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  3. Diagnosis Codes in MS-DRG 486 - Knee Procedures With Principal Diagnosis Of Infection With CC

Diagnosis Codes in MS-DRG 486 - Knee Procedures With Principal Diagnosis Of Infection With CC

The Medicare Severity Diagnosis-Related Group (MS-DRG) is a patient classification system used to categorize hospital cases based on clinical similarity and expected resource use. MS-DRGs organize all possible principal diagnoses into mutually exclusive groups known as Major Diagnostic Categories (MDCs), which help determine reimbursement under the Medicare Inpatient Prospective Payment System.

This section lists the diagnosis codes included in MS-DRG V42.0: Knee Procedures with Principal Diagnosis of Infection with CC from October 1, 2024, through September 30, 2025.

MS-DRG: 486

MS-DRG Title: Knee Procedures with Principal Diagnosis of Infection with CC

MCD: 08

Relative Weight: 2.1207 Relative Weight
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Geometric LOS: 2.12 Geometric Length of Stay
The geometric mean length of stay (GMLOS) is used by Medicare to calculate the reimbursement for patients whose medical treatment takes a much longer or shorter time than average.

Arithmetic LOS: 5.10 Arithmetic Length of Stay
The average length of stay (ALOS) reflects the average number of days a patient spends in a hospital for each admission.

  • A18.0 - Tuberculosis of bones and joints

    • A18.02 - Tuberculous arthritis of other joints

  • A54.4 - Gonococcal infection of musculoskeletal system

    • A54.42 - Gonococcal arthritis

  • M00 - Pyogenic arthritis

    • M00.9 - Pyogenic arthritis, unspecified

  • M00.06 - Staphylococcal arthritis, knee

    • M00.061 - Staphylococcal arthritis, right knee

    • M00.062 - Staphylococcal arthritis, left knee

    • M00.069 - Staphylococcal arthritis, unspecified knee

  • M00.16 - Pneumococcal arthritis, knee

    • M00.161 - Pneumococcal arthritis, right knee

    • M00.162 - Pneumococcal arthritis, left knee

    • M00.169 - Pneumococcal arthritis, unspecified knee

  • M00.26 - Other streptococcal arthritis, knee

    • M00.261 - Other streptococcal arthritis, right knee

    • M00.262 - Other streptococcal arthritis, left knee

    • M00.269 - Other streptococcal arthritis, unspecified knee

  • M00.86 - Arthritis due to other bacteria, knee

    • M00.861 - Arthritis due to other bacteria, right knee

    • M00.862 - Arthritis due to other bacteria, left knee

    • M00.869 - Arthritis due to other bacteria, unspecified knee

  • M01.X6 - Direct infection of knee in infectious and parasitic diseases classified elsewhere

    • M01.X61 - Direct infection of right knee in infectious and parasitic diseases classified elsewhere

    • M01.X62 - Direct infection of left knee in infectious and parasitic diseases classified elsewhere

    • M01.X69 - Direct infection of unspecified knee in infectious and parasitic diseases classified elsewhere

  • M71.06 - Abscess of bursa, knee

    • M71.061 - Abscess of bursa, right knee

    • M71.062 - Abscess of bursa, left knee

    • M71.069 - Abscess of bursa, unspecified knee

  • M71.16 - Other infective bursitis, knee

    • M71.161 - Other infective bursitis, right knee

    • M71.162 - Other infective bursitis, left knee

    • M71.169 - Other infective bursitis, unspecified knee

  • M86.06 - Acute hematogenous osteomyelitis, tibia and fibula

    • M86.061 - Acute hematogenous osteomyelitis, right tibia and fibula

    • M86.062 - Acute hematogenous osteomyelitis, left tibia and fibula

    • M86.069 - Acute hematogenous osteomyelitis, unspecified tibia and fibula

  • M86.16 - Other acute osteomyelitis, tibia and fibula

    • M86.161 - Other acute osteomyelitis, right tibia and fibula

    • M86.162 - Other acute osteomyelitis, left tibia and fibula

    • M86.169 - Other acute osteomyelitis, unspecified tibia and fibula

  • M86.26 - Subacute osteomyelitis, tibia and fibula

    • M86.261 - Subacute osteomyelitis, right tibia and fibula

    • M86.262 - Subacute osteomyelitis, left tibia and fibula

    • M86.269 - Subacute osteomyelitis, unspecified tibia and fibula

  • M86.36 - Chronic multifocal osteomyelitis, tibia and fibula

    • M86.361 - Chronic multifocal osteomyelitis, right tibia and fibula

    • M86.362 - Chronic multifocal osteomyelitis, left tibia and fibula

    • M86.369 - Chronic multifocal osteomyelitis, unspecified tibia and fibula

  • M86.46 - Chronic osteomyelitis with draining sinus, tibia and fibula

    • M86.461 - Chronic osteomyelitis with draining sinus, right tibia and fibula

    • M86.462 - Chronic osteomyelitis with draining sinus, left tibia and fibula

    • M86.469 - Chronic osteomyelitis with draining sinus, unspecified tibia and fibula

  • M86.56 - Other chronic hematogenous osteomyelitis, tibia and fibula

    • M86.561 - Other chronic hematogenous osteomyelitis, right tibia and fibula

    • M86.562 - Other chronic hematogenous osteomyelitis, left tibia and fibula

    • M86.569 - Other chronic hematogenous osteomyelitis, unspecified tibia and fibula

  • M86.66 - Other chronic osteomyelitis, tibia and fibula

    • M86.661 - Other chronic osteomyelitis, right tibia and fibula

    • M86.662 - Other chronic osteomyelitis, left tibia and fibula

    • M86.669 - Other chronic osteomyelitis, unspecified tibia and fibula

  • M86.8X - Other osteomyelitis

    • M86.8X6 - Other osteomyelitis, lower leg

  • T84.53 - Infection and inflammatory reaction due to internal right knee prosthesis

    • T84.53XA - Infection and inflammatory reaction due to internal right knee prosthesis, initial encounter

  • T84.54 - Infection and inflammatory reaction due to internal left knee prosthesis

    • T84.54XA - Infection and inflammatory reaction due to internal left knee prosthesis, initial encounter

  • T84.620 - Infection and inflammatory reaction due to internal fixation device of right femur

    • T84.620A - Infection and inflammatory reaction due to internal fixation device of right femur, initial encounter

  • T84.621 - Infection and inflammatory reaction due to internal fixation device of left femur

    • T84.621A - Infection and inflammatory reaction due to internal fixation device of left femur, initial encounter

  • T84.622 - Infection and inflammatory reaction due to internal fixation device of right tibia

    • T84.622A - Infection and inflammatory reaction due to internal fixation device of right tibia, initial encounter

  • T84.623 - Infection and inflammatory reaction due to internal fixation device of left tibia

    • T84.623A - Infection and inflammatory reaction due to internal fixation device of left tibia, initial encounter

  • T84.624 - Infection and inflammatory reaction due to internal fixation device of right fibula

    • T84.624A - Infection and inflammatory reaction due to internal fixation device of right fibula, initial encounter

  • T84.625 - Infection and inflammatory reaction due to internal fixation device of left fibula

    • T84.625A - Infection and inflammatory reaction due to internal fixation device of left fibula, initial encounter

  • T84.629 - Infection and inflammatory reaction due to internal fixation device of unspecified bone of leg

    • T84.629A - Infection and inflammatory reaction due to internal fixation device of unspecified bone of leg, initial encounter

  • T84.7 - Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants and grafts

    • T84.7XXA - Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants and grafts, initial encounter