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WCHQ Ambulatory Measure SpecificationDiabetes Care Performance Measures

Measurement Period 07/01/16 - 06/30/17Submission Period: 09/05/17 - 10/20/17

MEASURE DESCRIPTIONThe percentage of diabetes patients 18 through 75 years of age who had the following during the 12-month measurement period:

1. At least two A1c blood sugar tests annually2. Most recent A1c blood sugar level controlled to less than 8.0% 3. An annual nephropathy screening and/or treatment for kidney disease and/or diagnosis of kidney

disease4. Most recent Blood Pressure controlled to a level of less than 140/90 mm Hg5. Most recent Tobacco Status is Tobacco-Free6. Daily Aspirin or Other Antiplatelet for diabetes patients with Ischemic Vascular Disease (IVD)

unless contraindicated.7. Statin Use for patients ages 40 through 75 or patients with IVD of any age unless contraindicated.8. An eGFR (Estimated Glomerular Filtration Rate) test annually9. All or None Process Measure (Optimal Testing) composite of two A1C’s, one Kidney Function

Monitoring Test and one eGFR Test10. All or None Outcome Measure (Optimal Control) composite of A1C <8.0%, BP <140/90, Tobacco

Non-User, Statin Use, and Daily Aspirin or Other Antiplatelet for diabetes patients with IVD.

Disclaimer: Measures reported by WCHQ healthcare organizations represent a specific aspect of care in relation to an evidence-based standard, but are not clinical guidelines and do not establish standards of care. All providers should have an individual care plan established with their patient.

GENERAL INFORMATION/RATIONALEIn an effort to align with National Quality Form (NQF) endorsed diabetes measures, and referencing the 2013 American Diabetes Association (ADA) guidelines and the ACC/AHA practice guidelines on the treatment of cholesterol the following goals for people with diabetes are measured by the WCHQ:

Two A1c tests annually, at a minimum A1c level controlled to less than 8.0% Screening and/or treatment for kidney disease annually Blood pressure controlled to a level of less than 140/90 mm Hg Tobacco-Free Status Statin Use for diabetes patients ages 40 through 75 or those with IVD of any age Daily Aspirin or Other Antiplatelet for diabetes patients with IVD

In November 2013, The American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines released updated guidance for the treatment of blood cholesterol. The new recommendations remove treatment targets for LDL-C for the primary or secondary prevention of atherosclerotic cardiovascular disease (ASCVD) and recommend high or moderate intensity statin therapy based on patient risk factors. Four major stain benefit groups were identified for whom ASCVD risk clearly outweighs the risk of adverse events. Diabetics age 40 to 75 years, regardless of LDL-C level and without clinical ASCVD are one of the identified groups.

A large body of evidence from epidemiological, case-control and cohort studies provides convincing documentation of the causal link between cigarette smoking and health risks. Studies of individuals with diabetes consistently demonstrate that smokers have a heightened risk of CVD, premature death, and increased rate of microvascular complications of diabetes. Smoking may have a role in the development of type 2 diabetes. The ADA supports the recommendation to advise all patients not to smoke or use tobacco

Diabetes Care Annual Review –Final 2017_Fallv2This specification is updated annually; refer to previous versions for coding and other changes

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products and to include smoking cessation counseling and other forms of treatment as a routine component of diabetes care.

Based on trials involving other secondary prevention therapies, the ACC and AHA recommends aspirin in all patients, unless contraindicated, with established coronary and other atherosclerotic vascular disease, including peripheral arterial disease, atherosclerotic aortic disease, and carotid artery disease. The ACC and AHA also recommend the use of other antiplatelet agents based on disease type and clinical conditions. The ADA supports this recommendation as a secondary prevention strategy for type 1 or type 2 diabetes with a history of CVD.

Approximately 11% of U.S. adults have CKD. The condition is usually asymptomatic until its advanced stages. Most cases of CKD are associated with diabetes or hypertension. Chronic kidney disease is defined as decreased kidney function or kidney damage that persists for at least 3 months. Tests often suggested for screening that are feasible in primary care include testing the urine for protein (microalbuminuria or macroalbuminuria) and testing the blood for serum creatinine to estimate GFR.

References:National Quality Forum-Endorsed Measure #0575 A1c Control: https://www.qualityforum.org/QPS/0575National Quality Forum-Endorsed Measure #0061 BP Control: https://www.qualityforum.org/QPS/0061American Diabetes Association Clinical Practice Recommendations 2013: http://care.diabetesjournals.org/content/36/Supplement_1/S4.fullSmith SC Jr, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, Gibbons RJ, Grundy SM, Hiratzka LF, Jones DW, Lloyd-Jones DM, Minissian M, Mosca L, Peterson ED, Sacco RL, Spertus J, Stein JH, Taubert KA. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce : Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines- http://circ.ahajournals.org/search?tocsectionid=ACC/AHA+Prevention+Guideline&sortspec=date&submit=SubmitReference: Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008. Retrieved May 7, 2008 from, http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdfReference: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chronic-kidney-disease-ckd-screening

DEFINITIONS12 Months: Measurement Period24 Months: Measurement Period + Prior YearOffice Visit: Office visit in an outpatient, non-urgent care settingPCP: For WCHQ measure purposes, a primary care provider is defined as any General Practice, Internal Medicine, Family Medicine, Pediatrics provider with the following degree types (MD, DO, PA, and NP), and any other practitioners identified by the healthcare system as primary care practitioners. The rationale for the additional practitioner(s) must be documented and must be applied consistently across all preventive care and chronic care measures by the organization.

Measure Specific Specialist: As part of the denominator population for this measure visits to an Endocrinologist qualify as office visits for the denominator population.

Age Range 18-75: Patients born between 07/01/1941 and 07/01/1998Age Range 40-75: Patients born between 07/01/1941 and 07/01/1976


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https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chronic-kidney-disease-ckd-screening

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chronic-kidney-disease-ckd-screening

http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf

http://circ.ahajournals.org/search?tocsectionid=ACC/AHA+Prevention+Guideline&sortspec=date&submit=Submit

http://care.diabetesjournals.org/content/36/Supplement_1/S4.full

https://www.qualityforum.org/QPS/0061

https://www.qualityforum.org/QPS/0575



DENOMINATOR DESCRIPTION Patients whose age at the beginning of the one year measurement period is at least 18 and whose age at the end of the measurement period is less than 76 and are alive as of the last day of the Measurement Period. Expired patients for whom a specific date of expiration cannot be found are excluded from the denominator population

The rationale for the denominator population is built from the following criteria (See Figure D-1): [Question 1] – Is this a patient with the disease or condition?[Question 2] – Is this a patient whose care is managed within the physician group?[Question 3] – Is this a patient currently managed in our system?

MINIMUM POPULATION SIZE For every WCHQ Ambulatory Measure, each organization must calculate total denominator population for this measure, not a sample (see Encounter Data section). If the Denominator for any given measure is less than 50 patients, the organization does not have to report the Numerator for the measure to WCHQ. To allow for appropriate comparisons of performance across organizations, a minimum population of 50 patients ensures a maximum of a 2% incremental scale on proportional measures.

Publication on the Website: If the Denominator is less than 50, only the Physician Group Name, Population Size (N), and the following statement will display on www.wchq.org:

The patient population is too small (N<50) for purposes of reliably predicting Physician Group performance.

Historical Trend for Low Population Sizes: The historical trend display of Physician Group performance will not include measurement periods with population sizes less than 50. For each measurement period with insufficient data, there will be no display for that period.

Site Level Reporting:Denominator Minimum: For site level reporting there must be a minimum of 100 patients per clinic in the denominator for each measure. If the clinic denominator for any given measure is less than 100 patients the organization does not publicly report the results for the measure. The results will still be included in the organization level data.

Provider Minimum per Clinic: For site level reporting there are two options as follows:o A minimum of 3 providers per clinic who have patients in the measure denominator. There

could be a provider or providers in a given clinic who do not get counted because they have no patients in the measure denominator.

o If an organization desires, they can report site level data for a clinic with fewer than 3 providers as long as the clinic meets the 100 patient threshold. If your organization is planning to report results publicly for clinics with less than 3 providers, all clinics that meet this criteria will need to be reported.

Publication on the Website: Clinics who do not have enough providers or patients to be publicly reported for a given measure or measures will still display on the website by name but without results and with a caveat indicating that data was reported but did not meet the minimum provider or population size.


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Provider and /or Clinic Attrition Recommendation:1. If a provider or clinic has left the organization prior to the end of the measurement period

and if the organization can track the provider termination date, the provider will not be included in the site level reporting results. The provider or clinic is still included in the group level results.

2. If a clinic closes or is no longer affiliated with a health care system after the end of the measurement period and prior to next year’s data being published a termination date and verbiage will be added next to that clinic’s name on the website. This will require website updating throughout the year.

Assignment of Provider to Clinic:Organizations can use their current internal site level reporting methodology to assign a provider to a clinic. A provider must be assigned to a “home” clinic. Organizations who are not already doing internal site level reporting can work with WCHQ for assistance.

Assignment of Patient to Provider:For purposes of WCHQ site level reporting a patient must be attributed to one provider. Organizations can use their own internal algorithm to assign a patient to a provider. Those who are not already doing this can work with WCHQ for assistance.

ENCOUNTER DATA

Patients eligible for inclusion in the denominator include (See Figure D-1):[Question 1] – Is this a patient with the disease, or condition?

Those who had a minimum of two diabetes coded (including any diagnoses coded for the visit) – (Table D-1) office visits (Table D-2), with any provider (MD, DO, PA, NP) in the Physician Group with different dates of service in an ambulatory setting during the last 24 Months [Measurement Period + Prior Year], and

[Question 2] – Is this a patient whose care is managed within the physician group?Patients who had at least two office visits (Table D-2), regardless of diagnosis code, on different dates of service, to a PCP and/or Endocrinologist in the past 24 months. If the Endocrinologist is not considered a PCP, at least one of the two office visits must be to a PCP.

[Question 3] –Is this a patient current in our system?Those who had at least one office visit (Table D-2), regardless of diagnosis code, with a PCP and/or an Endocrinologist during the last 12 Months [Measurement Period].


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Figure D-1: Denominator Flow


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NUMERATOR DESCRIPTIONS

1. A1c BLOOD SUGAR TESTING (Figure D-2) This measure assesses the number of patients who had two or more A1c tests, one A1c test, or no A1c tests (Table D-3) within the last 12 Months [Measurement Period] as demonstrated through any of the following:

1. Administrative Data, which can include:a. Table D-3, using the Lab Test Collection Date, and if unavailable, the Result/Test Dateb. Internal or external A1C tests extracted electronically and requiring Test Date and

Result2. Medical Record Review (refer to Medical Record Review for Numerator

Inclusion/Denominator Exclusion section)

Testing Definitions: Two or more A1c tests : The subset of denominator patients who had two or more A1c tests,

on different dates of service, conducted within the last 12 Months [Measurement Period] and identified through either administrative data or medical record review (see Sampling).

Only one A1c test : The subset of denominator patients who had only one A1c test conducted within the last 12 months [Measurement Period].

Not Tested : The subset of denominator patients who did not have an A1c test result during the last 12 Months [Measurement Period].

2. A1c BLOOD SUGAR CONTROL (Figure D-2)These measures assess the number of diabetes patients who had, or did not have an A1c test (Table D-3) result during the last 12 Months [Measurement Period] and the level of control as demonstrated through any of the following:

1. Administrative Data, which can include:a) Table D-3 using the Lab Test Collection Date, and if unavailable, the Result/Test Dateb) Internal or external A1C test results extracted electronically and requiring Test Date and

Result2. Medical Record Review (refer to Medical Record Review for Numerator

Inclusion/Denominator Exclusion section)

Control Definitions: Good control: The subset of denominator patients whose most recent A1c test result during

the last 12 Months [Measurement Period] is less than 8.0%. Fair to poor control: The subset of denominator patients whose most recent A1c test result

during the last 12 Months [Measurement Period] is greater than or equal to 8.0%. Uncontrolled: The subset of denominator patients whose most recent A1c test result during

the last 12 Months [Measurement Period] is greater than 9.0%. Not Tested: The subset of denominator patients who did not have an A1c test result during

the last 12 Months [Measurement Period].


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3. M ONITORING FOR DIABETIC NEPHROPATHY (Figure D-2) This measures the number of patients in the denominator who are being monitored or treated for nephropathy. The numerator may include patients who have had the appropriate screening lab test or patients who already have evidence of nephropathy as demonstrated through any of the following:

Administrative Data 1. Screening for nephropathy

a. A microalbuminuria test (Table D-6) during the last 12 months [Measurement Period]. Medical record must include date of test and result. Tests included: 24-hour urine for microalbuminuria, time urine for microalbuminuria, spot urine for microalbuminuria, microalbumin/creatinine ratio.

2. Evidence of nephropathya. Evidence of diagnoses or treatment for nephropathy (Table D-5) during the last 12

months [Measurement Period].b. A nephropathy diagnosis (Table D-5: ICD Diagnosis Codes) from an ICD-9 based

problem list. The problem must be ACTIVE. There is no limit on the look back date, but the date of documentation or onset date must occur prior to the end of the measurement period.

c. A visit to a nephrologist (can include a nephrology NP or PA) (no restriction on the diagnoses or procedure codes for that visit) during the last 12 months [Measurement Period].

d. A gross proteinuria test (Table D-7) during the last 12 months [Measurement Period]. Medical record must include date of test.

e. Documentation of an active prescription for an ACE inhibitor or ARB or documentation on the patient’s medication list of ACE or ARB usage at any time during the Measurement Period (Table D-17).

Medical Record Review (refer to Medical Record Review for Numerator Inclusion/Denominator Exclusion section)

4. BLOOD PRESSURE CONTROL (Figure D-3)


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The number of patients in the denominator whose most recent blood pressure (BP) is adequately controlled during the Measurement Period. Adequate control is a representative systolic Blood Pressure less than 140 mm Hg and a representative diastolic Blood Pressure less than 90 mm Hg (defined by The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure).

IDENTIFYING A REPRESENTATIVE BLOOD PRESSURE

Blood Pressure Selection Criteria: Blood Pressure reading must have been obtained during the Measurement Period. Systolic and Diastolic numbers must be from the same BP reading. A controlled BP requires that both the systolic and diastolic readings must be less

than140/90. Exclusions: Inpatient Stays, Emergency Room Visits, Urgent Care Visits, and Patient Self-

Reported BP’s (Home and Health Fair Blood Pressures) Inclusions: Any office visit encounter, including Nurse Only BP Checks, not listed under

Exclusions above. NOTE: A BP performed at a patient’s home by a nurse who then inputs the result into an EMR counts as a Nurse Only BP.

BP results included in an organization’s EMR taken externally in an ambulatory setting can be included as numerator result as long as there is a date associated with the result.

Select the Blood Pressure from the most recent visit. In the event that multiple Blood Pressures are recorded in the same day of service, select

any reading that is controlled. If none are in control, select an uncontrolled reading. If no Blood Pressure is recorded during the Measurement Period, the patient is assumed to

be “not controlled”.

5. TOBACCO FREE (Figure D-3) The number of patients in the denominator whose most recent tobacco documentation status with any provider within the 12 month measurement period is Tobacco Free.

Tobacco Use Definition: Cigarette Cigar Pipe Smoking Smokeless Tobacco (Chewing Tobacco, Snuff, etc.)

Tobacco Use Status can be identified by any of the following criteria:1. Documentation stating that the patient has been asked if they are one of the following during

the Measurement Period with the numerator compliant goal of Tobacco-Free:1. Tobacco-Free (see examples below):

a. Former tobacco user b. Never used c. Non-tobacco userd. Passive smoker

2. Non Tobacco-Freea. Current tobacco user


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3. No Documentation: The subset of denominator patients who did not have documentation of tobacco status during the last 12 Months [Measurement Period]

2. ICD-9 or 10, CPT, HCPCS and CPT-II Codes indicating tobacco use status during the Measurement Period) from billing or encounter data only. Do not use the problem list for these codes. (Table D-8)

6. STATIN USE UNLESS CONTRAINDICATED (F igure D-5) This measure applies to a subset of patients in the denominator as follows:

All patients ages 40 through 75

All patients with IVD regardless of age (use IVD Population Subset Definition below to identify those patients with IVD)

The measure assesses the percentage of patients in the subset with documentation within the medical record of statin use at any time during the measurement period demonstrated through any of the following:

1. Documentation of an active prescription for a statin (see acceptable medications in Table D-15)

2. Documentation on the patient’s medication list of active usage of a statin (see acceptable medications in Table D-15)

3. Contraindication to Statina. Contraindications will count as numerator compliant. The date of documentation or

onset date must occur prior to the end of the measurement period.b. Accepted contraindications:

i. Female patients between ages of 12 and 55 pregnant during the MP or prior year (see codes in Table D-19) NOTE: This is the same code set as Tables H-5, BMI-2, CS-2, IVD-12

ii. In Vitro Fertilization during the MP or prior year (see codes in Table D-20)iii. Clomiphene taken during MP or prior year (see Table D-21)iv. ESRD during MP or prior year (see codes in Table D-18)v. Cirrhosis during MP or prior year (see codes in Table D-22)vi. Myalgia, Myositis, Myopathy or Rhabdomyolysis during MP or prior year (see

codes in Table D-23)vii. ESRD, Cirrhosis, Myalgia, Myositis, Myopathy, or Rhambdomyolysis status

from an ICD-9 or ICD-10 diagnosis-based problem list or past medical history. There is no limit on the look back date, but the date of documentation or onset date must occur prior to the end of the measurement period.

7. DAILY ASPIRIN OR OTHER ANTIPLATELET FOR DIABETES PATIENTS WITH THE DIAGNOSIS OF ISCHEMIC VASCULAR DISEASE (IVD) UNLESS CONTRAINDICATED (Figure D-4)

This measure assesses the subset of diabetic patients with IVD (see tables D-9, D10 and D-11) who have documentation within the medical record of daily aspirin or daily other antiplatelet agent at any time during the measurement period demonstrated through criteria 1-3 below.

4. Documentation of an active prescription for daily Aspirin (see suggested list in Table D-12) or daily other antiplatelet medications (see acceptable medications in Table D-13)


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5. Documentation on the patient’s medication list of active daily usage of Aspirin (see suggested list in Table D-12) or daily other antiplatelet medications (see acceptable medications in Table D-13)

6. Contraindication to Aspirinc. Contraindications will count as numerator compliant. Any valid contraindication date

prior to the end of the measure end date will count as compliant. There is no limit on the look back date, but the date of documentation or onset date must occur prior to the end of the measurement period.

d. Accepted contraindications: i. History of gastrointestinal (GI) bleed (see codes in Table D-14)ii. History of intracranial bleed (ICB) (see codes in Table D-14)iii. History of Idiopathic Thrombocytopenic Purpura (ITP) (see codes in Table D-

14)viii. Gastric Bypass status (see codes in Table D-14)ix. History of GI Bleed, ICB or ITP or Gastric Bypass status from an ICD-9 or

ICD-10 diagnosis-based problem list or past medical history. There is no limit on the look back date, but the date of documentation or onset date must occur prior to the end of the measurement period.

x. Anticoagulant Use (see acceptable list of Medications in Table D-16). There must be documentation of an active anticoagulant at any time during the Measurement Period.

IVD Population Subset Definition (Figure D-4): This subset of patients will be counted in Numerator 7 – Daily Aspirin or Other Antiplatelet for Diabetes Patients with the Diagnosis of Ischemic Vascular Disease (IVD) Unless Contraindicated. Identify IVD denominator patients who meet any of the following criteria (NOTE: This IVD subset population matches the IVD Care measures population):

Patients eligible for inclusion in the subset denominator include:[Question 1] – Is this a patient with the disease, or condition?

CORONARY ARTERY DISEASE (OR CAD RISK EQUIVALENT) DIAGNOSIS RELATED OUTPATIENT VISITS Those patients with a total of two or more visits during the last 24 months [Measurement Period + Prior Year] from Table D-12 (Office Visit Encounter Codes-Outpatient) with any provider (MD, DO, PA, NP) within the Physician Group on different dates of service coded (including primary and secondary diagnoses) with diagnosis codes from Table D-9 (Coronary Artery Disease) or Table D-10 (CAD Risk-Equivalent Conditions). The following criteria apply:

Any combination of two or more diagnosis codes from either Table D-9 or Table D-10, on different dates of service. OR ACUTE CORONARY EVENT- RELATED HOSPITAL VISITS Those patients who had a minimum of one hospital related visit (excluding Emergency and Lab Only visits) for an Acute Coronary Event from Table D-11 during the last 24 Months [Measurement Period + Prior Year].


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[Question 2] – Is this a patient whose care is managed within the physician group?Those patients who have at least two Primary Care Office Visit (Table D-2) in an ambulatory setting, regardless of diagnosis code, on different dates of service, to a PCP or Cardiologist in the past 24 months [Measurement Period + Prior Year]. If Cardiologist is not considered a PCP, at least one of the two office visits must be to a PCP.

[Question 3] – Is this a patient current in our system?Those patients who had at least one Primary Care Office Visit (Table D-2) in an ambulatory setting, regardless of diagnosis code, with a PCP or a Cardiologist during the last 12 Months [Measurement Period].

8. An eGFR (Estimated Glomerular Filtration Rate) Test Annually (Figure D-6) This measure assesses the percentage of diabetic patients who had one or more eGFR tests within the last 12 Months [Measurement Period] as demonstrated through any of the following listed below. Patients with a diagnosis of ESRD are excluded from the eGFR requirement and those patients can be identified using the ESRD Population Subset Definition. Patients with ESRD will automatically be considered numerator compliant.

1. Administrative Data, which can include:a. Internal or external eGFR tests extracted electronically and requiring Test Date

2. Medical Record Review (refer to Medical Record Review for Numerator Inclusion/Denominator Exclusion section)

NOTES: A CPT Code alone will not provide an eGFR test. It is a calculated rate derived from the

MDRD (Modification of Diet in Renal Disease) The MDRD Study Equation can be found at the following reference: http://www.kidney.org/professionals/KLS/GFR.cfm#8

CPT Codes 80048, 80053, 80069, 82565 and possibly others are lab panels that may contain an eGFR component. Use of one of these CPT codes alone cannot define the eGFR calculation rather the specific eGFR Test Name or ID included within the lab panel will need to be identified to isolate the eGFR.

In cases where an eGFR result is not available because it cannot be calculated for any reason, excludes that eGFR test from counting as numerator compliant.

ESRD Population Subset Definition (Figure D-6): This subset of patients will automatically be considered numerator compliant for Numerator 8 – An eGFR Test Annually. Identify ESRD patients who meet any of the following criteria (NOTE: This ESRD subset population matches the Controlling High Blood Pressure ESRD exclusion population).

a) The Physician Group should exclude from the eligible population all diabetic patients diagnosed with any of the following:

1. End Stage Renal Disease (ESRD) meeting one or more of the following definitions:i. One ESRD coded office visit (including any diagnoses coded for the visit)-

(Table D-18) with any provider in an ambulatory setting during the last 24 months.

ii. One ESRD coded encounter (any type of visit to any service) – (Table D-18) during the last 24 months.


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iii. One ESRD diagnosis from an ICD 9 or 10 diagnosis-based problem list (Table D-18). The problem must be ACTIVE. There is no limit on the look back date, but the date of documentation or onset date must occur prior to the end of the measurement period.

9. ALL OR NONE MEASURES Diabetes All-or-None MeasuresThe Diabetes All-or-None Measures are two separate measures, one for process (optimal testing) and one for outcomes (optimal control). The optimal testing measure contains two goals. The optimal control measure contains four goals. All goals within a measure must be reached in order to meet that measure. The numerator of each all-or-none measure should be collected from the organization’s total diabetes denominator.

All-or-None Process Measure (Optimal Testing) - Using the diabetes denominator optimal testing includes:

Two A1C tests performed during the time period specified by the measureAnd One kidney function test during the time period specified by the measure, and/or

diagnosis and treatment of kidney diseaseAnd A minimum of one eGFR (Estimated Glomerular Filtration Rate) test annually

All-or-None Outcome Measure (Optimal Control) - Using the diabetes denominator optimal results include:

Most recent A1C test result is less than 8% And Most recent blood pressure measurement is less than 140/90 mm HgAnd Most recent tobacco status is Tobacco Free

NOTE: If there is No Documentation of Tobacco Status the patient is not compliant for this measure.

And Daily Aspirin or Other Antiplatelet for Diabetes Patients with the Diagnosis of

Ischemic Vascular Disease Unless Contraindicated.NOTE: If there is no diagnosis of IVD, the patient is automatically numerator compliant for this measure.

Statin UseNOTE: If the patient is less than age 40 and there is no diagnosis of IVD, the patient is automatically numerator compliant for this measure

Why use an All-or-None method? This method was chosen because of the benefits it provides to both the patient and the practitioner. First, this methodology more closely reflects the interests and likely desires of the patient. With the data collected in two scores (optimal testing and optimal results), patients can easily look and see how their provider group is performing on these criteria rather than trying to make sense of multiple scores on individual measures. Second, this method represents a systems perspective emphasizing the importance of optimal care through a patient’s entire healthcare experience. Third, this method gives a more sensitive scale for improvement. For those organizations scoring high marks on individual measures, the All-or-None measure will give room for benchmarks and additional improvements to be made.


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Nolan T, Berwick DM. All-or-none measurement raises the bar on performance. JAMA. 2006 Mar 8;295(10):1168-70.

Methodology Criteria for All or None Scores: Total Population Methodology: Based on entire Diabetes Denominator Random Sample Methodology: Based on Sample Population Hybrid Methodology: Based on Administrative Review Denominator and Manual Review

Sample

10. LDL CHOLESTEROL Lab Test

Continue to collect LDL test dates and values internally. (Refer to Table D-4 at end of Appendix B). There may be a future use for these lab values within the measure.


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Figure D-4: Diabetes IVD Subset Population and Daily Aspirin Numerator


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SAMPLING METHODOLOGY Organizations unable to collect numerator data by electronic means can do so by using the following criteria for chart review;The Sample size for chart review is determined based in the following criteria:

c = 95% Confidence Interval E = 5% Margin of Error N = Total number of patients in the diabetes denominator pool Use the “Sample Size Generator” at the Wisconsin Collaborative for Healthcare Quality

website (http://www.wchq.org/calculator/index.php), and enter values to generate the sample size appropriate for your organization

A 10% over sample is recommended beyond the generated sample size. Note: A healthcare organization using the Sampling Methodology may convert glycated

hemoglobin or glycohemoglobin to A1c using the following formula: A1c = (0.685 glycohemoglobin) + (1.2)

INTERNALLY DEVELOPED CODES – DATA TRANSLATION/MAPPING REQUIREMENTSIf a medical group utilizes internally generated codes to identify specific services or events required for a given WCHQ performance measure, the group may translate or map the information to the WCHQ performance measurement specifications. The medical group must assure that the internally generated code matches the clinical specificity of the standard (ICD-9 or 10, CPT) codes included in the WCHQ performance measurement specifications.

In order to use internally developed codes for WCHQ performance measure reporting, the medical group needs to document the translation/mapping to the codes in the specifications. This documentation should include the internally generated code, a description of the internally developed code, any additional clinical information for the internally developed code, and the equivalent standard code with description from the WCHQ performance measurement specifications. Once the translation/ mapping documentation is established, the medical group’s WCHQ performance measurement team must review the mapping on a yearly basis and document that internally developed codes have not changed and are being used in the manner described in the translation/ mapping document.

The medical group must have documented processes in place for adding codes to the medical group’s administrative data system and procedures to implement the internally developed codes.

MEDICAL RECORD REVIEW FOR NUMERATOR INCLUSION/DENOMINATOR EXCLUSIONIf appropriate, and/or when necessary, every organization may complement their electronic capture of patient medical history with electronic or manual record review. The following criteria apply only to data captured/reviewed during medical record review.

For WCHQ Chronic Condition Measures, proof of Numerator compliance requires: Date test was performed. Value of test (e.g., Blood Pressure, lab result) Documentation identifying evidence of monitoring or treatment for Nephropathy. Medical

record must include a note indicating medical attention during the last 12 Months [Measurement Period] for:


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o A nephrologist visit (can include a nephrology NP or PA) (no restriction on the

diagnoses or procedure codes for that visit), ORo Notes referencing one of the following:

diabetic nephropathy a microalbuminuria test or a gross proteinuria test end-stage renal disease (ESRD) chronic renal failure (CRF) chronic kidney disease (CKD) acute renal failure (ARF) dialysis, hemodialysis or peritoneal dialysis ACE or ARB

Date of Documentation for evidence of Nephropathy

Denominator ExclusionFor all WCHQ Measures, proof of Denominator exclusion requires:

Existence of exclusion criteria.

This data may be retrieved, in whole or in part, from any of the following: Notation in Progress Note Notation in Medical History or Surgical History Flag/Field in Electronic Medical Record Documentation in patient chart

REQUIRED DATA SUBMISSION FIELDSFields required for data submission for this measure depend upon the methodology used. The fields are as follows:

TOTAL POPULATION METHODOLOGY: Population Denominator (N) (Diabetic patients 18-75 years of age) Numerators

1. Blood Sugar (A1C) Screening within the last 12 months with data entry including: o 1 Test (patients who had only one A1C test within measurement period)o 2 Tests (patients who had two or more A1C tests within measurement period)

2. Blood Sugar (A1C) Control within the last 12 months with data entry including:o Good Control (patients whose A1C is <8.0)o Fair to Poor Control (patients whose A1C is >=8.0 and <=9.0)o Uncontrolled (patients whose A1C is >9.0)o Not Tested (patients who did not have an A1C test)

3. Kidney Function Monitored within the last 12 months (patients who have been screened for diabetic nephropathy or have evidence of diabetic nephropathy)

4. Blood Pressure Control within the last 12 months (patients whose Blood Pressure is <140/90 mm hg)

5. Most recent Tobacco Status6. Statin Use, unless contraindicated, for subset population7. Daily Aspirin or daily other Antiplatelet Medication Therapy unless contraindicated documented in

the medical record as active at any time during the last 12 months8. An eGFR (Estimated Glomerular Filtration Rate) test annually9. All or None Optimal Testing and Optimal Control


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Upon entry of these numbers, the rate is automatically calculated

RANDOM SAMPLE METHODOLOGY: Population Denominator (N) (Diabetic patients 18-75 years of age) Population Sample (n) (r) (Patients in Denominator Population whose records will be reviewed)

o (n)=Population Sample and (r)=Patients Reviewed equal the same number o The Population Sample size must be determined using the WCHQ Sample Calculator

http://www.wchq.org/calculator/index.php Numerators

1. Blood Sugar (A1C) Screening within the last 12 months with data entry including: o 1 Test (patients who had only one A1C test within measurement period from Population

Sample)o 2 Tests (patients who had two or more A1C tests within measurement period from Population

Sample)2. Blood Sugar (A1C) Control within the last 12 months with data entry including:

o Good Control (patients whose A1C is <8.0 from Population Sample)o Fair to Poor Control (patients whose A1C is >=8.0 and <=9.0 from Population Sample)o Uncontrolled (patients whose A1C is >9.0 from Population Sample)o Not Tested (patients who did not have an A1C test from Population Sample)

3. Kidney Function Monitored within the last 12 months (patients who have been screened for diabetic nephropathy or have evidence of diabetic nephropathy from Population Sample))

4. Blood Pressure Control within the last 12 months (patients whose Blood Pressure is <140/90 mm hg from Population Sample)

5. Most recent Tobacco Status 6. Statin Use, unless contraindicated, for subset population7. Daily Aspirin or daily other Antiplatelet Medication Therapy unless contraindicated documented in


Upon entry of these numbers, the rate is automatically calculated

HYBRID METHODOLOGY: Population Denominator (N) (Diabetic patients 18-75 years of age) Administrative Review Denominator (Patients in Total Denominator Population whose

numerator information is obtained through administrative data) Administrative Review Numerators

1. Blood Sugar (A1C) Screening within the last 12 months with data entry including: o 1 Test (patients who had only one A1C test within measurement period found through

administrative data)o 2 Tests (patients who had two or more A1C tests within measurement period found through

administrative data)2. Blood Sugar (A1C) Control within the last 12 months with data entry including:

o Good Control (patients whose A1C is <8.0 found through administrative data)o Fair to Poor Control (patients whose A1C is >=8.0 and <=9.0 found through administrative

data)o Uncontrolled (patients whose A1C is >9.0 found through administrative data)o Not Tested (patients who did not have an A1C test found through administrative data)

3. Kidney Function Monitored within the last 12 months (patients who have been screened for diabetic nephropathy or have evidence of diabetic nephropathy found through administrative data)

4. Blood Pressure Control within the last 12 months (patients whose Blood Pressure is <140/90 mm hg found through administrative data)


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Manual Review Denominator (Patients in Total Denominator Population whose numerator information cannot be obtained through administrative data)

Manual Review Sample Size (Patients in Manual Review Denominator Population whose records will be reviewed)o The Manual Review Sample size must be determined using the WCHQ Sample Calculator

plus a 10% over sample http://www.wchq.org/calculator/index.php Manual Review Numerators

1. Blood Sugar (A1C) Screening within the last 12 months with data entry including: o 1 Test (patients who had only one A1C test within measurement period found through manual

review sampling)o 2 Tests (patients who had two or more A1C tests within measurement period found through

manual review sampling)2. Blood Sugar (A1C) Control within the last 12 months with data entry including:

o Good Control (patients whose A1C is <8.0 found through manual review sampling)o Fair to Poor Control (patients whose A1C is >=8.0 and <=9.0 found through manual review

sampling)o Uncontrolled (patients whose A1C is >9.0 found through manual review samplingo Not Tested (patients who did not have an A1C test found through manual review sampling)

3. Kidney Function Monitored within the last 12 months (patients who have been screened for diabetic nephropathy or have evidence of diabetic nephropathy found through manual review sampling)

4. Blood Pressure Control within the last 12 months (patients whose Blood Pressure is <140/90 mm hg found through manual review sampling)



Upon entry of these numbers for each numerator, the Rates, Weight Factors and Total Reviewed are automatically calculated. Total Reviewed equals Administrative Review Denominator + Manual Review Sample Size.

Site Level Reporting:


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Non-RBS Organizations:1. Refer to the “Non-RBS Site Level Reporting Upload Template.xls” for specific instructions.

RBS Organizations:1. Refer to the “RBS Site Level Reporting Upload Template.xls” for specific instructions.

PAYER STRATIFICATION:1. Denominator data submission is requested by Payer Stratification for Medicare, Medicaid,

Commercial and Uninsured.2. Numerator data submission can be entered by primary payer category only for total

population methodology

Refer to Appendix A for definitions of the payer stratification categories.

FIELDS REQUIRED FOR MEASURE VALIDATIONValidation of this measure will require patient level data files for Administrative Data and/or for Manual Review. The following indicates fields needed for validation, which may be helpful to consider when querying the measure:

Denominator Data File fields: 1. Patient Identifier (can be medical record number or other ID)2. Office Visit Dates3. Provider Specialty4. Patient Date of Birth5. Diabetes Diagnosis Codes

Numerator Data File fields:1. Blood Sugar (A1C) Screening within the last 12 months

Patient Identifier (Can be medical record number or other ID) Lab Date(s) of Service (identify whether collection date versus test date) Lab ID Code(s) or Equivalent Test Name

2. Blood Sugar (A1C) Control within the last 12 months Patient Identifier (Can be medical record number or other ID) Lab Date(s) of Service (identify whether collection date versus test date) Lab ID Code(s) Lab Test Result(s) or Equivalent Test Name

3. Kidney Function Monitored within the last 12 months Patient Identifier (Can be medical record number or other ID) Lab Date(s) of Service (identify whether collection date versus test date) Lab ID Code(s) Lab Test Result(s) Evidence of Nephropathy Demonstrated by Diagnosis or Treatment Code(s) or by Medical Record

Documentation Evidence of Nephropathy Documentation Date Nephrologist Visit Active prescription for an ACE inhibitor or ARB or documentation on the patient’s medication list of

ACE or ARB usage

4. Blood Pressure Control within the last 12 months Patient Identifier (Can be medical record number or other ID)


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Blood Pressure Date(s) of Service Blood Pressure Result(s)

5. Most Recent Tobacco Status Patient Identifier (Can be medical record number or other ID) Tobacco Status Encounter Date of Service Associated with Tobacco Status

6. Statin Use for Subset Population Patient Identifier (Can be medical record number or other ID) Patient Age (40 through 75) IVD Diagnosis, if applicable Statin Medication name Medication status indicated as active during the measurement period Contraindications (if any apply)

7. Daily Aspirin or Daily Other Antiplatelet Therapy documented as active in the medical record at any time during the measurement period with data entry including: Patient Identifier (can be medical record number or other ID) IVD Diagnosis Aspirin or other Antiplatelet medication drug name Drug frequency Medication status indicated as active during the measurement period Contraindications (if any apply)

8. eGFR within the last 12 months Patient Identifier (Can be Medical Record Number or Other ID) Lab Date(s) of Service (identify whether collection date versus test date) Lab ID Code(s) or Equivalent Test Name

Site Level Reporting fields: Metric ID Clinical Topic Measure Clinic ID Clinic Name Metric Level (for A1C and LDL Testing and Control measures) Payer (optional) Numerator Denominator Percentage Provider Count Provider Minimum Count Flag Patient Minimum Count Flag

Appendix A

Primary PayerIn keeping with the changing atmosphere of quality measurement and reporting, WCHQ would like for participating organizations to include the primary payer source with their data submissions for the ambulatory care measures.


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The primary payer source should be identified in the denominator upon answering the question, “Is this patient current in our system?” Once it has been determined that a patient is current because of a visit to their physician within the specified time period (12 months for chronic care measures and 24 months for preventive care measures), the payer should be “pulled” into the query. The primary payer should be the payer at the most recent office visit within the measurement period.

There will be four categories of primary payer that will need to be submitted to WCHQ via the data submission tool: Medicare FFS, Medicaid (all types), Commercial (including Medicare HMO) and Uninsured/Self-Pay. The raw numbers for the denominator and numerator should be included for all three types of data submission, total population, hybrid, and sample.

RationaleOpportunities exist for WCHQ to collect and report data on specific populations, like the Medicare population, through grant applications to begin to understand the disparities in quality of care. The purpose of this is to begin to understand the challenges of putting in additional data elements and complexities of data display for public reporting. At this time, the primary payer information will not be publicly reported.

Definitions:Commercial: All plans not Medicaid or Medicare FFS (Includes VA, DoD, etc.)FFS Medicare: FFS plans, not Medicare HMO (Medicare Railroad is FFS Medicare)Medicaid: All Medicaid plans including those managed by commercial plansUninsured: Self-pay individuals

APPENDIX BCode tables with descriptions. Reference also “WCHQ Measure Spec Code List.xls”

TABLE D-1: Diagnosis Codes to Identify Patients with Diabetes ICD-9-CM

Diagnosis CodesDescription

250.xx Diabetes mellitus


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250.00 Diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled

250.01 Diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled

250.02 Diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled

250.03 Diabetes mellitus without mention of complication, type i [juvenile type], uncontrolled

250.10 Diabetes with ketoacidosis, type ii or unspecified type, not stated as uncontrolled

250.11 Diabetes with ketoacidosis, type i [juvenile type], not stated as uncontrolled 250.12 Diabetes with ketoacidosis, type ii or unspecified type, uncontrolled 250.13 Diabetes with ketoacidosis, type i [juvenile type], uncontrolled 250.20 Diabetes with hyperosmolarity, type ii or unspecified type, not stated as

uncontrolled 250.21 Diabetes with hyperosmolarity, type i [juvenile type], not stated as

uncontrolled 250.22 Diabetes with hyperosmolarity, type ii or unspecified type, uncontrolled 250.23 Diabetes with hyperosmolarity, type i [juvenile type], uncontrolled 250.30 Diabetes with other coma, type ii or unspecified type, not stated as

uncontrolled 250.31 Diabetes with other coma, type i [juvenile type], not stated as uncontrolled 250.32 Diabetes with other coma, type ii or unspecified type, uncontrolled 250.33 Diabetes with other coma, type i [juvenile type], uncontrolled 250.40 Diabetes with renal manifestations, type ii or unspecified type, not stated as

uncontrolled 250.41 Diabetes with renal manifestations, type i [juvenile type], not stated as

uncontrolled 250.42 Diabetes with renal manifestations, type ii or unspecified type, uncontrolled 250.43 Diabetes with renal manifestations, type i [juvenile type], uncontrolled 250.50 Diabetes with ophthalmic manifestations, type ii or unspecified type, not

stated as uncontrolled 250.51 Diabetes with ophthalmic manifestations, type i [juvenile type], not stated as

uncontrolled 250.52 Diabetes with ophthalmic manifestations, type ii or unspecified type,

uncontrolled 250.53 Diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled 250.60 Diabetes with neurological manifestations, type ii or unspecified type, not

stated as uncontrolled 250.61 Diabetes with neurological manifestations, type i [juvenile type], not stated as

uncontrolled 250.62 Diabetes with neurological manifestations, type ii or unspecified type,

uncontrolled 250.63 Diabetes with neurological manifestations, type i [juvenile type], uncontrolled 250.70 Diabetes with peripheral circulatory disorders, type ii or unspecified type, not

stated as uncontrolled 250.71 Diabetes with peripheral circulatory disorders, type i [juvenile type], not

stated as uncontrolled


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250.72 Diabetes with peripheral circulatory disorders, type ii or unspecified type, uncontrolled

250.73 Diabetes with peripheral circulatory disorders, type i [juvenile type], uncontrolled

250.80 Diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled

250.81 Diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled

250.82 Diabetes with other specified manifestations, type ii or unspecified type, uncontrolled

250.83 Diabetes with other specified manifestations, type i [juvenile type], uncontrolled

250.90 Diabetes with unspecified complication, type ii or unspecified type, not stated as uncontrolled

250.91 Diabetes with unspecified complication, type i [juvenile type], not stated as uncontrolled

250.92 Diabetes with unspecified complication, type ii or unspecified type, uncontrolled

250.93 Diabetes with unspecified complication, type i [juvenile type], uncontrolled357.2 Polyneuropathy in diabetes362.0x Diabetic retinopathy 362.01 Background diabetic retinopathy 362.02 Proliferative diabetic retinopathy 362.03 Nonproliferative diabetic retinopathy nos 362.04 Mild nonproliferative diabetic retinopathy 362.05 Moderate nonproliferative diabetic retinopathy 362.06 Severe nonproliferative diabetic retinopathy 362.07 Diabetic macular edema366.41 Diabetic cataract648.0x Complication of pregnancy, diabetes mellitus, excluding gestational diabetes 648.00 Diabetes mellitus of mother complicating pregnancy childbirth or the

puerperium unspecified as to episode of care 648.01 Diabetes mellitus of mother with delivery 648.02 Diabetes mellitus of mother with delivery with postpartum complication 648.03 Antepartum diabetes mellitus 648.04 Postpartum diabetes mellitus

Effective 10/01/2015ICD-10-CM

Diagnosis Codes Description


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E08.36 Diabetes mellitus due to underlying condition with diabetic cataractE08.42 Drug or chemical induced diabetes mellitus with diabetic cataractE09.36 Drug or chemical induced diabetes mellitus with diabetic cataractE09.42 Drug or chemical induced diabetes mellitus with neurological complications with

diabetic polyneuropathyE10.10 Type 1 diabetes mellitus with ketoacidosis without comaE10.11 Type 1 diabetes mellitus with ketoacidosis with comaE10.21 Type 1 diabetes mellitus with diabetic nephropathyE10.22 Type 1 diabetes mellitus with diabetic chronic kidney diseaseE10.29 Type 1 diabetes mellitus with other diabetic kidney complicationE10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edemaE10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular

edemaE10.321 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular

edemaE10.329 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without

macular edemaE10.331 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with

macular edemaE10.339 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without

macular edemaE10.341 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with

macular edemaE10.349 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without

macular edemaE10.351 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edemaE10.359 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular

edemaE10.36 Type 1 diabetes mellitus with diabetic cataractE10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complicationE10.40 Type 1 diabetes mellitus with diabetic neuropathy, unspecifiedE10.41 Type 1 diabetes mellitus with diabetic mononeuropathyE10.42 Type 1 diabetes mellitus with diabetic polyneuropathyE10.43 Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathyE10.44 Type 1 diabetes mellitus with diabetic amyotrophyE10.49 Type 1 diabetes mellitus with other diabetic neurological complicationE10.51 Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangreneE10.52 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangreneE10.59 Type 1 diabetes mellitus with other circulatory complicationsE10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathyE10.618 Type 1 diabetes mellitus with other diabetic arthropathyE10.620 Type 1 diabetes mellitus with diabetic dermatitisE10.621 Type 1 diabetes mellitus with foot ulcerE10.622 Type 1 diabetes mellitus with other skin ulcer


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E10.628 Type 1 diabetes mellitus with other skin complicationsE10.630 Type 1 diabetes mellitus with periodontal diseaseE10.638 Type 1 diabetes mellitus with other oral complicationsE10.641 Type 1 diabetes mellitus with hypoglycemia with comaE10.649 Type 1 diabetes mellitus with hypoglycemia without comaE10.65 Type 1 diabetes mellitus with hyperglycemiaE10.69 Type 1 diabetes mellitus with other specified complicationE10.8 Type 1 diabetes mellitus with unspecified complicationsE10.9 Type 1 diabetes mellitus without complicationsE11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-

hyperosmolar coma (NKHHC)E11.01 Type 2 diabetes mellitus with hyperosmolarity with comaE11.21 Type 2 diabetes mellitus with diabetic nephropathyE11.22 Type 2 diabetes mellitus with diabetic chronic kidney diseaseE11.29 Type 2 diabetes mellitus with other diabetic kidney complicationE11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edemaE11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular

edemaE11.321 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular

edemaE11.329 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without

macular edemaE11.331 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with

macular edemaE11.339 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without

macular edemaE11.341 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with

macular edemaE11.349 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without

macular edemaE11.351 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edemaE11.359 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular

edemaE11.36 Type 2 diabetes mellitus with diabetic cataractE11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complicationE11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecifiedE11.41 Type 2 diabetes mellitus with diabetic mononeuropathyE11.42 Type 2 diabetes mellitus with diabetic polyneuropathyE11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathyE11.44 Type 2 diabetes mellitus with diabetic amyotrophyE11.49 Type 2 diabetes mellitus with other diabetic neurological complicationE11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangreneE11.52 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangreneE11.59 Type 2 diabetes mellitus with other circulatory complicationsE11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathyE11.618 Type 2 diabetes mellitus with other diabetic arthropathyE11.620 Type 2 diabetes mellitus with diabetic dermatitisE11.621 Type 2 diabetes mellitus with foot ulcer


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E11.622 Type 2 diabetes mellitus with other skin ulcerE11.628 Type 2 diabetes mellitus with other skin complicationsE11.630 Type 2 diabetes mellitus with periodontal diseaseE11.638 Type 2 diabetes mellitus with other oral complicationsE11.641 Type 2 diabetes mellitus with hypoglycemia with comaE11.649 Type 2 diabetes mellitus with hypoglycemia without comaE11.65 Type 2 diabetes mellitus with hyperglycemiaE11.69 Type 2 diabetes mellitus with other specified complicationE11.8 Type 2 diabetes mellitus with unspecified complicationsE11.9 Type 2 diabetes mellitus without complicationsE13.00 Other specified diabetes mellitus with hyperosmolarity without nonketotic

hyperglycemic-hyperosmolar coma (NKHHC)E13.01 Other specified diabetes mellitus with hyperosmolarity with comaE13.10 Other specified diabetes mellitus with ketoacidosis without comaE13.11 Other specified diabetes mellitus with ketoacidosis with comaE13.21 Other specified diabetes mellitus with diabetic nephropathyE13.22 Other specified diabetes mellitus with diabetic chronic kidney diseaseE13.29 Other specified diabetes mellitus with other diabetic kidney complicationE13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular

edemaE13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without

macular edemaE13.321 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with

macular edemaE13.329 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy

without macular edemaE13.331 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy

with macular edemaE13.339 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy

without macular edemaE13.341 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy

with macular edemaE13.349 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy

without macular edemaE13.351 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular

edemaE13.359 Other specified diabetes mellitus with proliferative diabetic retinopathy without

macular edemaE13.36 Other specified diabetes mellitus with diabetic cataractE13.39 Other specified diabetes mellitus with other diabetic ophthalmic complicationE13.40 Other specified diabetes mellitus with diabetic neuropathy, unspecifiedE13.41 Other specified diabetes mellitus with diabetic mononeuropathyE13.42 Other specified diabetes mellitus with diabetic polyneuropathyE13.43 Other specified diabetes mellitus with diabetic autonomic (poly)neuropathyE13.44 Other specified diabetes mellitus with diabetic amyotrophyE13.49 Other specified diabetes mellitus with other diabetic neurological complicationE13.51 Other specified diabetes mellitus with diabetic peripheral angiopathy without

gangrene


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E13.52 Other specified diabetes mellitus with diabetic peripheral angiopathy with gangreneE13.59 Other specified diabetes mellitus with other circulatory complicationsE13.610 Other specified diabetes mellitus with diabetic neuropathic arthropathyE13.618 Other specified diabetes mellitus with other diabetic arthropathyE13.620 Other specified diabetes mellitus with diabetic dermatitisE13.621 Other specified diabetes mellitus with foot ulcerE13.622 Other specified diabetes mellitus with other skin ulcerE13.628 Other specified diabetes mellitus with other skin complicationsE13.630 Other specified diabetes mellitus with periodontal diseaseE13.638 Other specified diabetes mellitus with other oral complicationsE13.641 Other specified diabetes mellitus with hypoglycemia with comaE13.649 Other specified diabetes mellitus with hypoglycemia without comaE13.65 Other specified diabetes mellitus with hyperglycemiaE13.69 Other specified diabetes mellitus with other specified complicationE13.8 Other specified diabetes mellitus with unspecified complicationsE13.9 Other specified diabetes mellitus without complicationsO24.011 Pre-existing diabetes mellitus, type 1, in pregnancy, first trimesterO24.012 Pre-existing diabetes mellitus, type 1, in pregnancy, second trimesterO24.013 Pre-existing diabetes mellitus, type 1, in pregnancy, third trimesterO24.019 Pre-existing diabetes mellitus, type 1, in pregnancy, unspecified trimesterO24.02 Pre-existing diabetes mellitus, type 1, in childbirthO24.03 Pre-existing diabetes mellitus, type 1, in the puerperiumO24.111 Pre-existing diabetes mellitus, type 2, in pregnancy, first trimesterO24.112 Pre-existing diabetes mellitus, type 2, in pregnancy, second trimesterO24.113 Pre-existing diabetes mellitus, type 2, in pregnancy, third trimesterO24.119 Pre-existing diabetes mellitus, type 2, in pregnancy, unspecified trimesterO24.12 Pre-existing diabetes mellitus, type 2, in childbirthO24.13 Pre-existing diabetes mellitus, type 2, in the puerperiumO24.311 Unspecified pre-existing diabetes mellitus in pregnancy, first trimesterO24.312 Unspecified pre-existing diabetes mellitus in pregnancy, second trimesterO24.313 Unspecified pre-existing diabetes mellitus in pregnancy, third trimesterO24.319 Unspecified pre-existing diabetes mellitus in pregnancy, unspecified trimesterO24.32 Unspecified pre-existing diabetes mellitus in childbirthO24.33 Unspecified pre-existing diabetes mellitus in the puerperiumO24.811 Other pre-existing diabetes mellitus in pregnancy, first trimesterO24.812 Other pre-existing diabetes mellitus in pregnancy, second trimesterO24.813 Other pre-existing diabetes mellitus in pregnancy, third trimesterO24.819 Other pre-existing diabetes mellitus in pregnancy, unspecified trimesterO24.82 Other pre-existing diabetes mellitus in childbirthO24.83 Other pre-existing diabetes mellitus in the puerperiumO24.911 Unspecified diabetes mellitus in pregnancy, first trimesterO24.912 Unspecified diabetes mellitus in pregnancy, second trimesterO24.913 Unspecified diabetes mellitus in pregnancy, third trimesterO24.919 Unspecified diabetes mellitus in pregnancy, unspecified trimesterO24.92 Unspecified diabetes mellitus in childbirthO24.93 Unspecified diabetes mellitus in the puerperium


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TABLE D-2: Office Visit Encounter Codes (Outpatient) CPT Codes Description

99201-99205 Office or OPa visit E&Mb, new patient99212-99215 Office or OP visit E&M, established patient99241-99245 Office or other OP consultations99347-99350 Home visit for evaluation and management of an established patient99381 Initial comprehensive preventive medicine E&M, infant age younger than 1 year99382 Initial comprehensive preventive medicine E&M, early childhood, age 1-4 years99383 Initial comprehensive preventive medicine E&M, late childhood, age 5-11 years99384-99387 Initial preventive medicine E&Mb

99391 Periodic comprehensive preventive medicine, established patient, infant age younger than 1 year

99392 Periodic comprehensive preventive medicine E&M, established patient, early childhood, age 1-4 years

99393 Periodic comprehensive preventive medicine, established patient, late childhood, age 5-11 years

99394-99397 Periodic preventive medicine E&Mb

99401-99404 Preventive medicine counseling99411 Preventive medicine counseling, group99412 Preventive medicine counseling, group99420 Risk assessment, admin and interpretation99429 Unlisted preventive medicine service99461 Initial care, per day, for evaluation and management of normal newborn infant seen

in other than hospital or birthing center99488 (Deleted 01/01/15)

Complex chronic care coordination services; first hour of clinical staff time directed by a physician or other qualified health care professional with one face-to-face visit, per calendar month.

99490 Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements: Multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient; Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; Comprehensive care plan established, implemented, revised or monitored.

99495 Transitional Care Management Services (Moderate Complexity)99496 Transitional Care Management Services (High Complexity)

HCPCS Code Description

G0402(Effective 01/01/09)

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment

G0438 Annual wellness visit; includes a personalized prevention plan of service, initial visitG0439 Annual wellness visit; includes a personalized prevention plan of service,

subsequent visita outpatientb evaluation and management


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TABLE D-3: Codes to Identify Hemoglobin A1c CPT Codes Description

83036 Glycosolated Hemoglobin Test83037 Hemoglobin; glycosylated (A1c) by device cleared by the FDA for home use. (Used

when A1c is determined in a point-of-care environment within the clinic setting)LOINC4548-44549-217856-659261-862388-A71875-9CPT Category II

CodesDescription

**3044F Most Recent HbA1c level less than 7.0%**3045F Most Recent HbA1c level 7.0-9.0%**3046F Most Recent HbA1c level greater than 9.0%

**Codes can be included at the organization’s discretion. If included, the date the service was performed must be provided. If an 8P modifier is included with the CPT II code, it does not qualify as numerator compliant.

TABLE D-5: Evidence of Diagnosis or Treatment for Nephropathy CPT Codes Description

36147 Introduction of needle and/or catheter, arteriovenous shunt created for dialysis)36800 Insertion on cannula for hemodialysis, other purpose; vein to vein36810 Insertion of cannula – arteriovenous, external36815 Insertion of cannula – arteriovenous, external revision, or closure36818 Insertion of cannula – arteriovenous, external revision, or closure, upper arm36819 Arteriovenous anastomosis, open, by upper arm basilic vein transposition36820 Hemodialysis access, forearm vein transportation 36821 Hemodialysis access direct, any site 36831 Thrombectomy, open, arteriovenous fistula without revision, autogenous or

nonautogenous dialysis graft36832 Revision, open, arteriovenous fistula, without thrombectomy, autogenous or

nonautogenous dialysis graft36833 Revision, open, arteriovenous fistula with thrombectomy, autogenous or

nonautogenous dialysis graft50300 Donor nephrectomy, with preparation and maintenance of allograft, from cadaver

donor50320 Donor nephrectomy 50340 Recipient nephrectomy50360 Renal allotransplantation, implantation of graft50365 Renal allotransplantation, with recipient nephrectomy50370 Removal of transplanted renal allograft50380 Renal autotransplantation, reimplantation of kidney90935 Hemodialysis procedure with single physician evaluation90937 Hemodialysis procedure requiring repeat evaluations


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90940 Hemodialysis access flow study to determine blood flow in grafts and arteriovenous fistulae by an indicator method (was previously reported as code 90939)

90945 Dialysis procedure other than hemodialysis with single physician evaluation90947 Dialysis procedure other than hemodialysis requiring repeated physician

evaluations90957 ESRD Related Services monthly, for patients 12-19 years of age to include

monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month

90958 ESRD Related Services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face physician visits per month

90959 ESRD Related Services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month

90960 ESRD Related Services monthly, for patients 20 years of age and older; with 4 or more face-to-face physician visits per month

90961 ESRD Related Services monthly, for patients 20 years of age and older; with 2-3 face-to-face physician visits per month

90962 ESRD Related Services monthly, for patients 20 years of age and older; with 1 face-to-face physician visit per month

90965 ESRD Related Services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents

90966 ESRD Related Services for home dialysis per full month, for patients 20 years of age and older

90969 ESRD related services for dialysis less than a full month of service, per day; for patients 12-19 years of age

90970 ESRD related services for dialysis less than a full month of service, per day; for patients 20 years of age and older

90989 Dialysis training, patient, completed course90993 Dialysis training, patient, course not completed90997 Hemoperfusion90999 Unlisted dialysis procedure, inpatient or outpatient99512 Home visit for hemodialysisHCPCS Codes Description

G0257 ESRD ServicesS9339 Home Therapy, Peritoneal Dialysis

ICD-9-CM Procedure

CodesDescription

38.95 Venous catheterization for renal dialysis39.27 Arteriovenostomy for renal dialysis39.42 Revision of arteriovenous shunt for renal dialysis39.43 Removal of shunt for renal dialysis39.53 Repair of arteriovenous fistula39.93 Insertion of vessel-to-vessel cannula


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39.94 Replacement of vessel-to-vessel cannula39.95 Hemodialysis54.98 Peritoneal dialysis55.4 Partial Nephrectomy 55.5x Complete Nephrectomy 55.51 Nephroureterectomy 55.52 Nephrectomy of remaining kidney 55.53 Removal of transplanted or rejected kidney 55.54 Bilateral nephrectomy55.6x Transplant of Kidney 55.61 Renal autotransplantation 55.69 Other kidney transplantation

Effective 10/01/2015 ICD-10-PCS

Procedure Codes Description


35



5A1D00Z Performance of Urinary Filtration, Single5A1D60Z Performance of Urinary Filtration, Multiple3E1M39Z Irrigation of Peritoneal Cavity using Dialysate, Percutaneous Approach0TB00ZZ Excision of Right Kidney, Open Approach0TB03ZZ Excision of Right Kidney, Percutaneous Approach0TB04ZZ Excision of Right Kidney, Percutaneous Endoscopic Approach0TB07ZZ Excision of Right Kidney, Via Natural or Artificial Opening0TB08ZZ Excision of Right Kidney, Via Natural or Artificial Opening Endoscopic0TB10ZZ Excision of Left Kidney, Open Approach0TB13ZZ Excision of Left Kidney, Percutaneous Approach0TB14ZZ Excision of Left Kidney, Percutaneous Endoscopic Approach0TB17ZZ Excision of Left Kidney, Via Natural or Artificial Opening0TB18ZZ Excision of Left Kidney, Via Natural or Artificial Opening Endoscopic0TB30ZZ Excision of Right Kidney Pelvis, Open Approach0TB33ZZ Excision of Right Kidney Pelvis, Percutaneous Approach0TB34ZZ Excision of Right Kidney Pelvis, Percutaneous Endoscopic Approach0TB37ZZ Excision of Right Kidney Pelvis, Via Natural or Artificial Opening0TB38ZZ Excision of Right Kidney Pelvis, Via Natural or Artificial Opening Endoscopic0TB40ZZ Excision of Left Kidney Pelvis, Open Approach0TB43ZZ Excision of Left Kidney Pelvis, Percutaneous Approach0TB44ZZ Excision of Left Kidney Pelvis, Percutaneous Endoscopic Approach0TB47ZZ Excision of Left Kidney Pelvis, Via Natural or Artificial Opening0TB48ZZ Excision of Left Kidney Pelvis, Via Natural or Artificial Opening Endoscopic0TT30ZZ Resection of Right Kidney Pelvis, Open Approach0TT34ZZ Resection of Right Kidney Pelvis, Percutaneous Endoscopic Approach0TT37ZZ Resection of Right Kidney Pelvis, Via Natural or Artificial Opening0TT38ZZ Resection of Right Kidney Pelvis, Via Natural or Artificial Opening Endoscopic0TT40ZZ Resection of Left Kidney Pelvis, Open Approach0TT44ZZ Resection of Left Kidney Pelvis, Percutaneous Endoscopic Approach0TT47ZZ Resection of Left Kidney Pelvis, Via Natural or Artificial Opening0TT48ZZ Resection of Left Kidney Pelvis, Via Natural or Artificial Opening Endoscopic0TT00ZZ Resection of Right Kidney, Open Approach0TT04ZZ Resection of Right Kidney, Percutaneous Endoscopic Approach


36



0TT10ZZ Resection of Left Kidney, Open Approach0TT14ZZ Resection of Left Kidney, Percutaneous Endoscopic Approach0TT60ZZ Resection of Right Ureter, Open Approach0TT64ZZ Resection of Right Ureter, Percutaneous Endoscopic Approach0TT67ZZ Resection of Right Ureter, Via Natural or Artificial Opening0TT68ZZ Resection of Right Ureter, Via Natural or Artificial Opening Endoscopic0TT70ZZ Resection of Left Ureter, Open Approach0TT74ZZ Resection of Left Ureter, Percutaneous Endoscopic Approach0TT77ZZ Resection of Left Ureter, Via Natural or Artificial Opening0TT78ZZ Resection of Left Ureter, Via Natural or Artificial Opening Endoscopic0TT20ZZ Resection of Bilateral Kidneys, Open Approach0TT24ZZ Resection of Bilateral Kidneys, Percutaneous Endoscopic Approach0TS00ZZ Reposition Right Kidney, Open Approach0TS10ZZ Reposition Left Kidney, Open Approach0TY00Z0 Transplantation of Right Kidney, Allogeneic, Open Approach0TY00Z1 Transplantation of Right Kidney, Syngeneic, Open Approach0TY00Z2 Transplantation of Right Kidney, Zooplastic, Open Approach0TY10Z0 Transplantation of Left Kidney, Allogeneic, Open Approach0TY10Z1 Transplantation of Left Kidney, Syngeneic, Open Approach0TY10Z2 Transplantation of Left Kidney, Zooplastic, Open Approach

ICD-9-CM Diagnosis

CodesDescription

250.4x Diabetes with renal manifestation250.40 Diabetes with renal manifestations, type ii or unspecified type, not stated as

uncontrolled250.41 Diabetes with renal manifestations, type I [juvenile type], not stated as

uncontrolled250.42 Diabetes with renal manifestations, type ii or unspecified type, uncontrolled250.43 Diabetes with renal manifestations, type i [juvenile type], uncontrolled

403.xx Hypertensive chronic kidney disease 403.00 Hypertensive chronic kidney disease, malignant, with chronic kidney disease

stage I through stage IV, or unspecified 403.01 Hypertensive chronic kidney disease, malignant, with chronic kidney disease

stage V or end stage renal disease 403.10 Hypertensive chronic kidney disease, benign, with chronic kidney disease

stage I through stage IV, or unspecified 403.11 Hypertensive chronic kidney disease, benign, with chronic kidney disease

stage V or end stage renal disease 403.90 Hypertensive chronic kidney disease, unspecified, with chronic kidney

disease stage I through stage IV, or unspecified 403.91 Hypertensive chronic kidney disease, unspecified, with chronic kidney

disease stage V or end stage renal disease404.xx Hypertensive heart and kidney disease 404.00 Hypertensive heart and chronic kidney disease, malignant, without heart

failure and with chronic kidney disease stage I through stage IV, or unspecified

404.01 Hypertensive heart and chronic kidney disease, malignant, with heart failure


37



and with chronic kidney disease stage I through stage IV, or unspecified 404.02 Hypertensive heart and chronic kidney disease, malignant, with heart failure

and with chronic kidney disease stage I through stage IV, or unspecified 404.03 Hypertensive heart and chronic kidney disease, malignant, with heart failure

and with chronic kidney disease stage V or end stage renal disease 404.10 Hypertensive heart and chronic kidney disease, benign, without heart failure

and with chronic kidney disease stage I through stage IV, or unspecified 404.11 Hypertensive heart and chronic kidney disease, benign, with heart failure and

with chronic kidney disease stage I through stage IV, or unspecified 404.12 Hypertensive heart and chronic kidney disease, benign, without heart failure

and with chronic kidney disease stage V or end stage renal disease 404.13 Hypertensive heart and chronic kidney disease, benign, with heart failure and

chronic kidney disease stage V or end stage renal disease 404.90 Hypertensive heart and chronic kidney disease, unspecified, without heart

failure and with chronic kidney disease stage I through stage IV, or unspecified

404.91 Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage I through stage IV, or unspecified

404.92 Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage V or end stage renal disease

404.93 Hypertensive heart and chronic kidney disease, unspecified, with heart failure and chronic kidney disease stage V or end stage renal disease

405.01 Malignant Renovascular Hypertension–- initial episode405.11 Benign Renovascular Hypertension405.91 Secondary hypertension, renovascular580.xx Acute Glomerulonephritis 580.0 With lesion of proliferative glomerulonephritis 580.4 With lesion of rapidly progressive glomerulonephritis 580.8 With other specified pathological lesion in kidney 580.81 Acute glomerulonephritis in diseases classified elsewhere 580.89 Other 580.9 Acute glomerulonephritis with unspecified pathological lesion in kidney581.xx Nephrotic Syndrome 581.0 With lesion of proliferative glomerulonephritis 581.1 With lesion of membranous glomerulonephritis 581.2 With lesion of membranoproliferative glomerulonephritis 581.3 With lesion of minimal change glomerulonephritis 581.8 With other specified pathological lesion in kidney 581.81 Nephrotic syndrome in diseases classified elsewhere 581.89 Other 581.9 Nephrotic syndrome with unspecified pathological lesion in kidney582.xx Chronic glomerulonephritis 582.0 With lesion of proliferative glomerulonephritis 582.1 With lesion of membranous glomerulonephritis 582.2 With lesion of membranoproliferative glomerulonephritis 582.4 With lesion of rapidly progressive glomerulonephritis 582.8 With other specified pathological lesion in kidney


38



582.81 Chronic glomerulonephritis in diseases classified elsewhere 582.89 Other 582.9 Chronic glomerulonephritis with unspecified pathological lesion in kidney583.xx Nephritis and nephropathy, not specified as acute or chronic 583.0 With lesion of proliferative glomerulonephritis 583.1 With lesion of membranous glomerulonephritis 583.2 With lesion of membranoproliferative glomerulonephritis 583.4 With lesion of rapidly progressive glomerulonephritis 583.6 With lesion of renal cortical necrosis 583.7 With lesion of renal medullary necrosis 583.8 With other specified pathological lesion in kidney 583.81 With unspecified pathological lesion in kidney 583.89 Other 583.9 With unspecified pathological lesion in kidney584.x Acute renal failure 584.5 Acute renal failure with lesion of tubular necrosis 584.6 Acute renal failure with lesion of renal cortical necrosis 584.7 Acute renal failure with lesion of renal medullary (papillary) necrosis 584.8 Acute renal failure with other specified pathological lesion in kidney 584.9 Acute renal failure unspecified585 Chronic renal failure

(Note: Deleted October 2005)585.x Chronic Kidney Disease 585.1 Chronic kidney disease, stage I 585.2 Chronic kidney disease, stage ii (mild) 585.3 Chronic kidney disease, stage iii (moderate) 585.4 Chronic kidney disease, stage iv (severe) 585.5 Chronic kidney disease, stage v 585.6 End stage renal disease 585.9 Chronic kidney disease, unspecified586 Renal Failure, Unspecified587 Renal sclerosis, unspecified588.xx Disorders resulting from impaired renal function 588.0 Renal osteodystrophy 588.1 Nephrogenic diabetes insipidus 588.81 Secondary hyperparathyroidism (of renal origin) 588.89 Other specified disorders resulting from impaired renal function 588.9 Unspecified disorder resulting from impaired renal function753.0 Renal agensis and dysgenesis753.1x Congenital anomalies of urinary system 753.10 Cystic kidney disease unspecified 753.11 Congenital single renal cyst 753.12 Polycystic kidney unspecified type 753.13 Polycystic kidney autosomal dominant 753.14 Polycystic kidney autosomal recessive 753.15 Renal dysplasia 753.16 Medullary cystic kidney


39



753.17 Medullary sponge kidney 753.19 Other specified cystic kidney disease791.0 ProteinuriaV42.0 Kidney transplantV45.1x Renal dialysis status V45.11 Renal dialysis status (postprocedural) V45.12 Noncompliance with renal dialysis

Effective 10/01/2015 ICD-10-CM

Dignosis Codes DescriptionE11.29 Type 2 diabetes mellitus with other diabetic kidney complicationE10.29 Type 1 diabetes mellitus with other diabetic kidney complicationE11.21 Type 2 diabetes mellitus with diabetic nephropathyE10.21 Type 1 diabetes mellitus with diabetic nephropathyI12.0 Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end

stage renal diseaseI12.9 Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney

disease, or unspecified chronic kidney diseaseI13.10 Hypertensive heart and chronic kidney disease without heart failure, with stage 1

through stage 4 chronic kidney disease, or unspecified chronic kidney diseaseI13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1

through stage 4 chronic kidney disease, or unspecified chronic kidney diseaseI13.11 Hypertensive heart and chronic kidney disease without heart failure, with stage 5

chronic kidney disease, or end stage renal diseaseI13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5

chronic kidney disease, or end stage renal diseaseI15.0 Renovascular hypertensionN00.3 Acute nephritic syndrome with diffuse mesangial proliferative glomerulonephritisN01.3 Rapidly progressive nephritic syndrome with diffuse mesangial proliferative

glomerulonephritisN08 Glomerular disorders in diseases classified elsewhereN00.8 Acute nephritic syndrome with other morphologic changesN00.9 Acute nephritic syndrome with unspecified morphologic changesN04.4 Nephrotic syndrome with diffuse endocapillary proliferative glomerulonephritisN02.2 Recurrent and persistent hematuria with diffuse membranous glomerulonephritisN04.3 Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritisN04.0 Nephrotic syndrome with minor glomerular abnormalityN04.9 Nephrotic syndrome with unspecified morphologic changesN04.8 Nephrotic syndrome with other morphologic changesN03.2 Chronic nephritic syndrome with diffuse membranous glomerulonephritisN03.3 Chronic nephritic syndrome with diffuse mesangial proliferative glomerulonephritisN03.5 Chronic nephritic syndrome with diffuse mesangiocapillary glomerulonephritisN03.8 Chronic nephritic syndrome with other morphologic changesN03.9 Chronic nephritic syndrome with unspecified morphologic changesN05.9 Unspecified nephritic syndrome with unspecified morphologic changes


40



N05.2 Unspecified nephritic syndrome with diffuse membranous glomerulonephritisN05.5 Unspecified nephritic syndrome with diffuse mesangiocapillary glomerulonephritisN17.1 Acute kidney failure with acute cortical necrosisN17.2 Acute kidney failure with medullary necrosisN05.8 Unspecified nephritic syndrome with other morphologic changesN17.0 Acute kidney failure with tubular necrosisN17.8 Other acute kidney failureN17.9 Acute kidney failure, unspecifiedN18.1 Chronic kidney disease, stage 1N18.2 Chronic kidney disease, stage 2 (mild)N18.3 Chronic kidney disease, stage 3 (moderate)N18.4 Chronic kidney disease, stage 4 (severe)N18.5 Chronic kidney disease, stage 5N18.6 End stage renal diseaseN18.9 Chronic kidney disease, unspecifiedN19 Unspecified kidney failureN26.9 Renal sclerosis, unspecifiedN25.0 Renal osteodystrophyN25.1 Nephrogenic diabetes insipidusN25.81 Secondary hyperparathyroidism of renal originN25.89 Other disorders resulting from impaired renal tubular functionN25.9 Disorder resulting from impaired renal tubular function, unspecifiedQ60.2 Renal agenesis, unspecifiedQ60.5 Renal hypoplasia, unspecifiedQ61.00 Congenital renal cyst, unspecifiedQ61.9 Cystic kidney disease, unspecifiedQ61.01 Congenital single renal cystQ61.3 Polycystic kidney, unspecifiedQ61.2 Polycystic kidney, adult typeQ61.19 Other polycystic kidney, infantile typeQ61.4 Renal dysplasiaQ61.5 Medullary cystic kidneyQ61.02 Congenital multiple renal cystsQ61.8 Other cystic kidney diseasesR80.3 Bence Jones proteinuriaR80.9 Proteinuria, unspecifiedZ94.0 Kidney transplant statusZ99.2 Dependence on renal dialysisZ91.15 Patient's noncompliance with renal dialysis

UB-04 Revenue Codes Description

080x Inpatient Renal Dialysis 0800 Sessions Inpatient Renal Dialysis - General 0801 Sessions Inpatient Renal Dialysis – Inpatient Hemodialysis 0802 Sessions Inpatient Renal Dialysis – Inpatient Peritoneal (non-CAPD)


41



0803 Sessions Inpatient Renal Dialysis – Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD)

0804 Sessions Inpatient Renal Dialysis – Other Inpatient Dialysis 0809 Sessions Inpatient Renal Dialysis – Other Inpatient Dialysis082x Hemodialysis-Outpatient or Home 0820 Sessions Hemodialysis – Outpatient or Home - General 0821 Sessions Hemodialysis – Outpatient or Home – Hemodialysis / Composite

or Other Rate 0822 Sessions Hemodialysis – Outpatient or Home – Home Supplies 0823 Sessions Hemodialysis – Outpatient or Home – Home Equipment 0824 Sessions Hemodialysis – Outpatient or Home – Maintenance / 100% 0825 Sessions Hemodialysis – Outpatient or Home – Support Services 0829 Sessions Hemodialysis – Outpatient or Home - Other Outpatient

Hemodialysis083x Peritoneal Dialysis-Outpatient or Home 0830 Sessions Peritoneal Dialysis – Outpatient or Home - General 0831 Sessions Peritoneal Dialysis – Outpatient or Home – Peritoneal /

Composite or Other Rate 0832 Sessions Peritoneal Dialysis – Outpatient or Home - Home Supplies 0833 Sessions Peritoneal Dialysis – Outpatient or Home – Home Equipment 0834 Sessions Peritoneal Dialysis – Outpatient or Home – Maintenance / 100% 0835 Sessions Peritoneal Dialysis – Outpatient or Home – Support Services 0839 Sessions Peritoneal Dialysis – Outpatient or Home - Other Outpatient

Peritoneal Dialysis084x CAPD-Outpatient or Home 0840 CAPD - Outpatient or Home - General 0841 CAPD - Outpatient or Home - CAPD / Composite or Other Rate 0842 CAPD - Outpatient or Home - Home Supplies 0843 CAPD - Outpatient or Home – Home Equipment 0844 CAPD - Outpatient or Home - Maintenance / 100% 0845 CAPD - Outpatient or Home – Support Services 0849 CAPD - Outpatient or Home - Other Outpatient CAPD085x CCPD-Outpatient or Home 0850 CCPD - Outpatient or Home - General 0851 CCPD - Outpatient or Home - CCPD / Composite or Other Rate 0852 CCPD - Outpatient or Home - Home Supplies 0853 CCPD - Outpatient or Home – Home Equipment 0854 CCPD - Outpatient or Home - Maintenance / 100% 0855 CCPD - Outpatient or Home – Support Services 0859 CCPD - Outpatient or Home - Other Outpatient CCPD Dialysis086X RESERVED FOR DIALYSIS (NATIONAL ASSIGNMENT)087x RESERVED FOR DIALYSIS (NATIONAL ASSIGNMENT)088x Miscellaneous Dialysis 0880 Sessions Miscellaneous Dialysis – General 0881 Sessions Miscellaneous Dialysis – Ultra filtration 0882 Sessions Miscellaneous Dialysis – Home Dialysis Aid Visit 0889 Sessions Miscellaneous Dialysis – Miscellaneous Dialysis OtherUB Type of Bill Description


42



Codes721 Clinic-Hospital Based or Independent Renal Dialysis Center (Admit through

Discharge Claim)722 Clinic-Hospital Based or Independent Renal Dialysis Center (Interim-First Claim)723 Clinic-Hospital Based or Independent Renal Dialysis Center (Interim-Continuing

Claim)724 Clinic-Hospital Based or Independent Renal Dialysis Center (Interim-Last Claim)725 Clinic-Hospital Based or Independent Renal Dialysis Center (Late Charges Only

Claim)727 Clinic-Hospital Based or Independent Renal Dialysis Center (Replacement of Prior

Claim)729 Clinic-Hospital Based or Independent Renal Dialysis Center (Final Claim for a

Home Health PPS Episode)MS DRG’s Description (effective October 1, 2007)

682 Renal Failure with MCC683 Renal Failure with CC684 Renal Failure without MCC or CC685 Admission for Renal Dialysis

TABLE D-6: Codes to Identify Microalbuminuria Tests CPT Codes Description

82042 Serum albumin; urine or other source, quantitative, each specimen82043 Serum albumin; urine, micro albumin, quantitative82044 Serum albumin; urine, micro albumin, semi quantitative (e.g., reagent strip assay)84156 Protein, total, except by refractometry, urineLOINC 1753-3, 1754-1, 1755-8, 1757-4, 2887-8, 2888-6, 2889-4, 2890-2, 9318-7, 11218-5, 12842-1, 13801-6, 14956-7, 14957-5, 14958-3, 14959-1, 13705-9, 14585-4, 18373-1, 20621-9, 21059-1, 21482-5, 26801-1, 27298-9, 30000-4, 30001-2, 30003-8, 32209-9, 32294-1, 32551-4, 34366-5, 35663-4, 40486-3, 40662-9, 40663-7, 43605-5, 43606-3, 43607-1, 44292-1, 47558-2, 49023-5, 50949-7, 53121-0, 53530-2, 53531-0, 53532-8, 56553-1, 57369-1, 58448-2, 58992-9, 59159-4CPT Category

II CodesDescription

**3060F Positive Microalbuminuria test result documented and reviewed**3061F Negative Microalbuminuria test result documented and reviewed

**Codes can be included at the organization’s discretion. If included, the date the service was performed must be provided. If an 8P modifier is included with the CPT II code, it does not qualify as numerator compliant.

TABLE D-7: Codes to Identify Gross Proteinuria Tests CPT Code Description

81000-81003 81000: urinalysis81001: urinalysis automated, with microscopy81002: urinalysis non-automated, without microscopy81003: urinalysis, automated, without microscopy

81005 Urinalysis; qualitative or semi qualitative, except immunoassaysLOINC


43



CPT Code Description57735-3

TABLE D-8: Codes to Identify Tobacco Use Status ICD-9 Diagnosis

CodesDescription

305.1 Tobacco Use Disorder649.0x Tobacco Use Disorder Complicating Pregnancy 649.00 Tobacco Use Disorder complicating pregnancy, childbirth, puerperium, unspecified

episode of care 649.01 Tobacco Use Disorder complicating pregnancy, childbirth, puerperium, delivered 649.02 Tobacco Use Disorder complicating pregnancy, childbirth, puerperium, delivered

with mention of pp complication 649.03 Tobacco Use Disorder complicating pregnancy, childbirth, puerperium, antepartum

condition complication 649.04 Tobacco Use Disorder complicating pregnancy, childbirth, puerperium, pp condition

complication


Diagnosis Codes DescriptionF17.200 Nicotine dependence, unspecified, uncomplicatedF17.201 Nicotine dependence, unspecified, in remissionF17.203 Nicotine dependence unspecified, with withdrawalF17.208 Nicotine dependence, unspecified, with other nicotine-induced disordersF17.209 Nicotine dependence, unspecified, with unspecified nicotine-induced disordersF17.210 Nicotine dependence cigarettes uncomplicatedF17.211 Nicotine dependence, cigarettes, in remissionF17.213 Nicotine dependence, cigarettes, with withdrawalF17.218 Nicotine dependence, cigarettes, with other nicotine-induced disordersF17.219 Nicotine dependence, cigarettes, with unspecified nicotine-induced disordersF17.220 Nicotine dependence chewing tobacco uncomplicatedF17.221 Nicotine dependence, chewing tobacco, in remissionF17.223 Nicotine dependence, chewing tobacco, with withdrawalF17.228 Nicotine dependence, chewing tobacco, with other nicotine-induced disordersF17.229 Nicotine dependence, chewing tobacco, with unspecified nicotine-induced disordersF17.290 Nicotine dependence, other tobacco product, uncomplicatedF17.291 Nicotine dependence, other tobacco product, in remissionF17.293 Nicotine dependence, other tobacco product, with withdrawalF17.298 Nicotine dependence, other tobacco product, with other nicotine-induced disordersF17.299 Nicotine dependence, other tobacco product, with unspecified nicotine-induced

disordersO99.330 Smoking tobacco complicating pregnancy, unspecified trimesterO99.331 Smoking tobacco complicating pregnancy, first trimesterO99.332 Smoking tobacco complicating pregnancy, second trimesterO99.333 Smoking tobacco complicating pregnancy, third trimester O99.334 Smoking tobacco complicating childbirth O99.335 Smoking tobacco complicating the puerperium


44



Z72.0 Tobacco UseZ87.891 Personal history of nicotine dependence

CPT Codes Description

99406 Smoking and Tobacco Use Cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes

99407 Smoking and Tobacco Use Cessation counseling visit; intensive, greater than 10 minutes

HCPCS Codes DescriptionD1320 Tobacco Counseling for the Control and Prevention of Oral DiseaseG0436 Smoking and Tobacco Cessation counseling visit for the asymptomatic patient;

intermediate, greater than 3 minutes, up to 10 minutesG0437 Smoking and Tobacco Cessation counseling visit for the asymptomatic patient;

intensive, greater than 10 minutesG8402 Tobacco (smoke) use cessation intervention, counselingG8403 Tobacco (smoke) use cessation intervention not counseledG8453 Tobacco use cessation intervention, counselingG8454 Tobacco use cessation intervention not counseled, reason not specifiedG8455 Current Tobacco SmokerG8456 Current Smokeless Tobacco UserG8457 Tobacco Non-UserG8687 Currently a tobacco non-user and no exposure to secondhand smokeG8688 Currently a smokeless tobacco user (e.g. chew, snuff) and no exposure to

secondhand smokeG8691 Current tobacco nonuser and no exposure to secondhand smokeG8692 Current smokeless tobacco user (e.g. chew, snuff) and no exposure to secondhand

smokeG9458 Tobacco User Received Cessation InterventionG9459 Tobacco Non-UserS4995 Smoking Cessation GumS9075 Smoking Cessation TreatmentS9453 Smoking classes, nonphysician provider, per session

CPT Category II Codes Description

**1034 F Current Tobacco Smoker**1035 F Current Smokeless Tobacco User (eg. chew, snuff)**4000 F Tobacco use cessation intervention, counseling**4001 F Tobacco use cessation intervention, pharmacological therapy**4004F Patient screened for tobacco use AND received tobacco cessation counseling, if

identified as a tobacco user. **Codes can be included at the organization’s discretion. If included, the date the service was performed must be provided. If an 8P modifier is included with the CPT II code, it does not qualify as numerator compliant.

Table D-9: Diagnosis Codes to Identify Patients with CAD (Coronary Artery Disease)


45



ICD-9-CM Diagnosis Codes

Description

410.xx Acute myocardial infarction - any episode of care 410.00 Acute myocardial infarction of anterolateral wall episode of care unspecified 410.01 Acute myocardial infarction of anterolateral wall initial episode of care 410.02 Acute myocardial infarction of anterolateral wall subsequent episode of care 410.10 Acute myocardial infarction of other anterior wall episode of care unspecified 410.11 Acute myocardial infarction of other anterior wall initial episode of care 410.12 Acute myocardial infarction of other anterior wall subsequent episode of care 410.20 Acute myocardial infarction of inferolateral wall episode of care unspecified 410.21 Acute myocardial infarction of inferolateral wall initial episode of care 410.22 Acute myocardial infarction of inferolateral wall subsequent episode of care 410.30 Acute myocardial infarction of inferoposterior wall episode of care

unspecified 410.31 Acute myocardial infarction of inferoposterior wall initial episode of care 410.32 Acute myocardial infarction of inferoposterior wall subsequent episode of

care 410.40 Acute myocardial infarction of other inferior wall episode of care unspecified 410.41 Acute myocardial infarction of other inferior wall episode of care unspecified 410.42 Acute myocardial infarction of other inferior wall subsequent episode of care 410.50 Acute myocardial infarction of other lateral wall episode of care unspecified 410.51 Acute myocardial infarction of other lateral wall initial episode of care 410.52 Acute myocardial infarction of other lateral wall subsequent episode of care 410.60 True posterior wall infarction episode of care unspecified 410.61 True posterior wall infarction initial episode of care 410.62 True posterior wall infarction subsequent episode of care 410.70 Subendocardial infarction episode of care unspecified 410.71 Subendocardial infarction initial episode of care 410.72 Subendocardial infarction subsequent episode of care 410.80 Acute myocardial infarction of other specified sites episode of care

unspecified 410.81 Acute myocardial infarction of other specified sites initial episode of care 410.82 Acute myocardial infarction of other specified sites subsequent episode of

care 410.90 Acute myocardial infarction of unspecified site episode of care unspecified 410.91 Acute myocardial infarction of unspecified site initial episode of care 410.92 Acute myocardial infarction of unspecified site subsequent episode of care411.xx Other acute and subacute forms of ischemic heart disease 411.0 Postmyocardial infarction syndrome 411.1 Intermediate coronary syndrome 411.81 Acute coronary occlusion without myocardial infarction 411.89 Other acute and subacute forms of ischemic heart disease other412 Old myocardial infarction


46



413.x Angina Pectoris 413.0 Angina decubitus 413.1 Prinzmetal angina 413.9 Other and unspecified angina pectoris414.0x Coronary Atherosclerosis 414.00 Coronary atherosclerosis of unspecified type of vessel native or graft 414.01 Coronary atherosclerosis of native coronary artery 414.02 Coronary atherosclerosis of autologous vein bypass graft 414.03 Coronary atherosclerosis of nonautologous biological bypass graft 414.04 Coronary atherosclerosis of artery bypass graft 414.05 Coronary atherosclerosis of unspecified bypass graft 414.06 Coronary atherosclerosis of native coronary artery of transplanted heart 414.07 Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart414.2 Chronic Total Occlusion of Coronary Artery414.3 Coronary Atherosclerosis due to lipid rich plaque414.8 Other specified forms of chronic ischemic heart disease414.9 Chronic ischemic heart disease unspecified429.2 Cardiovascular disease, unspecifiedV45.81 Postsurgical Aortocoronary Bypass statusV45.82 Percutaneous transluminal coronary angioplasty (PTCA) status


Diagnosis Codes DescriptionI21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior

wallI21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior

wallI21.11 ST elevation (STEMI) myocardial infarction involving right coronary arteryI21.29 ST elevation (STEMI) myocardial infarction involving other sitesI21.4 Non-ST elevation (NSTEMI) myocardial infarctionI21.3 ST elevation (STEMI) myocardial infarction of unspecified siteI21.01 ST elevation (STEMI) myocardial infarction involving left main coronary arteryI21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending

coronary arteryI21.21 ST elevation (STEMI) myocardial infarction involving left circumflex coronary arteryI21.29 ST elevation (STEMI) myocardial infarction involving other sitesI22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wallI22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wallI22.8 Subsequent ST elevation (STEMI) myocardial infarction of other sitesI22.9 Subsequent ST elevation (STEMI) myocardial infarction of unspecified siteI24.0 Acute coronary thrombosis not resulting in myocardial infarctionI24.1 Dressler's syndromeI20.0 Unstable anginaI25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris


47



I25.700 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris

I25.710 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris

I25.720 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris

I25.730 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris

I25.750 Atherosclerosis of native coronary artery of transplanted heart with unstable anginaI25.760 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable

anginaI25.790 Atherosclerosis of other coronary artery bypass graft(s) with unstable angina

pectorisI24.8 Other forms of acute ischemic heart diseaseI24.9 Acute Ischemic Heart Disease UnspecifiedI25.2 Old myocardial infarctionI20.8 Other forms of angina pectorisI20.1 Angina pectoris with documented spasmI20.9 Angina pectoris, unspecifiedI25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with

documented spasmI25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina

pectorisI25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina

pectorisI25.701 Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris

with documented spasmI25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of

angina pectorisI25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified

angina pectorisI25.711 Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina

pectoris with documented spasmI25.718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms

of angina pectorisI25.719 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified

angina pectorisI25.721 Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina

pectoris with documented spasmI25.728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms

of angina pectorisI25.729 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified

angina pectorisI25.731 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with

angina pectoris with documented spasmI25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with

other forms of angina pectorisI25.739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with


48



unspecified angina pectorisI25.751 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris

with documented spasmI25.758 Atherosclerosis of native coronary artery of transplanted heart with other forms of

angina pectorisI25.759 Atherosclerosis of native coronary artery of transplanted heart with unspecified

angina pectorisI25.761 Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina

pectoris with documented spasmI25.768 Atherosclerosis of bypass graft of coronary artery of transplanted heart with other

forms of angina pectorisI25.769 Atherosclerosis of bypass graft of coronary artery of transplanted heart with

unspecified angina pectorisI25.791 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with

documented spasmI25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina

pectorisI25.799 Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina

pectorisI25.10 Atherosclerotic heart disease of native coronary artery without angina pectorisI25.810 Atherosclerosis of coronary artery bypass graft(s) without angina pectorisI25.6 Silent myocardial ischemiaI25.9 Chronic ischemic heart disease, unspecifiedI25.811 Atherosclerosis of native coronary artery of transplanted heart without angina

pectorisI25.812 Atherosclerosis of bypass graft of coronary artery of transplanted heart without

angina pectorisI25.82 Chronic total occlusion of coronary arteryI25.83 Coronary atherosclerosis due to lipid rich plaqueI25.5 Ischemic cardiomyopathyI25.89 Other forms of chronic ischemic heart diseaseI25.9 Chronic ischemic heart disease, unspecifiedZ95.1 Presence of aortocoronary bypass graftZ95.5 Presence of coronary angioplasty implant and graftZ95.818 Presence of other cardiac implants and graftsZ95.820 Peripheral vascular angioplasty status with implants and graftsZ95.828 Presence of other vascular implants and graftsZ95.9 Presence of cardiac and vascular implant and graft, unspecifiedZ98.61 Coronary angioplasty statusZ98.62 Peripheral vascular angioplasty status

Table D-10: Diagnosis Codes to Identify Patients with CAD Risk Equivalent Conditions1

ICD-9-CM Codes

Description

433.xx Occlusion and stenosis of precerebral arteries 433.00 Occlusion and stenosis of basilar artery without cerebral infarction 433.01 Occlusion and stenosis of basilar artery with cerebral infarction 433.10 Occlusion and stenosis of carotid artery without cerebral infarction


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433.11 Occlusion and stenosis of carotid artery without cerebral infarction 433.20 Occlusion and stenosis of vertebral artery without cerebral infarction 433.21 Occlusion and stenosis of vertebral artery with cerebral infarction 433.30 Occlusion and stenosis of multiple and bilateral precerebral arteries without

cerebral infarction 433.31 Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral

infarction 433.80 Occlusion and stenosis of other specified precerebral artery without cerebral

infarction 433.81 Occlusion and stenosis of other specified precerebral artery with cerebral infarction 433.90 Occlusion and stenosis of unspecified precerebral artery without cerebral infarction 433.91 Occlusion and stenosis of unspecified precerebral artery with cerebral infarction434.xx Occlusion of Cerebral Arteries 434.00 Cerebral thrombosis without cerebral infarction 434.01 Cerebral thrombosis with cerebral infarction 434.10 Cerebral embolism without cerebral infarction 434.11 Cerebral embolism with cerebral infarction 434.90 Cerebral artery occlusion unspecified without cerebral infarction 434.91 Cerebral artery occlusion unspecified with cerebral infarction440.1 Atherosclerosis of renal artery440.2x Atherosclerosis of native arteries of the extremities 440.20 Atherosclerosis of native arteries of the extremities unspecified 440.21 Atherosclerosis of native arteries of the extremities with intermittent claudication 440.22 Atherosclerosis of native arteries of the extremities with rest pain 440.23 Atherosclerosis of native arteries of the extremities with ulceration 440.24 Atherosclerosis of native arteries of the extremities with gangrene 440.29 Other atherosclerosis of native arteries of the extremities440.3x Atherosclerosis of bypass graft of extremities 440.30 Atherosclerosis of bypass graft of extremities, unspecified graft 440.31 Atherosclerosis of bypass graft of extremities, autologous vein bypass graft 440.32 Atherosclerosis of bypass graft of extremities, nonautologous biological bypass

graft440.4 Chronic Total Occlusion of Artery of the Extremities444.xx Arterial embolism and thrombosis 444.0 Embolism and thrombosis of abdominal aorta 444.01 Saddle embolus of abdominal aorta 444.09 Other arterial embolism and thrombosis of abdominal aorta 444.1 Embolism and thrombosis of thoracic aorta 444.2 Embolism and thrombosis of arteries of the extremities 444.21 Arterial embolism and thrombosis of upper extremity 444.22 Arterial embolism and thrombosis of lower extremity 444.81 Embolism and thrombosis of iliac artery 444.89 Embolism and thrombosis of other artery


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444.9 Embolism and thrombosis of unspecified artery445.xx Atheroembolism 445.01 Atheroembolism of upper extremity 445.02 Atheroembolism of lower extremity 445.81 Atheroembolism of kidney 445.89 Atheroembolism of other site

1non-coronary atherosclerosis


Diagnosis Codes DescriptionI65.1 Occlusion and stenosis of basilar arteryI63.02 Cerebral infarction due to thrombosis of basilar arteryI63.12 Cerebral infarction due to embolism of basilar arteryI63.22 Cerebral infarction due to unspecified occlusion or stenosis of basilar arteriesI65.21 Occlusion and stenosis of right carotid arteryI65.22 Occlusion and stenosis of left carotid arteryI65.23 Occlusion and stenosis of bilateral carotid arteriesI65.29 Occlusion and stenosis of unspecified carotid arteryI63.031 Cerebral infarction due to thrombosis of right carotid arteryI63.032 Cerebral infarction due to thrombosis of left carotid arteryI63.033 Cerebral infarction due to thrombosis of bilateral carotid arteriesI63.039 Cerebral infarction due to thrombosis of unspecified carotid arteryI63.131 Cerebral infarction due to embolism of right carotid arteryI63.132 Cerebral infarction due to embolism of left carotid arteryI63.133 Cerebral infarction due to embolism of bilateral carotid arteriesI63.139 Cerebral infarction due to embolism of unspecified carotid arteryI63.231 Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteriesI63.232 Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteriesI63.233 Cerebral infarction due to unspecified occlusion or stenosis of bilateral carotid

arteriesI63.239 Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid

arteriesI65.01 Occlusion and stenosis of right vertebral arteryI65.02 Occlusion and stenosis of left vertebral arteryI65.03 Occlusion and stenosis of bilateral vertebral arteriesI65.09 Occlusion and stenosis of unspecified vertebral arteryI63.011 Cerebral infarction due to thrombosis of right vertebral arteryI63.012 Cerebral infarction due to thrombosis of left vertebral arteryI63.013 Cerebral infarction due to thrombosis of bilateral vertebral arteryI63.019 Cerebral infarction due to thrombosis of unspecified vertebral arteryI63.111 Cerebral infarction due to embolism of right vertebral arteryI63.112 Cerebral infarction due to embolism of left vertebral arteryI63.113 Cerebral infarction due to embolism of bilateral vertebral arteriesI63.119 Cerebral infarction due to embolism of unspecified vertebral arteryI63.211 Cerebral infarction due to unspecified occlusion or stenosis of right vertebral arteriesI63.212 Cerebral infarction due to unspecified occlusion or stenosis of left vertebral arteries


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I63.213 Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries

I63.219 Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral arteries

I65.8 Occlusion and stenosis of other precerebral arteriesI63.09 Cerebral infarction due to thrombosis of other precerebral arteryI63.19 Cerebral infarction due to embolism of other precerebral arteryI63.00 Cerebral infarction due to thrombosis of unspecified precerebral arteryI63.10 Cerebral infarction due to embolism of unspecified precerebral arteryI63.29 Cerebral infarction due to unspecified occlusion or stenosis of other precerebral

arteriesI63.20 Cerebral infarction due to unspecified occlusion or stenosis of unspecified

precerebral arteriesI65.9 Occlusion and stenosis of unspecified precerebral arteryI66.01 Occlusion and stenosis of right middle cerebral arteryI66.02 Occlusion and stenosis of left middle cerebral arteryI66.03 Occlusion and stenosis of bilateral middle cerebral arteriesI66.09 Occlusion and stenosis of unspecified middle cerebral arteryI66.11 Occlusion and stenosis of right anterior cerebral arteryI66.12 Occlusion and stenosis of left anterior cerebral arteryI66.13 Occlusion and stenosis of bilateral anterior cerebral arteriesI66.19 Occlusion and stenosis of unspecified anterior cerebral arteryI66.21 Occlusion and stenosis of right posterior cerebral arteryI66.22 Occlusion and stenosis of left posterior cerebral arteryI66.23 Occlusion and stenosis of bilateral posterior cerebral arteriesI66.29 Occlusion and stenosis of unspecified posterior cerebral arteryI66.3 Occlusion and stenosis of cerebellar arteriesI66.8 Occlusion and stenosis of other cerebral arteriesI63.30 Cerebral infarction due to thrombosis of unspecified cerebral arteryI63.311 Cerebral infarction due to thrombosis of right middle cerebral arteryI63.312 Cerebral infarction due to thrombosis of left middle cerebral arteryI63.313 Cerebral infarction due to thrombosis of bilateral middle cerebral arteriesI63.319 Cerebral infarction due to thrombosis of unspecified middle cerebral arteryI63.321 Cerebral infarction due to thrombosis of right anterior cerebral arteryI63.322 Cerebral infarction due to thrombosis of left anterior cerebral arteryI63.323 Cerebral infarction due to thrombosis of bilateral anterior arteriesI63.329 Cerebral infarction due to thrombosis of unspecified anterior cerebral arteryI63.331 Cerebral infarction due to thrombosis of right posterior cerebral arteryI63.332 Cerebral infarction due to thrombosis of left posterior cerebral arteryI63.333 Cerebral infarction to thrombosis of bilateral posterior arteriesI63.339 Cerebral infarction due to thrombosis of unspecified posterior cerebral arteryI63.341 Cerebral infarction due to thrombosis of right cerebellar arteryI63.342 Cerebral infarction due to thrombosis of left cerebellar arteryI63.343 Cerebral infarction to thrombosis of bilateral cerebellar arteriesI63.349 Cerebral infarction due to thrombosis of unspecified cerebellar arteryI63.39 Cerebral infarction due to thrombosis of other cerebral arteryI63.6 Cerebral infarction due to cerebral venous thrombosis, nonpyogenicI63.40 Cerebral infarction due to embolism of unspecified cerebral artery


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I63.411 Cerebral infarction due to embolism of right middle cerebral arteryI63.412 Cerebral infarction due to embolism of left middle cerebral arteryI63.413 Cerebral infarction due to embolism of bilateral middle cerebral arteriesI63.419 Cerebral infarction due to embolism of unspecified middle cerebral arteryI63.421 Cerebral infarction due to embolism of right anterior cerebral arteryI63.422 Cerebral infarction due to embolism of left anterior cerebral arteryI63.423 Cerebral infarction due to embolism of bilateral anterior cerebral arteriesI63.429 Cerebral infarction due to embolism of unspecified anterior cerebral arteryI63.431 Cerebral infarction due to embolism of right posterior cerebral arteryI63.432 Cerebral infarction due to embolism of left posterior cerebral arteryI63.433 Cerebral infarction due to embolism of bilateral posterior cerebral arteriesI63.439 Cerebral infarction due to embolism of unspecified posterior cerebral arteryI63.441 Cerebral infarction due to embolism of right cerebellar arteryI63.442 Cerebral infarction due to embolism of left cerebellar arteryI63.443 Cerebral infarction due to embolism of bilateral cerebellar arteriesI63.449 Cerebral infarction due to embolism of unspecified cerebellar arteryI63.49 Cerebral infarction due to embolism of other cerebral arteryI66.9 Occlusion and stenosis of unspecified cerebral arteryI63.50 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral

arteryI63.511 Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral

arteryI63.512 Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral

arteryI63.513 Cerebral infarction due to unspecified occlusion or stenosis of bilateral middle

arteriesI63.519 Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle

cerebral arteryI63.52 Cerebral infarction due to unspecified occlusion or stenosis of anterior cerebral

arteryI63.521 Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral

arteryI63.522 Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral

arteryI63.523 Cerebral infarction due to unspecified occlusion or stenosis of bilateral anterior

arteriesI63.529 Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior

cerebral arteryI63.53 Cerebral infarction due to unspecified occlusion or stenosis of posterior cerebral

arteryI63.531 Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral

arteryI63.532 Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral

arteryI63.533 Cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior

arteriesI63.539 Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior

cerebral artery


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I63.541 Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar arteryI63.542 Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar arteryI63.543 Cerebral infarction due to unspecified occlusion or stenosis of bilateral cerebellar

arteriesI63.549 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar

arteryI63.59 Cerebral infarction due to unspecified occlusion or stenosis of other cerebral arteryI63.8 Other cerebral infarctionI63.9 Cerebral infarction, unspecifiedI70.1 Atherosclerosis of renal arteryI70.201 Unspecified atherosclerosis of native arteries of extremities, right legI70.202 Unspecified atherosclerosis of native arteries of extremities, left legI70.203 Unspecified atherosclerosis of native arteries of extremities, bilateral legsI70.208 Unspecified atherosclerosis of native arteries of extremities, other extremityI70.209 Unspecified atherosclerosis of native arteries of extremities, unspecified extremityI70.211 Atherosclerosis of native arteries of extremities with intermittent claudication, right

legI70.212 Atherosclerosis of native arteries of extremities with intermittent claudication, left legI70.213 Atherosclerosis of native arteries of extremities with intermittent claudication,

bilateral legsI70.218 Atherosclerosis of native arteries of extremities with intermittent claudication, other

extremityI70.219 Atherosclerosis of native arteries of extremities with intermittent claudication,

unspecified extremityI70.221 Atherosclerosis of native arteries of extremities with rest pain, right legI70.222 Atherosclerosis of native arteries of extremities with rest pain, left legI70.223 Atherosclerosis of native arteries of extremities with rest pain, bilateral legsI70.228 Atherosclerosis of native arteries of extremities with rest pain, other extremityI70.229 Atherosclerosis of native arteries of extremities with rest pain, unspecified extremityI70.231 Atherosclerosis of native arteries of right leg with ulceration of thighI70.232 Atherosclerosis of native arteries of right leg with ulceration of calfI70.233 Atherosclerosis of native arteries of right leg with ulceration of ankleI70.234 Atherosclerosis of native arteries of right leg with ulceration of heel and midfootI70.235 Atherosclerosis of native arteries of right leg with ulceration of other part of footI70.238 Atherosclerosis of native arteries of right leg with ulceration of other part of lower

right legI70.239 Atherosclerosis of native arteries of right leg with ulceration of unspecified siteI70.241 Atherosclerosis of native arteries of left leg with ulceration of thighI70.242 Atherosclerosis of native arteries of left leg with ulceration of calfI70.243 Atherosclerosis of native arteries of left leg with ulceration of ankleI70.244 Atherosclerosis of native arteries of left leg with ulceration of heel and midfootI70.245 Atherosclerosis of native arteries of left leg with ulceration of other part of footI70.248 Atherosclerosis of native arteries of left leg with ulceration of other part of lower left

legI70.249 Atherosclerosis of native arteries of left leg with ulceration of unspecified siteI70.25 Atherosclerosis of native arteries of other extremities with ulcerationI70.261 Atherosclerosis of native arteries of extremities with gangrene, right legI70.262 Atherosclerosis of native arteries of extremities with gangrene, left leg


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I70.263 Atherosclerosis of native arteries of extremities with gangrene, bilateral legsI70.268 Atherosclerosis of native arteries of extremities with gangrene, other extremityI70.269 Atherosclerosis of native arteries of extremities with gangrene, unspecified extremityI70.291 Other atherosclerosis of native arteries of extremities, right legI70.292 Other atherosclerosis of native arteries of extremities, left legI70.293 Other atherosclerosis of native arteries of extremities, bilateral legsI70.298 Other atherosclerosis of native arteries of extremities, other extremityI70.299 Other atherosclerosis of native arteries of extremities, unspecified extremityI70.301 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities,

right legI70.302 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities,

left legI70.303 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities,

bilateral legsI70.308 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities,

other extremityI70.309 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities,

unspecified extremityI70.311 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with

intermittent claudication, right legI70.312 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with

intermittent claudication, left legI70.313 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with

intermittent claudication, bilateral legsI70.318 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with

intermittent claudication, other extremityI70.319 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with

intermittent claudication, unspecified extremityI70.321 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest

pain, right legI70.322 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest

pain, left legI70.323 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest

pain, bilateral legsI70.328 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest

pain, other extremityI70.329 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest

pain, unspecified extremityI70.331 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration

of thighI70.332 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration

of calfI70.333 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration

of ankleI70.334 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration

of heel and midfootI70.335 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration

of other part of foot


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I70.338 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of lower leg

I70.339 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, unspecified extremity

I70.341 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of thigh

I70.342 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of calf

I70.343 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of ankle

I70.344 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of heel and midfoot

I70.345 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of foot

I70.348 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of lower leg

I70.349 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of unspecified site

I70.35 Atherosclerosis of unspecified type of bypass graft(s) of other extremity with ulceration

I70.361 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, right leg

I70.362 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, left leg

I70.363 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, bilateral legs

I70.368 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other extremity

I70.369 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, unspecified extremity

I70.391 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, right leg

I70.392 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, left legI70.393 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities,

bilateral legsI70.398 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, other

extremityI70.399 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities,

unspecified extremityI70.601 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, right

legI70.602 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, left

legI70.603 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities,

bilateral legsI70.608 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, other

extremityI70.609 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities,


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unspecified extremityI70.611 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent

claudication, right legI70.612 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent

claudication, left legI70.613 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent

claudication, bilateral legsI70.618 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent

claudication, other extremityI70.619 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent

claudication, unspecified extremityI70.621 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, right

legI70.622 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, left

legI70.623 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain,

bilateral legsI70.628 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain,

other extremityI70.629 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain,

unspecified extremityI70.631 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of

thighI70.632 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of calfI70.633 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of

ankleI70.634 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of heel

and midfootI70.635 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of

other part of footI70.638 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of

other part of lower legI70.639 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of

unspecified siteI70.641 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of thighI70.642 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of calfI70.643 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of ankleI70.644 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of heel

and midfootI70.645 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other

part of footI70.648 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other

part of lower legI70.649 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of

unspecified siteI70.65 Atherosclerosis of nonbiological bypass graft(s) of other extremity with ulcerationI70.661 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene,

right leg


57



I70.662 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, left leg

I70.663 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, bilateral legs

I70.668 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, other extremity

I70.669 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, unspecified extremity

I70.691 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, right legI70.692 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, left legI70.693 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, bilateral

legsI70.698 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, other

extremityI70.699 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, unspecified

extremityI70.701 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, right

legI70.702 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, left legI70.703 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities,

bilateral legsI70.708 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, other

extremityI70.709 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities,

unspecified extremityI70.711 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent

claudication, right legI70.712 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent

claudication, left legI70.713 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent

claudication, bilateral legsI70.718 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent

claudication, other extremityI70.719 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent

claudication, unspecified extremityI70.721 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, right

legI70.722 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left

legI70.723 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain,

bilateral legsI70.728 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain,

other extremityI70.729 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain,

unspecified extremityI70.731 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of thighI70.732 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of calfI70.733 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of


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ankleI70.734 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of heel

and midfootI70.735 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of

other part of footI70.738 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of

other part of lower legI70.739 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of

unspecified siteI70.741 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of thighI70.742 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of calfI70.743 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of ankleI70.744 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of heel

and midfootI70.745 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other

part of footI70.748 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other

part of lower legI70.749 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of

unspecified siteI70.75 Atherosclerosis of other type of bypass graft(s) of other extremity with ulcerationI70.761 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene,

right legI70.762 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, left

legI70.763 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene,

bilateral legsI70.768 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene,

other extremityI70.769 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene,

unspecified extremityI70.791 Other atherosclerosis of other type of bypass graft(s) of the extremities, right legI70.792 Other atherosclerosis of other type of bypass graft(s) of the extremities, left legI70.793 Other atherosclerosis of other type of bypass graft(s) of the extremities, bilateral legsI70.798 Other atherosclerosis of other type of bypass graft(s) of the extremities, other

extremityI70.799 Other atherosclerosis of other type of bypass graft(s) of the extremities, unspecified

extremityI70.401 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities,

right legI70.402 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, left

legI70.403 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities,

bilateral legsI70.408 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities,

other extremityI70.409 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities,

unspecified extremity


59



I70.411 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, right leg

I70.412 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, left leg

I70.413 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, bilateral legs

I70.418 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, other extremity

I70.419 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, unspecified extremity

I70.421 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, right leg

I70.422 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, left leg

I70.423 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, bilateral legs

I70.428 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, other extremity

I70.429 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, unspecified extremity

I70.431 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of thigh

I70.432 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of calf

I70.433 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of ankle

I70.434 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of heel and midfoot

I70.435 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot

I70.438 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of lower leg

I70.439 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of unspecified site

I70.441 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of thigh

I70.442 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of calf

I70.443 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of ankle

I70.444 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of heel and midfoot

I70.445 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of foot

I70.448 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of lower leg

I70.449 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of unspecified site


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I70.45 Atherosclerosis of autologous vein bypass graft(s) of other extremity with ulcerationI70.461 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene,

right legI70.462 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene,

left legI70.463 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene,

bilateral legsI70.468 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene,

other extremityI70.469 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene,

unspecified extremityI70.491 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, right legI70.492 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, left legI70.493 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, bilateral

legsI70.498 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, other

extremityI70.499 Other atherosclerosis of autologous vein bypass graft(s) of the extremities,

unspecified extremityI70.501 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the

extremities, right legI70.502 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the

extremities, left legI70.503 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the

extremities, bilateral legsI70.508 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the

extremities, other extremityI70.509 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the

extremities, unspecified extremityI70.511 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

intermittent claudication, right legI70.512 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

intermittent claudication, left legI70.513 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

intermittent claudication, bilateral legsI70.518 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

intermittent claudication, other extremityI70.519 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

intermittent claudication, unspecified extremityI70.521 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

rest pain, right legI70.522 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

rest pain, left legI70.523 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

rest pain, bilateral legsI70.528 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

rest pain, other extremityI70.529 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with


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rest pain, unspecified extremityI70.531 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with

ulceration of thighI70.532 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with

ulceration of calfI70.533 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with

ulceration of ankleI70.534 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with

ulceration of heel and midfootI70.535 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with

ulceration of other part of footI70.538 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with

ulceration of other part of lower legI70.539 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with

ulceration of unspecified siteI70.541 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with

ulceration of thighI70.542 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with

ulceration of calfI70.543 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with

ulceration of ankleI70.544 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with

ulceration of heel and midfootI70.545 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with

ulceration of other part of footI70.548 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with

ulceration of other part of lower legI70.549 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with

ulceration of unspecified siteI70.55 Atherosclerosis of nonautologous biological bypass graft(s) of other extremity with

ulcerationI70.561 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

gangrene, right legI70.562 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

gangrene, left legI70.563 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

gangrene, bilateral legsI70.568 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

gangrene, other extremityI70.569 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with

gangrene, unspecified extremityI70.591 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities,

right legI70.592 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities,

left legI70.593 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities,

bilateral legsI70.598 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities,


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other extremityI70.599 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities,

unspecified extremityI70.92 Chronic total occlusion of artery of the extremitiesI70.2 Chronic total occlusion of artery of the extremitiesI74.01 Saddle embolus of abdominal aortaI74.09 Other arterial embolism and thrombosis of abdominal aortaI74.11 Embolism and thrombosis of thoracic aortaI74.2 Embolism and thrombosis of arteries of the upper extremitiesI74.3 Embolism and thrombosis of arteries of the lower extremitiesI74.4 Embolism and thrombosis of arteries of extremities unspecifiedI74.5 Embolism and thrombosis of iliac arteryI74.8 Embolism and thrombosis of other arteriesI74.10 Embolism and thrombosis unspecified parts of aortaI74.19 Embolism and thrombosis of other parts of aortaI74.9 Embolism and thrombosis of unspecified arteryI75.011 Atheroembolism of right upper extremityI75.012 Atheroembolism of left upper extremityI75.013 Atheroembolism of bilateral upper extremitiesI75.019 Atheroembolism of unspecified upper extremityI75.021 Atheroembolism of right lower extremityI75.022 Atheroembolism of left lower extremityI75.023 Atheroembolism of bilateral lower extremitiesI75.029 Atheroembolism of unspecified lower extremityI75.81 Atheroembolism of kidneyI75.89 Atheroembolism of other site

Table D-11: Codes to Identify Patients with Acute Coronary Event (AMI, PCI, CABG)AMI – Acute Myocardial Infarction

ICD-9-CM Diagnosis Codes

Description

410.x1 Acute myocardial infarction - initial episode of care 410.01 Acute myocardial infarction of anterolateral wall initial episode of care 410.11 Acute myocardial infarction of other anterior wall initial episode of care 410.21 Acute myocardial infarction of inferolateral wall initial episode of care 410.31 Acute myocardial infarction of inferoposterior wall initial episode of care 410.41 Acute myocardial infarction of other inferior wall episode of care unspecified 410.51 Acute myocardial infarction of other lateral wall initial episode of care 410.61 True posterior wall infarction initial episode of care 410.71 Subendocardial infarction initial episode of care 410.81 Acute myocardial infarction of other specified sites initial episode of care 410.91 Acute myocardial infarction of unspecified site initial episode of care

Effective 10/01/2015


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ICD-10-CM Diagnosis Codes Description

I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall

I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall

I21.11 ST elevation (STEMI) myocardial infarction involving right coronary arteryI21.29 ST elevation (STEMI) myocardial infarction involving other sitesI21.4 Non-ST elevation (NSTEMI) myocardial infarctionI21.3 ST elevation (STEMI) myocardial infarction of unspecified siteI21.01 ST elevation (STEMI) myocardial infarction involving left main coronary arteryI21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending

coronary arteryI21.21 ST elevation (STEMI) myocardial infarction involving left circumflex coronary arteryI21.29 ST elevation (STEMI) myocardial infarction involving other sitesI22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wallI22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wallI22.2 Subsequent non-ST elevation (NSTEMI) myocardial infarctionI22.8 Subsequent ST elevation (STEMI) myocardial infarction of other sitesI22.9 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site

PCI – Percutaneous Coronary Intervention (including PTCA)

CPT Codes Description92920 Percutaneous transluminal coronary angioplasty; single major coronary artery or

branch92924 Percutaneous transluminal coronary atherectomy, with coronary angioplasty when

performed; single major coronary artery or branch92928 Percutaneous transcatheter placement of intracoronary stent(s), with coronary

angioplasty when performed; single major coronary artery or branch92933 Percutaneous transluminal coronary atherectomy, with intracoronary stent, with

coronary angioplasty when performed; single major coronary artery or branch92937 Percutaneous transluminal revascularization of or through coronary artery bypass

graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel

92941 Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel

92943 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel

92980 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention

92982 Percutaneous transluminal coronary balloon angioplasty, single vessel92995 Percutaneous transluminal coronary atherectomy, by mechanical or other method,

with or without balloon angioplasty, single vesselHCPCS Codes Description

G0290 Trans catheter placement of a drug-eluting intracoronary stent(s), percutaneous, with our without other therapeutic intervention, any method; single vessel


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ICD-9-CM Procedure Codes

Description

00.66 PTCA or Coronary Atherectomy36.03 Open chest coronary artery obstruction and insertion of stents36.06 Insertion of non-drug-eluting coronary artery stent(s)36.07 Insertion of drug-eluting coronary artery stent(s)


Procedure Codes Description0270346 Dilation of Coronary Artery, One Site, Bifurcation, with Drug-eluting Intraluminal

Device, Percutaneous Approach027034Z Dilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device,

Percutaneous Approach02703ZZ Dilation of Coronary Artery, One Site, Percutaneous Approach02703D6 Dilation of Coronary Artery, One Site, Bifurcation, with Intraluminal Device,

Percutaneous Approach02703DZ Dilation of Coronary Artery, One Site with Intraluminal Device, Percutaneous

Approach02703T6 Dilation of Coronary Artery, One Site, Bifurcation, with Radioactive Intraluminal

Device, Percutaneous Approach02703TZ Dilation of Coronary Artery, One Site with Radioactive Intraluminal Device,

Percutaneous Approach02703Z6 Dilation of Coronary Artery, One Site, Bifurcation, Percutaneous Approach0270446 Dilation of Coronary Artery, One Site, Bifurcation, with Drug-eluting Intraluminal

Device, Percutaneous Endoscopic Approach027044Z Dilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device,

Percutaneous Endoscopic Approach02704D6 Dilation of Coronary Artery, One Site, Bifurcation, with Intraluminal Device,

Percutaneous Endoscopic Approach02704DZ Dilation of Coronary Artery, One Site with Intraluminal Device, Percutaneous

Endoscopic Approach02704T6 Dilation of Coronary Artery, One Site, Bifurcation, with Radioactive Intraluminal

Device, Percutaneous Endoscopic Approach02704TZ Dilation of Coronary Artery, One Site with Radioactive Intraluminal Device,

Percutaneous Endoscopic Approach02704Z6 Dilation of Coronary Artery, One Site, Bifurcation, Percutaneous Endoscopic

Approach02704ZZ Dilation of Coronary Artery, One Site, Percutaneous Endoscopic Approach0271346 Dilation of Coronary Artery, Two Sites, Bifurcation, with Drug-eluting Intraluminal

Device, Percutaneous Approach027134Z Dilation of Coronary Artery, Two Sites with Drug-eluting Intraluminal Device,

Percutaneous Approach02713D6 Dilation of Coronary Artery, Two Sites, Bifurcation, with Intraluminal Device,

Percutaneous Approach02713DZ Dilation of Coronary Artery, Two Sites with Intraluminal Device, Percutaneous

Approach02713T6 Dilation of Coronary Artery, Two Sites, Bifurcation, with Radioactive Intraluminal

Device, Percutaneous Approach02713TZ Dilation of Coronary Artery, Two Sites with Radioactive Intraluminal Device,


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Percutaneous Approach02713Z6 Dilation of Coronary Artery, Two Sites, Bifurcation, Percutaneous Approach02713ZZ Dilation of Coronary Artery, Two Sites, Percutaneous Approach0271446 Dilation of Coronary Artery, Two Sites, Bifurcation, with Drug-eluting Intraluminal

Device, Percutaneous Endoscopic Approach027144Z Dilation of Coronary Artery, Two Sites with Drug-eluting Intraluminal Device,

Percutaneous Endoscopic Approach02714D6 Dilation of Coronary Artery, Two Sites, Bifurcation, with Intraluminal Device,

Percutaneous Endoscopic Approach02714DZ Dilation of Coronary Artery, Two Sites with Intraluminal Device, Percutaneous

Endoscopic Approach02714T6 Dilation of Coronary Artery, Two Sites, Bifurcation, with Radioactive Intraluminal

Device, Percutaneous Endoscopic Approach02714TZ Dilation of Coronary Artery, Two Sites with Radioactive Intraluminal Device,

Percutaneous Endoscopic Approach02714Z6 Dilation of Coronary Artery, Two Sites, Bifurcation, Percutaneous Endoscopic

Approach02714ZZ Dilation of Coronary Artery, Two Sites, Percutaneous Endoscopic Approach0272346 Dilation of Coronary Artery, Three Sites, Bifurcation, with Drug-eluting

Intraluminal Device, Percutaneous Approach027234Z Dilation of Coronary Artery, Three Sites with Drug-eluting Intraluminal Device,

Percutaneous Approach02723D6 Dilation of Coronary Artery, Three Sites, Bifurcation, with Intraluminal Device,

Percutaneous Approach02723DZ Dilation of Coronary Artery, Three Sites with Intraluminal Device, Percutaneous

Approach02723T6 Dilation of Coronary Artery, Three Sites, Bifurcation, with Radioactive Intraluminal

Device, Percutaneous Approach02723TZ Dilation of Coronary Artery, Three Sites with Radioactive Intraluminal Device,

Percutaneous Approach02723Z6 Dilation of Coronary Artery, Three Sites, Bifurcation, Percutaneous Approach02723ZZ Dilation of Coronary Artery, Three Sites, Percutaneous Approach0272446 Dilation of Coronary Artery, Three Sites, Bifurcation, with Drug-eluting

Intraluminal Device, Percutaneous Endoscopic Approach027244Z Dilation of Coronary Artery, Three Sites with Drug-eluting Intraluminal Device,

Percutaneous Endoscopic Approach02724D6 Dilation of Coronary Artery, Three Sites, Bifurcation, with Intraluminal Device,

Percutaneous Endoscopic Approach02724DZ Dilation of Coronary Artery, Three Sites with Intraluminal Device, Percutaneous

Endoscopic Approach02724T6 Dilation of Coronary Artery, Three Sites, Bifurcation, with Radioactive Intraluminal

Device, Percutaneous Endoscopic Approach02724TZ Dilation of Coronary Artery, Three Sites with Radioactive Intraluminal Device,

Percutaneous Endoscopic Approach02724Z6 Dilation of Coronary Artery, Three Sites, Bifurcation, Percutaneous Endoscopic

Approach02724ZZ Dilation of Coronary Artery, Three Sites, Percutaneous Endoscopic Approach0273346 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Drug-eluting

Intraluminal Device, Percutaneous Approach027334Z Dilation of Coronary Artery, Four or More Sites with Drug-eluting Intraluminal

Device, Percutaneous Approach02733D6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Intraluminal


66



Device, Percutaneous Approach02733DZ Dilation of Coronary Artery, Four or More Sites with Intraluminal Device,

Percutaneous Approach02733T6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Radioactive

Intraluminal Device, Percutaneous Approach02733TZ Dilation of Coronary Artery, Four or More Sites with Radioactive Intraluminal

Device, Percutaneous Approach02733Z6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, Percutaneous

Approach02733ZZ Dilation of Coronary Artery, Four or More Sites, Percutaneous Approach0273446 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Drug-eluting

Intraluminal Device, Percutaneous Endoscopic Approach027344Z Dilation of Coronary Artery, Four or More Sites with Drug-eluting Intraluminal

Device, Percutaneous Endoscopic Approach02734D6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Intraluminal

Device, Percutaneous Endoscopic Approach02734DZ Dilation of Coronary Artery, Four or More Sites with Intraluminal Device,

Percutaneous Endoscopic Approach02734T6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Radioactive

Intraluminal Device, Percutaneous Endoscopic Approach02734TZ Dilation of Coronary Artery, Four or More Sites with Radioactive Intraluminal

Device, Percutaneous Endoscopic Approach02734Z6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, Percutaneous

Endoscopic Approach02734ZZ Dilation of Coronary Artery, Four or More Sites, Percutaneous Endoscopic

Approach0270046 Dilation of Coronary Artery, One Site, Bifurcation, with Drug-eluting Intraluminal

Device, Open Approach027004Z Dilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device, Open

Approach02700D6 Dilation of Coronary Artery, One Site, Bifurcation, with Intraluminal Device, Open

Approach02700DZ Dilation of Coronary Artery, One Site with Intraluminal Device, Open Approach02700T6 Dilation of Coronary Artery, One Site, Bifurcation, with Radioactive Intraluminal

Device, Open Approach02700TZ Dilation of Coronary Artery, One Site with Radioactive Intraluminal Device, Open

Approach02700Z6 Dilation of Coronary Artery, One Site, Bifurcation, Open Approach02700ZZ Dilation of Coronary Artery, One Site, Open Approach0271046 Dilation of Coronary Artery, Two Sites, Bifurcation, with Drug-eluting Intraluminal

Device, Open Approach027104Z Dilation of Coronary Artery, Two Sites with Drug-eluting Intraluminal Device,

Open Approach02710D6 Dilation of Coronary Artery, Two Sites, Bifurcation, with Intraluminal Device, Open

Approach02710DZ Dilation of Coronary Artery, Two Sites with Intraluminal Device, Open Approach02710T6 Dilation of Coronary Artery, Two Sites, Bifurcation, with Radioactive Intraluminal

Device, Open Approach02710TZ Dilation of Coronary Artery, Two Sites with Radioactive Intraluminal Device, Open

Approach02710Z6 Dilation of Coronary Artery, Two Sites, Bifurcation, Open Approach02710ZZ Dilation of Coronary Artery, Two Sites, Open Approach


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0272046 Dilation of Coronary Artery, Three Sites, Bifurcation, with Drug-eluting Intraluminal Device, Open Approach

027204Z Dilation of Coronary Artery, Three Sites with Drug-eluting Intraluminal Device, Open Approach

02720D6 Dilation of Coronary Artery, Three Sites, Bifurcation, with Intraluminal Device, Open Approach

02720DZ Dilation of Coronary Artery, Three Sites with Intraluminal Device, Open Approach02720T6 Dilation of Coronary Artery, Three Sites, Bifurcation, with Radioactive Intraluminal

Device, Open Approach02720TZ Dilation of Coronary Artery, Three Sites with Radioactive Intraluminal Device,

Open Approach02720Z6 Dilation of Coronary Artery, Three Sites, Bifurcation, Open Approach02720ZZ Dilation of Coronary Artery, Three Sites, Open Approach0273046 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Drug-eluting

Intraluminal Device, Open Approach027304Z Dilation of Coronary Artery, Four or More Sites with Drug-eluting Intraluminal

Device, Open Approach02730D6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Intraluminal

Device, Open Approach02730DZ Dilation of Coronary Artery, Four or More Sites with Intraluminal Device, Open

Approach02730T6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Radioactive

Intraluminal Device, Open Approach02730TZ Dilation of Coronary Artery, Four or More Sites with Radioactive Intraluminal

Device, Open Approach02730Z6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, Open Approach02730ZZ Dilation of Coronary Artery, Four or More Sites, Open Approach02C00ZZ Extirpation of Matter from Coronary Artery, One Site, Open Approach02C10ZZ Extirpation of Matter from Coronary Artery, Two Sites, Open Approach02C20ZZ Extirpation of Matter from Coronary Artery, Three Sites, Open Approach02C30ZZ Extirpation of Matter from Coronary Artery, Four or More Sites, Open Approach0270056 Dilation of Coronary Artery, One Artery, Bifurcation, with Two Drug-eluting

Intraluminal Devices, Open Approach027005Z Dilation of Coronary Artery, One Artery with Two Drug-eluting Intraluminal

Devices, Open Approach0270066 Dilation of Coronary Artery, One Artery, Bifurcation, with Three Drug-eluting

Intraluminal Devices, Open Approach027006Z Dilation of Coronary Artery, One Artery with Three Drug-eluting Intraluminal

Devices, Open Approach0270076 Dilation of Coronary Artery, One Artery, Bifurcation, with Four or More Drug-

eluting Intraluminal Devices, Open Approach027007Z Dilation of Coronary Artery, One Artery with Four or More Drug-eluting

Intraluminal Devices, Open Approach02700E6 Dilation of Coronary Artery, One Artery, Bifurcation, with Two Intraluminal

Devices, Open Approach02700EZ Dilation of Coronary Artery, One Artery with Two Intraluminal Devices, Open

Approach02700F6 Dilation of Coronary Artery, One Artery, Bifurcation, with Three Intraluminal

Devices, Open Approach02700FZ Dilation of Coronary Artery, One Artery with Three Intraluminal Devices, Open

Approach


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02700G6 Dilation of Coronary Artery, One Artery, Bifurcation, with Four or More Intraluminal Devices, Open Approach

02700GZ Dilation of Coronary Artery, One Artery with Four or More Intraluminal Devices, Open Approach

0270356 Dilation of Coronary Artery, One Artery, Bifurcation, with Two Drug-eluting Intraluminal Devices, Percutaneous Approach

027035Z Dilation of Coronary Artery, One Artery with Two Drug-eluting Intraluminal Devices, Percutaneous Approach

0270366 Dilation of Coronary Artery, One Artery, Bifurcation, with Three Drug-eluting Intraluminal Devices, Percutaneous Approach

027036Z Dilation of Coronary Artery, One Artery with Three Drug-eluting Intraluminal Devices, Percutaneous Approach

0270376 Dilation of Coronary Artery, One Artery, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Percutaneous Approach

027037Z Dilation of Coronary Artery, One Artery with Four or More Drug-eluting Intraluminal Devices, Percutaneous Approach

02703E6 Dilation of Coronary Artery, One Artery, Bifurcation, with Two Intraluminal Devices, Percutaneous Approach

02703EZ Dilation of Coronary Artery, One Artery with Two Intraluminal Devices, Percutaneous Approach

02703F6 Dilation of Coronary Artery, One Artery, Bifurcation, with Three Intraluminal Devices, Percutaneous Approach

02703FZ Dilation of Coronary Artery, One Artery with Three Intraluminal Devices, Percutaneous Approach

02703G6 Dilation of Coronary Artery, One Artery, Bifurcation, with Four or More Intraluminal Devices, Percutaneous Approach

02703GZ Dilation of Coronary Artery, One Artery with Four or More Intraluminal Devices, Percutaneous Approach

0270456 Dilation of Coronary Artery, One Artery, Bifurcation, with Two Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027045Z Dilation of Coronary Artery, One Artery with Two Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

0270466 Dilation of Coronary Artery, One Artery, Bifurcation, with Three Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027046Z Dilation of Coronary Artery, One Artery with Three Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

0270476 Dilation of Coronary Artery, One Artery, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027047Z Dilation of Coronary Artery, One Artery with Four or More Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

02704E6 Dilation of Coronary Artery, One Artery, Bifurcation, with Two Intraluminal Devices, Percutaneous Endoscopic Approach

02704EZ Dilation of Coronary Artery, One Artery with Two Intraluminal Devices, Percutaneous Endoscopic Approach

02704F6 Dilation of Coronary Artery, One Artery, Bifurcation, with Three Intraluminal Devices, Percutaneous Endoscopic Approach

02704FZ Dilation of Coronary Artery, One Artery with Three Intraluminal Devices, Percutaneous Endoscopic Approach

02704G6 Dilation of Coronary Artery, One Artery, Bifurcation, with Four or More Intraluminal Devices, Percutaneous Endoscopic Approach

02704GZ Dilation of Coronary Artery, One Artery with Four or More Intraluminal Devices, Percutaneous Endoscopic Approach


69



0271056 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Open Approach

027105Z Dilation of Coronary Artery, Two Arteries with Two Drug-eluting Intraluminal Devices, Open Approach

0271066 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Open Approach

027106Z Dilation of Coronary Artery, Two Arteries with Three Drug-eluting Intraluminal Devices, Open Approach

0271076 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Open Approach

027107Z Dilation of Coronary Artery, Two Arteries with Four or More Drug-eluting Intraluminal Devices, Open Approach

02710E6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Two Intraluminal Devices, Open Approach

02710EZ Dilation of Coronary Artery, Two Arteries with Two Intraluminal Devices, Open Approach

02710F6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Three Intraluminal Devices, Open Approach

02710FZ Dilation of Coronary Artery, Two Arteries with Three Intraluminal Devices, Open Approach

02710G6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Four or More Intraluminal Devices, Open Approach

02710GZ Dilation of Coronary Artery, Two Arteries with Four or More Intraluminal Devices, Open Approach

0271356 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Percutaneous Approach

027135Z Dilation of Coronary Artery, Two Arteries with Two Drug-eluting Intraluminal Devices, Percutaneous Approach

0271366 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Percutaneous Approach

027136Z Dilation of Coronary Artery, Two Arteries with Three Drug-eluting Intraluminal Devices, Percutaneous Approach

0271376 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Percutaneous Approach

027137Z Dilation of Coronary Artery, Two Arteries with Four or More Drug-eluting Intraluminal Devices, Percutaneous Approach

02713E6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Two Intraluminal Devices, Percutaneous Approach

02713EZ Dilation of Coronary Artery, Two Arteries with Two Intraluminal Devices, Percutaneous Approach

02713F6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Three Intraluminal Devices, Percutaneous Approach

02713FZ Dilation of Coronary Artery, Two Arteries with Three Intraluminal Devices, Percutaneous Approach

02713G6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Four or More Intraluminal Devices, Percutaneous Approach

02713GZ Dilation of Coronary Artery, Two Arteries with Four or More Intraluminal Devices, Percutaneous Approach

0271456 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027145Z Dilation of Coronary Artery, Two Arteries with Two Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach


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0271466 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027146Z Dilation of Coronary Artery, Two Arteries with Three Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

0271476 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027147Z Dilation of Coronary Artery, Two Arteries with Four or More Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

02714E6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Two Intraluminal Devices, Percutaneous Endoscopic Approach

02714EZ Dilation of Coronary Artery, Two Arteries with Two Intraluminal Devices, Percutaneous Endoscopic Approach

02714F6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Three Intraluminal Devices, Percutaneous Endoscopic Approach

02714FZ Dilation of Coronary Artery, Two Arteries with Three Intraluminal Devices, Percutaneous Endoscopic Approach

02714G6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Four or More Intraluminal Devices, Percutaneous Endoscopic Approach

02714GZ Dilation of Coronary Artery, Two Arteries with Four or More Intraluminal Devices, Percutaneous Endoscopic Approach

0272056 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Open Approach

027205Z Dilation of Coronary Artery, Three Arteries with Two Drug-eluting Intraluminal Devices, Open Approach

0272066 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Open Approach

027206Z Dilation of Coronary Artery, Three Arteries with Three Drug-eluting Intraluminal Devices, Open Approach

0272076 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Open Approach

027207Z Dilation of Coronary Artery, Three Arteries with Four or More Drug-eluting Intraluminal Devices, Open Approach

02720E6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Two Intraluminal Devices, Open Approach

02720EZ Dilation of Coronary Artery, Three Arteries with Two Intraluminal Devices, Open Approach

02720F6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Three Intraluminal Devices, Open Approach

02720FZ Dilation of Coronary Artery, Three Arteries with Three Intraluminal Devices, Open Approach

02720G6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Four or More Intraluminal Devices, Open Approach

02720GZ Dilation of Coronary Artery, Three Arteries with Four or More Intraluminal Devices, Open Approach

0272356 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Percutaneous Approach

027235Z Dilation of Coronary Artery, Three Arteries with Two Drug-eluting Intraluminal Devices, Percutaneous Approach

0272366 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Percutaneous Approach

027236Z Dilation of Coronary Artery, Three Arteries with Three Drug-eluting Intraluminal Devices, Percutaneous Approach


71



0272376 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Percutaneous Approach

027237Z Dilation of Coronary Artery, Three Arteries with Four or More Drug-eluting Intraluminal Devices, Percutaneous Approach

02723E6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Two Intraluminal Devices, Percutaneous Approach

02723EZ Dilation of Coronary Artery, Three Arteries with Two Intraluminal Devices, Percutaneous Approach

02723F6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Three Intraluminal Devices, Percutaneous Approach

02723FZ Dilation of Coronary Artery, Three Arteries with Three Intraluminal Devices, Percutaneous Approach

02723G6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Four or More Intraluminal Devices, Percutaneous Approach

02723GZ Dilation of Coronary Artery, Three Arteries with Four or More Intraluminal Devices, Percutaneous Approach

0272456 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027245Z Dilation of Coronary Artery, Three Arteries with Two Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

0272466 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027246Z Dilation of Coronary Artery, Three Arteries with Three Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

0272476 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027247Z Dilation of Coronary Artery, Three Arteries with Four or More Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

02724E6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Two Intraluminal Devices, Percutaneous Endoscopic Approach

02724EZ Dilation of Coronary Artery, Three Arteries with Two Intraluminal Devices, Percutaneous Endoscopic Approach

02724F6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Three Intraluminal Devices, Percutaneous Endoscopic Approach

02724FZ Dilation of Coronary Artery, Three Arteries with Three Intraluminal Devices, Percutaneous Endoscopic Approach

02724G6 Dilation of Coronary Artery, Three Arteries, Bifurcation, with Four or More Intraluminal Devices, Percutaneous Endoscopic Approach

02724GZ Dilation of Coronary Artery, Three Arteries with Four or More Intraluminal Devices, Percutaneous Endoscopic Approach

0273056 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Open Approach

027305Z Dilation of Coronary Artery, Four or More Arteries with Two Drug-eluting Intraluminal Devices, Open Approach

0273066 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Open Approach

027306Z Dilation of Coronary Artery, Four or More Arteries with Three Drug-eluting Intraluminal Devices, Open Approach

0273076 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Open Approach

027307Z Dilation of Coronary Artery, Four or More Arteries with Four or More Drug-eluting Intraluminal Devices, Open Approach


72



02730E6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Two Intraluminal Devices, Open Approach

02730EZ Dilation of Coronary Artery, Four or More Arteries with Two Intraluminal Devices, Open Approach

02730F6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Three Intraluminal Devices, Open Approach

02730FZ Dilation of Coronary Artery, Four or More Arteries with Three Intraluminal Devices, Open Approach

02730G6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Four or More Intraluminal Devices, Open Approach

02730GZ Dilation of Coronary Artery, Four or More Arteries with Four or More Intraluminal Devices, Open Approach

0273356 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Percutaneous Approach

027335Z Dilation of Coronary Artery, Four or More Arteries with Two Drug-eluting Intraluminal Devices, Percutaneous Approach

0273366 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Percutaneous Approach

027336Z Dilation of Coronary Artery, Four or More Arteries with Three Drug-eluting Intraluminal Devices, Percutaneous Approach

0273376 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Percutaneous Approach

027337Z Dilation of Coronary Artery, Four or More Arteries with Four or More Drug-eluting Intraluminal Devices, Percutaneous Approach

02733E6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Two Intraluminal Devices, Percutaneous Approach

02733EZ Dilation of Coronary Artery, Four or More Arteries with Two Intraluminal Devices, Percutaneous Approach

02733F6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Three Intraluminal Devices, Percutaneous Approach

02733FZ Dilation of Coronary Artery, Four or More Arteries with Three Intraluminal Devices, Percutaneous Approach

02733G6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Four or More Intraluminal Devices, Percutaneous Approach

02733GZ Dilation of Coronary Artery, Four or More Arteries with Four or More Intraluminal Devices, Percutaneous Approach

0273456 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Two Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027345Z Dilation of Coronary Artery, Four or More Arteries with Two Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

0273466 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Three Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027346Z Dilation of Coronary Artery, Four or More Arteries with Three Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

0273476 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Four or More Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

027347Z Dilation of Coronary Artery, Four or More Arteries with Four or More Drug-eluting Intraluminal Devices, Percutaneous Endoscopic Approach

02734E6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Two Intraluminal Devices, Percutaneous Endoscopic Approach

02734EZ Dilation of Coronary Artery, Four or More Arteries with Two Intraluminal Devices, Percutaneous Endoscopic Approach


73



02734F6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Three Intraluminal Devices, Percutaneous Endoscopic Approach

02734FZ Dilation of Coronary Artery, Four or More Arteries with Three Intraluminal Devices, Percutaneous Endoscopic Approach

02734G6 Dilation of Coronary Artery, Four or More Arteries, Bifurcation, with Four or More Intraluminal Devices, Percutaneous Endoscopic Approach

02734GZ Dilation of Coronary Artery, Four or More Arteries with Four or More Intraluminal Devices, Percutaneous Endoscopic Approach

02C00Z6 Extirpation of Matter from Coronary Artery, One Artery, Bifurcation, Open Approach

02C10Z6 Extirpation of Matter from Coronary Artery, Two Arteries, Bifurcation, Open Approach

02C20Z6 Extirpation of Matter from Coronary Artery, Three Arteries, Bifurcation, Open Approach

02C30Z6 Extirpation of Matter from Coronary Artery, Four or More Arteries, Bifurcation, Open Approach

CABG – Coronary Artery Bypass Graft



74



33510-33516

Coronary artery bypass, vein only, coronary venous graft(s)

33510 Coronary artery bypass, vein only, single coronary venous graft 33511 Coronary artery bypass, vein only, two coronary venous grafts 33512 Coronary artery bypass, vein only, three coronary venous grafts 33513 Coronary artery bypass, vein only, four coronary venous grafts 33514 Coronary artery bypass, vein only, five coronary venous grafts 33516 Coronary artery bypass, vein only, six or more coronary venous grafts33517-33523

Coronary artery bypass, using venous graft(s) and arterial graft(s)

33517 Coronary artery bypass, using venous graft(s) and arterial graft(s);single vein graft

33518 Coronary artery bypass, using venous graft(s) and arterial graft(s);two venous grafts

33519 Coronary artery bypass, using venous graft(s) and arterial graft(s);three venous grafts

33521 Coronary artery bypass, using venous graft(s) and arterial graft(s);four venous grafts

33522 Coronary artery bypass, using venous graft(s) and arterial graft(s);five venous grafts

33523 Coronary artery bypass, using venous graft(s) and arterial graft(s);six or more venous grafts

33533-33536

Coronary artery bypass, using arterial graft(s)

33533 Coronary artery bypass, using arterial graft(s);single arterial graft 33534 Coronary artery bypass, using arterial graft(s);two arterial grafts 33535 Coronary artery bypass, using arterial graft(s);three arterial grafts 33536 Coronary artery bypass, using arterial graft(s);four or more arterial grafts


75



HCPCS Codes

Description

S2205-S2209

Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and/or venous graft(s)

S2205 Coronary artery bypass surgery, direct, with coronary artery grafts only, single

S2206 Coronary artery bypass surgery, direct, with coronary artery grafts only, two grafts

S2207 Coronary artery bypass surgery, direct, with coronary venous grafts only, single

S2208 Coronary artery bypass surgery, direct, with coronary arterial and venous grafts, single each

S2209 Coronary artery bypass surgery, direct, with coronary arterial and venous grafts, two arterial and single venous

ICD-9-CM Procedure Codes

Description

36.1x Bypass anastomosis for heart revascularization 36.10 Aortocoronary bypass for heart revascularization, not otherwise specified 36.11 (Aorto)coronary bypass of one coronary artery 36.12 (Aorto)coronary bypass of two coronary arteries 36.13 (Aorto)coronary bypass of three coronary arteries 36.14 (Aorto)coronary bypass of four coronary arteries 36.15 Single internal mammary-coronary artery bypass 36.16 Double internal mammary-coronary artery bypass 36.17 Abdominal-coronary artery bypass 36.19 Other bypass anastomosis for heart revascularization36.2 Heart revascularization by arterial implant


Procedure Codes Description0210093 Bypass Coronary Artery, One Site from Coronary Artery with Autologous Venous

Tissue, Open Approach02100A3 Bypass Coronary Artery, One Site from Coronary Artery with Autologous Arterial

Tissue, Open Approach02100J3 Bypass Coronary Artery, One Site from Coronary Artery with Synthetic Substitute,

Open Approach02100K3 Bypass Coronary Artery, One Site from Coronary Artery with Nonautologous

Tissue Substitute, Open Approach02100Z3 Bypass Coronary Artery, One Site from Coronary Artery, Open Approach0210493 Bypass Coronary Artery, One Site from Coronary Artery with Autologous Venous

Tissue, Percutaneous Endoscopic Approach02104A3 Bypass Coronary Artery, One Site from Coronary Artery with Autologous Arterial

Tissue, Percutaneous Endoscopic Approach02104J3 Bypass Coronary Artery, One Site from Coronary Artery with Synthetic Substitute,

Percutaneous Endoscopic Approach


76



02104K3 Bypass Coronary Artery, One Site from Coronary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

02104Z3 Bypass Coronary Artery, One Site from Coronary Artery, Percutaneous Endoscopic Approach

021009W Bypass Coronary Artery, One Site from Aorta with Autologous Venous Tissue, Open Approach

02100AW Bypass Coronary Artery, One Site from Aorta with Autologous Arterial Tissue, Open Approach

02100JW Bypass Coronary Artery, One Site from Aorta with Synthetic Substitute, Open Approach

02100KW Bypass Coronary Artery, One Site from Aorta with Nonautologous Tissue Substitute, Open Approach

021049W Bypass Coronary Artery, One Site from Aorta with Autologous Venous Tissue, Percutaneous Endoscopic Approach

02104AW Bypass Coronary Artery, One Site from Aorta with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

02104JW Bypass Coronary Artery, One Site from Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach

02104KW Bypass Coronary Artery, One Site from Aorta with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

021109W Bypass Coronary Artery, Two Sites from Aorta with Autologous Venous Tissue, Open Approach

02110AW Bypass Coronary Artery, Two Sites from Aorta with Autologous Arterial Tissue, Open Approach

02110JW Bypass Coronary Artery, Two Sites from Aorta with Synthetic Substitute, Open Approach

02110KW Bypass Coronary Artery, Two Sites from Aorta with Nonautologous Tissue Substitute, Open Approach

021149W Bypass Coronary Artery, Two Sites from Aorta with Autologous Venous Tissue, Percutaneous Endoscopic Approach

02114AW Bypass Coronary Artery, Two Sites from Aorta with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

02114JW Bypass Coronary Artery, Two Sites from Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach

02114KW Bypass Coronary Artery, Two Sites from Aorta with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

021209W Bypass Coronary Artery, Three Sites from Aorta with Autologous Venous Tissue, Open Approach

02120AW Bypass Coronary Artery, Three Sites from Aorta with Autologous Arterial Tissue, Open Approach

02120JW Bypass Coronary Artery, Three Sites from Aorta with Synthetic Substitute, Open Approach

02120KW Bypass Coronary Artery, Three Sites from Aorta with Nonautologous Tissue Substitute, Open Approach

021249W Bypass Coronary Artery, Three Sites from Aorta with Autologous Venous Tissue, Percutaneous Endoscopic Approach

02124AW Bypass Coronary Artery, Three Sites from Aorta with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

02124JW Bypass Coronary Artery, Three Sites from Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach

02124KW Bypass Coronary Artery, Three Sites from Aorta with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach


77



021309W Bypass Coronary Artery, Four or More Sites from Aorta with Autologous Venous Tissue, Open Approach

02130AW Bypass Coronary Artery, Four or More Sites from Aorta with Autologous Arterial Tissue, Open Approach

02130JW Bypass Coronary Artery, Four or More Sites from Aorta with Synthetic Substitute, Open Approach

02130KW Bypass Coronary Artery, Four or More Sites from Aorta with Nonautologous Tissue Substitute, Open Approach

021349W Bypass Coronary Artery, Four or More Sites from Aorta with Autologous Venous Tissue, Percutaneous Endoscopic Approach

02134AW Bypass Coronary Artery, Four or More Sites from Aorta with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

02134JW Bypass Coronary Artery, Four or More Sites from Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach

02134KW Bypass Coronary Artery, Four or More Sites from Aorta with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

0210098 Bypass Coronary Artery, One Site from Right Internal Mammary with Autologous Venous Tissue, Open Approach

0210099 Bypass Coronary Artery, One Site from Left Internal Mammary with Autologous Venous Tissue, Open Approach

021009C Bypass Coronary Artery, One Site from Thoracic Artery with Autologous Venous Tissue, Open Approach

02100A8 Bypass Coronary Artery, One Site from Right Internal Mammary with Autologous Arterial Tissue, Open Approach

02100A9 Bypass Coronary Artery, One Site from Left Internal Mammary with Autologous Arterial Tissue, Open Approach

02100AC Bypass Coronary Artery, One Site from Thoracic Artery with Autologous Arterial Tissue, Open Approach

02100J8 Bypass Coronary Artery, One Site from Right Internal Mammary with Synthetic Substitute, Open Approach

02100J9 Bypass Coronary Artery, One Site from Left Internal Mammary with Synthetic Substitute, Open Approach

02100JC Bypass Coronary Artery, One Site from Thoracic Artery with Synthetic Substitute, Open Approach

02100K8 Bypass Coronary Artery, One Site from Right Internal Mammary with Nonautologous Tissue Substitute, Open Approach

02100K9 Bypass Coronary Artery, One Site from Left Internal Mammary with Nonautologous Tissue Substitute, Open Approach

02100KC Bypass Coronary Artery, One Site from Thoracic Artery with Nonautologous Tissue Substitute, Open Approach

02100Z8 Bypass Coronary Artery, One Site from Right Internal Mammary, Open Approach02100Z9 Bypass Coronary Artery, One Site from Left Internal Mammary, Open Approach02100ZC Bypass Coronary Artery, One Site from Thoracic Artery, Open Approach0210498 Bypass Coronary Artery, One Site from Right Internal Mammary with Autologous

Venous Tissue, Percutaneous Endoscopic Approach0210499 Bypass Coronary Artery, One Site from Left Internal Mammary with Autologous

Venous Tissue, Percutaneous Endoscopic Approach021049C Bypass Coronary Artery, One Site from Thoracic Artery with Autologous Venous

Tissue, Percutaneous Endoscopic Approach02104A8 Bypass Coronary Artery, One Site from Right Internal Mammary with Autologous

Arterial Tissue, Percutaneous Endoscopic Approach02104A9 Bypass Coronary Artery, One Site from Left Internal Mammary with Autologous


78



Arterial Tissue, Percutaneous Endoscopic Approach02104AC Bypass Coronary Artery, One Site from Thoracic Artery with Autologous Arterial

Tissue, Percutaneous Endoscopic Approach02104J8 Bypass Coronary Artery, One Site from Right Internal Mammary with Synthetic

Substitute, Percutaneous Endoscopic Approach02104J9 Bypass Coronary Artery, One Site from Left Internal Mammary with Synthetic

Substitute, Percutaneous Endoscopic Approach02104JC Bypass Coronary Artery, One Site from Thoracic Artery with Synthetic Substitute,

Percutaneous Endoscopic Approach02104K8 Bypass Coronary Artery, One Site from Right Internal Mammary with

Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach02104K9 Bypass Coronary Artery, One Site from Left Internal Mammary with

Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach02104KC Bypass Coronary Artery, One Site from Thoracic Artery with Nonautologous Tissue

Substitute, Percutaneous Endoscopic Approach02104Z8 Bypass Coronary Artery, One Site from Right Internal Mammary, Percutaneous

Endoscopic Approach02104Z9 Bypass Coronary Artery, One Site from Left Internal Mammary, Percutaneous

Endoscopic Approach02104ZC Bypass Coronary Artery, One Site from Thoracic Artery, Percutaneous Endoscopic

Approach0211098 Bypass Coronary Artery, Two Sites from Right Internal Mammary with Autologous

Venous Tissue, Open Approach0211099 Bypass Coronary Artery, Two Sites from Left Internal Mammary with Autologous

Venous Tissue, Open Approach021109C Bypass Coronary Artery, Two Sites from Thoracic Artery with Autologous Venous

Tissue, Open Approach02110A8 Bypass Coronary Artery, Two Sites from Right Internal Mammary with Autologous

Arterial Tissue, Open Approach02110A9 Bypass Coronary Artery, Two Sites from Left Internal Mammary with Autologous

Arterial Tissue, Open Approach02110AC Bypass Coronary Artery, Two Sites from Thoracic Artery with Autologous Arterial

Tissue, Open Approach02110J8 Bypass Coronary Artery, Two Sites from Right Internal Mammary with Synthetic

Substitute, Open Approach02110J9 Bypass Coronary Artery, Two Sites from Left Internal Mammary with Synthetic

Substitute, Open Approach02110JC Bypass Coronary Artery, Two Sites from Thoracic Artery with Synthetic Substitute,

Open Approach02110K8 Bypass Coronary Artery, Two Sites from Right Internal Mammary with

Nonautologous Tissue Substitute, Open Approach02110K9 Bypass Coronary Artery, Two Sites from Left Internal Mammary with

Nonautologous Tissue Substitute, Open Approach02110KC Bypass Coronary Artery, Two Sites from Thoracic Artery with Nonautologous

Tissue Substitute, Open Approach02110Z8 Bypass Coronary Artery, Two Sites from Right Internal Mammary, Open Approach02110Z9 Bypass Coronary Artery, Two Sites from Left Internal Mammary, Open Approach02110ZC Bypass Coronary Artery, Two Sites from Thoracic Artery, Open Approach0211498 Bypass Coronary Artery, Two Sites from Right Internal Mammary with Autologous

Venous Tissue, Percutaneous Endoscopic Approach0211499 Bypass Coronary Artery, Two Sites from Left Internal Mammary with Autologous

Venous Tissue, Percutaneous Endoscopic Approach


79



021149C Bypass Coronary Artery, Two Sites from Thoracic Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach

02114A8 Bypass Coronary Artery, Two Sites from Right Internal Mammary with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

02114A9 Bypass Coronary Artery, Two Sites from Left Internal Mammary with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

02114AC Bypass Coronary Artery, Two Sites from Thoracic Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

02114J8 Bypass Coronary Artery, Two Sites from Right Internal Mammary with Synthetic Substitute, Percutaneous Endoscopic Approach

02114J9 Bypass Coronary Artery, Two Sites from Left Internal Mammary with Synthetic Substitute, Percutaneous Endoscopic Approach

02114JC Bypass Coronary Artery, Two Sites from Thoracic Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

02114K8 Bypass Coronary Artery, Two Sites from Right Internal Mammary with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

02114K9 Bypass Coronary Artery, Two Sites from Left Internal Mammary with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

02114KC Bypass Coronary Artery, Two Sites from Thoracic Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

02114Z8 Bypass Coronary Artery, Two Sites from Right Internal Mammary, Percutaneous Endoscopic Approach

02114Z9 Bypass Coronary Artery, Two Sites from Left Internal Mammary, Percutaneous Endoscopic Approach

02114ZC Bypass Coronary Artery, Two Sites from Thoracic Artery, Percutaneous Endoscopic Approach

021209C Bypass Coronary Artery, Three Sites from Thoracic Artery with Autologous Venous Tissue, Open Approach

02120AC Bypass Coronary Artery, Three Sites from Thoracic Artery with Autologous Arterial Tissue, Open Approach

02120JC Bypass Coronary Artery, Three Sites from Thoracic Artery with Synthetic Substitute, Open Approach

02120KC Bypass Coronary Artery, Three Sites from Thoracic Artery with Nonautologous Tissue Substitute, Open Approach

02120ZC Bypass Coronary Artery, Three Sites from Thoracic Artery, Open Approach021249C Bypass Coronary Artery, Three Sites from Thoracic Artery with Autologous Venous

Tissue, Percutaneous Endoscopic Approach02124AC Bypass Coronary Artery, Three Sites from Thoracic Artery with Autologous Arterial

Tissue, Percutaneous Endoscopic Approach02124JC Bypass Coronary Artery, Three Sites from Thoracic Artery with Synthetic

Substitute, Percutaneous Endoscopic Approach02124KC Bypass Coronary Artery, Three Sites from Thoracic Artery with Nonautologous

Tissue Substitute, Percutaneous Endoscopic Approach02124ZC Bypass Coronary Artery, Three Sites from Thoracic Artery, Percutaneous

Endoscopic Approach021309C Bypass Coronary Artery, Four or More Sites from Thoracic Artery with Autologous

Venous Tissue, Open Approach02130AC Bypass Coronary Artery, Four or More Sites from Thoracic Artery with Autologous

Arterial Tissue, Open Approach02130JC Bypass Coronary Artery, Four or More Sites from Thoracic Artery with Synthetic

Substitute, Open Approach02130KC Bypass Coronary Artery, Four or More Sites from Thoracic Artery with


80



Nonautologous Tissue Substitute, Open Approach02130ZC Bypass Coronary Artery, Four or More Sites from Thoracic Artery, Open Approach021349C Bypass Coronary Artery, Four or More Sites from Thoracic Artery with Autologous

Venous Tissue, Percutaneous Endoscopic Approach02134AC Bypass Coronary Artery, Four or More Sites from Thoracic Artery with Autologous

Arterial Tissue, Percutaneous Endoscopic Approach02134JC Bypass Coronary Artery, Four or More Sites from Thoracic Artery with Synthetic

Substitute, Percutaneous Endoscopic Approach02134KC Bypass Coronary Artery, Four or More Sites from Thoracic Artery with

Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach02134ZC Bypass Coronary Artery, Four or More Sites from Thoracic Artery, Percutaneous

Endoscopic Approach021009F Bypass Coronary Artery, One Site from Abdominal Artery with Autologous Venous

Tissue, Open Approach02100AF Bypass Coronary Artery, One Site from Abdominal Artery with Autologous Arterial

Tissue, Open Approach02100JF Bypass Coronary Artery, One Site from Abdominal Artery with Synthetic

Substitute, Open Approach02100KF Bypass Coronary Artery, One Site from Abdominal Artery with Nonautologous

Tissue Substitute, Open Approach02100ZF Bypass Coronary Artery, One Site from Abdominal Artery, Open Approach021049F Bypass Coronary Artery, One Site from Abdominal Artery with Autologous Venous

Tissue, Percutaneous Endoscopic Approach02104AF Bypass Coronary Artery, One Site from Abdominal Artery with Autologous Arterial

Tissue, Percutaneous Endoscopic Approach02104JF Bypass Coronary Artery, One Site from Abdominal Artery with Synthetic

Substitute, Percutaneous Endoscopic Approach02104KF Bypass Coronary Artery, One Site from Abdominal Artery with Nonautologous

Tissue Substitute, Percutaneous Endoscopic Approach02104ZF Bypass Coronary Artery, One Site from Abdominal Artery, Percutaneous

Endoscopic Approach0210093 Bypass Coronary Artery, One Site from Coronary Artery with Autologous Venous

Tissue, Open Approach02100A3 Bypass Coronary Artery, One Site from Coronary Artery with Autologous Arterial

Tissue, Open Approach02100J3 Bypass Coronary Artery, One Site from Coronary Artery with Synthetic Substitute,

Open Approach02100K3 Bypass Coronary Artery, One Site from Coronary Artery with Nonautologous

Tissue Substitute, Open Approach02100Z3 Bypass Coronary Artery, One Site from Coronary Artery, Open Approach0210493 Bypass Coronary Artery, One Site from Coronary Artery with Autologous Venous

Tissue, Percutaneous Endoscopic Approach02104A3 Bypass Coronary Artery, One Site from Coronary Artery with Autologous Arterial

Tissue, Percutaneous Endoscopic Approach02104J3 Bypass Coronary Artery, One Site from Coronary Artery with Synthetic Substitute,

Percutaneous Endoscopic Approach02104K3 Bypass Coronary Artery, One Site from Coronary Artery with Nonautologous

Tissue Substitute, Percutaneous Endoscopic Approach02104Z3 Bypass Coronary Artery, One Site from Coronary Artery, Percutaneous Endoscopic

Approach021K0Z8 Bypass Right Ventricle to Right Internal Mammary, Open Approach021K0Z9 Bypass Right Ventricle to Left Internal Mammary, Open Approach


81



021K0ZC Bypass Right Ventricle to Thoracic Artery, Open Approach021K0ZW Bypass Right Ventricle to Aorta, Open Approach021K0ZF Bypass Right Ventricle to Abdominal Artery, Open Approach021K4Z8 Bypass Right Ventricle to Right Internal Mammary, Percutaneous Endoscopic

Approach021K4Z9 Bypass Right Ventricle to Left Internal Mammary, Percutaneous Endoscopic

Approach021K4ZW Bypass Right Ventricle to Aorta, Percutaneous Endoscopic Approach021K4ZC Bypass Right Ventricle to Thoracic Artery, Percutaneous Endoscopic Approach021K4ZF Bypass Right Ventricle to Abdominal Artery, Percutaneous Endoscopic Approach021L09P Bypass Left Ventricle to Pulmonary Trunk with Autologous Venous Tissue, Open Approach021L09Q Bypass Left Ventricle to Right Pulmonary Artery with Autologous Venous Tissue, Open

Approach021L09R Bypass Left Ventricle to Left Pulmonary Artery with Autologous Venous Tissue, Open

Approach021L0AP Bypass Left Ventricle to Pulmonary Trunk with Autologous Arterial Tissue, Open Approach021L0AQ Bypass Left Ventricle to Right Pulmonary Artery with Autologous Arterial Tissue, Open

Approach021L0AR Bypass Left Ventricle to Left Pulmonary Artery with Autologous Arterial Tissue, Open

Approach021L0JP Bypass Left Ventricle to Pulmonary Trunk with Synthetic Substitute, Open Approach021L0JQ Bypass Left Ventricle to Right Pulmonary Artery with Synthetic Substitute, Open Approach021L0JR Bypass Left Ventricle to Left Pulmonary Artery with Synthetic Substitute, Open Approach021L0KP Bypass Left Ventricle to Pulmonary Trunk with Nonautologous Tissue Substitute, Open

Approach021L0KQ Bypass Left Ventricle to Right Pulmonary Artery with Nonautologous Tissue Substitute,

Open Approach021L0KR Bypass Left Ventricle to Left Pulmonary Artery with Nonautologous Tissue Substitute, Open

Approach021L0ZF Bypass Left Ventricle to Abdominal Artery, Open Approach021L0ZP Bypass Left Ventricle to Pulmonary Trunk, Open Approach021L0ZQ Bypass Left Ventricle to Right Pulmonary Artery, Open Approach021L0ZR Bypass Left Ventricle to Left Pulmonary Artery, Open Approach021L0Z8 Bypass Left Ventricle to Right Internal Mammary, Open Approach021L0Z9 Bypass Left Ventricle to Left Internal Mammary, Open Approach021L0ZC Bypass Left Ventricle to Thoracic Artery, Open Approach021L4Z8 Bypass Left Ventricle to Right Internal Mammary, Percutaneous Endoscopic

Approach021L4Z9 Bypass Left Ventricle to Left Internal Mammary, Percutaneous Endoscopic

Approach021L4ZC Bypass Left Ventricle to Thoracic Artery, Percutaneous Endoscopic Approach021L49P Bypass Left Ventricle to Pulmonary Trunk with Autologous Venous Tissue,

Percutaneous Endoscopic Approach021L49Q Bypass Left Ventricle to Right Pulmonary Artery with Autologous Venous Tissue,

Percutaneous Endoscopic Approach021L49R Bypass Left Ventricle to Left Pulmonary Artery with Autologous Venous Tissue,

Percutaneous Endoscopic Approach


82



021L4AP Bypass Left Ventricle to Pulmonary Trunk with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

021L4AQ Bypass Left Ventricle to Right Pulmonary Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

021L4AR Bypass Left Ventricle to Left Pulmonary Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

021L4JP Bypass Left Ventricle to Pulmonary Trunk with Synthetic Substitute, Percutaneous Endoscopic Approach

021L4JQ Bypass Left Ventricle to Right Pulmonary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

021L4JR Bypass Left Ventricle to Left Pulmonary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

021L4KP Bypass Left Ventricle to Pulmonary Trunk with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

021L4KQ Bypass Left Ventricle to Right Pulmonary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

021L4KR Bypass Left Ventricle to Left Pulmonary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

021L4ZF Bypass Left Ventricle to Abdominal Artery, Percutaneous Endoscopic Approach021L4ZP Bypass Left Ventricle to Pulmonary Trunk, Percutaneous Endoscopic Approach021L4ZQ Bypass Left Ventricle to Right Pulmonary Artery, Percutaneous Endoscopic

Approach021L4ZR Bypass Left Ventricle to Left Pulmonary Artery, Percutaneous Endoscopic

Approach0212098 Bypass Coronary Artery, Three Sites from Right Internal Mammary with

Autologous Venous Tissue, Open Approach0212099 Bypass Coronary Artery, Three Sites from Left Internal Mammary with Autologous

Venous Tissue, Open Approach02120A8 Bypass Coronary Artery, Three Sites from Right Internal Mammary with

Autologous Arterial Tissue, Open Approach02120A9 Bypass Coronary Artery, Three Sites from Left Internal Mammary with Autologous

Arterial Tissue, Open Approach02120J8 Bypass Coronary Artery, Three Sites from Right Internal Mammary with Synthetic

Substitute, Open Approach02120J9 Bypass Coronary Artery, Three Sites from Left Internal Mammary with Synthetic

Substitute, Open Approach02120K8 Bypass Coronary Artery, Three Sites from Right Internal Mammary with

Nonautologous Tissue Substitute, Open Approach02120K9 Bypass Coronary Artery, Three Sites from Left Internal Mammary with

Nonautologous Tissue Substitute, Open Approach02120Z8 Bypass Coronary Artery, Three Sites from Right Internal Mammary, Open

Approach02120Z9 Bypass Coronary Artery, Three Sites from Left Internal Mammary, Open Approach0212498 Bypass Coronary Artery, Three Sites from Right Internal Mammary with

Autologous Venous Tissue, Percutaneous Endoscopic Approach0212499 Bypass Coronary Artery, Three Sites from Left Internal Mammary with Autologous

Venous Tissue, Percutaneous Endoscopic Approach02124A8 Bypass Coronary Artery, Three Sites from Right Internal Mammary with

Autologous Arterial Tissue, Percutaneous Endoscopic Approach02124A9 Bypass Coronary Artery, Three Sites from Left Internal Mammary with Autologous

Arterial Tissue, Percutaneous Endoscopic Approach02124J8 Bypass Coronary Artery, Three Sites from Right Internal Mammary with Synthetic


83



Substitute, Percutaneous Endoscopic Approach02124J9 Bypass Coronary Artery, Three Sites from Left Internal Mammary with Synthetic

Substitute, Percutaneous Endoscopic Approach02124K8 Bypass Coronary Artery, Three Sites from Right Internal Mammary with

Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach02124K9 Bypass Coronary Artery, Three Sites from Left Internal Mammary with

Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach02124Z8 Bypass Coronary Artery, Three Sites from Right Internal Mammary, Percutaneous

Endoscopic Approach02124Z9 Bypass Coronary Artery, Three Sites from Left Internal Mammary, Percutaneous

Endoscopic Approach0213098 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary with

Autologous Venous Tissue, Open Approach0213099 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary with

Autologous Venous Tissue, Open Approach02130A8 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary with

Autologous Arterial Tissue, Open Approach02130A9 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary with

Autologous Arterial Tissue, Open Approach02130J8 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary with

Synthetic Substitute, Open Approach02130J9 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary with

Synthetic Substitute, Open Approach02130K8 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary with

Nonautologous Tissue Substitute, Open Approach02130K9 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary with

Nonautologous Tissue Substitute, Open Approach02130Z8 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary, Open

Approach02130Z9 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary, Open

Approach0213498 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary with

Autologous Venous Tissue, Percutaneous Endoscopic Approach0213499 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary with

Autologous Venous Tissue, Percutaneous Endoscopic Approach02134A8 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary with

Autologous Arterial Tissue, Percutaneous Endoscopic Approach02134A9 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary with

Autologous Arterial Tissue, Percutaneous Endoscopic Approach02134J8 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary with

Synthetic Substitute, Percutaneous Endoscopic Approach02134J9 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary with

Synthetic Substitute, Percutaneous Endoscopic Approach02134K8 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary with

Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach02134K9 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary with

Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach02134Z8 Bypass Coronary Artery, Four or More Sites from Right Internal Mammary,

Percutaneous Endoscopic Approach02134Z9 Bypass Coronary Artery, Four or More Sites from Left Internal Mammary,

Percutaneous Endoscopic Approach021109F Bypass Coronary Artery, Two Sites from Abdominal Artery with Autologous


84



Venous Tissue, Open Approach02110AF Bypass Coronary Artery, Two Sites from Abdominal Artery with Autologous

Arterial Tissue, Open Approach02110JF Bypass Coronary Artery, Two Sites from Abdominal Artery with Synthetic

Substitute, Open Approach02110KF Bypass Coronary Artery, Two Sites from Abdominal Artery with Nonautologous

Tissue Substitute, Open Approach02110ZF Bypass Coronary Artery, Two Sites from Abdominal Artery, Open Approach021149F Bypass Coronary Artery, Two Sites from Abdominal Artery with Autologous

Venous Tissue, Percutaneous Endoscopic Approach02114AF Bypass Coronary Artery, Two Sites from Abdominal Artery with Autologous

Arterial Tissue, Percutaneous Endoscopic Approach02114JF Bypass Coronary Artery, Two Sites from Abdominal Artery with Synthetic

Substitute, Percutaneous Endoscopic Approach02114KF Bypass Coronary Artery, Two Sites from Abdominal Artery with Nonautologous

Tissue Substitute, Percutaneous Endoscopic Approach02114ZF Bypass Coronary Artery, Two Sites from Abdominal Artery, Percutaneous

Endoscopic Approach021209F Bypass Coronary Artery, Three Sites from Abdominal Artery with Autologous

Venous Tissue, Open Approach02120AF Bypass Coronary Artery, Three Sites from Abdominal Artery with Autologous

Arterial Tissue, Open Approach02120JF Bypass Coronary Artery, Three Sites from Abdominal Artery with Synthetic

Substitute, Open Approach02120KF Bypass Coronary Artery, Three Sites from Abdominal Artery with Nonautologous

Tissue Substitute, Open Approach02120ZF Bypass Coronary Artery, Three Sites from Abdominal Artery, Open Approach021249F Bypass Coronary Artery, Three Sites from Abdominal Artery with Autologous

Venous Tissue, Percutaneous Endoscopic Approach02124AF Bypass Coronary Artery, Three Sites from Abdominal Artery with Autologous

Arterial Tissue, Percutaneous Endoscopic Approach02124JF Bypass Coronary Artery, Three Sites from Abdominal Artery with Synthetic

Substitute, Percutaneous Endoscopic Approach02124KF Bypass Coronary Artery, Three Sites from Abdominal Artery with Nonautologous

Tissue Substitute, Percutaneous Endoscopic Approach02124ZF Bypass Coronary Artery, Three Sites from Abdominal Artery, Percutaneous

Endoscopic Approach021309F Bypass Coronary Artery, Four or More Sites from Abdominal Artery with

Autologous Venous Tissue, Open Approach02130AF Bypass Coronary Artery, Four or More Sites from Abdominal Artery with

Autologous Arterial Tissue, Open Approach02130JF Bypass Coronary Artery, Four or More Sites from Abdominal Artery with Synthetic

Substitute, Open Approach02130KF Bypass Coronary Artery, Four or More Sites from Abdominal Artery with

Nonautologous Tissue Substitute, Open Approach02130ZF Bypass Coronary Artery, Four or More Sites from Abdominal Artery, Open

Approach021349F Bypass Coronary Artery, Four or More Sites from Abdominal Artery with

Autologous Venous Tissue, Percutaneous Endoscopic Approach02134AF Bypass Coronary Artery, Four or More Sites from Abdominal Artery with

Autologous Arterial Tissue, Percutaneous Endoscopic Approach02134JF Bypass Coronary Artery, Four or More Sites from Abdominal Artery with Synthetic


85



Substitute, Percutaneous Endoscopic Approach02134KF Bypass Coronary Artery, Four or More Sites from Abdominal Artery with

Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach02134ZF Bypass Coronary Artery, Four or More Sites from Abdominal Artery, Percutaneous

Endoscopic Approach0211093 Bypass Coronary Artery, Two Sites from Coronary Artery with Autologous Venous

Tissue, Open Approach02110A3 Bypass Coronary Artery, Two Sites from Coronary Artery with Autologous Arterial

Tissue, Open Approach02110J3 Bypass Coronary Artery, Two Sites from Coronary Artery with Synthetic

Substitute, Open Approach02110K3 Bypass Coronary Artery, Two Sites from Coronary Artery with Nonautologous

Tissue Substitute, Open Approach02110Z3 Bypass Coronary Artery, Two Sites from Coronary Artery, Open Approach0211493 Bypass Coronary Artery, Two Sites from Coronary Artery with Autologous Venous

Tissue, Percutaneous Endoscopic Approach02114A3 Bypass Coronary Artery, Two Sites from Coronary Artery with Autologous Arterial

Tissue, Percutaneous Endoscopic Approach02114J3 Bypass Coronary Artery, Two Sites from Coronary Artery with Synthetic

Substitute, Percutaneous Endoscopic Approach02114K3 Bypass Coronary Artery, Two Sites from Coronary Artery with Nonautologous

Tissue Substitute, Percutaneous Endoscopic Approach02114Z3 Bypass Coronary Artery, Two Sites from Coronary Artery, Percutaneous

Endoscopic Approach0212093 Bypass Coronary Artery, Three Sites from Coronary Artery with Autologous

Venous Tissue, Open Approach02120A3 Bypass Coronary Artery, Three Sites from Coronary Artery with Autologous

Arterial Tissue, Open Approach02120J3 Bypass Coronary Artery, Three Sites from Coronary Artery with Synthetic

Substitute, Open Approach02120K3 Bypass Coronary Artery, Three Sites from Coronary Artery with Nonautologous

Tissue Substitute, Open Approach02120Z3 Bypass Coronary Artery, Three Sites from Coronary Artery, Open Approach0212493 Bypass Coronary Artery, Three Sites from Coronary Artery with Autologous

Venous Tissue, Percutaneous Endoscopic Approach02124A3 Bypass Coronary Artery, Three Sites from Coronary Artery with Autologous

Arterial Tissue, Percutaneous Endoscopic Approach02124J3 Bypass Coronary Artery, Three Sites from Coronary Artery with Synthetic

Substitute, Percutaneous Endoscopic Approach02124K3 Bypass Coronary Artery, Three Sites from Coronary Artery with Nonautologous

Tissue Substitute, Percutaneous Endoscopic Approach02124Z3 Bypass Coronary Artery, Three Sites from Coronary Artery, Percutaneous

Endoscopic Approach0213093 Bypass Coronary Artery, Four or More Sites from Coronary Artery with Autologous

Venous Tissue, Open Approach02130A3 Bypass Coronary Artery, Four or More Sites from Coronary Artery with Autologous

Arterial Tissue, Open Approach02130J3 Bypass Coronary Artery, Four or More Sites from Coronary Artery with Synthetic

Substitute, Open Approach02130K3 Bypass Coronary Artery, Four or More Sites from Coronary Artery with

Nonautologous Tissue Substitute, Open Approach02130Z3 Bypass Coronary Artery, Four or More Sites from Coronary Artery, Open Approach


86



0213493 Bypass Coronary Artery, Four or More Sites from Coronary Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach

02134A3 Bypass Coronary Artery, Four or More Sites from Coronary Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

02134J3 Bypass Coronary Artery, Four or More Sites from Coronary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

02134K3 Bypass Coronary Artery, Four or More Sites from Coronary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

02134Z3 Bypass Coronary Artery, Four or More Sites from Coronary Artery, Percutaneous Endoscopic Approach

0210083 Bypass Coronary Artery, One Artery from Coronary Artery with Zooplastic Tissue, Open Approach

0210088 Bypass Coronary Artery, One Artery from Right Internal Mammary with Zooplastic Tissue, Open Approach

0210089 Bypass Coronary Artery, One Artery from Left Internal Mammary with Zooplastic Tissue, Open Approach

021008C Bypass Coronary Artery, One Artery from Thoracic Artery with Zooplastic Tissue, Open Approach

021008F Bypass Coronary Artery, One Artery from Abdominal Artery with Zooplastic Tissue, Open Approach

021008W Bypass Coronary Artery, One Artery from Aorta with Zooplastic Tissue, Open Approach

0210483 Bypass Coronary Artery, One Artery from Coronary Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

0210488 Bypass Coronary Artery, One Artery from Right Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach

0210489 Bypass Coronary Artery, One Artery from Left Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach

021048C Bypass Coronary Artery, One Artery from Thoracic Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

021048F Bypass Coronary Artery, One Artery from Abdominal Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

021048W Bypass Coronary Artery, One Artery from Aorta with Zooplastic Tissue, Percutaneous Endoscopic Approach

0211083 Bypass Coronary Artery, Two Arteries from Coronary Artery with Zooplastic Tissue, Open Approach

0211088 Bypass Coronary Artery, Two Arteries from Right Internal Mammary with Zooplastic Tissue, Open Approach

0211089 Bypass Coronary Artery, Two Arteries from Left Internal Mammary with Zooplastic Tissue, Open Approach

021108C Bypass Coronary Artery, Two Arteries from Thoracic Artery with Zooplastic Tissue, Open Approach

021108F Bypass Coronary Artery, Two Arteries from Abdominal Artery with Zooplastic Tissue, Open Approach

021108W Bypass Coronary Artery, Two Arteries from Aorta with Zooplastic Tissue, Open Approach

0211483 Bypass Coronary Artery, Two Arteries from Coronary Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

0211488 Bypass Coronary Artery, Two Arteries from Right Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach

0211489 Bypass Coronary Artery, Two Arteries from Left Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach


87



021148C Bypass Coronary Artery, Two Arteries from Thoracic Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

021148F Bypass Coronary Artery, Two Arteries from Abdominal Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

021148W Bypass Coronary Artery, Two Arteries from Aorta with Zooplastic Tissue, Percutaneous Endoscopic Approach

0212083 Bypass Coronary Artery, Three Arteries from Coronary Artery with Zooplastic Tissue, Open Approach

0212088 Bypass Coronary Artery, Three Arteries from Right Internal Mammary with Zooplastic Tissue, Open Approach

0212089 Bypass Coronary Artery, Three Arteries from Left Internal Mammary with Zooplastic Tissue, Open Approach

021208C Bypass Coronary Artery, Three Arteries from Thoracic Artery with Zooplastic Tissue, Open Approach

021208F Bypass Coronary Artery, Three Arteries from Abdominal Artery with Zooplastic Tissue, Open Approach

021208W Bypass Coronary Artery, Three Arteries from Aorta with Zooplastic Tissue, Open Approach

0212483 Bypass Coronary Artery, Three Arteries from Coronary Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

0212488 Bypass Coronary Artery, Three Arteries from Right Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach

0212489 Bypass Coronary Artery, Three Arteries from Left Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach

021248C Bypass Coronary Artery, Three Arteries from Thoracic Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

021248F Bypass Coronary Artery, Three Arteries from Abdominal Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

021248W Bypass Coronary Artery, Three Arteries from Aorta with Zooplastic Tissue, Percutaneous Endoscopic Approach

0213083 Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Zooplastic Tissue, Open Approach

0213088 Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Zooplastic Tissue, Open Approach

0213089 Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Zooplastic Tissue, Open Approach

021308C Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Zooplastic Tissue, Open Approach

021308F Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Zooplastic Tissue, Open Approach

021308W Bypass Coronary Artery, Four or More Arteries from Aorta with Zooplastic Tissue, Open Approach

0213483 Bypass Coronary Artery, Four or More Arteries from Coronary Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

0213488 Bypass Coronary Artery, Four or More Arteries from Right Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach

0213489 Bypass Coronary Artery, Four or More Arteries from Left Internal Mammary with Zooplastic Tissue, Percutaneous Endoscopic Approach

021348C Bypass Coronary Artery, Four or More Arteries from Thoracic Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

021348F Bypass Coronary Artery, Four or More Arteries from Abdominal Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach


88



021348W Bypass Coronary Artery, Four or More Arteries from Aorta with Zooplastic Tissue, Percutaneous Endoscopic Approach

Table D-12: Acceptable Aspirin Medications NOTE: The purpose of this list is to serve as a reference. If an organization finds a product not on this list that is appropriate for this patient population, it can be included. Non-aspirin and Aspirin Free medications should not be included.

Products Containing AspirinArthritis BC Powder Packet Aspirin Children's Easprin Arthritis Pain Aspirin-dipyridamole EC ASA ASA Aspirin EC Ecotrin ASA Baby Aspirin Enteric Coated Ecotrin Low Strength Adult ASA Baby Chewable Aspirin Litecoat Ecotrin Maximum StrengthASA Baby Coated Aspirin Lo-Dose EmpirinASA Bayer Aspirin Low Strength Enteric Coated Aspirin ASA Bayer Children's Bayer 8-hour Enteric Coated Baby Aspirin ASA Buffered Bayer Aspirin Excedrin – with aspirinASA Children’s Bayer Aspirin PM Extra Strength Extra Strength BayerASA EC Bayer Children’s FastprinASA Enteric Coated Bayer EC GenacoteAscriptin Bayer Enteric Coated GenninAscriptin Enteric Bayer Low Strength Gennin FCAspergum Bayer Plus GenprinAspir 81 EC Bayer Therapy EC HalfprinAspir-Low BL Adult Aspirin Norwich AspirinAspirin BL Aspirin St. Joseph AspirinAspirin Antacid Buffered ASA St. Joseph Aspirin ECAspirin Baby Buffered Aspirin St. Joseph Aspirin ChildrenAspirin Bayer Buffered Baby ASA Stanback AnalgesicAspirin Bayer Children's Bufferin Tri Buffered AspirinAspirin Buffered Bufferin Arthritis Strength YSP AspirinAspirin Child Bufferin Extra Strength ZorprinAspirin Child Chewable Coated Aspirin Zorprin SA

Table D-13: Acceptable Other Antiplatelet Medications

RXNORM Codes for Aspirin and Other Antiplatelets

119135212110732968


89

Oral Antiplatelet Medications Aggrenox® (Persantine and ASA) Pletal® (cilostazol)Plavix® (clopidogrel) Ticlid® (ticlopidine)Brilinta® (ticagrelor) Effient® (prasugrel)Persantine® (dipyridamole) Agrylin® (anagrelide)



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90



85581385581811166321116635111663611166391362082197374198466198471199274243663252380308411308414403924432389435504435521853499

Table D-14: Codes to identify contraindicationsICD-9

Diagnosis Codes

Description

430 Subarachnoid hemorrhage431 Intracerebral hemorrahage432.0 Nontraumatic extradural hemorrhage 432.1 Subdural hemorrhage432.9 Unspecified intracranial hemorrhage 456.0 Esophageal varices with bleeding456.20 Esophageal varices in diseases classified elsewhere with bleeding530.21 Ulcer of esophagus with bleeding530.4 Perforation of esophagus530.7 Gastroesophageal laceration-hemorrhage syndrome530.82 Esophageal hemorrhage531.00 Acute gastric ulcer with hemorrhage without obstruction531.01 Acute gastric ulcer with hemorrhage with obstruction531.10 Acute gastric ulcer with perforation without obstruction531.11 Acute gastric ulcer with perforation with obstruction531.20 Acute gastric ulcer with hemorrhage and perforation without obstruction531.21 Acute gastric ulcer with hemorrhage and perforation with obstruction532.00 Acute duodenal ulcer with hemorrhage without obstruction532.01 Acute duodenal ulcer with hemorrhage with obstruction532.10 Acute duodenal ulcer with perforation without obstruction


91



532.11 Acute duodenal ulcer with perforation with obstruction532.20 Acute duodenal ulcer with hemorrhage and perforation without obstruction532.21 Acute duodenal ulcer with hemorrhage and perforation with obstruction533.00 Acute peptic ulcer of unspecified site with hemorrhage without obstruction533.01 Acute peptic ulcer of unspecified site with hemorrhage with obstruction533.10 Acute peptic ulcer of unspecified site with perforation without obstruction533.11 Acute peptic ulcer of unspecified site with perforation with obstruction533.20 Acute peptic ulcer of unspecified site with hemorrhage and perforation without

obstruction533.21 Acute peptic ulcer of unspecified site with hemorrhage and perforation with obstruction534.00 Acute gastrojejunal ulcer with hemorrhage without obstruction534.01 Acute gastrojejunal ulcer with hemorrhage with obstruction534.10 Acute gastrojejunal ulcer with perforation without obstruction534.11 Acute gastrojejunal ulcer with perforation with obstruction534.20 Acute gastrojejunal ulcer with hemorrhage and perforation without obstruction534.21 Acute gastrojejunal ulcer with hemorrhage and perforation with obstruction531.40 Chronic or unspecified gastric ulcer with hemorrhage without obstruction531.41 Chronic or unspecified gastric ulcer with hemorrhage with obstruction531.50 Chronic or unspecified gastric ulcer with perforation without obstruction531.51 Chronic or unspecified gastric ulcer with perforation with obstruction531.60 Chronic or unspecified gastric ulcer with hemorrhage and perforation without obstruction531.61 Chronic or unspecified gastric ulcer with hemorrhage and perforation with obstruction532.40 Chronic or unspecified duodenal ulcer with hemorrhage without obstruction532.41 Chronic or unspecified duodenal ulcer with hemorrhage with obstruction532.50 Chronic or unspecified duodenal ulcer with perforation without obstruction532.51 Chronic or unspecified duodenal ulcer with perforation with obstruction532.60 Chronic or unspecified duodenal ulcer with hemorrhage and perforation without

obstruction532.61 Chronic or unspecified duodenal ulcer with hemorrhage and perforation with obstruction533.40 Chronic or unspecified peptic ulcer of unspecified site with hemorrhage without

obstruction533.41 Chronic or unspecified peptic ulcer of unspecified site with hemorrhage with obstruction533.50 Chronic or unspecified peptic ulcer of unspecified site with perforation without obstruction533.51 Chronic or unspecified peptic ulcer of unspecified site with perforation with obstruction533.60 Chronic or unspecified peptic ulcer of unspecified site with hemorrhage and perforation

without obstruction533.61 Chronic or unspecified peptic ulcer of unspecified site with hemorrhage and perforation

with obstruction534.40 Chronic or unspecified gastrojejunal ulcer with hemorrhage without obstruction534.41 Chronic or unspecified gastrojejunal ulcer with hemorrhage with obstruction534.50 Chronic or unspecified gastrojejunal ulcer with perforation without obstruction534.51 Chronic or unspecified gastrojejunal ulcer with perforation with obstruction534.60 Chronic or unspecified gastrojejunal ulcer with hemorrhage and perforation without

obstruction534.61 Chronic or unspecified gastrojejunal ulcer with hemorrhage and perforation with

obstruction535.01 Acute gastritis with hemorrhage535.11 Atrophic gastritis with hemorrhage


92



535.41 Other specified gastritis with hemorrhage535.51 Unspecified gastritis and gastroduodenitis with hemorrhage535.61 Duodenitis with hemorrhage537.83 Angiodysplasia of stomach and duodenum with hemorrhage578.0 Hematemesis569.83 Perforation of intestine569.3 Hemorrhage of rectum and anus562.12 Diverticulosis of colon with hemorrhage562.13 Diverticulitis of colon with hemorrhage562.02 Diverticulosis of small intestine with hemorrhage562.03 Diverticulitis of small intestine with hemorrhage569.85 Angiodysplasia of intestine with hemorrhage569.86 Dieulafoy lesion (hemorrhagic) of intestine578.1 Blood in stool (Hematochezia/Melena)578.9 Hemorrhage of gastrointestinal tract unspecified287.31 Idiopathic Thrombocytopenic Purpura (ITP)V45.86 Gastric bypass status

Effective 10/01/2015 ICD-10 CM Diagnosis

CodesDescription

I60.9 Nontraumatic subarachnoid hemorrhage, unspecifiedI60.00 Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcationI60.01 Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcationI60.02 Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcationI60.10 Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral arteryI60.11 Nontraumatic subarachnoid hemorrhage from right middle cerebral arteryI60.12 Nontraumatic subarachnoid hemorrhage from left middle cerebral arteryI60.20 Nontraumatic subarachnoid hemorrhage from unspecified anterior communicating arteryI60.21 Nontraumatic subarachnoid hemorrhage from right anterior communicating arteryI60.22 Nontraumatic subarachnoid hemorrhage from left anterior communicating arteryI60.30 Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating arteryI60.31 Nontraumatic subarachnoid hemorrhage from right posterior communicating arteryI60.32 Nontraumatic subarachnoid hemorrhage from left posterior communicating arteryI60.4 Nontraumatic subarachnoid hemorrhage from basilar arteryI60.50 Nontraumatic subarachnoid hemorrhage from unspecified vertebral arteryI60.51 Nontraumatic subarachnoid hemorrhage from right vertebral arteryI60.52 Nontraumatic subarachnoid hemorrhage from left vertebral arteryI60.6 Nontraumatic subarachnoid hemorrhage from other intracranial arteriesI60.7 Nontraumatic subarachnoid hemorrhage from unspecified intracranial arteryI60.8 Other nontraumatic subarachnoid hemorrhageI61.0 Nontraumatic intracerebral hemorrhage in hemisphere, subcorticalI61.1 Nontraumatic intracerebral hemorrhage in hemisphere, corticalI61.2 Nontraumatic intracerebral hemorrhage in hemisphere, unspecifiedI61.3 Nontraumatic intracerebral hemorrhage in brain stem


93



I61.4 Nontraumatic intracerebral hemorrhage in cerebellumI61.5 Nontraumatic intracerebral hemorrhage, intraventricularI61.6 Nontraumatic intracerebral hemorrhage, multiple localizedI61.8 Other nontraumatic intracerebral hemorrhageI61.9 Nontraumatic intracerebral hemorrhage, unspecifiedI62.1 Nontraumatic extradural hemorrhageI62.00 Nontraumatic subdural hemorrhage, unspecifiedI62.01 Nontraumatic acute subdural hemorrhageI62.02 Nontraumatic subacute subdural hemorrhageI62.03 Nontraumatic chronic subdural hemorrhageI62.9 Nontraumatic intracranial hemorrhage, unspecifiedI85.01 Esophageal varices with bleedingI85.11 Secondary esophageal varices with bleedingK22.11 Ulcer of esophagus with bleedingK22.3 Perforation of esophagusK22.6 Gastro-esophageal laceration-hemorrhage syndromeK22.8 Other specified diseases of esophagusK25.0 Acute gastric ulcer with hemorrhageK25.1 Acute gastric ulcer with perforationK25.2 Acute gastric ulcer with both hemorrhage and perforationK26.0 Acute duodenal ulcer with hemorrhageK26.1 Acute duodenal ulcer with perforationK26.2 Acute duodenal ulcer with both hemorrhage and perforationK27.0 Acute peptic ulcer, site unspecified, with hemorrhageK27.1 Acute peptic ulcer, site unspecified, with perforationK27.2 Acute peptic ulcer, site unspecified, with both hemorrhage and perforationK28.0 Acute gastrojejunal ulcer with hemorrhageK28.1 Acute gastrojejunal ulcer with perforationK28.2 Acute gastrojejunal ulcer with both hemorrhage and perforationK25.4 Chronic or unspecified gastric ulcer with hemorrhageK25.5 Chronic or unspecified gastric ulcer with perforationK25.6 Chronic or unspecified gastric ulcer with both hemorrhage and perforationK26.4 Chronic or unspecified duodenal ulcer with hemorrhageK26.5 Chronic or unspecified duodenal ulcer with perforationK26.6 Chronic or unspecified duodenal ulcer with both hemorrhage and perforationK27.4 Chronic or unspecified peptic ulcer, site unspecified, with hemorrhageK27.5 Chronic or unspecified peptic ulcer, site unspecified, with perforationK27.6 Chronic or unspecified peptic ulcer, site unspecified, with both hemorrhage and

perforationK28.4 Chronic or unspecified gastrojejunal ulcer with hemorrhageK28.5 Chronic or unspecified gastrojejunal ulcer with perforationK28.6 Chronic or unspecified gastrojejunal ulcer with both hemorrhage and perforationK29.01 Acute gastritis with bleedingK29.41 Chronic atrophic gastritis with bleedingK29.51 Unspecified chronic gastritis with bleedingK29.61 Other gastritis with bleedingK29.71 Gastritis, unspecified, with bleeding


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K29.91 Gastroduodenitis, unspecified, with bleedingK29.81 Duodenitis with bleedingK31.811 Angiodysplasia of stomach and duodenum with bleedingK92.0 HematemesisK63.1 Perforation of intestine (nontraumatic)K62.5 Hemorrhage of anus and rectumK57.31 Diverticulosis of large intestine without perforation or abscess with bleedingK57.33 Diverticulitis of large intestine without perforation or abscess with bleedingK57.11 Diverticulosis of small intestine without perforation or abscess with bleedingK57.13 Diverticulitis of small intestine without perforation or abscess with bleedingK55.21 Angiodysplasia of colon with hemorrhageK63.81 Dieulafoy lesion of intestineK92.1 MelenaK92.2 Gastrointestinal hemorrhage, unspecifiedD69.3 Idiopathic thrombocytopenic purpura (ITP) Z98.84 Gastric Bypass Status

ICD-9 Procedure

Codes

Description

44.39 Gastric Bypass44.31 Gastric Bypass, high (Printen and Mason)44.38 Gastric Bypass, laparoscopic

Effective 10/01/2015 ICD-10

Procedure Codes

Description

0D16079 Bypass Stomach to Duodenum with Autologous Tissue Substitute, Open Approach0D1607A Bypass Stomach to Jejunum with Autologous Tissue Substitute, Open Approach0D160J9 Bypass Stomach to Duodenum with Synthetic Substitute, Open Approach0D160JA Bypass Stomach to Jejunum with Synthetic Substitute, Open Approach0D160K9 Bypass Stomach to Duodenum with Nonautologous Tissue Substitute, Open Approach0D160KA Bypass Stomach to Jejunum with Nonautologous Tissue Substitute, Open Approach0D160Z9 Bypass Stomach to Duodenum, Open Approach0D160ZA Bypass Stomach to Jejunum, Open Approach0D16879 Bypass Stomach to Duodenum with Autologous Tissue Substitute, Via Natural or Artificial

Opening Endoscopic0D1687A Bypass Stomach to Jejunum with Autologous Tissue Substitute, Via Natural or Artificial

Opening Endoscopic0D168J9 Bypass Stomach to Duodenum with Synthetic Substitute, Via Natural or Artificial Opening

Endoscopic0D168JA Bypass Stomach to Jejunum with Synthetic Substitute, Via Natural or Artificial Opening

Endoscopic0D168K9 Bypass Stomach to Duodenum with Nonautologous Tissue Substitute, Via Natural or


95



Artificial Opening Endoscopic0D168KA Bypass Stomach to Jejunum with Nonautologous Tissue Substitute, Via Natural or

Artificial Opening Endoscopic0D168Z9 Bypass Stomach to Duodenum, Via Natural or Artificial Opening Endoscopic0D168ZA Bypass Stomach to Jejunum, Via Natural or Artificial Opening Endoscopic0D16479 Bypass Stomach to Duodenum with Autologous Tissue Substitute, Percutaneous

Endoscopic Approach0D1647A Bypass Stomach to Jejunum with Autologous Tissue Substitute, Percutaneous

Endoscopic Approach0D164J9 Bypass Stomach to Duodenum with Synthetic Substitute, Percutaneous Endoscopic

Approach0D164JA Bypass Stomach to Jejunum with Synthetic Substitute, Percutaneous Endoscopic

Approach0D164K9 Bypass Stomach to Duodenum with Nonautologous Tissue Substitute, Percutaneous

Endoscopic Approach0D164KA Bypass Stomach to Jejunum with Nonautologous Tissue Substitute, Percutaneous

Endoscopic Approach0D164Z9 Bypass Stomach to Duodenum, Percutaneous Endoscopic Approach0D164ZA Bypass Stomach to Jejunum, Percutaneous Endoscopic Approach


43846 Gastric restrictive procedure, with gastric bypass for morbid obesity43847 Gastric restrictive procedure, with gastric bypass for morbid obesity, with small intestine

reconstruction to limit absorption43644 Laparoscopy, surgical, gastric restrictive procedure, with gastric bypass and Roux-en-Y

gastroenterostomy43645 Laparoscopy, surgical, gastric restrictive procedure, with gastric bypass and small

intestine reconstruction to limit absorption

Table D-15: Acceptable Statin Medications AdvicorAltoprevAtorvastatinAtorvastatin/amlodipineAtorvastatin/ezetimibeCaduetCrestorFluvastatinFluvastatin XLJuvisyncLescolLescol XLLipitorLiptruzetLivalo


96



LovastatinLovastatin/niacinMevacorPitavastatinPravacholPravafenixPravastatinPravastatin/fenofibrateRosuvastatinSimcorSimvastatinSimvastatin/ezetimibeSimvastatin/niacinSimvastatin/sitagliptinVytorinZocor

RXNORM Codes for Statins6472

365674112742463728758336683367

103918103919104490104491151972152923153165196503197903197904197905198211200345203144203333


97



206257206258208220209013213319224938259255262095301542310404310405312961312962314231316174316175316176316672316673316674316675317497320864323828327008328265328267329299330788352387353377359731359732360507404011404013404773404775404914


98



433848433849476345476349476350476351484211495215541841541845542190542195563452563453563653563654565109567115567116568935573220574676582041582042582043597966597967597970597971597974597977597980597983597984597987597990597993617310617311


99



617312617313617314617317617318617319617320644112687047687048729605750197750199750201750203750205750207750209750211750213750215750217750219750221750223750225750227750229750231750233750235750237750239757702757703757704757705761907761909


100



762970763226763228763230763232763234763236791832791834791836791838791840791842791844791846803516859418859419859420859421859423859424859425859426859746859747859748859749859750859751859752859753861612861634861640861641861643861644861646


101



861647861648861649861650861651861652861653861654884383904457904458904459904460904466904467904468904469904474904475904476904477904480904481904482904483904664904668997006997007999935999937999939999942999944999946

1152281115228211579911157992


102



115810811581091158284115828511587531158754116169111616921163274116379111637921164454116534411653451165346116534711656601165661116606111660621169988116998911701931170826117132011713231173051117305311774001177401117751211775131179132117913311826241182627118463811846391187973


103



118797411898001189801118980311898041189808118981211898131189821118982311898271245416124542012454201245426124543012454371245439124544012454411245445124544912953231297766131240913124161312423137273113727541422082142208314220851422086142208714220881422090142209114220921422093


104



14220941422095142209614220971422098142209914221001422101143089214398851439886143988814398971483793179067617906771790679

Table D-16: Acceptable Anticoagulant Medications Warfarin (Coumadin/Jantoven)Rivaroxaban (Xarelto)Dabigatran (Pradaxa)Apixaban (Eliquis)Edoxaban (Savaysa)

RXNORM Codes for Anticoagulants

11289202421855288855290855296855298855302855304855306855308855310855312855314855316855318


105



855320855324855326855332855334855336855338855340855344855346

103704510370461037049103717910371811114195111419811141991114202123208212320841232086123208813644301364435136443613644451364447

Table D-17: ACE Inhibitors/ARBs AccuprilAccureticAceonAltaceAmLODIPine Besylate-Benazepril HydrochlorideAmLODIPine Besylate-TelmisartanAmLODIPine Besylate-ValsartanAmlodipine/Hydrochlorothiazide/ValsartanAtacandAtacand HCTAvalideAvaproAzilsartanAzorBenazepril HydrochlorideBenazepril-Hydrochlorothiazide


106



BenicarBenicar HCTCandesartan CilexetilCandesartan Cilexetil-HydrochlorothiazideCaptoprilCaptopril-HydrochlorothiazideCozaarDiovanDiovan HCTEdarbiEdarbyclorEnalapril MaleateEnalaprilatEnalapril-HydrochlorothiazideEpanedEprosartan MesylateExforgeExforge HCTFosinopril SodiumFosinopril-HydrochlorothiazideHydrochlorothiazide-IrbesartanHydrochlorothiazide-LisinoprilHydrochlorothiazide-LosartanHydrochlorothiazide-Moexipril HydrochlorideHydrochlorothiazide-Quinapril HydrochlorideHydrochlorothiazide-TelmisartanHydrochlorothiazide-ValsartanHyzaarIrbesartanLisinoprilLosartan PotassiumLotensinLotensin HCTLotrelMavikMicardisMicardis HCTMoexipril HydrochlorideOlmesartanPerindopril ErbuminePrinivilPrinzideQuinapril HydrochlorideRamipril


107



TarkaTelmisartanTevetenTeveten HCTTrandolaprilTrandolapril-Verapamil HydrochlorideTribenzorTwynstaUnireticUnivascValsartanValturnaVaseretic 10-25Vaseretic 5-12.5VasotecZestoreticZestril

RXNORM Codes for ACE/ARBs1998382738291886729046290463013135208352963845450166521755455269749722107349483818104375104376104377104378104384104385151482151558153665


108



153666153667153668153822153823196472197436197437197438197439197884197885197886197887198188198189199351199352199353199622199816199817199850199919200094200095200096200284200285203644205304205305205326206764206765206766206771207891207892207893207895207961207965210672210673213431


109



213432213482214223214287214354214536214618215458216652218088218245218353224921225030247516251856251857260333261962262418282755283316283317284531308962308963308964310139310140310792310793310796310797310809311353311354312748312749312750314076314077314203317173321064327503349199


110



349200349201349353349373349401349405349483351292351293351761351762352001352199352200352201352274401965401968403853403854403855411434477130485471577776577785577787578325578330636042636045639537639539639543722126722131722134722137724879724887724891724895730861730862730866730869


111



730872744632749833749837749841802749805855805859805863809014809018809022809026809030809858823934823938823942823971823982823986833237845488845489847042847055847060848131848134848135848139848140848145848151854925854984854988857166857169857171857174857183857187857189858618


112



858621858804858806858810858812858813858815858817858819858821858824858828858830858921876514876519876524876529882559897781897783897844897853898342898344898346898348898350898352898353898355898356898358898359898361898362898366898367898371898372898376898378898687898689898690898692


113



89871989872189872389872597946497946697946897947097947197947397948097948297948597948797949297949499996799998699999199999599999610000001000001100000510117181011729109165012998591299859129986112998711299871129989012998901299896129989612998971299897129995912999631299965172920017292011729205


114



TABLE D-18: Codes to Identify End Stage Renal Disease (ESRD)ICD-9-CM Diagnosis

CodesDescription

585.5 Chronic Kidney Disease, Stage V585.6 End Stage Renal Disease, (ESRD)V42.0 Kidney Transplant statusV45.1x Renal dialysis status V45.11 Renal dialysis status (postprocedural) V45.12 Noncompliance with renal dialysis



N18.5 Chronic kidney disease, stage 5N18.6 End stage renal diseaseZ94.0 Kidney transplant statusZ48.22 Encounter for aftercare following kidney transplantZ99.2 Dependence on renal dialysisZ91.15 Patient's noncompliance with renal dialysis

CPT Codes Description36145 Introduction of needle or intracatheter; arteriovenous shunt created for dialysis

(cannula, fistula, or graft)36147 Introduction of needle and/or catheter, arteriovenous shunt created for dialysis36800 Insertion on cannula for hemodialysis, other purpose; vein to vein36810 Insertion of cannula – arteriovenous, external36815 Insertion of cannula – arteriovenous, external revision, or closure36818 Insertion of cannula – arteriovenous, external revision, or closure, upper arm36819 Arteriovenous anastomosis, open, by upper arm basilic vein transposition36820 Hemodialysis access, forearm vein transportation 36821 Hemodialysis access direct, any site 36831 Thrombectomy, open, arteriovenous fistula without revision, autogenous or

nonautogenous dialysis graft36832 Revision, open, arteriovenous fistula, without thrombectomy, autogenous or

nonautogenous dialysis graft36833 Revision, open, arteriovenous fistula with thrombectomy, autogenous or

nonautogenous dialysis graft50300 Donor nephrectomy, with preparation and maintenance of allograft, from cadaver

donor50320 Donor nephrectomy from living donor50340 Recipient nephrectomy50360 Renal allotransplantation, implantation of graft50365 Renal allotransplantation, with recipient nephrectomy50370 Removal of transplanted renal allograft


115



50380 Renal autotransplantation, reimplantation of kidney90935 Hemodialysis procedure with single physician evaluation90937 Hemodialysis procedure requiring repeat evaluations90940 Hemodialysis access flow study to determine blood flow in grafts and

arteriovenous fistulae by an indicator method (was previously reported as code 90939)

90945 Dialysis procedure other than hemodialysis with single physician evaluation90947 Dialysis procedure other than hemodialysis requiring repeated physician

evaluations90957 ESRD Related Services monthly, for patients 12-19 years of age to include

monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month

90958 ESRD Related Services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face physician visits per month

90959 ESRD Related Services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month

90960 ESRD Related Services monthly, for patients 20 years of age and older; with 4 or more face-to-face physician visits per month

90961 ESRD Related Services monthly, for patients 20 years of age and older; with 2-3 face-to-face physician visits per month

90962 ESRD Related Services monthly, for patients 20 years of age and older; with 1 face-to-face physician visit per month

90965 ESRD Related Services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents

90966 ESRD Related Services for home dialysis per full month, for patients 20 years of age and older

90969 ESRD related services for dialysis less than a full month of service, per day; for patients 12-19 years of age

90970 ESRD related services for dialysis less than a full month of service, per day; for patients 20 years of age and older

90989 Dialysis training, patient, completed course90993 Dialysis training, patient, course not completed90997 Hemoperfusion90999 Unlisted dialysis procedure, inpatient or outpatient99512 Home visit for hemodialysis

HCPCS Codes DescriptionG0257 ESRD ServicesG0392 Transluminal balloon angioplasty, percutaneous: for maintenance of

hemodialysis access, arteriovenous fistula or graft; arterialG0393 Transluminal balloon angioplasty, percutaneous: for maintenance of

hemodialysis access, arteriovenous fistula or graft; venous


116



S9339 Home Therapy, Peritoneal Dialysis

ICD-9-CM Procedure Codes Description

38.95 Venous catheterization for renal dialysis39.27 Arteriovenostomy for renal dialysis39.42 Revision of arteriovenous shunt for renal dialysis39.43 Removal of shunt for renal dialysis39.53 Repair of arteriovenous fistula39.53 Repair of arteriovenous fistula39.93 Insertion of vessel-to-vessel cannula39.94 Replacement of vessel-to-vessel cannula39.95 Hemodialysis54.98 Peritoneal dialysis55.6x Transplant of Kidney 55.61 Renal autotransplantation 55.69 Other kidney transplantation


Procedure Codes Description

5A1D00Z Performance of Urinary Filtration, Single5A1D60Z Performance of Urinary Filtration, Multiple3E1M39Z Irrigation of Peritoneal Cavity using Dialysate, Percutaneous Approach0TS00ZZ Reposition Right Kidney, Open Approach0TS10ZZ Reposition Left Kidney, Open Approach0TY00Z0 Transplantation of Right Kidney, Allogeneic, Open Approach0TY00Z1 Transplantation of Right Kidney, Syngeneic, Open Approach0TY00Z2 Transplantation of Right Kidney, Zooplastic, Open Approach0TY10Z0 Transplantation of Left Kidney, Allogeneic, Open Approach0TY10Z1 Transplantation of Left Kidney, Syngeneic, Open Approach0TY10Z2 Transplantation of Left Kidney, Zooplastic, Open Approach

UB-92 Revenue Codes Description

080x Inpatient Renal Dialysis 0800 Sessions Inpatient Renal Dialysis – General 0801 Sessions Inpatient Renal Dialysis – Inpatient Hemodialysis 0802 Sessions Inpatient Renal Dialysis – Inpatient Peritoneal (non-CAPD) 0803 Sessions Inpatient Renal Dialysis – Inpatient Continuous Ambulatory Peritoneal

Dialysis (CAPD) 0804 Sessions Inpatient Renal Dialysis – Other Inpatient Dialysis 0809 Sessions Inpatient Renal Dialysis – Other Inpatient Dialysis082x Hemodialysis-Outpatient or Home 0820 Sessions Hemodialysis – Outpatient or Home – General


117



0821 Sessions Hemodialysis – Outpatient or Home – Hemodialysis / Composite or Other Rate

0822 Sessions Hemodialysis – Outpatient or Home – Home Supplies 0823 Sessions Hemodialysis – Outpatient or Home – Home Equipment 0824 Sessions Hemodialysis – Outpatient or Home – Maintenance / 100% 0825 Sessions Hemodialysis – Outpatient or Home – Support Services 0829 Sessions Hemodialysis – Outpatient or Home – Other Outpatient Hemodialysis083x Peritoneal Dialysis-Outpatient or Home 0830 Sessions Peritoneal Dialysis – Outpatient or Home – General 0831 Sessions Peritoneal Dialysis – Outpatient or Home – Peritoneal / Composite or

Other Rate 0832 Sessions Peritoneal Dialysis – Outpatient or Home – Home Supplies 0833 Sessions Peritoneal Dialysis – Outpatient or Home – Home Equipment 0834 Sessions Peritoneal Dialysis – Outpatient or Home – Maintenance / 100% 0835 Sessions Peritoneal Dialysis – Outpatient or Home – Support Services 0839 Sessions Peritoneal Dialysis – Outpatient or Home – Other Outpatient Peritoneal

Dialysis084x CAPD-Outpatient or Home 0840 CAPD – Outpatient or Home – General 0841 CAPD – Outpatient or Home – CAPD / Composite or Other Rate 0842 CAPD – Outpatient or Home – Home Supplies 0843 CAPD – Outpatient or Home – Home Equipment 0844 CAPD – Outpatient or Home – Maintenance / 100% 0845 CAPD – Outpatient or Home – Support Services 0849 CAPD – Outpatient or Home – Other Outpatient CAPD085x CCPD-Outpatient or Home 0850 CCPD – Outpatient or Home – General 0851 CCPD – Outpatient or Home – CCPD / Composite or Other Rate 0852 CCPD – Outpatient or Home – Home Supplies 0853 CCPD – Outpatient or Home – Home Equipment 0854 CCPD – Outpatient or Home – Maintenance / 100% 0855 CCPD – Outpatient or Home – Support Services 0859 CCPD – Outpatient or Home – Other Outpatient CCPD Dialysis086X RESERVED FOR DIALYSIS (NATIONAL ASSIGNMENT)087x RESERVED FOR DIALYSIS (NATIONAL ASSIGNMENT)088x Miscellaneous Dialysis 0880 Sessions Miscellaneous Dialysis – General 0881 Sessions Miscellaneous Dialysis – Ultra filtration 0882 Sessions Miscellaneous Dialysis – Home Dialysis Aid Visit 0889 Sessions Miscellaneous Dialysis – Miscellaneous Dialysis Other

UB Type of Bill Codes Description

721 Clinic-Hospital Based or Independent Renal Dialysis Center (Admit through Discharge Claim)

722 Clinic-Hospital Based or Independent Renal Dialysis Center (Interim-First Claim)723 Clinic-Hospital Based or Independent Renal Dialysis Center (Interim-Continuing

Claim)


118



724 Clinic-Hospital Based or Independent Renal Dialysis Center (Interim-Last Claim)725 Clinic-Hospital Based or Independent Renal Dialysis Center (Late Charges Only

Claim)727 Clinic-Hospital Based or Independent Renal Dialysis Center (Replacement of

Prior Claim)729 Clinic-Hospital Based or Independent Renal Dialysis Center (Final Claim for a

Home Health PPS Episode)MS DRG’s Description (effective October 1, 2007)

682 Renal Failure with MCC683 Renal Failure with CC684 Renal Failure without MCC or CC685 Admission for Renal Dialysis

TABLE D-19: Codes to Identify PregnancyICD-9-CM Diagnosis

CodesDescription

630Hydatidiform mole (Trophoblastic disease NOS; Vesicularmole) (excludes: chorioadenoma (destruens) (236.1); chorionepithelioma (181); malignant hydatidiform mole (236.1))

631 Other abnormal product of conception (blighted ovum; mole: NOS, carneous, fleshy, stone)631.0 Inappropriate change in quantitative human chorionic gonadotropin (hCG) in early pregnancy631.8 Other abnormal product of conception

632

Missed abortion (Early fetal death before completion of 22 weeks’ gestation with retention of dead fetus; Retained products of conception, not following spontaneous or induced abortion or delivery) (excludes: failed induced abortion (638.0-638.9); fetal

633.00 Abdominal pregnancy without intrauterine pregnancy633.01 Abdominal pregnancy with intrauterine pregnancy633.10 Tubal pregnancy without intrauterine pregnancy633.11 Tubal pregnancy with intrauterine pregnancy633.20 Ovarian pregnancy without intrauterine pregnancy633.21 Ovarian pregnancy with intrauterine pregnancy633.80 Other ectopic pregnancy without intrauterine pregnancy633.81 Other ectopic pregnancy with intrauterine pregnancy633.90 Unspecified ectopic pregnancy without intrauterine pregnancy633.91 Unspecified ectopic pregnancy with intrauterine pregnancy634.00 Unspecified spontaneous abortion complicated by genital tract and pelvic infection634.01 Incomplete spontaneous abortion complicated by genital tract and pelvic infection634.02 Complete spontaneous abortion complicated by genital tract and pelvic infection634.10 Unspecified spontaneous abortion complicated by delayed or excessive hemorrhage634.11 Incomplete spontaneous abortion complicated by delayed or excessive hemorrhage634.12 Complete spontaneous abortion complicated by delayed or excessive hemorrhage634.20 Unspecified spontaneous abortion complicated by damage to pelvic organs or tissues634.21 Incomplete spontaneous abortion complicated by damage to pelvic organs or tissues634.22 Complete spontaneous abortion complicated by damage to pelvic organs or tissues634.30 Unspecified spontaneous abortion complicated by renal failure634.31 Incomplete spontaneous abortion complicated by renal failure634.32 Complete spontaneous abortion complicated by renal failure634.40 Unspecified spontaneous abortion complicated by metabolic disorder


119



634.41 Incomplete spontaneous abortion complicated by metabolic disorder634.42 Complete spontaneous abortion complicated by metabolic disorder634.50 Unspecified spontaneous abortion complicated by shock634.51 Incomplete spontaneous abortion complicated by shock634.52 Incomplete spontaneous abortion complicated by shock634.60 Unspecified spontaneous abortion complicated by embolism634.61 Incomplete spontaneous abortion complicated by embolism634.62 Complete spontaneous abortion complicated by embolism634.70 Unspecified spontaneous abortion with other specified complications634.71 Incomplete spontaneous abortion with other specified complications634.72 Complete spontaneous abortion with other specified complications634.80 Unspecified spontaneous abortion with unspecified complication634.81 Incomplete spontaneous abortion with unspecified complication634.82 Complete spontaneous abortion with unspecified complication634.90 Unspecified spontaneous abortion without mention of complication634.91 Incomplete spontaneous abortion without mention of complication634.92 Complete spontaneous abortion without mention of complication635.00 Unspecified legally induced abortion complicated by genital tract and pelvic infection635.01 Incomplete legally induced abortion complicated by genital tract and pelvic infection635.02 Complete legally induced abortion complicated by genital tract and pelvic infection635.10 Unspecified legally induced abortion complicated by delayed or excessive hemorrhage635.11 Incomplete legally induced abortion complicated by delayed or excessive hemorrhage635.12 Complete legally induced abortion complicated by delayed or excessive hemorrhage635.20 Unspecified legally induced abortion complicated by damage to pelvic organs or tissues635.21 Legally induced abortion complicated by damage to pelvic organs or tissues, incomplete635.22 Complete legally induced abortion complicated by damage to pelvic organs or tissues635.30 Unspecified legally induced abortion complicated by renal failure635.31 Incomplete legally induced abortion complicated by renal failure635.32 Complete legally induced abortion complicated by renal failure635.40 Unspecified legally induced abortion complicated by metabolic disorder635.41 Incomplete legally induced abortion complicated by metabolic disorder635.42 Complete legally induced abortion complicated by metabolic disorder635.50 Unspecified legally induced abortion complicated by shock635.51 Legally induced abortion, complicated by shock, incomplete635.52 Complete legally induced abortion complicated by shock635.60 Unspecified legally induced abortion complicated by embolism635.61 Incomplete legally induced abortion complicated by embolism635.62 Complete legally induced abortion complicated by embolism635.70 Unspecified legally induced abortion with other specified complications635.71 Incomplete legally induced abortion with other specified complications635.72 Complete legally induced abortion with other specified complications635.80 Unspecified legally induced abortion with unspecified complication635.81 Incomplete legally induced abortion with unspecified complication635.82 Complete legally induced abortion with unspecified complication635.90 Unspecified legally induced abortion without mention of complication635.91 Incomplete legally induced abortion without mention of complication635.92 Complete legally induced abortion without mention of complication636.00 Unspecified illegally induced abortion complicated by genital tract and pelvic infection


120



636.01 Incomplete illegally induced abortion complicated by genital tract and pelvic infection636.02 Complete illegally induced abortion complicated by genital tract and pelvic infection636.10 Unspecified illegally induced abortion complicated by delayed or excessive hemorrhage636.11 Incomplete illegally induced abortion complicated by delayed or excessive hemorrhage636.12 Complete illegally induced abortion complicated by delayed or excessive hemorrhage636.20 Unspecified illegally induced abortion complicated by damage to pelvic organs or tissues636.21 Complicated by damage to pelvic organs or tissues636.22 Complete illegally induced abortion complicated by damage to pelvic organs or tissues636.30 Unspecified illegally induced abortion complicated by renal failure636.31 Incomplete illegally induced abortion complicated by renal failure636.32 Complete illegally induced abortion complicated by renal failure636.40 Unspecified illegally induced abortion complicated by metabolic disorder636.41 Incomplete illegally induced abortion complicated by metabolic disorder636.42 Complete illegally induced abortion complicated by metabolic disorder636.50 Unspecified illegally induced abortion complicated by shock636.51 Incomplete illegally induced abortion complicated by shock636.52 Complete illegally induced abortion complicated by shock636.60 Unspecified illegally induced abortion complicated by embolism636.61 Incomplete illegally induced abortion complicated by embolism636.62 Complete illegally induced abortion complicated by embolism636.70 Unspecified illegally induced abortion with other specified complications636.71 Incomplete illegally induced abortion with other specified complications636.72 Complete illegally induced abortion with other specified complications636.80 Unspecified illegally induced abortion with unspecified complication636.81 Incomplete illegally induced abortion with unspecified complication636.82 Complete illegally induced abortion with unspecified complication636.90 Unspecified illegally induced abortion without mention of complication636.91 Incomplete illegally induced abortion without mention of complication636.92 Complete illegally induced abortion without mention of complication

637.00Abortion, unspecified as to completion or legality, complicated by genital tract and pelvic infection

637.01 Legally unspecified abortion, incomplete, complicated by genital tract and pelvic infection637.02 Legally unspecified abortion, complete, complicated by genital tract and pelvic infection

637.10Abortion, unspecified as to completion or legality, complicated by delayed or excessive hemorrhage

637.11 Legally unspecified abortion, incomplete, complicated by delayed or excessive hemorrhage637.12 Legally unspecified abortion, complete, complicated by delayed or excessive hemorrhage

637.20Abortion, unspecified as to completion or legality, complicated by damage to pelvic organs or tissues

637.21 Legally unspecified abortion, incomplete, complicated by damage to pelvic organs or tissues637.22 Legally unspecified abortion, complete, complicated by damage to pelvic organs or tissues637.30 Abortion, unspecified as to completion or legality, complicated by renal failure637.31 Legally unspecified abortion, incomplete, complicated by renal failure637.32 Legally unspecified abortion, complete, complicated by renal failure637.40 Abortion, unspecified as to completeness or legality, complicated by metabolic disorder637.41 Legally unspecified abortion, incomplete, complicated by metabolic disorder637.42 Legally unspecified abortion, complete, complicated by metabolic disorder637.50 Abortion, unspecified as to completion or legality, complicated by shock637.51 Legally unspecified abortion, incomplete, complicated by shock


121



637.52 Legally unspecified abortion, complete, complicated by shock637.60 Abortion, unspecified as to completion or legality, complicated by embolism637.61 Legally unspecified abortion, incomplete, complicated by embolism637.62 Legally unspecified abortion, complete, complicated by embolism637.70 Abortion, unspecified as to completion or legality, with other specified complications637.71 Legally unspecified abortion, incomplete, with other specified complications637.72 Legally unspecified abortion, complete, with other specified complications637.80 Abortion, unspecified as to completion or legality, with unspecified complication637.81 Legally unspecified abortion, incomplete, with unspecified complication637.82 Legally unspecified abortion, complete, with unspecified complication

637.90Unspecified type of abortion, unspecified as to completion or legality, without mention of complication

637.91 Legally unspecified abortion, incomplete, without mention of complication637.92 Legally unspecified abortion, complete, without mention of complication638.0 Complicated by genital tract and pelvic infection638.1 Complicated by delayed or excessive hemorrhage638.2 Complicated by damage to pelvic organs or tissues638.3 Complicated by renal failure638.4 Complicated by metabolic disorder638.5 Complicated by shock638.6 Complicated by embolism638.7 With other specified complications638.8 With unspecified complication638.9 Without mention of complication639.0 Genital tract and pelvic infection639.1 Delayed or excessive hemorrhage639.2 Damage to pelvic organs and tissues639.3 Kidney failure639.4 Metabolic disorders639.5 Shock639.6 Embolism639.8 Other specified complications following abortion or ectopic and molar pregnancy639.9 Unspecified complication following abortion or ectopic and molar pregnancy640.00 Threatened abortion, unspecified as to episode of care640.01 Threatened abortion unspecified as to episode of care640.03 Threatened abortion, antepartum640.80 Other specified hemorrhage in early pregnancy, unspecified as to episode of care640.81 Other specified hemorrhage in early pregnancy, delivered640.83 Other specified hemorrhage in early pregnancy, antepartum640.90 Unspecified hemorrhage in early pregnancy, unspecified as to episode of care640.91 Unspecified hemorrhage in early pregnancy, delivered640.93 Unspecified hemorrhage in early pregnancy, antepartum641.00 Placenta previa without hemorrhage, unspecified as to episode of care641.01 Placenta previa without hemorrhage, with delivery641.03 Placenta previa without hemorrhage, antepartum641.10 Hemorrhage from placenta previa, unspecified as to episode of care641.11 Hemorrhage from placenta previa, with delivery641.13 Hemorrhage from placenta previa, antepartum


122



641.20 Premature separation of placenta, unspecified as to episode of care641.21 Premature separation of placenta, with delivery641.23 Premature separation of placenta, antepartum

641.30Antepartum hemorrhage associated with coagulation defects, unspecified as to episode of care

641.31 Antepartum hemorrhage associated with coagulation defects, with delivery641.33 Antepartum hemorrhage associated with coagulation defect, antepartum641.80 Other antepartum hemorrhage, unspecified as to episode of care641.81 Other antepartum hemorrhage, with delivery641.83 Other antepartum hemorrhage, antepartum641.90 Unspecified antepartum hemorrhage, unspecified as to episode of care641.91 Unspecified antepartum hemorrhage, with delivery641.93 Unspecified antepartum hemorrhage, antepartum

642.00Benign essential hypertension complicating pregnancy, childbirth, and the puerperium, unspecified as to episode of care

642.01 Benign essential hypertension with delivery642.02 Benign essential hypertension, with delivery, with current postpartum complication642.03 Benign essential hypertension antepartum642.04 Benign essential hypertension, previous postpartum complication

642.10Hypertension secondary to renal disease, complicating pregnancy, childbirth, and the puerperium, unspecified as to episode of care

642.11 Hypertension secondary to renal disease, with delivery642.12 Hypertension secondary to renal disease, with delivery, with current postpartum complication642.13 Hypertension secondary to renal disease, antepartum642.14 Hypertension secondary to renal disease, previous postpartum condition

642.20Other pre-existing hypertension complicating pregnancy, childbirth, and the puerperium, unspecified as to episode of care

642.21 Other pre-existing hypertension, with delivery642.22 Other pre-existing hypertension, with delivery, with current postpartum complication642.23 Other pre-existing hypertension, antepartum642.24 Other pre-existing hypertension, previous postpartum condition642.30 Transient hypertension of pregnancy, unspecified as to episode of care642.31 Transient hypertension of pregnancy, with delivery642.32 Transient hypertension of pregnancy, with delivery, with current postpartum complication642.33 Transient hypertension of pregnancy, with delivery, with current postpartum complication642.34 Transient hypertension of pregnancy, previous postpartum condition642.40 Mild or unspecified pre-eclampsia, unspecified as to episode of care642.41 Mild or unspecified pre-eclampsia, with delivery642.42 Mild or unspecified pre-eclampsia, with delivery, with current postpartum complication642.43 Mild or unspecified pre-eclampsia, antepartum642.44 Mild or unspecified pre-eclampsia, previous postpartum condition642.50 Severe pre-eclampsia, unspecified as to episode of care642.51 Severe pre-eclampsia, with delivery642.52 Severe pre-eclampsia, with delivery, with current postpartum complication642.53 Severe pre-eclampsia, antepartum642.54 Severe pre-eclampsia, previous postpartum condition

642.60Eclampsia complicating pregnancy, childbirth or the puerperium, unspecified as to episode of care

642.61 Eclampsia, with delivery


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642.62 Eclampsia, with delivery, with current postpartum complication642.63 Eclampsia, antepartum642.64 Eclampsia, previous postpartum condition

642.70Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

642.71 Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, with delivery

642.72Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, with delivery, with current postpartum complication

642.73 Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, antepartum642.74 Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, postpartum

642.90Unspecified hypertension complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

642.91 Unspecified hypertension, with delivery642.92 Unspecified hypertension, with delivery, with current postpartum complication642.93 Unspecified hypertension, with delivery, with current postpartum complication642.94 Unspecified hypertension, previous postpartum condition643.00 Mild hyperemesis gravidarum, unspecified as to episode of care643.01 Mild hyperemesis gravidarum, delivered643.03 Mild hyperemesis gravidarum, antepartum643.10 Hyperemesis gravidarum with metabolic disturbance, unspecified as to episode of care643.11 Hyperemesis gravidarum with metabolic disturbance, delivered643.13 Hyperemesis gravidarum with metabolic disturbance, antepartum643.20 Late vomiting of pregnancy, unspecified as to episode of care643.21 Late vomiting of pregnancy, delivered643.23 Late vomiting of pregnancy, antepartum643.80 Other vomiting complicating pregnancy, unspecified as to episode of care643.81 Other vomiting complicating pregnancy, delivered643.83 Other vomiting complicating pregnancy, antepartum643.90 Unspecified vomiting of pregnancy, unspecified as to episode of care643.91 Unspecified vomiting of pregnancy, delivered643.93 Unspecified vomiting of pregnancy, antepartum644.00 Threatened premature labor, unspecified as to episode of care644.03 Threatened premature labor, antepartum644.10 Other threatened labor, unspecified as to episode of care644.13 Other threatened labor, antepartum644.20 Early onset of delivery, unspecified as to episode of care644.21 Early onset of delivery, delivered, with or without mention of antepartum condition645.10 Post term pregnancy, unspecified as to episode of care or not applicable645.11 Post term pregnancy, delivered, with or without mention of antepartum condition645.13 Post term pregnancy, antepartum condition or complication645.20 Prolonged pregnancy, unspecified as to episode of care or not applicable645.21 Prolonged pregnancy, delivered, with or without mention of antepartum condition645.23 Prolonged pregnancy, antepartum condition or complication646.00 Papyraceous fetus, unspecified as to episode of care646.01 Papyraceous fetus, delivered, with or without mention of antepartum condition646.03 Papyraceous fetus, antepartum646.10 Edema or excessive weight gain in pregnancy, unspecified as to episode of care

646.11Edema or excessive weight gain in pregnancy, with delivery, with or without mention of antepartum complication


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646.12Edema or excessive weight gain in pregnancy, with delivery, with current postpartum complication

646.13 Edema or excessive weight gain, antepartum646.14 Edema or excessive weight gain, previous postpartum condition646.20 Unspecified renal disease in pregnancy, unspecified as to episode of care646.21 Unspecified renal disease in pregnancy, with delivery646.22 Unspecified renal disease in pregnancy, with delivery, with current postpartum complication646.23 Unspecified antepartum renal disease646.24 Unspecified renal disease, previous postpartum condition646.30 Pregnancy complication, habitual aborter unspecified as to episode of care646.31 Pregnancy complication, habitual aborter with or without mention of antepartum condition646.33 Habitual aborter, antepartum condition or complication646.40 Peripheral neuritis in pregnancy, unspecified as to episode of care646.41 Peripheral neuritis in pregnancy, with delivery646.42 Peripheral neuritis in pregnancy, with delivery, with current postpartum complication646.43 Peripheral neuritis antepartum646.44 Peripheral neuritis, previous postpartum condition646.50 Asymptomatic bacteriuria in pregnancy, unspecified as to episode of care646.51 Asymptomatic bacteriuria in pregnancy, with delivery646.52 Asymptomatic bacteriuria in pregnancy, with delivery, with current postpartum complication646.53 Asymptomatic bacteriuria antepartum646.54 Asymptomatic bacteriuria, previous postpartum condition646.60 Infections of genitourinary tract in pregnancy, unspecified as to episode of care646.61 Infections of genitourinary tract in pregnancy, with delivery

646.62Infections of genitourinary tract in pregnancy, with delivery, with current postpartum complication

646.63 Infections of genitourinary tract antepartum646.64 Infections of genitourinary tract, previous postpartum condition646.70 Liver disorders in pregnancy, unspecified as to episode of care646.71 Liver disorders in pregnancy, with delivery646.73 Liver disorders antepartum646.80 Other specified complication of pregnancy, unspecified as to episode of care646.81 Other specified complication of pregnancy, with delivery

646.82Other specified complications of pregnancy, with delivery, with current postpartum complication

646.83 Other specified complication, antepartum646.84 Other specified complications, previous postpartum condition646.90 Unspecified complication of pregnancy, unspecified as to episode of care646.91 Unspecified complication of pregnancy, with delivery646.93 Unspecified complication of pregnancy, antepartum

647.00Maternal syphilis, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

647.01 Maternal syphilis, complicating pregnancy, with delivery

647.02Maternal syphilis, complicating pregnancy, with delivery, with current postpartum complication

647.03 Maternal syphilis, antepartum647.04 Maternal syphilis, previous postpartum condition

647.10Maternal gonorrhea complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care


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647.11 Gonorrhea of mother with delivery647.12 Maternal gonorrhea, with delivery, with current postpartum complication647.13 Maternal gonorrhea, antepartum647.14 Maternal gonorrhea, previous postpartum condition

647.20Other maternal venereal diseases, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

647.21 Other venereal diseases of mother with delivery647.22 Other maternal venereal diseases with delivery, with current postpartum complication647.23 Other antepartum maternal venereal disease, previous postpartum condition647.24 Other postpartum venereal diseases

647.30Maternal tuberculosis complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

647.31 Tuberculosis of mother with delivery647.32 Maternal tuberculosis with delivery, with current postpartum complication647.33 Maternal tuberculosis, antepartum647.34 Maternal tuberculosis, previous postpartum condition

647.40Maternal malaria complicating pregnancy, childbirth or the puerperium, unspecified as to episode of care

647.41 Malaria of mother with delivery647.42 Maternal malaria with delivery, with current postpartum complication647.43 Maternal malaria, antepartum647.44 Maternal malaria, previous postpartum condition

647.50Maternal rubella complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

647.51 Rubella of mother with delivery647.52 Maternal rubella with delivery, with current postpartum complication647.53 Maternal rubella, antepartum647.54 Maternal rubella, previous postpartum condition

647.60Other maternal viral disease complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

647.61 Other viral diseases of mother with delivery647.62 Other maternal viral disease with delivery, with current postpartum complication647.63 Other maternal viral disease, antepartum647.64 Other maternal viral disease, previous postpartum condition

647.80Other specified maternal infectious and parasitic disease complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

647.81 Other specified infectious and parasitic diseases of mother with delivery

647.82Other specified maternal infectious and parasitic disease with delivery, with current postpartum complication

647.83 Other specified infectious and parasitic diseases of mother antepartum647.84 Other specified maternal infectious and parasitic disease, previous postpartum condition

647.90Unspecified maternal infection or infestation complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

647.91 Unspecified infection or infestation of mother with delivery

647.92Unspecified maternal infection or infestation with delivery, with current postpartum complication

647.93 Unspecified maternal infection or infestation, antepartum647.94 Unspecified maternal infection or infestation, previous postpartum condition648.01 Diabetes mellitus of mother with delivery648.02 Maternal diabetes mellitus with delivery, with current postpartum complication


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648.03 Maternal diabetes mellitus, antepartum648.04 Maternal diabetes mellitus, previous postpartum condition

648.10Maternal thyroid dysfunction complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable

648.11 Maternal thyroid dysfunction with delivery, with or without mention of antepartum condition648.12 Maternal thyroid dysfunction with delivery, with current postpartum complication648.13 Maternal thyroid dysfunction, antepartum condition or complication648.14 Maternal thyroid dysfunction, previous postpartum condition or complication

648.20Maternal anemia of mother, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

648.21 Maternal anemia, with delivery648.22 Maternal anemia with delivery, with current postpartum complication648.23 Maternal anemia, antepartum648.24 Maternal anemia, previous postpartum condition

648.30Maternal drug dependence complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

648.31 Maternal drug dependence, with delivery648.32 Maternal drug dependence, with delivery, with current postpartum complication648.33 Maternal drug dependence, antepartum648.34 Maternal drug dependence, previous postpartum condition

648.40Maternal mental disorders, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

648.41 Maternal mental disorders, with delivery648.42 Maternal mental disorders, with delivery, with current postpartum complication648.43 Maternal mental disorders, antepartum648.44 Maternal mental disorders, previous postpartum condition

648.50Maternal congenital cardiovascular disorders, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

648.51 Maternal congenital cardiovascular disorders, with delivery

648.52Maternal congenital cardiovascular disorders, with delivery, with current postpartum complication

648.53 Maternal congenital cardiovascular disorders, antepartum648.54 Maternal congenital cardiovascular disorders, previous postpartum condition

648.60Other maternal cardiovascular diseases complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

648.61 Other maternal cardiovascular diseases, with delivery648.62 Other maternal cardiovascular diseases, with delivery, with current postpartum complication648.63 Other maternal cardiovascular diseases, antepartum648.64 Other maternal cardiovascular diseases, antepartum

648.70Bone and joint disorders of maternal back, pelvis, and lower limbs, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

648.71 Bone and joint disorders of maternal back, pelvis, and lower limbs, with delivery

648.72Bone and joint disorders of maternal back, pelvis, and lower limbs, with delivery, with current postpartum complication

648.73 Bone and joint disorders of maternal back, pelvis, and lower limbs, antepartum

648.74Bone and joint disorders of maternal back, pelvis, and lower limbs, previous postpartum condition

648.80Abnormal maternal glucose tolerance, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

648.81 Abnormal maternal glucose tolerance, with delivery


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648.82 Abnormal maternal glucose tolerance, with delivery, with current postpartum complication648.83 Abnormal maternal glucose tolerance, antepartum648.84 Abnormal maternal glucose tolerance, previous postpartum condition

648.90Other current maternal conditions classifiable elsewhere, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care

648.91 Other current maternal conditions classifiable elsewhere, with delivery

648.92Other current maternal conditions classifiable elsewhere, with delivery, with current postpartum complication

648.93 Other current maternal conditions classifiable elsewhere, antepartum648.94 Other current maternal conditions classifiable elsewhere, previous postpartum condition

649.00Tobacco use disorder complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable

649.01Tobacco use disorder complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition

649.02Tobacco use disorder complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication

649.03Tobacco use disorder complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication

649.04Tobacco use disorder complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication

649.10Obesity complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable

649.11Obesity complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition

649.12Obesity complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication

649.13Obesity complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication

649.14Obesity complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication

649.20Bariatric surgery status complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable

649.21Bariatric surgery status complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition

649.22Bariatric surgery status complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication

649.23Bariatric surgery status complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication

649.24Bariatric surgery status complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication

649.30Coagulation defects complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable

649.31Coagulation defects complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition

649.32Coagulation defects complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication

649.33Coagulation defects complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication

649.34Coagulation defects complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication

649.40Epilepsy complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable


128



649.41Epilepsy complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition

649.42Epilepsy complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication

649.43Epilepsy complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication

649.44Epilepsy complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication

649.50 Spotting complicating pregnancy, unspecified as to episode of care or not applicable649.51 Spotting complicating pregnancy, delivered, with or without mention of antepartum condition649.53 Spotting complicating pregnancy, antepartum condition or complication649.60 Uterine size date discrepancy, unspecified as to episode of care or not applicable649.61 Uterine size date discrepancy, delivered, with or without mention of antepartum condition649.62 Uterine size date discrepancy, delivered, with mention of postpartum complication649.63 Uterine size date discrepancy, antepartum condition or complication649.64 Uterine size date discrepancy, postpartum condition or complication649.70 Cervical shortening649.71 Cervical shortening, delivered, with or without mention of antepartum condition649.73 Cervical shortening, antepartum condition or complication

649.81

Onset (spontaneous) of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by (planned) cesarean section, delivered, with or without mention of antepartum condition

649.82

Onset (spontaneous) of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by (planned) cesarean section, delivered, with mention of postpartum complication

650 Normal delivery651.00 Twin pregnancy, unspecified as to episode of care651.01 Twin pregnancy, delivered651.03 Twin pregnancy antepartum condition or complication651.10 Triplet pregnancy, unspecified as to episode of care651.11 Triplet pregnancy, delivered651.13 Triplet pregnancy antepartum condition or complication651.20 Quadruplet pregnancy, unspecified as to episode of care651.21 Quadruplet pregnancy, delivered651.23 Quadruplet pregnancy antepartum condition or complication

651.30Twin pregnancy with fetal loss and retention of one fetus, unspecified as to episode of care or not applicable

651.31Twin pregnancy with fetal loss and retention of one fetus delivered with or without antepartum condition

651.33Twin pregnancy with fetal loss and retention of one fetus antepartum condition or complication

651.40Triplet pregnancy with fetal loss and retention of one or more, unspecified as to episode of care or not applicable

651.41Triplet pregnancy with fetal loss and retention of one or more fetus(es) delivered with or without antepartum condition

651.43Triplet pregnancy with fetal loss and retention of one or more fetus(es) antepartum condition or complication

651.50Quadruplet pregnancy with fetal loss and retention of one or more, unspecified as to episode of care or not applicable

651.51Quadruplet pregnancy with fetal loss and retention of one or more fetus(es) delivered with or without antepartum condition


129



651.53Quadruplet pregnancy with fetal loss and retention of one or more fetus(es) antepartum condition or complication

651.60Other multiple pregnancy with fetal loss and retention of one or more fetus(es), unspecified as to episode of care or not applicable

651.61Other multiple pregnancy with fetal loss and retention of one or more fetus(es) delivered with or without antepartum condition

651.63Other multiple pregnancy with fetal loss and retention of one or more fetus(es) antepartum condition or complication

651.70Multiple gestation following (elective) fetal reduction, unspecified as to episode of care or not applicable

651.71Multiple gestation following (elective) fetal reduction, delivered, with or without mention of antepartum condition

651.73 Multiple gestation following (elective) fetal reduction, antepartum condition or complication651.80 Other specified multiple gestation, unspecified as to episode of care651.81 Other specified multiple gestation, delivered651.83 Other specified multiple gestation antepartum condition or complication651.90 Unspecified multiple gestation, unspecified as to episode of care651.91 Unspecified multiple gestation, delivered651.93 Unspecified multiple gestation antepartum condition or complication652.00 Unstable lie of fetus, unspecified as to episode of care652.01 Unstable lie of fetus, delivered652.03 Unstable lie antepartum condition or complication

652.10Breech or other malpresentation successfully converted to cephalic presentation, unspecified as to episode of care

652.11 Breech or other malpresentation successfully converted to cephalic presentation, delivered652.13 Breech or other malpresentation successfully converted to cephalic presentation, antepartum652.20 Breech presentation without mention of version, unspecified as to episode of care652.21 Breech presentation without mention of version, delivered652.23 Breech presentation without mention of version, antepartum652.30 Transverse or oblique fetal presentation, unspecified as to episode of care652.31 Transverse or oblique fetal presentation, delivered652.33 Transverse or oblique fetal presentation, antepartum652.40 Fetal face or brow presentation, unspecified as to episode of care652.41 Fetal face or brow presentation, delivered652.43 Fetal face or brow presentation, antepartum652.50 High fetal head at term, unspecified as to episode of care652.51 High fetal head at term, delivered652.53 High fetal head at term, antepartum

652.60Multiple gestation with malpresentation of one fetus or more, unspecified as to episode of care

652.61 Multiple gestation with malpresentation of one fetus or more, delivered652.63 Multiple gestation with malpresentation of one fetus or more, antepartum652.70 Prolapsed arm of fetus, unspecified as to episode of care652.71 Prolapsed arm of fetus, delivered652.73 Prolapsed arm of fetus, antepartum condition or complication652.80 Other specified malposition or malpresentation of fetus, unspecified as to episode of care652.81 Other specified malposition or malpresentation of fetus, delivered652.83 Other specified malposition or malpresentation of fetus, antepartum652.90 Unspecified malposition or malpresentation of fetus, unspecified as to episode of care652.91 Unspecified malposition or malpresentation of fetus, delivered


130



652.93 Unspecified malposition or malpresentation of fetus, antepartum

653.00Major abnormality of bony pelvis, not further specified in pregnancy, unspecified as to episode of care

653.01 Major abnormality of bony pelvis, not further specified, delivered653.03 Major abnormality of bony pelvis, not further specified, antepartum653.10 Generally contracted pelvis in pregnancy, unspecified as to episode of care in pregnancy653.11 Generally contracted pelvis in pregnancy, delivered653.13 Generally contracted pelvis in pregnancy, antepartum653.20 Inlet contraction of pelvis in pregnancy, unspecified as to episode of care in pregnancy653.21 Inlet contraction of pelvis in pregnancy, delivered653.23 Inlet contraction of pelvis in pregnancy, antepartum653.30 Outlet contraction of pelvis in pregnancy, unspecified as to episode of care in pregnancy653.31 Outlet contraction of pelvis in pregnancy, delivered653.33 Outlet contraction of pelvis in pregnancy, antepartum653.40 Fetopelvic disproportion, unspecified as to episode of care653.41 Fetopelvic disproportion, delivered653.43 Fetopelvic disproportion, antepartum653.50 Unusually large fetus causing disproportion, unspecified as to episode of care653.51 Unusually large fetus causing disproportion, delivered653.53 Unusually large fetus causing disproportion, antepartum653.60 Hydrocephalic fetus causing disproportion, unspecified as to episode of care653.61 Hydrocephalic fetus causing disproportion, delivered653.63 Hydrocephalic fetus causing disproportion, antepartum653.70 Other fetal abnormality causing disproportion, unspecified as to episode of care653.71 Other fetal abnormality causing disproportion, delivered653.73 Other fetal abnormality causing disproportion, antepartum653.80 Fetal disproportion of other origin, unspecified as to episode of care653.81 Fetal disproportion of other origin, delivered653.83 Fetal disproportion of other origin, antepartum653.90 Unspecified fetal disproportion, unspecified as to episode of care653.91 Unspecified fetal disproportion, delivered653.93 Unspecified fetal disproportion, antepartum654.00 Congenital abnormalities of pregnant uterus, unspecified as to episode of care654.01 Congenital abnormalities of pregnant uterus, delivered

654.02Congenital abnormalities of pregnant uterus, delivered, with mention of postpartum complication

654.03 Congenital abnormalities of uterus antepartum condition or complication654.04 Congenital abnormalities of pregnant uterus654.10 Tumors of body of pregnant uterus, unspecified as to episode of care in pregnancy654.11 Tumors of body of uterus with delivery654.12 Tumors of body of uterus, delivered, with mention of postpartum complication654.13 Tumors of body of uterus, antepartum condition or complication654.14 Tumors of body of uterus, postpartum condition or complication654.20 Previous cesarean delivery, unspecified as to episode of care or not applicable654.21 Previous cesarean delivery, delivered, with or without mention of antepartum condition654.23 Previous cesarean delivery, antepartum condition or complication654.30 Retroverted and incarcerated gravid uterus, unspecified as to episode of care654.31 Retroverted and incarcerated gravid uterus, delivered654.32 Retroverted and incarcerated gravid uterus, delivered, with mention of postpartum


131



complication654.33 Retroverted and incarcerated gravid uterus, antepartum654.34 Retroverted and incarcerated gravid uterus, postpartum

654.40Other abnormalities in shape or position of gravid uterus and of neighboring structures, unspecified as to episode of care

654.41Other abnormalities in shape or position of gravid uterus and of neighboring structures, delivered

654.42Other abnormalities in shape or position of gravid uterus and of neighboring structures, delivered, with mention of postpartum complication

654.43Other abnormalities in shape or position of gravid uterus and of neighboring structures, antepartum

654.44Other abnormalities in shape or position of gravid uterus and of neighboring structures, postpartum

654.50 Cervical incompetence, unspecified as to episode of care in pregnancy654.51 Cervical incompetence with delivery654.52 Cervical incompetence, delivered, with mention of postpartum complication654.53 Cervical incompetence, antepartum condition or complication654.54 Cervical incompetence, postpartum condition or complication

654.60Other congenital or acquired abnormality of cervix, unspecified as to episode of care in pregnancy

654.61 Other congenital or acquired abnormality of cervix, with delivery

654.62Other congenital or acquired abnormality of cervix, delivered, with mention of postpartum complication

654.63 Other congenital or acquired abnormality of cervix, antepartum condition or complication654.64 Other congenital or acquired abnormality of cervix, postpartum condition or complication654.70 Congenital or acquired abnormality of vagina, unspecified as to episode of care in pregnancy654.71 Congenital or acquired abnormality of vagina, with delivery

654.72Congenital or acquired abnormality of vagina, delivered, with mention of postpartum complication

654.73 Congenital or acquired abnormality of vagina, antepartum condition or complication654.74 Congenital or acquired abnormality of vagina, postpartum condition or complication654.80 Congenital or acquired abnormality of vulva, unspecified as to episode of care in pregnancy654.81 Congenital or acquired abnormality of vulva, with delivery

654.82Congenital or acquired abnormality of vulva, delivered, with mention of postpartum complication

654.83 Congenital or acquired abnormality of vulva, antepartum condition or complication654.84 Congenital or acquired abnormality of vulva, postpartum condition or complication

654.90Other and unspecified abnormality of organs and soft tissues of pelvis, unspecified as to episode of care in pregnancy

654.91 Other and unspecified abnormality of organs and soft tissues of pelvis, with delivery

654.92Other and unspecified abnormality of organs and soft tissues of pelvis, delivered, with mention of postpartum complication

654.93Other and unspecified abnormality of organs and soft tissues of pelvis, antepartum condition or complication

654.94Other and unspecified abnormality of organs and soft tissues of pelvis, postpartum condition or complication

655.00Central nervous system malformation in fetus, unspecified as to episode of care in pregnancy

655.01 Central nervous system malformation in fetus, with delivery655.03 Central nervous system malformation in fetus, antepartum655.10 Chromosomal abnormality in fetus, affecting management of mother, unspecified as to


132



episode of care in pregnancy655.11 Chromosomal abnormality in fetus, affecting management of mother, with delivery655.13 Chromosomal abnormality in fetus, affecting management of mother, antepartum

655.20Hereditary disease in family possibly affecting fetus, affecting management of mother, unspecified as to episode of care in pregnancy

655.21Hereditary disease in family possibly affecting fetus, affecting management of mother, with delivery

655.23Hereditary disease in family possibly affecting fetus, affecting management of mother, antepartum condition or complication

655.30Suspected damage to fetus from viral disease in mother, affecting management of mother, unspecified as to episode of care in pregnancy

655.31Suspected damage to fetus from viral disease in the mother affecting management of mother with delivery

655.33Suspected damage to fetus from viral disease in the mother affecting management of mother antepartum condition or complication

655.40Suspected damage to fetus from other disease in mother, affecting management of mother, unspecified as to episode of care in pregnancy

655.41Suspected damage to fetus from other disease in the mother affecting management of mother with delivery

655.43Suspected damage to fetus from other disease in the mother affecting management of mother antepartum condition or complication

655.50Suspected damage to fetus from drugs, affecting management of mother, unspecified as to episode of care

655.51 Suspected damage to fetus from drugs, affecting management of mother, delivered655.53 Suspected damage to fetus from drugs, affecting management of mother, antepartum

655.60Suspected damage to fetus from radiation, affecting management of mother, unspecified as to episode of care

655.61 Suspected damage to fetus from radiation, affecting management of mother, delivered

655.63Suspected damage to fetus from radiation, affecting management of mother, antepartum condition or complication

655.70 Decreased fetal movements, unspecified as to episode of care655.71 Decreased fetal movements, affecting management of mother, delivered

655.73Decreased fetal movements, affecting management of mother, antepartum condition or complication

655.8 Other known or suspected fetal abnormality, not elsewhere classified

655.80Other known or suspected fetal abnormality, not elsewhere classified, affecting management of mother, unspecified as to episode of care

655.81Other known or suspected fetal abnormality not elsewhere classified affecting management of mother with delivered

655.83Other known or suspected fetal abnormality, not elsewhere classified, affecting management of mother, antepartum condition or complication

655.90Unspecified fetal abnormality affecting management of mother, unspecified as to episode of care

655.91 Unspecified suspected fetal abnormality affecting management of mother delivered

655.93Unspecified suspected fetal abnormality affecting management of mother antepartum condition or complication

656.00 Fetal-maternal hemorrhage, unspecified as to episode of care in pregnancy656.01 Fetal-maternal hemorrhage, with delivery656.03 Fetal-maternal hemorrhage, antepartum condition or complication656.10 Rhesus isoimmunization unspecified as to episode of care in pregnancy656.11 Rhesus isoimmunization, delivered with or without mention of antepartum condition656.13 Rhesus isoimmunization affecting management of mother, antepartum condition


133



656.20Isoimmunization from other and unspecified blood-group incompatibility, unspecified as to episode of care in pregnancy

656.21Isoimmunization from other and unspecified blood-group incompatibility, affecting management of mother, delivered

656.23Isoimmunization from other and unspecified blood-group incompatibility, affecting management of mother, antepartum

656.30 Fetal distress affecting management of mother, unspecified as to episode of care656.31 Fetal distress affecting management of mother, delivered656.33 Fetal distress affecting management of mother, antepartum656.40 Intrauterine death affecting management of mother, unspecified as to episode of care656.41 Intrauterine death affecting management of mother, delivered656.43 Intrauterine death affecting management of mother, antepartum656.50 Poor fetal growth, affecting management of mother, unspecified as to episode of care656.51 Poor fetal growth, affecting management of mother, delivered656.53 Poor fetal growth, affecting management of mother, antepartum condition or complication656.60 Excessive fetal growth affecting management of mother, unspecified as to episode of care656.61 Excessive fetal growth affecting management of mother, delivered656.63 Excessive fetal growth affecting management of mother, antepartum

656.70Other placental conditions affecting management of mother, unspecified as to episode of care

656.71 Other placental conditions affecting management of mother, delivered656.73 Other placental conditions affecting management of mother, antepartum

656.80Other specified fetal and placental problems affecting management of mother, unspecified as to episode of care

656.81 Other specified fetal and placental problems affecting management of mother, delivered656.83 Other specified fetal and placental problems affecting management of mother, antepartum

656.90Unspecified fetal and placental problem affecting management of mother, unspecified as to episode of care

656.91 Unspecified fetal and placental problem affecting management of mother, delivered656.93 Unspecified fetal and placental problem affecting management of mother, antepartum657.00 Polyhydramnios, unspecified as to episode of care657.01 Polyhydramnios, with delivery657.03 Polyhydramnios, antepartum complication658.00 Oligohydramnios, unspecified as to episode of care658.01 Oligohydramnios, delivered658.03 Oligohydramnios, antepartum658.10 Premature rupture of membranes in pregnancy, unspecified as to episode of care658.11 Premature rupture of membranes in pregnancy, delivered658.13 Premature rupture of membranes in pregnancy, antepartum

658.20Delayed delivery after spontaneous or unspecified rupture of membranes, unspecified as to episode of care

658.21 Delayed delivery after spontaneous or unspecified rupture of membranes, delivered658.23 Delayed delivery after spontaneous or unspecified rupture of membranes, antepartum658.30 Delayed delivery after artificial rupture of membranes, unspecified as to episode of care658.31 Delayed delivery after artificial rupture of membranes, delivered658.33 Delayed delivery after artificial rupture of membranes, antepartum658.40 Infection of amniotic cavity, unspecified as to episode of care658.41 Infection of amniotic cavity, delivered658.43 Infection of amniotic cavity, antepartum658.80 Other problem associated with amniotic cavity and membranes, unspecified as to episode of


134



care658.81 Other problem associated with amniotic cavity and membranes, delivered658.83 Other problem associated with amniotic cavity and membranes, antepartum

658.90Unspecified problem associated with amniotic cavity and membranes, unspecified as to episode of care

658.91 Unspecified problem associated with amniotic cavity and membranes, delivered658.93 Unspecified problem associated with amniotic cavity and membranes, antepartum659.00 Failed mechanical induction of labor, unspecified as to episode of care659.01 Failed mechanical induction of labor, delivered659.03 Failed mechanical induction of labor, antepartum659.10 Failed medical or unspecified induction of labor, unspecified as to episode of care659.11 Failed medical or unspecified induction of labor, delivered659.13 Failed medical or unspecified induction of labor, antepartum659.20 Unspecified maternal pyrexia during labor, unspecified as to episode of care659.21 Unspecified type maternal pyrexia during labor delivered659.23 Unspecified type maternal pyrexia antepartum659.30 Generalized infection during labor, unspecified as to episode of care659.31 Generalized infection during labor, delivered659.33 Generalized infection during labor, antepartum659.40 Grand multiparity with current pregnancy, unspecified as to episode of care659.41 Grand multiparity, delivered, with or without mention of antepartum condition659.43 Grand multiparity with current pregnancy, antepartum659.50 Elderly primigravida, unspecified as to episode of care659.51 Elderly primigravida, delivered659.53 Elderly primigravida, antepartum659.60 Elderly multigravida, unspecified as to episode of care or not applicable659.61 Other advanced maternal age delivered with or without antepartum condition659.63 Other advanced maternal age antepartum condition or complication659.70 Abnormality in fetal heart rate or rhythm, unspecified as to episode of care or not applicable

659.71Abnormality in fetal heart rate or rhythm, delivered, with or without mention of antepartum condition

659.73 Abnormality in fetal heart rate or rhythm, antepartum condition or complication

659.80Other specified indication for care or intervention related to labor and delivery, unspecified as to episode of care

659.81 Other specified indication for care or intervention related to labor and delivery, delivered659.83 Other specified indication for care or intervention related to labor and delivery, antepartum

659.90Unspecified indication for care or intervention related to labor and delivery, unspecified as to episode of care

659.91 Unspecified indication for care or intervention related to labor and delivery, delivered659.93 Unspecified indication for care or intervention related to labor and delivery, antepartum

660.00Obstruction caused by malposition of fetus at onset of labor, unspecified as to episode of care

660.01 Obstruction caused by malposition of fetus at onset of labor with delivery660.03 Obstruction caused by malposition of fetus at onset of labor, antepartum660.10 Obstruction by bony pelvis during labor and delivery, unspecified as to episode of care660.11 Obstruction by bony pelvis during labor and delivery, delivered660.13 Obstruction by bony pelvis during labor and delivery, antepartum

660.20Obstruction by abnormal pelvic soft tissues during labor and delivery, unspecified as to episode of care


135



660.21 Obstruction by abnormal pelvic soft tissues during labor and delivery, delivered660.23 Obstruction by abnormal pelvic soft tissues during labor and delivery, antepartum

660.30Deep transverse arrest and persistent occipitoposterior position during labor and delivery, unspecified as to episode of care

660.31Deep transverse arrest and persistent occipitoposterior position during labor and deliver, delivered

660.33Deep transverse arrest and persistent occipitoposterior position during labor and delivery, antepartum

660.40 Shoulder (girdle) dystocia during labor and delivery, unspecified as to episode of care660.41 Shoulder (girdle) dystocia during labor and deliver, delivered660.43 Shoulder (girdle) dystocia during labor and delivery, antepartum660.50 Locked twins during labor and delivery, unspecified as to episode of care in pregnancy660.51 Locked twins with delivery660.53 Locked twins, antepartum660.60 Unspecified failed trial of labor, unspecified as to episode660.61 Unspecified failed trial of labor with delivery660.63 Unspecified failed trial of labor, antepartum660.70 Unspecified failed forceps or vacuum extractor, unspecified as to episode of care660.71 Unspecified failed forceps or vacuum extractor with delivery660.73 Failed forceps or vacuum extractor, unspecified, antepartum660.80 Other causes of obstructed labor, unspecified as to episode of care660.81 Other causes of obstructed labor with delivery660.83 Other causes of obstructed labor, antepartum660.90 Unspecified obstructed labor, unspecified as to episode of care660.91 Unspecified obstructed labor, with delivery660.93 Unspecified obstructed labor, antepartum661.00 Primary uterine inertia, unspecified as to episode of care661.01 Primary uterine inertia, with delivery661.03 Primary uterine inertia, antepartum661.10 Secondary uterine inertia, unspecified as to episode of care661.11 Secondary uterine inertia, with delivery661.13 Secondary uterine inertia, antepartum661.20 Other and unspecified uterine inertia, unspecified as to episode of care661.21 Other and unspecified uterine inertia, with delivery661.23 Other and unspecified uterine inertia, antepartum661.30 Precipitate labor, unspecified as to episode of care661.31 Precipitate labor, with delivery661.33 Precipitate labor, antepartum661.40 Hypertonic, incoordinate, or prolonged uterine contractions, unspecified as to episode of care661.41 Hypertonic, incoordinate, or prolonged uterine contractions, with delivery661.43 Hypertonic, incoordinate, or prolonged uterine contractions, antepartum661.90 Unspecified abnormality of labor, unspecified as to episode of care661.91 Unspecified abnormality of labor, with delivery661.93 Unspecified abnormality of labor, antepartum662.00 Prolonged first stage of labor, unspecified as to episode of care662.01 Prolonged first stage of labor, delivered662.03 Prolonged first stage of labor, antepartum662.10 Unspecified prolonged labor, unspecified as to episode of care662.11 Unspecified type prolonged labor delivered


136



662.13 Unspecified type prolonged labor antepartum662.20 Prolonged second stage of labor, unspecified as to episode of care662.21 Prolonged second stage of labor, delivered662.23 Prolonged second stage of labor, antepartum662.30 Delayed delivery of second twin, triplet, etc., unspecified as to episode of care662.31 Delayed delivery of second twin, triplet, etc., delivered662.33 Delayed delivery of second twin, triplet, etc., antepartum663.00 Prolapse of cord, complicating labor and delivery, unspecified as to episode of care663.01 Prolapse of cord, complicating labor and delivery, delivered663.03 Prolapse of cord, complicating labor and delivery, antepartum

663.10Cord around neck, with compression, complicating labor and delivery, unspecified as to episode of care

663.11 Cord around neck, with compression, complicating labor and delivery, delivered663.13 Cord around neck, with compression, complicating labor and delivery, antepartum

663.20Other and unspecified cord entanglement, with compression, complicating labor and delivery, unspecified as to episode of care

663.21Other and unspecified cord entanglement, with compression, complicating labor and delivery, delivered

663.23Other and unspecified cord entanglement, with compression, complicating labor and delivery, antepartum

663.30Other and unspecified cord entanglement, without mention of compression, complicating labor and delivery, unspecified as to episode of care

663.31Other and unspecified cord entanglement, without mention of compression, complicating labor and delivery, delivered

663.33Other and unspecified cord entanglement, without mention of compression, complicating labor and delivery, antepartum

663.40 Short cord complicating labor and delivery, unspecified as to episode of care663.41 Short cord complicating labor and delivery, delivered663.43 Short cord complicating labor and delivery, antepartum663.50 Vasa previa complicating labor and delivery, unspecified as to episode of care663.51 Vasa previa complicating labor and delivery, delivered663.53 Vasa previa complicating labor and delivery, antepartum663.60 Vascular lesions of cord complicating labor and delivery, unspecified as to episode of care663.61 Vascular lesions of cord complicating labor and delivery, delivered663.63 Vascular lesions of cord complicating labor and delivery, antepartum

663.80Other umbilical cord complications during labor and delivery, unspecified as to episode of care

663.81 Other umbilical cord complications during labor and delivery, delivered663.83 Other umbilical cord complications during labor and delivery, antepartum

663.90Unspecified umbilical cord complication during labor and delivery, unspecified as to episode of care

663.91 Unspecified umbilical cord complication during labor and delivery, delivered663.93 Unspecified umbilical cord complication during labor and delivery, antepartum664.00 First-degree perineal laceration, unspecified as to episode of care in pregnancy664.01 First-degree perineal laceration, with delivery664.04 First-degree perineal laceration, postpartum664.10 Second-degree perineal laceration, unspecified as to episode of care in pregnancy664.11 Second-degree perineal laceration, with delivery664.14 Second-degree perineal laceration, postpartum664.20 Third-degree perineal laceration, unspecified as to episode of care in pregnancy


137



664.21 Third-degree perineal laceration, with delivery664.24 Third-degree perineal laceration, postpartum664.30 Fourth-degree perineal laceration, unspecified as to episode of care in pregnancy664.31 Fourth-degree perineal laceration, with delivery664.34 Fourth-degree perineal laceration, postpartum664.40 Unspecified perineal laceration, unspecified as to episode of care in pregnancy664.41 Unspecified perineal laceration, with delivery664.44 Unspecified perineal laceration, postpartum664.50 Vulvar and perineal hematoma, unspecified as to episode of care in pregnancy664.51 Vulvar and perineal hematoma, with delivery664.54 Vulvar and perineal hematoma, postpartum

664.60Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration, unspecified as to episode of care or not applicable

664.61Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration, delivered, with or without mention of antepartum condition

664.64Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration, postpartum condition or complication

664.80Other specified trauma to perineum and vulva, unspecified as to episode of care in pregnancy

664.81 Other specified trauma to perineum and vulva, with delivery664.84 Other specified trauma to perineum and vulva, postpartum664.90 Unspecified trauma to perineum and vulva, unspecified as to episode of care in pregnancy664.91 Unspecified trauma to perineum and vulva, with delivery664.94 Unspecified trauma to perineum and vulva, postpartum665.00 Rupture of uterus before onset of labor, unspecified as to episode of care665.01 Rupture of uterus before onset of labor, with delivery665.03 Rupture of uterus before onset of labor, antepartum665.10 Rupture of uterus before onset of labor, antepartum665.11 Rupture of uterus during labor, with delivery665.20 Inversion of uterus, unspecified as to episode of care in pregnancy665.22 Inversion of uterus, delivered with postpartum complication665.24 Inversion of uterus, postpartum665.30 Laceration of cervix, unspecified as to episode of care in pregnancy665.31 Laceration of cervix, with delivery665.34 Laceration of cervix, postpartum665.40 High vaginal laceration, unspecified as to episode of care in pregnancy665.41 High vaginal laceration, with delivery665.44 High vaginal laceration, postpartum665.50 Other injury to pelvic organs, unspecified as to episode of care in pregnancy665.51 Other injury to pelvic organs, with delivery665.54 Other injury to pelvic organs, postpartum665.60 Damage to pelvic joints and ligaments, unspecified as to episode of care in pregnancy665.61 Damage to pelvic joints and ligaments, with delivery665.64 Damage to pelvic joints and ligaments, postpartum665.70 Pelvic hematoma, unspecified as to episode of care665.71 Pelvic hematoma, with delivery665.72 Pelvic hematoma, delivered with postpartum complication665.74 Pelvic hematoma, postpartum665.80 Other specified obstetrical trauma, unspecified as to episode of care


138



665.81 Other specified obstetrical trauma, with delivery665.82 Other specified obstetrical trauma, delivered, with postpartum665.83 Other specified obstetrical trauma, antepartum665.84 Other specified obstetrical trauma, postpartum665.90 Unspecified obstetrical trauma, unspecified as to episode of care665.91 Unspecified obstetrical trauma, with delivery665.92 Unspecified obstetrical trauma, delivered, with postpartum complication665.93 Unspecified obstetrical trauma, antepartum665.94 Unspecified obstetrical trauma, postpartum666.00 Third-stage postpartum hemorrhage, unspecified as to episode of care666.02 Third-stage postpartum hemorrhage, with delivery666.04 Third-stage postpartum hemorrhage, postpartum666.10 Other immediate postpartum hemorrhage, unspecified as to episode of care666.12 Other immediate postpartum hemorrhage with delivery666.14 Other immediate postpartum hemorrhage, postpartum666.20 Delayed and secondary postpartum hemorrhage, unspecified as to episode of care666.22 Delayed and secondary postpartum hemorrhage, with delivery666.24 Delayed and secondary postpartum hemorrhage, postpartum666.30 Postpartum coagulation defects, unspecified as to episode of care666.32 Postpartum coagulation defects, with delivery666.34 Postpartum coagulation defects, postpartum667.00 Retained placenta without hemorrhage, unspecified as to episode of care

667.02Retained placenta without hemorrhage, with delivery, with mention of postpartum complication

667.04 Retained placenta without hemorrhage, postpartum condition or complication

667.10Retained portions of placenta or membranes, without hemorrhage, unspecified as to episode of care

667.12Retained portions of placenta or membranes, without hemorrhage, delivered, with mention of postpartum complication

667.14Retained portions of placenta or membranes, without hemorrhage, postpartum condition or complication

668.00Pulmonary complications of the administration of anesthesia or other sedation in labor and delivery, unspecified as to episode of care

668.01Pulmonary complications of the administration of anesthesia or other sedation in labor and delivery, delivered

668.02Pulmonary complications of the administration of anesthesia or other sedation in labor and delivery, delivered, with mention of postpartum complication

668.03Pulmonary complications of the administration of anesthesia or other sedation in labor and delivery, antepartum

668.04Pulmonary complications of the administration of anesthesia or other sedation in labor and delivery, postpartum

668.10Cardiac complications of the administration of anesthesia or other sedation in labor and delivery, unspecified as to episode of care

668.11Cardiac complications of the administration of anesthesia or other sedation in labor and delivery, delivered

668.12Cardiac complications of the administration of anesthesia or other sedation in labor and delivery, delivered, with mention of postpartum complication

668.13Cardiac complications of the administration of anesthesia or other sedation in labor and delivery, antepartum

668.14Cardiac complications of the administration of anesthesia or other sedation in labor and delivery, postpartum


139



668.20Central nervous system complications of the administration of anesthesia or other sedation in labor and delivery, unspecified as to episode of care

668.21Central nervous system complications of the administration of anesthesia or other sedation in labor and delivery, delivered

668.22Central nervous system complications of the administration of anesthesia or other sedation in labor and delivery, delivered, with mention of postpartum complication

668.23Central nervous system complications of the administration of anesthesia or other sedation in labor and delivery, antepartum

668.24Central nervous system complications of the administration of anesthesia or other sedation in labor and delivery, postpartum

668.80Other complications of the administration of anesthesia or other sedation in labor and delivery, unspecified as to episode of care

668.81Other complications of the administration of anesthesia or other sedation in labor and delivery, delivered

668.82Other complications of the administration of anesthesia or other sedation in labor and delivery, delivered, with mention of postpartum complication

668.83Other complications of the administration of anesthesia or other sedation in labor and delivery, antepartum

668.84Other complications of the administration of anesthesia or other sedation in labor and delivery, postpartum

668.90Unspecified complication of the administration of anesthesia or other sedation in labor and delivery, unspecified as to episode of care

668.91Unspecified complication of the administration of anesthesia or other sedation in labor and delivery, delivered

668.92Unspecified complication of the administration of anesthesia or other sedation in labor and delivery, delivered, with mention of postpartum complication

668.93Unspecified complication of the administration of anesthesia or other sedation in labor and delivery, antepartum

668.94Unspecified complication of the administration of anesthesia or other sedation in labor and delivery, postpartum

669.00 Maternal distress complicating labor and delivery, unspecified as to episode of care669.01 Maternal distress, with delivery, with or without mention of antepartum condition669.02 Maternal distress, with delivery, with mention of postpartum complication669.03 Maternal distress complicating labor and delivery, antepartum condition or complication669.04 Maternal distress complicating labor and delivery, postpartum condition or complication669.10 Shock during or following labor and delivery, unspecified as to episode of care

669.11Shock during or following labor and delivery, with delivery, with or without mention of antepartum condition

669.12Shock during or following labor and delivery, with delivery, with mention of postpartum complication

669.13 Shock during or following labor and delivery, antepartum shock669.14 Shock during or following labor and delivery, postpartum shock

669.20Maternal hypotension syndrome complicating labor and delivery, unspecified as to episode of care

669.21Maternal hypotension syndrome, with delivery, with or without mention of antepartum condition

669.22 Maternal hypotension syndrome, with delivery, with mention of postpartum complication669.23 Maternal hypotension syndrome, antepartum669.24 Maternal hypotension syndrome, postpartum

669.30Acute kidney failure following labor and delivery, unspecified as to episode of care or not applicable

669.32 Acute kidney failure following labor and delivery, delivered, with mention of postpartum


140



complication669.34 Acute kidney failure following labor and delivery, postpartum condition or complication669.40 Other complications of obstetrical surgery and procedures, unspecified as to episode of care

669.41Other complications of obstetrical surgery and procedures, with delivery, with or without mention of antepartum condition

669.42Other complications of obstetrical surgery and procedures, with delivery, with mention of postpartum complication

669.43Other complications of obstetrical surgery and procedures, antepartum condition or complication

669.44Other complications of obstetrical surgery and procedures, postpartum condition or complication

669.50Forceps or vacuum extractor delivery without mention of indication, unspecified as to episode of care

669.51Forceps or vacuum extractor delivery without mention of indication, delivered, with or without mention of antepartum condition

669.60 Breech extraction, without mention of indication, unspecified as to episode of care

669.61Breech extraction, without mention of indication, delivered, with or without mention of antepartum condition

669.70 Cesarean delivery, without mention of indication, unspecified as to episode of care

669.71Cesarean delivery, without mention of indication, delivered, with or without mention of antepartum condition

669.80 Other complication of labor and delivery, unspecified as to episode of care

669.81Other complication of labor and delivery, delivered, with or without mention of antepartum condition

669.82 Other complication of labor and delivery, delivered, with mention of postpartum complication669.83 Other complications of labor and delivery antepartum condition or complication669.84 Other complication of labor and delivery, postpartum condition or complication669.90 Unspecified complication of labor and delivery, unspecified as to episode of care

669.91Unspecified complication of labor and delivery, with delivery, with or without mention of antepartum condition

669.92Unspecified complication of labor and delivery, with delivery, with mention of postpartum complication

669.93 Unspecified complication of labor and delivery, antepartum condition or complication669.94 Unspecified complication of labor and delivery, postpartum condition or complication670.00 Major puerperal infection, unspecified, unspecified as to episode of care or not applicable670.02 Major puerperal infection, unspecified, delivered, with mention of postpartum complication670.04 Major puerperal infection, unspecified, postpartum condition or complication670.10 Puerperal endometritis, unspecified as to episode of care or not applicable670.12 Puerperal endometritis, delivered, with mention of postpartum complication670.14 Puerperal endometritis, postpartum condition or complication670.20 Puerperal sepsis, unspecified as to episode of care or not applicable670.22 Puerperal sepsis, delivered, with mention of postpartum complication670.24 Puerperal sepsis, postpartum condition or complication670.30 Puerperal septic thrombophlebitis, unspecified as to episode of care or not applicable670.32 Puerperal septic thrombophlebitis, delivered, with mention of postpartum complication670.34 Puerperal septic thrombophlebitis, postpartum condition or complication670.80 Other major puerperal infection, unspecified as to episode of care or not applicable670.82 Other major puerperal infection, delivered, with mention of postpartum complication670.84 Other major puerperal infection, postpartum condition or complication671.00 Varicose veins of legs complicating pregnancy and the puerperium, unspecified as to


141



episode of care671.01 Varicose veins of legs, with delivery, with or without mention of antepartum condition671.02 Varicose veins of legs, with delivery, with mention of postpartum complication671.03 Varicose veins of legs, antepartum671.04 Varicose veins of legs, postpartum

671.10Varicose veins of vulva and perineum complicating pregnancy and the puerperium, unspecified as to episode of care

671.11Varicose veins of vulva and perineum, with delivery, with or without mention of antepartum condition

671.12 Varicose veins of vulva and perineum, with delivery, with mention of postpartum complication671.13 Varicose veins of vulva and perineum, antepartum671.14 Varicose veins of vulva and perineum, antepartum

671.20Superficial thrombophlebitis complicating pregnancy and the puerperium, unspecified as to episode of care

671.21 Superficial thrombophlebitis with delivery, with or without mention of antepartum condition671.22 Superficial thrombophlebitis with delivery, with mention of postpartum complication671.23 Superficial thrombophlebitis, antepartum671.24 Superficial thrombophlebitis, postpartum671.30 Deep phlebothrombosis, antepartum, unspecified as to episode of care671.31 Deep phlebothrombosis, antepartum, with delivery671.33 Deep phlebothrombosis, antepartum671.40 Deep phlebothrombosis, postpartum, unspecified as to episode of care671.42 Deep phlebothrombosis, postpartum, with delivery671.44 Deep phlebothrombosis, postpartum

671.50Other phlebitis and thrombosis complicating pregnancy and the puerperium, unspecified as to episode of care

671.51 Other phlebitis and thrombosis with delivery, with or without mention of antepartum condition671.52 Other phlebitis and thrombosis with delivery, with mention of postpartum complication671.53 Other antepartum phlebitis and thrombosis671.54 Other postpartum phlebitis and thrombosis

671.80Other venous complication of pregnancy and the puerperium, unspecified as to episode of care

671.81 Other venous complication, with delivery, with or without mention of antepartum condition671.82 Other venous complication, with delivery, with mention of postpartum complication671.83 Other venous complication, antepartum671.84 Other venous complication, postpartum

671.90Unspecified venous complication of pregnancy and the puerperium, unspecified as to episode of care

671.91Unspecified venous complication, with delivery, with or without mention of antepartum condition

671.92 Unspecified venous complication, with delivery, with mention of postpartum complication671.93 Unspecified venous complication, antepartum671.94 Unspecified venous complication, postpartum672.00 Puerperal pyrexia of unknown origin, unspecified as to episode of care672.02 Puerperal pyrexia of unknown origin, delivered, with mention of postpartum complication672.04 Puerperal pyrexia of unknown origin, postpartum673.00 Obstetrical air embolism, unspecified as to episode of care673.01 Obstetrical air embolism, with delivery, with or without mention of antepartum condition673.02 Obstetrical air embolism, with delivery, with mention of postpartum complication673.03 Obstetrical air embolism, antepartum condition or complication


142



673.04 Obstetrical air embolism, postpartum condition or complication673.10 Amniotic fluid embolism, unspecified as to episode of care673.11 Amniotic fluid embolism, with delivery, with or without mention of antepartum condition673.12 Amniotic fluid embolism, with delivery, with mention of postpartum complication673.13 Amniotic fluid embolism, antepartum condition or complication673.14 Amniotic fluid embolism, postpartum condition or complication673.20 Obstetrical blood-clot embolism, unspecified as to episode of care

673.21Obstetrical blood-clot embolism, with delivery, with or without mention of antepartum condition

673.22 Obstetrical blood-clot embolism, with mention of postpartum complication673.23 Obstetrical blood-clot embolism, antepartum673.24 Obstetrical blood-clot embolism, postpartum673.30 Obstetrical pyemic and septic embolism, unspecified as to episode of care

673.31Obstetrical pyemic and septic embolism, with delivery, with or without mention of antepartum condition

673.32Obstetrical pyemic and septic embolism, with delivery, with mention of postpartum complication

673.33 Obstetrical pyemic and septic embolism, antepartum673.34 Obstetrical pyemic and septic embolism, postpartum673.80 Other obstetrical pulmonary embolism, unspecified as to episode of care

673.81Other obstetrical pulmonary embolism, with delivery, with or without mention of antepartum condition

673.82Other obstetrical pulmonary embolism, with delivery, with mention of postpartum complication

673.83 Other obstetrical pulmonary embolism, antepartum673.84 Other obstetrical pulmonary embolism, postpartum

674.00Cerebrovascular disorder occurring in pregnancy, childbirth, or the puerperium, unspecified as to episode of care

674.01 Cerebrovascular disorder, with delivery, with or without mention of antepartum condition674.02 Cerebrovascular disorder, with delivery, with mention of postpartum complication674.03 Cerebrovascular disorder, antepartum674.04 Cerebrovascular disorder, postpartum674.10 Disruption of cesarean wound, unspecified as to episode of care674.12 Disruption of cesarean wound, with delivery, with mention of postpartum complication674.14 Disruption of cesarean wound, postpartum674.20 Disruption of perineal wound, unspecified as to episode of care in pregnancy674.22 Disruption of perineal wound, with delivery, with mention of postpartum complication674.24 Disruption of perineal wound, postpartum674.30 Other complication of obstetrical surgical wounds, unspecified as to episode of care

674.32Other complication of obstetrical surgical wounds, with delivery, with mention of postpartum complication

674.34 Other complication of obstetrical surgical wounds, postpartum condition or complication674.40 Placental polyp, unspecified as to episode of care674.42 Placental polyp, with delivery, with mention of postpartum complication674.44 Placental polyp, postpartum674.50 Peripartum cardiomyopathy, unspecified as to episode of care or not applicable674.51 Peripartum cardiomyopathy, delivered, with or without mention of antepartum condition674.52 Peripartum cardiomyopathy, delivered, with mention of postpartum condition674.53 Peripartum cardiomyopathy with antepartum condition or complication


143



674.54 Peripartum cardiomyopathy, postpartum condition or complication674.80 Other complication of puerperium, unspecified as to episode of care674.82 Other complication of puerperium, with delivery, with mention of postpartum complication674.84 Other complication of puerperium674.90 Unspecified complications of puerperium, unspecified as to episode of care

674.92Unspecified complications of puerperium, with delivery, with mention of postpartum complication

674.94 Unspecified complications of puerperium675.00 Infection of nipple associated with childbirth, unspecified as to episode of care

675.01Infection of nipple associated with childbirth, delivered, with or without mention of antepartum condition

675.02Infection of nipple associated with childbirth, delivered with mention of postpartum complication

675.03 Infection of nipple, antepartum675.04 Infection of nipple, postpartum675.10 Abscess of breast associated with childbirth, unspecified as to episode of care

675.11Abscess of breast associated with childbirth, delivered, with or without mention of antepartum condition

675.12Abscess of breast associated with childbirth, delivered, with mention of postpartum complication

675.13 Abscess of breast, antepartum675.14 Abscess of breast, postpartum675.20 Nonpurulent mastitis, unspecified as to episode of prenatal or postnatal care675.21 Nonpurulent mastitis associated with childbirth delivered with or without antepartum condition675.22 Nonpurulent mastitis associated with childbirth delivered with postpartum complication675.23 Nonpurulent mastitis, antepartum675.24 Nonpurulent mastitis, postpartum

675.80Other specified infection of the breast and nipple associated with childbirth, unspecified as to episode of care

675.81Other specified infection of the breast and nipple associated with childbirth, delivered, with or without mention of antepartum condition

675.82Other specified infection of the breast and nipple associated with childbirth, delivered, with mention of postpartum complication

675.83 Other specified infection of the breast and nipple, antepartum675.84 Other specified infection of the breast and nipple, postpartum

675.90Unspecified infection of the breast and nipple, unspecified as to prenatal or postnatal episode of care

675.91Unspecified infection of the breast and nipple associated with childbirth delivered with or without antepartum condition

675.92Unspecified infection of the breast and nipple associated with childbirth delivered with postpartum complication

675.93 Unspecified infection of the breast and nipple, antepartum675.94 Unspecified infection of the breast and nipple, postpartum676.00 Retracted nipple, unspecified as to prenatal or postnatal episode of care676.01 Retracted nipple associated with childbirth delivered with or without antepartum condition676.02 Retracted nipple associated with childbirth delivered with postpartum complication676.03 Retracted nipple associated with childbirth antepartum condition or complication676.04 Retracted nipple, postpartum condition or complication676.10 Cracked nipple, unspecified as to prenatal or postnatal episode of care676.11 Cracked nipple associated with childbirth delivered with or without antepartum condition


144



676.12 Cracked nipple associated with childbirth delivered with postpartum complication676.13 Cracked nipple associated with childbirth antepartum condition or complication676.14 Cracked nipple, postpartum condition or complication676.20 Engorgement of breasts, unspecified as to prenatal or postnatal episode of care

676.21Engorgement of breasts associated with childbirth delivered with or without antepartum condition

676.22 Engorgement of breasts associated with childbirth delivered with postpartum complication676.23 Antepartum engorgement of breasts associated with childbirth676.24 Engorgement of breast, postpartum

676.30Other and unspecified disorder of breast associated with childbirth, unspecified as to episode of care

676.31Other and unspecified disorder of breast associated with childbirth, delivered, with or without mention of antepartum condition

676.32Other and unspecified disorder of breast associated with childbirth, delivered, with mention of postpartum complication

676.33Other and unspecified disorder of breast associated with childbirth, antepartum condition or complication

676.34Other and unspecified disorder of breast associated with childbirth, postpartum condition or complication

676.40 Failure of lactation, unspecified as to episode of care676.41 Failure of lactation, with delivery, with or without mention of antepartum condition676.42 Failure of lactation, with delivery, with mention of postpartum complication676.43 Failure of lactation, antepartum condition or complication676.44 Failure of lactation, postpartum condition or complication676.50 Suppressed lactation, unspecified as to episode of care676.51 Suppressed lactation, with delivery, with or without mention of antepartum condition676.52 Suppressed lactation, with delivery, with mention of postpartum complication676.53 Suppressed lactation, antepartum condition or complication676.54 Suppressed lactation, postpartum condition or complication676.60 Galactorrhea associated with childbirth, unspecified as to episode of care676.61 Galactorrhea, with delivery, with or without mention of antepartum condition676.62 Galactorrhea, with delivery, with mention of postpartum complication676.63 Galactorrhea, antepartum condition or complication676.64 Galactorrhea, postpartum condition or complication676.80 Other disorder of lactation, unspecified as to episode of care676.81 Other disorder of lactation, with delivery, with or without mention of antepartum condition676.82 Other disorder of lactation, with delivery, with mention of postpartum complication676.83 Other disorder of lactation, with delivery, with mention of postpartum complication676.84 Other disorder of lactation, postpartum condition or complication676.90 Unspecified disorder of lactation, unspecified as to episode of care

676.91Unspecified disorder of lactation, with delivery, with or without mention of antepartum condition

676.92 Unspecified disorder of lactation, with delivery, with mention of postpartum complication676.93 Unspecified disorder of lactation, antepartum condition or complication676.94 Unspecified disorder of lactation, postpartum condition or complication677 Late effect of complication of pregnancy, childbirth, and the puerperium678.00 Fetal hematologic conditions, unspecified as to episode of care or not applicable678.01 Fetal hematologic conditions, delivered, with or without mention of antepartum condition678.03 Fetal hematologic conditions, antepartum condition or complication


145



678.10 Fetal conjoined twins, unspecified as to episode of care or not applicable678.11 Fetal conjoined twins, delivered, with or without mention of antepartum condition678.13 Fetal conjoined twins, antepartum condition or complication

679.00Maternal complications from in utero procedure, unspecified as to episode of care or not applicable

679.01Maternal complications from in utero procedure, delivered, with or without mention of antepartum condition

679.02Maternal complications from in utero procedure, delivered, with mention of postpartum complication

679.03 Maternal complications from in utero procedure, antepartum condition or complication679.04 Maternal complications from in utero procedure, postpartum condition or complication

679.10Fetal complications from in utero procedure, unspecified as to episode of care or not applicable

679.11Fetal complications from in utero procedures, delivered, with or without mention of antepartum condition

679.12Fetal complications from in utero procedures, delivered, with mention of postpartum complication

679.13 Fetal complications from in utero procedures, antepartum condition or complication679.14 Fetal complications from in utero procedure, postpartum condition or complication

V22Normal pregnancy (excludes pregnancy examination or test, pregnancy unconfirmed (V72.40))

V22.0 Supervision of normal first pregnancyV22.1 Supervision of other normal pregnancyV22.2 Pregnant state, incidentalV23 Supervision of high-risk pregnancyV23.0 Pregnancy with history of infertilityV23.1 Pregnancy with history of trophoblastic diseaseV23.2 Pregnancy with history of abortionV23.3 Grand MultiparityV23.4 Pregnancy with other poor obstetric historyV23.41 Pregnancy with history of pre-term laborV23.42 Pregnancy with history of ectopic pregnancyV23.49 Pregnancy with other poor obstetric historyV23.5 Pregnancy with other poor reproductive historyV23.7 Insufficient prenatal careV23.8 Other high-risk pregnancyV23.81 Elderly primigravidaV23.82 Elderly multigravidaV23.83 Young primigravidaV23.84 Young multigravidaV23.85 Pregnancy resulting from assisted reproductive technologyV23.86 Pregnancy with history of in utero procedure during previous pregnancyV23.87 Pregnancy with inconclusive fetal viabilityV23.89 Other high-risk pregnancyV23.9 Unspecified high-risk pregnancy

V28

Encounter for antenatal screening of mother (excludes abnormal findings on screening-code to findings; routine prenatal care (V22.0-V23.9); suspected fetal conditions affecting management of pregnancy (655.00-655.93, 656.00-656.93, 657.00-657.03, , , , , , 658.00, 658.93); suspected fetal conditions not found (V89.01-V89.09) )

V28.0 Screening for chromosomal anomalies by amniocentesis


146



V28.1 Screening for raised alpha-fetoprotein levels in amniotic fluidV28.2 Other screening based on amniocentesisV28.3 Encounter for routine screening for malformation using ultrasonicsV28.4 Screening for fetal growth retardation using ultrasonicsV28.5 Screening for isoimmunizationV28.6 Screening for Streptococcus BV28.8 Other specified antenatal screeningV28.81 Encounter for fetal anatomic surveyV28.82 Encounter for screening for risk of pre-term laborV28.89 Other specified antenatal screeningV28.9 Unspecified antenatal screening



A34 Obstetrical TetanusO00.0 Abdominal pregnancyO00.00 Abdominal pregnancy without intrauterine pregnancyO00.01 Abdominal pregnancy with intrauterine pregnancyO00.1 Tubal pregnancyO00.10 Tubal pregnancy without intrauterine pregnancyO00.11 Tubal pregnancy with intrauterine pregnancyO00.2 Ovarian pregnancyO00.20 Ovarian pregnancy without intrauterine pregnancyO00.21 Ovarian pregnancy with intrauterine pregnancyO00.8 Other ectopic pregnancyO00.80 Other ectopic pregnancy without intrauterine pregnancyO00.81 Other ectopic pregnancy with intrauterine pregnancyO00.9 Ectopic pregnancy, unspecifiedO00.90 Unspecified ectopic pregnancy without intrauterine pregnancyO00.91 Unspecified ectopic pregnancy with intrauterine pregnancyO01.0 Classical hydatidiform moleO01.1 Incomplete and partial hydatidiform moleO01.9 Hydatidiform mole, unspecifiedO02.0 Blighted ovum and nonhydatidiform moleO02.1 Missed abortionO02.8 Other specified abnormal products of conceptionO02.9 Abnormal product of conception, unspecifiedO03.0 Genital tract and pelvic infection following incomplete spontaneous abortionO03.1 Delayed or excessive hemorrhage following incomplete spontaneous abortionO03.2 Embolism following incomplete spontaneous abortionO03.30 Unspecified complication following incomplete spontaneous abortionO03.35 Other venous complications following incomplete spontaneous abortionO03.36 Cardiac arrest following incomplete spontaneous abortionO03.37 Sepsis following incomplete spontaneous abortionO03.38 Urinary tract infection following incomplete spontaneous abortionO03.39 Incomplete spontaneous abortion with other complicationsO03.4 Incomplete spontaneous abortion without complication


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O03.5Genital tract and pelvic infection following complete or unspecified spontaneous abortion

O03.6Delayed or excessive hemorrhage following complete or unspecified spontaneous abortion

O03.7 Embolism following complete or unspecified spontaneous abortion

O03.80Unspecified complication following complete or unspecified spontaneous abortion

O03.81 Shock following complete or unspecified spontaneous abortionO03.82 Renal failure following complete or unspecified spontaneous abortionO03.83 Metabolic disorder following complete or unspecified spontaneous abortion

O03.84Damage to pelvic organs following complete or unspecified spontaneous abortion

O03.85Other venous complications following complete or unspecified spontaneous abortion

O03.86 Cardiac arrest following complete or unspecified spontaneous abortionO03.87 Sepsis following complete or unspecified spontaneous abortionO03.88 Urinary tract infection following complete or unspecified spontaneous abortionO03.89 Complete or unspecified spontaneous abortion with other complicationsO03.9 Complete or unspecified spontaneous abortion without complicationO04.5 Genital tract and pelvic infection following (induced) termination of pregnancy

O04.6Delayed or excessive hemorrhage following (induced) termination of pregnancy

O04.7 Embolism following (induced) termination of pregnancyO04.80 (Induced) termination of pregnancy with unspecified complicationsO04.81 Shock following (induced) termination of pregnancyO04.82 Renal failure following (induced) termination of pregnancyO04.83 Metabolic disorder following (induced) termination of pregnancyO04.84 Damage to pelvic organs following (induced) termination of pregnancyO04.85 Other venous complications following (induced) termination of pregnancyO04.86 Cardiac arrest following (induced) termination of pregnancyO04.87 Sepsis following (induced) termination of pregnancyO04.88 Urinary tract infection following (induced) termination of pregnancyO04.89 (Induced) termination of pregnancy with other complications

O07.0Genital tract and pelvic infection following failed attempted termination of pregnancy

O07.1Delayed or excessive hemorrhage following failed attempted termination of pregnancy

O07.2 Embolism following failed attempted termination of pregnancyO07.30 Failed attempted termination of pregnancy with unspecified complicationsO07.31 Shock following failed attempted termination of pregnancyO07.32 Renal failure following failed attempted termination of pregnancyO07.33 Damage to pelvic organs following failed attempted termination of pregnancyO07.34 Damage to pelvic organs following failed attempted termination of pregnancy

O07.35Other venous complications following failed attempted termination of pregnancy

O07.36 Cardiac arrest following failed attempted termination of pregnancyO07.37 Sepsis following failed attempted termination of pregnancyO07.38 Urinary tract infection following failed attempted termination of pregnancy


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O07.39 Failed attempted termination of pregnancy with other complicationsO07.4 Failed attempted termination of pregnancy without complicationO08.0 Genital tract and pelvic infection following ectopic and molar pregnancyO08.1 Delayed or excessive hemorrhage following ectopic and molar pregnancyO08.2 Embolism following ectopic and molar pregnancyO08.3 Shock following ectopic and molar pregnancyO08.4 Renal failure following ectopic and molar pregnancyO08.5 Metabolic disorders following an ectopic and molar pregnancy

O08.6Damage to pelvic organs and tissues following an ectopic and molar pregnancy

O08.7 Other venous complications following an ectopic and molar pregnancyO08.81 Cardiac arrest following an ectopic and molar pregnancyO08.82 Sepsis following ectopic and molar pregnancyO08.83 Urinary tract infection following an ectopic and molar pregnancyO08.89 Other complications following an ectopic and molar pregnancyO08.9 Unspecified complication following an ectopic and molar pregnancyO09.00 Supervision of pregnancy with history of infertility, unspecified trimesterO09.01 Supervision of pregnancy with history of infertility, first trimesterO09.02 Supervision of pregnancy with history of infertility, second trimesterO09.03 Supervision of pregnancy with history of infertility, third trimester

O09.10Supervision of pregnancy with history of ectopic or molar pregnancy, unspecified trimester

O09.11Supervision of pregnancy with history of ectopic or molar pregnancy, first trimester

O09.12Supervision of pregnancy with history of ectopic or molar pregnancy, second trimester

O09.13Supervision of pregnancy with history of ectopic or molar pregnancy, third trimester

O09.A0Supervision of pregnancy with history of ectopic or molar pregnancy, unspecified trimester

O09.A1Supervision of pregnancy with history of ectopic or molar pregnancy, first trimester

O09.A2Supervision of pregnancy with history of ectopic or molar pregnancy, second trimester

O09.A3Supervision of pregnancy with history of ectopic or molar pregnancy, third trimester

O09.211 Supervision of pregnancy with history of pre-term labor, first trimesterO09.212 Supervision of pregnancy with history of pre-term labor, second trimesterO09.213 Supervision of pregnancy with history of pre-term labor, third trimesterO09.219 Supervision of pregnancy with history of pre-term labor, unspecified trimester

O09.291 Supervision of pregnancy with other poor reproductive or obstetric history, firsttrimester

O09.292 Supervision of pregnancy with other poor reproductive or obstetric history, secondtrimester

O09.293 Supervision of pregnancy with other poor reproductive or obstetric history, thirdtrimester

O09.299 Supervision of pregnancy with other poor reproductive or obstetric history,unspecified trimester


149



O09.30 Supervision of pregnancy with insufficient antenatal care, unspecified trimesterO09.31 Supervision of pregnancy with insufficient antenatal care, first trimesterO09.32 Supervision of pregnancy with insufficient antenatal care, second trimesterO09.33 Supervision of pregnancy with insufficient antenatal care, third trimesterO09.40 Supervision of pregnancy with grand multiparity, unspecified trimesterO09.41 Supervision of pregnancy with grand multiparity, first trimesterO09.42 Supervision of pregnancy with grand multiparity, second trimesterO09.43 Supervision of pregnancy with grand multiparity, third trimesterO09.511 Supervision of elderly primigravida, first trimesterO09.512 Supervision of elderly primigravida, second trimesterO09.513 Supervision of elderly primigravida, third trimesterO09.519 Supervision of elderly primigravida, unspecified trimesterO09.521 Supervision of elderly multigravida, first trimesterO09.522 Supervision of elderly multigravida, second trimesterO09.523 Supervision of elderly multigravida, third trimesterO09.529 Supervision of elderly multigravida, unspecified trimesterO09.611 Supervision of young primigravida, first trimesterO09.612 Supervision of young primigravida, second trimesterO09.613 Supervision of young primigravida, third trimesterO09.619 Supervision of young primigravida, unspecified trimesterO09.621 Supervision of young multigravida, first trimesterO09.622 Supervision of young multigravida, second trimesterO09.623 Supervision of young multigravida, third trimesterO09.629 Supervision of young multigravida, unspecified trimester

O09.70Supervision of high risk pregnancy due to social problems, unspecified trimester

O09.71 Supervision of high risk pregnancy due to social problems, first trimesterO09.72 Supervision of high risk pregnancy due to social problems, second trimesterO09.73 Supervision of high risk pregnancy due to social problems, third trimester

O09.811Supervision of pregnancy resulting from assisted reproductive technology, firsttrimester

O09.812Supervision of pregnancy resulting from assisted reproductive technology, secondtrimester

O09.813Supervision of pregnancy resulting from assisted reproductive technology, thirdtrimester

O09.819Supervision of pregnancy resulting from assisted reproductive technology,unspecified trimester

O09.821Supervision of pregnancy with history of in utero procedure during previouspregnancy, first trimester

O09.822Supervision of pregnancy with history of in utero procedure during previouspregnancy, second trimester

O09.823Supervision of pregnancy with history of in utero procedure during previouspregnancy, third trimester

O09.829Supervision of pregnancy with history of in utero procedure during previouspregnancy, unspecified trimester

O09.891 Supervision of other high risk pregnancies, first trimesterO09.892 Supervision of other high risk pregnancies, second trimesterO09.893 Supervision of other high risk pregnancies, third trimester


150



O09.899 Supervision of other high risk pregnancies, unspecified trimesterO09.90 Supervision of high risk pregnancy, unspecified, unspecified trimesterO09.91 Supervision of high risk pregnancy, unspecified, first trimesterO09.92 Supervision of high risk pregnancy, unspecified, second trimesterO09.93 Supervision of high risk pregnancy, unspecified, third trimesterO10.011 Pre-existing essential hypertension complicating pregnancy, first trimesterO10.012 Pre-existing essential hypertension complicating pregnancy, second trimesterO10.013 Pre-existing essential hypertension complicating pregnancy, third trimester

O10.019 Pre-existing essential hypertension complicating pregnancy, unspecified trimester

O10.02 Pre-existing essential hypertension complicating childbirthO10.03 Pre-existing essential hypertension complicating the puerperium

O10.03Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, childbirth and the puerperium

O10.111 Pre-existing hypertensive heart disease complicating pregnancy, first trimester

O10.112 Pre-existing hypertensive heart disease complicating pregnancy, second trimester

O10.113 Pre-existing hypertensive heart disease complicating pregnancy, third trimester

O10.119Pre-existing hypertensive heart disease complicating pregnancy, unspecified trimester

O10.12 Pre-existing hypertensive heart disease complicating childbirthO10.13 Pre-existing hypertensive heart disease complicating the puerperium

O10.211 Pre-existing hypertensive chronic kidney disease complicating pregnancy, first trimester

O10.212 Pre-existing hypertensive chronic kidney disease complicating pregnancy, second trimester

O10.213 Pre-existing hypertensive chronic kidney disease complicating pregnancy, third trimester

O10.219Pre-existing hypertensive chronic kidney disease complicating pregnancy, unspecified trimester

O10.22 Pre-existing hypertensive chronic kidney disease complicating childbirthO10.23 Pre-existing hypertensive chronic kidney disease complicating the puerperium

O10.311 Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, first trimester

O10.312 Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, second trimester

O10.313 Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, third trimester

O10.319Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, unspecified trimester

O10.32Pre-existing hypertensive heart and chronic kidney disease complicating childbirth

O10.33Pre-existing hypertensive heart and chronic kidney disease complicating the puerperium

O10.411 Pre-existing secondary hypertension complicating pregnancy, first trimesterO10.412 Pre-existing secondary hypertension complicating pregnancy, second trimesterO10.413 Pre-existing secondary hypertension complicating pregnancy, third trimesterO10.419 Pre-existing secondary hypertension complicating pregnancy, unspecified


151



trimesterO10.42 Pre-existing secondary hypertension complicating childbirthO10.43 Pre-existing secondary hypertension complicating the puerperiumO10.911 Unspecified pre-existing hypertension complicating pregnancy, first trimester

O10.912Unspecified pre-existing hypertension complicating pregnancy, second trimester

O10.913 Unspecified pre-existing hypertension complicating pregnancy, third trimester

O10.919 Pre-existing hypertensive heart disease complicating pregnancy, unspecified trimester

O10.92 Unspecified pre-existing hypertension complicating childbirthO10.93 Unspecified pre-existing hypertension complicating the puerperiumO11.1 Pre-existing hypertension with pre-eclampsia, first trimesterO11.2 Pre-existing hypertension with pre-eclampsia, second trimesterO11.3 Pre-existing hypertension with pre-eclampsia, third trimesterO11.4 Pre-existing hypertension with pre-eclampsia, complicating childbirthO11.5 Pre-existing hypertension with pre-eclampsia, complicating the puerperiumO11.9 Pre-existing hypertension with pre-eclampsia, unspecified trimesterO12.00 Gestational edema, unspecified trimesterO12.01 Gestational edema, first trimesterO12.02 Gestational edema, second trimesterO12.03 Gestational edema, third trimesterO12.04 Gestational edema, complicating childbirthO12.05 Gestational edema, complicating the puerperiumO12.10 Gestational proteinuria, unspecified trimesterO12.14 Gestational proteinuria, complicating childbirthO12.15 Gestational proteinuria, complicating the puerperiumO12.20 Gestational edema with proteinuria, unspecified trimesterO12.21 Gestational edema with proteinuria, first trimesterO12.22 Gestational edema with proteinuria, second trimesterO12.23 Gestational edema with proteinuria, third trimesterO12.24 Gestational edema with proteinuria, complicating childbirthO12.25 Gestational edema with proteinuria, complicating the puerperium

O13.1 Gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester

O13.2 Gestational [pregnancy-induced] hypertension without significant proteinuria, second trimester

O13.3 Gestational [pregnancy-induced] hypertension without significant proteinuria, third trimester

O13.4Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating childbirth

O13.5Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating the puerperium

O13.9Gestational [pregnancy-induced] hypertension without significant proteinuria, unspecified trimester

O14.00 Mild to moderate pre-eclampsia, unspecified trimesterO14.02 Mild to moderate pre-eclampsia, second trimesterO14.03 Mild to moderate pre-eclampsia, third trimesterO14.04 Mild to moderate pre-eclampsia, complicating childbirth


152



O14.05 Mild to moderate pre-eclampsia, complicating the puerperiumO14.10 Severe pre-eclampsia, unspecified trimesterO14.12 Severe pre-eclampsia, second trimesterO14.13 Severe pre-eclampsia, third trimesterO14.14 Severe pre-eclampsia complicating childbirthO14.15 Severe pre-eclampsia, complicating the puerperiumO14.20 HELLP syndrome (HELLP), unspecified trimesterO14.22 HELLP syndrome (HELLP), second trimesterO14.23 HELLP syndrome (HELLP), third trimesterO14.24 HELLP syndrome, complicating childbirthO14.25 HELLP syndrome, complicating the puerperiumO14.90 Unspecified pre-eclampsia, unspecified trimesterO14.92 Unspecified pre-eclampsia, second trimesterO14.93 Unspecified pre-eclampsia, third trimesterO14.94 Unspecified pre-eclampsia, complicating childbirthO14.95 Unspecified pre-eclampsia, complicating the puerperiumO15.02 Eclampsia in pregnancy, second trimesterO15.03 Eclampsia in pregnancy, third trimesterO15.1 Eclampsia in laborO15.2 Eclampsia in the puerperiumO15.9 Eclampsia, unspecified as to time periodO16.1 Unspecified maternal hypertension, first trimesterO16.2 Unspecified maternal hypertension, second trimesterO16.3 Unspecified maternal hypertension, third trimesterO16.4 Unspecified maternal hypertension, complicating childbirthO16.5 Unspecified maternal hypertension, complicating the puerperiumO16.9 Unspecified maternal hypertension, unspecified trimesterO20.0 Threatened abortionO20.8 Other hemorrhage in early pregnancyO20.9 Hemorrhage in early pregnancy, unspecifiedO21.0 Mild hyperemesis gravidarumO21.1 Hyperemesis gravidarum with metabolic disturbanceO21.2 Late vomiting of pregnancyO21.8 Other vomiting complicating pregnancyO21.9 Vomiting of pregnancy, unspecifiedO22.00 Varicose veins of lower extremity in pregnancy, unspecified trimesterO22.01 Varicose veins of lower extremity in pregnancy, first trimesterO22.02 Varicose veins of lower extremity in pregnancy, second trimesterO22.03 Varicose veins of lower extremity in pregnancy, third trimesterO22.10 Genital varices in pregnancy, unspecified trimesterO22.11 Genital varices in pregnancy, first trimesterO22.12 Genital varices in pregnancy, second trimesterO22.13 Genital varices in pregnancy, third trimesterO22.20 Superficial thrombophlebitis in pregnancy, unspecified trimesterO22.21 Superficial thrombophlebitis in pregnancy, first trimesterO22.22 Superficial thrombophlebitis in pregnancy, second trimesterO22.23 Superficial thrombophlebitis in pregnancy, third trimester


153



O22.30 Deep phlebothrombosis in pregnancy, unspecified trimesterO22.31 Deep phlebothrombosis in pregnancy, first trimesterO22.32 Deep phlebothrombosis in pregnancy, second trimesterO22.33 Deep phlebothrombosis in pregnancy, third trimesterO22.40 Hemorrhoids in pregnancy, unspecified trimesterO22.41 Hemorrhoids in pregnancy, first trimesterO22.42 Hemorrhoids in pregnancy, second trimesterO22.43 Hemorrhoids in pregnancy, third trimesterO22.50 Cerebral venous thrombosis in pregnancy, unspecified trimesterO22.51 Cerebral venous thrombosis in pregnancy, first trimesterO22.52 Cerebral venous thrombosis in pregnancy, second trimesterO22.53 Cerebral venous thrombosis in pregnancy, third trimesterO22.8x1 Other venous complications in pregnancy, first trimesterO22.8x2 Other venous complications in pregnancy, second trimesterO22.8x3 Other venous complications in pregnancy, third trimesterO22.8x9 Other venous complications in pregnancy, unspecified trimesterO22.90 Venous complication in pregnancy, unspecified, unspecified trimesterO22.91 Venous complication in pregnancy, unspecified, first trimesterO22.92 Venous complication in pregnancy, unspecified, second trimesterO22.93 Venous complication in pregnancy, unspecified, third trimesterO23.00 Infections of kidney in pregnancy, unspecified trimesterO23.10 Infections of bladder in pregnancy, unspecified trimesterO23.20 Infections of urethra in pregnancy, unspecified trimesterO23.30 Infections of other parts of urinary tract in pregnancy, unspecified trimesterO23.40 Unspecified infection of urinary tract in pregnancy, unspecified trimesterO23.41 Unspecified infection of urinary tract in pregnancy, first trimesterO23.42 Unspecified infection of urinary tract in pregnancy, second trimesterO23.43 Unspecified infection of urinary tract in pregnancy, third trimesterO23.519 Infections of cervix in pregnancy, unspecified trimesterO23.529 Salpingo-oophoritis in pregnancy, unspecified trimesterO23.599 Infection of other part of genital tract in pregnancy, unspecified trimesterO23.90 Unspecified genitourinary tract infection in pregnancy, unspecified trimesterO23.91 Unspecified genitourinary tract infection in pregnancy, first trimesterO23.92 Unspecified genitourinary tract infection in pregnancy, second trimesterO23.93 Unspecified genitourinary tract infection in pregnancy, third trimesterO24.319 Unspecified pre-existing diabetes mellitus in pregnancy, unspecified trimesterO24.32 Unspecified pre-existing diabetes mellitus in childbirth

O24.415Gestational diabetes mellitus in pregnancy, controlled by oral hypoglycemic drugs

O24.419 Gestational diabetes mellitus in pregnancy, unspecified control

O24.425Gestational diabetes mellitus in childbirth, controlled by oral hypoglycemic drugs

O24.429 Gestational diabetes mellitus in childbirth, unspecified control

O24.435Gestational diabetes mellitus in puerperium, controlled by oral hypoglycemic drugs

O24.439 Gestational diabetes mellitus in the puerperium, unspecified controlO24.911 Unspecified diabetes mellitus in pregnancy, first trimesterO24.912 Unspecified diabetes mellitus in pregnancy, second trimester


154



O24.913 Unspecified diabetes mellitus in pregnancy, third trimesterO24.92 Unspecified diabetes mellitus in childbirthO24.93 Unspecified diabetes mellitus in puerperiumO25.10 Malnutrition in pregnancy, unspecified trimesterO25.11 Malnutrition in pregnancy, first trimesterO25.12 Malnutrition in pregnancy, second trimesterO25.13 Malnutrition in pregnancy, third trimesterO25.2 Malnutrition in childbirthO25.3 Malnutrition in the puerperiumO26.00 Excessive weight gain in pregnancy, unspecified trimesterO26.01 Excessive weight gain in pregnancy, first trimesterO26.02 Excessive weight gain in pregnancy, second trimesterO26.03 Excessive weight gain in pregnancy, third trimesterO26.10 Low weight gain in pregnancy, unspecified trimesterO26.11 Low weight gain in pregnancy, first trimesterO26.12 Low weight gain in pregnancy, second trimesterO26.13 Low weight gain in pregnancy, third trimesterO26.20 Retained intrauterine contraceptive device in pregnancy, unspecified trimesterO26.21 Pregnancy care for patient with recurrent pregnancy loss, first trimesterO26.22 Pregnancy care for patient with recurrent pregnancy loss, second trimesterO26.23 Pregnancy care for patient with recurrent pregnancy loss, third trimesterO26.50 Maternal hypotension syndrome, unspecified trimesterO26.51 Maternal hypotension syndrome, first trimesterO26.52 Maternal hypotension syndrome, second trimesterO26.53 Maternal hypotension syndrome, third trimesterO26.611 Pregnancy related exhaustion and fatigue, first trimesterO26.612 Pregnancy related exhaustion and fatigue, second trimesterO26.613 Pregnancy related exhaustion and fatigue, third trimesterO26.619 Pregnancy related exhaustion and fatigue, unspecified trimesterO26.62 Liver disorders in childbirthO26.811 Pregnancy related exhaustion and fatigue, first trimesterO26.812 Pregnancy related exhaustion and fatigue, second trimesterO26.813 Pregnancy related exhaustion and fatigue, third trimesterO26.819 Pregnancy related exhaustion and fatigue, unspecified trimesterO26.821 Pregnancy related peripheral neuritis, first trimesterO26.822 Pregnancy related peripheral neuritis, second trimesterO26.823 Pregnancy related peripheral neuritis, third trimesterO26.829 Pregnancy related peripheral neuritis, unspecified trimesterO26.831 Pregnancy related renal disease, first trimesterO26.832 Pregnancy related renal disease, second trimesterO26.833 Pregnancy related renal disease, third trimesterO26.839 Pregnancy related renal disease, unspecified trimesterO26.841 Uterine size-date discrepancy, first trimesterO26.842 Uterine size-date discrepancy, second trimesterO26.843 Uterine size-date discrepancy, third trimesterO26.849 Uterine size-date discrepancy, unspecified trimesterO26.851 Spotting complicating pregnancy, first trimester


155



O26.852 Spotting complicating pregnancy, second trimesterO26.853 Spotting complicating pregnancy, third trimesterO26.859 Spotting complicating pregnancy, unspecified trimesterO26.872 Cervical shortening, second trimesterO26.873 Cervical shortening, third trimesterO26.879 Cervical shortening, unspecified trimesterO26.891 Other specified pregnancy related conditions, first trimesterO26.892 Other specified pregnancy related conditions, second trimesterO26.893 Other specified pregnancy related conditions, third trimesterO26.899 Pregnancy related peripheral neuritis, unspecified trimesterO26.90 Pregnancy related conditions, unspecified, unspecified trimesterO26.91 Pregnancy related conditions, unspecified, first trimesterO26.92 Pregnancy related conditions, unspecified, second trimesterO26.93 Pregnancy related conditions, unspecified, third trimesterO28.0 Abnormal hematological finding on antenatal screening of motherO28.1 Abnormal biochemical finding on antenatal screening of motherO28.2 Abnormal cytological finding on antenatal screening of motherO28.3 Abnormal ultrasonic finding on antenatal screening of motherO28.4 Abnormal radiological finding on antenatal screening of motherO28.5 Abnormal chromosomal and genetic finding on antenatal screening of motherO28.8 Other abnormal findings on antenatal screening of motherO28.9 Unspecified abnormal findings on antenatal screening of motherO29.011 Aspiration pneumonitis due to anesthesia during pregnancy, first trimesterO29.012 Aspiration pneumonitis due to anesthesia during pregnancy, second trimesterO29.013 Aspiration pneumonitis due to anesthesia during pregnancy, third trimester

O29.019Aspiration pneumonitis due to anesthesia during pregnancy, unspecified trimester

O29.021 Pressure collapse of lung due to anesthesia during pregnancy, first trimester

O29.022Pressure collapse of lung due to anesthesia during pregnancy, second trimester

O29.023 Pressure collapse of lung due to anesthesia during pregnancy, third trimester

O29.029Pressure collapse of lung due to anesthesia during pregnancy, unspecified trimester

O29.091 Other pulmonary complications of anesthesia during pregnancy, first trimester

O29.092Other pulmonary complications of anesthesia during pregnancy, second trimester

O29.093 Other pulmonary complications of anesthesia during pregnancy, third trimester

O29.099Other pulmonary complications of anesthesia during pregnancy, unspecified trimester

O29.111 Cardiac arrest due to anesthesia during pregnancy, first trimesterO29.112 Cardiac arrest due to anesthesia during pregnancy, second trimesterO29.113 Cardiac arrest due to anesthesia during pregnancy, third trimesterO29.119 Cardiac arrest due to anesthesia during pregnancy, unspecified trimesterO29.121 Cardiac failure due to anesthesia during pregnancy, first trimesterO29.122 Cardiac failure due to anesthesia during pregnancy, second trimesterO29.123 Cardiac failure due to anesthesia during pregnancy, third trimesterO29.129 Cardiac failure due to anesthesia during pregnancy, unspecified trimesterO29.191 Other cardiac complications of anesthesia during pregnancy, first trimester


156



O29.192 Other cardiac complications of anesthesia during pregnancy, second trimesterO29.193 Other cardiac complications of anesthesia during pregnancy, third trimester

O29.199Other cardiac complications of anesthesia during pregnancy, unspecified trimester

O29.211 Cerebral anoxia due to anesthesia during pregnancy, first trimesterO29.212 Cerebral anoxia due to anesthesia during pregnancy, second trimesterO29.213 Cerebral anoxia due to anesthesia during pregnancy, third trimesterO29.219 Cerebral anoxia due to anesthesia during pregnancy, unspecified trimester

O29.291Other central nervous system complications of anesthesia during pregnancy, first trimester

O29.292Other central nervous system complications of anesthesia during pregnancy, second trimester

O29.293Other central nervous system complications of anesthesia during pregnancy, third trimester

O29.299Other central nervous system complications of anesthesia during pregnancy, unspecified trimester

O29.3X1 Toxic reaction to local anesthesia during pregnancy, first trimesterO29.3X2 Toxic reaction to local anesthesia during pregnancy, second trimesterO29.3X3 Toxic reaction to local anesthesia during pregnancy, third trimesterO29.3X9 Toxic reaction to local anesthesia during pregnancy, unspecified trimester

O29.40Spinal and epidural anesthesia induced headache during pregnancy, unspecified trimester

O29.41Spinal and epidural anesthesia induced headache during pregnancy, first trimester

O29.42Spinal and epidural anesthesia induced headache during pregnancy, second trimester

O29.43Spinal and epidural anesthesia induced headache during pregnancy, third trimester

O29.5X1Other complications of spinal and epidural anesthesia during pregnancy, first trimester

O29.5X2Other complications of spinal and epidural anesthesia during pregnancy, second trimester

O29.5X3Other complications of spinal and epidural anesthesia during pregnancy, third trimester

O29.5X9Other complications of spinal and epidural anesthesia during pregnancy, unspecified trimester

O29.60Failed or difficult intubation for anesthesia during pregnancy, unspecified trimester

O29.61 Failed or difficult intubation for anesthesia during pregnancy, first trimesterO29.62 Failed or difficult intubation for anesthesia during pregnancy, second trimesterO29.63 Failed or difficult intubation for anesthesia during pregnancy, third trimesterO29.8X1 Other complications of anesthesia during pregnancy, first trimesterO29.8X2 Other complications of anesthesia during pregnancy, second trimesterO29.8X3 Other complications of anesthesia during pregnancy, third trimesterO29.8X9 Other complications of anesthesia during pregnancy, unspecified trimester

O29.90Unspecified complication of anesthesia during pregnancy, unspecified trimester

O29.91 Unspecified complication of anesthesia during pregnancy, first trimester


157



O29.92 Unspecified complication of anesthesia during pregnancy, second trimesterO29.93 Unspecified complication of anesthesia during pregnancy, third trimester

O30.001 Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first trimester

O30.002 Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, second trimester

O30.003 Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third trimester

O30.009 Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester

O30.011 Twin pregnancy, monochorionic/monoamniotic, first trimesterO30.012 Twin pregnancy, monochorionic/monoamniotic, second trimesterO30.013 Twin pregnancy, monochorionic/monoamniotic, third trimesterO30.021 Conjoined twins, first trimesterO30.022 Conjoined twins, second trimesterO30.023 Conjoined twins, third trimesterO30.029 Conjoined twins, unspecified trimesterO30.031 Twin pregnancy, monochorionic/diamniotic, first trimesterO30.032 Twin pregnancy, monochorionic/diamniotic, second trimesterO30.033 Twin pregnancy, monochorionic/diamniotic, third trimesterO30.041 Twin pregnancy, dichorionic/diamniotic, first trimesterO30.042 Twin pregnancy, dichorionic/diamniotic, second trimesterO30.043 Twin pregnancy, dichorionic/diamniotic, third trimester

O30.091Twin pregnancy, unable to determine number of placenta and number of anmiotic sacs, first trimester

O30.092Twin pregnancy, unable to determine number of placenta and number of anmiotic sacs, second trimester

O30.093Twin pregnancy, unable to determine number of placenta and number of anmiotic sacs, third trimester

O30.101Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first trimester

O30.102Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, second trimester

O30.103Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third trimester

O30.109Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester

O30.111 Triplet pregnancy with two or more monochorionic fetuses, first trimesterO30.112 Triplet pregnancy with two or more monochorionic fetuses, second trimesterO30.113 Triplet pregnancy with two or more monochorionic fetuses, third trimester

O30.119Triplet pregnancy with two or more monochorionic fetuses, unspecified trimester

O30.121 Triplet pregnancy with two or more monoamniotic fetuses, first trimesterO30.122 Triplet pregnancy with two or more monoamniotic fetuses, second trimesterO30.123 Triplet pregnancy with two or more monoamniotic fetuses, third trimester

O30.129Triplet pregnancy with two or more monoamniotic fetuses, unspecified trimester

O30.191 Triplet pregnancy, unable to determine number of placenta and number of


158



amniotic sacs, first trimester

O30.192Triplet pregnancy, unable to determine number of placenta and number of amniotic sacs, second trimester

O30.193Triplet pregnancy, unable to determine number of placenta and number of amniotic sacs, third trimester

O30.199Triplet pregnancy, unable to determine number of placenta and number of amniotic sacs, unspecified trimester

O30.201 Quadruplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first trimester

O30.202 Quadruplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, second trimester

O30.203 Quadruplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third trimester

O30.209 Quadruplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester

O30.211 Quadruplet pregnancy with two or more monochorionic fetuses, first trimester

O30.212 Quadruplet pregnancy with two or more monochorionic fetuses, second trimester

O30.213 Quadruplet pregnancy with two or more monochorionic fetuses, third trimester

O30.219 Quadruplet pregnancy with two or more monochorionic fetuses, unspecified trimester

O30.221 Quadruplet pregnancy with two or more monoamniotic fetuses, first trimester

O30.222 Quadruplet pregnancy with two or more monoamniotic fetuses, second trimester

O30.223 Quadruplet pregnancy with two or more monoamniotic fetuses, third trimester

O30.229 Quadruplet pregnancy with two or more monoamniotic fetuses, unspecified trimester

O30.291 Quadruplet pregnancy, unable to determine number of placenta and number of amniotic sacs, first trimester

O30.292 Quadruplet pregnancy, unable to determine number of placenta and number of amniotic sacs, second trimester

O30.293 Quadruplet pregnancy, unable to determine number of placenta and number of amniotic sacs, third trimester

O30.299 Quadruplet pregnancy, unable to determine number of placenta and number of amniotic sacs, unspecified trimester

O30.801 Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic sacs, first trimester

O30.802 Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic sacs, second trimester

O30.803 Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic sacs, third trimester

O30.809 Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester

O30.811 Other specified multiple gestation with two or more monochorionic fetuses, first trimester

O30.812 Other specified multiple gestation with two or more monochorionic fetuses, second trimester

O30.813 Other specified multiple gestation with two or more monochorionic fetuses,


159



third trimester

O30.819 Other specified multiple gestation with two or more monochorionic fetuses, unspecified trimester

O30.821 Other specified multiple gestation with two or more monoamniotic fetuses, first trimester

O30.822 Other specified multiple gestation with two or more monoamniotic fetuses, second trimester

O30.823 Other specified multiple gestation with two or more monoamniotic fetuses, third trimester

O30.829 Other specified multiple gestation with two or more monoamniotic fetuses, unspecified trimester

O30.891 Other specified multiple gestation, unable to determine number of placenta and number of amniotic sacs, first trimester

O30.892 Other specified multiple gestation, unable to determine number of placenta and number of amniotic sacs, second trimester

O30.893 Other specified multiple gestation, unable to determine number of placenta and number of amniotic sacs, third trimester

O30.899 Other specified multiple gestation, unable to determine number of placenta and number of amniotic sacs, unspecified trimester

O30.90 Multiple gestation, unspecified, unspecified trimesterO30.91 Multiple gestation, unspecified, first trimesterO30.92 Multiple gestation, unspecified, second trimesterO30.93 Multiple gestation, unspecified, third trimesterO31.00X0 Papyraceous fetus, unspecified trimester, not applicable or unspecifiedO31.00X1 Papyraceous fetus, unspecified trimester, fetus 1O31.00X2 Papyraceous fetus, unspecified trimester, fetus 2O31.00X3 Papyraceous fetus, unspecified trimester, fetus 3O31.00X4 Papyraceous fetus, unspecified trimester, fetus 4O31.00X5 Papyraceous fetus, unspecified trimester, fetus 5O31.00X9 Papyraceous fetus, unspecified trimester, other fetusO31.01X0 Papyraceous fetus, first trimester, not applicable or unspecifiedO31.01X1 Papyraceous fetus, first trimester, fetus 1O31.01X2 Papyraceous fetus, first trimester, fetus 2O31.01X3 Papyraceous fetus, first trimester, fetus 3O31.01X4 Papyraceous fetus, first trimester, fetus 4O31.01X5 Papyraceous fetus, first trimester, fetus 5O31.01X9 Papyraceous fetus, first trimester, other fetusO31.02X0 Papyraceous fetus, second trimester, not applicable or unspecifiedO31.02X1 Papyraceous fetus, second trimester, fetus 1O31.02X2 Papyraceous fetus, second trimester, fetus 2O31.02X3 Papyraceous fetus, second trimester, fetus 3O31.02X4 Papyraceous fetus, second trimester, fetus 4O31.02X5 Papyraceous fetus, second trimester, fetus 5O31.02X9 Papyraceous fetus, second trimester, other fetusO31.03X0 Papyraceous fetus, third trimester, not applicable or unspecifiedO31.03X1 Papyraceous fetus, third trimester, fetus 1O31.03X2 Papyraceous fetus, third trimester, fetus 2O31.03X3 Papyraceous fetus, third trimester, fetus 3


160



O31.03X4 Papyraceous fetus, third trimester, fetus 4O31.03X5 Papyraceous fetus, third trimester, fetus 5O31.03X9 Papyraceous fetus, third trimester, other fetus

O31.10X0Continuing pregnancy after spontaneous abortion of one fetus or more, unspecified trimester, not applicable or unspecified

O31.10X1Continuing pregnancy after spontaneous abortion of one fetus or more, unspecified trimester, fetus 1





O31.10X9Continuing pregnancy after spontaneous abortion of one fetus or more, unspecified trimester, other fetus

O31.11X0Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, not applicable or unspecified

O31.11X1Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, fetus 1





O31.11X9Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, other fetus

O31.12X0Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, not applicable or unspecified

O31.12X1Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 1





O31.12X9Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, other fetus

O31.13X0Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, not applicable or unspecified

O31.13X1 Continuing pregnancy after spontaneous abortion of one fetus or more, third


161



trimester, fetus 1

O31.13X2Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, fetus 2




O31.13X9Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, other fetus

O31.20X0Continuing pregnancy after intrauterine death of one fetus or more, unspecified trimester, not applicable or unspecified

O31.20X1Continuing pregnancy after intrauterine death of one fetus or more, unspecified trimester, fetus 1





O31.20X9Continuing pregnancy after intrauterine death of one fetus or more, unspecified trimester, other fetus

O31.21X0Continuing pregnancy after intrauterine death of one fetus or more, first trimester, not applicable or unspecified

O31.21X1Continuing pregnancy after intrauterine death of one fetus or more, first trimester, fetus 1





O31.21X9Continuing pregnancy after intrauterine death of one fetus or more, first trimester, other fetus

O31.22X0Continuing pregnancy after intrauterine death of one fetus or more, second trimester, not applicable or unspecified

O31.22X1Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 1



O31.22X4 Continuing pregnancy after intrauterine death of one fetus or more, second


162



trimester, fetus 4


O31.22X9Continuing pregnancy after intrauterine death of one fetus or more, second trimester, other fetus

O31.23X0Continuing pregnancy after intrauterine death of one fetus or more, third trimester, not applicable or unspecified

O31.23X1Continuing pregnancy after intrauterine death of one fetus or more, third trimester, fetus 1





O31.23X9Continuing pregnancy after intrauterine death of one fetus or more, third trimester, other fetus

O31.30X0Continuing pregnancy after elective fetal reduction of one fetus or more, unspecified trimester, not applicable or unspecified

O31.30X1Continuing pregnancy after elective fetal reduction of one fetus or more, unspecified trimester, fetus 1





O31.30X9Continuing pregnancy after elective fetal reduction of one fetus or more, unspecified trimester, other fetus

O31.31X0Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, not applicable or unspecified

O31.31X1Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, fetus 1





O31.31X9Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, other fetus

O31.32X0 Continuing pregnancy after elective fetal reduction of one fetus or more,


163



second trimester, not applicable or unspecified

O31.32X1Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, fetus 1





O31.32X9Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, other fetus

O31.33X0Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, not applicable or unspecified

O31.33X1Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 1





O31.33X9Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, other fetus

O31.8X10Other complications specific to multiple gestation, first trimester, not applicable or unspecified

O31.8X11 Other complications specific to multiple gestation, first trimester, fetus 1O31.8X12 Other complications specific to multiple gestation, first trimester, fetus 2O31.8X13 Other complications specific to multiple gestation, first trimester, fetus 3O31.8X14 Other complications specific to multiple gestation, first trimester, fetus 4O31.8X15 Other complications specific to multiple gestation, first trimester, fetus 5O31.8X19 Other complications specific to multiple gestation, first trimester, other fetus

O31.8X20Other complications specific to multiple gestation, second trimester, not applicable or unspecified

O31.8X21 Other complications specific to multiple gestation, second trimester, fetus 1O31.8X22 Other complications specific to multiple gestation, second trimester, fetus 2O31.8X23 Other complications specific to multiple gestation, second trimester, fetus 3O31.8X24 Other complications specific to multiple gestation, second trimester, fetus 4O31.8X25 Other complications specific to multiple gestation, second trimester, fetus 5O31.8X29 Other complications specific to multiple gestation, second trimester, other fetus

O31.8X30Other complications specific to multiple gestation, third trimester, not applicable or unspecified

O31.8X31 Other complications specific to multiple gestation, third trimester, fetus 1O31.8X32 Other complications specific to multiple gestation, third trimester, fetus 2O31.8X33 Other complications specific to multiple gestation, third trimester, fetus 3


164



O31.8X34 Other complications specific to multiple gestation, third trimester, fetus 4O31.8X35 Other complications specific to multiple gestation, third trimester, fetus 5O31.8X39 Other complications specific to multiple gestation, third trimester, other fetus

O31.8X90Other complications specific to multiple gestation, unspecified trimester, not applicable or unspecified

O31.8X91 Other complications specific to multiple gestation, unspecified trimester, fetus 1O31.8X92 Other complications specific to multiple gestation, unspecified trimester, fetus 2O31.8X93 Other complications specific to multiple gestation, unspecified trimester, fetus 3O31.8X94 Other complications specific to multiple gestation, unspecified trimester, fetus 4O31.8X95 Other complications specific to multiple gestation, unspecified trimester, fetus 5

O31.8X99Other complications specific to multiple gestation, unspecified trimester, other fetus

O32.0XX0 Maternal care for unstable lie, not applicable or unspecifiedO32.0XX1 Maternal care for unstable lie, fetus 1O32.0XX2 Maternal care for unstable lie, fetus 2O32.0XX3 Maternal care for unstable lie, fetus 3O32.0XX4 Maternal care for unstable lie, fetus 4O32.0XX5 Maternal care for unstable lie, fetus 5O32.0XX9 Maternal care for unstable lie, other fetusO32.1XX0 Maternal care for breech presentation, not applicable or unspecifiedO32.1XX1 Maternal care for breech presentation, fetus 1O32.1XX2 Maternal care for breech presentation, fetus 2O32.1XX3 Maternal care for breech presentation, fetus 3O32.1XX4 Maternal care for breech presentation, fetus 4O32.1XX5 Maternal care for breech presentation, fetus 5O32.1XX9 Maternal care for breech presentation, other fetusO32.2XX0 Maternal care for transverse and oblique lie, not applicable or unspecifiedO32.2XX1 Maternal care for transverse and oblique lie, fetus 1O32.2XX2 Maternal care for transverse and oblique lie, fetus 2O32.2XX3 Maternal care for transverse and oblique lie, fetus 3O32.2XX4 Maternal care for transverse and oblique lie, fetus 4O32.2XX5 Maternal care for transverse and oblique lie, fetus 5O32.2XX9 Maternal care for transverse and oblique lie, other fetus

O32.3XX0Maternal care for face, brow and chin presentation, not applicable or unspecified

O32.3XX1 Maternal care for face, brow and chin presentation, fetus 1O32.3XX2 Maternal care for face, brow and chin presentation, fetus 2O32.3XX3 Maternal care for face, brow and chin presentation, fetus 3O32.3XX4 Maternal care for face, brow and chin presentation, fetus 4O32.3XX5 Maternal care for face, brow and chin presentation, fetus 5O32.3XX9 Maternal care for face, brow and chin presentation, other fetusO32.4XX0 Maternal care for high head at term, not applicable or unspecifiedO32.4XX1 Maternal care for high head at term, fetus 1O32.4XX2 Maternal care for high head at term, fetus 2O32.4XX3 Maternal care for high head at term, fetus 3O32.4XX4 Maternal care for high head at term, fetus 4O32.4XX5 Maternal care for high head at term, fetus 5O32.4XX9 Maternal care for high head at term, other fetus


165



O32.6XX0 Maternal care for compound presentation, not applicable or unspecifiedO32.6XX1 Maternal care for compound presentation, fetus 1O32.6XX2 Maternal care for compound presentation, fetus 2O32.6XX3 Maternal care for compound presentation, fetus 3O32.6XX4 Maternal care for compound presentation, fetus 4O32.6XX5 Maternal care for compound presentation, fetus 5O32.6XX9 Maternal care for compound presentation, other fetusO32.8XX0 Maternal care for other malpresentation of fetus, not applicable or unspecifiedO32.8XX1 Maternal care for other malpresentation of fetus, fetus 1O32.8XX2 Maternal care for other malpresentation of fetus, fetus 2O32.8XX3 Maternal care for other malpresentation of fetus, fetus 3O32.8XX4 Maternal care for other malpresentation of fetus, fetus 4O32.8XX5 Maternal care for other malpresentation of fetus, fetus 5O32.8XX9 Maternal care for other malpresentation of fetus, other fetus

O32.9XX0Maternal care for malpresentation of fetus, unspecified, not applicable or unspecified

O32.9XX1 Maternal care for malpresentation of fetus, unspecified, fetus 1O32.9XX2 Maternal care for malpresentation of fetus, unspecified, fetus 2O32.9XX3 Maternal care for malpresentation of fetus, unspecified, fetus 3O32.9XX4 Maternal care for malpresentation of fetus, unspecified, fetus 4O32.9XX5 Maternal care for malpresentation of fetus, unspecified, fetus 5O32.9XX9 Maternal care for malpresentation of fetus, unspecified, other fetusO33.0 Maternal care for disproportion due to deformity of maternal pelvic bonesO33.1 Maternal care for disproportion due to generally contracted pelvisO33.2 Maternal care for disproportion due to inlet contraction of pelvis

O33.3XX0Maternal care for disproportion due to outlet contraction of pelvis, not applicable or unspecified

O33.3XX1 Maternal care for disproportion due to outlet contraction of pelvis, fetus 1O33.3XX2 Maternal care for disproportion due to outlet contraction of pelvis, fetus 2O33.3XX3 Maternal care for disproportion due to outlet contraction of pelvis, fetus 3O33.3XX4 Maternal care for disproportion due to outlet contraction of pelvis, fetus 4O33.3XX5 Maternal care for disproportion due to outlet contraction of pelvis, fetus 5O33.3XX9 Maternal care for disproportion due to outlet contraction of pelvis, other fetus

O33.4XX0Maternal care for disproportion of mixed maternal and fetal origin, not applicable or unspecified

O33.4XX1 Maternal care for disproportion of mixed maternal and fetal origin, fetus 1O33.4XX2 Maternal care for disproportion of mixed maternal and fetal origin, fetus 2O33.4XX3 Maternal care for disproportion of mixed maternal and fetal origin, fetus 3O33.4XX4 Maternal care for disproportion of mixed maternal and fetal origin, fetus 4O33.4XX5 Maternal care for disproportion of mixed maternal and fetal origin, fetus 5O33.4XX9 Maternal care for disproportion of mixed maternal and fetal origin, other fetus

O33.5XX0Maternal care for disproportion due to unusually large fetus, not applicable or unspecified

O33.5XX1 Maternal care for disproportion due to unusually large fetus, fetus 1O33.5XX2 Maternal care for disproportion due to unusually large fetus, fetus 2O33.5XX3 Maternal care for disproportion due to unusually large fetus, fetus 3O33.5XX4 Maternal care for disproportion due to unusually large fetus, fetus 4O33.5XX5 Maternal care for disproportion due to unusually large fetus, fetus 5


166



O33.5XX9 Maternal care for disproportion due to unusually large fetus, other fetus

O33.6XX0Maternal care for disproportion due to hydrocephalic fetus, not applicable or unspecified

O33.6XX1 Maternal care for disproportion due to hydrocephalic fetus, fetus 1O33.6XX2 Maternal care for disproportion due to hydrocephalic fetus, fetus 2O33.6XX3 Maternal care for disproportion due to hydrocephalic fetus, fetus 3O33.6XX4 Maternal care for disproportion due to hydrocephalic fetus, fetus 4O33.6XX5 Maternal care for disproportion due to hydrocephalic fetus, fetus 5O33.6XX9 Maternal care for disproportion due to hydrocephalic fetus, other fetusO33.7 Maternal care for disproportion due to other fetal deformitiesO33.7XX0 Maternal care for disproprtn due to other fetal deform, unspecifiedO33.7XX1 Maternal care for disproprtn due to other fetal deform, fts1O33.7XX2 Maternal care for disproprtn due to other fetal deform, fts2O33.7XX3 Maternal care for disproprtn due to other fetal deform, fts3O33.7XX4 Maternal care for disproprtn due to other fetal deform, fts4O33.7XX5 Maternal care for disproprtn due to other fetal deform, fts5O33.7XX9 Maternal care for disproprtn due to other fetal deform, other fetusO33.8 Maternal care for disproportion of other originO33.9 Maternal care for disproportion, unspecified

O34.00Maternal care for unspecified congenital malformation of uterus, unspecified trimester

O34.01 Maternal care for unspecified congenital malformation of uterus, first trimester

O34.02Maternal care for unspecified congenital malformation of uterus, second trimester

O34.03 Maternal care for unspecified congenital malformation of uterus, third trimesterO34.10 Maternal care for benign tumor of corpus uteri, unspecified trimesterO34.11 Maternal care for benign tumor of corpus uteri, first trimesterO34.12 Maternal care for benign tumor of corpus uteri, second trimesterO34.13 Maternal care for benign tumor of corpus uteri, third trimesterO34.21 Maternal care for scar from previous cesarean deliveryO34.211 Maternal care for low transverse scar from prev cesarean delO34.212 Maternal care for vertical scar from previous cesarean delO34.219 Maternal care for unsp type scar from previous cesarean delO34.30 Maternal care for cervical incompetence, unspecified trimesterO34.31 Maternal care for cervical incompetence, first trimesterO34.32 Maternal care for cervical incompetence, second trimesterO34.33 Maternal care for cervical incompetence, third trimesterO34.40 Maternal care for other abnormalities of cervix, unspecified trimesterO34.41 Maternal care for other abnormalities of cervix, first trimesterO34.42 Maternal care for other abnormalities of cervix, second trimesterO34.43 Maternal care for other abnormalities of cervix, third trimesterO34.511 Maternal care for incarceration of gravid uterus, first trimesterO34.512 Maternal care for incarceration of gravid uterus, second trimesterO34.513 Maternal care for incarceration of gravid uterus, third trimesterO34.519 Maternal care for incarceration of gravid uterus, unspecified trimesterO34.521 Maternal care for prolapse of gravid uterus, first trimesterO34.522 Maternal care for prolapse of gravid uterus, second trimesterO34.523 Maternal care for prolapse of gravid uterus, third trimester


167



O34.529 Maternal care for prolapse of gravid uterus, unspecified trimesterO34.531 Maternal care for retroversion of gravid uterus, first trimesterO34.532 Maternal care for retroversion of gravid uterus, second trimesterO34.533 Maternal care for retroversion of gravid uterus, third trimesterO34.539 Maternal care for retroversion of gravid uterus, unspecified trimesterO34.591 Maternal care for other abnormalities of gravid uterus, first trimesterO34.592 Maternal care for other abnormalities of gravid uterus, second trimesterO34.593 Maternal care for other abnormalities of gravid uterus, third trimesterO34.599 Maternal care for other abnormalities of gravid uterus, unspecified trimesterO34.60 Maternal care for abnormality of vagina, unspecified trimesterO34.61 Maternal care for abnormality of vagina, first trimesterO34.62 Maternal care for abnormality of vagina, second trimesterO34.63 Maternal care for abnormality of vagina, third trimesterO34.70 Maternal care for abnormality of vulva and perineum, unspecified trimesterO34.71 Maternal care for abnormality of vulva and perineum, first trimesterO34.72 Maternal care for abnormality of vulva and perineum, second trimesterO34.73 Maternal care for abnormality of vulva and perineum, third trimesterO34.73 Maternal care for abnormality of vulva and perineum, third trimesterO34.80 Maternal care for other abnormalities of pelvic organs, unspecified trimesterO34.81 Maternal care for other abnormalities of pelvic organs, first trimesterO34.82 Maternal care for other abnormalities of pelvic organs, second trimesterO34.83 Maternal care for other abnormalities of pelvic organs, third trimester

O34.90Maternal care for abnormality of pelvic organ, unspecified, unspecified trimester

O34.91 Maternal care for abnormality of pelvic organ, unspecified, first trimesterO34.92 Maternal care for abnormality of pelvic organ, unspecified, second trimesterO34.93 Maternal care for abnormality of pelvic organ, unspecified, third trimester

O35.0XX0Maternal care for (suspected) central nervous system malformation in fetus, not applicable or unspecified

O35.0XX1Maternal care for (suspected) central nervous system malformation in fetus, fetus 1





O35.0XX9Maternal care for (suspected) central nervous system malformation in fetus, other fetus

O35.1XX0Maternal care for (suspected) chromosomal abnormality in fetus, not applicable or unspecified

O35.1XX1 Maternal care for (suspected) chromosomal abnormality in fetus, fetus 1O35.1XX2 Maternal care for (suspected) chromosomal abnormality in fetus, fetus 2O35.1XX3 Maternal care for (suspected) chromosomal abnormality in fetus, fetus 3O35.1XX4 Maternal care for (suspected) chromosomal abnormality in fetus, fetus 4O35.1XX5 Maternal care for (suspected) chromosomal abnormality in fetus, fetus 5


168



O35.1XX9 Maternal care for (suspected) chromosomal abnormality in fetus, other fetus

O35.2XX0Maternal care for (suspected) hereditary disease in fetus, not applicable or unspecified

O35.2XX1 Maternal care for (suspected) hereditary disease in fetus, fetus 1O35.2XX2 Maternal care for (suspected) hereditary disease in fetus, fetus 2O35.2XX3 Maternal care for (suspected) hereditary disease in fetus, fetus 3O35.2XX4 Maternal care for (suspected) hereditary disease in fetus, fetus 4O35.2XX5 Maternal care for (suspected) hereditary disease in fetus, fetus 5O35.2XX9 Maternal care for (suspected) hereditary disease in fetus, other fetus

O35.3XX0Maternal care for (suspected) damage to fetus from viral disease in mother, not applicable or unspecified

O35.3XX1Maternal care for (suspected) damage to fetus from viral disease in mother, fetus 1





O35.3XX9Maternal care for (suspected) damage to fetus from viral disease in mother, other fetus

O35.4XX0Maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified

O35.4XX1 Maternal care for (suspected) damage to fetus from alcohol, fetus 1O35.4XX2 Maternal care for (suspected) damage to fetus from alcohol, fetus 2O35.4XX3 Maternal care for (suspected) damage to fetus from alcohol, fetus 3O35.4XX4 Maternal care for (suspected) damage to fetus from alcohol, fetus 4O35.4XX5 Maternal care for (suspected) damage to fetus from alcohol, fetus 5O35.4XX9 Maternal care for (suspected) damage to fetus from alcohol, other fetus

O35.5XX0Maternal care for (suspected) damage to fetus by drugs, not applicable or unspecified

O35.5XX1 Maternal care for (suspected) damage to fetus by drugs, fetus 1O35.5XX2 Maternal care for (suspected) damage to fetus by drugs, fetus 2O35.5XX3 Maternal care for (suspected) damage to fetus by drugs, fetus 3O35.5XX4 Maternal care for (suspected) damage to fetus by drugs, fetus 4O35.5XX5 Maternal care for (suspected) damage to fetus by drugs, fetus 5O35.5XX9 Maternal care for (suspected) damage to fetus by drugs, other fetus

O35.6XX0Maternal care for (suspected) damage to fetus by radiation, not applicable or unspecified

O35.6XX1 Maternal care for (suspected) damage to fetus by radiation, fetus 1O35.6XX2 Maternal care for (suspected) damage to fetus by radiation, fetus 2O35.6XX3 Maternal care for (suspected) damage to fetus by radiation, fetus 3O35.6XX4 Maternal care for (suspected) damage to fetus by radiation, fetus 4O35.6XX5 Maternal care for (suspected) damage to fetus by radiation, fetus 5O35.6XX9 Maternal care for (suspected) damage to fetus by radiation, other fetusO35.7XX0 Maternal care for (suspected) damage to fetus by other medical procedures,


169



not applicable or unspecified

O35.7XX1Maternal care for (suspected) damage to fetus by other medical procedures, fetus 1





O35.7XX9Maternal care for (suspected) damage to fetus by other medical procedures, other fetus

O35.8XX0Maternal care for other (suspected) fetal abnormality and damage, not applicable or unspecified

O35.8XX1 Maternal care for other (suspected) fetal abnormality and damage, fetus 1O35.8XX2 Maternal care for other (suspected) fetal abnormality and damage, fetus 2O35.8XX3 Maternal care for other (suspected) fetal abnormality and damage, fetus 3O35.8XX4 Maternal care for other (suspected) fetal abnormality and damage, fetus 4O35.8XX5 Maternal care for other (suspected) fetal abnormality and damage, fetus 5O35.8XX9 Maternal care for other (suspected) fetal abnormality and damage, other fetus

O35.9XX0Maternal care for (suspected) fetal abnormality and damage, unspecified, not applicable or unspecified

O35.9XX1Maternal care for (suspected) fetal abnormality and damage, unspecified, fetus 1





O35.9XX9Maternal care for (suspected) fetal abnormality and damage, unspecified, other fetus

O36.0110 Maternal care for anti-D [Rh] antibodies, first trimester, not applicable or unspecified

O36.0111 Maternal care for anti-D [Rh] antibodies, first trimester, fetus 1O36.0111 Maternal care for other rhesus isoimmunization, third trimester, other fetusO36.0112 Maternal care for anti-D [Rh] antibodies, first trimester, fetus 2O36.0113 Maternal care for anti-D [Rh] antibodies, first trimester, fetus 3O36.0114 Maternal care for anti-D [Rh] antibodies, first trimester, fetus 4O36.0115 Maternal care for anti-D [Rh] antibodies, first trimester, fetus 5O36.0119 Maternal care for anti-D [Rh] antibodies, first trimester, other fetus

O36.0120 Maternal care for anti-D [Rh] antibodies, second trimester, not applicable or unspecified

O36.0121 Maternal care for anti-D [Rh] antibodies, second trimester, fetus 1O36.0122 Maternal care for anti-D [Rh] antibodies, second trimester, fetus 2


170



O36.0123 Maternal care for anti-D [Rh] antibodies, second trimester, fetus 3O36.0124 Maternal care for anti-D [Rh] antibodies, second trimester, fetus 4O36.0125 Maternal care for anti-D [Rh] antibodies, second trimester, fetus 5O36.0129 Maternal care for anti-D [Rh] antibodies, second trimester, other fetus

O36.0130 Maternal care for anti-D [Rh] antibodies, third trimester, not applicable or unspecified

O36.0131 Maternal care for anti-D [Rh] antibodies, third trimester, fetus 1O36.0132 Maternal care for anti-D [Rh] antibodies, third trimester, fetus 2O36.0133 Maternal care for anti-D [Rh] antibodies, third trimester, fetus 3O36.0134 Maternal care for anti-D [Rh] antibodies, third trimester, fetus 4O36.0135 Maternal care for anti-D [Rh] antibodies, third trimester, fetus 5O36.0139 Maternal care for anti-D [Rh] antibodies, third trimester, other fetus

O36.0190 Maternal care for anti-D [Rh] antibodies, unspecified trimester, not applicable or unspecified

O36.0191 Maternal care for anti-D [Rh] antibodies, unspecified trimester, fetus 1O36.0192 Maternal care for anti-D [Rh] antibodies, unspecified trimester, fetus 2O36.0193 Maternal care for anti-D [Rh] antibodies, unspecified trimester, fetus 3O36.0194 Maternal care for anti-D [Rh] antibodies, unspecified trimester, fetus 4O36.0195 Maternal care for anti-D [Rh] antibodies, unspecified trimester, fetus 5O36.0199 Maternal care for anti-D [Rh] antibodies, unspecified trimester, other fetus

O36.0910Maternal care for other rhesus isoimmunization, first trimester, not applicable or unspecified

O36.0911 Maternal care for other rhesus isoimmunization, first trimester, fetus 1O36.0912 Maternal care for other rhesus isoimmunization, first trimester, fetus 2O36.0913 Maternal care for other rhesus isoimmunization, first trimester, fetus 3O36.0914 Maternal care for other rhesus isoimmunization, first trimester, fetus 4O36.0915 Maternal care for other rhesus isoimmunization, first trimester, fetus 5O36.0919 Maternal care for other rhesus isoimmunization, first trimester, other fetus

O36.0920Maternal care for other rhesus isoimmunization, second trimester, not applicable or unspecified

O36.0921 Maternal care for other rhesus isoimmunization, second trimester, fetus 1O36.0922 Maternal care for other rhesus isoimmunization, second trimester, fetus 2O36.0923 Maternal care for other rhesus isoimmunization, second trimester, fetus 3O36.0924 Maternal care for other rhesus isoimmunization, second trimester, fetus 4O36.0925 Maternal care for other rhesus isoimmunization, second trimester, fetus 5O36.0929 Maternal care for other rhesus isoimmunization, second trimester, other fetus

O36.0930Maternal care for other rhesus isoimmunization, third trimester, not applicable or unspecified

O36.0931 Maternal care for other rhesus isoimmunization, third trimester, fetus 1O36.0932 Maternal care for other rhesus isoimmunization, third trimester, fetus 2O36.0933 Maternal care for other rhesus isoimmunization, third trimester, fetus 3O36.0934 Maternal care for other rhesus isoimmunization, third trimester, fetus 4O36.0935 Maternal care for other rhesus isoimmunization, third trimester, fetus 5O36.0939 Maternal care for other rhesus isoimmunization, third trimester, fetus 5O36.0939 Maternal care for other rhesus isoimmunization, third trimester, other fetus

O36.0990 Maternal care for other rhesus isoimmunization, unspecified trimester, not applicable or unspecified

O36.0991 Maternal care for other rhesus isoimmunization, unspecified trimester, fetus 1


171



O36.0992 Maternal care for other rhesus isoimmunization, unspecified trimester, fetus 2O36.0993 Maternal care for other rhesus isoimmunization, unspecified trimester, fetus 3O36.0994 Maternal care for other rhesus isoimmunization, unspecified trimester, fetus 4O36.0995 Maternal care for other rhesus isoimmunization, unspecified trimester, fetus 5

O36.0999 Maternal care for other rhesus isoimmunization, unspecified trimester, other fetus

O36.1110Maternal care for Anti-A sensitization, first trimester, not applicable or unspecified

O36.1111 Maternal care for Anti-A sensitization, first trimester, fetus 1O36.1112 Maternal care for Anti-A sensitization, first trimester, fetus 2O36.1113 Maternal care for Anti-A sensitization, first trimester, fetus 3O36.1114 Maternal care for Anti-A sensitization, first trimester, fetus 4O36.1115 Maternal care for Anti-A sensitization, first trimester, fetus 5O36.1119 Maternal care for Anti-A sensitization, first trimester, fetus 9

O36.1120Maternal care for Anti-A sensitization, second trimester, not applicable or unspecified

O36.1121 Maternal care for Anti-A sensitization, second trimester, fetus 1O36.1122 Maternal care for Anti-A sensitization, second trimester, fetus 2O36.1123 Maternal care for Anti-A sensitization, second trimester, fetus 3O36.1124 Maternal care for Anti-A sensitization, second trimester, fetus 4O36.1125 Maternal care for Anti-A sensitization, second trimester, fetus 5O36.1129 Maternal care for Anti-A sensitization, second trimester, other fetus

O36.1130Maternal care for Anti-A sensitization, third trimester, not applicable or unspecified

O36.1131 Maternal care for Anti-A sensitization, third trimester, fetus 1O36.1132 Maternal care for Anti-A sensitization, third trimester, fetus 2O36.1133 Maternal care for Anti-A sensitization, third trimester, fetus 3O36.1134 Maternal care for Anti-A sensitization, third trimester, fetus 4O36.1135 Maternal care for Anti-A sensitization, third trimester, fetus 5O36.1139 Maternal care for Anti-A sensitization, third trimester, other fetus

O36.1190Maternal care for Anti-A sensitization, unspecified trimester, not applicable or unspecified

O36.1191 Maternal care for Anti-A sensitization, unspecified trimester, fetus 1O36.1192 Maternal care for Anti-A sensitization, unspecified trimester, fetus 2O36.1193 Maternal care for Anti-A sensitization, unspecified trimester, fetus 3O36.1194 Maternal care for Anti-A sensitization, unspecified trimester, fetus 4O36.1195 Maternal care for Anti-A sensitization, unspecified trimester, fetus 5O36.1199 Maternal care for Anti-A sensitization, unspecified trimester, other fetus

O36.1910Maternal care for other isoimmunization, first trimester, not applicable or unspecified

O36.1911 Maternal care for other isoimmunization, first trimester, fetus 1O36.1912 Maternal care for other isoimmunization, first trimester, fetus 2O36.1913 Maternal care for other isoimmunization, first trimester, fetus 3O36.1914 Maternal care for other isoimmunization, first trimester, fetus 4O36.1915 Maternal care for other isoimmunization, first trimester, fetus 5O36.1919 Maternal care for other isoimmunization, first trimester, other fetus

O36.1920Maternal care for other isoimmunization, second trimester, not applicable or unspecified


172



O36.1921 Maternal care for other isoimmunization, second trimester, fetus 1O36.1922 Maternal care for other isoimmunization, second trimester, fetus 2O36.1923 Maternal care for other isoimmunization, second trimester, fetus 3O36.1924 Maternal care for other isoimmunization, second trimester, fetus 4O36.1925 Maternal care for other isoimmunization, second trimester, fetus 5O36.1929 Maternal care for other isoimmunization, second trimester, other fetus

O36.1930Maternal care for other isoimmunization, third trimester, not applicable or unspecified

O36.1931 Maternal care for other isoimmunization, third trimester, fetus 1O36.1932 Maternal care for other isoimmunization, third trimester, fetus 2O36.1933 Maternal care for other isoimmunization, third trimester, fetus 3O36.1934 Maternal care for other isoimmunization, third trimester, fetus 4O36.1935 Maternal care for other isoimmunization, third trimester, fetus 5O36.1939 Maternal care for other isoimmunization, third trimester, other fetus

O36.1990Maternal care for other isoimmunization, unspecified trimester, not applicable or unspecified

O36.1991 Maternal care for other isoimmunization, unspecified trimester, fetus 1O36.1992 Maternal care for other isoimmunization, unspecified trimester, fetus 2O36.1993 Maternal care for other isoimmunization, unspecified trimester, fetus 3O36.1994 Maternal care for other isoimmunization, unspecified trimester, fetus 4O36.1995 Maternal care for other isoimmunization, unspecified trimester, fetus 5O36.1999 Maternal care for other isoimmunization, unspecified trimester, other fetus

O36.20X0Maternal care for hydrops fetalis, unspecified trimester, not applicable or unspecified

O36.20X1 Maternal care for hydrops fetalis, unspecified trimester, fetus 1O36.20X2 Maternal care for hydrops fetalis, unspecified trimester, fetus 2O36.20X3 Maternal care for hydrops fetalis, unspecified trimester, fetus 3O36.20X4 Maternal care for hydrops fetalis, unspecified trimester, fetus 4O36.20X5 Maternal care for hydrops fetalis, unspecified trimester, fetus 5O36.20X9 Maternal care for hydrops fetalis, unspecified trimester, other fetus O36.4XX0 Maternal care for intrauterine death, not applicable or unspecifiedO36.4XX1 Maternal care for intrauterine death, fetus 1O36.4XX2 Maternal care for intrauterine death, fetus 2O36.4XX3 Maternal care for intrauterine death, fetus 3O36.4XX4 Maternal care for intrauterine death, fetus 4O36.4XX5 Maternal care for intrauterine death, fetus 5O36.4XX9 Maternal care for intrauterine death, other fetus

O36.5110 Maternal care for known or suspected placental insufficiency, first trimester, not applicable or unspecified

O36.5111 Maternal care for known or suspected placental insufficiency, first trimester, fetus 1




O36.5115 Maternal care for known or suspected placental insufficiency, first trimester,


173



fetus 5

O36.5119 Maternal care for known or suspected placental insufficiency, first trimester,other fetus

O36.5120 Maternal care for known or suspected placental insufficiency, second trimester, not applicable or unspecified

O36.5121 Maternal care for known or suspected placental insufficiency, second trimester, fetus 1





O36.5125 Maternal care for known or suspected placental insufficiency, third trimester, fetus 5

O36.5129 Maternal care for known or suspected placental insufficiency, second trimester, other fetus

O36.5130 Maternal care for known or suspected placental insufficiency, third trimester, not applicable or unspecified





O36.5139 Maternal care for known or suspected placental insufficiency, third trimester, other fetus

O36.5190Maternal care for known or suspected placental insufficiency, unspecified trimester, not applicable or unspecified

O36.5191Maternal care for known or suspected placental insufficiency, unspecified trimester, fetus 1





O36.5199Maternal care for known or suspected placental insufficiency, unspecified trimester, other fetus

O36.5910 Maternal care for other known or suspected poor fetal growth, first trimester, not applicable or unspecified

O36.5911 Maternal care for other known or suspected poor fetal growth, first trimester,


174



fetus 1

O36.5912 Maternal care for other known or suspected poor fetal growth, first trimester, fetus 2




O36.5919 Maternal care for other known or suspected poor fetal growth, first trimester, other fetus

O36.5920 Maternal care for other known or suspected poor fetal growth, second trimester, not applicable or unspecified

O36.5921 Maternal care for other known or suspected poor fetal growth, second trimester, fetus 1





O36.5925 Maternal care for other known or suspected poor fetal growth, third trimester, fetus 5

O36.5929 Maternal care for other known or suspected poor fetal growth, second trimester, other fetus

O36.5930 Maternal care for other known or suspected poor fetal growth, third trimester, not applicable or unspecified





O36.5939 Maternal care for other known or suspected poor fetal growth, third trimester, other fetus

O36.5990 Maternal care for other known or suspected poor fetal growth, unspecified trimester, not applicable or unspecified

O36.5991 Maternal care for other known or suspected poor fetal growth, unspecified trimester, fetus 1



O36.5994 Maternal care for other known or suspected poor fetal growth, unspecified


175



trimester, fetus 4


O36.5999 Maternal care for other known or suspected poor fetal growth, unspecified trimester, other fetus

O36.60X0Maternal care for excessive fetal growth, unspecified trimester, not applicable or unspecified

O36.60X1 Maternal care for excessive fetal growth, unspecified trimester, fetus 1O36.60X2 Maternal care for excessive fetal growth, unspecified trimester, fetus 2O36.60X3 Maternal care for excessive fetal growth, unspecified trimester, fetus 3O36.60X4 Maternal care for excessive fetal growth, unspecified trimester, fetus 4O36.60X5 Maternal care for excessive fetal growth, unspecified trimester, fetus 5O36.60X9 Maternal care for excessive fetal growth, unspecified trimester, other fetus

O36.61X0Maternal care for excessive fetal growth, first trimester, not applicable or unspecified

O36.61X1 Maternal care for excessive fetal growth, first trimester, fetus 1O36.61X2 Maternal care for excessive fetal growth, first trimester, fetus 2O36.61X3 Maternal care for excessive fetal growth, first trimester, fetus 3O36.61X4 Maternal care for excessive fetal growth, first trimester, fetus 4O36.61X5 Maternal care for excessive fetal growth, first trimester, fetus 5O36.61X9 Maternal care for excessive fetal growth, first trimester, other fetus

O36.62X0Maternal care for excessive fetal growth, second trimester, not applicable or unspecified

O36.62X1 Maternal care for excessive fetal growth, second trimester, fetus 1O36.62X2 Maternal care for excessive fetal growth, second trimester, fetus 2O36.62X3 Maternal care for excessive fetal growth, second trimester, fetus 3O36.62X4 Maternal care for excessive fetal growth, second trimester, fetus 4O36.62X5 Maternal care for excessive fetal growth, second trimester, fetus 5O36.62X9 Maternal care for excessive fetal growth, second trimester, other fetus

O36.63X0Maternal care for excessive fetal growth, third trimester, not applicable or unspecified

O36.63X1 Maternal care for excessive fetal growth, third trimester, fetus 1O36.63X2 Maternal care for excessive fetal growth, third trimester, fetus 2O36.63X3 Maternal care for excessive fetal growth, third trimester, fetus 3O36.63X4 Maternal care for excessive fetal growth, third trimester, fetus 4O36.63X5 Maternal care for excessive fetal growth, third trimester, fetus 5O36.63X9 Maternal care for excessive fetal growth, third trimester, other fetus

O36.70X0Maternal care for viable fetus in abdominal pregnancy, unspecified trimester, not applicable or unspecified

O36.70X1Maternal care for viable fetus in abdominal pregnancy, unspecified trimester, fetus 1




O36.70X5 Maternal care for viable fetus in abdominal pregnancy, unspecified trimester,


176



fetus 5

O36.70X9Maternal care for viable fetus in abdominal pregnancy, unspecified trimester, other fetus

O36.8210Fetal anemia and thrombocytopenia, first trimester; not applicable or unspecified

O36.8211 Fetal anemia and thrombocytopenia, first trimester; fetus 1O36.8212 Fetal anemia and thrombocytopenia, first trimester; fetus 2O36.8213 Fetal anemia and thrombocytopenia, first trimester; fetus 3O36.8214 Fetal anemia and thrombocytopenia, first trimester; fetus 4O36.8215 Fetal anemia and thrombocytopenia, first trimester; fetus 5O36.8219 Fetal anemia and thrombocytopenia, first trimester; other fetus

O36.8220Fetal anemia and thrombocytopenia, second trimester; not applicable or unspecified

O36.8221 Fetal anemia and thrombocytopenia, second trimester; fetus 1O36.8222 Fetal anemia and thrombocytopenia, second trimester; fetus 2O36.8223 Fetal anemia and thrombocytopenia, second trimester; fetus 3O36.8224 Fetal anemia and thrombocytopenia, second trimester; fetus 4O36.8225 Fetal anemia and thrombocytopenia, second trimester; fetus 5O36.8229 Fetal anemia and thrombocytopenia, second trimester; other fetus

O36.8230Fetal anemia and thrombocytopenia, third trimester; not applicable or unspecified

O36.8231 Fetal anemia and thrombocytopenia, third trimester; fetus 1O36.8232 Fetal anemia and thrombocytopenia, third trimester; fetus 2O36.8233 Fetal anemia and thrombocytopenia, third trimester; fetus 3O36.8234 Fetal anemia and thrombocytopenia, third trimester; fetus 4O36.8235 Fetal anemia and thrombocytopenia, third trimester; fetus 5O36.8239 Fetal anemia and thrombocytopenia, third trimester; other fetus

O36.8290Fetal anemia and thrombocytopenia, unspecified trimester; not applicable or unspecified

O36.8291 Fetal anemia and thrombocytopenia, unspecified trimester; fetus 1O36.8292 Fetal anemia and thrombocytopenia, unspecified trimester; fetus 2O36.8293 Fetal anemia and thrombocytopenia, unspecified trimester; fetus 3O36.8294 Fetal anemia and thrombocytopenia, unspecified trimester; fetus 4O36.8295 Fetal anemia and thrombocytopenia, unspecified trimester; fetus 5O36.8299 Fetal anemia and thrombocytopenia, unspecified trimester; other fetus

O36.8910Maternal care for other specified fetal problems, first trimester, not applicable or unspecified

O36.8911 Maternal care for other specified fetal problems, first trimester, fetus 1O36.8912 Maternal care for other specified fetal problems, first trimester, fetus 2O36.8913 Maternal care for other specified fetal problems, first trimester, fetus 3O36.8914 Maternal care for other specified fetal problems, first trimester, fetus 4O36.8915 Maternal care for other specified fetal problems, first trimester, fetus 5O36.8919 Maternal care for other specified fetal problems, first trimester, other fetus

O36.8920Maternal care for other specified fetal problems, second trimester, not applicable or unspecified

O36.8921 Maternal care for other specified fetal problems, second trimester, fetus 1O36.8922 Maternal care for other specified fetal problems, second trimester, fetus 2O36.8923 Maternal care for other specified fetal problems, second trimester, fetus 3


177



O36.8924 Maternal care for other specified fetal problems, second trimester, fetus 4O36.8925 Maternal care for other specified fetal problems, second trimester, fetus 5O36.8929 Maternal care for other specified fetal problems, second trimester, other fetus

O36.8930Maternal care for other specified fetal problems, third trimester, not applicable or unspecified

O36.8931 Maternal care for other specified fetal problems, third trimester, fetus 1O36.8932 Maternal care for other specified fetal problems, third trimester, fetus 2O36.8933 Maternal care for other specified fetal problems, third trimester, fetus 3O36.8934 Maternal care for other specified fetal problems, third trimester, fetus 4O36.8935 Maternal care for other specified fetal problems, third trimester, fetus 5O36.8939 Maternal care for other specified fetal problems, third trimester, other fetus

O36.8990Maternal care for other specified fetal problems, unspecified trimester, not applicable or unspecified

O36.8991 Maternal care for other specified fetal problems, unspecified trimester, fetus 1O36.8992 Maternal care for other specified fetal problems, unspecified trimester, fetus 2O36.8993 Maternal care for other specified fetal problems, unspecified trimester, fetus 3O36.8994 Maternal care for other specified fetal problems, unspecified trimester, fetus 4O36.8995 Maternal care for other specified fetal problems, unspecified trimester, fetus 5

O36.8999Maternal care for other specified fetal problems, unspecified trimester, other fetus

O36.90x0Maternal care for fetal problem, unspecified, unspecified trimester, not applicable or unspecified

O36.90X0Maternal care for fetal problem, unspecified, unspecified trimester, not applicable or unspecified

O36.90X1 Maternal care for fetal problem, unspecified, unspecified trimester, fetus 1O36.90X2 Maternal care for fetal problem, unspecified, unspecified trimester, fetus 2O36.90X3 Maternal care for fetal problem, unspecified, unspecified trimester, fetus 3O36.90X4 Maternal care for fetal problem, unspecified, unspecified trimester, fetus 4O36.90X5 Maternal care for fetal problem, unspecified, unspecified trimester, fetus 5O36.90X9 Maternal care for fetal problem, unspecified, unspecified trimester, other fetus

O36.91X0Maternal care for fetal problem, unspecified, first trimester, not applicable or unspecified

O36.91X1 Maternal care for fetal problem, unspecified, first trimester, fetus 1O36.91X2 Maternal care for fetal problem, unspecified, first trimester, fetus 2O36.91X3 Maternal care for fetal problem, unspecified, first trimester, fetus 3O36.91X4 Maternal care for fetal problem, unspecified, first trimester, fetus 4O36.91X5 Maternal care for fetal problem, unspecified, first trimester, fetus 5O36.91X9 Maternal care for fetal problem, unspecified, first trimester, other fetus

O36.92X0Maternal care for fetal problem, unspecified, second trimester, not applicable or unspecified

O36.92X1 Maternal care for fetal problem, unspecified, second trimester, fetus 1O36.92X2 Maternal care for fetal problem, unspecified, second trimester, fetus 2O36.92X3 Maternal care for fetal problem, unspecified, second trimester, fetus 3O36.92X4 Maternal care for fetal problem, unspecified, second trimester, fetus 4O36.92X5 Maternal care for fetal problem, unspecified, second trimester, fetus 5O36.92X9 Maternal care for fetal problem, unspecified, second trimester, other fetus

O36.93X0Maternal care for fetal problem, unspecified, third trimester, not applicable or unspecified


178



O36.93X1 Maternal care for fetal problem, unspecified, third trimester, fetus 1O36.93X2 Maternal care for fetal problem, unspecified, third trimester, fetus 2O36.93X3 Maternal care for fetal problem, unspecified, third trimester, fetus 3O36.93X4 Maternal care for fetal problem, unspecified, third trimester, fetus 4O36.93X5 Maternal care for fetal problem, unspecified, third trimester, fetus 5O36.93X9 Maternal care for fetal problem, unspecified, third trimester, other fetusO40.1XX0 Polyhydramnios, first trimester, not applicable or unspecifiedO40.1XX1 Polyhydramnios, first trimester, fetus 1O40.1XX2 Polyhydramnios, first trimester, fetus 2O40.1XX3 Polyhydramnios, first trimester, fetus 3O40.1XX4 Polyhydramnios, first trimester, fetus 4O40.1XX5 Polyhydramnios, first trimester, fetus 5O40.1XX9 Polyhydramnios, first trimester, other fetusO40.2XX0 Polyhydramnios, second trimester, not applicable or unspecifiedO40.2XX1 Polyhydramnios, second trimester, fetus 1O40.2XX2 Polyhydramnios, second trimester, fetus 2O40.2XX3 Polyhydramnios, second trimester, fetus 3O40.2XX4 Polyhydramnios, second trimester, fetus 4O40.2XX5 Polyhydramnios, second trimester, fetus 5O40.2XX9 Polyhydramnios, second trimester, other fetusO40.3XX0 Polyhydramnios, third trimester, not applicable or unspecifiedO40.3XX1 Polyhydramnios, third trimester, fetus 1O40.3XX2 Polyhydramnios, third trimester, fetus 2O40.3XX3 Polyhydramnios, third trimester, fetus 3O40.3XX4 Polyhydramnios, third trimester, fetus 4O40.3XX5 Polyhydramnios, third trimester, fetus 5O40.3XX9 Polyhydramnios, third trimester, other fetusO40.9XX0 Polyhydramnios, unspecified trimester, not applicable or unspecifiedO40.9XX1 Polyhydramnios, unspecified trimester, fetus 1O40.9XX2 Polyhydramnios, unspecified trimester, fetus 2O40.9XX3 Polyhydramnios, unspecified trimester, fetus 3O40.9XX4 Polyhydramnios, unspecified trimester, fetus 4O40.9XX5 Polyhydramnios, unspecified trimester, fetus 5O40.9XX9 Polyhydramnios, unspecified trimester, other fetusO41.00X0 Oligohydramnios, unspecified trimester, not applicable or unspecifiedO41.00X1 Oligohydramnios, unspecified trimester, fetus 1O41.00X2 Oligohydramnios, unspecified trimester, fetus 2O41.00X3 Oligohydramnios, unspecified trimester, fetus 3O41.00X4 Oligohydramnios, unspecified trimester, fetus 4O41.00X5 Oligohydramnios, unspecified trimester, fetus 5O41.00X9 Oligohydramnios, unspecified trimester, other fetusO41.01X0 Oligohydramnios, first trimester, not applicable or unspecifiedO41.01X1 Oligohydramnios, first trimester, fetus 1O41.01X2 Oligohydramnios, first trimester, fetus 2O41.01X3 Oligohydramnios, first trimester, fetus 3O41.01X4 Oligohydramnios, first trimester, fetus 4O41.01X5 Oligohydramnios, first trimester, fetus 5


179



O41.01X9 Oligohydramnios, first trimester, other fetusO41.02X0 Oligohydramnios, second trimester, not applicable or unspecifiedO41.02X1 Oligohydramnios, second trimester, fetus 1O41.02X2 Oligohydramnios, second trimester, fetus 2O41.02X3 Oligohydramnios, second trimester, fetus 3O41.02X4 Oligohydramnios, second trimester, fetus 4O41.02X5 Oligohydramnios, second trimester, fetus 5O41.02X9 Oligohydramnios, second trimester, other fetusO41.03X0 Oligohydramnios, third trimester, not applicable or unspecifiedO41.03X1 Oligohydramnios, third trimester, fetus 1O41.03X2 Oligohydramnios, third trimester, fetus 2O41.03X3 Oligohydramnios, third trimester, fetus 3O41.03X4 Oligohydramnios, third trimester, fetus 4O41.03X5 Oligohydramnios, third trimester, fetus 5O41.03X9 Oligohydramnios, third trimester, other fetus

O41.1010Infection of amniotic sac and membranes, unspecified, first trimester, not applicable or unspecified

O41.1011 Infection of amniotic sac and membranes, unspecified, first trimester, fetus 1O41.1012 Infection of amniotic sac and membranes, unspecified, first trimester, fetus 2O41.1013 Infection of amniotic sac and membranes, unspecified, first trimester, fetus 3O41.1014 Infection of amniotic sac and membranes, unspecified, first trimester, fetus 4O41.1015 Infection of amniotic sac and membranes, unspecified, first trimester, fetus 5

O41.1019Infection of amniotic sac and membranes, unspecified, first trimester, other fetus

O41.1020Infection of amniotic sac and membranes, unspecified, second trimester, not applicable or unspecified

O41.1021Infection of amniotic sac and membranes, unspecified, second trimester, fetus 1





O41.1029Infection of amniotic sac and membranes, unspecified, second trimester, other fetus

O41.1030Infection of amniotic sac and membranes, unspecified, third trimester, not applicable or unspecified

O41.1031 Infection of amniotic sac and membranes, unspecified, third trimester, fetus 1O41.1032 Infection of amniotic sac and membranes, unspecified, third trimester, fetus 2O41.1033 Infection of amniotic sac and membranes, unspecified, third trimester, fetus 3O41.1034 Infection of amniotic sac and membranes, unspecified, third trimester, fetus 4O41.1035 Infection of amniotic sac and membranes, unspecified, third trimester, fetus 5

O41.1039Infection of amniotic sac and membranes, unspecified, third trimester, other fetus

O41.1090 Infection of amniotic sac and membranes, unspecified, unspecified trimester,


180



not applicable or unspecified

O41.1091 Infection of amniotic sac and membranes, unspecified, unspecified trimester, fetus 1





O41.1099 Infection of amniotic sac and membranes, unspecified, unspecified trimester, other fetus

O41.1210 Chorioamnionitis, first trimester, not applicable or unspecifiedO41.1211 Chorioamnionitis, first trimester, fetus 1O41.1212 Chorioamnionitis, first trimester, fetus 2O41.1213 Chorioamnionitis, first trimester, fetus 3O41.1214 Chorioamnionitis, first trimester, fetus 4O41.1215 Chorioamnionitis, first trimester, fetus 5O41.1219 Chorioamnionitis, first trimester, other fetus O41.1220 Chorioamnionitis, second trimester, not applicable or unspecifiedO41.1221 Chorioamnionitis, second trimester, fetus 1O41.1222 Chorioamnionitis, second trimester, fetus 2O41.1223 Chorioamnionitis, second trimester, fetus 3O41.1224 Chorioamnionitis, second trimester, fetus 4O41.1225 Chorioamnionitis, second trimester, fetus 5O41.1229 Chorioamnionitis, second trimester, other fetus O41.1230 Chorioamnionitis, third trimester, not applicable or unspecifiedO41.1231 Chorioamnionitis, third trimester, fetus 1O41.1232 Chorioamnionitis, third trimester, fetus 2O41.1233 Chorioamnionitis, third trimester, fetus 3O41.1234 Chorioamnionitis, third trimester, fetus 4O41.1235 Chorioamnionitis, third trimester, fetus 5O41.1239 Chorioamnionitis, third trimester, other fetus O41.1290 Chorioamnionitis, unspecified trimester, not applicable or unspecifiedO41.1291 Chorioamnionitis, unspecified trimester, fetus 1O41.1292 Chorioamnionitis, unspecified trimester, fetus 2O41.1293 Chorioamnionitis, unspecified trimester, fetus 3O41.1294 Chorioamnionitis, unspecified trimester, fetus 4O41.1295 Chorioamnionitis, unspecified trimester, fetus 5O41.1299 Chorioamnionitis, unspecified trimester, other fetus O41.1410 Placentitis, first trimester, not applicable or unspecifiedO41.1411 Placentitis, first trimester, fetus 1O41.1412 Placentitis, first trimester, fetus 2O41.1413 Placentitis, first trimester, fetus 3O41.1414 Placentitis, first trimester, fetus 4O41.1415 Placentitis, first trimester, fetus 5O41.1419 Placentitis, first trimester, other fetus


181



O41.1420 Placentitis, second trimester, not applicable or unspecifiedO41.1421 Placentitis, second trimester, fetus 1O41.1422 Placentitis, second trimester, fetus 2O41.1423 Placentitis, second trimester, fetus 3O41.1424 Placentitis, second trimester, fetus 4O41.1425 Placentitis, second trimester, fetus 5O41.1429 Placentitis, second trimester, other fetus O41.1430 Placentitis, third trimester, not applicable or unspecifiedO41.1431 Placentitis, third trimester, fetus 1O41.1432 Placentitis, third trimester, fetus 2O41.1433 Placentitis, third trimester, fetus 3O41.1434 Placentitis, third trimester, fetus 4O41.1435 Placentitis, third trimester, fetus 5O41.1439 Placentitis, third trimester, other fetus O41.1490 Placentitis, unspecified trimester, not applicable or unspecifiedO41.1491 Placentitis, unspecified trimester, fetus 1O41.1492 Placentitis, unspecified trimester, fetus 2O41.1493 Placentitis, unspecified trimester, fetus 3O41.1494 Placentitis, unspecified trimester, fetus 4O41.1495 Placentitis, unspecified trimester, fetus 5O41.1499 Placentitis, unspecified trimester, other fetus

O41.8X10Other specified disorders of amniotic fluid and membranes, first trimester, not applicable or unspecified

O41.8X11Other specified disorders of amniotic fluid and membranes, first trimester, fetus 1





O41.8X19Other specified disorders of amniotic fluid and membranes, first trimester, other fetus

O41.8X20Other specified disorders of amniotic fluid and membranes, second trimester, not applicable or unspecified

O41.8X21Other specified disorders of amniotic fluid and membranes, second trimester, fetus 1





O41.8X29 Other specified disorders of amniotic fluid and membranes, second trimester,


182



other fetus

O41.8X30Other specified disorders of amniotic fluid and membranes, third trimester, not applicable or unspecified

O41.8X31Other specified disorders of amniotic fluid and membranes, third trimester, fetus 1





O41.8X39Other specified disorders of amniotic fluid and membranes, third trimester, other fetus

O41.8X90Other specified disorders of amniotic fluid and membranes, unspecified trimester, not applicable or unspecified

O41.8X91Other specified disorders of amniotic fluid and membranes, unspecified trimester, fetus 1





O41.8X99Other specified disorders of amniotic fluid and membranes, unspecified trimester, other fetus

O41.90X0Disorder of amniotic fluid and membranes, unspecified, unspecified trimester, not applicable or unspecified

O41.90X1Disorder of amniotic fluid and membranes, unspecified, unspecified trimester, fetus 1





O41.90X9Disorder of amniotic fluid and membranes, unspecified, unspecified trimester, other fetus

O41.91X0Disorder of amniotic fluid and membranes, unspecified, first trimester, not applicable or unspecified

O41.91X1 Disorder of amniotic fluid and membranes, unspecified, first trimester, fetus 1O41.91X2 Disorder of amniotic fluid and membranes, unspecified, first trimester, fetus 2O41.91X3 Disorder of amniotic fluid and membranes, unspecified, first trimester, fetus 3


183



O41.91X4 Disorder of amniotic fluid and membranes, unspecified, first trimester, fetus 4O41.91X5 Disorder of amniotic fluid and membranes, unspecified, first trimester, fetus 5

O41.91X9Disorder of amniotic fluid and membranes, unspecified, first trimester, other fetus

O41.92X0Disorder of amniotic fluid and membranes, unspecified, second trimester, not applicable or unspecified

O41.92X1Disorder of amniotic fluid and membranes, unspecified, second trimester, fetus 1





O41.92X9Disorder of amniotic fluid and membranes, unspecified, second trimester, other fetus

O41.93X0Disorder of amniotic fluid and membranes, unspecified, third trimester, not applicable or unspecified

O41.93X1 Disorder of amniotic fluid and membranes, unspecified, third trimester, fetus 1O41.93X2 Disorder of amniotic fluid and membranes, unspecified, third trimester, fetus 2O41.93X3 Disorder of amniotic fluid and membranes, unspecified, third trimester, fetus 3O41.93X4 Disorder of amniotic fluid and membranes, unspecified, third trimester, fetus 4O41.93X5 Disorder of amniotic fluid and membranes, unspecified, third trimester, fetus 5

O41.93X9Disorder of amniotic fluid and membranes, unspecified, third trimester, other fetus

O42.00Premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestation

O42.011Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, first trimester

O42.012Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, second trimester

O42.013Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, third trimester

O42.02Full-term premature rupture of membranes, onset of labor within 24 hours of rupture

O42.10Premature rupture of membranes, onset of labor more than 24 hours following rupture, unspecified weeks of gestation

O42.111Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, first trimester

O42.112Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, second trimester

O42.113Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, third trimester

O42.12Full-term premature rupture of membranes, onset of labor more than 24 hours following rupture

O43.011 Fetomaternal placental transfusion syndrome, first trimester


184



O43.012 Fetomaternal placental transfusion syndrome, second trimesterO43.013 Fetomaternal placental transfusion syndrome, third trimesterO43.019 Fetomaternal placental transfusion syndrome, unspecified trimesterO43.021 Fetus-to-fetus placental transfusion syndrome, first trimesterO43.022 Fetus-to-fetus placental transfusion syndrome, second trimesterO43.023 Fetus-to-fetus placental transfusion syndrome, third trimesterO43.029 Fetus-to-fetus placental transfusion syndrome, unspecified trimesterO43.101 Malformation of placenta, unspecified, first trimesterO43.102 Malformation of placenta, unspecified, second trimesterO43.103 Malformation of placenta, unspecified, third trimesterO43.109 Malformation of placenta, unspecified, unspecified trimesterO43.111 Circumvallate placenta, first trimesterO43.112 Circumvallate placenta, second trimesterO43.113 Circumvallate placenta, third trimesterO43.119 Circumvallate placenta, unspecified trimesterO43.191 Other malformation of placenta, first trimesterO43.192 Other malformation of placenta, second trimesterO43.193 Other malformation of placenta, third trimesterO43.199 Other malformation of placenta, unspecified trimesterO43.211 Placenta accreta, first trimesterO43.212 Placenta accreta, second trimesterO43.213 Placenta accreta, third trimesterO43.221 Placenta increta, first trimesterO43.222 Placenta increta, second trimesterO43.223 Placenta increta, third trimesterO43.231 Placenta percreta, first trimesterO43.232 Placenta percreta, second trimesterO43.233 Placenta percreta, third trimesterO43.239 Placenta percreta, unspecified trimesterO43.811 Placental infarction, first trimesterO43.812 Placental infarction, second trimesterO43.813 Placental infarction, third trimesterO43.90 Unspecified placental disorder, unspecified trimesterO43.91 Unspecified placental disorder, first trimesterO43.92 Unspecified placental disorder, second trimesterO43.93 Unspecified placental disorder, third trimester

O44.00Complete Placenta previa specified as without hemorrhage, unspecified trimester

O44.01 Complete Placenta previa specified as without hemorrhage, first trimesterO44.02 Complete Placenta previa specified as without hemorrhage, second trimesterO44.03 Complete Placenta previa specified as without hemorrhage, third trimesterO44.10 Complete Placenta previa with hemorrhage, unspecified trimesterO44.11 Complete Placenta previa with hemorrhage, first trimesterO44.12 Complete Placenta previa with hemorrhage, second trimesterO44.13 Complete Placenta previa with hemorrhage, third trimesterO44.20 Partial placenta previa NOS or without hemorrhage, unspecified trimesterO44.21 Partial placenta previa NOS or without hemorrhage, first trimester


185



O44.22 Partial placenta previa NOS or without hemorrhage, second trimesterO44.23 Partial placenta previa NOS or without hemorrhage, third trimesterO44.30 Partial placenta previa with hemorrhage, unsp trimesterO44.31 Partial placenta previa with hemorrhage, first trimesterO44.32 Partial placenta previa with hemorrhage, second trimesterO44.33 Partial placenta previa with hemorrhage, third trimesterO44.40 Low lying placenta NOS or without hemorrhage, unspecified trimesteO44.41 Low lying placenta NOS or without hemorrhage, first trimesterO44.42 Low lying placenta NOS or without hemorrhage, second trimesterO44.43 Low lying placenta NOS or without hemorrhage, third trimesterO44.50 Low lying placenta with hemorrhage, unspecified trimesterO44.51 Low lying placenta with hemorrhage, first trimesterO44.52 Low lying placenta with hemorrhage, second trimesterO44.53 Low lying placenta with hemorrhage, third trimester

O45.001Premature separation of placenta with coagulation defect, unspecified, first trimester

O45.002 Premature separation of placenta with coagulation defect, unspecified, second trimester

O45.003Premature separation of placenta with coagulation defect, unspecified, third trimester

O45.011 Premature separation of placenta with afibrinogenemia, first trimesterO45.012 Premature separation of placenta with afibrinogenemia, second trimesterO45.013 Premature separation of placenta with afibrinogenemia, third trimester

O45.021Premature separation of placenta with disseminated intravascular coagulation, first trimester

O45.022 Premature separation of placenta with disseminated intravascular coagulation, second trimester

O45.023Premature separation of placenta with disseminated intravascular coagulation, third trimester

O45.091 Premature separation of placenta with other coagulation defect, first trimester

O45.092 Premature separation of placenta with other coagulation defect, second trimester

O45.093 Premature separation of placenta with other coagulation defect, third trimesterO45.8x1 Other premature separation of placenta, first trimesterO45.8x2 Other premature separation of placenta, second trimesterO45.8x3 Other premature separation of placenta, third trimesterO45.8x9 Other premature separation of placenta, unspecified trimesterO45.91 Premature separation of placenta, unspecified, first trimesterO45.92 Premature separation of placenta, unspecified, second trimesterO45.93 Premature separation of placenta, unspecified, third trimesterO46.001 Antepartum hemorrhage with coagulation defect, unspecified, first trimesterO46.002 Antepartum hemorrhage with coagulation defect, unspecified, second trimesterO46.003 Antepartum hemorrhage with coagulation defect, unspecified, third trimester

O46.009Antepartum hemorrhage with coagulation defect, unspecified, unspecified trimester

O46.011 Antepartum hemorrhage with afibrinogenemia, first trimesterO46.012 Antepartum hemorrhage with afibrinogenemia, second trimesterO46.013 Antepartum hemorrhage with afibrinogenemia, third trimester


186



O46.019 Antepartum hemorrhage with afibrinogenemia, unspecified trimester

O46.021Antepartum hemorrhage with disseminated intravascular coagulation, first trimester

O46.022 Antepartum hemorrhage with disseminated intravascular coagulation, second trimester

O46.023 Antepartum hemorrhage with disseminated intravascular coagulation, third trimester

O46.029Antepartum hemorrhage with disseminated intravascular coagulation, unspecified trimester

O46.091 Antepartum hemorrhage with other coagulation defect, first trimesterO46.091 Antepartum hemorrhage with other coagulation defect, first trimesterO46.092 Antepartum hemorrhage with other coagulation defect, second trimesterO46.092 Antepartum hemorrhage with other coagulation defect, second trimesterO46.093 Antepartum hemorrhage with other coagulation defect, third trimesterO46.093 Antepartum hemorrhage with other coagulation defect, third trimesterO46.099 Antepartum hemorrhage with other coagulation defect, unspecified trimesterO46.8x1 Other antepartum hemorrhage, first trimesterO46.8x2 Other antepartum hemorrhage, second trimesterO46.8x3 Other antepartum hemorrhage, third trimesterO46.8x9 Other antepartum hemorrhage, unspecified trimesterO46.90 Antepartum hemorrhage, unspecified, unspecified trimesterO46.91 Antepartum hemorrhage, unspecified, first trimesterO46.92 Antepartum hemorrhage, unspecified, second trimesterO46.93 Antepartum hemorrhage, unspecified, third trimesterO47.00 False labor before 37 completed weeks of gestation, unspecified trimesterO47.02 False labor before 37 completed weeks of gestation, second trimesterO47.03 False labor before 37 completed weeks of gestation, third trimesterO47.1 False labor at or after 37 completed weeks of gestationO47.9 False labor, unspecifiedO48.0 Post-term pregnancyO48.1 Prolonged pregnancyO60.00 Preterm labor without delivery, unspecified trimesterO60.02 Preterm labor without delivery, second trimesterO60.03 Preterm labor without delivery, third trimester

O60.10X0Preterm labor with preterm delivery, unspecified trimester, not applicable or unspecified

O60.12X0Preterm labor second trimester with preterm delivery second trimester, not applicable or unspecified

O60.13X0Preterm labor second trimester with preterm delivery third trimester, not applicable or unspecified

O60.14X0Preterm labor third trimester with preterm delivery third trimester, not applicable or unspecified

O61.0 Failed medical induction of laborO61.0 Failed medical induction of laborO61.1 Failed instrumental induction of laborO61.8 Other failed induction of laborO61.9 Failed induction of labor, unspecifiedO62.0 Primary inadequate contractions


187



O62.1 Secondary uterine inertiaO62.2 Other uterine inertiaO62.3 Precipitate laborO62.4 Hypertonic, incoordinate, and prolonged uterine contractionsO62.9 Abnormality of forces of labor, unspecifiedO63.0 Prolonged first stage (of labor)O63.1 Prolonged second stage (of labor)O63.2 Delayed delivery of second twin, triplet, etc.O63.9 Long labor, unspecified

O64.0XX0Obstructed labor due to incomplete rotation of fetal head, not applicable or unspecified

O64.0XX1 Obstructed labor due to incomplete rotation of fetal head, fetus 1O64.0XX2 Obstructed labor due to incomplete rotation of fetal head, fetus 2O64.0XX3 Obstructed labor due to incomplete rotation of fetal head, fetus 3O64.0XX4 Obstructed labor due to incomplete rotation of fetal head, fetus 4O64.0XX5 Obstructed labor due to incomplete rotation of fetal head, fetus 5O64.0XX9 Obstructed labor due to incomplete rotation of fetal head, other fetus O64.1XX0 Obstructed labor due to breech presentation, not applicable or unspecifiedO64.1XX1 Obstructed labor due to breech presentation, fetus 1O64.1XX2 Obstructed labor due to breech presentation, fetus 2O64.1XX3 Obstructed labor due to breech presentation, fetus 3O64.1XX4 Obstructed labor due to breech presentation, fetus 4O64.1XX5 Obstructed labor due to breech presentation, fetus 5O64.1XX9 Obstructed labor due to breech presentation,other fetus O64.2XX0 Obstructed labor due to face presentation, not applicable or unspecifiedO64.2XX1 Obstructed labor due to face presentation, fetus 1O64.2XX2 Obstructed labor due to face presentation, fetus 2O64.2XX3 Obstructed labor due to face presentation, fetus 3O64.2XX4 Obstructed labor due to face presentation, fetus 4O64.2XX5 Obstructed labor due to face presentation, fetus 5O64.2XX9 Obstructed labor due to face presentation, other fetus O64.3XX0 Obstructed labor due to brow presentation, not applicable or unspecifiedO64.3XX1 Obstructed labor due to brow presentation, fetus 1O64.3XX2 Obstructed labor due to brow presentation, fetus 2O64.3XX3 Obstructed labor due to brow presentation, fetus 3O64.3XX4 Obstructed labor due to brow presentation, fetus 4O64.3XX5 Obstructed labor due to brow presentation, fetus 5O64.3XX9 Obstructed labor due to brow presentation, other fetus O64.4XX0 Obstructed labor due to shoulder presentation, not applicable or unspecifiedO64.4XX1 Obstructed labor due to shoulder presentation, fetus 1O64.4XX2 Obstructed labor due to shoulder presentation, fetus 2O64.4XX3 Obstructed labor due to shoulder presentation, fetus 3O64.4XX4 Obstructed labor due to shoulder presentation, fetus 4O64.4XX5 Obstructed labor due to shoulder presentation, fetus 4O64.4XX9 Obstructed labor due to shoulder presentation, other fetus O64.5XX0 Obstructed labor due to compound presentation, not applicable or unspecifiedO64.5XX1 Obstructed labor due to compound presentation, fetus 1


188



O64.5XX2 Obstructed labor due to compound presentation, fetus 2O64.5XX3 Obstructed labor due to compound presentation, fetus 3O64.5XX4 Obstructed labor due to compound presentation, fetus 4O64.5XX5 Obstructed labor due to compound presentation, fetus 5O64.5XX9 Obstructed labor due to compound presentation, other fetus

O64.8XX0 Obstructed labor due to other malposition and malpresentation, not applicable or unspecified

O64.8XX1 Obstructed labor due to other malposition and malpresentation, fetus 1O64.8XX2 Obstructed labor due to other malposition and malpresentation, fetus 2O64.8XX3 Obstructed labor due to other malposition and malpresentation, fetus 3O64.8XX4 Obstructed labor due to other malposition and malpresentation, fetus 4O64.8XX5 Obstructed labor due to other malposition and malpresentation, fetus 5O64.8XX9 Obstructed labor due to other malposition and malpresentation, other fetus

O64.9XX0Obstructed labor due to malposition and malpresentation, unspecified, not applicable or unspecified

O64.9XX1 Obstructed labor due to malposition and malpresentation, unspecified, fetus 1O64.9XX2 Obstructed labor due to malposition and malpresentation, unspecified, fetus 2O64.9XX3 Obstructed labor due to malposition and malpresentation, unspecified, fetus 3O64.9XX4 Obstructed labor due to malposition and malpresentation, unspecified, fetus 4O64.9XX5 Obstructed labor due to malposition and malpresentation, unspecified, fetus 5

O64.9XX9Obstructed labor due to malposition and malpresentation, unspecified, other fetus

O65.2 Obstructed labor due to pelvic inlet contractionO65.4 Obstructed labor due to fetopelvic disproportion, unspecifiedO65.5 Obstructed labor due to abnormality of maternal pelvic organsO65.8 Obstructed labor due to other maternal pelvic abnormalitiesO65.9 Obstructed labor due to maternal pelvic abnormality, unspecifiedO65.9 Obstructed labor due to maternal pelvic abnormality, unspecifiedO66.0 Obstructed labor due to shoulder dystociaO66.1 Obstructed labor due to locked twinsO66.40 Failed trial of labor, unspecifiedO66.5 Attempted application of vacuum extractor and forcepsO66.8 Other specified obstructed laborO66.9 Obstructed labor, unspecifiedO67.0 Intrapartum hemorrhage with coagulation defectO67.8 Other intrapartum hemorrhageO67.9 Intrapartum hemorrhage, unspecifiedO68 Labor and delivery complicated by abnormality of fetal acid-base balance

O69.0XX0 Labor and delivery complicated by prolapse of cord, not applicable or unspecified

O69.0XX1 Labor and delivery complicated by prolapse of cord, fetus 1O69.0XX2 Labor and delivery complicated by prolapse of cord, fetus 2O69.0XX3 Labor and delivery complicated by prolapse of cord, fetus 3O69.0XX4 Labor and delivery complicated by prolapse of cord, fetus 4O69.0XX5 Labor and delivery complicated by prolapse of cord, fetus 5O69.0XX9 Labor and delivery complicated by prolapse of cord, other fetus

O69.1XX0 Labor and delivery complicated by cord around neck, with compression, not applicable or unspecified


189



O69.1XX1 Labor and delivery complicated by cord around neck, with compression, fetus 1O69.1XX2 Labor and delivery complicated by cord around neck, with compression, fetus 2O69.1XX3 Labor and delivery complicated by cord around neck, with compression, fetus 3O69.1XX4 Labor and delivery complicated by cord around neck, with compression, fetus 4O69.1XX5 Labor and delivery complicated by cord around neck, with compression, fetus 5

O69.1XX9 Labor and delivery complicated by cord around neck, with compression, other fetus

O69.2XX0Labor and delivery complicated by other cord entanglement, with compression, not applicable or unspecified

O69.2XX1Labor and delivery complicated by other cord entanglement, with compression, fetus 1





O69.2XX9Labor and delivery complicated by other cord entanglement, with compression, other fetus

O69.3XX0 Labor and delivery complicated by short cord, not applicable or unspecifiedO69.3XX1 Labor and delivery complicated by short cord, fetus 1O69.3XX2 Labor and delivery complicated by short cord, fetus 2O69.3XX3 Labor and delivery complicated by short cord, fetus 3O69.3XX4 Labor and delivery complicated by short cord, fetus 4O69.3XX5 Labor and delivery complicated by short cord, fetus 5O69.3XX9 Labor and delivery complicated by short cord, other fetus O69.4XX0 Labor and delivery complicated by vasa previa, not applicable or unspecifiedO69.4XX1 Labor and delivery complicated by vasa previa, fetus 1O69.4XX2 Labor and delivery complicated by vasa previa, fetus 2O69.4XX3 Labor and delivery complicated by vasa previa, fetus 3O69.4XX4 Labor and delivery complicated by vasa previa, fetus 4O69.4XX5 Labor and delivery complicated by vasa previa, fetus 5O69.4XX9 Labor and delivery complicated by vasa previa, other fetus

O69.5XX0Labor and delivery complicated by vascular lesion of cord, not applicable or unspecified

O69.5XX1 Labor and delivery complicated by vascular lesion of cord, fetus 1O69.5XX2 Labor and delivery complicated by vascular lesion of cord, fetus 2O69.5XX3 Labor and delivery complicated by vascular lesion of cord, fetus 3O69.5XX4 Labor and delivery complicated by vascular lesion of cord, fetus 4O69.5XX5 Labor and delivery complicated by vascular lesion of cord, fetus 5O69.5XX9 Labor and delivery complicated by vascular lesion of cord, other fetus

O69.81X0 Labor and delivery complicated by cord around neck, without compression, not applicable or unspecified

O69.81X1 Labor and delivery complicated by cord around neck, without compression, fetus 1

O69.81X2 Labor and delivery complicated by cord around neck, without compression,


190



fetus 2




O69.81X9 Labor and delivery complicated by cord around neck, without compression, other fetus

O69.82X0 Labor and delivery complicated by other cord entanglement, without compression, not applicable or unspecified

O69.82X1 Labor and delivery complicated by other cord entanglement, without compression, fetus 1





O69.82X9 Labor and delivery complicated by other cord entanglement, without compression, other fetus

O69.89X0Labor and delivery complicated by other cord complications, not applicable or unspecified

O69.89X0 Labor and delivery complicated by other cord complications, not applicable or unspecified

O69.89X1 Labor and delivery complicated by other cord complications, fetus 1O69.89X2 Labor and delivery complicated by other cord complications, fetus 2O69.89X2 Labor and delivery complicated by other cord complications, fetus 2O69.89X3 Labor and delivery complicated by other cord complications, fetus 3O69.89X4 Labor and delivery complicated by other cord complications, fetus 4O69.89X5 Labor and delivery complicated by other cord complications, fetus 5O69.89X5 Labor and delivery complicated by other cord complications, fetus 5O69.89X9 Labor and delivery complicated by other cord complications, other fetus

O69.9XX0Labor and delivery complicated by cord complication, unspecified, not applicable or unspecified

O69.9XX1 Labor and delivery complicated by cord complication, unspecified, fetus 1O69.9XX2 Labor and delivery complicated by cord complication, unspecified, fetus 2O69.9XX3 Labor and delivery complicated by cord complication, unspecified, fetus 3O69.9XX4 Labor and delivery complicated by cord complication, unspecified, fetus 4O69.9XX5 Labor and delivery complicated by cord complication, unspecified, fetus 5O69.9XX9 Labor and delivery complicated by cord complication, unspecified, fetus 9O70.0 First degree perineal laceration during deliveryO70.1 Second degree perineal laceration during deliveryO70.2 Third degree perineal laceration during deliveryO70.20 Third degree perineal laceration during delivery, unspecifiedO70.21 Third degree perineal laceration during delivery, IIIa


191



O70.22 Third degree perineal laceration during delivery, IIIbO70.23 Third degree perineal laceration during delivery, IIIcO70.3 Fourth degree perineal laceration during delivery

O70.4Anal sphincter tear complicating delivery, not associated with third degree laceration

O70.9 Perineal laceration during delivery, unspecifiedO71.00 Rupture of uterus before onset of labor, unspecified trimesterO71.02 Rupture of uterus before onset of labor, second trimesterO71.03 Rupture of uterus before onset of labor, third trimesterO71.1 Rupture of uterus during laborO71.2 Postpartum inversion of uterusO71.3 Obstetric laceration of cervixO71.4 Obstetric high vaginal laceration aloneO71.5 Other obstetric injury to pelvic organsO71.6 Obstetric damage to pelvic joints and ligamentsO71.7 Obstetric hematoma of pelvisO71.82 Other specified trauma to perineum and vulvaO71.89 Other specified obstetric traumaO71.9 Obstetric trauma, unspecifiedO72.0 Third-stage hemorrhageO72.1 Other immediate postpartum hemorrhageO72.2 Delayed and secondary postpartum hemorrhageO72.3 Postpartum coagulation defectsO73.0 Retained placenta without hemorrhageO73.1 Retained portions of placenta and membranes, without hemorrhageO74.1 Other pulmonary complications of anesthesia during labor and deliveryO74.1 Other pulmonary complications of anesthesia during labor and deliveryO74.2 Cardiac complications of anesthesia during labor and deliveryO74.3 Central nervous system complications of anesthesia during labor and deliveryO74.8 Other complications of anesthesia during labor and deliveryO74.9 Complication of anesthesia during labor and delivery, unspecifiedO75.0 Maternal distress during labor and deliveryO75.1 Shock during or following labor and deliveryO75.2 Pyrexia during labor, not elsewhere classifiedO75.3 Other infection during laborO75.4 Other complications of obstetric surgery and proceduresO75.5 Delayed delivery after artificial rupture of membranesO75.81 Maternal exhaustion complicating labor and deliveryO75.81 Maternal exhaustion complicating labor and delivery

O75.81 Maternal exhaustion complicating labor and delivery Maternal exhaustion complicating labor and delivery

O75.82 Onset (spontaneous) of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by (planned) cesarean section

O75.89 Other specified complications of labor and deliveryO75.89 Other specified complications of labor and delivery O75.9 Complication of labor and delivery, unspecifiedO76 Abnormality in fetal heart rate and rhythm complicating labor and deliveryO77.0 Labor and delivery complicated by meconium in amniotic fluid


192



O80 Encounter for full-term uncomplicated deliveryO82 Encounter for cesarean delivery without indicationO85 Puerperal sepsisO86.0 Infection of obstetric surgical woundO86.11 Cervicitis following deliveryO86.12 Endometritis following deliveryO86.13 Vaginitis following deliveryO86.19 Other infection of genital tract following deliveryO86.20 Urinary tract infection following delivery, unspecifiedO86.21 Infection of kidney following deliveryO86.22 Infection of bladder following deliveryO86.29 Other urinary tract infection following deliveryO86.4 Pyrexia of unknown origin following deliveryO86.81 Puerperal septic thrombophlebitisO86.89 Other specified puerperal infectionsO86.89 Other specified puerperal infectionsO87.0 Superficial thrombophlebitis in the puerperiumO87.1 Deep phlebothrombosis in the puerperiumO87.2 Hemorrhoids in the puerperiumO87.3 Cerebral venous thrombosis in the puerperiumO87.4 Varicose veins of lower extremity in the puerperiumO87.8 Other venous complications in the puerperiumO87.9 Venous complication in the puerperium, unspecified O88.011 Air embolism in pregnancy, first trimesterO88.012 Air embolism in pregnancy, second trimesterO88.013 Air embolism in pregnancy, third trimesterO88.019 Air embolism in pregnancy, unspecified trimesterO88.02 Air embolism in childbirthO88.02 Air embolism in childbirthO88.03 Air embolism in the puerperiumO88.111 Amniotic fluid embolism in pregnancy, first trimesterO88.112 Amniotic fluid embolism in pregnancy, second trimesterO88.113 Amniotic fluid embolism in pregnancy, third trimesterO88.119 Amniotic fluid embolism in pregnancy, unspecified trimesterO88.12 Amniotic fluid embolism in childbirthO88.13 Amniotic fluid embolism in the puerperiumO88.211 Thromboembolism in pregnancy, first trimesterO88.212 Thromboembolism in pregnancy, second trimesterO88.213 Thromboembolism in pregnancy, third trimesterO88.219 Thromboembolism in pregnancy, unspecified trimesterO88.22 Thromboembolism in childbirthO88.23 Thromboembolism in puerperiumO88.311 Pyemic and septic embolism in pregnancy, first trimesterO88.312 Pyemic and septic embolism in pregnancy, second trimesterO88.313 Pyemic and septic embolism in pregnancy, third trimesterO88.319 Pyemic and septic embolism in pregnancy, unspecified trimesterO88.32 Pyemic and septic embolism in childbirth


193



O88.33 Pyemic and septic embolism in puerperiumO88.811 Other embolism in pregnancy, first trimesterO88.812 Other embolism in pregnancy, second trimesterO88.813 Other embolism in pregnancy, third trimesterO88.819 Other embolism in pregnancy, unspecified trimesterO88.82 Other embolism in childbirthO88.83 Other embolism in the puerperiumO89.09 Other pulmonary complications of anesthesia during the puerperiumO89.1 Cardiac complications of anesthesia during the puerperiumO89.2 Central nervous system complications of anesthesia during the puerperiumO89.8 Other complications of anesthesia during the puerperiumO89.9 Complication of anesthesia during the puerperium, unspecifiedO90.0 Disruption of cesarean delivery woundO90.1 Disruption of perineal obstetric woundO90.2 Hematoma of obstetric woundO90.3 Peripartum cardiomyopathyO90.4 Postpartum acute kidney failureO90.5 Postpartum thyroiditisO90.6 Postpartum mood disturbanceO90.81 Anemia of the puerperiumO90.89 Other complications of the puerperium, not elsewhere classifiedO90.89 Other complications of the puerperium, not elsewhere classifiedO90.9 Complication of the puerperium, unspecifiedO91.011 Infection of nipple associated with pregnancy, first trimesterO91.012 Infection of nipple associated with pregnancy, second trimesterO91.013 Infection of nipple associated with pregnancy, third trimesterO91.019 Infection of nipple associated with pregnancy, unspecified trimesterO91.02 Infection of nipple associated with the puerperiumO91.111 Abscess of breast associated with pregnancy, first trimesterO91.112 Abscess of breast associated with pregnancy, second trimesterO91.113 Abscess of breast associated with pregnancy, third trimesterO91.12 Abscess of breast associated with the puerperiumO91.211 Nonpurulent mastitis associated with pregnancy, first trimesterO91.212 Nonpurulent mastitis associated with pregnancy, second trimesterO91.213 Nonpurulent mastitis associated with pregnancy, third trimesterO91.219 Nonpurulent mastitis associated with pregnancy, unspecified trimesterO91.22 Nonpurulent mastitis associated with the puerperiumO91.23 Nonpurulent mastitis associated with lactationO92.011 Retracted nipple associated with pregnancy, first trimesterO92.012 Retracted nipple associated with pregnancy, second trimesterO92.013 Retracted nipple associated with pregnancy, third trimesterO92.019 Retracted nipple associated with pregnancy, unspecified trimesterO92.03 Retracted nipple associated with lactationO92.111 Cracked nipple associated with pregnancy, first trimesterO92.112 Cracked nipple associated with pregnancy, second trimesterO92.113 Cracked nipple associated with pregnancy, third trimesterO92.119 Cracked nipple associated with pregnancy, unspecified trimester


194



O92.13 Cracked nipple associated with lactationO92.20 Other disorders of breast associated with pregnancy and the puerperiumO92.20 Unspecified disorder of breast associated with pregnancy and the puerperiumO92.29 Other disorders of breast associated with pregnancy and the puerperiumO92.3 AgalactiaO92.5 Suppressed lactationO92.6 GalactorrheaO92.70 Unspecified disorders of lactationO92.79 Other disorders of lactationO94 Sequelae of complication of pregnancy, childbirth, and the puerperiumO98.011 Syphilis complicating pregnancy, first trimesterO98.012 Syphilis complicating pregnancy, second trimesterO98.013 Syphilis complicating pregnancy, third trimesterO98.019 Tuberculosis complicating pregnancy, unspecified trimesterO98.019 Syphilis complicating pregnancy, unspecified trimesterO98.02 Tuberculosis complicating childbirthO98.03 Tuberculosis complicating puerperiumO98.111 Syphilis complicating pregnancy, first trimesterO98.112 Syphilis complicating pregnancy, second trimesterO98.113 Syphilis complicating pregnancy, third trimesterO98.119 Syphilis complicating pregnancy, unspecified trimesterO98.12 Syphilis complicating childbirthO98.13 Syphilis complicating the puerperiumO98.13 Syphilis complicating the puerperiumO98.211 Gonorrhea complicating pregnancy, first trimesterO98.212 Gonorrhea complicating pregnancy, second trimesterO98.213 Gonorrhea complicating pregnancy, third trimesterO98.219 Gonorrhea complicating pregnancy, unspecified trimesterO98.22 Gonorrhea complicating childbirthO98.23 Gonorrhea complicating the puerperium

O98.311Other infections with a predominantly sexual mode of transmission complicating pregnancy, first trimester

O98.312Other infections with a predominantly sexual mode of transmission complicating pregnancy, second trimester

O98.313Other infections with a predominantly sexual mode of transmission complicating pregnancy, third trimester

O98.319Other infections with a predominantly sexual mode of transmission complicating pregnancy, unspecified trimester

O98.32Other infections with a predominantly sexual mode of transmission complicating childbirth

O98.33Other infections with a predominantly sexual mode of transmission complicating the puerperium

O98.42 Viral hepatitis complicating childbirthO98.43 Viral hepatitis complicating the puerperiumO98.511 Other viral diseases complicating pregnancy, first trimesterO98.512 Other viral diseases complicating pregnancy, second trimesterO98.513 Other viral diseases complicating pregnancy, third trimesterO98.519 Other viral diseases complicating pregnancy, unspecified trimester


195



O98.519 Other viral diseases complicating pregnancy, unspecified trimesterO98.52 Other viral diseases complicating childbirthO98.53 Other viral diseases complicating puerperiumO98.611 Protozoal diseases complicating pregnancy, first trimesterO98.612 Protozoal diseases complicating pregnancy, second trimesterO98.613 Protozoal diseases complicating pregnancy, third trimesterO98.619 Protozoal diseases complicating pregnancy, unspecified trimesterO98.62 Protozoal diseases complicating childbirthO98.63 Protozoal diseases complicating the puerperium

O98.811Other maternal infectious and parasitic diseases complicating pregnancy, first trimester

O98.812Other maternal infectious and parasitic diseases complicating pregnancy, second trimester

O98.813Other maternal infectious and parasitic diseases complicating pregnancy, third trimester

O98.819Other maternal infectious and parasitic diseases complicating pregnancy, unspecified trimester

O98.82 Other maternal infectious and parasitic diseases complicating childbirthO98.83 Other maternal infectious and parasitic diseases complicating puerperium

O98.911Unspecified maternal infectious and parasitic disease complicating pregnancy, first trimester

O98.912Unspecified maternal infectious and parasitic disease complicating pregnancy, second trimester

O98.913Unspecified maternal infectious and parasitic disease complicating pregnancy, third trimester

O98.919 Unspecified maternal infectious and parasitic disease complicating pregnancy, unspecified trimester

O98.92 Unspecified maternal infectious and parasitic disease complicating childbirthO98.93 Unspecified maternal infectious and parasitic disease complicating puerperiumO99.011 Anemia complicating pregnancy, first trimesterO99.012 Anemia complicating pregnancy, second trimesterO99.013 Anemia complicating pregnancy, third trimesterO99.019 Anemia complicating pregnancy, unspecified trimesterO99.02 Anemia complicating childbirthO99.03 Anemia complicating the puerperium

O99.111Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, first trimester

O99.112 Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, second trimester

O99.113Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, third trimester

O99.119

Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, unspecified trimester

O99.12Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating childbirth

O99.13 Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating the puerperium


196



O99.210 Obesity complicating pregnancy, unspecified trimesterO99.211 Obesity complicating pregnancy, first trimesterO99.212 Obesity complicating pregnancy, second trimesterO99.213 Obesity complicating pregnancy, third trimesterO99.214 Obesity complicating childbirthO99.215 Obesity complicating the puerperium

O99.280Endocrine, nutritional and metabolic diseases complicating pregnancy, unspecified trimester

O99.281Endocrine, nutritional and metabolic diseases complicating pregnancy, first trimester

O99.282Endocrine, nutritional and metabolic diseases complicating pregnancy, second trimester

O99.283Endocrine, nutritional and metabolic diseases complicating pregnancy, third trimester

O99.284 Endocrine, nutritional and metabolic diseases complicating childbirthO99.285 Endocrine, nutritional and metabolic diseases complicating the puerperiumO99.320 Drug use complicating pregnancy, unspecified trimesterO99.321 Drug use complicating pregnancy, first trimesterO99.322 Drug use complicating pregnancy, second trimesterO99.323 Drug use complicating pregnancy, third trimesterO99.324 Drug use complicating childbirthO99.325 Drug use complicating the puerperiumO99.330 Smoking (tobacco) complicating pregnancy, unspecified trimesterO99.331 Smoking (tobacco) complicating pregnancy, first trimesterO99.332 Smoking (tobacco) complicating pregnancy, second trimesterO99.333 Smoking (tobacco) complicating pregnancy, third trimesterO99.334 Smoking (tobacco) complicating childbirthO99.335 Smoking (tobacco) complicating the puerperiumO99.340 Other mental disorders complicating pregnancy, unspecified trimesterO99.341 Other mental disorders complicating pregnancy, first trimesterO99.342 Other mental disorders complicating pregnancy, second trimesterO99.343 Other mental disorders complicating pregnancy, third trimesterO99.344 Other mental disorders complicating childbirthO99.345 Other mental disorders complicating puerperiumO99.350 Diseases of the nervous system complicating pregnancy, unspecified trimesterO99.351 Diseases of the nervous system complicating pregnancy, first trimesterO99.352 Diseases of the nervous system complicating pregnancy, second trimesterO99.353 Diseases of the nervous system complicating pregnancy, third trimesterO99.354 Diseases of the nervous system complicating childbirthO99.355 Diseases of the nervous system complicating puerperiumO99.411 Diseases of the circulatory system complicating pregnancy, first trimesterO99.412 Diseases of the circulatory system complicating pregnancy, second trimesterO99.413 Diseases of the circulatory system complicating pregnancy, third trimester

O99.419Diseases of the circulatory system complicating pregnancy, unspecified trimester

O99.42 Diseases of the circulatory system complicating childbirthO99.42 Diseases of the circulatory system complicating childbirthO99.43 Diseases of the circulatory system complicating the puerperium


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O99.43 Diseases of the circulatory system complicating puerperiumO99.810 Abnormal glucose complicating pregnancyO99.810 Abnormal glucose complicating pregnancyO99.814 Abnormal glucose complicating childbirthO99.815 Abnormal glucose complicating the puerperiumO99.834 Other infection carrier state complicating childbirthO99.835 Other infection carrier state complicating puerperiumO99.840 Bariatric surgery status complicating pregnancy, unspecified trimesterO99.841 Bariatric surgery status complicating pregnancy, first trimesterO99.842 Bariatric surgery status complicating pregnancy, second trimesterO99.843 Bariatric surgery status complicating pregnancy, third trimesterO99.844 Bariatric surgery status complicating childbirthO99.845 Bariatric surgery status complicating the puerperium

O99.89Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium

O02.81 Chemical pregnancyO02.89 Molar pregnancy with choriocarcinomaO03.31 Incomplete spontaneous abortion complicated by shockO03.32 Incomplete spontaneous abortion complicated by renal failureO03.33 Incomplete spontaneous abortion complicated by metabolic disorder

O03.34Incomplete spontaneous abortion complicated by damage to pelvic organs or tissues

O12.11 Gestational proteinuria in first trimesterO12.12 Gestational proteinuria in second trimesterO12.13 Gestational proteinuria in third trimesterO14.23 HELLP syndrome in third trimesterO15.00 Eclampsia, antepartumO23.01 Infection of kidney in pregnancy in first trimesterO23.02 Infection of kidney in pregnancy in second trimesterO23.03 Infection of kidney in pregnancy in third trimesterO23.11 Infection of bladder in pregnancy in first trimesterO23.12 Infection of bladder in pregnancy in second trimesterO23.13 Infection of bladder in pregnancy in third trimesterO23.21 Infection of urethra in pregnancy in first trimesterO23.22 Infection of urethra in pregnancy in second trimesterO23.23 Infection of urethra in pregnancy in third trimesterO23.31 Infections of other parts of urinary tract in pregnancy, first trimesterO23.32 Infections of other parts of urinary tract in pregnancy, second trimesterO23.33 Infections of other parts of urinary tract in pregnancy, third trimesterO23.511 Infection of cervix in pregnancy in first trimesterO23.512 Infection of cervix in pregnancy in second trimesterO23.513 Infection of cervix in pregnancy in third trimesterO23.521 Salpingo-oophoritis in pregnancy in first trimesterO23.522 Salpingo-oophoritis in pregnancy in second trimesterO23.523 Salpingo-oophoritis in pregnancy in third trimesterO23.591 Infection of other part of genital tract in pregnancy, first trimesterO23.592 Infection of other part of genital tract in pregnancy, second trimester


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O23.593 Infection of other part of genital tract in pregnancy, third trimesterO24.011 Pre-existing type 1 diabetes mellitus in pregnancy in first trimesterO24.012 Pre-existing type 1 diabetes mellitus in pregnancy in second trimesterO24.013 Pre-existing type 1 diabetes mellitus in pregnancy in third trimesterO24.019 Type 1 diabetes mellitus complicating pregnancy, antepartumO24.02 Pre-existing type 1 diabetes mellitus in childbirthO24.03 Pre-existing type 1 diabetes mellitus in puerperiumO24.111 Pre-existing type 2 diabetes mellitus in pregnancy in first trimesterO24.112 Pre-existing type 2 diabetes mellitus in pregnancy in second trimesterO24.113 Pre-existing type 2 diabetes mellitus in pregnancy in third trimesterO24.119 Type 2 diabetes mellitus complicating pregnancy, antepartumO24.12 Pre-existing type 2 diabetes mellitus in childbirthO24.13 Pre-existing type 2 diabetes mellitus in puerperiumO24.311 Pre-existing diabetes mellitus in pregnancy in first trimesterO24.312 Pre-existing diabetes mellitus in pregnancy in second trimesterO24.313 Pre-existing diabetes mellitus in pregnancy in third trimesterO24.33 Pre-existing diabetes mellitus in puerperiumO24.410 Gestational diabetes mellitus, class A1O24.414 Gestational diabetes mellitus, class A2O24.420 Gestational diabetes mellitus in childbirth, diet controlledO24.424 Gestational diabetes mellitus in childbirth, insulin controlledO24.430 Diet controlled gestational diabetes mellitus in puerperiumO24.434 Insulin controlled gestational diabetes mellitus in puerperiumO24.811 Other pre-existing diabetes mellitus in pregnancy, first trimesterO24.812 Other pre-existing diabetes mellitus in pregnancy, second trimesterO24.813 Other pre-existing diabetes mellitus in pregnancy, third trimesterO24.819 Secondary diabetes complicating pregnancyO24.82 Other pre-existing diabetes mellitus in childbirthO24.83 Other pre-existing diabetes mellitus in the puerperium

O24.919Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care(648.00)

O26.30 Retained intrauterine device during pregnancy, antepartumO26.31 Retained intrauterine contraceptive device in pregnancy in first trimesterO26.32 Retained intrauterine contraceptive device in pregnancy in second trimesterO26.33 Retained intrauterine contraceptive device in pregnancy in third trimesterO26.40 Herpes gestationisO26.41 Herpes gestationis in first trimesterO26.42 Herpes gestationis in second trimesterO26.43 Herpes gestationis in third trimesterO26.63 Acute yellow atrophy of liver following molar or ectopic pregnancyO26.711 Subluxation of symphysis pubis in pregnancy in first trimesterO26.712 Subluxation of symphysis pubis in pregnancy in second trimesterO26.713 Subluxation of symphysis pubis in pregnancy in third trimesterO26.719 Subluxation of symphysis pubis in pregnancyO26.72 Pubis subluxation of symphysis in childbirthO26.73 Pubis subluxation of symphysis in puerperiumO26.86 Papular dermatitis of pregnancy


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O30.019 Twin monochorionic monoamniotic placentaO30.039 Twin monochorionic diamniotic placentaO30.049 Twin dichorionic diamniotic placentaO30.099 Twin gestation, indeterminate number of placentas and amniotic sacsO34.29 Pregnancy w/ hx of uterine myomectomyO36.21X0 Maternal care for hydrops fetalis in first trimesterO36.21X1 Maternal care for hydrops fetalis, first trimester, fetus 1O36.21X2 Maternal care for hydrops fetalis, first trimester, fetus 2O36.21X3 Maternal care for hydrops fetalis, first trimester, fetus 3O36.21X4 Maternal care for hydrops fetalis, first trimester, fetus 4O36.21X5 Maternal care for hydrops fetalis, first trimester, fetus 5O36.21X9 Maternal care for hydrops fetalis, first trimester, other fetusO36.22X0 Maternal care for hydrops fetalis in second trimesterO36.22X1 Maternal care for hydrops fetalis, second trimester, fetus 1O36.22X2 Maternal care for hydrops fetalis, second trimester, fetus 2O36.22X3 Maternal care for hydrops fetalis, second trimester, fetus 3O36.22X4 Maternal care for hydrops fetalis, second trimester, fetus 4O36.22X5 Maternal care for hydrops fetalis, second trimester, fetus 5O36.22X9 Maternal care for hydrops fetalis, second trimester, other fetusO36.23X0 Maternal care for hydrops fetalis in third trimesterO36.23X1 Maternal care for hydrops fetalis, third trimester, fetus 1O36.23X2 Maternal care for hydrops fetalis, third trimester, fetus 2O36.23X3 Maternal care for hydrops fetalis, third trimester, fetus 3O36.23X4 Maternal care for hydrops fetalis, third trimester, fetus 4O36.23X5 Maternal care for hydrops fetalis, third trimester, fetus 5O36.23X9 Maternal care for hydrops fetalis, third trimester, other fetus

O36.5135Maternal care for known or suspected placental insufficiency, third trimester, fetus 5

O36.5935Maternal care for other known or suspected poor fetal growth, third trimester, fetus 5

O36.71X0 Maternal care for viable fetus in abdominal pregnancy in first trimesterO36.71X1 Maternal care for viable fetus in abdominal pregnancy, first trimester, fetus 1O36.71X2 Maternal care for viable fetus in abdominal pregnancy, first trimester, fetus 2O36.71X3 Maternal care for viable fetus in abdominal pregnancy, first trimester, fetus 3O36.71X4 Maternal care for viable fetus in abdominal pregnancy, first trimester, fetus 4O36.71X5 Maternal care for viable fetus in abdominal pregnancy, first trimester, fetus 5

O36.71X9Maternal care for viable fetus in abdominal pregnancy, first trimester, other fetus

O36.72X0 Maternal care for viable fetus in abdominal pregnancy in second trimester

O36.72X1Maternal care for viable fetus in abdominal pregnancy, second trimester, fetus 1




O36.72X5 Maternal care for viable fetus in abdominal pregnancy, second trimester, fetus


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5

O36.72X9Maternal care for viable fetus in abdominal pregnancy, second trimester, other fetus

O36.73X0 Maternal care for viable fetus in abdominal pregnancy in third trimesterO36.73X1 Maternal care for viable fetus in abdominal pregnancy, third trimester, fetus 1O36.73X2 Maternal care for viable fetus in abdominal pregnancy, third trimester, fetus 2O36.73X3 Maternal care for viable fetus in abdominal pregnancy, third trimester, fetus 3O36.73X4 Maternal care for viable fetus in abdominal pregnancy, third trimester, fetus 4O36.73X5 Maternal care for viable fetus in abdominal pregnancy, third trimester, fetus 5

O36.73X9Maternal care for viable fetus in abdominal pregnancy, third trimester, other fetus

O36.80X0 Pregnancy with inconclusive fetal viabilityO36.80X1 Pregnancy with inconclusive fetal viability, fetus 1O36.80X2 Pregnancy with inconclusive fetal viability, fetus 2O36.80X3 Pregnancy with inconclusive fetal viability, fetus 3O36.80X4 Pregnancy with inconclusive fetal viability, fetus 4O36.80X5 Pregnancy with inconclusive fetal viability, fetus 5O36.80X9 Pregnancy with inconclusive fetal viability, other fetusO36.8120 Decreased fetal movements in second trimesterO36.8121 Decreased fetal movements, second trimester, fetus 1O36.8122 Decreased fetal movements, second trimester, fetus 2O36.8123 Decreased fetal movements, second trimester, fetus 3O36.8124 Decreased fetal movements, second trimester, fetus 4O36.8125 Decreased fetal movements, second trimester, fetus 5O36.8129 Decreased fetal movements, second trimester, other fetusO36.8130 Decreased fetal movements in third trimesterO36.8131 Decreased fetal movements, third trimester, fetus 1O36.8132 Decreased fetal movements, third trimester, fetus 2O36.8133 Decreased fetal movements, third trimester, fetus 3O36.8134 Decreased fetal movements, third trimester, fetus 4O36.8135 Decreased fetal movements, third trimester, fetus 5O36.8139 Decreased fetal movements, third trimester, other fetus

O36.8190Decreased fetal movements, affecting management of mother, unspecified as to episode of care in pregnancy

O36.8191 Decreased fetal movements, unspecified trimester, fetus 1O36.8192 Decreased fetal movements, unspecified trimester, fetus 2O36.8193 Decreased fetal movements, unspecified trimester, fetus 3O36.8194 Decreased fetal movements, unspecified trimester, fetus 4O36.8195 Decreased fetal movements, unspecified trimester, fetus 5O36.8199 Decreased fetal movements, unspecified trimester, other fetus

O42.019Preterm premature rupture of membranes with onset of labor within 24 hours of rupture

O42.119Preterm premature rupture of membranes with onset of labor more than 24 hours following rupture

O42.90Premature rupture of membranes in pregnancy, unspecified as to episode of care

O42.911 Preterm premature rupture of membranes in first trimesterO42.912 Preterm premature rupture of membranes in second trimester


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O42.913 Preterm premature rupture of membranes in third trimesterO42.919 Preterm premature rupture of membranesO42.92 Full-term premature rupture of membranesO43.121 Velamentous insertion of umbilical cord in first trimesterO43.122 Velamentous insertion of umbilical cord in second trimesterO43.123 Velamentous insertion of umbilical cord in third trimesterO43.129 Velamentous insertion of umbilical cordO43.219 Placenta accretaO43.229 Placenta incretaO43.819 Placental infarct affecting management of motherO43.891 Other placental disorders, first trimesterO43.892 Other placental disorders, second trimesterO43.893 Other placental disorders, third trimesterO43.899 Other placental conditions affecting management of mother, deliveredO45.009 Premature separation of placenta with coagulation defectO45.019 Premature separation of placenta with afibrinogenemiaO45.029 Premature separation of placenta with disseminated intravascular coagulation

O45.099Premature separation of placenta with other coagulation defect, unspecified trimester

O45.90 Premature separation of placenta, unspecified as to episode of careO60.10X1 Preterm labor with preterm delivery, unspecified trimester, fetus 1O60.10X2 Preterm labor with preterm delivery, unspecified trimester, fetus 2O60.10X3 Preterm labor with preterm delivery, unspecified trimester, fetus 3O60.10X4 Preterm labor with preterm delivery, unspecified trimester, fetus 4O60.10X5 Preterm labor with preterm delivery, unspecified trimester, fetus 5O60.10X9 Preterm labor with preterm delivery, unspecified trimester, other fetusO60.12X1 Preterm labor second trimester with preterm delivery second trimester, fetus 1O60.12X2 Preterm labor second trimester with preterm delivery second trimester, fetus 2O60.12X3 Preterm labor second trimester with preterm delivery second trimester, fetus 3O60.12X4 Preterm labor second trimester with preterm delivery second trimester, fetus 4O60.12X5 Preterm labor second trimester with preterm delivery second trimester, fetus 5

O60.12X9Preterm labor second trimester with preterm delivery second trimester, other fetus

O60.13X1 Preterm labor second trimester with preterm delivery third trimester, fetus 1O60.13X2 Preterm labor second trimester with preterm delivery third trimester, fetus 2O60.13X3 Preterm labor second trimester with preterm delivery third trimester, fetus 3O60.13X4 Preterm labor second trimester with preterm delivery third trimester, fetus 4O60.13X5 Preterm labor second trimester with preterm delivery third trimester, fetus 5O60.13X9 Preterm labor second trimester with preterm delivery third trimester, other fetusO60.14X1 Preterm labor third trimester with preterm delivery third trimester, fetus 1O60.14X2 Preterm labor third trimester with preterm delivery third trimester, fetus 2O60.14X3 Preterm labor third trimester with preterm delivery third trimester, fetus 3O60.14X4 Preterm labor third trimester with preterm delivery third trimester, fetus 4O60.14X5 Preterm labor third trimester with preterm delivery third trimester, fetus 5O60.14X9 Preterm labor third trimester with preterm delivery third trimester, other fetusO60.20X0 Term delivery with preterm laborO60.20X1 Term delivery with preterm labor, unspecified trimester, fetus 1


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O60.20X2 Term delivery with preterm labor, unspecified trimester, fetus 2O60.20X3 Term delivery with preterm labor, unspecified trimester, fetus 3O60.20X4 Term delivery with preterm labor, unspecified trimester, fetus 4O60.20X5 Term delivery with preterm labor, unspecified trimester, fetus 5O60.20X9 Term delivery with preterm labor, unspecified trimester, other fetusO60.22X0 Term delivery with preterm labor in second trimesterO60.22X1 Term delivery with preterm labor, second trimester, fetus 1O60.22X2 Term delivery with preterm labor, second trimester, fetus 2O60.22X3 Term delivery with preterm labor, second trimester, fetus 3O60.22X4 Term delivery with preterm labor, second trimester, fetus 4O60.22X5 Term delivery with preterm labor, second trimester, fetus 5O60.22X9 Term delivery with preterm labor, second trimester, other fetusO60.23X0 Term delivery with preterm labor in third trimesterO60.23X1 Term delivery with preterm labor, third trimester, fetus 1O60.23X2 Term delivery with preterm labor, third trimester, fetus 2O60.23X3 Term delivery with preterm labor, third trimester, fetus 3O60.23X4 Term delivery with preterm labor, third trimester, fetus 4O60.23X5 Term delivery with preterm labor, third trimester, fetus 5O60.23X9 Term delivery with preterm labor, third trimester, other fetusO62.8 Other abnormalities of forces of laborO65.0 Obstructed labor due to deformed pelvisO65.1 Obstructed labor due to generally contracted pelvisO65.3 Obstructed labor due to pelvic outlet contractionO66.2 Obstructed labor due to unusually large fetusO66.3 Obstructed labor due to other abnormalities of fetusO66.41 Failed attempted vaginal birth after previous cesarean deliveryO66.6 Obstructed labor due to other multiple fetusesO71.81 Laceration of uterus, not elsewhere classifiedO74.0 Aspiration pneumonitis due to anesthesia during labor and deliveryO74.4 Toxic reaction to local anesthesia during labor and deliveryO74.5 Spinal headache complicating labor and deliveryO74.6 Other complications of spinal and epidural anesthesia during labor and deliveryO74.7 Failed or difficult intubation for anesthesia during labor and deliveryO77.1 Fetal stress in labor or delivery due to drug administrationO77.8 Labor and delivery complicated by other evidence of fetal stress

O77.9Fetal distress affecting management of mother, unspecified as to episode of care

O89.01 Aspiration pneumonitis due to anesthesia during puerperiumO89.3 Toxic reaction to local anesthesia during puerperiumO89.4 Postpartum spinal headacheO89.5 Other complications of spinal and epidural anesthesia during the puerperiumO89.6 Failed or difficult intubation for anesthesia during the puerperiumO91.03 Infection of nipple associated with lactationO91.119 Abscess of breast associated with childbirth, unspecified as to episode of careO91.13 Abscess of breast associated with lactationO92.02 Retracted nipple, delivered, with mention of postpartum complicationO92.12 Cracked nipple, delivered, with mention of postpartum complication


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O92.4 HypogalactiaO98.411 Viral hepatitis complicating pregnancy in first trimesterO98.412 Viral hepatitis complicating pregnancy in second trimesterO98.413 Viral hepatitis complicating pregnancy in third trimesterO98.419 Acute viral hepatitis complicating pregnancyO98.711 Human immunodeficiency disease complicating pregnancy in first trimesterO98.712 Human immunodeficiency disease complicating pregnancy in second trimesterO98.713 Human immunodeficiency disease complicating pregnancy in third trimesterO98.719 Symptomatic HIV infection, maternal, antepartumO98.72 Human immunodeficiency (HIV) disease complicating childbirthO98.73 Human immunodeficiency disease complicating puerperiumO99.310 Alcohol abuse complicating pregnancyO99.311 Alcohol use complicating pregnancy in first trimesterO99.312 Alcohol use complicating pregnancy in second trimesterO99.313 Alcohol use complicating pregnancy in third trimesterO99.314 Alcohol use complicating childbirthO99.315 Alcohol use complicating puerperiumO99.511 Respiratory system disease complicating pregnancy in first trimesterO99.512 Respiratory system disease complicating pregnancy in second trimesterO99.513 Respiratory system disease complicating pregnancy in third trimesterO99.519 Pneumonia complicating pregnancyO99.52 Diseases of respiratory system complicating childbirthO99.53 Diseases of respiratory system complicating puerperiumO99.611 Digestive system disease complicating pregnancy in first trimesterO99.612 Digestive system disease complicating pregnancy in second trimesterO99.613 Digestive system disease complicating pregnancy in third trimesterO99.619 Constipation in pregnancyO99.62 Diseases of digestive system complicating childbirthO99.63 Disease of digestive system complicating puerperiumO99.711 Skin and subcutaneous tissue disease complicating pregnancy in first trimester

O99.712Skin and subcutaneous tissue disease complicating pregnancy in second trimester

O99.713Skin and subcutaneous tissue disease complicating pregnancy in third trimester

O99.719 Pruritic urticarial papules and plaques of pregnancy, antepartumO99.72 Diseases of the skin and subcutaneous tissue complicating childbirthO99.73 Diseases of the skin and subcutaneous tissue complicating the puerperiumO99.820 Group B streptococcal infection in pregnancyO99.824 Streptococcus b carrier state complicating childbirthO99.825 Streptococcus B carrier state complicating puerperiumO99.830 Other infection carrier state complicating pregnancyO9A.12 Malignant neoplasm complicating childbirthO9A.13 Malignant neoplasm complicating puerperium

O9A.22Injury, poisoning and certain other consequences of external causes complicating childbirth

O9A.23Injury, poisoning and certain other consequences of external causes complicating the puerperium

O9A.32 Physical abuse complicating childbirth


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O9A.33 Physical abuse complicating puerperiumO9A.42 Sexual abuse complicating childbirthO9A.43 Sexual abuse complicating puerperiumO9A.52 Psychological abuse complicating childbirthO9A.53 Psychological abuse complicating puerperiumO9A.111 Malignant neoplasm complicating pregnancy, first trimesterO9A.112 Malignant neoplasm complicating pregnancy, second trimesterO9A.113 Malignant neoplasm complicating pregnancy, third trimesterO9A.119 Malignant neoplasm complicating pregnancy, unspecified trimester

O9A.211Injury, poisoning and certain other consequences of external causes complicating pregnancy, first trimester

O9A.212Injury, poisoning and certain other consequences of external causes complicating pregnancy, second trimester

O9A.213Injury, poisoning and certain other consequences of external causes complicating pregnancy, third trimester

O9A.219Injury, poisoning and certain other consequences of external causes complicating pregnancy, unspecified trimester

O9A.311 Physical abuse complicating pregnancy, first trimesterO9A.312 Physical abuse complicating pregnancy, second trimesterO9A.313 Physical abuse complicating pregnancy, third trimesterO9A.319 Physical abuse complicating pregnancy, unspecified trimesterO9A.411 Sexual abuse complicating pregnancy, first trimesterO9A.412 Sexual abuse complicating pregnancy, second trimesterO9A.413 Sexual abuse complicating pregnancy, third trimesterO9A.419 Sexual abuse complicating pregnancy, unspecified trimesterO9A.511 Psychological abuse complicating pregnancy, first trimesterO9A.512 Psychological abuse complicating pregnancy, second trimesterO9A.513 Psychological abuse complicating pregnancy, third trimesterO9A.519 Psychological abuse complicating pregnancy, unspecified trimesterZ33.1 Pregnant state, incidentalZ33.2 Encounter for elective termination of pregnancyZ33.3 Pregnant state, gestational carrierZ34.00 Encounter for supervision of normal first pregnancy, unspecified trimesterZ34.01 Encounter for supervision of normal first pregnancy, first trimesterZ34.02 Encounter for supervision of normal first pregnancy, second trimesterZ34.03 Encounter for supervision of normal first pregnancy, third trimesterZ34.80 Encounter for supervision of other normal pregnancy, unspecified trimesterZ34.81 Encounter for supervision of other normal pregnancy, first trimesterZ34.82 Encounter for supervision of other normal pregnancy, second trimesterZ34.83 Encounter for supervision of other normal pregnancy, third trimester

Z34.90Encounter for supervision of normal pregnancy, unspecified, unspecified trimester

Z34.91 Encounter for supervision of normal pregnancy, unspecified, first trimesterZ34.92 Encounter for supervision of normal pregnancy, unspecified, second trimesterZ34.93 Encounter for supervision of normal pregnancy, unspecified, third trimesterZ36 Encounter for antenatal screening of mother


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TABLE D-20: Codes to Identify In Vitro Fertilization

HCPCS Codes DescriptionS4015 Complete in vitro fertilization cycle, not otherwise specified, case rateS4016 Frozen in vitro fertilization cycle, case rate S4018 Frozen embryo transfer procedure cancelled before transfer, case rate S4020 In vitro fertilization procedure cancelled before aspiration, case rate S4021 In vitro fertilization procedure cancelled after aspiration, case rate

TABLE D-21: Clomiphene MedicationsClomiphene (Clomid/Serophene)

RXNORM Codes for Clomiphene109306110930601093059142431115337036894837157111533712596115113131754111511331093062118076011807619679

TABLE D-22: Codes to Identify CirrhosisICD-9-CM Diagnosis

CodesDescription

571.2 Alcoholic cirrhosis of liver571.5 Cirrhosis of liver without mention of alcohol571.6 Biliary cirrhosis

ICD-10-CM Description


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Diagnosis CodesK70.30 Alcoholic cirrhosis of liver without ascitesK70.31 Alcoholic cirrhosis of liver with ascitesK74.3 Primary biliary cirrhosisK74.4 Secondary biliary cirrhosisK74.5 Biliary cirrhosis, unspecifiedK74.60 Unspecified cirrhosis of liverK74.69 Other cirrhosis of liver

TABLE D-23: Codes to Identify Myalgia, Myositis, Myopathy or RhabdomyolysisICD-9-CM Diagnosis

CodesDescription

359.4 Toxic myopathy359.9 Myopathy, unspecified728.88 Rhabdomyolysis729.1 Myalgia and myositis, unspecified

ICD-10-CM Diagnosis Codes Description

G72.0 Drug-induced myopathyG72.2 Myopathy due to other toxic agentsG72.9 Myopathy, unspecifiedM62.82 RhabdomyolysisM79.1 Myalgia

NOTE: For Internal Data Collection Only At This TimeTABLE D-4: Codes to identify LDL Laboratory Test

CPT Code Description80061 Lipid panel including the following:

Cholesterol, serum (82465) Lipoprotein, direct measurement, high density cholesterol (HDL Cholesterol)

(83718) Triglycerides (84478)

83700 (Added 01/01/07)

Lipoprotein, blood; electrophoretic separation and quantitation

83701 (Added 01/01/07)

High resolution fractionation and quantitation of lipoprotein cholesterols (e.g., electrophoresis, nuclear magnetic resonance, ultra-centrifugation)

83704 Quantitation of lipoprotein particle subclases ie. by nuclear magnetic resonance spectroscopy**If this code is used a direct LDL result must be included. Particle Size results alone cannot be used because they are not standard with WCHQ LDL results.

83721 Direct measurement, LDL cholesterol


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LOINC 2089-112773-813457-718261-818262-622748-824331-139469-2


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