52712   9.00     20
 8     223      223   Major shoulder, elbow or Other upper extremity proc w/ CC                                H     0.52712   9.00     20
 8     224      224   Minor shoulder, elbow, forearm proc w/o CC                                               H     0.52712   9.00     20
 8     225      225   FOOT Procedures                                                                          H     0.52712   9.00     20
 8     226      226   SOFT TISSUE Procedures w/ CC                                                             H     0.52712   9.00     20
 8     227      227   SOFT TISSUE Procedures w/o CC                                                            H     0.52712   9.00     20
 8     228      228   Major thumb or joint, or Other hand or wrist proc w/ CC                                  H     0.52712   9.00     20
 8     229      229   Hand or wrist proc except maor joint proc w/o CC                                         H     0.52712   9.00     20
 8     230      230   REMOVAL INT FIX DEVIC of HIP, FEMUR                                                      H     0.52712   9.00     20
 8     231             No Longer Valid; See DRG 537-538
 8     232      232   ARTHROSCOPY                                                                              H     0.52712   9.00     20
 8     233      233   Other MUSC SYS/CONN TISS O.R. PR w/ CC                                                   H     0.52712   9.00     20
 8     234      234   Other MUSC SYS/CON TISS O.R. PR w/o CC                                                   H     0.52712   9.00     20
 8     235      235   FRACTURES of FEMUR                                                                       H     0.52712   9.00     20
 8     236      236   FRACTURES of HIP & PELVIS                                                                H     0.52712   9.00     20
 8     237      237   Sprains, strains, & dislocation of hip, pelvis, & thigh                                  H     0.52712   9.00     20
 8     238      238   OSTEOMYELITIS                                                                            H     0.52712   9.00     20
 8     239      239   PATH FRACT & MUSCULO/CON TISS MALIG                                                      H     0.52712   9.00     20
 8     240      240   CONNECTIVE TISSUE DISORDERS w/ CC                                                        H     0.52712   9.00     20
 8     241      241   CONNECTIVE TISSUE DISORDERS w/o CC                                                       H     0.52712   9.00     20
 8     242      242   SEPTIC ARTHRITIS                                                                         H     0.52712   9.00     20
 8     243      243   MEDICAL BACK PROBLEMS                                                                    H     0.52712   9.00     20
 8     244      244   Bone Dz & specific arthropathies w/ CC                                                   H     0.52712   9.00     20
 8     245      245   Bone Dz & specific arthropathies w/o CC                                                  H     0.52712   9.00     20


      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                              Rehab    pg 53
      Mn DHS, Minn Health Care Programs                                       Acute Physical Rehab   2007-2010                                  Sort by DRG
                                                                                                                 Rehab                   Rehab
      Rehab                                                                                                            Rehab Rel Rehab
                  REHAB
Fed
                                   Grouper V.23 DRG NUMBER & DESCRIPTOR                        Rehab Comments     V.23                    Trim Additions/ Corrections/
MDC   DRG #                                                                                                               Val    ALOS
                                                                                                                 MnDC                    Point Comments
 8     246      246   NON-SPECIFIC ARTHrOPATHIES                                                                   H    0.52712   9.00     20
 8     247      247   SIGNS/SYMPT of MUSCLO SYS/CONN TISS                                                          H    0.52712   9.00     20
 8     248      248   TENDONITIS, MYOSITIS & BURSITIS                                                              H    0.52712   9.00     20
 8     249      249   AFTERCARE MUSCULO SYS & CONN TISSUE                                                          H    0.52712   9.00     20
 8     250      250   Injury to forearm, hand, foot, age >17 w/ CC                                                 H    0.52712   9.00     20
 8     251      251   Injury to forearm, hand, foot, age >17 w/o CC                                                H    0.52712   9.00     20
 8     252      252   Injury forearm, hand, foot, age 0-17                                                         H    0.52712   9.00     20
 8     253      253   Injury upper arm, lower leg exc foot, age >17 w/ CC                                          H    0.52712   9.00     20
 8     254      254   Injury upper arm, lower leg exc foot, age >17 w/o CC                                         H    0.52712   9.00     20
 8     255      255   Injury upper arm, lower leg exc foot, age 0-17                                               H    0.52712   9.00     20
 8     256      256   Other musculoskeletal Sx & connective tissue Dx                                              H    0.52712   9.00     20
 9     257      257   TOTAL MASTECTOMY for MALIGNCY w/ CC                                                          T    0.99455  14.44     37
 9     258      258   TOTAL MASTECTOMY for MALIGNCY w/o CC                                                         T    0.99455  14.44     37
 9     259      259   SUBTOT MASTECTOMY for MALIGNCY w/ CC                                                         T    0.99455  14.44     37
 9     260      260   SUBTOT MASTECTMY for MALIGNCY w/o CC                                                         T    0.99455  14.44     37
 9     261      261   BREAST Procedure for NON-MALIG except BIOP                                                   T    0.99455  14.44     37
 9     262      262   BREAST BIOP/LOCAL EXCIS NON-MALIG                                                            T    0.99455  14.44     37
 9     263      263   SKN GRFT/DEBR SKN ULCER/CELLU w/ CC                                                          T    0.99455  14.44     37
 9     264      264   SKN GRFT/DEBR SKN ULCER/CELLU w/o CC                                                         T    0.99455  14.44     37
 9     265      265   SKN GRFT/DEBR except SKN ULC/CELLU w/ CC                                                     T    0.99455  14.44     37
 9     266      266   SKN GRFT/DEBR except SKN ULC/CELL w/o CC                                                     T    0.99455  14.44     37
 9     267      267   PERIANAL & PILONIDAL Procedures                                                              T    0.99455  14.44     37
 9     268      268   SKIN/SUBCUT TISS & BREAST PLAST PRC                                                          T    0.99455  14.44     37
 9     269      269   Other SKIN/SUBCUT TISS/BREAST PR w/ CC                                                       T    0.99455  14.44     37
 9     270      270   Other SKN/SUBCUT TISS/BREAST PR w/o CC                                                       T    0.99455  14.44     37
 9     271      271   SKIN ULCERS                                                                                  T    0.99455  14.44     37
 9     272      272   MAJOR SKIN DISORDERS w/ CC                                                                   T    0.99455  14.44     37
 9     273      273   MAJOR SKIN DISORDERS w/o CC                                                                  T    0.99455  14.44     37
 9     274      274   MALIGNANT BREAST DISORDERS w/ CC                                                             T    0.99455  14.44     37
 9     275      275   MALIGNANT BREAST DISORDERS w/o CC                                                            T    0.99455  14.44     37
 9     276      276   NON-MALIGANT BREAST DISORDERS                                                                T    0.99455  14.44     37
 9     277      277   CELLULITIS age >17 w/ CC                                                                     T    0.99455  14.44     37
 9     278      278   CELLULITIS age >17 w/o CC                                                                    T    0.99455  14.44     37
 9     279      279   CELLULITIS age 0-17                                                                          T    0.99455  14.44     37
 9     280      280   Trauma to skin, subq tissue & breast, age >17 w/ CC                                          T    0.99455  14.44     37
 9     281      281   Trauma to skin, subq tissue, & breast, age >17 w/oCC                                         T    0.99455  14.44     37
 9     282      282   Trauma to skin, subq tissue & breast, age 0-17                                               T    0.99455  14.44     37
 9     283      283   MINOR SKIN DISORDERS w/ CC                                                                   T    0.99455  14.44     37
 9     284      284   MINOR SKIN DISORDERS w/o CC                                                                  T    0.99455  14.44     37
10     285      285   Amp Lower Limb for endocr, nutritional, metabolic D/O                                        T    0.99455  14.44     37
10     286      286   ADRENAL & PITUITARY Procedures                                                               T    0.99455  14.44     37
10     287      287   Skin Graft/Debrid for endocr, nutrit, metabolic D/O                                          T    0.99455  14.44     37
10     288      288   O.R. Procedures for OBESITY                                                                  T    0.99455  14.44     37
10     289      289   PARATHYROID Procedures                                                                       T    0.99455  14.44     37
10     290      290   THYROID Procedures                                                                           T    0.99455  14.44     37
10     291      291   THYROGLOSSAL Procedures                                                                      T    0.99455  14.44     37
10     292      292   Other Endocrine, Nutritional, Metabolic OR Proc w/CC                                         T    0.99455  14.44     37
10     293      293   Other ENDOC/NUTRIT/META O.R. Proc w/o CC                                                     T    0.99455  14.44     37
10     294      294   DIABETES age >35                                                                             T    0.99455  14.44     37
10     295      295   DIABETES age 0-35                                                                            T    0.99455  14.44     37


      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                               Rehab      pg 54
      Mn DHS, Minn Health Care Programs                                     Acute Physical Rehab   2007-2010                                  Sort by DRG
                                                                                                               Rehab                   Rehab
      Rehab                                                                                                          Rehab Rel Rehab
                  REHAB
Fed
                                   Grouper V.23 DRG NUMBER & DESCRIPTOR                      Rehab Comments     V.23                    Trim Additions/ Corrections/
MDC   DRG #                                                                                                             Val    ALOS
                                                                                                               MnDC                    Point Comments
10     296      296   NUTRIT & MISC METAB D/O, age >17 w/ CC                                                     T    0.99455  14.44     37
10     297      297   NUTRT & MISC METAB D/O, age >17 w/o CC                                                     T    0.99455  14.44     37
10     298      298   NUTRIT & MISC METAB DISORD age 0-17                                                        T    0.99455  14.44     37
10     299      299   INBORN ERRORS of METABOLISM                                                                T    0.99455  14.44     37
10     300      300   ENDOCRINE DISORDERS w/ CC                                                                  T    0.99455  14.44     37
10     301      301    ENDOCRINE DISORDERS w/o CC                                                                T    0.99455  14.44     37
11     302      302   KIDNEY TRANSPLANT                                                                          T    0.99455  14.44     37
11     303      303   Kidney, Ureter, Maj Bladder Proc for neoplasm                                              T    0.99455  14.44     37
11     304      304   Kidney, Ureter, Maj Bladder Proc for nonNeopl w/CC                                         T    0.99455  14.44     37
11     305      305   Kidney, Ureter, Maj Bladder Proc for nonNeopl w/oCC                                        T    0.99455  14.44     37
11     306      306   PROSTATECTOMY w/ CC                                                                        T    0.99455  14.44     37
11     307      307   PROSTATECTOMY w/o CC                                                                       T    0.99455  14.44     37
11     308      308   MINOR BLADDER Procedures w/ CC                                                             T    0.99455  14.44     37
11     309      309   MINOR BLADDER Procedures w/o CC                                                            T    0.99455  14.44     37
11     310      310   TransUrethral Procedures w/ CC                                                             T    0.99455  14.44     37
11     311      311    TransUrethral Procedures w/o CC                                                           T    0.99455  14.44     37
11     312      312   Urethral Procedures , age >17 w/ CC                                                        T    0.99455  14.44     37
11     313      313   Urethral Procedures , age >17 w/o CC                                                       T    0.99455  14.44     37
11     314      314   Urethral Procedures , age 0-17                                                             T    0.99455  14.44     37
11     315      315   Other Kidney & Urinary Tract OR Procedure                                                  T    0.99455  14.44     37
11     316      316   RENAL FAILURE                                                                              T    0.99455  14.44     37
11     317      317   ADMIT for RENAL DIALYSIS                                                                   T    0.99455  14.44     37
11     318      318   KIDNEY & URINARY TRACT NEOPL w/ CC                                                         T    0.99455  14.44     37
11     319      319   KIDNEY & URINARY TRACT NEOPL w/o CC                                                        T    0.99455  14.44     37
11     320      320   KIDNEY/URINARY TR INFECT age>17 w/ CC                                                      T    0.99455  14.44     37
11     321      321    KIDNEY/URINRY TR INFCT age>17 w/o CC                                                      T    0.99455  14.44     37
11     322      322   KIDNEY/URINRY TR INFECT age 0-17                                                           T    0.99455  14.44     37
11     323      323   URINARY STONES w/ CC, ESW Lithotripsy                                                      T    0.99455  14.44     37
11     324      324   URINARY STONES w/o CC                                                                      T    0.99455  14.44     37
11     325      325   KIDNEY/URIN SIGNS/SYMP age>17 w/ CC                                                        T    0.99455  14.44     37
11     326      326   KIDNEY/URIN SIGNS/SYMP age>17 w/o CC                                                       T    0.99455  14.44     37
11     327      327   KIDNEY/URIN SIGNS/SYMP age 0-17                                                            T    0.99455  14.44     37
11     328      328   Urethral STRICTURE age >1 w/ CC                                                            T    0.99455  14.44     37
11     329      329   Urethral STRICTURE age >17 w/o CC                                                          T    0.99455  14.44     37
11     330      330   Urethral STRICTURE age 0-17                                                                T    0.99455  14.44     37
11     331      331   Other kidney & urinary tract Dx, age >17 w/ CC                                             T    0.99455  14.44     37
11     332      332   Other KIDNEY/URIN TR Dx age>17 w/o CC                                                      T    0.99455  14.44     37
11     333      333   Other KIDNEY/URIN TR Dx age 0-17                                                           T    0.99455  14.44     37
12     334      334   MAJOR MALE PELVIC Procedures w/ CC                                                         T    0.99455  14.44     37
12     335      335   MAJOR MALE PELVIC Procedures w/o CC                                                        T    0.99455  14.44     37
12     336      336   Transurethral PROSTATECTOMY w/ CC                                                          T    0.99455  14.44     37
12     337      337   Transurethral PROSTATECTOMY w/o CC                                                         T    0.99455  14.44     37
12     338      338   TESTES Procedures , for MALIGNANCY                                                         T    0.99455  14.44     37
12     339      339   TESTES PROC, NON-MALIGNCY age >17                                                          T    0.99455  14.44     37
12     340      340   TESTES PROC, NON-MALIGNCY age 0-17                                                         T    0.99455  14.44     37
12     341      341   PENIS Procedures                                                                           T    0.99455  14.44     37
12     342      342   CIRCUMCISION age >17                                                                       T    0.99455  14.44     37
12     343      343   CIRCUMCISION age 0-17                                                                      T    0.99455  14.44     37
12     344      344   Other Male Reproductive OR Procedure for Malig                                             T    0.99455  14.44     37
12     345      345   Other Male Reproductive OR Proc Exc for Malig                                              T    0.99455  14.44     37


      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                             Rehab      pg 55
      Mn DHS, Minn Health Care Programs                                 Acute Physical Rehab   2007-2010                                    Sort by DRG
                                                                                                           Rehab                    Rehab
      Rehab                                                                                                      Rehab Rel Rehab
                  REHAB
Fed
                                   Grouper V.23 DRG NUMBER & DESCRIPTOR                  Rehab Comments     V.23                     Trim Additions/ Corrections/
MDC   DRG #                                                                                                         Val    ALOS
                                                                                                           MnDC                     Point Comments
12     346      346   MALIGNANCY, MALE REPROD SYS w/ CC                                                      T    0.99455  14.44      37
12     347      347   MALIGNANCY, MALE REPROD SYS w/o CC                                                     T    0.99455  14.44      37
12     348      348   BENIGN PROSTATIC HYPERTROPHY w/ CC                                                     T    0.99455  14.44      37
12     349      349   BENIGN PROSTATIC HYPERTROPHY w/o CC                                                    T    0.99455  14.44      37
12     350      350   Inflammation of the Male Reproductive System                                           T    0.99455  14.44      37
12     351      351   STERILIZATION, MALE                                                                    T    0.99455  14.44      37
12     352      352   Other MALE REPRODUCTIVE SYSTEM Dx                                                      T    0.99455  14.44      37
13     353      353   PELVIC EVISCER, RADICAL HYSTERECTOMY                                                   T    0.99455  14.44      37
13     354      354   UTER, ADNEXA Procedure for MALIG w/ CC                                                 T    0.99455  14.44      37
13     355      355   UTER, ADNEXA Procedure for MALIG w/o CC                                                T    0.99455  14.44      37
13     356      356   FEMALE REPROD SYS RECONSTRUC PROC                                                      T    0.99455  14.44      37
13     357      357   Uterine, Adnexa Proc for Ovarian & Adnexal Malig                                       T    0.99455  14.44      37
13     358      358   Uterine, Adnexa Procedure for NonMalig w/ CC                                           T    0.99455  14.44      37
13     359      359   Uterine, Adnexa Procedure for NonMalig w/o CC                                          T    0.99455  14.44      37
13     360      360   VAGINA, CERVIX & VULVA Procedures                                                      T    0.99455  14.44      37
13     361      361   LAPAROSCOPY & INCIS TUBAL INTERRUPT                                                    T    0.99455  14.44      37
13     362      362   ENDOSCOPIC TUBAL INTERRUPTION                                                          T    0.99455  14.44      37
13     363      363   D&C,CONIZATION,RADIO-IMPLNT w/ MALIG                                                   T    0.99455  14.44      37
13     364      364   D&C, CONIZATION EXCEPT for MALIGNCY                                                    T    0.99455  14.44      37
13     365      365   Other FEMALE REPROD SYS O.R. PROC                                                      T    0.99455  14.44      37
13     366      366   MALIG, FEMALE REPROD SYSTEM w/ CC                                                      T    0.99455  14.44      37
13     367      367   MALIG, FEMALE REPROD SYSTEM w/o CC                                                     T    0.99455  14.44      37
13     368      368   INFECT, FEMALE REPRODUCTIVE SYSTEM                                                     T    0.99455  14.44      37
13     369      369   MENSTRL & Other FEMALE REPROD SYS Dz                                                   T    0.99455  14.44      37
14     370      370   CESAREAN SECTION w/ CC                                                                 T    0.99455  14.44      37
14     371      371   CESAREAN SECTION w/o CC                                                                T    0.99455  14.44      37
14     372      372   VAGINAL DELIVERY w/ COMPLICATING Dx                                                    T    0.99455  14.44      37
14     373      373   VAGINAL DELIVERY w/o COMPLICATING Dx                                                   T    0.99455  14.44      37
14     374      374   VAGINAL DELIV w/ Sterilization &/or D&C                                                T    0.99455  14.44      37
14     375      375   Vag Delivery w/ OR Proc Except Sterilization/ D&C                                      T    0.99455  14.44      37
14     376      376   PostPartum/ PostAbortion Dx w/o OR Procedure                                           T    0.99455  14.44      37
14     377      377   PostPartum/PostAbortion Dx w/ OR Procedure                                             T    0.99455  14.44      37
14     378      378   ECTOPIC PREGNANCY                                                                      T    0.99455  14.44      37
14     379      379   Threatened ABORTION                                                                    T    0.99455  14.44      37
14     380      380   ABORTION w/o D&C                                                                       T    0.99455  14.44      37
14     381      381   Abortion w/ D&C, Asp Curettage or Hysterotomy                                          T    0.99455  14.44      37
14     382      382   FALSE LABOR                                                                            T    0.99455  14.44      37
14     383      383   Other Antepartum Dx w/ Medical Complications                                           T    0.99455  14.44      37
14     384      384   Other Antepartum Dx w/o Medical Complications                                          T    0.99455  14.44      37
15     385      385   NEONATES died/ transferred to another hospital
15     385      385   NEONATES died/ transferred to another hospital (2)                                     T    0.99455   14.44     37
15     386      386   Extreme Immaturity & Neonatal Resp Distress Syndrome                                   T    0.99455   14.44     37
15     387      387   PREMATURITY w/ MAJOR PROBLEMS                                                          T    0.99455   14.44     37
15     388      388   PREMATURITY w/o MAJOR PROBLEMS                                                         T    0.99455   14.44     37
15     389      389   FULL TERM NEONATE w/ MAJOR PROBLEMS                                                    T    0.99455   14.44     37
15     390      390   NEONATE w/ Other SIGNIFICANT PROBS                                                     T    0.99455   14.44     37
15     391      391   NORMAL NEWBORN                                                                         T    0.99455   14.44     37
16     392      392   SPLENECTOMY, Age >17                                                                   T    0.99455   14.44     37
16     393      393   SPLENECTOMY, Age 0-17                                                                  T    0.99455   14.44     37
16     394      394   Other OR Proc of Blood & Blood Forming Organs                                          T    0.99455   14.44     37


      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                            Rehab    pg 56
      Mn DHS, Minn Health Care Programs                                     Acute Physical Rehab         2007-2010                                                Sort by DRG
                                                                                                                                 Rehab                    Rehab
      Rehab                                                                                                                            Rehab Rel Rehab
                  REHAB
Fed
                                   Grouper V.23 DRG NUMBER & DESCRIPTOR                         Rehab Comments                    V.23                     Trim Additions/ Corrections/
MDC   DRG #                                                                                                                               Val    ALOS
                                                                                                                                 MnDC                     Point Comments
16     395      395   RED BLOOD CELL DISORDERS, Age >17                                                                            T    0.99455  14.44      37
16     396      396   RED BLOOD CELL DISORDERS, Age 0-17                                                                           T    0.99455  14.44      37
16     397      397   COAGULATION DISORDERS                                                                                        T    0.99455  14.44      37
16     398      398   RETICULOENDOTHEL & IMMUN Dz w/ CC                                                                            T    0.99455  14.44      37
16     399      399   RETICULOENDOTHEL & IMMUN Dz w/o CC                                                                           T    0.99455  14.44      37
17     400             No Longer Valid; See DRG 539-540
17     401      401   Lymphoma/NonAcute Leukemia w/OR Proc w/ CC                                                                  T     0.99455   14.44     37
17     402      402   Lymphoma/NonAcute Leukemia w/OR Proc w/o CC                                                                 T     0.99455   14.44     37
17     403      403   Lymphoma/NonAcute LEUKEMIA w/ CC                                                                            T     0.99455   14.44     37
17     404      404   Lymphoma/NonAcute LEUKEMIA w/o CC                                                                           T     0.99455   14.44     37
17     405      405   Acute Leukemia w/o Maj OR procedure, age 0-17                                                               T     0.99455   14.44     37
17     406      406   MYELOPROLIF Dz w/ Maj OR proc w/ CC                                                                         T     0.99455   14.44     37
17     407      407   MYELOPROLIF Dz w/ Maj OR procedure w/o CC                                                                   T     0.99455   14.44     37
17     408      408   MYELOPROLIF Dz w/ Other OR Procedure                                                                        T     0.99455   14.44     37
17     409      409   RADIOTHERAPY                                                                                                T     0.99455   14.44     37
17     410      410   Chemotherapy w/o Acute Leukemia as 2nd Dx                                                                   T     0.99455   14.44     37
17     411      411   HISTORY of MALIGNANCY w/o ENDOSCOPY                                                                         T     0.99455   14.44     37
17     412      412   HISTORY of MALIGNANCY w/ ENDOSCOPY                                                                          T     0.99455   14.44     37
17     413      413   Other myeloprolif Dz/ poorly differentiated Neopl w/CC                                                      T     0.99455   14.44     37
17     414      414   Other Myeloprolif Dz/ poorly differentIated Neopl w/oCC                                                     T     0.99455   14.44     37
18     415      415   O.R. Procedure for INFECT & PARASTIC Dz                                                                     T     0.99455   14.44     37
18     416      416   SEPTICEMIA age >17                                                                                          T     0.99455   14.44     37
18     417      417   SEPTICEMIA age 0-17                                                                                         T     0.99455   14.44     37
18     418      418   Postop & Post-Traumatic Infections                                                                          T     0.99455   14.44     37
18     419      419   FEVER of Unknown origin, age >17 w/ CC                                                                      T     0.99455   14.44     37
18     420      420   FEVER of unknown origin, age >17 w/o CC                                                                     T     0.99455   14.44     37
18     421      421   Viral illnes, age >17                                                                                       T     0.99455   14.44     37
18     422      422   Viral illness & fever of unknown origin, age 0-17                                                           T     0.99455   14.44     37
18     423      423   Other Infectious & Parasitic Diseases Diagnoses                                                             T     0.99455   14.44     37
19     424      424   O.R. Procedure w/ PDx of Mental Illness                                                                     R     1.08291   15.88     37
19     425      425   Acute Adjustment Reaction/ Psychological Dysfunction                                                        R     1.08291   15.88     37
19     426      426   Depressive Neuroses                                                                                         R     1.08291   15.88     37
19     427      427   Neuroses except Depressive                                                                                  R     1.08291   15.88     37
19     428      428   Disorders of Personality & Impulse Control                                                                  R     1.08291   15.88     37
19     429      429   Organic Disturbance/ Mental Retardation                                                                     R     1.08291   15.88     37
19     430      430    Psychoses                                                                                                  R     1.08291   15.88     37
19     431      431   Childhood Mental Disorders                                                                                  R     1.08291   15.88     37
19     432      432   Other Mental Disorder Diagnoses                                                                             R     1.08291   15.88     37
20     433      433   Alcohol/Drug Abuse/Dependence Left AMA                             Discharge destination changed to home
21     439      439   Skin Grafts for Injuries                                                                                     T    0.99455   14.44     37
21     440      440   Wound debridements for injuries                                                                              T    0.99455   14.44     37
21     441      441   HAND Procedures for Injuries                                                                                 T    0.99455   14.44     37
21     442      442   Other O.R. Procedure for Injury w/ CC                                                                        T    0.99455   14.44     37
21     443      443   Other O.R. Procedure for Injury w/o CC                                                                       T    0.99455   14.44     37
21     444      444   Traumatic Injury age >17 w/ CC                                                                               T    0.99455   14.44     37
21     445      445   Traumatic Injury age >17 w/o CC                                                                              T    0.99455   14.44     37
21     446      446   Traumatic Injury age 0-17                                                                                    T    0.99455   14.44     37
21     447      447   Allergic Reactions age >17                                                                                   T    0.99455   14.44     37
21     448      448   Allergic Reactions age 0-17                                                                                  T    0.99455   14.44     37
21     449      449   Poisoning/Toxic effects of drugs, age >17 w/ CC                                                              T    0.99455   14.44     37


      Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                  Rehab    pg 57
        Mn DHS, Minn Health Care Programs                                     Acute Physical Rehab   2007-2010                                    Sort by DRG
                                                                                                                 Rehab                    Rehab
        Rehab                                                                                                          Rehab Rel Rehab
                    REHAB
 Fed
                                     Grouper V.23 DRG NUMBER & DESCRIPTOR                      Rehab Comments     V.23                     Trim Additions/ Corrections/
 MDC    DRG #                                                                                                             Val    ALOS
                                                                                                                 MnDC                     Point Comments
  21       450    450   Poisoning/Toxic effects of drugs, age>17 w/o CC                                            T    0.99455  14.44      37
  21       451    451   Poisoning/Toxic effects of drugs, age 0-17                                                 T    0.99455  14.44      37
  21       452    452   Complications of Treatment w/ CC                                                           T    0.99455  14.44      37
  21       453    453   Complications of Treatment w/o CC                                                          T    0.99455  14.44      37
  21       454    454   Other Injury, Poisoning, Toxic Effects Dx w/ CC                                            T    0.99455  14.44      37
  21       455    455   Other Injury, Poisoning, Toxic Effects Dx w/o CC                                           T    0.99455  14.44      37
  23       461    461   OR Procedure w/ Dx Other Contact w/ Health Services                                        T    0.99455  14.44      37
  23       462    462   Rehabilitation                                                                             T    0.99455  14.44      37
  23       463    463   Signs & Symptoms w/ CC                                                                     T    0.99455  14.44      37
  23       464    464   Signs & Symptoms w/o CC                                                                    T    0.99455  14.44      37
  23       465    465   AFTERCARE w/ Hx of malig as secondary Dx                                                   T    0.99455  14.44      37
  23       466    466   AFTERCARE w/o Hx of malig as secondary Dx                                                  T    0.99455  14.44      37
  23       467    467   Other FACTORS INFLUENCING HLTH STAT                                                        T    0.99455  14.44      37
 Unrelated 468    468   Extensive OR Procedure Unrelated to Principal Dx                                           S    0.94524  13.43      29
   14      469    469   Prin Dx Invalid as Discharge Dx
   15      470    470   UNGROUPABLE
    8      471    471   Bilateral/Mult Maj Joint Proc of Low Extremity                                            H     0.52712    9.00     20
   17      473    473   ACUTE LEUK w/o MAJ O.R. PRC age >17                                                       T     0.99455   14.44     37
    4      475    475   Respiratory System Dx w/ Vent Support                                                     T     0.99455   14.44     37
 Unrelated 476    476   Prostatic O.R. Procedure Unre;lted to PDx                                                 S     0.94524   13.43     29
 Unrelated 477    477   Non-Extensive O.R. Procedure Unrelated to PDx                                             S     0.94524   13.43     29
    5      478           No Longer Valid; See DRG 553-554
    5      479    479   Other VASCULAR Procedures w/o CC                                                           T    0.99455   14.44     37
PreMDC 480        480   LIVER TRANSPLANT                                                                           T    0.99455   14.44     37
PreMDC 481        481   BONE MARROW TRANSPLANT                                                                     T    0.99455   14.44     37
PreMDC 482        482   Tracheostomy For Face, Mouth, Neck Dx                                                      T    0.99455   14.44     37
PreMDC 483               No Longer Valid; See 541-542
   24      484    484   CRANIOTOMY for MULTI SIGNIF TRAUMA                                                        S     0.94524   13.43     29
   24      485    485   HIP, FEMUR, LIMB REATTACH PROCS                                                           S     0.94524   13.43     29
   24      486    486   Other O.R. PROCS/MULTI SIGNIF TRAUMA                                                      S     0.94524   13.43     29
   24      487    487   Other Multiple Signifant Trauma                                                           S     0.94524   13.43     29
   25      488    488   HIV w/ EXTENSIVE O.R. PROCEDURE                                                           T     0.99455   14.44     37
   25      489    489   HIV w/ MAJOR RELATED CONDITION                                                            T     0.99455   14.44     37
   25      490    490   HIV w/ O.R. w/o Other related conditions                                                  T     0.99455   14.44     37
    8      491    491   MAJ JOINT/LIMB REATTACH UPPR EXTREM                                                       H     0.52712    9.00     20
   17      492    492   CHEMOTHERAPY w/ Acute Leukemia as 2nd Dx                                                  T     0.99455   14.44     37
    7      493    493   LAP CHOLECYSTECTOMY w/o CDE w/ CC                                                         T     0.99455   14.44     37
    7      494    494   LAPAR CHOLECYSTECTOMY w/o CDE w/o CC                                                      T     0.99455   14.44     37
PreMDC 495        495   LUNG TRANSPLANT                                                                           T     0.99455   14.44     37
    8      496    496   Combined Anterior/Posterior SPINAL FUSION                                                 H     0.52712    9.00     20
    8      497    497   Spinal Fusion except Cervical w/ CC                                                       H     0.52712    9.00     20
    8      498    498   Spinal Fusion except Cervical w/o CC                                                      H     0.52712    9.00     20
    8      499    499   BACK & NECK Procedures except fusion w/ CC                                                H     0.52712    9.00     20
    8      500    500   BACK & NECK Procedures except fusion w/o CC                                               H     0.52712    9.00     20
    8      501    501   KNEE Procedures w/ PDx of Infection w/ CC                                                 H     0.52712    9.00     20
    8      502    502   KNEE Procedures w/ PDx of Infection w/o CC                                                H     0.52712    9.00     20
    8      503    503   KNEE Procedures w/o PDx of Infection                                                      H     0.52712    9.00     20
   22      504    504   Extensive 3rd Degree Burns w/ Skin Graft                                                  T     0.99455   14.44     37
   22      505    505   Extensive 3rd Degree Burns w/o Skin Graft                                                 T     0.99455   14.44     37
   22      506    506   Full Thick Burn w Sk Graft or Inh Inj w/CC or Sign Trauma                                 T     0.99455   14.44     37


        Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                Rehab    pg 58
       Mn DHS, Minn Health Care Programs                                    Acute Physical Rehab                  2007-2010                                                      Sort by DRG
                                                                                                                                                Rehab                    Rehab
       Rehab                                                                                                                                          Rehab Rel Rehab
                   REHAB
 Fed
                                    Grouper V.23 DRG NUMBER & DESCRIPTOR                               Rehab Comments                            V.23                     Trim Additions/ Corrections/
 MDC   DRG #                                                                                                                                             Val    ALOS
                                                                                                                                                MnDC                     Point Comments
  22    507      507   Full Thick Burn w Sk Graft or Inh Inj w/o CC or Sign Trauma                                                                T    0.99455  14.44      37
  22    508      508   Full Thick Burn w/o Sk Graft or Inh Inj w CC or Sign Trauma                                                                T    0.99455  14.44      37
  22    509      509   Full Thick Burn w/o Sk Graft or Inh Inj w/o CC or Sign Trauma                                                              T    0.99455  14.44      37
  22    510      510   Non-extensive Burns w/ CC or Signif Trauma                                                                                 T    0.99455  14.44      37
  22    511      511   Non-extensive Burns w/o CC or Signif Trauma                                                                                T    0.99455  14.44      37
PreMDC 512       512   Simultaneous Pancreas/ Kidney Transplant                                                                                   T    0.99455  14.44      37
PreMDC 513       513   Pancreas Transplant                                                                                                        T    0.99455  14.44      37
    5   514            No Longer Valid
    5   515      515   Cardiac Defibrillator Implant without Cardiac Cath                                                                         T    0.99455   14.44     37
    5   516             No Longer Valid
    5   517             No Longer Valid
    5   518      518   Percutaneous Cardiovascular Procedures without Stent without AMI                                                          T     0.99455   14.44     37
    8   519      519   Cervical Spinal Fusion with Complications                                                                                 H     0.52712    9.00     20
    8   520      520   Cervical Spinal Fusion without Complications                                                                              H     0.52712    9.00     20
   20   521      521   Alcohol/Drug Abuse or Dependence with CC                            except w/ Proc 94.**(.61, .63, .64, .66, .67, .69)    R     1.08291   15.88     37
   20   522      522   Alcohol/Drug Abuse or Dependence with Rehab without CC
   20   523      523   Alcohol/Drug Abuse or Dependence without Rehab without CC                                                                 R     1.08291   15.88     37
    1   524      524   Transient Ischemia (Groups to DRG 15, 16 or 17)                                                                           A     0.93042   14.46     37
    5   525      525   Heart Assist System Implant (Groups to DRG 104 -105)                                                                      T     0.99455   14.44     37
    5   526             No longer valid; See DRG 555-558
    5   527             No longer valid; See DRG 555-558
    1   528      528   Intracranial Vascular Procedure w/ PDx of Hemorrhage                                                                      A     0.93042   14.46     37
    1   529      529   Ventricular Shunt Procedure w/ CC                                                                                         A     0.93042   14.46     37
    1   530      530   Ventricular Shunt Procedure w/o CC                                                                                        A     0.93042   14.46     37
    1   531      531    Spinal Procedure w/ CC                                                                                                   A     0.93042   14.46     37
    1   532      532   Spinal Procedure w/o CC                                                                                                   A     0.93042   14.46     37
    1   533      533   Extracranial Procedure w/ CC                                                                                              A     0.93042   14.46     37
    1   534      534   Extracranial Procedure w/o CC                                                                                             A     0.93042   14.46     37
    5   535      535   ICD Implant with Cath with AMI, HF, or Shock                                                                              T     0.99455   14.44     37
    5   536      536   Cardiac Defib Implant w/o Cath with AMI, HF, or Shock                                                                     T     0.99455   14.44     37
    8   537      537    Local Excis & Remov Intern Fxtn Dev Exc Hip & Femur w/ CC                                                                H     0.52712    9.00     20
    8   538      538    Local Excis & Remov Intern Fxtn Dev Exc Hip & Femur w/o CC                                                               H     0.52712    9.00     20
   17   539      539    Lymphoma & Leukemia w/ Maj OR Procedure w/ CC                                                                            T     0.99455   14.44     37
   17   540      540    Lymphoma & Leukemia w/ Maj OR Procedure w/o CC                                                                           T     0.99455   14.44     37
 PreMDC 541      541    Trach w/ MV 96+ hr or PDx exc Fce, Mth & Nck w/ Maj O.R.                                                                 T     0.99455   14.44     37
 PreMDC 542      542    Trach w/ MV 96+hr Exc Face, Mouth & Neck w/o Maj O.R.                                                                    T     0.99455   14.44     37
    1   543      543   Crani w/Implnt Chemotherap Agnt or Ac Cmplx CNS PDx                                                                       A     0.93042   14.46     37
    8   544      544   Maj Joint Replacement or Reattachment of Lower Extremity                                                                  H     0.52712    9.00     20
    8   545      545   Revision of Hip or Knee Replacement                                                                                       H     0.52712    9.00     20
    8   546      546   Spinal Fusion Except Cervical w/ Curvature of Spine or Malignancy                                                         H     0.52712    9.00     20
    5   547      547   Coronary Bypass with Cardiac Cath with Maj CV Dx                                                                          T     0.99455   14.44     37
    5   548      548   Coronary Bypass with Cardiac Cath w/o Maj CV Dx                                                                           T     0.99455   14.44     37
    5   549      549   Coronary Bypass w/o Cardiac Cath with Maj CV Dx                                                                           T     0.99455   14.44     37
    5   550      550   Coronary Bypass w/o Cardiac Cath w/o Maj CV Dx                                                                            T     0.99455   14.44     37
    5   551      551    PPM Implant with Maj CV Dx, or AICD Lead or Generator                                                                    T     0.99455   14.44     37
    5   552      552   Other Cardiac PPM Implant w/o Maj CV Dx                                                                                   T     0.99455   14.44     37
    5   553      553   Other Vascular Procedure with CC with Maj CV Dx                                                                           T     0.99455   14.44     37
    5   554      554   Other Vascular Procedure with CC w/o Maj CV Dx                                                                            T     0.99455   14.44     37
    5   555      555   Perc CV Procedure with Maj CV Dx                                                                                          T     0.99455   14.44     37
    5   556      556   Perc CV Procedure with Non-Drug-Eluding Stent w/o Maj CV Dx                                                               T     0.99455   14.44     37


       Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                Rehab    pg 59
        Mn DHS, Minn Health Care Programs                                      Acute Physical Rehab                     2007-2010                                                               Sort by DRG
                                                                                                                                                     Rehab                             Rehab
        Rehab                                                                                                                                              Rehab Rel Rehab
                    REHAB
Fed
                                     Grouper V.23 DRG NUMBER & DESCRIPTOR                                      Rehab Comments                         V.23                              Trim Additions/ Corrections/
MDC     DRG #                                                                                                                                                 Val    ALOS
                                                                                                                                                     MnDC                              Point Comments
  5       557     557 Perc CV Procedure with Drug Eluding Stent with Maj CV Dx                                                                         T    0.99455  14.44               37
  5       558     558 Perc CV Procedure with Drug Eluding Stent w/o Maj CV Dx                                                                          T    0.99455  14.44               37
  1       559     559 Acute Ischemic Stroke w/ Use of a Thrombolytic Agent                                                                             A    0.93042  14.46               37
                  Effective for admission on or after January 1, 2007
                  Grouper Version 24 DRGs effective Oct. 1, 2006 (DHS does not use DRG 560-579.)
                  To determine a Grouper 23 DRG, enter a test claim with a discharge between 10/1/2005 and 9/31/2006 for discharges between 1/1/07 & 12/31/08.
predicted ** IMPORTANT The predicted Grouper V. 23 DRG & the actual Grouper V. 23 DRG that     is paid has the potential to vary. The creator of the crosswalk does not have the algorithms developed by Medicare.
                The newer DRGs are included to assist providers with their payment audits.
         560    Bacterial and tuberculous infections of the nervous system                     DRG 20?
         561    Non bacterial infections of nervous system except viral meningitis             DRG 20?
         562    Seizure age>17 w/ CC                                                           DRG 24
         563    Seizure age>17 w/o CC                                                          DRG 25
         564    Headaches, age >17                                                             DRG 24 (Minn Dx Cat A13) & 25 (MnDC A16)
         565    Respiratory system diagnosis with ventilator support 96+ hours                 475-2 D2
         566    Respiratory system diagnosis with ventilator support <96 hours                 475-1 D1
         567    Stomach, esophageal and duodenal proc age >17 w/ CC w/ major GI Dx             DRG 154
         568    Stomach, esophageal and duodenal proc age >17 w/ CC w/o major GI Dx            DRG 155
         569    Major small and large bowel procedures w/CC w/ major GI Dx                     DRG 148
         570    Major small and large bowel procedures w/ CC w/o major GI Dx                   DRG 149
         571    Major esophageal disorders                                                     DRG 182-184 or 188-190 (guesstimate - need to test with your grouper)
         572    Major gastrointestinal disorders and peritoneal infections                     DRG 182-184 or 188-190 (guesstimate - need to test with your grouper)
         573    Major bladder procedures                                                       DRG 303 & 304
         574    Major hematologic/immunologic diag except sickle cell crisis and coagulation   395, 396, 398, 399
         575    Septicemia w/ MV 96+ hours, age >17                                            416
         576    Septicemia w/o MV 96+hours, age >17                                            416
         577    Carotid artery stent                                                           Version 23: DRG 533 & 534
         578    Infectious and parasitic diseases w/ OR procedure                              415
         579    Postoperative or post-traumatic infections w/ OR procedure                     415




        Ann Gjerstad, MnDHS 651-431-2541 Ann.Gjerstad@state.mn.us                                                                                                                             Rehab         pg 60
         Mn DHS, Mn Health Care Programs                                 Transfers to an NICU                         2007-2010                                                    Sort by DRG



* Minnesota Diagnostic Categories must be determined in conjunction with Mn Rules 9500.1100 Subp.20g. Other DRG Requirements, A.-O.
For payment under Subp. 20f. (NICU transfers ) the neonate must transfer out of the hospital of birth to another hospital (with a different provider number).
Any blue highlighted cell indicates that, w/i NICU per diem rates, the DRG or case groups to a different payment category as defined in Mn Rules 9500.1100 (see 20g. letter A-I)

                                                                                    NICU                                                                     Relative
 DRG #       NICU Transfers                    Grouper V.23 DRG NUMBER & DESCRIPTOR MnDC                                  NICU Comment
                                                                                                                                                              Value
                                                                                                                                                                      Additions/ Corrections/
                                                                                                                                                                            Comments
   385     385    NEONATES died or transferred to another hospital                                             DC destination changed to home
   386     386-2 Extreme Immaturity & Neonatal Resp Distress Syndrome (Wt. < 750 Gms)                KK2             Includes 765.01, 765.02                 1.21224
   386     386-4 Extreme Immaturity & Neonatal Resp Distress Syndrome (Wt. 750-1499 Gms)             KK4            Includes 765.03 - 765.05                 1.02079
   386     386-5 Extreme Immaturity & Neonatal Resp Distress Syndrome                                KK5    Codes for DRG 386 except 765.01-765.05           0.85610
   387     387-4 Prematurity with major problems (Extreme immaturity, unspecified wt.)               KK4              387, Dx 765.00 only                    1.02079
   387     388 Prematurity with major problems                                                        LL       Codes for DRG 387 except 765.00               0.84907
   388     388 Prematurity without major problems                                                     MM                                                     0.82434
   389     389 Full term neonate w/ major problems                                                   NN1                                                     1.03606
   390     390 Neonate w/ other significant problems                                                 NN2                                                     0.75929
   391     391 NORMAL NEWBORN
   482     482 Tracheostomy for Face, Mouth, Neck Diagnoses                                          KK2                       Age < 1                       1.21224
   541     541 ECMO/Trach w/ MV 96+ hr or PDx except Face, Mouth & Neck w/ Major O.R.                KK2                       Age < 1                       1.21224
   542     542 Trach w/ MV 96+ hrs or PDx except Face, Mouth & Neck w/o Maj O.R.                     KK2                       Age < 1                       1.21224
Effective for admission on or after January 1, 2007 - December 31, 2010
Neonates transferred to an NICU at another hospital for V29.x must include a secondary diagnosis of the suspected disease or condition that resulted in transfer to the NICU.
ICD-9 Dx subcategory code 765.24 -765.29 will not impact DRG unless a code from 764.x, 765.0x or 765.1x is present on claim.
Neonates with an admission and a discharge on the same date should pay even though neonate was not in a bassinet at midnight.

                                                                                                            Neonate Transferred From Birth Hosp to NICU
                                                                                                                                                              & the
                                                                                                                        IF ICD-9 Dx code =                                  then the MnDC =
                                                                                                                                                              DRG =
                                                                                                                               765.00                          387                 KK4
                                                                                                                               765.01                          386                 KK2
                                                                                                                               765.02                          386                 KK2
                                                                                                                               765.03                          386                 KK4
                                                                                                                               765.04                          386                 KK4
                                                                                                                               765.05                          386                 KK4
                                                                                                                              769 alone                        386                 KK5




         Ann Gjerstad, MnDHS   651-431-2541   Ann.Gjerstad@state.mn.us                                                                                       NICU Transfers              Pg 1 of 1
             Mn DHS, Mn Health Care Programs                                 Transfers to an NICU   2007-2010                    Sort by DRG




fer to the NICU.




             Ann Gjerstad, MnDHS   651-431-2541   Ann.Gjerstad@state.mn.us                                      NICU Transfers       Pg 1 of 1
        MHCP                                                                                   Special DRGs 800-811                 2007-2010

* Minnesota Diagnostic Categories must be determined in conjunction with Mn Rule 9500.1100 Subp. 20g. Other DRG Requirements, A.-O.
NOTES: "Minnesota DRGs" are assigned for a Medicare DRG that is split into 2 or more DRGs.
A blue cell indicate that the DRG isn't covered or groups to a different pymt category as defined in Mn Rules (20g. letter A-O)
Any cell with a red triangle in the corner includes a more complete explantion. To read the comment, place curser within the cell
ICD-9 Dx subcategory code 765.2* is not used without a code from 765.0*, 765.1* or 764 on the claim.
                                                                                         DRGs included in                                                                                                                 Medicare      Correction/
  Mn      Special Mn DRGs for split payment            MA                                                                                      ICD-9 Dx codes included             Rehab
                                                                  MA Comments          MnDC for Payment        GA MnDC        GA Comments                                                        Rehab Comments             DRGs       Explanation,
 DRG          of Medicare (Federal) DRGs             MnDC                                                                                             in Rehab MnDC                MnDC
                                                                                               (MA)                                                                                                                        included    Date Changed
                                                                                                                                                                                            Dx 344.01-344.04, 344.09,
                                                                                                                                                                                            806.0x, 806.1x, or 952.0x
        Rehab Only; Specific late effects or                                                                                                                                                WITH 907.2, excluding
                                                                                                                                               Rehab Dx Code Definitions:                                                               Descriptor
        conditions secondary to spinal cord or                                                                                                                                              781.0, 781.2, & 780.03; or   Not DRG
                                                                                                                                               781.0: abn involuntary mvmnt;                                                            changed &
        intracranial injury or skull fracture        Rehab                                                       Rehab                         781.2: abnormal gait;
                                                                                                                                                                                            Dx 344.00-344.04, 344.09,    dependent--
 800                                                                                                                                                                                 Z      342.01, 342.81, or 342.91                    Column K
        resulting in quadriplegia or hemiplegia       only                                                        only                         781.3: lack of coordination;                                              based on
                                                                                                                                               780.03: Persistent vegetative
                                                                                                                                                                                            WITH 907.0 or 905.0,                       corrected on
        (see Mn DRG 809 for next pull-out Rehab                                                                                                state                                        excluding 781.0, 781.3, &    ICD-9 codes    10/20/09
        group)                                                                                                                                                                              780.03


                                                              Includes Proc 20.96 -                                                                                                                                                     Add MnDC
  801   Cochlear Implants (DRG 049)                    C7                                   DRG 049                                                                                         not used in Rehab
                                                              20.98 Only                                                                                                                                                                 7/30/08

        Major Head & Neck Procedures (DRG                     Excludes Proc 20.96                                                                                                                                                       Add MnDC
 802                                                   C6                                   DRG 049                                                                                         not used in Rehab
        49) excluding cochlear implants                       -20.98                                                                                                                                                                     7/30/08

        Respiratory System Diagnoses w/ Vent                                                                                                                                                                                            Add MnDC
 803                                                   D1     Excludes 96.72                DRG 475                          Excludes 96.72              DRG 475                            not used in Rehab
        support (DRG 475) for < 96hr                                                                                                                                                                                                     7/30/08

        Respiratory System Diagnoses w/ Vent                                                                                                                                                                                            Add MnDC
 804                                                   D2      Includes 96.72               DRG 475                          Includes 96.72              DRG 475                            not used in Rehab
        support (DRG 475) for 96+hr                                                                                                                                                                                                      7/30/08

 805      No longer in use as of Jan 1, 2007
 806     No longer in use as of Jan 1, 2003
                                                              does not include
        Neonate died on birthdate at birth                                                                                 GA does not                                                                                                  Add MnDC
 807                                                  MM      NICU transfers                DRG 485                                                                                         not used in Rehab
        hospital                                                                                                           include neonates                                                                                              7/30/08
                                                              (COS 073)
                                                                                                                           DRG 521 with Proc
        Alcohol/Drug Abuse or Dependence w/                   DRG 521 with Proc
                                                      Non-                                                        Non-     94.61, 94.63,                                           Non-
 808 CC with CD Rehabilitation --                             94.61, 94.63, 94.64,          DRG 521
                                                    Covered                                                     Covered 94.64, 94.66,                                             Covered
        Noncoverd DRG under FFS                               94.66, 94.67, 94.69
                                                                                                                           94.67, 94.69
                                                                                                                                               Rehab Dx Code Description:                   Dx 344.1, 806.21, 806.26,
        Rehab Only; Specific late effects or                                                                                                   781.0: abn invol mvmt;                       806.31, 806.36, 952.11,                     Descriptor
                                                                                                                                               781.2: abnormal gait;                                                     Not DRG
        conditions secondary to spinal cord or                                                                                                                                              952.16 WITH 905.0,                          changed &
                                                     Rehab                                                       Rehab                         781.3: lack of coordination;                                              dependent--
 809 intracranial injury or skull fracture                                                                                                     781.4: transient limb paralysis.      Y      907.0, or 907.2, excluding                   Column K
                                                      only                                                        only                                                                      cases w/ 781.0, 781.2,       based on
        resulting in paraplegia (see Mn DRG 800                                                                                                                                                                                        corrected on
                                                                                                                                                                                            781.3, & 781.4               ICD-9 codes     10/20/09
        for other pull-out Rehab group)


        DRG 003 with ventricular shunt as                     Groups to DRG                                                                                                                                                             Add MnDC
  810                                                  A3                                    DRG 003
        PProc w/ CC, age 0-17                                 529                                                                                                                                                                        7/30/08

        DRG 003 w/ Ventricular shunt as PProc                 Groups to DRG                                                                                                                                                             Add MnDC
  811                                                  A7                                   DRG 003
        w/o CC, age 0-17                                      530                                                                                                                                                                        7/30/08




        Ann.Gjerstad@state.mn.us

				
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