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M99.16

Billable

Subluxation complex (vertebral) of lower extremity

Chapter 13: Diseases of the musculoskeletal system and connective tissue

Additional Information

From parent codes: M00-M99 (Chapter 13)

Excludes 2 — Not Included HereFrom M00-M99

Excludes2 means 'NOT INCLUDED HERE!' An Excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time.

  • arthropathic psoriasis (L40.5-)
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • compartment syndrome (traumatic) (T79.A-)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
NotesFrom M00-M99

Additional notes from parent codes that apply to this code.

  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition

Inpatient DRG Payments

DRG 56315,402 discharges

Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without Mcc

Avg. Medicare Payment

$6,629

Total Payment$8,749
Patient Responsibility$2,120
Hospital Charge$45,159
DRG 5621,309 discharges

Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh With Mcc

Avg. Medicare Payment

$12,148

Total Payment$14,612
Patient Responsibility$2,464
Hospital Charge$73,074
DRG 9641,052 discharges

Other Multiple Significant Trauma With Cc

Avg. Medicare Payment

$13,599

Total Payment$19,129
Patient Responsibility$5,529
Hospital Charge$88,040
DRG 963792 discharges

Other Multiple Significant Trauma With Mcc

Avg. Medicare Payment

$29,419

Total Payment$35,483
Patient Responsibility$6,063
Hospital Charge$149,213