For the purposes of Regulation .20D(2)—(3) of this chapter, a patient with severe injury shall have: An injury severity score (ISS) greater than or equal to 13; A penetrating injury with systolic blood pressure of less than or equal to 90 millimeters of mercury; A thoracic injury classified as one or more of the following International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM) codes: 861.21 — Lung contusion, without open wound to thorax; 861.31 — Lung contusion, with open wound into thorax; or 807.4 — Flail chest; A blunt injury to the abdomen with major solid visceral injury classified as one or more of the following ICD-9-CM codes: 864.03 — Moderate laceration injury to liver without mention of open wound into cavity; 864.04 — Major laceration injury to liver without mention of open wound into cavity; 864.13 — Moderate laceration injury to liver with open wound into cavity; 864.14 — Major laceration of liver with open wound into cavity; 865.03 — Injury to spleen with laceration extending into parenchyma without mention of open wound into cavity; 865.04 — Injury to spleen with massive parenchymal disruption without mention of open wound into cavity; 865.13 — Injury to spleen with laceration extending into parenchyma and open wound into cavity; 865.14 — Injury to spleen with massive parenchymal disruption and open wound into cavity; 866.01 — Hematoma of kidney without rupture of capsule or mention of open wound into cavity; 866.02 — Laceration of kidney without mention of open wound into cavity; 866.11 — Hematoma of kidney without rupture of capsule but with open wound into cavity; or 866.12 — Laceration of kidney with open wound into cavity; A major surgical procedure in the cranial, thoracic, vascular, abdominal, or spinal body regions, classified as one or more of the following ICD-9-CM procedure codes: Cranial: 01.2X — Craniotomy and craniectomy; 01.3X — Incision of brain and cerebral meninges; 01.52 — Hemispherectomy; 01.53 — Lobectomy of brain; 02.0X — Cranioplasty; 02.1X — Repair of cerebral meninges; 02.3 — Extracranial ventricular shunt; 02.92 — Repair of brain; or 02.94 — Insertion of replacement of skull tongs or halo traction device; Thoracic: 34.02 — Exploratory thoracotomy; 34.82 — Suture of laceration of diaphragm; 34.84 — Other repair of diaphragm; 37.1X — Cardiotomy and pericardiotomy; or 37.91 — Open chest cardiac massage; Vascular: 38.3 — Resection of vessel with anastomosis (use 4th digits 2, 3, 4, 5, 6, 7, 8, 9); 38.4 — Resection of vessel with replacement (use 4th digits 2, 3, 4, 5, 6, 7, 8, 9); 38.8 — Other surgical occlusion of vessels (use 4th digits 2, 3, 4, 5, 6, 7, 8, 9); 39.3 — Suture of vessel; 39.56 <MD >Repair of blood vessel with tissue patch graft; 39.57 — Repair of blood vessel with synthetic patch graft; 39.58 — Other repair of vessel; 39.6X — Extracorporeal circulation and procedures auxiliary to heart surgery; or 39.98 — Control of hemorrhage, not otherwise specified; Abdominal: 41.43 — Partial splenectomy; 41.5 — Total splenectomy; 41.95 — Repair and plastic operations on spleen; 42.82 — Suture of laceration of esophagus; 42.89 — Other repair of esophagus; 44.61 — Suture of laceration of stomach; 44.69 — Other repair of stomach, not otherwise specified; 45.0X — Enterotomy; 45.5X — Isolation of intestinal segment; 45.6X — Other excision of small intestine; 45.7X — Partial excision of large intestine; 45.8 — Total intra-abdominal colectomy; 46.0 through 46.03 — Other operations on intestine; 46.7X — Other repair of intestine; 50.0 — Hepatotomy; 50.22 — Partial hepatectomy; 50.3 — Lobectomy of liver; 50.4 — Total hepatectomy; 50.6X — Repair of liver; 52.5X — Partial pancreatectomy; 52.6 — Total pancreatectomy; 52.95 — Other repair of the pancreas; 54.11 — Exploratory laparotomy; 55.4 — Partial nephrectomy; 55.5X — Complete nephrectomy; 55.8X — Other repair of kidney; 56.8X — Repair of ureter; or 57.8X — Other repair of urinary bladder; or Spinal: 03.53 — Repair of vertebral fracture; 81.00 — Spinal fusion, not otherwise specified; 81.01 — Atlas-axis spinal fusion; 81.02 — Other cervical fusion, anterior technique; 81.03 — Other cervical fusion, posterior technique; 81.04 — Dorsal and dorsolumbar fusion anterior technique; 81.05 — Dorsal and dorsolumbar fusion, posterior technique; or 81.06 — Lumbar and lumbosacral fusion, anterior technique; A major pelvic fracture, classified as one or more of the following ICD-9-CM codes: 808.43 — Multiple, closed, pelvic fractures with disruption of pelvic circle; or 808.53 — Multiple, open, pelvic fractures with disruption of pelvic circle; or Two or more long bone lower extremity fractures that can be either ipsilateral or contralateral, classified as one or more of the following ICD-9-CM codes: 820.XX — Fractures of neck of femur; 821.XX — Fractures of other and unspecified parts of femur; or 823.X2 — Fractures of fibula with tibia.