Medicare Data Utilities Appendices

Medicare Data Utilities Appendices 

B Beneficiary Primary Payer Table 

C BETOS Table 

D Carrier Claim Payment Denial Table 

E Carrier Line Provider Type Table 

G CMS Provider Specialty Table 

H CMS Type of Service Table 

I Line Place of Service Table 

J NCH Edit Table 

K NCH Patch Table 

L State Table 

M Identification of variables used in summary level aggregation 

N Agency for Healthcare Research and Quality (AHRQ)Diagnostic Codes 

O Agency for Healthcare Research and Quality (AHRQ)Procedure Codes 

P International Classification of Diseases (ICD-9) Diagnostic Codes (v18) 

Q International Classification of Diseases (ICD-9) Surgery Codes (v18) 

R Diagnostic Related Group (DRG) Number Table (v18) 

S Alpha-Numeric HCPCS Codes

Appendix B Beneficiary Primary Payer Table 

The following claim-level variables reference this Appendix: 

bprpycd Line beneficiary primary payer code 

A = Working aged bene/spouse with employer group health plan (eghp) 

B = End stage renal disease (ESRD) beneficiary in the 18 month 

coordination period with an employer group health plan 

C = Conditional payment by Medicare; future reimbursement expected 

D = Automobile no-fault (eff. 4/97; Prior to 3/94, also included any 

Liability insurance) 

E = Workers' compensation 

F = Public Health Service or other federal agency (other than Dept. of 

Veterans Affairs) 

G = Working disabled bene (under age 65 with LGHP) 

H = Black Lung 

I = Dept. of Veterans Affairs 

J = Any liability insurance (eff. 3/94 - 3/97) 

L = Any liability insurance (eff. 4/97) (eff. 12/90 for carrier claims 

and 10/93 for FI claims; obsoleted for all claim types 7/1/96) 

M = Override code: EGHP services involved (eff. 12/90 for carrier 

claims and 10/93 for FI claims; obsoleted for all claim types 

7/1/96) 

N = Override code: non-EGHP services involved (eff. 12/90 for carrier 

claims and 10/93 for FI claims; obsoleted for all claim types 

7/1/96) 

BLANK = Medicare is primary payer (not sure of effective date: in use 

1/91, if not earlier) 

T = MSP cost avoided - IEQ contractor (eff. 7/96 carrier claims only) 

U = MSP cost avoided - HMO rate cell adjustment contractor (eff. 7/96 

carrier claims only) 

V = MSP cost avoided - litigation settlement contractor (eff. 7/96 

carrier claims only) 

X = MSP cost avoided override code (eff. 12/90 for carrier claims and 

10/93 for FI claims; obsoleted for all claim types 7/1/96) 

***Prior to 12/90*** 

Y = Other secondary payer investigation shows Medicare as primary payer 

Z = Medicare is primary payer 

NOTE: Values C, M, N, Y, Z and BLANK indicate Medicare is primary 

payer. (values Z and Y were used prior to 12/90. BLANK was suppose 

to be effective after 12/90, but may have been used prior to that 

date.)

Appendix C BETOS Table 

The Berenson-Eggers type of service (BETOS) for a procedure code is based on generally 

agreed upon clinically meaningful groupings of procedures and services. 


betos Line NCH BETOS code 

M1A = Office visits - new 

M1B = Office visits - established 

M2A = Hospital visit - initial 

M2B = Hospital visit - subsequent 

M2C = Hospital visit - critical care 

M3 = Emergency room visit 

M4A = Home visit 

M4B = Nursing home visit 

M5A = Specialist - pathology 

M5B = Specialist - psychiatry 

M5C = Specialist - opthamology 

M5D = Specialist - other 

M6 = Consultations 

P0 = Anesthesia 

P1A = Major procedure - breast 

P1B = Major procedure - colectomy 

P1C = Major procedure - cholecystectomy 

P1D = Major procedure - turp 

P1E = Major procedure - hysterctomy 

P1F = Major procedure - explor/decompr/excisdisc 

P1G = Major procedure - Other 

P2A = Major procedure, cardiovascular-CABG 

P2B = Major procedure, cardiovascular-Aneurysm repair 

P2C = Major Procedure, cardiovascular-Thromboendarterect 

P2D = Major procedure, cardiovascualr-Coronary angioplas 

P2E = Major procedure, cardiovascular-Pacemaker insertio 

P2F = Major procedure, cardiovascular-Other 

P3A = Major procedure, orthopedic - Hip fracture repair 

P3B = Major procedure, orthopedic - Hip replacement 

P3C = Major procedure, orthopedic - Knee replacement 

P3D = Major procedure, orthopedic - other 

P4A = Eye procedure - corneal transplant 

P4B = Eye procedure - cataract removal/lens insertion 

P4C = Eye procedure - retinal detachment 

P4D = Eye procedure - treatment 

P4E = Eye procedure - other 

P5A = Ambulatory procedures - skin 

P5B = Ambulatory procedures - musculoskeletal 

P5C = Ambulatory procedures - inguinal hernia repair 

P5D = Ambulatory procedures - lithotripsy 

P5E = Ambulatory procedures - other 

P6A = Minor procedures - skin 

P6B = Minor procedures - musculoskeletal 

P6C = Minor procedures - other (Medicare fee schedule) 

P6D = Minor procedures - other (non-Medicare fee schedule) 

P7A = Oncology - radiation therapy 

P7B = Oncology - other 

P8A = Endoscopy - arthroscopy

P8B = Endoscopy - upper gastrointestinal 

P8C = Endoscopy - sigmoidoscopy 

P8D = Endoscopy - colonoscopy 

P8E = Endoscopy - cystoscopy 

P8F = Endoscopy - bronchoscopy 

P8G = Endoscopy - laparoscopic cholecystectomy 

P8H = Endoscopy - laryngoscopy 

P8I = Endoscopy - other 

P9A = Dialysis services 

I1A = Standard imaging - chest 

I1B = Standard imaging - musculoskeletal 

I1C = Standard imaging - breast 

I1D = Standard imaging - contrast gastrointestinal 

I1E = Standard imaging - nuclear medicine 

I1F = Standard imaging - other 

I2A = Advanced imaging - CAT: head 

I2B = Advanced imaging - CAT: other 

I2C = Advanced imaging - MRI: brain 

I2D = Advanced imaging - MRI: other 

I3A = Echography - eye 

I3B = Echography - abdomen/pelvis 

I3C = Echography - heart 

I3D = Echography - carotid arteries 

I3E = Echography - prostate, transrectal 

I3F = Echography - other 

I4A = Imaging/procedure - heart including cardiac catheter 

I4B = Imaging/procedure - other 

T1A = Lab tests - routine venipuncture (non Medicare fee schedule) 

T1B = Lab tests - automated general profiles 

T1C = Lab tests - urinalysis 

T1D = Lab tests - blood counts 

T1E = Lab tests - glucose 

T1F = Lab tests - bacterial cultures 

T1G = Lab tests - other (Medicare fee schedule) 

T1H = Lab tests - other (non-Medicare fee schedule) 

T2A = Other tests - electrocardiograms 

T2B = Other tests - cardiovascular stress tests 

T2C = Other tests - EKG monitoring 

T2D = Other tests - other 

D1A = Medical/surgical supplies 

D1B = Hospital beds 

D1C = Oxygen and supplies 

D1D = Wheelchairs 

D1E = Other DME 

D1F = Orthotic devices 

O1A = Ambulance 

O1B = Chiropractic 

O1C = Enteral and parenteral 

O1D = Chemotherapy 

O1E = Other drugs 

O1F = Vision, hearing and speech services 

O1G = Influenza immunization 

Y1 = Other - Medicare fee schedule 

Y2 = Other - non-Medicare fee schedule 

Z1 = Local codes 

Z2 = Undefined codes

Appendix D Carrier Claim Payment Denial Table 


bdenycd Carrier claim payment denial code 

0 = Denied 

1 = Physician/supplier 

2 = Beneficiary 

3 = Both physician/supplier and beneficiary 

4 = Hospital (hospital based physicians) 

5 = Both hospital and beneficiary 

6 = Group practice 

7 = Other entries 

8 = Federally funded 

9 = PA service 

A = Beneficiary under limitation of liability 

B = Physician/supplier under limitation of liability 

D = Denied due to demonstration involvement (eff. 5/97) 

P = Physician ownership denial (eff 3/92) 

T = MSP cost avoided - IEQ contractor (eff. 7/76) 

U = MSP cost avoided - HMO rate cell adjustment (eff. 7/96) 

V = MSP cost avoided - litigation settlement (eff. 7/96) 

X = MSP cost avoided - generic 

Y = MSP cost avoided - IRS/SSA data match

Appendix E Carrier Line Provider Type Table 


bprvtyp Carrier line provider type code 

For Physician/Supplier (RIC O) Claims: 

0 = Clinics, groups, associations, partnerships, or other entities 

1 = Physicians or suppliers reporting as solo practitioners 

2 = Suppliers (other than sole proprietorship) 

3 = Institutional provider 

4 = Independent laboratories 

5 = Clinics (multiple specialties) 

6 = Groups (single specialty) 

7 = Other entities 

For DMERC (RIC M) Claims - PRIOR TO VERSION H: 

0 = Clinics, groups, associations, partnerships, or other entities 

for whom the carrier's own ID number has been assigned. 

1 = Physicians or suppliers billing as solo practitioners for whom 

SSN's are shown in the physician ID code field. 

2 = Physicians or suppliers billing as solo practitioners for whom the 

carrier's own physician ID code is shown. 

3 = Suppliers (other than sole proprietorship) for whom EI numbers are 

used in coding the ID field. 

4 = Suppliers (other than sole proprietorship) for whom the carrier's 

own code has been shown. 

5 = Institutional providers and independent laboratories for whom EI 

numbers are used in coding the ID field. 

6 = Institutional providers and independent laboratories for whom the 

carrier's own ID number is shown. 

7 = Clinics, groups, associations, or partnerships for whom EI numbers 

are used in coding the ID field. 

8 = Other entities for whom EI numbers are used in coding the ID field 

or proprietorship for whom EI numbers are used in coding the ID 

field.

Appendix G CMS Provider Specialty Table 


bcspec Carrier line provider specialty code 

speccode Physician supplier/CMS provider specialty code 

**Prior to 5/92** 

01 = General practice 

02 = General surgery 

03 = Allergy (revised 10/91 to mean allergy/immunology) 

04 = Otology, laryngology, rhinology revised 10/91 to mean 

otolaryngology) 

05 = Anesthesiology 

06 = Cardiovascular disease (revised 10/91 to mean cardiology) 

07 = Dermatology 

08 = Family practice 

09 = Gynecology--osteopaths only (deleted 10/91; changed to '16') 

10 = Gastroenterology 

11 = Internal medicine 

12 = Manipulative therapy (osteopaths only) (revised 10/91 to mean 

osteopathic manipulative therapy) 

13 = Neurology 

14 = Neurological surgery (revised 10/91 to mean neurosurgery) 

15 = Obstetrics--osteopaths only (deleted 10/91; changed to '16') 

16 = OB-gynecology 

17 = Ophthalmology, otology, laryngology rhinology--osteopaths only 

(deleted 10/91; changed to '18' if physicians practice is more 

than 50% ophthalmology or to '04' if physician's practice is 

more than 50% otolaryngology. If practice is 50/50, choose 

specialty with greater allowed charges. 

18 = Ophthalmology 

19 = Oral surgery (dentists only) 

20 = Orthopedic surgery 

21 = Pathologic anatomy, clinical pathology-osteopaths only (deleted 

10/91; changed to '22') 

22 = Pathology 

23 = Peripheral vascular disease or surgery (deleted 10/91; changed to 

'76') 

24 = Plastic surgery (revised to mean plastic and reconstructive 

surgery). 

25 = Physical medicine and rehabilitation 

26 = Psychiatry 

27 = Psychiatry, neurology (osteopaths only)(deleted 10/91; changed to 

'86') 

28 = Proctology (revised 10/91 to mean colorectal surgery). 

29 = Pulmonary disease 

30 = Radiology (revised 10/91 to mean diagnostic radiology) 

31 = Roentgenology, radiology (osteopaths)(deleted 10/91; changed to 

'30') 

32 = Radiation therapy--osteopaths (deleted 10/91; changed to '92') 

33 = Thoracic surgery 

34 = Urology 

35 = Chiropractor, licensed (revised 10/91 to mean chiropractic) 

36 = Nuclear medicine 

37 = Pediatrics (revised 10/91 to mean pediatric medicine)

38 = Geriatrics (revised 10/91 to mean geriatric medicine) 

39 = Nephrology 

40 = Hand surgery 

41 = Optometrist - services related to condition of aphakia (revised 

10/91 to mean optometrist) 

42 = Certified nurse midwife (added 7/88) 

43 = Certified registered nurse anesthetist(revised 10/91 to mean CRNA, 

anesthesia assistant) 

44 = Infectious disease 

46 = Endocrinology (added 10/91) 

48 = Podiatry - surgery chiropody (revised 10/91 to mean podiatry) 

49 = Miscellaneous (include ASCS) 

51 = Medical supply company with C.O. certification (certified 

orthotist - certified by American Board for Certification in 

Prosthetics and Orthotics. 

52 = Medical supply company with C.P. certification (certified 

prosthetist - certified by American Board for Certification in 

Prosthetics and Orthotics). 

53 = Medical supply company with C.P.O. certification (certified 

prosthetist - orthotist - certified by American Board for 

Certification in Prosthetics and Orthotics). 

54 = Medical supply company not included in 51, 52, or 53. 

55 = Individual certified orthotist 

56 = Individual certified prosthetist 

57 = Individual certified prosthetist - orthotist 

58 = Individuals not included in 55,56 or 57 

59 = Ambulance service supplier (e.g. private ambulance companies, 

funeral homes, etc.) 

60 = Public health or welfare agencies (federal, state, and local) 

61 = Voluntary health or charitable agencies (e.g. National Cancer 

Society, National Heart Association, Catholic Charities) 

62 = Psychologist--billing independently 

63 = Portable X-ray supplier-billing independently (revised 10/91 to 

mean portable X-ray supplier) 

64 = Audiologist (billing independently) 

65 = Physical therapist (independent practice) 

66 = Rheumatology (added 10/91) 

67 = Occupational therapist-independent practice 

68 = Clinical psychologist 

69 = Independent laboratory-billing independently (revised 10/91 to 

mean independent clinical laboratory -- billing independently) 

70 = Clinic or other group practice, except Group Practice Prepayment 

Plan (GPPP) 

71 = Group Practice Prepayment Plan - diagnostic X-ray (do not use 

after 1/92) 

72 = Group Practice Prepayment Plan - diagnostic laboratory (do not use 

after 1/92) 

73 = Group Practice Prepayment Plan - physiotherapy (do not use after 

1/92) 

74 = Group Practice Prepayment Plan - occupational therapy (do not use 

after 1/92) 

75 = Group Practice Prepayment Plan - other medical care (do not use 

after 1/92) 

76 = Peripheral vascular disease (added 10/91) 

77 = Vascular surgery (added 10/91) 

78 = Cardiac surgery (added 10/91) 

79 = Addiction medicine (added 10/91)

8O = Clinical social worker (1991) 

81 = Critical care-intensivists (added 10/91) 

82 = Ophthalmology, cataracts specialty (added 10/91; used only until 

5/92) 

83 = Hematology/oncology (added 10/91) 

84 = Preventive medicine (added 10/91) 

85 = Maxillofacial surgery (added 10/91) 

86 = Neuropsychiatry (added 10/91) 

87 = All other (e.g. drug and department stores) (revised 10/91 to mean 

all other suppliers) 

88 = Unknown (revised 10/91 to mean physician assistant) 

90 = Medical oncology (added 10/91) 

91 = Surgical oncology (added 10/91) 

92 = Radiation oncology (added 10/91) 

93 = Emergency medicine (added 10/91) 

94 = Interventional radiology (added 10/91) 

95 = Independent physiological laboratory (added 10/91) 

96 = Unknown physician specialty (added 10/91) 

99 = Unknown--incl. social worker's psychiatric services (revised 10/91 

to mean unknown supplier/provider) 

--------------------------------------- 

**Effective 5/92** 

00 = Carrier wide 

01 = General practice 

02 = General surgery 

03 = Allergy/immunology 

04 = Otolaryngology 

05 = Anesthesiology 

06 = Cardiology 

07 = Dermatology 

08 = Family practice 

09 = Gynecology (osteopaths only) (discontinued 5/92 use code 16) 

10 = Gastroenterology 

11 = Internal medicine 

12 = Osteopathic manipulative therapy 

13 = Neurology 

14 = Neurosurgery 

15 = Obstetrics (osteopaths only) (discontinued 5/92 use code 16) 

16 = Obstetrics/gynecology 

17 = Ophthalmology, otology, laryngology, rhinology (osteopaths only) 

(discontinued 5/92 use codes 18 or 04 depending on percentage of 

practice) 

18 = Ophthalmology 

19 = Oral surgery (dentists only) 

20 = Orthopedic surgery 

21 = Pathologic anatomy, clinical pathology (osteopaths only) 

(discontinued 5/92 use code 22) 

22 = Pathology 

23 = Peripheral vascular disease, medical or surgical (osteopaths only) 

(discontinued 5/92 use code 76) 

24 = Plastic and reconstructive surgery 

25 = Physical medicine and rehabilitation 

26 = Psychiatry 

27 = Psychiatry, neurology (osteopaths only) (discontinued 5/92 use 

code 86)

28 = Colorectal surgery (formerly proctology) 

29 = Pulmonary disease 

30 = Diagnostic radiology 

31 = Roentgenology, radiology (osteopaths only) (discontinued 5/92 use 

code 30) 

32 = Radiation therapy (osteopaths only) (discontinued 5/92 use code 

92) 

33 = Thoracic surgery 

34 = Urology 

35 = Chiropractic 

36 = Nuclear medicine 

37 = Pediatric medicine 

38 = Geriatric medicine 

39 = Nephrology 

40 = Hand surgery 

41 = Optometry (revised 10/93 to mean optometrist) 

42 = Certified nurse midwife (eff 1/87) 

43 = Crna, anesthesia assistant (eff 1/87) 

44 = Infectious disease 

45 = Mammography screening center 

46 = Endocrinology (eff 5/92) 

48 = Podiatry 

49 = Ambulatory surgical center (formerly miscellaneous) 

50 = Nurse practitioner 

51 = Medical supply company with certified orthotist (certified by 

American Board for Certification in Prosthetics and Orthotics) 

52 = Medical supply company with certified prosthetist (certified by 

American Board for Certification In Prosthetics and Orthotics) 

53 = Medical supply company with certified prosthetist-orthotist 

(certified by American Board for Certification in Prosthetics 

and Orthotics) 

54 = Medical supply company not included in 51, 52, or 53. (Revised 

10/93 to mean medical supply company for DMERC) 

55 = Individual certified orthotist 

56 = Individual certified prosthetist 

57 = Individual certified prosthetist-orthotist 

58 = Individuals not included in 55, 56, or 57 (revised 10/93 to mean 

medical supply company with registered pharmacist) 

59 = Ambulance service supplier, e.g., private ambulance companies, 

funeral homes, etc. 

60 = Public health or welfare agencies (federal, state, and local) 

61 = Voluntary health or charitable agencies (e.G., National Cancer 

Society, National Heart Associiation, Catholic Charities) 

62 = Psychologist (billing independently) 

63 = Portable X-ray supplier 

64 = Audiologist (billing independently) 

65 = Physical therapist (independently practicing) 

66 = Rheumatology (eff 5/92) Note: during 93/94 DMERC also used this 

to mean medical supply company with respiratory therapist 

67 = Occupational therapist (independently practicing) 

68 = Clinical psychologist 

69 = Clinical laboratory (billing independently) 

70 = Multispecialty clinic or group practice 

71 = Diagnostic X-ray (GPPP) (not to be assigned after 5/92) 

72 = Diagnostic laboratory (GPPP) (not to be assigned after 5/92) 

73 = Physiotherapy (GPPP) (not to be assigned after 5/92) 

74 = Occupational therapy (GPPP)(not to be assigned after 5/92)

75 = Other medical care (GPPP) (not to assigned after 5/92) 

76 = Peripheral vascular disease (eff 5/92) 

77 = Vascular surgery (eff 5/92) 

78 = Cardiac surgery (eff 5/92) 

79 = Addiction medicine (eff 5/92) 

80 = Licensed clinical social worker 

81 = Critical care (intensivists) (eff 5/92) 

82 = Hematology (eff 5/92) 

83 = Hematology/oncology (eff 5/92) 

84 = Preventive medicine (eff 5/92) 

85 = Maxillofacial surgery (eff 5/92) 

86 = Neuropsychiatry (eff 5/92) 

87 = All other suppliers (e.g. drug and department stores) (note: DMERC 

used 87 to mean department store from 10/93 through 9/94; recoded 

eff 10/94 to A7; NCH cross-walked DMERC reported 87 to A7. 

88 = Unknown supplier/provider specialty (note: DMERC used 87 to mean 

grocery store from 10/93 - 9/94; recoded eff 10/94 to A8; NCH 

cross-walked DMERC reported 88 to A8. 

89 = Certified clinical nurse specialist 

90 = Medical oncology (eff 5/92) 

91 = Surgical oncology (eff 5/92) 

92 = Radiation oncology (eff 5/92) 

93 = Emergency medicine (eff 5/92) 

94 = Interventional radiology (eff 5/92) 

95 = Independent physiological laboratory (eff 5/92) 

96 = Optician (eff 10/93) 

97 = Physician assistant (eff 5/92) 

98 = Gynecologist/oncologist (eff 10/94) 

99 = Unknown physician specialty 

A0 = Hospital (eff 10/93) 

A1 = SNF (eff 10/93) 

A2 = Intermediate care nursing facility (eff 10/93) 

A3 = Nursing facility, other (eff 10/93) 

A4 = HHA (eff 10/93) 

A5 = Pharmacy (eff 10/93) 

A6 = Medical supply company with respiratory therapist (eff 10/93) 

A7 = Department store (for DMERC use: eff 10/94, but cross-walked from 

code 87 eff 10/93) 

A8 = Grocery store (for DMERC use: eff 10/94, but cross-walked from 

code 88 eff 10/93)

Appendix H CMS Type of Service Table 


btos Line HCFA type service code 

bctos Carrier line type service 

1 = Medical care 

2 = Surgery 

3 = Consultation 

4 = Diagnostic radiology 

5 = Diagnostic laboratory 

6 = Therapeutic radiology 

7 = Anesthesia 

8 = Assistant at surgery 

9 = Other medical items or services 

0 = Whole blood only eff 01/96, whole blood or packed red 

cells before 01/96 

A = Used durable medical equipment (DME) 

B = High risk screening mammography 

C = Low risk screening mammography 

D = Ambulance (eff 04/95) 

E = Enteral/parenteral nutrients/supplies (eff 04/95) 

F = Ambulatory surgical center (facility usage for surgical services) 

G = Immunosuppressive drugs 

H = Hospice services (discontinued 01/95) 

I = Purchase of DME (installment basis) (discontinued 04/95) 

J = Diabetic shoes (eff 04/95) 

K = Hearing items and services (eff 04/95) 

L = ESRD supplies (eff 04/95)(renal supplier in the home before 04/95) 

M = Monthly capitation payment for dialysis 

N = Kidney donor 

P = Lump sum purchase of DME, prosthetics, orthotics 

Q = Vision items or services 

R = Rental of DME 

S = Surgical dressings or other medical supplies (eff 04/95) 

T = Psychological therapy (term. 12/31/97) outpatient mental health 

limitation (eff. 1/1/98) 

U = Occupational therapy 

V = Pneumococcal/flu vaccine (eff 01/96), 

Pneumococcal/flu/hepatitis B vaccine (eff 04/95-12/95), 

Pneumococcal only before 04/95 

W = Physical therapy 

Y = Second opinion on elective surgery (obsoleted 1/97) 

Z = Third opinion on elective surgery (obsoleted 1/97)

Appendix I Line Place of Service Table 


bplacsv Line place of service code 

**Prior To 1/92** 

1 = Office 

2 = Home 

3 = Inpatient hospital 

4 = SNF 

5 = Outpatient hospital 

6 = Independent lab 

7 = Other 

8 = Independent kidney disease treatment center 

9 = Ambulatory 

A = Ambulance service 

H = Hospice 

M = Mental health, rural mental health 

N = Nursing home 

R = Rural codes 

--------------------------------------- 

**Effective 1/92** 

11 = Office 

12 = Home 

21 = Inpatient hospital 

22 = Outpatient hospital 

23 = Emergency room - hospital 

24 = Ambulatory surgical center 

25 = Birthing center 

26 = Military treatment facility 

31 = Skilled nursing facility 

32 = Nursing facility 

33 = Custodial care facility 

34 = Hospice 

35 = Adult living care facilities (ALCF) (eff. NYD - added 12/3/97) 

41 = Ambulance - land 

42 = Ambulance - air or water 

50 = Federally qualified health centers (eff. 10/1/93) 

51 = Inpatient psychiatric facility 

52 = Psychiatric facility partial hospitalization 

53 = Community mental health center 

54 = Intermediate care facility/mentally retarded 

55 = Residential substance abuse treatment facility 

56 = Psychiatric residential treatment center 

60 = Mass immunizations center (eff. 9/1/97) 

61 = Comprehensive inpatient rehabilitation facility 

62 = Comprehensive outpatient rehabilitation facility 

65 = End stage renal disease treatment facility 

71 = State or local public health clinic 

72 = Rural health clinic 

81 = Independent laboratory 

99 = Other unlisted facility

Appendix J NCH Edit Table 

A0X1 = (C) PHYSICIAN-SUPPLIER ZIP CODE 

A000 = (C) REIMB > $100,000 OR UNITS > 150 

A002 = (C) CLAIM IDENTIFIER (CAN) 

A003 = (C) BENEFICIARY IDENTIFICATION (BIC) 

A004 = (C) PATIENT SURNAME BLANK 

A005 = (C) PATIENT 1ST INITIAL NOT-ALPHABETIC 

A006 = (C) DATE OF BIRTH IS NOT NUMERIC 

A007 = (C) INVALID GENDER (0, 1, 2) 

A008 = (C) INVALID QUERY-CODE (WAS CORRECTED) 

A025 = (C) FOR OV 4, TOB MUST = 13,83,85,73 

A1X1 = (C) PERCENT ALLOWED INDICATOR 

A1X2 = (C) DT>97273,DG1=7611,DG103,163,1589 

A1X3 = (C) DT>96365,DIAG=V725 

A1X4 = (C) INVALID DIAGNOSTIC CODES 

C050 = (U) HOSPICE - SPELL VALUE INVALID 

D102 = (C) DME DATE OF BIRTH INVALID 

D2X2 = (C) DME SCREEN SAVINGS INVALID 

D2X3 = (C) DME SCREEN RESULT INVALID 

D2X4 = (C) DME DECISION IND INVALID 

D2X5 = (C) DME WAIVER OF PROV LIAB INVALID 

D3X1 = (C) DME NATIONAL DRUG CODE INVALID 

D4X1 = (C) DME BENE RESIDNC STATE CODE INVALID 

D4X2 = (C) DME OUT OF DMERC SERVICE AREA 

D4X3 = (C) DME STATE CODE INVALID 

D5X1 = (C) TOS INVALID FOR DME HCPCS 

D5X2 = (C) DME HCPCS NOC & NOC DESCRIP MISSING 

D5X3 = (C) DME INVALID USE OF MS MODIFIER 

D5X4 = (C) TOS9 NDC REQD WHEN HCPCS OMITTED 

D5X5 = (C) TOS9 NDC REQD FOR Q0127-130 HCPCS 

D5X6 = (C) TOS9 NDC/DIAGNOSIS CODE INVALID 

D6X1 = (C) DME SUPPLIER NUMBER MISSING 

D7X1 = (C) DME PURCHASE ALLOWABLE INVALID 

D919 = (C) CAPPED/PEN PUMPS,NUM OF SRVCS > 1 

D921 = (C) SHOE HCPC W/O MOD RT,LT REQ U=2/4/6 

XXXX = (D) SYS DUPL: HOST/BATCH/QUERY-CODE 

Y001 = (C) HCPCS R0075/UNITS>1/SERVICES=1 

Y002 = (C) HCPCS R0075/UNITS=1/SERVICES>1 

Y003 = (C) HCPCS R0075/UNITS=SERVICES 

Y010 = (C) TOB=13X/14X AND T.C.>$7,500 

Y011 = (C) INP CLAIM/REIM > $75,000 

Z001 = (C) RVNU 820-859 REQ COND CODE 71-76 

Z002 = (C) CC M2 PRESENT/REIMB > $150,000 

Z003 = (C) CC M2 PRESENT/UNITS > 150 

Z004 = (C) CC M2 PRESENT/UNITS & REIM < MAX 

Z005 = (C) REIMB>99999 AND REIMB99 AND UNITS11 OR SPEC08 

0018 = (C) DEMO=31,ACT CD1/5 OR ENT CD1/5 

0020 = (C) CANCEL ONLY CODE INVALID 

0021 = (C) DEMO COUNT > 1 

0301 = (C) INVALID HI CLAIM NUMBER 

0302 = (C) BENE IDEN CDE (BIC) INVAL OR BLK 

04A1 = (C) PATIENT SURNAME BLANK (PHYS/SUP) 

04B1 = (C) PATIENT 1ST INITIAL NOT-ALPHABETIC 

0401 = (C) BILL TYPE/PROVIDER INVALID 

0402 = (C) BILL TYPE/REV CODE/PROVR RANGE

0406 = (C) MAMMOGRAPHY WITH NO HCPCS 76092 

0407 = (C) RESPITE CARE BILL TYPE 34X,NO REV 66 

0408 = (C) REV CODE 403 /TYPE 71X/ PROV3800-974 

0410 = (C) IMMUNO DRUG OCCR-36,NO REV-25 OR 636 

0412 = (C) BILL TYPE XX5 HAS ACCOM. REV. CODES 

0413 = (C) CABG/PCOE BUT TOB = HHA,OUT,HOS 

0414 = (C) VALU CD 61,MSA AMOUNT MISSING 

0415 = (C) HOME HEALTH INCORRECT ALPHA RIC 

05X4 = (C) UPIN REQUIRED FOR TYPE-OF-SERVICE 

05X5 = (C) UPIN REQUIRED FOR DME HCPCS 

0501 = (C) UNIQUE PHY IDEN. (UPIN) BLANK 

0502 = (C) UNIQUE PHY IDEN. (UPIN) INVALID 

0601 = (C) GENDER INVALID 

0701 = (C) CONTRACTOR INVALID CARRIER/ETC 

0702 = (C) PROVIDER NUMBER INCONSISTANT 

0703 = (C) MAMMOGRAPHY FOR NOT FEMALE 

0704 = (C) INVALID CONT FOR CABG DEMO 

0705 = (C) INVALID CONT FOR PCOE DEMO 

0901 = (C) INVALID DISP CODE OF 02 

0902 = (C) INVALID DISP CODE OF SPACES 

0903 = (C) INVALID DISP CODE 

1001 = (C) PROF REVIEW/ACT CODE/BILL TYPE 

13X2 = (C) MULTIPLE ITEMS FOR SAME SERVICE 

1301 = (C) LINE COUNT NOT NUMERIC OR > 13 

1302 = (C) RECORD LENGTH INVALID 

1401 = (C) INVALID MEDICARE STATUS CODE 

1501 = (C) ADMIT DATE/ENTRY CODE INVALID 

1502 = (C) ADMIT DATE > STAY FROM DATE 

1503 = (C) ADMIT DATE INVALID WITH THRU DATE 

1504 = (C) ADM/FROM/THRU DATE > TODAYS DATE 

1505 = (C) HCPCS W SERVICE DATES > 09-30-94 

1601 = (C) INVESTIGATION IND INVALID 

1701 = (C) SPLIT IND INVALID 

1801 = (C) PAY-DENY CODE INVALID 

1802 = (C) HEADER AMT AND NOT DENIED CLAIM 

1803 = (C) MSP COST AVD/ALL MSP LI NOT SAME 

1901 = (C) AB CROSSOVER IND INVALID 

2001 = (C) HOSPICE OVERRIDE INVALID 

2101 = (C) HMO-OVERRIDE/PATIENT-STAT INVALID 

2102 = (C) FROM/THRU DATE OR KRON/PAT STAT 

2201 = (C) FROM/THRU DATE OR HCPCS YR INVAL 

2202 = (C) STAY-FROM DATE > THRU-DATE 

2203 = (C) THRU DATE INVALID 

2204 = (C) FROM DATE BEFORE EFFECTIVE DATE 

2205 = (C) DATE YEARS DIFFERENT ON OUTPAT 

2207 = (C) MAMMOGRAPHY BEFORE 1991 

2301 = (C) DOCUMENT CNTL OR UTIL DYS INVALID 

2302 = (C) COVERED DAYS INVALID OR INCONSIST 

2303 = (C) COST REPORT DAYS > ACCOMIDATION 

2304 = (C) UTIL DAYS = ZERO ON PATIENT BILL 

2305 = (C) UTIL DAYS = INCONSISTENCIES 

2306 = (C) UTIL DYS/NOPAY/REIMB INCONSISTENT 

2307 = (C) COND=40,UTL DYS >0/VAL CDE A1,08,09 

2308 = (C) NOPAY = R WHEN UTIL DAYS = ZERO 

2401 = (C) NON-UTIL DAYS INVALID 

2501 = (C) CLAIM RCV DT OR COINSURANCE INVAL 

2502 = (C) COIN+LR>UTIL DAYS/RCPT DTE>CUR DTE

2503 = (C) COIN/TR TYP/UTIL DYS/RCPT DTE>PD/DEN 

2504 = (C) COINSURANCE AMOUNT EXCESSIVE 

2505 = (C) COINSURANCE RATE > ALLOWED AMOUNT 

2506 = (C) COINSURANCE DAYS/AMOUNT INCONSIST 

2507 = (C) COIN+LR DAYS > TOTAL DAYS FOR YR 

2508 = (C) COINSURANCE DAYS INVALID FOR TRAN 

2601 = (C) CLAIM PAID DT INVALID OR LIFE RES 

2602 = (C) LR-DYS, NO VAL 08,10/PD/DEN>CUR+27 

2603 = (C) LIFE RESERVE > RATE FOR CAL YEAR 

2604 = (C) PPS BILL, NO DAY OUTLIER 

2605 = (C) LIFE RESERVE RATE > DAILY RATE AVR. 

28XA = (C) UTIL DAYS > FROM TO BENEF EXH 

28XB = (C) BENEFITS EXH DATE > FROM DATE 

28XC = (C) BENEFITS EXH DATE/INVALID TRANS TYPE 

28XD = (C) OCCUR 23 WITH SPAN 70 ON INPAT HOSP 

28XE = (C) MULTI BENE EXH DATE (OCCR A3,B3,C3) 

28XF = (C) ACE DATE ON SNF (NOPAY =B, C, N, W) 

28XG = (C) SPAN CD 70+4+6+9 NOT = NONUTIL DAYS 

28XM = (C) OCC CD 42 DATE NOT = SRVCE THRU DTE 

28XN = (C) INVALID OCC CODE 

28X0 = (C) BENE EXH DATE OUTSIDE SERVICE DATES 

28X1 = (C) OCCUR DATE INVALID 

28X2 = (C) OCCUR = 20 AND TRANS = 4 

28X3 = (C) OCCUR 20 DATE < ADMIT DATE 

28X4 = (C) OCCUR 20 DATE > ADMIT + 12 

28X5 = (C) OCCUR 20 AND ADMIT NOT = FROM 

28X6 = (C) OCCUR 20 DATE < BENE EXH DATE 

28X7 = (C) OCCUR 20 DATE+UTIL-COIN>COVERAGE 

28X8 = (C) OCCUR 22 DATE < FROM OR > THRU 

28X9 = (C) UTIL > FROM - THRU LESS NCOV 

33X1 = (C) QUAL STAY DATES INVALID (SPAN=70) 

33X2 = (C) QS FROM DATE NOT < THRU (SPAN=70) 

33X3 = (C) QS DAYS/ADMISSION ARE INVALID 

33X4 = (C) QS THRU DATE > ADMIT DATE (SPAN=70) 

33X5 = (C) SPAN 70 INVALID FOR DATE OF SERVICE 

33X6 = (C) TOB=18/21/28/51,COND=WO,HMO90091 

33X7 = (C) TOB18/21/28/51,COND=WO 

33X8 = (C) TOB=18/21/28/51,CO=WO,ADM DT< STAY FROM/ > STAY THRU 

3701 = (C) ASSIGN CODE INVALID 

3705 = (C) 1ST CHAR OF IDE# IS NOT ALPHA 

3706 = (C) INVALID IDE NUMBER-NOT IN FILE 

3710 = (C) NUM OF IDE# > REV 0624 

3715 = (C) NUM OF IDE# < REV 0624 

3720 = (C) IDE AND LINE ITEM NUMBER > 2 

3801 = (C) AMT BENE PD INVALID 

4001 = (C) BLOOD PINTS FURNISHED INVALID 

4002 = (C) BLOOD FURNISHED/REPLACED INVALID 

4003 = (C) BLOOD FURNISHED/VERIFIED/DEDUCT 

4201 = (C) BLOOD PINTS UNREPLACED INVALID 

4202 = (C) BLOOD PINTS UNREPLACED/BLOOD DED 

4203 = (C) INVALID CPO PROVIDER NUMBER 

4301 = (C) BLOOD DEDUCTABLE INVALID 

4302 = (C) BLOOD DEDUCT/FURNISHED PINTS 

4303 = (C) BLOOD DEDUCT > UNREPLACED BLOOD 

4304 = (C) BLOOD DEDUCT > 3 - REPLACED 

4501 = (C) PRIMARY DIAGNOSIS INVALID 

46XA = (C) MSP VET AND VET AT MEDICARE

46XB = (C) MULTIPLE COIN VALU CODES (A2,B2,C2) 

46XC = (C) COIN VALUE (A2,B2,C2) ON INP/SNF 

46XG = (C) VALU CODE 20 INVALID 

46XN = (C) VALUE CODE 37,38,39 INVALID 

46XO = (C) VALUE CDE 38>0/VAL CDE 06 MISSNG 

46XP = (C) BLD UNREP VS REV CDS AND/OR UNITS 

46XQ = (C) VALUE CDE 37=39 AND 38 IS PRESENT 

46XR = (C) BLD FIELDS VS REV CDE 380,381,382 

46XS = (C) VALU CODE 39, AND 37 IS NOT PRESENT 

46XT = (C) CABG/PCOE,VCY1,Y2,Y3,Y4,VA NOT>0 

46X1 = (C) VALUE AMOUNT INVALID 

46X2 = (C) VALU 06 AND BLD-DED-PTS IS ZERO 

46X3 = (C) VALU 06 AND TTL-CHGS=NC-CHGS(001) 

46X4 = (C) VALU (A1,B1,C1): AMT > DEDUCT 

46X5 = (C) DEDUCT VALUE (A1,B1,C1) ON SNF BILL 

46X6 = (C) VALU 17 AND NO COND CODE 60 OR 61 

46X7 = (C) OUTLIER(VAL 17) > REIMB + VAL6-16 

46X8 = (C) MULTI CASH DED VALU CODES (A1,B1,C1) 

46X9 = (C) DEMO ID=03,REQUIRED HCPCS NOT SHOWN 

4600 = (C) CAPITAL TOTAL NOT = CAP VALUES 

4601 = (C) CABG/PCOE, MSP CODE PRESENT 

4603 = (C) DEMO ID = 03 AND RIC NOT=6,7 

4901 = (C) PCOE/CABG,DEN CD NOT D 

4902 = (C) PCOE/CABG BUT DME 

50X1 = (C) RVCD=54,TOB13,23,32,33,34,83,85 

50X2 = (C) REV CD=054X,MOD NOT = QM,QN 

5051 = (E) EDB: NOMATCH ON 3 CHARACTERISTICS 

5052 = (E) EDB: NOMATCH ON MASTER-ID RECORD 

5053 = (E) EDB: NOMATCH ON CLAIM-NUMBER 

51XA = (C) HCPCS EYEWARE & REV CODE NOT 274 

51XC = (C) HCPCS REQUIRES DIAG CODE OF CANCER 

51XD = (C) HCPCS REQUIRES UNITS > ZERO 

51XE = (C) HCPCS REQUIRES REVENUE CODE 636 

51XF = (C) INV BILL TYP/ANTI-CAN DRUG HCPCS 

51XG = (C) HCPCS REQUIRES DIAG OF HEMOPHILL1A 

51XH = (C) TOB 21X/P82=2/3/4;REV CD9044 

51XI = (C) TOB 21X/P822/3/4:REV CD>899948,TOB NOT=12,13,85,83 

51XM = (C) 21X,RC>9041/9032/ 0 

51X4 = (C) INP:CHGS/YR-RATE,ETC; OUTP:PSYCH>YR 

51X5 = (C) REVENUE NON-COVERED > TOTAL CHRGE 

51X6 = (C) REV TOTAL CHARGES EQUAL ZERO 

51X7 = (C) REV CDE 403 WTH NO BILL 14 23 71 85 

51X8 = (C) MAMMOGRAPHY SUBMISSION INVALID 

51X9 = (C) HCPCS/REV CODE/BILL TYPE 

5100 = (U) TRANSITION SPELL / SNF 

5160 = (U) LATE CHG HSP BILL STAY DAYS > 0 

5166 = (U) PROVIDER NE TO 1ST WORK PRVDR 

5167 = (U) PROVIDER 1 NE 2: FROM DT < START DT

5169 = (U) PROVIDER NE TO WORK PROVIDER 

5177 = (U) PROVIDER NE TO WORK PROVIDER 

5178 = (U) HOSPICE BILL THRU < DOLBA 

5181 = (U) HOSP BILL OCCR 27 DISCREPANCY 

5200 = (E) ENTITLEMENT EFFECTIVE DATE 

5201 = (U) HOSP DATE DIFFERENCE NE 60 OR 90 

5202 = (E) ENTITLEMENT HOSPICE EFFECTIVE DATE 

5202 = (U) HOSPICE TRAILER ERROR 

5203 = (E) ENTITLEMENT HOSPICE PERIODS 

5203 = (U) HOSPICE START DATE ERROR 

5204 = (U) HOSPICE DATE DIFFERENCE NE 90 

5205 = (U) HOSPICE DATE DISCREPANCY 


5207 = (U) HOSPICE THRU > TERM DATE 2ND 

5208 = (U) HOSPICE PERIOD NUMBER BLANK 


5210 = (E) ENTITLEMENT FRM/TRU/END DATES 

5211 = (E) ENTITLEMENT DATE DEATH/THRU 

5212 = (E) ENTITLEMENT DATE DEATH/THRU 

5213 = (E) ENTITLEMENT DATE DEATH MBR 

5220 = (E) ENTITLEMENT FROM/EFF DATES 

5225 = (E) ENT INP PPS SPAN 70 DATES 

5232 = (E) ENTL HMO NO HMO OVERRIDE CDE 

5233 = (E) ENTITLEMENT HMO PERIODS 

5234 = (E) ENTITLEMENT HMO NUMBER NEEDED 

5235 = (E) ENTITLEMENT HMO HOSP+NO CC07 

5236 = (E) ENTITLEMENT HMO HOSP + CC07 

5237 = (E) ENTITLEMENT HOSP OVERLAP 

5238 = (U) HOSPICE CLAIM OVERLAP > 90 

5239 = (U) HOSPICE CLAIM OVERLAP > 60 

524Z = (E) HOSP OVERLAP NO OVD NO DEMO 

5240 = (U) HOSPICE DAYS STAY+USED > 90 

5241 = (U) HOSPICE DAYS STAY+USED > 60 

5242 = (C) INVALID CARRIER FOR RRB 

5243 = (C) HMO=90091,INVALID SERVICE DTE 

5244 = (E) DEMO CABG/PCOE MISSING ENTL 

5245 = (C) INVALID CARRIER FOR NON RRB 

525Z = (E) HMO/HOSP 6/7 NO OVD NO DEMO 

5250 = (U) HOSPICE DOEBA/DOLBA 

5255 = (U) HOSPICE DAYS USED 

5256 = (U) HOSPICE DAYS USED > 999 

526Y = (E) HMO/HOSP DEMO 5/15 REIMB > 0 

526Z = (E) HMO/HOSP DEMO 5/15 REIMB = 0 

527Y = (E) HMO/HOSP DEMO OVD=1 REIMB > 0 

527Z = (E) HMO/HOSP DEMO OVD=1 REIMB = 0 

5299 = (U) HOSPICE PERIOD NUMBER ERROR 

5320 = (U) BILL > DOEBA AND IND-1 = 2 

5350 = (U) HOSPICE DOEBA/DOLBA SECONDARY 

5355 = (U) HOSPICE DAYS USED SECONDARY 

5378 = (C) SERVICE DATE < AGE 50 

5399 = (U) HOSPICE PERIOD NUM MATCH 

5410 = (U) INPAT DEDUCTABLE 

5425 = (U) PART B DEDUCTABLE CHECK 


5450 = (U) PART B COMPARE MED EXPENSE 

5460 = (U) PART B COMPARE MED EXPENSE 

5499 = (U) MED EXPENSE TRAILER MISSING

5500 = (U) FULL DAYS/SNF-HOSP FULL DAYS 

5510 = (U) COIN DAYS/SNF COIN DAYS 

5515 = (U) FULL DAYS/COIN DAYS 

5516 = (U) SNF FULL DAYS/SNF COIN DAYS 

5520 = (U) LIFE RESERVE DAYS 

5530 = (U) UTIL DAYS/LIFE PSYCH DAYS 

5540 = (U) HH VISITS NE AFT PT B TRLR 

5550 = (E) SNF LESS THAN PT A EFF DATE 

5600 = (D) LOGICAL DUPE, COVERED 

5601 = (D) LOGICAL DUPE, QRY-CDE, RIC 123 

5602 = (D) LOGICAL DUPE, PANDE C, E OR I 

5603 = (D) LOGICAL DUPE, COVERED 

5605 = (D) POSS DUPE, OUTPAT REIMB 

5606 = (D) POSS DUPE, HOME HEALTH COVERED U 

5623 = (U) NON-PAY CODE IS P 

57X1 = (C) PROVIDER SPECIALITY CODE INVALID 

57X2 = (C) PHYS THERAPY/PROVIDER SPEC INVAL 

57X3 = (C) PLACE/TYPE/SPECIALTY/REIMB IND 

57X4 = (C) SPECIALTY CODE VS. HCPCS INVALID 

5700 = (U) LINKED TO THREE SPELLS 

5701 = (C) DEMO ID=02,RIC NOT = 5 

5702 = (C) DEMO ID=02,INVALID PROVIDER NUM 

58X1 = (C) PROVIDER TYPE INVALID 

58X9 = (C) TYPE OF SERVICE INVALID 

5802 = (C) REIMB > $150,000 

5803 = (C) UNITS/VISITS > 150 

5804 = (C) UNITS/VISITS > 99 

59XA = (C) PROST ORTH HCPCS/FROM DATE 

59XB = (C) HCPCS/FROM DATE/TYPE P OR I 

59XC = (C) HCPCS Q0036,37,42,43,46/FROM DATE 

59XD = (C) HCPCS Q0038-41/FROM DATE/TYPE 

59XE = (C) HCPCS/MAMMOGRAPHY-RISK/ DIAGNOSIS 

59XG = (C) CAPPED/FREQ-MAINT/PROST HCPCS 

59XH = (C) HCPCS E0620/TYPE/DATE 

59XI = (C) HCPCS E0627-9/ DATE < 1991 

59XL = (C) HCPCS 00104 - TOS/POS 

59X1 = (C) INVALID HCPCS/TOS COMBINATION 

59X2 = (C) ASC IND/TYPE OF SERVICE INVALID 

59X3 = (C) TOS INVALID TO MODIFIER 

59X4 = (C) KIDNEY DONOR/TYPE/PLACE/REIMB 

59X5 = (C) MAMMOGRAPHY FOR MALE 

59X6 = (C) DRUG AND NON DRUG BILL LINE ITEMS 

59X7 = (C) CAPPED-HCPCS/FROM DATE 

59X8 = (C) FREQUENTLY MAINTAINED HCPCS 

59X9 = (C) HCPCS E1220/FROM DATE/TYPE IS R 

5901 = (U) ERROR CODE OF Q 

60X1 = (C) ASSIGN IND INVALID 

6000 = (U) ADJUSTMENT BILL SPELL DATA 

6020 = (U) CURRENT SPELL DOEBA < 1990 

6030 = (U) ADJUSTMENT BILL SPELL DATA 

6035 = (U) ADJUSTMENT BILL THRU DTE/DOLBA 

61X1 = (C) PAY PROCESS IND INVALID 

61X2 = (C) DENIED CLAIM/NO DENIED LINE 

61X3 = (C) PAY PROCESS IND/ALLOWED CHARGES 

61X4 = (C) RATE MISSING OR NON-NUMERIC 

6100 = (C) REV 0001 NOT PRESENT ON CLAIM 

6101 = (C) REV COMPUTED CHARGES NOT=TOTAL

6102 = (C) REV COMPUTED NON-COVERED/NON-COV 

6103 = (C) REV TOTAL CHARGES < PRIMARY PAYER 

62XA = (C) PSYC OT PT/REIM/TYPE 

62X1 = (C) DME/DATE/100% OR INVAL REIMB IND 

62X6 = (C) RAD PATH/PLACE/TYPE/DATE/DED 

62X8 = (C) KIDNEY DONO/TYPE/100% 

62X9 = (C) PNEUM VACCINE/TYPE/100% 

6201 = (C) TOTAL DEDUCT > CHARGES/NON-COV 

6203 = (U) HOSPICE ADJUSTMENT PERIOD/DATE 

6204 = (U) HOSPICE ADJUSTMENT THRU>DOLBA 

6260 = (U) HOSPICE ADJUSTMENT STAY DAYS 

6261 = (U) HOSPICE ADJUSTMENT DAYS USED 

6265 = (U) HOSPICE ADJUSTMENT DAYS USED 

6269 = (U) HOSPICE ADJUSTMENT PERIOD# (MAIN) 

63X1 = (C) DEDUCT IND INVALID 

63X2 = (C) DED/HCFA COINS IN PCOE/CABG 

6365 = (U) HOSPICE ADJUSTMENT SECONDARY DAYS 

6369 = (U) HOSPICE ADJUSTMENT PERIOD# (SECOND) 

64X1 = (C) PROVIDER IND INVALID 


65X1 = (C) PAYSCREEN IND INVALID 

66?? = (D) POSS DUPE, CR/DB, DOC-ID 

66XX = (D) POSS DUPE, CR/DB, DOC-ID 

66X1 = (C) UNITS AMOUNT INVALID 

66X2 = (C) UNITS IND > 0; AMT NOT VALID 

66X3 = (C) UNITS IND = 0; AMT > 0 

66X4 = (C) MT INDICATOR/AMOUNT 

6600 = (U) ADJUSTMENT BILL FULL DAYS 

6610 = (U) ADJUSTMENT BILL COIN DAYS 

6620 = (U) ADJUSTMENT BILL LIFE RESERVE 

6630 = (U) ADJUSTMENT BILL LIFE PSYCH DYS 

67X1 = (C) UNITS INDICATOR INVALID 

67X2 = (C) CHG ALLOWED > 0; UNITS IND = 0 

67X3 = (C) TOS/HCPCS=ANEST, MTU IND NOT = 2 

67X4 = (C) HCPCS = AMBULANCE, MTU IND NOT = 1 

67X6 = (C) INVALID PROC FOR MT IND 2, ANEST 

67X7 = (C) INVALID UNITS IND WITH TOS OF BLOOD 

67X8 = (C) INVALID PROC FOR MT IND 4, OXYGEN 

6700 = (U) ADJUSTMENT BILL FULL/SNF DAYS 

6710 = (U) ADJUSTMENT BILL COIN/SNF DAYS 

68X1 = (C) INVALID HCPCS CODE 

68X2 = (C) MAMMOGRAPY/DATE/PROC NOT 76092 

68X3 = (C) TYPE OF SERVICE = G /PROC CODE 

68X4 = (C) HCPCS NOT VALID FOR SERVICE DATE 

68X5 = (C) MODIFIER NOT VALID FOR HCPCS, ETC 

68X6 = (C) TYPE SERVICE INVALID FOR HCPCS, ETC 

68X7 = (C) ZX MOD REQ FOR THER SHOES/INS/MOD. 

68X8 = (C) LINE ITEM INCORRECT OR DATE INVAL. 

69XA = (C) MODIFIER NOT VALID FOR HCPCS/GLOBAL 

69X3 = (C) PROC CODE MOD = LL / TYPE = R 

69X6 = (C) PROC CODE MOD/NOT CAPPED 

69X8 = (C) SPEC CODE NURSE PRACT, MOD INVAL 

6901 = (C) KRON IND AND UTIL DYS EQUALS ZERO 

6902 = (C) KRON IND AND NO-PAY CODE B OR N 

6903 = (C) KRON IND AND INPATIENT DEDUCT = 0 

6904 = (C) KRON IND AND TRANS CODE IS 4 

6910 = (C) REV CODES ON HOME HEALTH

6911 = (C) REV CODE 274 ON OUTPAT AND HH ONLY 

6912 = (C) REV CODE INVAL FOR PROSTH AND ORTHO 

6913 = (C) REV CODE INVAL FOR OXYGEN 

6914 = (C) REV CODE INVAL FOR DME 

6915 = (C) PURCHASE OF RENT DME INVAL ON DATES 

6916 = (C) PURCHASE OF RENT DME INVAL ON DATES 

6917 = (C) PURCHASE OF LIFT CHAIR INVAL > 91000 

6918 = (C) HCPCS INVALID ON DATE RANGES 

6919 = (C) DME OXYGEN ON HH INVAL BEFORE 7/1/89 

6920 = (C) HCPCS INVAL ON REV 270/BILL 32-33 

6921 = (C) HCPCS ON REV CODE 272 BILL TYPE 83X 

6922 = (C) HCPCS ON BILL TYPE 83X -NOT REV 274 

6923 = (C) RENTAL OF DME CUSTOMIZE AND REV 291 

6924 = (C) INVAL MODIFIER FOR CAPPED RENTAL 

6925 = (C) HCPCS ALLOWED ON BILL TYPES 32X-34X 

6929 = (U) ADJUSTMENT BILL LIFE RESERVE 

6930 = (U) ADJUSTMENT BILL LIFE PSYCH DYS 

7000 = (U) INVALID DOEBA/DOLBA 

7002 = (U) LESS THAN 60/61 BETWEEN SPELLS 

7010 = (E) TOB 85X/ELECTN PRD: COND CD 07 REQD 

71X1 = (C) SUBMITTED CHARGES INVALID 

71X2 = (C) MAMMOGRPY/PROC CODE MOD TC,26/CHG 

72X1 = (C) ALLOWED CHGS INVALID 

72X2 = (C) ALLOWED/SUBMITTED CHARGES/TYPE 

72X3 = (C) DENIED LINE/ALLOWED CHARGES 

73X1 = (C) SS NUMBER INVALID 

73X2 = (C) CARRIER ASSIGNED PROV NUM MISSING 

74X1 = (C) LOCALITY CODE INVAL FOR CONTRACT 

76X1 = (C) PL OF SER INVAL ON MAMMOGRAPHY BILL 

77X1 = (C) PLACE OF SERVICE INVALID 

77X2 = (C) PHYS THERAPY/PLACE 

77X3 = (C) PHYS THERAPY/SPECIALTY/TYPE 

77X4 = (C) ASC/TYPE/PLACE/REIMB IND/DED IND 

77X6 = (C) TOS=F, PL OF SER NOT = 24 

7701 = (C) INCORRECT MODIFIER 

7777 = (D) POSS DUPE, PART B DOC-ID 

78XA = (C) MAMMOGRAPHY BEFORE 1991 

78X1 = (C) THRU DATE INVALID 

78X3 = (C) FROM DATE GREATER THAN THRU DATE 

78X4 = (C) FROM DATE > RCVD DATE/PAY-DENY 

78X5 = (C) FROM DATE > PAID DATE/TYPE/100% 

78X7 = (C) LAB EDIT/TYPE/100%/FROM DATE 

79X3 = (C) THRU DATE>RECD DATE/NOT DENIED 

79X4 = (C) THRU DATE>PAID DATE/NOT DENIED 

8000 = (U) MAIN & 2NDARY DOEBA < 01/01/90 

8028 = (E) NO ENTITLEMENT 

8029 = (U) HH BEFORE PERIOD NOT PRESENT 

8030 = (U) HH BILL VISITS > PT A REMAINING 

8031 = (U) HH PT A REMAINING > 0 

8032 = (U) HH DOLBA+59 NOT GT FROM-DATE 

8050 = (U) HH QUALIFYING INDICATOR = 1 

8051 = (U) HH # VISITS NE AFT PT B APPLIED 

8052 = (U) HH # VISITS NE AFT TRAILER 

8053 = (U) HH BENEFIT PERIOD NOT PRESENT 

8054 = (U) HH DOEBA/DOLBA NOT > 0 

8060 = (U) HH QUALIFYING INDICATOR NE 1 

8061 = (U) HH DATE NE DOLBA IN AFT TRLR

8062 = (U) HH NE PT-A VISITS REMAINING 

81X1 = (C) NUM OF SERVICES INVALID 

83X1 = (C) DIAGNOSIS INVALID 

8301 = (C) HCPCS/GENDER DIAGNOSIS 

8302 = (C) HCPCS G0101 V-CODE/SEX CODE 

8304 = (C) BILL TYPE INVALID FOR G0123/4 

84X1 = (C) PAP SMEAR/DIAGNOSIS/GENDER/PROC 

84X2 = (C) INVALID DME START DATE 

84X3 = (C) INVALID DME START DATE W/HCPCS 

84X4 = (C) HCPCS G0101 V-CODE/SEX CODE 

84X5 = (C) HCPCS CODE WITH INV DIAG CODE 

86X8 = (C) CLIA REQUIRES NON-WAIVER HCPCS 

88XX = (D) POSS DUPE, DOC-ID,UNITS,ENT,ALWD 

9000 = (U) DOEBA/DOLBA CALC 

9005 = (U) FULL/COINS HOSP DAYS CALC 

9010 = (U) FULL/COINS SNF DAYS CALC 

9015 = (U) LIFE RESERVE DAYS CALC 

9020 = (U) LIFE PSYCH DAYS CALC 

9030 = (U) INPAT DEDUCTABLE CALC 

9040 = (U) DATA INDICATOR 1 SET 

9050 = (U) DATA INDICATOR 2 SET 

91X1 = (C) PATIENT REIMB/PAY-DENY CODE 

92X1 = (C) PATIENT REIMB INVALID 

92X2 = (C) PROVIDER REIMB INVALID 

92X3 = (C) LINE DENIED/PATIENT-PROV REIMB 

92X4 = (C) MSP CODE/AMT/DATE/ALLOWED CHARGES 

92X5 = (C) CHARGES/REIMB AMT NOT CONSISTANT 

92X7 = (C) REIMB/PAY-DENY INCONSISTANT 

9201 = (C) UPIN REF NAME OR INITIAL MISSING 

9202 = (C) UPIN REF FIRST 3 CHAR INVALID 

9203 = (C) UPIN REF LAST 3 CHAR NOT NUMERIC 

93X1 = (C) CASH DEDUCTABLE INVALID 

93X2 = (C) DEDUCT INDICATOR/CASH DEDUCTIBLE 

93X3 = (C) DENIED LINE/CASH DEDUCTIBLE 

93X4 = (C) FROM DATE/CASH DEDUCTIBLE 

93X5 = (C) TYPE/CASH DEDUCTIBLE/ALLOWED CHGS 

9300 = (C) UPIN OTHER, NOT PRESENT 

9301 = (C) UPIN NME MIS/DED TOT LI>0 FR DEN CLM 

9302 = (C) UPIN OPERATING, FIRST 3 NOT NUMERIC 

9303 = (C) UPIN L 3 CH NT NUM/DED TOT LI>YR DED 

94A1 = (C) NON-COVERED FROM DATE INVALID 

94A2 = (C) NON-COVERED FROM > THRU DATE 

94A3 = (C) NON-COVERED THRU DATE INVALID 

94A4 = (C) NON-COVERED THRU DATE > ADMIT 

94A5 = (C) NON-COVERED THRU DATE/ADMIT DATE 

94C1 = (C) PR-PSYCH DAYS INVALID 

94C3 = (C) PR-PSYCH DAYS > PROVIDER LIMIT 

94F1 = (C) REIMBURSEMENT AMOUNT INVALID 

94F2 = (C) REIMBURSE AMT NOT 0 FOR HMO PAID 

94G1 = (C) NO-PAY CODE INVALID 

94G2 = (C) NO-PAY CODE SPACE/NON-COVERD=TOTL 

94G3 = (C) NO-PAY/PROVIDER INCONSISTANT 

94G4 = (C) NO PAY CODE = R & REIMB PRESENT 

94X1 = (C) BLOOD LIMIT INVALID 

94X2 = (C) TYPE/BLOOD DEDUCTIBLE 

94X3 = (C) TYPE/DATE/LIMIT AMOUNT 

94X4 = (C) BLOOD DED/TYPE/NUMBER OF SERVICES

94X5 = (C) BLOOD/MSP CODE/COMPUTED LINE MAX 

9401 = (C) BLOOD DEDUCTIBLE AMT > 3 

9402 = (C) BLOOD FURNISHED > DEDUCTIBLE 

9403 = (C) DATE OF BIRTH MISSING ON PRO-PAY 

9404 = (C) INVALID GENDER CODE ON PRO-PAY 

9407 = (C) INVALID DRG NUMBER 

9408 = (C) INVALID DRG NUMBER (GLOBAL) 

9409 = (C) HCFA DRGDRG ON BILL 

9410 = (C) CABG/PCOE,INVALID DRG 

95X1 = (C) MSP CODE G/DATE BEFORE 1/1/87 

95X2 = (C) MSP AMOUNT APPLIED INVALID 

95X3 = (C) MSP AMOUNT APPLIED > SUB CHARGES 

95X4 = (C) MSP PRIMARY PAY/AMOUNT/CODE/DATE 

95X5 = (C) MSP CODE = G/DATE BEFORE 1987 

95X6 = (C) MSP CODE = X AND NOT AVOIDED 

95X7 = (C) MSP CODE VALID, CABG/PCOE 

96X1 = (C) OTHER AMOUNTS INVALID 

96X2 = (C) OTHER AMOUNTS > PAT-PROV REIMB 

97X1 = (C) OTHER AMOUNTS INDICATOR INVALID 

97X2 = (C) GRUDMAN SW/GRUDMAN AMT NOT > 0 

98X1 = (C) COINSURANCE INVALID 

98X3 = (C) MSP CODE/TYPE/COIN AMT/ALLOW/CSH 

98X4 = (C) DATE/MSP/TYPE/CASH DED/ALLOW/COI 

98X5 = (C) DATE/ALLOW/CASH DED/REIMB/MSP/TYP 

99XX = (D) POSS DUPE, PART B DOC-ID 

9901 = (C) REV CODE INVALID OR TRAILER CNT=0 

9902 = (C) ACCOMMODATION DAYS/FROM/THRU DATE 

9903 = (C) NO CLINIC VISITS FOR RHC 

9904 = (C) INCOMPATIBLE DATES/CLAIM TYPE 

991X = (C) NO DATE OF SERVICE 

9910 = (C) EDIT 9910 (NEW) 

9911 = (C) BLOOD VERIFIED INVALID 

9920 = (C) EDIT 9920 (NEW) 

9930 = (C) EDIT 9930 (NEW) 

9931 = (C) OUTPAT COINSURANCE VALUES 

9933 = (C) RATE EXCEDES MAMMOGRAPHY LIMIT 

9940 = (C) EDIT 9940 (NEW) 

9942 = (C) EDIT 9942 (NEW) 

9944 = (C) STAY FROM>97273,DIAGV103,163,7612 

9945 = (C) SERVICE DATE < 98001 

9946 = (C) INVALID DIAGNOSIS CODE 

9947 = (C) INVALID DIAGNOSIS CODE 

9948 = (C) STAY FROM>96365,DIAG=V725 

9960 = (C) MED CHOICE BUT HMO DATA MISSING 

9965 = (C) HMO PRESENT BUT MED CHOICE MISSING 

9968 = (C) MED CHOICE NOT= HMO PLAN NUMBER

Appendix K NCH Patch Table 


ptchcd1 NCH patch code 1 

01 = RRB Category Equatable BIC - changed (all claim types) - applied 

during the Nearline 'G' conversion to claims with NCH weekly 

process date before 3/91. Prior to Version 'H', patch indicator 

stored in redefined Claim Edit Group, 3rd occurrence, position 2. 

02 = Claim Transaction Code made consistent with NCH payment/edit RIC 

code (OP and HHA) -- effective 3/94, CWFMQA began patch. During 

'H' conversion, patch applied to claims with NCH weekly process 

date prior to 3/94. Prior to version 'H', patch indicator stored 

in redefined Claim Edit Group, 4th occurrence, position 1. 

03 = Garbage/nonnumeric Claim Total Charge Amount set to zeroes 

(Instnl) -- during the Version 'G' conversion, error occurred in 

the derivation of this field where the claim was missing revenue 

center code = '0001'. In 1994, patch was applied to the OP and 

HHA SAFs only. (This SAF patch indicator was stored in the 

redefined Claim Edit Group, 4th occurrence, position 2). During 

the 'H' ocnversion, patch applied to Nearline claims where garbage 

or nonnumeric values. 

04 = Incorrect bene residence SSA standard county code '999' changed 

(all claim types) -- applied during the Nearline 'G' conversion 

and ongoing through 4/21/94, calling EQSTZIP routine to claims 

with NCH weekly process date prior to 4/22/94. Prior to Version 

'H' patch indicator stored in redefined Claim Edit Group, 3rd 

occurrence, position 4. 

05 = Wrong century bene birth date corrected (all claim types) - 

applied during Nearline 'H' conversion to all history where 

century greater than 1700 and less than 1850; if century less than 

1700, zeroes moved. 

06 = Inconsistent CWF bene medicare status code made consistent with 

age (all claim types) -- applied during Nearline 'H' conversion to 

all history and patched ongoing. Bene age is calculated to 

determine the correct value; if greater than 64, 1st position 

MSC ='1'; if less than 65, 1st position MSC = '2'. 

07 = Missing CWF bene mediare status code derived (all claim types) - 

applied during Nearline 'H' conversion to all history and patched 

ongoing, except claims with unknown DOB and/or Claim From Date='0' 

(left blank). Bene age is calculated to determine missing value; 

if greater than 64, MSC='10'; if less than 65, MSC = '20'. 

08 = Invalid NCH primary payer code set to blanks (Instnl) -- applied 

during Version 'H' conversion to claims with NCH weekly process 

date 10/1/93-10/30/95, where MSP values = invalid '0', '1', '2', 

'3' or '4' (caused by erroneous logic in HCFA program code, which 

was corrected on 11/1/95). 

09 = Zero CWF claim accretion date replaced with NCH weekly process 

date (all claim types) -- applied during Version 'H' conversion to 

Instnl and DMERC claims; applied during Version 'G' conversion to 

non-institutional (non-DMERC) claims. Prior to Version 'H', patch 

indicator stored in redefined claim edit group, 3rd occurrence, 

position 1.

Appendix L State Table 


provno Medicare provider number 

prvstgrp Line NCH provider state code 

stategrp Residence SSA standard state code 

The following summary-level variables reference this Appendix: 

prvstgrp Line NCH provider state code 

stategrp Residence SSA standard state code 

01 = Alabama 

02 = Alaska 

03 = Arizona 

04 = Arkansas 

05 = California 

06 = Colorado 

07 = Connecticut 

08 = Delaware 

09 = District of Columbia 

10 = Florida 

11 = Georgia 

12 = Hawaii 

13 = Idaho 

14 = Illinois 

15 = Indiana 

16 = Iowa 

17 = Kansas 

18 = Kentucky 

19 = Louisiana 

20 = Maine 

21 = Maryland 

22 = Massachusetts 

23 = Michigan 

24 = Minnesota 

25 = Mississippi 

26 = Missouri 

27 = Montana 

28 = Nebraska 

29 = Nevada 

30 = New Hampshire 

31 = New Jersey 

32 = New Mexico 

33 = New York 

34 = North Carolina 

35 = North Dakota 

36 = Ohio 

37 = Oklahoma 

38 = Oregon 

39 = Pennsylvania 

40 = Puerto Rico 

41 = Rhode Island 

42 = South Carolina 

43 = South Dakota 

44 = Tennessee 

45 = Texas

46 = Utah 

47 = Vermont 

48 = Virgin Islands 

49 = Virginia 

50 = Washington 

51 = West Virginia 

52 = Wisconsin 

53 = Wyoming 

54 = Africa 

55 = Asia 

56 = Canada & Islands 

57 = Central America and West Indies 

58 = Europe 

59 = Mexico 

60 = Oceania 

61 = Philippines 

62 = South America 

63 = U.S. Possessions 

64 = American Samoa 

65 = Guam 

66 = Saipan 

97 = Northern Marianas 

98 = Guam 

99 = With 000 county code is American Samoa; otherwise unknown

Appendix M Identification of variables used in summary level aggregation 

To produce summary level records from the claim level files, it is necessary 

to determine which variable to use to define the period of time represented 

in the summary. Below is a list of each source file and the corresponding 

time variable used to aggregate information. 

All summary files are presented as quarterly records except the GHP, which 

is an annual file. 

Group Health Plan Master Record 1989+ 

YEAR 

Home Health Agency SAF Version G 1989+ 

CFDTE Claim from date 

Hospice SAF Version G 1989+ 


Inpatient MEDPAR 1986, 1988 

ADMDTE Claim admission date 

Inpatient MEDPAR 1987, 1989+ 


Outpatient Hospital SAF Version D 1986, 1988 


Outpatient Hospital SAF Version G 1987, 1989+ 


Physician/Supplier BMAD 1985-1990 

BEXPDT1 First expense date 

Physician/Supplier Carrier SAF Version H 1991+ 


SNF MEDPAR 1986, 1988 


SNF MEDPAR 1987, 1989+ 

ADMDTE Claim admission date

Appendix N Agency for Healthcare Research and Quality (AHRQ) Diagnostic Codes 


d2ag01 Secondary diagnosis code 1 

diag01 Claim principal diagnosis code 

.Z Overall 

. No diagnosis 

.A Invalid diagnosis 

1 Tuberculosis 

2 Septicemia (except in labor) 

3 Bacterial infection, unspecified site 

4 Mycoses 

5 HIV infection 

6 Hepatitis 

7 Viral infection 

8 Other infections, including parasitic 

9 Sexually transmitted infections (not HIV or hepatitis) 

10 Immunizations and screening for infectious disease 

11 Cancer of head and neck 

12 Cancer of esophagus 

13 Cancer of stomach 

14 Cancer of colon 

15 Cancer of rectum and anus 

16 Cancer of liver and intrahepatic bile duct 

17 Cancer of pancreas 

18 Cancer of other GI organs, peritoneum 

19 Cancer of bronchus, lung 

20 Cancer, other respiratory and intrathoracic 

21 Cancer of bone and connective tissue 

22 Melanomas of skin 

23 Other non-epithelial cancer of skin 

24 Cancer of breast 

25 Cancer of uterus 

26 Cancer of cervix 

27 Cancer of ovary 

28 Cancer of other female genital organs 

29 Cancer of prostate 

30 Cancer of testis 

31 Cancer of other male genital organs 

32 Cancer of bladder 

33 Cancer of kidney and renal pelvis 

34 Cancer of other urinary organs 

35 Cancer of brain and nervous system 

36 Cancer of thyroid 

37 Hodgkin's disease 

38 Non-Hodgkin's lymphoma 

39 Leukemias 

40 Multiple myeloma 

41 Cancer, other and unspecified primary 

42 Secondary malignancies 

43 Malignant neoplasm without specification of site 

44 Neoplasms of unspecified nature or uncertain behavior 

45 Maintenance chemotherapy, radiotherapy 

46 Benign neoplasm of uterus 

47 Other and unspecified benign neoplasm

48 Thyroid disorders 

49 Diabetes mellitus without complication 

50 Diabetes mellitus with complications 

51 Other endocrine disorders 

52 Nutritional deficiencies 

53 Disorders of lipid metabolism 

54 Gout and other crystal arthropathies 

55 Fluid and electrolyte disorders 

56 Cystic fibrosis 

57 Immunity disorders 

58 Other nutritional, endocrine, and metabolic disorders 

59 Deficiency and other anemia 

60 Acute posthemorrhagic anemia 

61 Sickle cell anemia 

62 Coagulation and hemorrhagic disorders 

63 Diseases of white blood cells 

64 Other hematologic conditions 

65 Mental retardation 

66 Alcohol-related mental disorders 

67 Substance-related mental disorders 

68 Senility and organic mental disorders 

69 Affective disorders 

70 Schizophrenia and related disorders 

71 Other psychoses 

72 Anxiety, somatoform, dissociative, and personality disorders 

73 Preadult disorders 

74 Other mental conditions 

75 Personal history of mental disorder, mental and behavioral problems, observation 

and screening for mental condition 

76 Meningitis (except that caused by tuberculosis or sexually transmitted disease) 

77 Encephalitis (except that caused by tuberculosis or sexually transmitted disease) 

78 Other CNS infection and poliomyelitis 

79 Parkinson's disease 

80 Multiple sclerosis 

81 Other hereditary and degenerative nervous system conditions 

82 Paralysis 

83 Epilepsy, convulsions 

84 Headache, including migraine 

85 Coma, stupor, and brain damage 

86 Cataract 

87 Retinal detachments, defects, vascular occlusion, and retinopathy 

88 Glaucoma 

89 Blindness and vision defects 

90 Inflammation, infection of eye (except that caused by tuberculosis or sexually 

transmitted disease) 

91 Other eye disorders 

92 Otitis media and related conditions 

93 Conditions associated with dizziness or vertigo 

94 Other ear and sense organ disorders 

95 Other nervous system disorders 

96 Heart valve disorders 

97 Peri-, endo-, and myocarditis, cardiomyopathy (except that caused by tuberculosis 

or sexually transmitted disease) 

98 Essential hypertension 

99 Hypertension with complications and secondary hypertension 

100 Acute myocardial infarction 

101 Coronary atherosclerosis and other heart disease

102 Nonspecific chest pain 

103 Pulmonary heart disease 

104 Other and ill-defined heart disease 

105 Conduction disorders 

106 Cardiac dysrhythmias 

107 Cardiac arrest and ventricular fibrillation 

108 Congestive heart failure, nonhypertensive 

109 Acute cerebrovascular disease 

110 Occlusion or stenosis of precerebral arteries 

111 Other and ill-defined cerebrovascular disease 

112 Transient cerebral ischemia 

113 Late effects of cerebrovascular disease 

114 Peripheral and visceral atherosclerosis 

115 Aortic, peripheral, and visceral artery aneurysms 

116 Aortic and peripheral arterial embolism or thrombosis 

117 Other circulatory disease 

118 Phlebitis, thrombophlebitis and thromboembolism 

119 Varicose veins of lower extremity 

120 Hemorrhoids 

121 Other diseases of veins and lymphatics 

122 Pneumonia (except that caused by tuberculosis or sexually transmitted disease) 

123 Influenza 

124 Acute and chronic tonsillitis 

125 Acute bronchitis 

126 Other upper respiratory infections 

127 Chronic obstructive pulmonary disease and bronchiectasis 

128 Asthma 

129 Aspiration pneumonitis, food/vomitus 

130 Pleurisy, pneumothorax, pulmonary collapse 

131 Respiratory failure, insufficiency, arrest (adult) 

132 Lung disease due to external agents 

133 Other lower respiratory disease 

134 Other upper respiratory disease 

135 Intestinal infection 

136 Disorders of teeth and jaw 

137 Diseases of mouth, excluding dental 

138 Esophageal disorders 

139 Gastroduodenal ulcer (except hemorrhage) 

140 Gastritis and duodenitis 

141 Other disorders of stomach and duodenum 

142 Appendicitis and other appendiceal conditions 

143 Abdominal hernia 

144 Regional enteritis and ulcerative colitis 

145 Intestinal obstruction without hernia 

146 Diverticulosis and diverticulitis 

147 Anal and rectal conditions 

148 Peritonitis and intestinal abscess 

149 Biliary tract disease 

150 Liver disease, alcohol-related 

151 Other liver diseases 

152 Pancreatic disorders (not diabetes) 

153 Gastrointestinal hemorrhage 

154 Noninfectious gastroenteritis 

155 Other gastrointestinal disorders 

156 Nephritis, nephrosis, renal sclerosis 

157 Acute and unspecified renal failure 

158 Chronic renal failure

159 Urinary tract infections 

160 Calculus of urinary tract 

161 Other diseases of kidney and ureters 

162 Other diseases of bladder and urethra 

163 Genitourinary symptoms and ill-defined conditions 

164 Hyperplasia of prostate 

165 Inflammatory conditions of male genital organs 

166 Other male genital disorders 

167 Nonmalignant breast conditions 

168 Inflammatory diseases of female pelvic organs 

169 Endometriosis 

170 Prolapse of female genital organs 

171 Menstrual disorders 

172 Ovarian cyst 

173 Menopausal disorders 

174 Female infertility 

175 Other female genital disorders 

176 Contraceptive and procreative management 

177 Spontaneous abortion 

178 Induced abortion 

179 Postabortion complications 

180 Ectopic pregnancy 

181 Other complications of pregnancy 

182 Hemorrhage during pregnancy, abruptio placenta, placenta previa 

183 Hypertension complicating pregnancy, childbirth and the puerperium 

184 Early or threatened labor 

185 Prolonged pregnancy 

186 Diabetes or abnormal glucose tolerance complicating pregnancy, childbirth, or 

the puerperium 

187 Malposition, malpresentation 

188 Fetopelvic disproportion, obstruction 

189 Previous C-section 

190 Fetal distress and abnormal forces of labor 

191 Polyhydramnios and other problems of amniotic cavity 

192 Umbilical cord complication 

193 Trauma to perineum and vulva 

194 Forceps delivery 

195 Other complications of birth, puerperium affecting management of mother 

196 Normal pregnancy and/or delivery 

197 Skin and subcutaneous tissue infections 

198 Other inflammatory condition of skin 

199 Chronic ulcer of skin 

200 Other skin disorders 

201 Infective arthritis and osteomyelitis (except that caused by tuberculosis or 

sexually transmitted disease) 

202 Rheumatoid arthritis and related disease 

203 Osteoarthritis 

204 Other non-traumatic joint disorders 

205 Spondylosis, intervertebral disc disorders, other back problems 

206 Osteoporosis 

207 Pathological fracture 

208 Acquired foot deformities 

209 Other acquired deformities 

210 Systemic lupus erythematosus and connective tissue disorders 

211 Other connective tissue disease 

212 Other bone disease and musculoskeletal deformities 

213 Cardiac and circulatory congenital anomalies

214 Digestive congenital anomalies 

215 Genitourinary congenital anomalies 

216 Nervous system congenital anomalies 

217 Other congenital anomalies 

218 Liveborn 

219 Short gestation, low birth weight, and fetal growth retardation 

220 Intrauterine hypoxia and birth asphyxia 

221 Respiratory distress syndrome 

222 Hemolytic jaundice and perinatal jaundice 

223 Birth trauma 

224 Other perinatal conditions 

225 Joint disorders and dislocations, trauma-related 

226 Fracture of neck of femur (hip) 

227 Spinal cord injury 

228 Skull and face fractures 

229 Fracture of upper limb 

230 Fracture of lower limb 

231 Other fractures 

232 Sprains and strains 

233 Intracranial injury 

234 Crushing injury or internal injury 

235 Open wounds of head, neck, and trunk 

236 Open wounds of extremities 

237 Complication of device, implant or graft 

238 Complications of surgical procedures or medical care 

239 Superficial injury, contusion 

240 Burns 

241 Poisoning by psychotropic agents 

242 Poisoning by other medications and drugs 

243 Poisoning by nonmedicinal substances 

244 Other injuries and conditions due to external causes 

245 Syncope 

246 Fever of unknown origin 

247 Lymphadenitis 

248 Gangrene 

249 Shock 

250 Nausea and vomiting 

251 Abdominal pain 

252 Malaise and fatigue 

253 Allergic reactions 

254 Rehabilitation care, fitting of prostheses, and adjustment of devices 

255 Administrative/social admission 

256 Medical examination/evaluation 

257 Other aftercare 

258 Other screening for suspected conditions (not mental disorders or 

infectious disease) 

259 Residual codes, unclassified 

260 E (external causes of injury and poisoning) codes

Appendix O Agency for Healthcare Research and Quality (AHRQ) Procedure Codes 


s2rg01 Secondary procedure code 1 

surg01 Surgical procedure claim code 1 

.Z Overall 

. No procedure 

.A Invalid procedure 

1 Incision and excision of CNS 

2 Insertion, replacement, or removal of extracranial ventricular shunt 

3 Laminectomy, excision intervertebral disc 

4 Diagnostic spinal tap 

5 Insertion of catheter or spinal stimulator and injection into 

spinal canal 

6 Decompression peripheral nerve 

7 Other diagnostic nervous system procedures 

8 Other non-OR or closed therapeutic nervous system procedures 

9 Other OR therapeutic nervous system procedures 

10 Thyroidectomy, partial or complete 

11 Diagnostic endocrine procedures 

12 Other therapeutic endocrine procedures 

13 Corneal transplant 

14 Glaucoma procedures 

15 Lens and cataract procedures 

16 Repair of retinal tear, detachment 

17 Destruction of lesion of retina and choroid 

18 Diagnostic procedures on eye 

19 Other therapeutic procedures on eyelids, conjunctiva, cornea 

20 Other intraocular therapeutic procedures 

21 Other extraocular muscle and orbit therapeutic procedures 

22 Tympanoplasty 

23 Myringotomy 

24 Mastoidectomy 

25 Diagnostic procedures on ear 

26 Other therapeutic ear procedures 

27 Control of epistaxis 

28 Plastic procedures on nose 

29 Dental procedures 

30 Tonsillectomy and/or adenoidectomy 

31 Diagnostic procedures on nose, mouth and pharynx 

32 Other non-OR therapeutic procedures on nose, mouth and pharynx 

33 Other OR therapeutic procedures on nose, mouth and pharynx 

34 Tracheostomy, temporary and permanent 

35 Tracheoscopy and laryngoscopy with biopsy 

36 Lobectomy or pneumonectomy 

37 Diagnostic bronchoscopy and biopsy of bronchus 

38 Other diagnostic procedures on lung and bronchus 

39 Incision of pleura, thoracentesis, chest drainage 

40 Other diagnostic procedures of respiratory tract and mediastinum 

41 Other non-OR therapeutic procedures on respiratory system 

42 Other OR therapeutic procedures on respiratory system 

43 Heart valve procedures 

44 Coronary artery bypass graft (CABG) 

45 Percutaneous transluminal coronary angioplasty (PTCA) 

46 Coronary thrombolysis

47 Diagnostic cardiac catheterization, coronary arteriography 

48 Insertion, revision, replacement, removal of cardiac pacemaker or 

cardioverter/defibrillator 

49 Other OR heart procedures 

50 Extracorporeal circulation auxiliary to open heart procedures 

51 Endarterectomy, vessel of head and neck 

52 Aortic resection, replacement or anastomosis 

53 Varicose vein stripping, lower limb 

54 Other vascular catheterization, not heart 

55 Peripheral vascular bypass 

56 Other vascular bypass and shunt, not heart 

57 Creation, revision and removal of arteriovenous fistula or vessel-to-vessel 

cannula for dialysis 

58 Hemodialysis 

59 Other OR procedures on vessels of head and neck 

60 Embolectomy and endarterectomy of lower limbs 

61 Other OR procedures on vessels other than head and neck 

62 Other diagnostic cardiovascular procedures 

63 Other non-OR therapeutic cardiovascular procedures 

64 Bone marrow transplant 

65 Bone marrow biopsy 

66 Procedures on spleen 

67 Other therapeutic procedures, hemic and lymphatic system 

68 Injection or ligation of esophageal varices 

69 Esophageal dilatation 

70 Upper gastrointestinal endoscopy, biopsy 

71 Gastrostomy, temporary and permanent 

72 Colostomy, temporary and permanent 

73 Ileostomy and other enterostomy 

74 Gastrectomy, partial and total 

75 Small bowel resection 

76 Colonoscopy and biopsy 

77 Proctoscopy and anorectal biopsy 

78 Colorectal resection 

79 Local excision of large intestine lesion (not endoscopic) 

80 Appendectomy 

81 Hemorrhoid procedures 

82 Endoscopic retrograde cannulation of pancreas (ERCP) 

83 Biopsy of liver 

84 Cholecystectomy and common duct exploration 

85 Inguinal and femoral hernia repair 

86 Other hernia repair 

87 Laparoscopy 

88 Abdominal paracentesis 

89 Exploratory laparotomy 

90 Excision, lysis peritoneal adhesions 

91 Peritoneal dialysis 

92 Other bowel diagnostic procedures 

93 Other non-OR upper GI therapeutic procedures 

94 Other OR upper GI therapeutic procedures 

95 Other non-OR lower GI therapeutic procedures 

96 Other OR lower GI therapeutic procedures 

97 Other gastrointestinal diagnostic procedures 

98 Other non-OR gastrointestinal therapeutic procedures 

99 Other OR gastrointestinal therapeutic procedures 

100 Endoscopy and endoscopic biopsy of the urinary tract 

101 Transurethral excision, drainage, or removal urinary obstruction

102 Ureteral catheterization 

103 Nephrotomy and nephrostomy 

104 Nephrectomy, partial or complete 

105 Kidney transplant 

106 Genitourinary incontinence procedures 

107 Extracorporeal lithotripsy, urinary 

108 Indwelling catheter 

109 Procedures on the urethra 

110 Other diagnostic procedures of urinary tract 

111 Other non-OR therapeutic procedures of urinary tract 

112 Other OR therapeutic procedures of urinary tract 

113 Transurethral resection of prostate (TURP) 

114 Open prostatectomy 

115 Circumcision 

116 Diagnostic procedures, male genital 

117 Other non-OR therapeutic procedures, male genital 

118 Other OR therapeutic procedures, male genital 

119 Oophorectomy, unilateral and bilateral 

120 Other operations on ovary 

121 Ligation of fallopian tubes 

122 Removal of ectopic pregnancy 

123 Other operations on fallopian tubes 

124 Hysterectomy, abdominal and vaginal 

125 Other excision of cervix and uterus 

126 Abortion (termination of pregnancy) 

127 Dilatation and curettage (D&C), aspiration after delivery or abortion 

128 Diagnostic dilatation and curettage (D&C) 

129 Repair of cystocele and rectocele, obliteration of vaginal vault 

130 Other diagnostic procedures, female organs 

131 Other non-OR therapeutic procedures, female organs 

132 Other OR therapeutic procedures, female organs 

133 Episiotomy 

134 Cesarean section 

135 Forceps, vacuum, and breech delivery 

136 Artificial rupture of membranes to assist delivery 

137 Other procedures to assist delivery 

138 Diagnostic amniocentesis 

139 Fetal monitoring 

140 Repair of current obstetric laceration 

141 Other therapeutic obstetrical procedures 

142 Partial excision bone 

143 Bunionectomy or repair of toe deformities 

144 Treatment, facial fracture or dislocation 

145 Treatment, fracture or dislocation of radius and ulna 

146 Treatment, fracture or dislocation of hip and femur 

147 Treatment, fracture or dislocation of lower extremity (other than hip or femur) 

148 Other fracture and dislocation procedure 

149 Arthroscopy 

150 Division of joint capsule, ligament or cartilage 

151 Excision of semilunar cartilage of knee 

152 Arthroplasty knee 

153 Hip replacement, total and partial 

154 Arthroplasty other than hip or knee 

155 Arthrocentesis 

156 Injections and aspirations of muscles, tendons, bursa, joints and soft tissue 

157 Amputation of lower extremity 

158 Spinal fusion

159 Other diagnostic procedures on musculoskeletal system 

160 Other therapeutic procedures on muscles and tendons 

161 Other OR therapeutic procedures on bone 

162 Other OR therapeutic procedures on joints 

163 Other non-OR therapeutic procedures on musculoskeletal system 

164 Other OR therapeutic procedures on musculoskeletal system 

165 Breast biopsy and other diagnostic procedures on breast 

166 Lumpectomy, quadrantectomy of breast 

167 Mastectomy 

168 Incision and drainage, skin and subcutaneous tissue 

169 Debridement of wound, infection or burn 

170 Excision of skin lesion 

171 Suture of skin and subcutaneous tissue 

172 Skin graft 

173 Other diagnostic procedures on skin and subcutaneous tissue 

174 Other non-OR therapeutic procedures on skin and breast 

175 Other OR therapeutic procedures on skin and breast 

176 Other organ transplantation 

177 Computerized axial tomography (CT) scan head 

178 CT scan chest 

179 CT scan abdomen 

180 Other CT scan 

181 Myelogram 

182 Mammography 

183 Routine chest X-ray 

184 Intraoperative cholangiogram 

185 Upper gastrointestinal X-ray 

186 Lower gastrointestinal X-ray 

187 Intravenous pyelogram 

188 Cerebral arteriogram 

189 Contrast aortogram 

190 Contrast arteriogram of femoral and lower extremity arteries 

191 Arterio- or venogram (not heart and head) 

192 Diagnostic ultrasound of head and neck 

193 Diagnostic ultrasound of heart (echocardiogram) 

194 Diagnostic ultrasound of gastrointestinal tract 

195 Diagnostic ultrasound of urinary tract 

196 Diagnostic ultrasound of abdomen or retroperitoneum 

197 Other diagnostic ultrasound 

198 Magnetic resonance imaging 

199 Electroencephalogram (EEG) 

200 Nonoperative urinary system measurements 

201 Cardiac stress tests 

202 Electrocardiogram 

203 Electrographic cardiac monitoring 

204 Swan-Ganz catheterization for monitoring 

205 Arterial blood gases 

206 Microscopic examination (bacterial smear, culture, toxicology) 

207 Radioisotope bone scan 

208 Radioisotope pulmonary scan 

209 Radioisotope scan and function studies 

210 Other radioisotope scan 

211 Therapeutic radiology 

212 Diagnostic physical therapy 

213 Physical therapy exercises, manipulation, and other procedures 

214 Traction, splints, and other wound care 

215 Other physical therapy and rehabilitation

216 Respiratory intubation and mechanical ventilation 

217 Other respiratory therapy 

218 Psychological and psychiatric evaluation and therapy 

219 Alcohol and drug rehabilitation/detoxification 

220 Ophthalmologic and otologic diagnosis and treatment 

221 Nasogastric tube 

222 Blood transfusion 

223 Enteral and parenteral nutrition 

224 Cancer chemotherapy 

225 Conversion of cardiac rhythm 

226 Other diagnostic radiology and related techniques 

227 Other diagnostic procedures (interview, evaluation, consultation) 

228 Prophylactic vaccinations and inoculations 

229 Nonoperative removal of foreign body 

230 Extracorporeal shock wave lithotripsy, other than urinary 

231 Other therapeutic procedures

Appendix P International Classification of Diseases (ICD-9) Diagnostic Codes (v18) 


blndx Line diagnosis code 

diag0 Admission diagnosis code 

diag01 Claim principal diagnosis code 

diag02 Claim diagnosis code 2 

pdgns_cd Claim principal diagnosis code 


pdgns_cd Claim principal diagnosis code 

001 CHOLERA* 

0010 CHOLERA D/T VIB CHOLERAE 

0011 CHOLERA D/T VIB EL TOR 

0019 CHOLERA NOS 

002 TYPHOID/PARATYPHOID FEV* 

0020 TYPHOID FEVER 

0021 PARATYPHOID FEVER A 

0022 PARATYPHOID FEVER B 

0023 PARATYPHOID FEVER C 

0029 PARATYPHOID FEVER NOS 

003 OTH SALMONELLA INFECTION* 

0030 SALMONELLA ENTERITIS 

0031 SALMONELLA SEPTICEMIA 

0032 LOCAL SALMONELLA INFECT* 

00320 LOCAL SALMONELLA INF NOS 

00321 SALMONELLA MENINGITIS 

00322 SALMONELLA PNEUMONIA 

00323 SALMONELLA ARTHRITIS 

00324 SALMONELLA OSTEOMYELITIS 

00329 LOCAL SALMONELLA INF NEC 

0038 SALMONELLA INFECTION NEC 

0039 SALMONELLA INFECTION NOS 

004 SHIGELLOSIS* 

0040 SHIGELLA DYSENTERIAE 

0041 SHIGELLA FLEXNERI 

0042 SHIGELLA BOYDII 

0043 SHIGELLA SONNEI 

0048 SHIGELLA INFECTION NEC 

0049 SHIGELLOSIS NOS 

005 OTHER FOOD POISONING* 

0050 STAPH FOOD POISONING 

0051 BOTULISM 

0052 FOOD POIS D/T C. PERFRIN 

0053 FOOD POIS: CLOSTRID NEC 

0054 FOOD POIS: V. PARAHAEM 

0058 BACT FOOD POISONING NEC* 

00581 FOOD POISN D/T V. VULNIF 

00589 BACT FOOD POISONING NEC 

0059 FOOD POISONING NOS 

006 AMEBIASIS* 

0060 AC AMEBIASIS W/O ABSCESS 

0061 CHR AMEBIASIS W/O ABSCES 

0062 AMEBIC NONDYSENT COLITIS 

0063 AMEBIC LIVER ABSCESS

0064 AMEBIC LUNG ABSCESS 

0065 AMEBIC BRAIN ABSCESS 

0066 AMEBIC SKIN ULCERATION 

0068 AMEBIC INFECTION NEC 

0069 AMEBIASIS NOS 

007 OTH PROTOZOAL INTEST DIS* 

0070 BALANTIDIASIS 

0071 GIARDIASIS 

0072 COCCIDIOSIS 

0073 INTEST TRICHOMONIASIS 

0074 CRYPTOSPORIDIOSIS 

0078 PROTOZOAL INTEST DIS NEC 

0079 PROTOZOAL INTEST DIS NOS 

008 INTESTINAL INFECTION NEC* 

0080 E. COLI ENTERITIS* 

00800 INTEST INFEC E COLI NOS 

00801 INT INF E COLI ENTRPATH 

00802 INT INF E COLI ENTRTOXGN 

00803 INT INF E COLI ENTRNVSV 

00804 INT INF E COLI ENTRHMRG 

00809 INT INF E COLI SPCF NEC 

0081 ARIZONA ENTERITIS 

0082 AEROBACTER ENTERITIS 

0083 PROTEUS ENTERITIS 

0084 BACTERIAL ENTERITIS NEC* 

00841 STAPHYLOCOCC ENTERITIS 

00842 PSEUDOMONAS ENTERITIS 

00843 INT INFEC CAMPYLOBACTER 

00844 INT INF YRSNIA ENTRCLTCA 

00845 INT INF CLSTRDIUM DFCILE 

00846 INTES INFEC OTH ANEROBES 

00847 INT INF OTH GRM NEG BCTR 

00849 BACTERIAL ENTERITIS NEC 

0085 BACTERIAL ENTERITIS NOS 

0086 VIRAL ENTERITIS NEC* 

00861 INTES INFEC ROTAVIRUS 

00862 INTES INFEC ADENOVIRUS 

00863 INT INF NORWALK VIRUS 

00864 INT INF OTH SML RND VRUS 

00865 INTES INFEC CALCIVIRUS 

00866 INTES INFEC ASTROVIRUS 

00867 INT INF ENTEROVIRUS NEC 

00869 OTHER VIRAL INTES INFEC 

0088 VIRAL ENTERITIS NOS 

009 ILL-DEFINED INTEST INF* 

0090 INFECTIOUS ENTERITIS NOS 

0091 ENTERITIS OF INFECT ORIG 

0092 INFECTIOUS DIARRHEA NOS 

0093 DIARRHEA OF INFECT ORIG 

010 PRIMARY TB INFECTION* 

0100 PRIMARY TB COMPLEX* 

01000 PRIM TB COMPLEX-UNSPEC 

01001 PRIM TB COMPLEX-NO EXAM 

01002 PRIM TB COMPLEX-EXM UNKN 

01003 PRIM TB COMPLEX-MICRO DX 

01004 PRIM TB COMPLEX-CULT DX 

01005 PRIM TB COMPLEX-HISTO DX

01006 PRIM TB COMPLEX-OTH TEST 

0101 PRIMARY TB PLEURISY* 

01010 PRIM TB PLEURISY-UNSPEC 

01011 PRIM TB PLEURISY-NO EXAM 

01012 PRIM TB PLEUR-EXAM UNKN 

01013 PRIM TB PLEURIS-MICRO DX 

01014 PRIM TB PLEURISY-CULT DX 

01015 PRIM TB PLEURIS-HISTO DX 

01016 PRIM TB PLEURIS-OTH TEST 

0108 PRIM PROGRESSIVE TB NEC* 

01080 PRIM PROG TB NEC-UNSPEC 

01081 PRIM PROG TB NEC-NO EXAM 

01082 PRIM PR TB NEC-EXAM UNKN 

01083 PRIM PRG TB NEC-MICRO DX 

01084 PRIM PROG TB NEC-CULT DX 

01085 PRIM PRG TB NEC-HISTO DX 

01086 PRIM PRG TB NEC-OTH TEST 

0109 PRIMARY TB INFECTION NOS* 

01090 PRIMARY TB NOS-UNSPEC 

01091 PRIMARY TB NOS-NO EXAM 

01092 PRIMARY TB NOS-EXAM UNKN 

01093 PRIMARY TB NOS-MICRO DX 

01094 PRIMARY TB NOS-CULT DX 

01095 PRIMARY TB NOS-HISTO DX 

01096 PRIMARY TB NOS-OTH TEST 

011 PULMONARY TUBERCULOSIS* 

0110 TB OF LUNG, INFILTRATIVE* 

01100 TB LUNG INFILTR-UNSPEC 

01101 TB LUNG INFILTR-NO EXAM 

01102 TB LUNG INFILTR-EXM UNKN 

01103 TB LUNG INFILTR-MICRO DX 

01104 TB LUNG INFILTR-CULT DX 

01105 TB LUNG INFILTR-HISTO DX 

01106 TB LUNG INFILTR-OTH TEST 

0111 TB OF LUNG, NODULAR* 

01110 TB LUNG NODULAR-UNSPEC 

01111 TB LUNG NODULAR-NO EXAM 

01112 TB LUNG NODUL-EXAM UNKN 

01113 TB LUNG NODULAR-MICRO DX 

01114 TB LUNG NODULAR-CULT DX 

01115 TB LUNG NODULAR-HISTO DX 

01116 TB LUNG NODULAR-OTH TEST 

0112 TB OF LUNG W CAVITATION* 

01120 TB LUNG W CAVITY-UNSPEC 

01121 TB LUNG W CAVITY-NO EXAM 

01122 TB LUNG CAVITY-EXAM UNKN 

01123 TB LUNG W CAVIT-MICRO DX 

01124 TB LUNG W CAVITY-CULT DX 

01125 TB LUNG W CAVIT-HISTO DX 

01126 TB LUNG W CAVIT-OTH TEST 

0113 TUBERCULOSIS OF BRONCHUS* 

01130 TB OF BRONCHUS-UNSPEC 

01131 TB OF BRONCHUS-NO EXAM 

01132 TB OF BRONCHUS-EXAM UNKN 

01133 TB OF BRONCHUS-MICRO DX 

01134 TB OF BRONCHUS-CULT DX 

01135 TB OF BRONCHUS-HISTO DX

01136 TB OF BRONCHUS-OTH TEST 

0114 TB FIBROSIS OF LUNG* 

01140 TB LUNG FIBROSIS-UNSPEC 

01141 TB LUNG FIBROSIS-NO EXAM 

01142 TB LUNG FIBROS-EXAM UNKN 

01143 TB LUNG FIBROS-MICRO DX 

01144 TB LUNG FIBROSIS-CULT DX 

01145 TB LUNG FIBROS-HISTO DX 

01146 TB LUNG FIBROS-OTH TEST 

0115 TB BRONCHIECTASIS* 

01150 TB BRONCHIECTASIS-UNSPEC 

01151 TB BRONCHIECT-NO EXAM 

01152 TB BRONCHIECT-EXAM UNKN 

01153 TB BRONCHIECT-MICRO DX 

01154 TB BRONCHIECT-CULT DX 

01155 TB BRONCHIECT-HISTO DX 

01156 TB BRONCHIECT-OTH TEST 

0116 TUBERCULOUS PNEUMONIA* 

01160 TB PNEUMONIA-UNSPEC 

01161 TB PNEUMONIA-NO EXAM 

01162 TB PNEUMONIA-EXAM UNKN 

01163 TB PNEUMONIA-MICRO DX 

01164 TB PNEUMONIA-CULT DX 

01165 TB PNEUMONIA-HISTO DX 

01166 TB PNEUMONIA-OTH TEST 

0117 TUBERCULOUS PNEUMOTHORAX* 

01170 TB PNEUMOTHORAX-UNSPEC 

01171 TB PNEUMOTHORAX-NO EXAM 

01172 TB PNEUMOTHORX-EXAM UNKN 

01173 TB PNEUMOTHORAX-MICRO DX 

01174 TB PNEUMOTHORAX-CULT DX 

01175 TB PNEUMOTHORAX-HISTO DX 

01176 TB PNEUMOTHORAX-OTH TEST 

0118 PULMONARY TB NEC* 

01180 PULMONARY TB NEC-UNSPEC 

01181 PULMONARY TB NEC-NO EXAM 

01182 PULMON TB NEC-EXAM UNKN 

01183 PULMON TB NEC-MICRO DX 

01184 PULMON TB NEC-CULT DX 

01185 PULMON TB NEC-HISTO DX 

01186 PULMON TB NEC-OTH TEST 

0119 PULMONARY TB NOS* 

01190 PULMONARY TB NOS-UNSPEC 

01191 PULMONARY TB NOS-NO EXAM 

01192 PULMON TB NOS-EXAM UNKN 

01193 PULMON TB NOS-MICRO DX 

01194 PULMON TB NOS-CULT DX 

01195 PULMON TB NOS-HISTO DX 

01196 PULMON TB NOS-OTH TEST 

012 OTHER RESPIRATORY TB* 

0120 TUBERCULOUS PLEURISY* 

01200 TB PLEURISY-UNSPEC 

01201 TB PLEURISY-NO EXAM 

01202 TB PLEURISY-EXAM UNKN 

01203 TB PLEURISY-MICRO DX 

01204 TB PLEURISY-CULT DX 

01205 TB PLEURISY-HISTOLOG DX

01206 TB PLEURISY-OTH TEST 

0121 TB THORACIC LYMPH NODES* 

01210 TB THORACIC NODES-UNSPEC 

01211 TB THORAX NODE-NO EXAM 

01212 TB THORAX NODE-EXAM UNKN 

01213 TB THORAX NODE-MICRO DX 

01214 TB THORAX NODE-CULT DX 

01215 TB THORAX NODE-HISTO DX 

01216 TB THORAX NODE-OTH TEST 

0122 ISOLATED TRACH/BRONCH TB* 

01220 ISOL TRACHEAL TB-UNSPEC 

01221 ISOL TRACHEAL TB-NO EXAM 

01222 ISOL TRACH TB-EXAM UNKN 

01223 ISOLAT TRACH TB-MICRO DX 

01224 ISOL TRACHEAL TB-CULT DX 

01225 ISOLAT TRACH TB-HISTO DX 

01226 ISOLAT TRACH TB-OTH TEST 

0123 TUBERCULOUS LARYNGITIS* 

01230 TB LARYNGITIS-UNSPEC 

01231 TB LARYNGITIS-NO EXAM 

01232 TB LARYNGITIS-EXAM UNKN 

01233 TB LARYNGITIS-MICRO DX 

01234 TB LARYNGITIS-CULT DX 

01235 TB LARYNGITIS-HISTO DX 

01236 TB LARYNGITIS-OTH TEST 

0128 RESPIRATORY TB NEC* 

01280 RESP TB NEC-UNSPEC 

01281 RESP TB NEC-NO EXAM 

01282 RESP TB NEC-EXAM UNKN 

01283 RESP TB NEC-MICRO DX 

01284 RESP TB NEC-CULT DX 

01285 RESP TB NEC-HISTO DX 

01286 RESP TB NEC-OTH TEST 

013 CNS TUBERCULOSIS* 

0130 TUBERCULOUS MENINGITIS* 

01300 TB MENINGITIS-UNSPEC 

01301 TB MENINGITIS-NO EXAM 

01302 TB MENINGITIS-EXAM UNKN 

01303 TB MENINGITIS-MICRO DX 

01304 TB MENINGITIS-CULT DX 

01305 TB MENINGITIS-HISTO DX 

01306 TB MENINGITIS-OTH TEST 

0131 TUBERCULOMA OF MENINGES* 

01310 TUBRCLMA MENINGES-UNSPEC 

01311 TUBRCLMA MENING-NO EXAM 

01312 TUBRCLMA MENIN-EXAM UNKN 

01313 TUBRCLMA MENING-MICRO DX 

01314 TUBRCLMA MENING-CULT DX 

01315 TUBRCLMA MENING-HISTO DX 

01316 TUBRCLMA MENING-OTH TEST 

0132 TUBERCULOMA OF BRAIN* 

01320 TUBERCULOMA BRAIN-UNSPEC 

01321 TUBRCLOMA BRAIN-NO EXAM 

01322 TUBRCLMA BRAIN-EXAM UNKN 

01323 TUBRCLOMA BRAIN-MICRO DX 

01324 TUBRCLOMA BRAIN-CULT DX 

01325 TUBRCLOMA BRAIN-HISTO DX

01326 TUBRCLOMA BRAIN-OTH TEST 

0133 TB ABSCESS OF BRAIN* 

01330 TB BRAIN ABSCESS-UNSPEC 

01331 TB BRAIN ABSCESS-NO EXAM 

01332 TB BRAIN ABSC-EXAM UNKN 

01333 TB BRAIN ABSC-MICRO DX 

01334 TB BRAIN ABSCESS-CULT DX 

01335 TB BRAIN ABSC-HISTO DX 

01336 TB BRAIN ABSC-OTH TEST 

0134 TUBERCULOMA SPINAL CORD* 

01340 TUBRCLMA SP CORD-UNSPEC 

01341 TUBRCLMA SP CORD-NO EXAM 

01342 TUBRCLMA SP CD-EXAM UNKN 

01343 TUBRCLMA SP CRD-MICRO DX 

01344 TUBRCLMA SP CORD-CULT DX 

01345 TUBRCLMA SP CRD-HISTO DX 

01346 TUBRCLMA SP CRD-OTH TEST 

0135 TB ABSCESS SPINAL CORD* 

01350 TB SP CRD ABSCESS-UNSPEC 

01351 TB SP CRD ABSC-NO EXAM 

01352 TB SP CRD ABSC-EXAM UNKN 

01353 TB SP CRD ABSC-MICRO DX 

01354 TB SP CRD ABSC-CULT DX 

01355 TB SP CRD ABSC-HISTO DX 

01356 TB SP CRD ABSC-OTH TEST 

0136 TB ENCEPHALITIS/MYELITIS* 

01360 TB ENCEPHALITIS-UNSPEC 

01361 TB ENCEPHALITIS-NO EXAM 

01362 TB ENCEPHALIT-EXAM UNKN 

01363 TB ENCEPHALITIS-MICRO DX 

01364 TB ENCEPHALITIS-CULT DX 

01365 TB ENCEPHALITIS-HISTO DX 

01366 TB ENCEPHALITIS-OTH TEST 

0138 CNS TUBERCULOSIS NEC* 

01380 CNS TB NEC-UNSPEC 

01381 CNS TB NEC-NO EXAM 

01382 CNS TB NEC-EXAM UNKN 

01383 CNS TB NEC-MICRO DX 

01384 CNS TB NEC-CULT DX 

01385 CNS TB NEC-HISTO DX 

01386 CNS TB NEC-OTH TEST 

0139 CNS TUBERCULOSIS NOS* 

01390 CNS TB NOS-UNSPEC 

01391 CNS TB NOS-NO EXAM 

01392 CNS TB NOS-EXAM UNKN 

01393 CNS TB NOS-MICRO DX 

01394 CNS TB NOS-CULT DX 

01395 CNS TB NOS-HISTO DX 

01396 CNS TB NOS-OTH TEST 

014 INTESTINAL TB* 

0140 TUBERCULOUS PERITONITIS* 

01400 TB PERITONITIS-UNSPEC 

01401 TB PERITONITIS-NO EXAM 

01402 TB PERITONITIS-EXAM UNKN 

01403 TB PERITONITIS-MICRO DX 

01404 TB PERITONITIS-CULT DX 

01405 TB PERITONITIS-HISTO DX

01406 TB PERITONITIS-OTH TEST 

0148 INTESTINAL TB NEC* 

01480 INTESTINAL TB NEC-UNSPEC 

01481 INTESTIN TB NEC-NO EXAM 

01482 INTEST TB NEC-EXAM UNKN 

01483 INTESTIN TB NEC-MICRO DX 

01484 INTESTIN TB NEC-CULT DX 

01485 INTESTIN TB NEC-HISTO DX 

01486 INTESTIN TB NEC-OTH TEST 

015 TB OF BONE AND JOINT* 

0150 TB OF VERTEBRAL COLUMN* 

01500 TB OF VERTEBRA-UNSPEC 

01501 TB OF VERTEBRA-NO EXAM 

01502 TB OF VERTEBRA-EXAM UNKN 

01503 TB OF VERTEBRA-MICRO DX 

01504 TB OF VERTEBRA-CULT DX 

01505 TB OF VERTEBRA-HISTO DX 

01506 TB OF VERTEBRA-OTH TEST 

0151 TB OF HIP* 

01510 TB OF HIP-UNSPEC 

01511 TB OF HIP-NO EXAM 

01512 TB OF HIP-EXAM UNKN 

01513 TB OF HIP-MICRO DX 

01514 TB OF HIP-CULT DX 

01515 TB OF HIP-HISTO DX 

01516 TB OF HIP-OTH TEST 

0152 TB OF KNEE* 

01520 TB OF KNEE-UNSPEC 

01521 TB OF KNEE-NO EXAM 

01522 TB OF KNEE-EXAM UNKN 

01523 TB OF KNEE-MICRO DX 

01524 TB OF KNEE-CULT DX 

01525 TB OF KNEE-HISTO DX 

01526 TB OF KNEE-OTH TEST 

0155 TB OF LIMB BONES* 

01550 TB OF LIMB BONES-UNSPEC 

01551 TB LIMB BONES-NO EXAM 

01552 TB LIMB BONES-EXAM UNKN 

01553 TB LIMB BONES-MICRO DX 

01554 TB LIMB BONES-CULT DX 

01555 TB LIMB BONES-HISTO DX 

01556 TB LIMB BONES-OTH TEST 

0156 TB OF MASTOID* 

01560 TB OF MASTOID-UNSPEC 

01561 TB OF MASTOID-NO EXAM 

01562 TB OF MASTOID-EXAM UNKN 

01563 TB OF MASTOID-MICRO DX 

01564 TB OF MASTOID-CULT DX 

01565 TB OF MASTOID-HISTO DX 

01566 TB OF MASTOID-OTH TEST 

0157 TB OF BONE NEC* 

01570 TB OF BONE NEC-UNSPEC 

01571 TB OF BONE NEC-NO EXAM 

01572 TB OF BONE NEC-EXAM UNKN 

01573 TB OF BONE NEC-MICRO DX 

01574 TB OF BONE NEC-CULT DX 

01575 TB OF BONE NEC-HISTO DX

01576 TB OF BONE NEC-OTH TEST 

0158 TB OF JOINT NEC* 

01580 TB OF JOINT NEC-UNSPEC 

01581 TB OF JOINT NEC-NO EXAM 

01582 TB JOINT NEC-EXAM UNKN 

01583 TB OF JOINT NEC-MICRO DX 

01584 TB OF JOINT NEC-CULT DX 

01585 TB OF JOINT NEC-HISTO DX 

01586 TB OF JOINT NEC-OTH TEST 

0159 TB OF BONE & JOINT NOS* 

01590 TB BONE/JOINT NOS-UNSPEC 

01591 TB BONE/JT NOS-NO EXAM 

01592 TB BONE/JT NOS-EXAM UNKN 

01593 TB BONE/JT NOS-MICRO DX 

01594 TB BONE/JT NOS-CULT DX 

01595 TB BONE/JT NOS-HISTO DX 

01596 TB BONE/JT NOS-OTH TEST 

016 GENITOURINARY TB* 

0160 TB OF KIDNEY* 

01600 TB OF KIDNEY-UNSPEC 

01601 TB OF KIDNEY-NO EXAM 

01602 TB OF KIDNEY-EXAM UNKN 

01603 TB OF KIDNEY-MICRO DX 

01604 TB OF KIDNEY-CULT DX 

01605 TB OF KIDNEY-HISTO DX 

01606 TB OF KIDNEY-OTH TEST 

0161 TB OF BLADDER* 

01610 TB OF BLADDER-UNSPEC 

01611 TB OF BLADDER-NO EXAM 

01612 TB OF BLADDER-EXAM UNKN 

01613 TB OF BLADDER-MICRO DX 

01614 TB OF BLADDER-CULT DX 

01615 TB OF BLADDER-HISTO DX 

01616 TB OF BLADDER-OTH TEST 

0162 TB OF URETER* 

01620 TB OF URETER-UNSPEC 

01621 TB OF URETER-NO EXAM 

01622 TB OF URETER-EXAM UNKN 

01623 TB OF URETER-MICRO DX 

01624 TB OF URETER-CULT DX 

01625 TB OF URETER-HISTO DX 

01626 TB OF URETER-OTH TEST 

0163 TB OF URINARY ORGAN NEC* 

01630 TB URINARY NEC-UNSPEC 

01631 TB URINARY NEC-NO EXAM 

01632 TB URINARY NEC-EXAM UNKN 

01633 TB URINARY NEC-MICRO DX 

01634 TB URINARY NEC-CULT DX 

01635 TB URINARY NEC-HISTO DX 

01636 TB URINARY NEC-OTH TEST 

0164 TB OF EPIDIDYMIS* 

01640 TB EPIDIDYMIS-UNSPEC 

01641 TB EPIDIDYMIS-NO EXAM 

01642 TB EPIDIDYMIS-EXAM UNKN 

01643 TB EPIDIDYMIS-MICRO DX 

01644 TB EPIDIDYMIS-CULT DX 

01645 TB EPIDIDYMIS-HISTO DX

01646 TB EPIDIDYMIS-OTH TEST 

0165 TB MALE GENITAL ORG NEC* 

01650 TB MALE GENIT NEC-UNSPEC 

01651 TB MALE GEN NEC-NO EXAM 

01652 TB MALE GEN NEC-EX UNKN 

01653 TB MALE GEN NEC-MICRO DX 

01654 TB MALE GEN NEC-CULT DX 

01655 TB MALE GEN NEC-HISTO DX 

01656 TB MALE GEN NEC-OTH TEST 

0166 TB OF OVARY AND TUBE* 

01660 TB OVARY & TUBE-UNSPEC 

01661 TB OVARY & TUBE-NO EXAM 

01662 TB OVARY/TUBE-EXAM UNKN 

01663 TB OVARY & TUBE-MICRO DX 

01664 TB OVARY & TUBE-CULT DX 

01665 TB OVARY & TUBE-HISTO DX 

01666 TB OVARY & TUBE-OTH TEST 

0167 TB FEMALE GENIT ORG NEC* 

01670 TB FEMALE GEN NEC-UNSPEC 

01671 TB FEM GEN NEC-NO EXAM 

01672 TB FEM GEN NEC-EXAM UNKN 

01673 TB FEM GEN NEC-MICRO DX 

01674 TB FEM GEN NEC-CULT DX 

01675 TB FEM GEN NEC-HISTO DX 

01676 TB FEM GEN NEC-OTH TEST 

0169 GENITOURINARY TB NOS* 

01690 GU TB NOS-UNSPEC 

01691 GU TB NOS-NO EXAM 

01692 GU TB NOS-EXAM UNKN 

01693 GU TB NOS-MICRO DX 

01694 GU TB NOS-CULT DX 

01695 GU TB NOS-HISTO DX 

01696 GU TB NOS-OTH TEST 

017 TUBERCULOSIS NEC* 

0170 TB SKIN & SUBCUTANEOUS* 

01700 TB SKIN/SUBCUTAN-UNSPEC 

01701 TB SKIN/SUBCUT-NO EXAM 

01702 TB SKIN/SUBCUT-EXAM UNKN 

01703 TB SKIN/SUBCUT-MICRO DX 

01704 TB SKIN/SUBCUT-CULT DX 

01705 TB SKIN/SUBCUT-HISTO DX 

01706 TB SKIN/SUBCUT-OTH TEST 

0171 ERYTHEMA NODOSUM IN TB* 

01710 ERYTHEMA NODOS TB-UNSPEC 

01711 ERYTHEM NODOS TB-NO EXAM 

01712 ERYTHEM NOD TB-EXAM UNKN 

01713 ERYTHEM NOD TB-MICRO DX 

01714 ERYTHEM NODOS TB-CULT DX 

01715 ERYTHEM NOD TB-HISTO DX 

01716 ERYTHEM NOD TB-OTH TEST 

0172 TB OF PERIPH LYMPH NODE* 

01720 TB PERIPH LYMPH-UNSPEC 

01721 TB PERIPH LYMPH-NO EXAM 

01722 TB PERIPH LYMPH-EXAM UNK 

01723 TB PERIPH LYMPH-MICRO DX 

01724 TB PERIPH LYMPH-CULT DX 

01725 TB PERIPH LYMPH-HISTO DX

01726 TB PERIPH LYMPH-OTH TEST 

0173 TB OF EYE* 

01730 TB OF EYE-UNSPEC 

01731 TB OF EYE-NO EXAM 

01732 TB OF EYE-EXAM UNKN 

01733 TB OF EYE-MICRO DX 

01734 TB OF EYE-CULT DX 

01735 TB OF EYE-HISTO DX 

01736 TB OF EYE-OTH TEST 

0174 TB OF EAR* 

01740 TB OF EAR-UNSPEC 

01741 TB OF EAR-NO EXAM 

01742 TB OF EAR-EXAM UNKN 

01743 TB OF EAR-MICRO DX 

01744 TB OF EAR-CULT DX 

01745 TB OF EAR-HISTO DX 

01746 TB OF EAR-OTH TEST 

0175 TB OF THYROID GLAND* 

01750 TB OF THYROID-UNSPEC 

01751 TB OF THYROID-NO EXAM 

01752 TB OF THYROID-EXAM UNKN 

01753 TB OF THYROID-MICRO DX 

01754 TB OF THYROID-CULT DX 

01755 TB OF THYROID-HISTO DX 

01756 TB OF THYROID-OTH TEST 

0176 TB OF ADRENAL GLAND* 

01760 TB OF ADRENAL-UNSPEC 

01761 TB OF ADRENAL-NO EXAM 

01762 TB OF ADRENAL-EXAM UNKN 

01763 TB OF ADRENAL-MICRO DX 

01764 TB OF ADRENAL-CULT DX 

01765 TB OF ADRENAL-HISTO DX 

01766 TB OF ADRENAL-OTH TEST 

0177 TB OF SPLEEN* 

01770 TB OF SPLEEN-UNSPEC 

01771 TB OF SPLEEN-NO EXAM 

01772 TB OF SPLEEN-EXAM UNKN 

01773 TB OF SPLEEN-MICRO DX 

01774 TB OF SPLEEN-CULT DX 

01775 TB OF SPLEEN-HISTO DX 

01776 TB OF SPLEEN-OTH TEST 

0178 TB OF ESOPHAGUS* 

01780 TB ESOPHAGUS-UNSPEC 

01781 TB ESOPHAGUS-NO EXAM 

01782 TB ESOPHAGUS-EXAM UNKN 

01783 TB ESOPHAGUS-MICRO DX 

01784 TB ESOPHAGUS-CULT DX 

01785 TB ESOPHAGUS-HISTO DX 

01786 TB ESOPHAGUS-OTH TEST 

0179 TB OF ORGAN NEC* 

01790 TB OF ORGAN NEC-UNSPEC 

01791 TB OF ORGAN NEC-NO EXAM 

01792 TB ORGAN NEC-EXAM UNKN 

01793 TB OF ORGAN NEC-MICRO DX 

01794 TB OF ORGAN NEC-CULT DX 

01795 TB OF ORGAN NEC-HISTO DX 

01796 TB OF ORGAN NEC-OTH TEST

018 MILIARY TUBERCULOSIS* 

0180 ACUTE MILIARY TB* 

01800 ACUTE MILIARY TB-UNSPEC 

01801 ACUTE MILIARY TB-NO EXAM 

01802 AC MILIARY TB-EXAM UNKN 

01803 AC MILIARY TB-MICRO DX 

01804 ACUTE MILIARY TB-CULT DX 

01805 AC MILIARY TB-HISTO DX 

01806 AC MILIARY TB-OTH TEST 

0188 MILIARY TB NEC* 

01880 MILIARY TB NEC-UNSPEC 

01881 MILIARY TB NEC-NO EXAM 

01882 MILIARY TB NEC-EXAM UNKN 

01883 MILIARY TB NEC-MICRO DX 

01884 MILIARY TB NEC-CULT DX 

01885 MILIARY TB NEC-HISTO DX 

01886 MILIARY TB NEC-OTH TEST 

0189 MILIARY TUBERCULOSIS NOS* 

01890 MILIARY TB NOS-UNSPEC 

01891 MILIARY TB NOS-NO EXAM 

01892 MILIARY TB NOS-EXAM UNKN 

01893 MILIARY TB NOS-MICRO DX 

01894 MILIARY TB NOS-CULT DX 

01895 MILIARY TB NOS-HISTO DX 

01896 MILIARY TB NOS-OTH TEST 

020 PLAGUE* 

0200 BUBONIC PLAGUE 

0201 CELLULOCUTANEOUS PLAGUE 

0202 SEPTICEMIC PLAGUE 

0203 PRIMARY PNEUMONIC PLAGUE 

0204 SECONDARY PNEUMON PLAGUE 

0205 PNEUMONIC PLAGUE NOS 

0208 OTHER TYPES OF PLAGUE 

0209 PLAGUE NOS 

021 TULAREMIA* 

0210 ULCEROGLANDUL TULAREMIA 

0211 ENTERIC TULAREMIA 

0212 PULMONARY TULAREMIA 

0213 OCULOGLANDULAR TULAREMIA 

0218 TULAREMIA NEC 

0219 TULAREMIA NOS 

022 ANTHRAX* 

0220 CUTANEOUS ANTHRAX 

0221 PULMONARY ANTHRAX 

0222 GASTROINTESTINAL ANTHRAX 

0223 ANTHRAX SEPTICEMIA 

0228 OTHER ANTHRAX MANIFEST 

0229 ANTHRAX NOS 

023 BRUCELLOSIS* 

0230 BRUCELLA MELITENSIS 

0231 BRUCELLA ABORTUS 

0232 BRUCELLA SUIS 

0233 BRUCELLA CANIS 

0238 BRUCELLOSIS NEC 

0239 BRUCELLOSIS NOS 

024 GLANDERS 

025 MELIOIDOSIS

026 RAT-BITE FEVER* 

0260 SPIRILLARY FEVER 

0261 STREPTOBACILLARY FEVER 

0269 RAT-BITE FEVER NOS 

027 OTHER BACTERIAL ZOONOSES* 

0270 LISTERIOSIS 

0271 ERYSIPELOTHRIX INFECTION 

0272 PASTEURELLOSIS 

0278 ZOONOTIC BACT DIS NEC 

0279 ZOONOTIC BACT DIS NOS 

030 LEPROSY* 

0300 LEPROMATOUS LEPROSY 

0301 TUBERCULOID LEPROSY 

0302 INDETERMINATE LEPROSY 

0303 BORDERLINE LEPROSY 

0308 LEPROSY NEC 

0309 LEPROSY NOS 

031 OTHER MYCOBACTERIAL DIS* 

0310 PULMONARY MYCOBACTERIA 

0311 CUTANEOUS MYCOBACTERIA 

0312 DMAC BACTEREMIA 

0318 MYCOBACTERIAL DIS NEC 

0319 MYCOBACTERIAL DIS NOS 

032 DIPHTHERIA* 

0320 FAUCIAL DIPHTHERIA 

0321 NASOPHARYNX DIPHTHERIA 

0322 ANT NASAL DIPHTHERIA 

0323 LARYNGEAL DIPHTHERIA 

0328 OTHER DIPHTHERIA* 

03281 CONJUNCTIVAL DIPHTHERIA 

03282 DIPHTHERITIC MYOCARDITIS 

03283 DIPHTHERITIC PERITONITIS 

03284 DIPHTHERITIC CYSTITIS 

03285 CUTANEOUS DIPHTHERIA 

03289 DIPHTHERIA NEC 

0329 DIPHTHERIA NOS 

033 WHOOPING COUGH* 

0330 BORDETELLA PERTUSSIS 

0331 BORDETELLA PARAPERTUSSIS 

0338 WHOOPING COUGH NEC 

0339 WHOOPING COUGH NOS 

034 STREP THROAT/SCARLET FEV* 

0340 STREP SORE THROAT 

0341 SCARLET FEVER 

035 ERYSIPELAS 

036 MENINGOCOCCAL INFECTION* 

0360 MENINGOCOCCAL MENINGITIS 

0361 MENINGOCOCC ENCEPHALITIS 

0362 MENINGOCOCCEMIA 

0363 MENINGOCOCC ADRENAL SYND 

0364 MENINGOCOCCAL CARDITIS* 

03640 MENINGOCOCC CARDITIS NOS 

03641 MENINGOCOCC PERICARDITIS 

03642 MENINGOCOCC ENDOCARDITIS 

03643 MENINGOCOCC MYOCARDITIS 

0368 OTHER MENINGOCOCCAL INF* 

03681 MENINGOCOCC OPTIC NEURIT

03682 MENINGOCOCC ARTHROPATHY 

03689 MENINGOCOCCAL INFECT NEC 

0369 MENINGOCOCCAL INFECT NOS 

037 TETANUS 

038 SEPTICEMIA* 

0380 STREPTOCOCCAL SEPTICEMIA 

0381 STAPHYLOCOCC SEPTICEMIA* 

03810 STAPHYLCOCC SEPTICEM NOS 

03811 STAPH AUREUS SEPTICEMIA 

03819 STAPHYLCOCC SEPTICEM NEC 

0382 PNEUMOCOCCAL SEPTICEMIA 

0383 ANAEROBIC SEPTICEMIA 

0384 GRAM-NEG SEPTICEMIA NEC* 

03840 GRAM-NEG SEPTICEMIA NOS 

03841 H. INFLUENAE SEPTICEMIA 

03842 E COLI SEPTICEMIA 

03843 PSEUDOMONAS SEPTICEMIA 

03844 SERRATIA SEPTICEMIA 

03849 GRAM-NEG SEPTICEMIA NEC 

0388 SEPTICEMIA NEC 

0389 SEPTICEMIA NOS 

039 ACTINOMYCOTIC INFECTIONS* 

0390 CUTANEOUS ACTINOMYCOSIS 

0391 PULMONARY ACTINOMYCOSIS 

0392 ABDOMINAL ACTINOMYCOSIS 

0393 CERVICOFAC ACTINOMYCOSIS 

0394 MADURA FOOT 

0398 ACTINOMYCOSIS NEC 

0399 ACTINOMYCOSIS NOS 

040 OTHER BACTERIAL DISEASES* 

0400 GAS GANGRENE 

0401 RHINOSCLEROMA 

0402 WHIPPLE'S DISEASE 

0403 NECROBACILLOSIS 

0408 BACTERIAL DISEASES NEC* 

04081 TROPICAL PYOMYOSITIS 

04089 BACTERIAL DISEASES NEC 

041 BACT INF IN OTH DIS/NOS* 

0410 STREPTOCOCCUS INFECT NOS* 

04100 STREPTOCOCCUS UNSPECF 

04101 STREPTOCOCCUS GROUP A 

04102 STREPTOCOCCUS GROUP B 

04103 STREPTOCOCCUS GROUP C 

04104 ENTEROCOCCUS GROUP D 

04105 STREPTOCOCCUS GROUP G 

04109 OTHER STREPTOCOCCUS 

0411 STAPH INFECTION NOS* 

04110 STAPHYLOCOCCUS UNSPCFIED 

04111 STAPHYLOCOCCUS AUREUS 

04119 OTHER STAPHYLOCOCCUS 

0412 PNEUMOCOCCUS INFECT NOS 

0413 KLEBSIELLA INFECT NOS 

0414 E. COLI INFECT NOS 

0415 H. INFLUENZAE INFECT NOS 

0416 PROTEUS INFECTION NOS 

0417 PSEUDOMONAS INFECT NOS 

0418 BACTERIAL INFECTION NEC*

04181 MYCOPLASMA 

04182 BACILLUS FRAGILIS 

04183 CLOSTRIDIUM PERFRINGENS 

04184 OTHER ANAEROBES 

04185 OTH GRAM NEGATV BACTERIA 

04186 HELICOBACTER PYLORI 

04189 OTH SPECF BACTERIA 

0419 BACTERIAL INFECTION NOS 

042 HUMAN IMMUNO VIRUS DIS 

045 ACUTE POLIOMYELITIS* 

0450 ACUTE BULBAR POLIO* 

04500 AC BULBAR POLIO-TYPE NOS 

04501 AC BULBAR POLIO-TYPE 1 



0451 AC PARALYTIC POLIO NEC* 

04510 PARAL POLIO NEC-TYPE NOS 

04511 PARAL POLIO NEC-TYPE 1 



0452 ACUTE NONPARALYTIC POLIO* 

04520 NONPARALY POLIO-TYPE NOS 

04521 NONPARALYT POLIO-TYPE 1 



0459 ACUTE POLIOMYELITIS NOS* 

04590 AC POLIO NOS-TYPE NOS 

04591 AC POLIO NOS-TYPE 1 



046 CNS SLOW VIRUS INFECTION* 

0460 KURU 

0461 JAKOB-CREUTZFELDT DIS 

0462 SUBAC SCLEROS PANENCEPH 

0463 PROG MULTIFOC LEUKOENCEP 

0468 CNS SLOW VIRUS INFEC NEC 

0469 CNS SLOW VIRUS INFEC NOS 

047 ENTEROVIRAL MENINGITIS* 

0470 COXSACKIE VIRUS MENING 

0471 ECHO VIRUS MENINGITIS 

0478 VIRAL MENINGITIS NEC 

0479 VIRAL MENINGITIS NOS 

048 OTH ENTEROVIRAL CNS DIS 

049 OTH NONARTHROPOD CNS VIR* 

0490 LYMPHOCYTIC CHORIOMENING 

0491 ADENOVIRAL MENINGITIS 

0498 VIRAL ENCEPHALITIS NEC 

0499 VIRAL ENCEPHALITIS NOS 

050 SMALLPOX* 

0500 VARIOLA MAJOR 

0501 ALASTRIM 

0502 MODIFIED SMALLPOX 

0509 SMALLPOX NOS 

051 COWPOX AND PARAVACCINIA* 

0510 COWPOX 

0511 PSEUDOCOWPOX 

0512 CONTAGIOUS PUSTULAR DERM

0519 PARAVACCINIA NOS 

052 CHICKENPOX* 

0520 POSTVARICELLA ENCEPHALIT 

0521 VARICELLA PNEUMONITIS 

0527 VARICELLA COMPLICAT NEC 

0528 VARICELLA COMPLICAT NOS 

0529 VARICELLA UNCOMPLICATED 

053 HERPES ZOSTER* 

0530 HERPES ZOSTER MENINGITIS 

0531 OTH H ZOSTER NERV SYST* 

05310 H ZOSTER NERV SYST NOS 

05311 GENICULATE HERPES ZOSTER 

05312 POSTHERPES TRIGEM NEURAL 

05313 POSTHERPES POLYNEUROPATH 

05319 H ZOSTER NERV SYST NEC 

0532 HERPES ZOSTER OF EYE* 

05320 HERPES ZOSTER OF EYELID 

05321 H ZOSTER KERATOCONJUNCT 

05322 H ZOSTER IRIDOCYCLITIS 

05329 HERPES ZOSTER OF EYE NEC 

0537 OTH COMPLICATED H ZOSTER* 

05371 H ZOSTER OTITIS EXTERNA 

05379 H ZOSTER COMPLICATED NEC 

0538 H ZOSTER COMPLICATED NOS 

0539 HERPES ZOSTER NOS 

054 HERPES SIMPLEX* 

0540 ECZEMA HERPETICUM 

0541 GENITAL HERPES* 

05410 GENITAL HERPES NOS 

05411 HERPETIC VULVOVAGINITIS 

05412 HERPETIC ULCER OF VULVA 

05413 HERPETIC INFECT OF PENIS 

05419 GENITAL HERPES NEC 

0542 HERPETIC GINGIVOSTOMAT 

0543 HERPETIC ENCEPHALITIS 

0544 HERPES SIMPLEX OF EYE* 

05440 HERPES SIMPLEX EYE NOS 

05441 HERPES SIMPLEX OF EYELID 

05442 DENDRITIC KERATITIS 

05443 H SIMPLEX KERATITIS 

05444 H SIMPLEX IRIDOCYCLITIS 

05449 HERPES SIMPLEX EYE NEC 

0545 HERPETIC SEPTICEMIA 

0546 HERPETIC WHITLOW 

0547 OTH COMPLICAT H SIMPLEX* 

05471 VISCERAL HERPES SIMPLEX 

05472 H SIMPLEX MENINGITIS 

05473 H SIMPLEX OTITIS EXTERNA 

05479 H SIMPLEX COMPLICAT NEC 

0548 H SIMPLEX COMPLICAT NOS 

0549 HERPES SIMPLEX NOS 

055 MEASLES* 

0550 POSTMEASLES ENCEPHALITIS 

0551 POSTMEASLES PNEUMONIA 

0552 POSTMEASLES OTITIS MEDIA 

0557 OTH MEASLES COMPLICATION* 

05571 MEASLES KERATITIS

05579 MEASLES COMPLICATION NEC 

0558 MEASLES COMPLICATION NOS 

0559 MEASLES UNCOMPLICATED 

056 RUBELLA* 

0560 RUBELLA W NERVE COMPL* 

05600 RUBELLA NERVE COMPL NOS 

05601 RUBELLA ENCEPHALITIS 

05609 RUBELLA NERVE COMPL NEC 

0567 OTH RUBELLA COMPLICATION* 

05671 ARTHRITIS DUE TO RUBELLA 

05679 RUBELLA COMPLICATION NEC 

0568 RUBELLA COMPLICATION NOS 

0569 RUBELLA UNCOMPLICATED 

057 OTHER VIRAL EXANTHEMATA* 

0570 ERYTHEMA INFECTIOSUM 

0578 VIRAL EXANTHEMATA NEC 

0579 VIRAL EXANTHEMATA NOS 

060 YELLOW FEVER* 

0600 SYLVATIC YELLOW FEVER 

0601 URBAN YELLOW FEVER 

0609 YELLOW FEVER NOS 

061 DENGUE 

062 MOSQUIT-BORNE VIR ENCEPH* 

0620 JAPANESE ENCEPHALITIS 

0621 WEST EQUINE ENCEPHALITIS 

0622 EAST EQUINE ENCEPHALITIS 

0623 ST LOUIS ENCEPHALITIS 

0624 AUSTRALIAN ENCEPHALITIS 

0625 CALIFORNIA ENCEPHALITIS 

0628 MOSQUIT-BORNE ENCEPH NEC 

0629 MOSQUIT-BORNE ENCEPH NOS 

063 TICK-BORNE VIRAL ENCEPH* 

0630 RUSSIA SPR-SUMMER ENCEPH 

0631 LOUPING ILL 

0632 CENT EUROPE ENCEPHALITIS 

0638 TICK-BORNE ENCEPH NEC 

0639 TICK-BORNE ENCEPH NOS 

064 VIR ENCEPH ARTHROPOD NEC 

065 ARTHROPOD HEMORRHAG FEV* 

0650 CRIMEAN HEMORRHAGIC FEV 

0651 OMSK HEMORRHAGIC FEVER 

0652 KYASANUR FOREST DISEASE 

0653 TICK-BORNE HEM FEVER NEC 

0654 MOSQUITO-BORNE HEM FEVER 

0658 ARTHROPOD HEM FEVER NEC 

0659 ARTHROPOD HEM FEVER NOS 

066 OTHER ARTHROPOD VIRUS* 

0660 PHLEBOTOMUS FEVER 

0661 TICK-BORNE FEVER 

0662 VENEZUELAN EQUINE FEVER 

0663 MOSQUITO-BORNE FEVER NEC 

0668 ARTHROPOD VIRUS NEC 

0669 ARTHROPOD VIRUS NOS 

070 VIRAL HEPATITIS* 

0700 HEPATITIS A WITH COMA 

0701 HEPATITIS A W/O COMA 

0702 HEPATITIS B WITH COMA*

07020 HPT B ACTE COMA WO DLTA 

07021 HPT B ACTE COMA W DLTA 

07022 HPT B CHRN COMA WO DLTA 

07023 HPT B CHRN COMA W DLTA 

0703 HEPATITIS B W/O COMA* 

07030 HPT B ACTE WO CM WO DLTA 

07031 HPT B ACTE WO CM W DLTA 

07032 HPT B CHRN WO CM WO DLTA 

07033 HPT B CHRN WO CM W DLTA 

0704 VIRAL HEPAT NEC W COMA* 

07041 HPT C ACUTE W HEPAT COMA 

07042 HPT DLT WO B W HPT COMA 

07043 HPT E W HEPAT COMA 

07044 CHRNC HPT C W HEPAT COMA 

07049 OTH VRL HEPAT W HPT COMA 

0705 VIRAL HEPAT NEC W/O COMA* 

07051 HPT C ACUTE WO HPAT COMA 

07052 HPT DLT WO B WO HPT COMA 

07053 HPT E WO HEPAT COMA 

07054 CHRNC HPT C WO HPAT COMA 

07059 OTH VRL HPAT WO HPT COMA 

0706 VIRAL HEPAT NOS W COMA 

0709 VIRAL HEPAT NOS W/O COMA 

071 RABIES 

072 MUMPS* 

0720 MUMPS ORCHITIS 

0721 MUMPS MENINGITIS 

0722 MUMPS ENCEPHALITIS 

0723 MUMPS PANCREATITIS 

0727 OTH MUMPS COMPLICATIONS* 

07271 MUMPS HEPATITIS 

07272 MUMPS POLYNEUROPATHY 

07279 MUMPS COMPLICATION NEC 

0728 MUMPS COMPLICATION NOS 

0729 MUMPS UNCOMPLICATED 

073 ORNITHOSIS* 

0730 ORNITHOSIS PNEUMONIA 

0737 ORNITHOSIS COMPLICAT NEC 

0738 ORNITHOSIS COMPLICAT NOS 

0739 ORNITHOSIS NOS 

074 COXSACKIE VIRAL DISEASE* 

0740 HERPANGINA 

0741 EPIDEMIC PLEURODYNIA 

0742 COXSACKIE CARDITIS* 

07420 COXSACKIE CARDITIS NOS 

07421 COXSACKIE PERICARDITIS 

07422 COXSACKIE ENDOCARDITIS 

07423 COXSACKIE MYOCARDITIS 

0743 HAND, FOOT & MOUTH DIS 

0748 COXSACKIE VIRUS NEC 

075 INFECTIOUS MONONUCLEOSIS 

076 TRACHOMA* 

0760 TRACHOMA, INITIAL STAGE 

0761 TRACHOMA, ACTIVE STAGE 

0769 TRACHOMA NOS 

077 OTH VIRAL CONJUNCTIVITIS* 

0770 INCLUSION CONJUNCTIVITIS

0771 EPIDEM KERATOCONJUNCTIV 

0772 PHARYNGOCONJUNCT FEVER 

0773 ADENOVIRAL CONJUNCT NEC 

0774 EPIDEM HEM CONJUNCTIVIT 

0778 VIRAL CONJUNCTIVITIS NEC 

0779 VIRAL CONJUNCTIVITIS NOS* 

07798 UNSP DS CONJUC CHLAMYDIA 

07799 UNSP DS CONJUC VIRUSES 

078 OTHER VIRAL DISEASE* 

0780 MOLLUSCUM CONTAGIOSUM 

0781 VIRAL WARTS* 

07810 VIRAL WARTS NOS 

07811 CONDYLOMA ACUMINATUM 

07819 OTH SPECFD VIRAL WARTS 

0782 SWEATING FEVER 

0783 CAT-SCRATCH DISEASE 

0784 FOOT & MOUTH DISEASE 

0785 CYTOMEGALOVIRAL DISEASE 

0786 HEM NEPHROSONEPHRITIS 

0787 ARENAVIRAL HEM FEVER 

0788 VIRAL DISEASE NEC* 

07881 EPIDEMIC VERTIGO 

07882 EPIDEMIC VOMITING SYND 

07888 OTH SPEC DIS CHLAMYDIAE 

07889 OTH SPEC DIS VIRUSES 

079 VIRAL INF IN OTH DIS/NOS* 

0790 ADENOVIRUS INFECT NOS 

0791 ECHO VIRUS INFECT NOS 

0792 COXSACKIE VIRUS INF NOS 

0793 RHINOVIRUS INFECT NOS 

0794 HUMAN PAPILLOMA VIRUS 

0795 RETROVIRUS* 

07950 RETROVIRUS, UNSPECIFIED 

07951 HTLV-1 INFECTION OTH DIS 

07952 HTLV-II INFECTN OTH DIS 

07953 HIV-2 INFECTION OTH DIS 

07959 OTH SPECFIED RETROVIRUS 

0796 RESPRTRY SYNCYTIAL VIRUS 

0798 OTH SPCF VRL CHLAMD INFC* 

07981 HANTAVIRUS INFECTION 

07988 OTH SPCF CHLAMYDIAL INFC 

07989 OTH SPECF VIRAL INFECTN 

0799 UNSPCF VRL CHLAMYDL INFC* 

07998 CHLAMYDIAL INFECTION NOS 

07999 VIRAL INFECTION NOS 

080 LOUSE-BORNE TYPHUS 

081 OTHER TYPHUS* 

0810 MURINE TYPHUS 

0811 BRILL'S DISEASE 

0812 SCRUB TYPHUS 

0819 TYPHUS NOS 

082 TICK-BORNE RICKETTSIOSES* 

0820 SPOTTED FEVERS 

0821 BOUTONNEUSE FEVER 

0822 NORTH ASIAN TICK FEVER 

0823 QUEENSLAND TICK TYPHUS 

0828 TICK-BORNE RICKETTS NEC

0829 TICK-BORNE RICKETTS NOS 

083 OTHER RICKETTSIOSES* 

0830 Q FEVER 

0831 TRENCH FEVER 

0832 RICKETTSIALPOX 

0838 RICKETTSIOSES NEC 

0839 RICKETTSIOSIS NOS 

084 MALARIA* 

0840 FALCIPARUM MALARIA 

0841 VIVAX MALARIA 

0842 QUARTAN MALARIA 

0843 OVALE MALARIA 

0844 MALARIA NEC 

0845 MIXED MALARIA 

0846 MALARIA NOS 

0847 INDUCED MALARIA 

0848 BLACKWATER FEVER 

0849 MALARIA COMPLICATED NEC 

085 LEISHMANIASIS* 

0850 VISCERAL LEISHMANIASIS 

0851 CUTAN LEISHMANIAS URBAN 

0852 CUTAN LEISHMANIAS ASIAN 

0853 CUTAN LEISHMANIAS ETHIOP 

0854 CUTAN LEISHMANIAS AMER 

0855 MUCOCUTAN LEISHMANIASIS 

0859 LEISHMANIASIS NOS 

086 TRYPANOSOMIASIS* 

0860 CHAGAS DISEASE OF HEART 

0861 CHAGAS DIS OF OTH ORGAN 

0862 CHAGAS DISEASE NOS 

0863 GAMBIAN TRYPANOSOMIASIS 

0864 RHODESIAN TRYPANOSOMIAS 

0865 AFRICAN TRYPANOSOMA NOS 

0869 TRYPANOSOMIASIS NOS 

087 RELAPSING FEVER* 

0870 LOUSE-BORNE RELAPS FEVER 

0871 TICK-BORNE RELAPS FEVER 

0879 RELAPSING FEVER NOS 

088 OTH ARTHROPOD-BORNE DIS* 

0880 BARTONELLOSIS 

0888 ARTHROPOD-BORNE DIS NEC* 

08881 LYME DISEASE 

08882 BABESIOSIS 

08889 OTH ARTHROPOD-BORNE DIS 

0889 ARTHROPOD-BORNE DIS NOS 

090 CONGENITAL SYPHILIS* 

0900 EARLY CONG SYPH SYMPTOM 

0901 EARLY CONGEN SYPH LATENT 

0902 EARLY CONGEN SYPH NOS 

0903 SYPHILITIC KERATITIS 

0904 JUVENILE NEUROSYPHILIS* 

09040 JUVENILE NEUROSYPH NOS 

09041 CONGEN SYPH ENCEPHALITIS 

09042 CONGEN SYPH MENINGITIS 

09049 JUVENILE NEUROSYPH NEC 

0905 LATE CONGEN SYPH SYMPTOM 

0906 LATE CONGEN SYPH LATENT

0907 LATE CONGEN SYPH NOS 

0909 CONGENITAL SYPHILIS NOS 

091 EARLY SYMPTOMATIC SYPHIL* 

0910 PRIMARY GENITAL SYPHILIS 

0911 PRIMARY ANAL SYPHILIS 

0912 PRIMARY SYPHILIS NEC 

0913 SECONDARY SYPH SKIN 

0914 SYPHILITIC ADENOPATHY 

0915 SYPHILITIC UVEITIS* 

09150 SYPHILITIC UVEITIS NOS 

09151 SYPHILIT CHORIORETINITIS 

09152 SYPHILITIC IRIDOCYCLITIS 

0916 SECOND SYPH VISCERA/BONE* 

09161 SYPHILITIC PERIOSTITIS 

09162 SYPHILITIC HEPATITIS 

09169 SECOND SYPH VISCERA NEC 

0917 SECOND SYPHILIS RELAPSE 

0918 OTH SECONDARY SYPHILIS* 

09181 ACUTE SYPHIL MENINGITIS 

09182 SYPHILITIC ALOPECIA 

09189 SECONDARY SYPHILIS NEC 

0919 SECONDARY SYPHILIS NOS 

092 EARLY SYPHILIS LATENT* 

0920 EARLY SYPH LATENT RELAPS 

0929 EARLY SYPHIL LATENT NOS 

093 CARDIOVASCULAR SYPHILIS* 

0930 AORTIC ANEURYSM, SYPHIL 

0931 SYPHILITIC AORTITIS 

0932 SYPHILITIC ENDOCARDITIS* 

09320 SYPHIL ENDOCARDITIS NOS 

09321 SYPHILITIC MITRAL VALVE 

09322 SYPHILITIC AORTIC VALVE 

09323 SYPHIL TRICUSPID VALVE 

09324 SYPHIL PULMONARY VALVE 

0938 CARDIOVASCULAR SYPH NEC* 

09381 SYPHILITIC PERICARDITIS 

09382 SYPHILITIC MYOCARDITIS 

09389 CARDIOVASCULAR SYPH NEC 

0939 CARDIOVASCULAR SYPH NOS 

094 NEUROSYPHILIS* 

0940 TABES DORSALIS 

0941 GENERAL PARESIS 

0942 SYPHILITIC MENINGITIS 

0943 ASYMPTOMAT NEUROSYPHILIS 

0948 OTHER NEUROSYPHILIS* 

09481 SYPHILITIC ENCEPHALITIS 

09482 SYPHILITIC PARKINSONISM 

09483 SYPH DISSEM RETINITIS 

09484 SYPHILITIC OPTIC ATROPHY 

09485 SYPH RETROBULB NEURITIS 

09486 SYPHIL ACOUSTIC NEURITIS 

09487 SYPH RUPT CEREB ANEURYSM 

09489 NEUROSYPHILIS NEC 

0949 NEUROSYPHILIS NOS 

095 OTH LATE SYMPT SYPHILIS* 

0950 SYPHILITIC EPISCLERITIS 

0951 SYPHILIS OF LUNG

0952 SYPHILITIC PERITONITIS 

0953 SYPHILIS OF LIVER 

0954 SYPHILIS OF KIDNEY 

0955 SYPHILIS OF BONE 

0956 SYPHILIS OF MUSCLE 

0957 SYPHILIS OF TENDON/BURSA 

0958 LATE SYMPT SYPHILIS NEC 

0959 LATE SYMPT SYPHILIS NOS 

096 LATE SYPHILIS LATENT 

097 OTH & UNSPEC SYPHILIS* 

0970 LATE SYPHILIS NOS 

0971 LATENT SYPHILIS NOS 

0979 SYPHILIS NOS 

098 GONOCOCCAL INFECTIONS* 

0980 ACUTE GC INFECT LOWER GU 

0981 ACUTE GC INFECT UPPER GU* 

09810 GC (ACUTE) UPPER GU NOS 

09811 GC CYSTITIS (ACUTE) 

09812 GC PROSTATITIS (ACUTE) 

09813 GC ORCHITIS (ACUTE) 

09814 GC SEM VESICULIT (ACUTE) 

09815 GC CERVICITIS (ACUTE) 

09816 GC ENDOMETRITIS (ACUTE) 

09817 ACUTE GC SALPINGITIS 

09819 GC (ACUTE) UPPER GU NEC 

0982 CHR GC INFECT LOWER GU 

0983 CHR GC INFECT UPPER GU* 

09830 CHR GC UPPER GU NOS 

09831 GC CYSTITIS, CHRONIC 

09832 GC PROSTATITIS, CHRONIC 

09833 GC ORCHITIS, CHRONIC 

09834 GC SEM VESICULITIS, CHR 

09835 GC CERVICITIS, CHRONIC 

09836 GC ENDOMETRITIS, CHRONIC 

09837 GC SALPINGITIS (CHRONIC) 

09839 CHR GC UPPER GU NEC 

0984 GONOCOCCAL INFECTION EYE* 

09840 GONOCOCCAL CONJUNCTIVIT 

09841 GONOCOCCAL IRIDOCYCLITIS 

09842 GONOCOCCAL ENDOPHTHALMIA 

09843 GONOCOCCAL KERATITIS 

09849 GONOCOCCAL EYE NEC 

0985 GONOCOCCAL INFECT JOINT* 

09850 GONOCOCCAL ARTHRITIS 

09851 GONOCOCCAL SYNOVITIS 

09852 GONOCOCCAL BURSITIS 

09853 GONOCOCCAL SPONDYLITIS 

09859 GC INFECT JOINT NEC 

0986 GONOCOCCAL INFEC PHARYNX 

0987 GC INFECT ANUS & RECTUM 

0988 GONOCOCCAL INF OTH SITES* 

09881 GONOCOCCAL KERATOSIS 

09882 GONOCOCCAL MENINGITIS 

09883 GONOCOCCAL PERICARDITIS 

09884 GONOCOCCAL ENDOCARDITIS 

09885 GONOCOCCAL HEART DIS NEC 

09886 GONOCOCCAL PERITONITIS

09889 GONOCOCCAL INF SITE NEC 

099 OTHER VENEREAL DISEASE* 

0990 CHANCROID 

0991 LYMPHOGRANULOMA VENEREUM 

0992 GRANULOMA INGUINALE 

0993 REITER'S DISEASE 

0994 NONGONOCOCC URETHRIT NEC* 

09940 UNSPCF NONGNCCL URETHRTS 

09941 CHLMYD TRACHOMATIS URETH 

09949 NONGC URTH OTH SPF ORGSM 

09950 OTH VD CHLM TRCH UNSP ST 

09951 OTH VD CHLM TRCH PHARYNX 

09952 OTH VD CHLM TRCH ANS RCT 

09953 OTH VD CHLM TRCH LOWR GU 

09954 OTH VD CHLM TRCH OTH GU 

09955 OT VD CHLM TRCH UNSPF GU 

09956 OT VD CHLM TRCH PRTONEUM 

09959 OTH VD CHLM TRCH SPCF ST 

0998 VENEREAL DISEASE NEC 

0999 VENEREAL DISEASE NOS 

100 LEPTOSPIROSIS* 

1000 LEPTOSPIROS ICTEROHEM 

1008 OTH LEPTOSPIRAL INFECT* 

10081 LEPTOSPIRAL MENINGITIS 

10089 LEPTOSPIRAL INFECT NEC 

1009 LEPTOSPIROSIS NOS 

101 VINCENT'S ANGINA 

102 YAWS* 

1020 INITIAL LESIONS YAWS 

1021 MULTIPLE PAPILLOMATA 

1022 EARLY SKIN YAWS NEC 

1023 HYPERKERATOSIS OF YAWS 

1024 GUMMATA AND ULCERS, YAWS 

1025 GANGOSA 

1026 YAWS OF BONE & JOINT 

1027 YAWS MANIFESTATIONS NEC 

1028 LATENT YAWS 

1029 YAWS NOS 

103 PINTA* 

1030 PINTA PRIMARY LESIONS 

1031 PINTA INTERMED LESIONS 

1032 PINTA LATE LESIONS 

1033 PINTA MIXED LESIONS 

1039 PINTA NOS 

104 OTHER SPIROCHETAL INFECT* 

1040 NONVENEREAL ENDEMIC SYPH 

1048 SPIROCHETAL INFECT NEC 

1049 SPIROCHETAL INFECT NOS 

110 DERMATOPHYTOSIS* 

1100 DERMATOPHYT SCALP/BEARD 

1101 DERMATOPHYTOSIS OF NAIL 

1102 DERMATOPHYTOSIS OF HAND 

1103 DERMATOPHYTOSIS OF GROIN 

1104 DERMATOPHYTOSIS OF FOOT 

1105 DERMATOPHYTOSIS OF BODY 

1106 DEEP DERMATOPHYTOSIS 

1108 DERMATOPHYTOSIS SITE NEC

1109 DERMATOPHYTOSIS SITE NOS 

111 DERMATOMYCOSIS NEC/NOS* 

1110 PITYRIASIS VERSICOLOR 

1111 TINEA NIGRA 

1112 TINEA BLANCA 

1113 BLACK PIEDRA 

1118 DERMATOMYCOSES NEC 

1119 DERMATOMYCOSIS NOS 

112 CANDIDIASIS* 

1120 THRUSH 

1121 CANDIDAL VULVOVAGINITIS 

1122 CANDIDIAS UROGENITAL NEC 

1123 CUTANEOUS CANDIDIASIS 

1124 CANDIDIASIS OF LUNG 

1125 DISSEMINATED CANDIDIASIS 

1128 CANDIDIASIS OTHER SITES* 

11281 CANDIDAL ENDOCARDITIS 

11282 CANDIDAL OTITIS EXTERNA 

11283 CANDIDAL MENINGITIS 

11284 CANDIDAL ESOPHAGITIS 

11285 CANDIDAL ENTERITIS 

11289 CANDIDIASIS SITE NEC 

1129 CANDIDIASIS SITE NOS 

114 COCCIDIOIDOMYCOSIS* 

1140 PRIMARY COCCIDIOIDOMYCOS 

1141 PRIM CUTAN COCCIDIOID 

1142 COCCIDIOIDAL MENINGITIS 

1143 PROGRESS COCCIDIOID NEC 

1144 CH PL COCCIDIOIDOMYCOSIS 

1145 PL COCIDIOIDOMYCOSIS NOS 

1149 COCCIDIOIDOMYCOSIS NOS 

115 HISTOPLASMOSIS* 

1150 HISTOPLASMA CAPSULATUM* 

11500 HISTOPLASMA CAPSULAT NOS 

11501 HISTOPLASM CAPSUL MENING 

11502 HISTOPLASM CAPSUL RETINA 

11503 HISTOPLASM CAPS PERICARD 

11504 HISTOPLASM CAPS ENDOCARD 

11505 HISTOPLASM CAPS PNEUMON 

11509 HISTOPLASMA CAPSULAT NEC 

1151 HISTOPLASMA DUBOISII* 

11510 HISTOPLASMA DUBOISII NOS 

11511 HISTOPLASM DUBOIS MENING 

11512 HISTOPLASM DUBOIS RETINA 

11513 HISTOPLASM DUB PERICARD 

11514 HISTOPLASM DUB ENDOCARD 

11515 HISTOPLASM DUB PNEUMONIA 

11519 HISTOPLASMA DUBOISII NEC 

1159 HISTOPLASMOSIS, UNSPEC* 

11590 HISTOPLASMOSIS NOS 

11591 HISTOPLASMOSIS MENINGIT 

11592 HISTOPLASMOSIS RETINITIS 

11593 HISTOPLASMOSIS PERICARD 

11594 HISTOPLASMOSIS ENDOCARD 

11595 HISTOPLASMOSIS PNEUMONIA 

11599 HISTOPLASMOSIS NEC 

116 BLASTOMYCOTIC INFECTION*

1160 BLASTOMYCOSIS 

1161 PARACOCCIDIOIDOMYCOSIS 

1162 LOBOMYCOSIS 

117 OTHER MYCOSES* 

1170 RHINOSPORIDIOSIS 

1171 SPOROTRICHOSIS 

1172 CHROMOBLASTOMYCOSIS 

1173 ASPERGILLOSIS 

1174 MYCOTIC MYCETOMAS 

1175 CRYPTOCOCCOSIS 

1176 ALLESCHERIOSIS 

1177 ZYGOMYCOSIS 

1178 DEMATIACIOUS FUNGI INF 

1179 MYCOSES NEC & NOS 

118 OPPORTUNISTIC MYCOSES 

120 SCHISTOSOMIASIS* 

1200 SCHISTOSOMA HAEMATOBIUM 

1201 SCHISTOSOMA MANSONI 

1202 SCHISTOSOMA JAPONICUM 

1203 CUTANEOUS SCHISTOSOMA 

1208 SCHISTOSOMIASIS NEC 

1209 SCHISTOSOMIASIS NOS 

121 OTH TREMATODE INFECTION* 

1210 OPISTHORCHIASIS 

1211 CLONORCHIASIS 

1212 PARAGONIMIASIS 

1213 FASCIOLIASIS 

1214 FASCIOLOPSIASIS 

1215 METAGONIMIASIS 

1216 HETEROPHYIASIS 

1218 TREMATODE INFECTION NEC 

1219 TREMATODE INFECTION NOS 

122 ECHINOCOCCOSIS* 

1220 ECHINOCOCC GRANUL LIVER 

1221 ECHINOCOCC GRANUL LUNG 

1222 ECHINOCOCC GRAN THYROID 

1223 ECHINOCOCC GRANUL NEC 

1224 ECHINOCOCC GRANUL NOS 

1225 ECHINOCOC MULTILOC LIVER 

1226 ECHINOCOCC MULTILOC NEC 

1227 ECHINOCOCC MULTILOC NOS 

1228 ECHINOCOCCOSIS NOS LIVER 

1229 ECHINOCOCCOSIS NEC/NOS 

123 OTHER CESTODE INFECTION* 

1230 TAENIA SOLIUM INTESTINE 

1231 CYSTICERCOSIS 

1232 TAENIA SAGINATA INFECT 

1233 TAENIASIS NOS 

1234 DIPHYLLOBOTHRIAS INTEST 

1235 SPARGANOSIS 

1236 HYMENOLEPIASIS 

1238 CESTODE INFECTION NEC 

1239 CESTODE INFECTION NOS 

124 TRICHINOSIS 

125 FILARIAL INFECTION* 

1250 BANCROFTIAN FILARIASIS 

1251 MALAYAN FILARIASIS

1252 LOIASIS 

1253 ONCHOCERCIASIS 

1254 DIPETALONEMIASIS 

1255 MANSONELLA OZZARDI INFEC 

1256 FILARIASIS NEC 

1257 DRACONTIASIS 

1259 FILARIASIS NOS 

126 ANCYLOSTOMIASIS* 

1260 ANCYLOSTOMA DUODENALE 

1261 NECATOR AMERICANUS 

1262 ANCYLOSTOMA BRAZILIENSE 

1263 ANCYLOSTOMA CEYLANICUM 

1268 ANCYLOSTOMA NEC 

1269 ANCYLOSTOMIASIS NOS 

127 OTH INTEST HELMINTHIASES* 

1270 ASCARIASIS 

1271 ANISAKIASIS 

1272 STRONGYLOIDIASIS 

1273 TRICHURIASIS 

1274 ENTEROBIASIS 

1275 CAPILLARIASIS 

1276 TRICHOSTRONGYLIASIS 

1277 INTEST HELMINTHIASIS NEC 

1278 MIXED INTESTINE HELMINTH 

1279 INTEST HELMINTHIASIS NOS 

128 HELMINTHIASES NEC & NOS* 

1280 TOXOCARIASIS 

1281 GNATHOSTOMIASIS 

1288 HELMINTHIASIS NEC 

1289 HELMINTHIASIS NOS 

129 INTESTIN PARASITISM NOS 

130 TOXOPLASMOSIS* 

1300 TOXOPLASM MENINGOENCEPH 

1301 TOXOPLASM CONJUNCTIVITIS 

1302 TOXOPLASM CHORIORETINIT 

1303 TOXOPLASMA MYOCARDITIS 

1304 TOXOPLASMA PNEUMONITIS 

1305 TOXOPLASMA HEPATITIS 

1307 TOXOPLASMOSIS SITE NEC 

1308 MULTISYSTEM TOXOPLASMOS 

1309 TOXOPLASMOSIS NOS 

131 TRICHOMONIASIS* 

1310 UROGENITAL TRICHOMONIAS* 

13100 UROGENITAL TRICHOMON NOS 

13101 TRICHOMONAL VAGINITIS 

13102 TRICHOMONAL URETHRITIS 

13103 TRICHOMONAL PROSTATITIS 

13109 UROGENITAL TRICHOMON NEC 

1318 TRICHOMONIASIS NEC 

1319 TRICHOMONIASIS NOS 

132 PEDICULOSIS AND PHTHIRUS* 

1320 PEDICULUS CAPITIS 

1321 PEDICULUS CORPORIS 

1322 PHTHIRUS PUBIS 

1323 MIXED PEDICUL & PHTHIRUS 

1329 PEDICULOSIS NOS 

133 ACARIASIS*

1330 SCABIES 

1338 ACARIASIS NEC 

1339 ACARIASIS NOS 

134 OTHER INFESTATION* 

1340 MYIASIS 

1341 ARTHROPOD INFEST NEC 

1342 HIRUDINIASIS 

1348 INFESTATION NEC 

1349 INFESTATION NOS 

135 SARCOIDOSIS 

136 INF/PARASITE DIS NEC/NOS* 

1360 AINHUM 

1361 BEHCET'S SYNDROME 

1362 FREE-LIVING AMEBA INFECT 

1363 PNEUMOCYSTOSIS 

1364 PSOROSPERMIASIS 

1365 SARCOSPORIDIOSIS 

1368 INFECT/PARASITE DIS NEC 

1369 INFECT/PARASITE DIS NOS 

137 LATE EFFECT TUBERCULOSIS* 

1370 LATE EFFECT TB, RESP/NOS 

1371 LATE EFFECT CNS TB 

1372 LATE EFFECT GU TB 

1373 LATE EFF BONE & JOINT TB 

1374 LATE EFFECT TB NEC 

138 LATE EFFECT ACUTE POLIO 

139 LATE EFFECT INFECT NEC* 

1390 LATE EFF VIRAL ENCEPHAL 

1391 LATE EFFECT OF TRACHOMA 

1398 LATE EFF INFECT DIS NEC 

140 MALIGNANT NEOPLASM LIP* 

1400 MAL NEO UPPER VERMILION 

1401 MAL NEO LOWER VERMILION 

1403 MAL NEO UPPER LIP, INNER 

1404 MAL NEO LOWER LIP, INNER 

1405 MAL NEO LIP, INNER NOS 

1406 MAL NEO LIP, COMMISSURE 

1408 MAL NEO LIP NEC 

1409 MAL NEO LIP/VERMIL NOS 

141 MALIG NEO TONGUE* 

1410 MAL NEO TONGUE BASE 

1411 MAL NEO DORSAL TONGUE 

1412 MAL NEO TIP/LAT TONGUE 

1413 MAL NEO VENTRAL TONGUE 

1414 MAL NEO ANT 2/3 TONGUE 

1415 MAL NEO TONGUE JUNCTION 

1416 MAL NEO LINGUAL TONSIL 

1418 MALIG NEO TONGUE NEC 

1419 MALIG NEO TONGUE NOS 

142 MAL NEO MAJOR SALIVARY* 

1420 MALIG NEO PAROTID 

1421 MALIG NEO SUBMANDIBULAR 

1422 MALIG NEO SUBLINGUAL 

1428 MAL NEO MAJ SALIVARY NEC 

1429 MAL NEO SALIVARY NOS 

143 MALIGNANT NEOPLASM GUM* 

1430 MALIG NEO UPPER GUM

1431 MALIG NEO LOWER GUM 

1438 MALIG NEO GUM NEC 

1439 MALIG NEO GUM NOS 

144 MALIG NEO MOUTH FLOOR* 

1440 MAL NEO ANT FLOOR MOUTH 

1441 MAL NEO LAT FLOOR MOUTH 

1448 MAL NEO MOUTH FLOOR NEC 

1449 MAL NEO MOUTH FLOOR NOS 

145 MALIG NEO MOUTH NEC/NOS* 

1450 MAL NEO CHEEK MUCOSA 

1451 MAL NEO MOUTH VESTIBULE 

1452 MALIG NEO HARD PALATE 

1453 MALIG NEO SOFT PALATE 

1454 MALIGNANT NEOPLASM UVULA 

1455 MALIGNANT NEO PALATE NOS 

1456 MALIG NEO RETROMOLAR 

1458 MALIG NEOPLASM MOUTH NEC 

1459 MALIG NEOPLASM MOUTH NOS 

146 MALIG NEO OROPHARYNX* 

1460 MALIGNANT NEOPL TONSIL 

1461 MAL NEO TONSILLAR FOSSA 

1462 MAL NEO TONSIL PILLARS 

1463 MALIGN NEOPL VALLECULA 

1464 MAL NEO ANT EPIGLOTTIS 

1465 MAL NEO EPIGLOTTIS JUNCT 

1466 MAL NEO LAT OROPHARYNX 

1467 MAL NEO POST OROPHARYNX 

1468 MAL NEO OROPHARYNX NEC 

1469 MALIG NEO OROPHARYNX NOS 

147 MALIG NEO NASOPHARYNX* 

1470 MAL NEO SUPER NASOPHARYN 

1471 MAL NEO POST NASOPHARYNX 

1472 MAL NEO LAT NASOPHARYNX 

1473 MAL NEO ANT NASOPHARYNX 

1478 MAL NEO NASOPHARYNX NEC 

1479 MAL NEO NASOPHARYNX NOS 

148 MALIG NEOPL HYPOPHARYNX* 

1480 MAL NEO POSTCRICOID 

1481 MAL NEO PYRIFORM SINUS 

1482 MAL NEO ARYEPIGLOTT FOLD 

1483 MAL NEO POST HYPOPHARYNX 

1488 MAL NEO HYPOPHARYNX NEC 

1489 MAL NEO HYPOPHARYNX NOS 

149 OTH MALIG NEO OROPHARYNX* 

1490 MAL NEO PHARYNX NOS 

1491 MAL NEO WALDEYER'S RING 

1498 MAL NEO ORAL/PHARYNX NEC 

1499 MAL NEO OROPHRYN ILL-DEF 

150 MALIGNANT NEO ESOPHAGUS* 

1500 MAL NEO CERVICAL ESOPHAG 

1501 MAL NEO THORACIC ESOPHAG 

1502 MAL NEO ABDOMIN ESOPHAG 

1503 MAL NEO UPPER 3RD ESOPH 

1504 MAL NEO MIDDLE 3RD ESOPH 

1505 MAL NEO LOWER 3RD ESOPH 

1508 MAL NEO ESOPHAGUS NEC 

1509 MAL NEO ESOPHAGUS NOS

151 MALIGNANT NEO STOMACH* 

1510 MAL NEO STOMACH CARDIA 

1511 MALIGNANT NEO PYLORUS 

1512 MAL NEO PYLORIC ANTRUM 

1513 MAL NEO STOMACH FUNDUS 

1514 MAL NEO STOMACH BODY 

1515 MAL NEO STOM LESSER CURV 

1516 MAL NEO STOM GREAT CURV 

1518 MALIG NEOPL STOMACH NEC 

1519 MALIG NEOPL STOMACH NOS 

152 MALIG NEO SMALL BOWEL* 

1520 MALIGNANT NEOPL DUODENUM 

1521 MALIGNANT NEOPL JEJUNUM 

1522 MALIGNANT NEOPLASM ILEUM 

1523 MAL NEO MECKEL'S DIVERT 

1528 MAL NEO SMALL BOWEL NEC 

1529 MAL NEO SMALL BOWEL NOS 

153 MALIGNANT NEOPLASM COLON* 

1530 MAL NEO HEPATIC FLEXURE 

1531 MAL NEO TRANSVERSE COLON 

1532 MAL NEO DESCEND COLON 

1533 MAL NEO SIGMOID COLON 

1534 MALIGNANT NEOPLASM CECUM 

1535 MALIGNANT NEO APPENDIX 

1536 MALIG NEO ASCEND COLON 

1537 MAL NEO SPLENIC FLEXURE 

1538 MALIGNANT NEO COLON NEC 

1539 MALIGNANT NEO COLON NOS 

154 MALIG NEO RECTUM/ANUS* 

1540 MAL NEO RECTOSIGMOID JCT 

1541 MALIGNANT NEOPL RECTUM 

1542 MALIG NEOPL ANAL CANAL 

1543 MALIGNANT NEO ANUS NOS 

1548 MAL NEO RECTUM/ANUS NEC 

155 MALIGNANT NEOPLASM LIVER* 

1550 MAL NEO LIVER, PRIMARY 

1551 MAL NEO INTRAHEPAT DUCTS 

1552 MALIGNANT NEO LIVER NOS 

156 MAL NEO GB/EXTRAHEPATIC* 

1560 MALIG NEO GALLBLADDER 

1561 MAL NEO EXTRAHEPAT DUCTS 

1562 MAL NEO AMPULLA OF VATER 

1568 MALIG NEO BILIARY NEC 

1569 MALIG NEO BILIARY NOS 

157 MALIGNANT NEO PANCREAS* 

1570 MAL NEO PANCREAS HEAD 

1571 MAL NEO PANCREAS BODY 

1572 MAL NEO PANCREAS TAIL 

1573 MAL NEO PANCREATIC DUCT 

1574 MAL NEO ISLET LANGERHANS 

1578 MALIG NEO PANCREAS NEC 

1579 MALIG NEO PANCREAS NOS 

158 MALIG NEO PERITONEUM* 

1580 MAL NEO RETROPERITONEUM 

1588 MAL NEO PERITONEUM NEC 

1589 MAL NEO PERITONEUM NOS 

159 OTH MALIG NEO GI/PERITON*

1590 MALIG NEO INTESTINE NOS 

1591 MALIGNANT NEO SPLEEN NEC 

1598 MAL NEO GI/INTRA-ABD NEC 

1599 MAL NEO GI TRACT ILL-DEF 

160 MAL NEO NASAL CAV/SINUS* 

1600 MAL NEO NASAL CAVITIES 

1601 MALIG NEO MIDDLE EAR 

1602 MAL NEO MAXILLARY SINUS 

1603 MAL NEO ETHMOIDAL SINUS 

1604 MALIG NEO FRONTAL SINUS 

1605 MAL NEO SPHENOID SINUS 

1608 MAL NEO ACCESS SINUS NEC 

1609 MAL NEO ACCESS SINUS NOS 

161 MALIGNANT NEO LARYNX* 

1610 MALIGNANT NEO GLOTTIS 

1611 MALIG NEO SUPRAGLOTTIS 

1612 MALIG NEO SUBGLOTTIS 

1613 MAL NEO CARTILAGE LARYNX 

1618 MALIGNANT NEO LARYNX NEC 

1619 MALIGNANT NEO LARYNX NOS 

162 MAL NEO TRACHEA/LUNG* 

1620 MALIGNANT NEO TRACHEA 

1622 MALIG NEO MAIN BRONCHUS 

1623 MAL NEO UPPER LOBE LUNG 

1624 MAL NEO MIDDLE LOBE LUNG 

1625 MAL NEO LOWER LOBE LUNG 

1628 MAL NEO BRONCH/LUNG NEC 

1629 MAL NEO BRONCH/LUNG NOS 

163 MALIGNANT NEOPL PLEURA* 

1630 MAL NEO PARIETAL PLEURA 

1631 MAL NEO VISCERAL PLEURA 

1638 MALIG NEOPL PLEURA NEC 

1639 MALIG NEOPL PLEURA NOS 

164 MAL NEO THYMUS/MEDIASTIN* 

1640 MALIGNANT NEOPL THYMUS 

1641 MALIGNANT NEOPL HEART 

1642 MAL NEO ANT MEDIASTINUM 

1643 MAL NEO POST MEDIASTINUM 

1648 MAL NEO MEDIASTINUM NEC 

1649 MAL NEO MEDIASTINUM NOS 

165 OTH/ILL-DEF MAL NEO RESP* 

1650 MAL NEO UPPER RESP NOS 

1658 MAL NEO THORAX/RESP NEC 

1659 MAL NEO RESP SYSTEM NOS 

170 MAL NEO BONE/ARTIC CART* 

1700 MAL NEO SKULL/FACE BONE 

1701 MALIGNANT NEO MANDIBLE 

1702 MALIG NEO VERTEBRAE 

1703 MAL NEO RIBS/STERN/CLAV 

1704 MAL NEO LONG BONES ARM 

1705 MAL NEO BONES WRIST/HAND 

1706 MAL NEO PELVIC GIRDLE 

1707 MAL NEO LONG BONES LEG 

1708 MAL NEO BONES ANKLE/FOOT 

1709 MALIG NEOPL BONE NOS 

171 MAL NEO SOFT TISSUE* 

1710 MAL NEO SOFT TISSUE HEAD

1712 MAL NEO SOFT TISSUE ARM 

1713 MAL NEO SOFT TISSUE LEG 

1714 MAL NEO SOFT TIS THORAX 

1715 MAL NEO SOFT TIS ABDOMEN 

1716 MAL NEO SOFT TIS PELVIS 

1717 MAL NEOPL TRUNK NOS 

1718 MAL NEO SOFT TISSUE NEC 

1719 MAL NEO SOFT TISSUE NOS 

172 MALIGNANT MELANOMA SKIN* 

1720 MALIG MELANOMA LIP 

1721 MALIG MELANOMA EYELID 

1722 MALIG MELANOMA EAR 

1723 MAL MELANOM FACE NEC/NOS 

1724 MAL MELANOMA SCALP/NECK 

1725 MALIG MELANOMA TRUNK 

1726 MALIG MELANOMA ARM 

1727 MALIG MELANOMA LEG 

1728 MALIG MELANOMA SKIN NEC 

1729 MALIG MELANOMA SKIN NOS 

173 OTHER MALIG NEOPL SKIN* 

1730 MALIG NEO SKIN LIP 

1731 MALIG NEO SKIN EYELID 

1732 MALIG NEO SKIN EAR 

1733 MAL NEO SKIN FACE NEC 

1734 MAL NEO SCALP/SKIN NECK 

1735 MALIG NEO SKIN TRUNK 

1736 MALIG NEO SKIN ARM 

1737 MALIG NEO SKIN LEG 

1738 MALIG NEO SKIN NEC 

1739 MALIG NEO SKIN NOS 

174 MALIG NEO FEMALE BREAST* 

1740 MALIG NEO NIPPLE 

1741 MAL NEO BREAST-CENTRAL 

1742 MAL NEO BREAST UP-INNER 

1743 MAL NEO BREAST LOW-INNER 

1744 MAL NEO BREAST UP-OUTER 

1745 MAL NEO BREAST LOW-OUTER 

1746 MAL NEO BREAST-AXILLARY 

1748 MALIGN NEOPL BREAST NEC 

1749 MALIGN NEOPL BREAST NOS 

175 MALIG NEO MALE BREAST* 

1750 MAL NEO MALE NIPPLE 

1759 MAL NEO MALE BREAST NEC 

1760 SKIN - KAPOSI'S SARCOMA 

1761 SFT TISUE - KPSI'S SRCMA 

1762 PALATE - KPSI's SARCOMA 

1763 GI SITES - KPSI'S SRCOMA 

1764 LUNG - KAPOSI'S SARCOMA 

1765 LYM NDS - KPSI'S SARCOMA 

1768 SPF STS - KPSI'S SARCOMA 

1769 KAPOSI'S SARCOMA NOS 

179 MALIG NEOPL UTERUS NOS 

180 MALIG NEOPL CERVIX UTERI* 

1800 MALIG NEO ENDOCERVIX 

1801 MALIG NEO EXOCERVIX 

1808 MALIG NEO CERVIX NEC 

1809 MAL NEO CERVIX UTERI NOS

181 MALIGNANT NEOPL PLACENTA 

182 MALIG NEOPL UTERUS BODY* 

1820 MALIG NEO CORPUS UTERI 

1821 MAL NEO UTERINE ISTHMUS 

1828 MAL NEO BODY UTERUS NEC 

183 MAL NEO UTERINE ADNEXA* 

1830 MALIGN NEOPL OVARY 

1832 MAL NEO FALLOPIAN TUBE 

1833 MAL NEO BROAD LIGAMENT 

1834 MALIG NEO PARAMETRIUM 

1835 MAL NEO ROUND LIGAMENT 

1838 MAL NEO ADNEXA NEC 

1839 MAL NEO ADNEXA NOS 

184 MAL NEO FEM GEN NEC/NOS* 

1840 MALIGN NEOPL VAGINA 

1841 MAL NEO LABIA MAJORA 

1842 MAL NEO LABIA MINORA 

1843 MALIGN NEOPL CLITORIS 

1844 MALIGN NEOPL VULVA NOS 

1848 MAL NEO FEMALE GENIT NEC 

1849 MAL NEO FEMALE GENIT NOS 

185 MALIGN NEOPL PROSTATE 

186 MALIGN NEOPL TESTIS* 

1860 MAL NEO UNDESCEND TESTIS 

1869 MALIG NEO TESTIS NEC 

187 MAL NEO MALE GENITAL NEC* 

1871 MALIGN NEOPL PREPUCE 

1872 MALIG NEO GLANS PENIS 

1873 MALIG NEO PENIS BODY 

1874 MALIG NEO PENIS NOS 

1875 MALIG NEO EPIDIDYMIS 

1876 MAL NEO SPERMATIC CORD 

1877 MALIGN NEOPL SCROTUM 

1878 MAL NEO MALE GENITAL NEC 

1879 MAL NEO MALE GENITAL NOS 

188 MALIGN NEOPL BLADDER* 

1880 MAL NEO BLADDER-TRIGONE 

1881 MAL NEO BLADDER-DOME 

1882 MAL NEO BLADDER-LATERAL 

1883 MAL NEO BLADDER-ANTERIOR 

1884 MAL NEO BLADDER-POST 

1885 MAL NEO BLADDER NECK 

1886 MAL NEO URETERIC ORIFICE 

1887 MALIG NEO URACHUS 

1888 MALIG NEO BLADDER NEC 

1889 MALIG NEO BLADDER NOS 

189 MAL NEO URINARY NEC/NOS* 

1890 MALIG NEOPL KIDNEY 

1891 MALIG NEO RENAL PELVIS 

1892 MALIGN NEOPL URETER 

1893 MALIGN NEOPL URETHRA 

1894 MAL NEO PARAURETHRAL 

1898 MAL NEO URINARY NEC 

1899 MAL NEO URINARY NOS 

190 MALIGNANT NEOPLASM EYE* 

1900 MALIGN NEOPL EYEBALL 

1901 MALIGN NEOPL ORBIT

1902 MAL NEO LACRIMAL GLAND 

1903 MAL NEO CONJUNCTIVA 

1904 MALIGN NEOPL CORNEA 

1905 MALIGN NEOPL RETINA 

1906 MALIGN NEOPL CHOROID 

1907 MAL NEO LACRIMAL DUCT 

1908 MALIGN NEOPL EYE NEC 

1909 MALIGN NEOPL EYE NOS 

191 MALIGNANT NEOPLASM BRAIN* 

1910 MALIGN NEOPL CEREBRUM 

1911 MALIG NEO FRONTAL LOBE 

1912 MAL NEO TEMPORAL LOBE 

1913 MAL NEO PARIETAL LOBE 

1914 MAL NEO OCCIPITAL LOBE 

1915 MAL NEO CEREB VENTRICLE 

1916 MAL NEO CEREBELLUM NOS 

1917 MAL NEO BRAIN STEM 

1918 MALIG NEO BRAIN NEC 

1919 MALIG NEO BRAIN NOS 

192 MAL NEO NERVE NEC/NOS* 

1920 MAL NEO CRANIAL NERVES 

1921 MAL NEO CEREBRAL MENING 

1922 MAL NEO SPINAL CORD 

1923 MAL NEO SPINAL MENINGES 

1928 MAL NEO NERVOUS SYST NEC 

1929 MAL NEO NERVOUS SYST NOS 

193 MALIGN NEOPL THYROID 

194 MAL NEO OTHER ENDOCRINE* 

1940 MALIGN NEOPL ADRENAL 

1941 MALIG NEO PARATHYROID 

1943 MALIG NEO PITUITARY 

1944 MALIGN NEO PINEAL GLAND 

1945 MAL NEO CAROTID BODY 

1946 MAL NEO PARAGANGLIA NEC 

1948 MAL NEO ENDOCRINE NEC 

1949 MAL NEO ENDOCRINE NOS 

195 MAL NEO OTH/ILL-DEF SITE* 

1950 MAL NEO HEAD/FACE/NECK 

1951 MALIGN NEOPL THORAX 

1952 MALIG NEO ABDOMEN 

1953 MALIGN NEOPL PELVIS 

1954 MALIGN NEOPL ARM 

1955 MALIGN NEOPL LEG 

1958 MALIG NEO SITE NEC 

196 MALIG NEO LYMPH NODES* 

1960 MAL NEO LYMPH-HEAD/NECK 

1961 MAL NEO LYMPH-INTRATHOR 

1962 MAL NEO LYMPH INTRA-ABD 

1963 MAL NEO LYMPH-AXILLA/ARM 

1965 MAL NEO LYMPH-INGUIN/LEG 

1966 MAL NEO LYMPH-INTRAPELV 

1968 MAL NEO LYMPH NODE-MULT 

1969 MAL NEO LYMPH NODE NOS 

197 SECONDRY MAL NEO GI/RESP* 

1970 SECONDARY MALIG NEO LUNG 

1971 SEC MAL NEO MEDIASTINUM 

1972 SECOND MALIG NEO PLEURA

1973 SEC MALIG NEO RESP NEC 

1974 SEC MALIG NEO SM BOWEL 

1975 SEC MALIG NEO LG BOWEL 

1976 SEC MAL NEO PERITONEUM 

1977 SECOND MALIG NEO LIVER 

1978 SEC MAL NEO GI NEC 

198 SEC MALIG NEO OTH SITES* 

1980 SECOND MALIG NEO KIDNEY 

1981 SEC MALIG NEO URIN NEC 

1982 SECONDARY MALIG NEO SKIN 

1983 SEC MAL NEO BRAIN/SPINE 

1984 SEC MALIG NEO NERVE NEC 

1985 SECONDARY MALIG NEO BONE 

1986 SECOND MALIG NEO OVARY 

1987 SECOND MALIG NEO ADRENAL 

1988 OTH SECONDARY MALIG NEO* 

19881 SECOND MALIG NEO BREAST 

19882 SECOND MALIG NEO GENITAL 

19889 SECONDARY MALIG NEO NEC 

199 MALIGNANT NEOPLASM NOS* 

1990 MALIG NEO DISSEMINATED 

1991 MALIGNANT NEOPLASM NOS 

200 LYMPHOSARC/RETICULOSARC* 

2000 RETICULOSARCOMA* 

20000 RETCLSRC UNSP XTRNDL ORG 

20001 RETICULOSARCOMA HEAD 

20002 RETICULOSARCOMA THORAX 

20003 RETICULOSARCOMA ABDOM 

20004 RETICULOSARCOMA AXILLA 

20005 RETICULOSARCOMA INGUIN 

20006 RETICULOSARCOMA PELVIC 

20007 RETICULOSARCOMA SPLEEN 

20008 RETICULOSARCOMA MULT 

2001 LYMPHOSARCOMA* 

20010 LYMPHSRC UNSP XTRNDL ORG 

20011 LYMPHOSARCOMA HEAD 

20012 LYMPHOSARCOMA THORAX 

20013 LYMPHOSARCOMA ABDOM 

20014 LYMPHOSARCOMA AXILLA 

20015 LYMPHOSARCOMA INGUIN 

20016 LYMPHOSARCOMA PELVIC 

20017 LYMPHOSARCOMA SPLEEN 

20018 LYMPHOSARCOMA MULT 

2002 BURKITT'S TUMOR/LYMPHOMA* 

20020 BRKT TMR UNSP XTRNDL ORG 

20021 BURKITT'S TUMOR HEAD 

20022 BURKITT'S TUMOR THORAX 

20023 BURKITT'S TUMOR ABDOM 

20024 BURKITT'S TUMOR AXILLA 

20025 BURKITT'S TUMOR INGUIN 

20026 BURKITT'S TUMOR PELVIC 

20027 BURKITT'S TUMOR SPLEEN 

20028 BURKITT'S TUMOR MULT 

2008 MIXED LYMPHOSARCOMA* 

20080 OTH VARN UNSP XTRNDL ORG 

20081 MIXED LYMPHOSARC HEAD 

20082 MIXED LYMPHOSARC THORAX

20083 MIXED LYMPHOSARC ABDOM 

20084 MIXED LYMPHOSARC AXILLA 

20085 MIXED LYMPHOSARC INGUIN 

20086 MIXED LYMPHOSARC PELVIC 

20087 MIXED LYMPHOSARC SPLEEN 

20088 MIXED LYMPHOSARC MULT 

201 HODGKIN'S DISEASE* 

2010 HODGKIN'S PARAGRANULOMA* 

20100 HDGK PRG UNSP XTRNDL ORG 

20101 HODGKINS PARAGRAN HEAD 

20102 HODGKINS PARAGRAN THORAX 

20103 HODGKINS PARAGRAN ABDOM 

20104 HODGKINS PARAGRAN AXILLA 

20105 HODGKINS PARAGRAN INGUIN 

20106 HODGKINS PARAGRAN PELVIC 

20107 HODGKINS PARAGRAN SPLEEN 

20108 HODGKINS PARAGRAN MULT 

2011 HODGKIN'S GRANULOMA* 

20110 HDGK GRN UNSP XTRNDL ORG 

20111 HODGKINS GRANULOM HEAD 

20112 HODGKINS GRANULOM THORAX 

20113 HODGKINS GRANULOM ABDOM 

20114 HODGKINS GRANULOM AXILLA 

20115 HODGKINS GRANULOM INGUIN 

20116 HODGKINS GRANULOM PELVIC 

20117 HODGKINS GRANULOM SPLEEN 

20118 HODGKINS GRANULOM MULT 

2012 HODGKIN'S SARCOMA* 

20120 HDGK SRC UNSP XTRNDL ORG 

20121 HODGKINS SARCOMA HEAD 

20122 HODGKINS SARCOMA THORAX 

20123 HODGKINS SARCOMA ABDOM 

20124 HODGKINS SARCOMA AXILLA 

20125 HODGKINS SARCOMA INGUIN 

20126 HODGKINS SARCOMA PELVIC 

20127 HODGKINS SARCOMA SPLEEN 

20128 HODGKINS SARCOMA MULT 

2014 HODGKINS LYMPH-HISTIOCYT* 

20140 LYM-HST UNSP XTRNDL ORGN 

20141 HODG LYMPH-HISTIO HEAD 

20142 HODG LYMPH-HISTIO THORAX 

20143 HODG LYMPH-HISTIO ABDOM 

20144 HODG LYMPH-HISTIO AXILLA 

20145 HODG LYMPH-HISTIO INGUIN 

20146 HODG LYMPH-HISTIO PELVIC 

20147 HODG LYMPH-HISTIO SPLEEN 

20148 HODG LYMPH-HISTIO MULT 

2015 HODGKINS NODULAR SCLEROS* 

20150 NDR SCLR UNSP XTRNDL ORG 

20151 HODG NODUL SCLERO HEAD 

20152 HODG NODUL SCLERO THORAX 

20153 HODG NODUL SCLERO ABDOM 

20154 HODG NODUL SCLERO AXILLA 

20155 HODG NODUL SCLERO INGUIN 

20156 HODG NODUL SCLERO PELVIC 

20157 HODG NODUL SCLERO SPLEEN 

20158 HODG NODUL SCLERO MULT

2016 HODGKINS MIX CELLULARITY* 

20160 MXD CELR UNSP XTRNDL ORG 

20161 HODGKINS MIX CELL HEAD 

20162 HODGKINS MIX CELL THORAX 

20163 HODGKINS MIX CELL ABDOM 

20164 HODGKINS MIX CELL AXILLA 

20165 HODGKINS MIX CELL INGUIN 

20166 HODGKINS MIX CELL PELVIC 

20167 HODGKINS MIX CELL SPLEEN 

20168 HODGKINS MIX CELL MULT 

2017 HODG LYMPHOCYTIC DEPLET* 

20170 LYM DPLT UNSP XTRNDL ORG 

20171 HODG LYMPH DEPLET HEAD 

20172 HODG LYMPH DEPLET THORAX 

20173 HODG LYMPH DEPLET ABDOM 

20174 HODG LYMPH DEPLET AXILLA 

20175 HODG LYMPH DEPLET INGUIN 

20176 HODG LYMPH DEPLET PELVIC 

20177 HODG LYMPH DEPLET SPLEEN 

20178 HODG LYMPH DEPLET MULT 

2019 HODGKINS DISEASE NOS* 

20190 HDGK DIS UNSP XTRNDL ORG 

20191 HODGKINS DIS NOS HEAD 

20192 HODGKINS DIS NOS THORAX 

20193 HODGKINS DIS NOS ABDOM 

20194 HODGKINS DIS NOS AXILLA 

20195 HODGKINS DIS NOS INGUIN 

20196 HODGKINS DIS NOS PELVIC 

20197 HODGKINS DIS NOS SPLEEN 

20198 HODGKINS DIS NOS MULT 

202 OTH MAL NEO LYMPH/HISTIO* 

2020 NODULAR LYMPHOMA* 

20200 NDLR LYM UNSP XTRNDL ORG 

20201 NODULAR LYMPHOMA HEAD 

20202 NODULAR LYMPHOMA THORAX 

20203 NODULAR LYMPHOMA ABDOM 

20204 NODULAR LYMPHOMA AXILLA 

20205 NODULAR LYMPHOMA INGUIN 

20206 NODULAR LYMPHOMA PELVIC 

20207 NODULAR LYMPHOMA SPLEEN 

20208 NODULAR LYMPHOMA MULT 

2021 MYCOSIS FUNGOIDES* 

20210 MYCS FNG UNSP XTRNDL ORG 

20211 MYCOSIS FUNGOIDES HEAD 

20212 MYCOSIS FUNGOIDES THORAX 

20213 MYCOSIS FUNGOIDES ABDOM 

20214 MYCOSIS FUNGOIDES AXILLA 

20215 MYCOSIS FUNGOIDES INGUIN 

20216 MYCOSIS FUNGOIDES PELVIC 

20217 MYCOSIS FUNGOIDES SPLEEN 

20218 MYCOSIS FUNGOIDES MULT 

2022 SEZARY'S DISEASE* 

20220 SZRY DIS UNSP XTRNDL ORG 

20221 SEZARY'S DISEASE HEAD 

20222 SEZARY'S DISEASE THORAX 

20223 SEZARY'S DISEASE ABDOM 

20224 SEZARY'S DISEASE AXILLA

20225 SEZARY'S DISEASE INGUIN 

20226 SEZARY'S DISEASE PELVIC 

20227 SEZARY'S DISEASE SPLEEN 

20228 SEZARY'S DISEASE MULT 

2023 MALIGNANT HISTIOCYTOSIS* 

20230 MLG HIST UNSP XTRNDL ORG 

20231 MAL HISTIOCYTOSIS HEAD 

20232 MAL HISTIOCYTOSIS THORAX 

20233 MAL HISTIOCYTOSIS ABDOM 

20234 MAL HISTIOCYTOSIS AXILLA 

20235 MAL HISTIOCYTOSIS INGUIN 

20236 MAL HISTIOCYTOSIS PELVIC 

20237 MAL HISTIOCYTOSIS SPLEEN 

20238 MAL HISTIOCYTOSIS MULT 

2024 LEUKEM RETICULOENDOTHEL* 

20240 LK RTCTL UNSP XTRNDL ORG 

20241 HAIRY-CELL LEUKEM HEAD 

20242 HAIRY-CELL LEUKEM THORAX 

20243 HAIRY-CELL LEUKEM ABDOM 

20244 HAIRY-CELL LEUKEM AXILLA 

20245 HAIRY-CELL LEUKEM INGUIN 

20246 HAIRY-CELL LEUKEM PELVIC 

20247 HAIRY-CELL LEUKEM SPLEEN 

20248 HAIRY-CELL LEUKEM MULT 

2025 LETTERER-SIWE DISEASE* 

20250 LTR-SIWE UNSP XTRNDL ORG 

20251 LETTERER-SIWE DIS HEAD 

20252 LETTERER-SIWE DIS THORAX 

20253 LETTERER-SIWE DIS ABDOM 

20254 LETTERER-SIWE DIS AXILLA 

20255 LETTERER-SIWE DIS INGUIN 

20256 LETTERER-SIWE DIS PELVIC 

20257 LETTERER-SIWE DIS SPLEEN 

20258 LETTERER-SIWE DIS MULT 

2026 MALIG MAST CELL TUMORS* 

20260 MLG MAST UNSP XTRNDL ORG 

20261 MAL MASTOCYTOSIS HEAD 

20262 MAL MASTOCYTOSIS THORAX 

20263 MAL MASTOCYTOSIS ABDOM 

20264 MAL MASTOCYTOSIS AXILLA 

20265 MAL MASTOCYTOSIS INGUIN 

20266 MAL MASTOCYTOSIS PELVIC 

20267 MAL MASTOCYTOSIS SPLEEN 

20268 MAL MASTOCYTOSIS MULT 

2028 LYMPHOMAS NEC* 

20280 OTH LYMP UNSP XTRNDL ORG 

20281 LYMPHOMAS NEC HEAD 

20282 LYMPHOMAS NEC THORAX 

20283 LYMPHOMAS NEC ABDOM 

20284 LYMPHOMAS NEC AXILLA 

20285 LYMPHOMAS NEC INGUIN 

20286 LYMPHOMAS NEC PELVIC 

20287 LYMPHOMAS NEC SPLEEN 

20288 LYMPHOMAS NEC MULT 

2029 MAL NEO LYM/HIST TIS NEC* 

20290 UNSP LYM UNSP XTRNDL ORG 

20291 LYMPHOID MAL NEC HEAD

20292 LYMPHOID MAL NEC THORAX 

20293 LYMPHOID MAL NEC ABDOM 

20294 LYMPHOID MAL NEC AXILLA 

20295 LYMPHOID MAL NEC INGUIN 

20296 LYMPHOID MAL NEC PELVIC 

20297 LYMPHOID MAL NEC SPLEEN 

20298 LYMPHOID MAL NEC MULT 

203 MULTIPLE MYELOMA ET AL* 

2030 MULTIPLE MYELOMA* 

20300 MULT MYELM W/O REMISSION 

20301 MULT MYELM W REMISSION 

2031 PLASMA CELL LEUKEMIA* 

20310 PLSM CELL LEUK W/O RMSON 

20311 PLSM CELL LEUK W RMSON 

2038 IMMUNOPROLIFERAT NEO NEC* 

20380 OTH IMNPRFL NPL W/O RMSN 

20381 OTH IMNPRFL NPL W RMSN 

204 LYMPHOID LEUKEMIA* 

2040 ACUTE LYMPHOID LEUKEMIA* 

20400 ACT LYM LEUK W/O RMSION 

20401 ACT LYM LEUK W RMSION 

2041 CHR LYMPHOID LEUKEMIA* 

20410 CHR LYM LEUK W/O RMSION 

20411 CHR LYM LEUK W RMSION 

2042 SUBAC LYMPHOID LEUKEMIA* 

20420 SBAC LYM LEUK W/O RMSION 

20421 SBAC LYM LEUK W RMSION 

2048 LYMPHOID LEUKEMIA NEC* 

20480 OTH LYM LEUK W/O RMSION 

20481 OTH LYM LEUK W RMSION 

2049 LYMPHOID LEUKEMIA NOS* 

20490 UNS LYM LEUK W/O RMSION 

20491 UNS LYM LEUK W RMSION 

205 MYELOID LEUKEMIA* 

2050 ACUTE MYELOID LEUKEMIA* 

20500 ACT MYL LEUK W/O RMSION 

20501 ACT MYL LEUK W RMSION 

2051 CHRONIC MYELOID LEUKEMIA* 

20510 CHR MYL LEUK W/O RMSION 

20511 CHR MYL LEUK W RMSION 

2052 SUBACUT MYELOID LEUKEMIA* 

20520 SBAC MYL LEUK W/O RMSION 

20521 SBAC MYL LEUK W RMSION 

2053 MYELOID SARCOMA* 

20530 MYL SRCOMA W/O RMSION 

20531 MYL SRCOMA W RMSION 

2058 MYELOID LEUKEMIA NEC* 

20580 OTH MYL LEUK W/O RMSION 

20581 OTH MYL LEUK W RMSION 

2059 MYELOID LEUKEMIA NOS* 

20590 UNS MYL LEUK W/O RMSION 

20591 UNS MYL LEUK W RMSION 

206 MONOCYTIC LEUKEMIA* 

2060 ACUTE MONOCYTIC LEUKEMIA* 

20600 ACT MONO LEUK W/O RMSION 

20601 ACT MONO LEUK W RMSION 

2061 CHR MONOCYTIC LEUKEMIA*

20610 CHR MONO LEUK W/O RMSION 

20611 CHR MONO LEUK W RMSION 

2062 SUBAC MONOCYTIC LEUKEMIA* 

20620 SBAC MONO LEUK W/O RMSON 

20621 SBAC MONO LEUK W RMSION 

2068 MONOCYTIC LEUKEMIA NEC* 

20680 OTH MONO LEUK W/O RMSION 

20681 OTH MONO LEUK W RMSION 

2069 MONOCYTIC LEUKEMIA NOS* 

20690 UNS MONO LEUK W/O RMSION 

20691 UNS MONO LEUK W RMSION 

207 OTHER SPECIFIED LEUKEMIA* 

2070 ACUTE ERYTHREMIA* 

20700 ACT ERTH/ERYLK W/O RMSON 

20701 ACT ERTH/ERYLK W RMSON 

2071 CHRONIC ERYTHREMIA* 

20710 CHR ERYTHRM W/O REMISION 

20711 CHR ERYTHRM W REMISION 

2072 MEGAKARYOCYTIC LEUKEMIA* 

20720 MGKRYCYT LEUK W/O RMSION 

20721 MGKRYCYT LEUK W RMSION 

2078 SPECIFIED LEUKEMIA NEC* 

20780 OTH SPF LEUK W/O REMSION 

20781 OTH SPF LEUK W REMSION 

208 LEUKEMIA-UNSPECIF CELL* 

2080 ACT LEUK UNS CL W/O RMSN* 

20800 ACT LEUK UNS CL W/O RMSN 

20801 ACT LEUK UNS CL W RMSON 

2081 CHRONIC LEUKEMIA NOS* 

20810 CHR LEUK UNS CL W/O RMSN 

20811 CHR LEUK UNS CL W RMSON 

2082 SUBACUTE LEUKEMIA NOS* 

20820 SBAC LEUK UNS CL W/O RMS 

20821 SBAC LEUK UNS CL W RMSON 

2088 LEUKEMIA-UNSPEC CELL NEC* 

20880 OTH LEUK UNS CL W/O RMSN 

20881 OTH LEUK UNS CL W RMSON 

2089 LEUKEMIA-UNSPEC CELL NOS* 

20890 LEUKEMIA NOS W/O REMSION 

20891 LEUKEMIA NOS W REMISSION 

210 BEN NEO ORAL CAV/PHARYNX* 

2100 BENIGN NEOPLASM LIP 

2101 BENIGN NEOPLASM TONGUE 

2102 BEN NEO MAJOR SALIVARY 

2103 BENIGN NEO MOUTH FLOOR 

2104 BENIGN NEO MOUTH NEC/NOS 

2105 BENIGN NEOPLASM TONSIL 

2106 BENIGN NEO OROPHARYN NEC 

2107 BENIGN NEO NASOPHARYNX 

2108 BENIGN NEO HYPOPHARYNX 

2109 BENIGN NEO PHARYNX NOS 

211 OTH BENIGN NEOPLASM GI* 

2110 BENIGN NEO ESOPHAGUS 

2111 BENIGN NEOPLASM STOMACH 

2112 BENIGN NEOPLASM SM BOWEL 

2113 BENIGN NEOPLASM LG BOWEL 

2114 BENIGN NEOPL RECTUM/ANUS

2115 BEN NEO LIVER/BILE DUCTS 

2116 BENIGN NEOPLASM PANCREAS 

2117 BEN NEO ISLETS LANGERHAN 

2118 BEN NEO PERITONEUM 

2119 BEN NEO GI TRACT NEC/NOS 

212 BEN NEO RESP SYST/THORAX* 

2120 BEN NEO NASAL CAV/SINUS 

2121 BENIGN NEO LARYNX 

2122 BENIGN NEO TRACHEA 

2123 BENIGN NEO BRONCHUS/LUNG 

2124 BENIGN NEOPLASM PLEURA 

2125 BENIGN NEO MEDIASTINUM 

2126 BENIGN NEOPLASM THYMUS 

2127 BENIGN NEOPLASM HEART 

2128 BENIGN NEO RESP SYS NEC 

2129 BENIGN NEO RESP SYS NOS 

213 BEN NEO BONE/ARTIC CART* 

2130 BEN NEO SKULL/FACE BONE 

2131 BEN NEO LOWER JAW BONE 

2132 BENIGN NEO VERTEBRAE 

2133 BEN NEO RIBS/STERN/CLAV 

2134 BEN NEO LONG BONES ARM 

2135 BEN NEO BONES WRIST/HAND 

2136 BENIGN NEO PELVIC GIRDLE 

2137 BEN NEO LONG BONES LEG 

2138 BEN NEO BONES ANKLE/FOOT 

2139 BENIGN NEO BONE NOS 

214 LIPOMA* 

2140 LIPOMA SKIN FACE 

2141 LIPOMA SKIN NEC 

2142 LIPOMA INTRATHORACIC 

2143 LIPOMA INTRA-ABDOMINAL 

2144 LIPOMA SPERMATIC CORD 

2148 LIPOMA NEC 

2149 LIPOMA NOS 

215 OTH BEN NEO SOFT TISSUE* 

2150 BEN NEO SOFT TISSUE HEAD 

2152 BEN NEO SOFT TISSUE ARM 

2153 BEN NEO SOFT TISSUE LEG 

2154 BEN NEO SOFT TIS THORAX 

2155 BEN NEO SOFT TIS ABDOMEN 

2156 BEN NEO SOFT TIS PELVIS 

2157 BENIGN NEO TRUNK NOS 

2158 BEN NEO SOFT TISSUE NEC 

2159 BEN NEO SOFT TISSUE NOS 

216 BENIGN NEOPLASM OF SKIN* 

2160 BENIGN NEO SKIN LIP 

2161 BENIGN NEO SKIN EYELID 

2162 BENIGN NEO SKIN EAR 

2163 BENIGN NEO SKIN FACE NEC 

2164 BEN NEO SCALP/SKIN NECK 

2165 BENIGN NEO SKIN TRUNK 

2166 BENIGN NEO SKIN ARM 

2167 BENIGN NEO SKIN LEG 

2168 BENIGN NEOPLASM SKIN NEC 

2169 BENIGN NEOPLASM SKIN NOS 

217 BENIGN NEOPLASM BREAST

218 UTERINE LEIOMYOMA* 

2180 SUBMUCOUS LEIOMYOMA 

2181 INTRAMURAL LEIOMYOMA 

2182 SUBSEROUS LEIOMYOMA 

2189 UTERINE LEIOMYOMA NOS 

219 OTH BENIGN NEO UTERUS* 

2190 BENIGN NEO CERVIX UTERI 

2191 BENIGN NEO CORPUS UTERI 

2198 BENIGN NEO UTERUS NEC 

2199 BENIGN NEO UTERUS NOS 

220 BENIGN NEOPLASM OVARY 

221 BEN NEO OTH FEM GENITAL* 

2210 BEN NEO FALLOPIAN TUBE 

2211 BENIGN NEOPLASM VAGINA 

2212 BENIGN NEOPLASM VULVA 

2218 BEN NEO FEM GENITAL NEC 

2219 BEN NEO FEM GENITAL NOS 

222 BENIGN NEO MALE GENITAL* 

2220 BENIGN NEOPLASM TESTIS 

2221 BENIGN NEOPLASM PENIS 

2222 BENIGN NEOPLASM PROSTATE 

2223 BENIGN NEO EPIDIDYMIS 

2224 BENIGN NEOPLASM SCROTUM 

2228 BEN NEO MALE GENITAL NEC 

2229 BEN NEO MALE GENITAL NOS 

223 BENIGN NEOPLASM URINARY* 

2230 BENIGN NEOPLASM KIDNEY 

2231 BENIGN NEO RENAL PELVIS 

2232 BENIGN NEOPLASM URETER 

2233 BENIGN NEOPLASM BLADDER 

2238 BENIGN NEO OTH URINARY* 

22381 BENIGN NEOPLASM URETHRA 

22389 BENIGN NEO URINARY NEC 

2239 BENIGN NEO URINARY NOS 

224 BENIGN NEOPLASM OF EYE* 

2240 BENIGN NEOPLASM EYEBALL 

2241 BENIGN NEOPLASM ORBIT 

2242 BEN NEO LACRIMAL GLAND 

2243 BENIGN NEO CONJUNCTIVA 

2244 BENIGN NEOPLASM CORNEA 

2245 BENIGN NEOPLASM RETINA 

2246 BENIGN NEOPLASM CHOROID 

2247 BEN NEO LACRIMAL DUCT 

2248 BENIGN NEOPLASM EYE NEC 

2249 BENIGN NEOPLASM EYE NOS 

225 BENIGN NEO NERVOUS SYST* 

2250 BENIGN NEOPLASM BRAIN 

2251 BENIGN NEO CRANIAL NERVE 

2252 BEN NEO CEREBR MENINGES 

2253 BENIGN NEO SPINAL CORD 

2254 BEN NEO SPINAL MENINGES 

2258 BENIGN NEO NERV SYS NEC 

2259 BENIGN NEO NERV SYS NOS 

226 BENIGN NEOPLASM THYROID 

227 BEN NEO OTH ENDOCRINE* 

2270 BENIGN NEOPLASM ADRENAL 

2271 BENIGN NEO PARATHYROID

2273 BENIGN NEO PITUITARY 

2274 BEN NEOPL PINEAL GLAND 

2275 BENIGN NEO CAROTID BODY 

2276 BEN NEO PARAGANGLIA NEC 

2278 BENIGN NEO ENDOCRINE NEC 

2279 BENIGN NEO ENDOCRINE NOS 

228 HEMANGIOMA/LYMPHANGIOMA* 

2280 HEMANGIOMA, ANY SITE* 

22800 HEMANGIOMA NOS 

22801 HEMANGIOMA SKIN 

22802 HEMANGIOMA INTRACRANIAL 

22803 HEMANGIOMA RETINA 

22804 HEMANGIOMA INTRA-ABDOM 

22809 HEMANGIOMA NEC 

2281 LYMPHANGIOMA, ANY SITE 

229 BENIGN NEOPLASM NEC/NOS* 

2290 BENIGN NEO LYMPH NODES 

2298 BENIGN NEOPLASM NEC 

2299 BENIGN NEOPLASM NOS 

230 CA IN SITU DIGESTIVE ORG* 

2300 CA IN SITU ORAL CAV/PHAR 

2301 CA IN SITU ESOPHAGUS 

2302 CA IN SITU STOMACH 

2303 CA IN SITU COLON 

2304 CA IN SITU RECTUM 

2305 CA IN SITU ANAL CANAL 

2306 CA IN SITU ANUS NOS 

2307 CA IN SITU BOWEL NEC/NOS 

2308 CA IN SITU LIVER/BILIARY 

2309 CA IN SITU GI NEC/NOS 

231 CA IN SITU RESPIRATORY* 

2310 CA IN SITU LARYNX 

2311 CA IN SITU TRACHEA 

2312 CA IN SITU BRONCHUS/LUNG 

2318 CA IN SITU RESP SYS NEC 

2319 CA IN SITU RESP SYS NOS 

232 CARCINOMA IN SITU SKIN* 

2320 CA IN SITU SKIN LIP 

2321 CA IN SITU EYELID 

2322 CA IN SITU SKIN EAR 

2323 CA IN SITU SKIN FACE NEC 

2324 CA IN SITU SCALP 

2325 CA IN SITU SKIN TRUNK 

2326 CA IN SITU SKIN ARM 

2327 CA IN SITU SKIN LEG 

2328 CA IN SITU SKIN NEC 

2329 CA IN SITU SKIN NOS 

233 CA IN SITU BREAST/GU* 

2330 CA IN SITU BREAST 

2331 CA IN SITU CERVIX UTERI 

2332 CA IN SITU UTERUS NEC 

2333 CA IN SITU FEM GEN NEC 

2334 CA IN SITU PROSTATE 

2335 CA IN SITU PENIS 

2336 CA IN SITU MALE GEN NEC 

2337 CA IN SITU BLADDER 

2339 CA IN SITU URINARY NEC

234 CA IN SITU NEC/NOS* 

2340 CA IN SITU EYE 

2348 CA IN SITU NEC 

2349 CA IN SITU NOS 

235 UNC BEHAV NEO GI/RESP* 

2350 UNC BEHAV NEO SALIVARY 

2351 UNC BEHAV NEO ORAL/PHAR 

2352 UNC BEHAV NEO INTESTINE 

2353 UNC BEHAV NEO LIVER 

2354 UNC BEHAV NEO PERITONEUM 

2355 UNC BEHAV NEO GI NEC 

2356 UNC BEHAV NEO LARYNX 

2357 UNC BEHAV NEO LUNG 

2358 UNC BEHAV NEO PLEURA 

2359 UNC BEHAV NEO RESP NEC 

236 UNC BEHAV NEO GU* 

2360 UNCERT BEHAV NEO UTERUS 

2361 UNC BEHAV NEO PLACENTA 

2362 UNC BEHAV NEO OVARY 

2363 UNC BEHAV NEO FEMALE NEC 

2364 UNC BEHAV NEO TESTIS 

2365 UNC BEHAV NEO PROSTATE 

2366 UNC BEHAV NEO MALE NEC 

2367 UNC BEHAV NEO BLADDER 

2369 UNC BEHAV NEO OTH URINAR* 

23690 UNC BEHAV NEO URINAR NOS 

23691 UNC BEHAV NEO KIDNEY 

23699 UNC BEHAV NEO URINAR NEC 

237 UNCER NEO ENDOCRINE/NERV* 

2370 UNC BEHAV NEO PITUITARY 

2371 UNC BEHAV NEO PINEAL 

2372 UNC BEHAV NEO ADRENAL 

2373 UNC BEHAV NEO PARAGANG 

2374 UNCER NEO ENDOCRINE NEC 

2375 UNC BEH NEO BRAIN/SPINAL 

2376 UNC BEHAV NEO MENINGES 

2377 NEUROFIBROMATOSIS* 

23770 NEUROFIBROMATOSIS NOS 

23771 NEUROFIBROMATOSIS TYPE I 

23772 NEUROFIBROMATOSIS TYP II 

2379 UNC BEH NEO NERV SYS NEC 

238 UNC BEHAV NEO NEC/NOS* 

2380 UNC BEHAV NEO BONE 

2381 UNC BEHAV NEO SOFT TISSU 

2382 UNC BEHAV NEO SKIN 

2383 UNC BEHAV NEO BREAST 

2384 POLYCYTHEMIA VERA 

2385 MASTOCYTOMA NOS 

2386 PLASMACYTOMA NOS 

2387 LYMPHOPROLIFERAT DIS NOS 

2388 UNCERT BEHAVIOR NEO NEC 

2389 UNCERT BEHAVIOR NEO NOS 

239 UNSPECIFIED NEOPLASM* 

2390 DIGESTIVE NEOPLASM NOS 

2391 RESPIRATORY NEOPLASM NOS 

2392 BONE/SKIN NEOPLASM NOS 

2393 BREAST NEOPLASM NOS

2394 BLADDER NEOPLASM NOS 

2395 OTHER GU NEOPLASM NOS 

2396 BRAIN NEOPLASM NOS 

2397 ENDOCRINE/NERV NEO NOS 

2398 NEOPLASM NOS, SITE NEC 

2399 NEOPLASM NOS 

240 GOITER, SIMPLE/NOS* 

2400 SIMPLE GOITER 

2409 GOITER NOS 

241 NONTOXIC NODULAR GOITER* 

2410 NONTOX UNINODULAR GOITER 

2411 NONTOX MULTINODUL GOITER 

2419 NONTOX NODUL GOITER NOS 

242 THYROTOXICOSIS* 

2420 TOXIC DIFFUSE GOITER* 

24200 TOX DIF GOITER NO CRISIS 

24201 TOX DIF GOITER W CRISIS 

2421 TOXIC UNINODULAR GOITER* 

24210 TOX UNINOD GOIT NO CRIS 

24211 TOX UNINOD GOIT W CRISIS 

2422 TOXIC MULTINODUL GOITER* 

24220 TOX MULTNOD GOIT NO CRIS 

24221 TOX MULTNOD GOIT W CRIS 

2423 TOXIC NODULAR GOITER NOS* 

24230 TOX NOD GOITER NO CRISIS 

24231 TOX NOD GOITER W CRISIS 

2424 THYROTOX D/T ECTOP NODUL* 

24240 THYROTOX-ECT NOD NO CRIS 

24241 THYROTOX-ECT NOD W CRIS 

2428 THYROTOX SPEC ORIGIN NEC* 

24280 THYRTOX ORIG NEC NO CRIS 

24281 THYROTOX ORIG NEC W CRIS 

2429 THYROTOXICOSIS NOS* 

24290 THYROTOX NOS NO CRISIS 

24291 THYROTOX NOS W CRISIS 

243 CONGENITAL HYPOTHYROIDSM 

244 ACQUIRED HYPOTHYROIDISM* 

2440 POSTSURGICAL HYPOTHYROID 

2441 POSTABLAT HYPOTHYR NEC 

2442 IODINE HYPOTHYROIDISM 

2443 IATROGEN HYPOTHYROID NEC 

2448 ACQUIRED HYPOTHYROID NEC 

2449 HYPOTHYROIDISM NOS 

245 THYROIDITIS* 

2450 ACUTE THYROIDITIS 

2451 SUBACUTE THYROIDITIS 

2452 CHR LYMPHOCYT THYROIDIT 

2453 CHR FIBROUS THYROIDITIS 

2454 IATROGENIC THYROIDITIS 

2458 CHR THYROIDITIS NEC/NOS 

2459 THYROIDITIS NOS 

246 OTH DISORDERS OF THYROID* 

2460 DIS THYROCALCITON SECRET 

2461 DYSHORMONOGENIC GOITER 

2462 CYST OF THYROID 

2463 HEMORR/INFARC THYROID 

2468 DISORDERS OF THYROID NEC

2469 DISORDER OF THYROID NOS 

250 DIABETES MELLITUS* 

2500 DIABETES MELLITUS UNCOMP* 

25000 DMII WO CMP NT ST UNCNTR 

25001 DMI WO CMP NT ST UNCNTRL 

25002 DMII WO CMP UNCNTRLD 

25003 DMI WO CMP UNCNTRLD 

2501 DIABETES W KETOACIDOSIS* 

25010 DMII KETO NT ST UNCNTRLD 

25011 DMI KETO NT ST UNCNTRLD 

25012 DMII KETOACD UNCONTROLD 

25013 DMI KETOACD UNCONTROLD 

2502 DIAB W HYPEROSMOLAR COMA* 

25020 DMII HPRSM NT ST UNCNTRL 

25021 DMI HPRSM NT ST UNCNTRLD 

25022 DMII HPROSMLR UNCONTROLD 

25023 DMI HPROSMLR UNCONTROLD 

2503 DIABETES WITH COMA NEC* 

25030 DMII O CM NT ST UNCNTRLD 

25031 DMI O CM NT ST UNCNTRLD 

25032 DMII OTH COMA UNCONTROLD 

25033 DMI OTH COMA UNCONTROLD 

2504 DIAB W RENAL MANIFEST* 

25040 DMII RENL NT ST UNCNTRLD 

25041 DMI RENL NT ST UNCNTRLD 

25042 DMII RENAL UNCNTRLD 

25043 DMI RENAL UNCNTRLD 

2505 DIAB W OPHTHALMIC MANIF* 

25050 DMII OPHTH NT ST UNCNTRL 

25051 DMI OPHTH NT ST UNCNTRLD 

25052 DMII OPHTH UNCNTRLD 

25053 DMI OPHTH UNCNTRLD 

2506 DIAB W NEUROLOGIC MANIF* 

25060 DMII NEURO NT ST UNCNTRL 

25061 DMI NEURO NT ST UNCNTRLD 

25062 DMII NEURO UNCNTRLD 

25063 DMI NEURO UNCNTRLD 

2507 DIABETES W CIRCULAT DIS* 

25070 DMII CIRC NT ST UNCNTRLD 

25071 DMI CIRC NT ST UNCNTRLD 

25072 DMII CIRC UNCNTRLD 

25073 DMI CIRC UNCNTRLD 

2508 DIABETES W MANIFEST NEC* 

25080 DMII OTH NT ST UNCNTRLD 

25081 DMI OTH NT ST UNCNTRLD 

25082 DMII OTH UNCNTRLD 

25083 DMI OTH UNCNTRLD 

2509 DIABETES W COMPLIC NOS* 

25090 DMII UNSPF NT ST UNCNTRL 

25091 DMI UNSPF NT ST UNCNTRLD 

25092 DMII UNSPF UNCNTRLD 

25093 DMI UNSPF UNCNTRLD 

251 OTH PANCREATIC DISORDER* 

2510 HYPOGLYCEMIC COMA 

2511 OTH SPCF HYPOGLYCEMIA 

2512 HYPOGLYCEMIA NOS 

2513 POSTSURG HYPOINSULINEMIA

2514 ABN SECRETION GLUCAGON 

2515 ABNORM SECRETION GASTRIN 

2518 PANCREATIC DISORDER NEC 

2519 PANCREATIC DISORDER NOS 

252 PARATHYROID DISORDER* 

2520 HYPERPARATHYROIDISM 

2521 HYPOPARATHYROIDISM 

2528 PARATHYROID DISORDER NEC 

2529 PARATHYROID DISORDER NOS 

253 PITUITARY/HYPOTHALM DIS* 

2530 ACROMEGALY AND GIGANTISM 

2531 ANT PITUIT HYPERFUNC NEC 

2532 PANHYPOPITUITARISM 

2533 PITUITARY DWARFISM 

2534 ANTER PITUITARY DIS NEC 

2535 DIABETES INSIPIDUS 

2536 NEUROHYPOPHYSIS DIS NEC 

2537 IATROGENIC PITUITARY DIS 

2538 PITUITARY DISORDER NEC 

2539 PITUITARY DISORDER NOS 

254 DISEASES OF THYMUS GLAND* 

2540 PERSIST HYPERPLAS THYMUS 

2541 ABSCESS OF THYMUS 

2548 DISEASES OF THYMUS NEC 

2549 DISEASE OF THYMUS NOS 

255 ADRENAL GLAND DISORDERS* 

2550 CUSHING'S SYNDROME 

2551 HYPERALDOSTERONISM 

2552 ADRENOGENITAL DISORDERS 

2553 CORTICOADREN OVERACT NEC 

2554 CORTICOADRENAL INSUFFIC 

2555 ADRENAL HYPOFUNCTION NEC 

2556 MEDULLOADRENAL HYPERFUNC 

2558 ADRENAL DISORDER NEC 

2559 ADRENAL DISORDER NOS 

256 OVARIAN DYSFUNCTION* 

2560 HYPERESTROGENISM 

2561 OVARIAN HYPERFUNC NEC 

2562 POSTABLATIV OVARIAN FAIL 

2563 OVARIAN FAILURE NEC 

2564 POLYCYSTIC OVARIES 

2568 OVARIAN DYSFUNCTION NEC 

2569 OVARIAN DYSFUNCTION NOS 

257 TESTICULAR DYSFUNCTION* 

2570 TESTICULAR HYPERFUNCTION 

2571 POSTABLAT TESTIC HYPOFUN 

2572 TESTICULAR HYPOFUNC NEC 

2578 TESTICULAR DYSFUNCT NEC 

2579 TESTICULAR DYSFUNCT NOS 

258 POLYGLANDULAR DYSFUNCT* 

2580 WERMER'S SYNDROME 

2581 COMB ENDOCR DYSFUNCT NEC 

2588 POLYGLANDUL DYSFUNC NEC 

2589 POLYGLANDUL DYSFUNC NOS 

259 OTH ENDORINE DISORDERS* 

2590 DELAY SEXUAL DEVELOP NEC 

2591 SEXUAL PRECOCITY NEC

2592 CARCINOID SYNDROME 

2593 ECTOPIC HORMONE SECR NEC 

2594 DWARFISM NEC 

2598 ENDOCRINE DISORDERS NEC 

2599 ENDOCRINE DISORDER NOS 

260 KWASHIORKOR 

261 NUTRITIONAL MARASMUS 

262 OTH SEVERE MALNUTRITION 

263 PROT-CAL MALNUTR NEC/NOS* 

2630 MALNUTRITION MOD DEGREE 

2631 MALNUTRITION MILD DEGREE 

2632 ARREST DEVEL D/T MALNUTR 

2638 PROTEIN-CAL MALNUTR NEC 

2639 PROTEIN-CAL MALNUTR NOS 

264 VITAMIN A DEFICIENCY* 

2640 VIT A CONJUNCTIV XEROSIS 

2641 VIT A BITOT'S SPOT 

2642 VIT A CORNEAL XEROSIS 

2643 VIT A CORNEA ULCER/XEROS 

2644 VIT A KERATOMALACIA 

2645 VIT A NIGHT BLINDNESS 

2646 VIT A DEF W CORNEAL SCAR 

2647 VIT A OCULAR DEFIC NEC 

2648 VITAMIN A DEFICIENCY NEC 

2649 VITAMIN A DEFICIENCY NOS 

265 THIAMINE/NIACIN DEFIC* 

2650 BERIBERI 

2651 THIAMINE DEFIC NEC/NOS 

2652 PELLAGRA 

266 B-COMPLEX DEFICIENCIES* 

2660 ARIBOFLAVINOSIS 

2661 VITAMIN B6 DEFICIENCY 

2662 B-COMPLEX DEFIC NEC 

2669 VITAMIN B DEFICIENCY NOS 

267 ASCORBIC ACID DEFICIENCY 

268 VITAMIN D DEFICIENCY* 

2680 RICKETS, ACTIVE 

2681 RICKETS, LATE EFFECT 

2682 OSTEOMALACIA NOS 

2689 VITAMIN D DEFICIENCY NOS 

269 OTH NUTRITION DEFICIENCY* 

2690 DEFICIENCY OF VITAMIN K 

2691 VITAMIN DEFICIENCY NEC 

2692 VITAMIN DEFICIENCY NOS 

2693 MINERAL DEFICIENCY NEC 

2698 NUTRITION DEFICIENCY NEC 

2699 NUTRITION DEFICIENCY NOS 

270 DIS AMIN-ACID METABOLISM* 

2700 AMINO-ACID TRANSPORT DIS 

2701 PHENYLKETONURIA - PKU 

2702 AROM AMIN-ACID METAB NEC 

2703 BRAN-CHAIN AMIN-ACID DIS 

2704 SULPH AMINO-ACID MET DIS 

2705 DIS HISTIDINE METABOLISM 

2706 DIS UREA CYCLE METABOL 

2707 STRAIG AMIN-ACID MET NEC 

2708 DIS AMINO-ACID METAB NEC

2709 DIS AMINO-ACID METAB NOS 

271 DIS CARBOHYDRATE METABOL* 

2710 GLYCOGENOSIS 

2711 GALACTOSEMIA 

2712 HERED FRUCTOSE INTOLERAN 

2713 DISACCHARIDASE DEF/MALAB 

2714 RENAL GLYCOSURIA 

2718 DIS CARBOHYDR METAB NEC 

2719 DIS CARBOHYDR METAB NOS 

272 DIS OF LIPOID METABOLISM* 

2720 PURE HYPERCHOLESTEROLEM 

2721 PURE HYPERGLYCERIDEMIA 

2722 MIXED HYPERLIPIDEMIA 

2723 HYPERCHYLOMICRONEMIA 

2724 HYPERLIPIDEMIA NEC/NOS 

2725 LIPOPROTEIN DEFICIENCIES 

2726 LIPODYSTROPHY 

2727 LIPIDOSES 

2728 LIPOID METABOL DIS NEC 

2729 LIPOID METABOL DIS NOS 

273 DIS PLASMA PROTEIN METAB* 

2730 POLYCLON HYPERGAMMAGLOBU 

2731 MONOCLON PARAPROTEINEMIA 

2732 PARAPROTEINEMIA NEC 

2733 MACROGLOBULINEMIA 

2738 DIS PLAS PROTEIN MET NEC 

2739 DIS PLAS PROTEIN MET NOS 

274 GOUT* 

2740 GOUTY ARTHROPATHY 

2741 GOUTY NEPHROPATHY* 

27410 GOUTY NEPHROPATHY NOS 

27411 URIC ACID NEPHROLITHIAS 

27419 GOUTY NEPHROPATHY NEC 

2748 GOUT W OTH MANIFESTATION* 

27481 GOUTY TOPHI OF EAR 

27482 GOUTY TOPHI SITE NEC 

27489 GOUT W MANIFESTATION NEC 

2749 GOUT NOS 

275 DIS MINERAL METABOLISM* 

2750 DIS IRON METABOLISM 

2751 DIS COPPER METABOLISM 

2752 DIS MAGNESIUM METABOLISM 

2753 DIS PHOSPHORUS METABOL 

2754 DIS CALCIUM METABOLISM* 

27540 DIS CALCIUM METABLSM NOS 

27541 HYPOCALCEMIA 

27542 HYPERCALCEMIA 

27549 DIS CALCIUM METABLSM NEC 

2758 DIS MINERAL METABOL NEC 

2759 DIS MINERAL METABOL NOS 

276 FLUID/ELECTROLYTE DIS* 

2760 HYPEROSMOLALITY 

2761 HYPOSMOLALITY 

2762 ACIDOSIS 

2763 ALKALOSIS 

2764 MIXED ACID-BASE BAL DIS 

2765 HYPOVOLEMIA

2766 FLUID OVERLOAD 

2767 HYPERPOTASSEMIA 

2768 HYPOPOTASSEMIA 

2769 ELECTROLYT/FLUID DIS NEC 

277 METABOLISM DIS NEC/NOS* 

2770 CYSTIC FIBROSIS* 

27700 CYSTIC FIBROS W/O ILEUS 

27701 CYSTIC FIBROSIS W ILEUS 

2771 DIS PORPHYRIN METABOLISM 

2772 PURINE/PYRIMID DIS NEC 

2773 AMYLOIDOSIS 

2774 DIS BILIRUBIN EXCRETION 

2775 MUCOPOLYSACCHARIDOSIS 

2776 DEFIC CIRCUL ENZYME NEC 

2778 METABOLISM DISORDER NEC 

2779 METABOLISM DISORDER NOS 

278 OBESITY/HYPERALIMENT* 

2780 OBESITY* 

27800 OBESITY NOS 

27801 MORBID OBESITY 

2781 LOCALIZED ADIPOSITY 

2782 HYPERVITAMINOSIS A 

2783 HYPERCAROTINEMIA 

2784 HYPERVITAMINOSIS D 

2788 OTHER HYPERALIMENTATION 

279 DIS IMMUNE MECHANISM* 

2790 DEFIC HUMORAL IMMUNITY* 

27900 HYPOGAMMAGLOBULINEM NOS 

27901 SELECTIVE IGA IMMUNODEF 

27902 SELECTIVE IGM IMMUNODEF 

27903 SELECTIVE IG DEFIC NEC 

27904 CONG HYPOGAMMAGLOBULINEM 

27905 IMMUNODEFIC W HYPER-IGM 

27906 COMMON VARIABL IMMUNODEF 

27909 HUMORAL IMMUNITY DEF NEC 

2791 DEFIC CELLULAR IMMUNITY* 

27910 IMMUNDEF T-CELL DEF NOS 

27911 DIGEORGE'S SYNDROME 

27912 WISKOTT-ALDRICH SYNDROME 

27913 NEZELOF'S SYNDROME 

27919 DEFIC CELL IMMUNITY NOS 

2792 COMBINED IMMUNITY DEFIC 

2793 IMMUNITY DEFICIENCY NOS 

2794 AUTOIMMUNE DISEASE NEC 

2798 IMMUNE MECHANISM DIS NEC 

2799 IMMUNE MECHANISM DIS NOS 

280 IRON DEFICIENCY ANEMIAS* 

2800 CHR BLOOD LOSS ANEMIA 

2801 IRON DEF ANEMIA DIETARY 

2808 IRON DEFIC ANEMIA NEC 

2809 IRON DEFIC ANEMIA NOS 

281 OTHER DEFICIENCY ANEMIA* 

2810 PERNICIOUS ANEMIA 

2811 B12 DEFIC ANEMIA NEC 

2812 FOLATE-DEFICIENCY ANEMIA 

2813 MEGALOBLASTIC ANEMIA NEC 

2814 PROTEIN DEFIC ANEMIA

2818 NUTRITIONAL ANEMIA NEC 

2819 DEFICIENCY ANEMIA NOS 

282 HEREDIT HEMOLYTIC ANEMIA* 

2820 HEREDITARY SPHEROCYTOSIS 

2821 HEREDIT ELLIPTOCYTOSIS 

2822 GLUTATHIONE DIS ANEMIA 

2823 ENZYME DEFIC ANEMIA NEC 

2824 THALASSEMIAS 

2825 SICKLE-CELL TRAIT 

2826 SICKLE-CELL ANEMIA* 

28260 SICKLE-CELL ANEMIA NOS 

28261 HB-S DISEASE W/O CRISIS 

28262 HB-S DISEASE WITH CRISIS 

28263 SICKLE-CELL/HB-C DISEASE 

28269 SICKLE-CELL ANEMIA NEC 

2827 HEMOGLOBINOPATHIES NEC 

2828 HERED HEMOLYTIC ANEM NEC 

2829 HERED HEMOLYTIC ANEM NOS 

283 ACQ HEMOLYTIC ANEMIA* 

2830 AUTOIMMUN HEMOLYTIC ANEM 

2831 NONAUTOIMMU HEMOLYT ANEM* 

28310 NONAUTO HEM ANEMIA NOS 

28311 HEMOLYTIC UREMIC SYND 

28319 OTH NONAUTO HEM ANEMIA 

2832 HEMOLYTIC HEMOGLOBINURIA 

2839 ACQ HEMOLYTIC ANEMIA NOS 

284 APLASTIC ANEMIA* 

2840 CONGEN APLASTIC ANEMIA 

2848 APLASTIC ANEMIAS NEC 

2849 APLASTIC ANEMIA NOS 

285 ANEMIA NEC/NOS* 

2850 SIDEROBLASTIC ANEMIA 

2851 AC POSTHEMORRHAG ANEMIA 

2858 ANEMIA NEC 

2859 ANEMIA NOS 

286 COAGULATION DEFECTS* 

2860 CONG FACTOR VIII DIORD 

2861 CONG FACTOR IX DISORDER 

2862 CONG FACTOR XI DISORDER 

2863 CONG DEF CLOT FACTOR NEC 

2864 VON WILLEBRAND'S DISEASE 

2865 CIRCULATING ANTICOAG DIS 

2866 DEFIBRINATION SYNDROME 

2867 ACQ COAGUL FACTOR DEFIC 

2869 COAGULAT DEFECT NEC/NOS 

287 PURPURA & OTH HEMOR COND* 

2870 ALLERGIC PURPURA 

2871 THROMBOCYTOPATHY 

2872 PURPURA NOS 

2873 PRIMARY THROMBOCYTOPENIA 

2874 SECOND THROMBOCYTOPENIA 

2875 THROMBOCYTOPENIA NOS 

2878 HEMORRHAGIC COND NEC 

2879 HEMORRHAGIC COND NOS 

288 WBC DISORDERS* 

2880 AGRANULOCYTOSIS 

2881 FUNCTION DIS NEUTROPHILS

2882 GENETIC ANOMALY LEUKOCYT 

2883 EOSINOPHILIA 

2888 WBC DISEASE NEC 

2889 WBC DISEASE NOS 

289 OTHER BLOOD DISEASE* 

2890 SECONDARY POLYCYTHEMIA 

2891 CHRONIC LYMPHADENITIS 

2892 MESENTERIC LYMPHADENITIS 

2893 LYMPHADENITIS NOS 

2894 HYPERSPLENISM 

2895 OTHER SPLEEN DISEASES* 

28950 SPLEEN DISEASE NOS 

28951 CHR CONGEST SPLENOMEGALY 

28959 SPLEEN DISEASE NEC 

2896 FAMILIAL POLYCYTHEMIA 

2897 METHEMOGLOBINEMIA 

2898 BLOOD DISEASES NEC 

2899 BLOOD DISEASE NOS 

290 SENILE/PRESENILE PSYCHOS* 

2900 SENILE DEMENTIA UNCOMP 

2901 PRESENILE DEMENTIA* 

29010 PRESENILE DEMENTIA 

29011 PRESENILE DELIRIUM 

29012 PRESENILE DELUSION 

29013 PRESENILE DEPRESSION 

2902 SENILE DELUSION/DEPRESS* 

29020 SENILE DELUSION 

29021 SENILE DEPRESSIVE 

2903 SENILE DELIRIUM 

2904 ARTERIOSCLEROT DEMENTIA* 

29040 ARTERIOSCLER DEMENT NOS 

29041 ARTERIOSCLER DELIRIUM 

29042 ARTERIOSCLER DELUSION 

29043 ARTERIOSCLER DEPRESSIVE 

2908 SENILE PSYCHOSIS NEC 

2909 SENILE PSYCHOT COND NOS 

291 ALCOHOLIC PSYCHOSES* 

2910 DELIRIUM TREMENS 

2911 ALCOHOL AMNESTIC SYND 

2912 ALCOHOLIC DEMENTIA NEC 

2913 ALCOHOL HALLUCINOSIS 

2914 PATHOLOGIC ALCOHOL INTOX 

2915 ALCOHOLIC JEALOUSY 

2918 ALCOHOLIC PSYCHOSIS NEC* 

29181 ALCOHOL WITHDRAWAL 

29189 ALCOHOLIC PSYCHOSIS NEC 

2919 ALCOHOLIC PSYCHOSIS NOS 

292 DRUG PSYCHOSES* 

2920 DRUG WITHDRAWAL SYNDROME 

2921 DRUG PARANOID/HALLUCINOS* 

29211 DRUG PARANOID STATE 

29212 DRUG HALLUCINOSIS 

2922 PATHOLOGIC DRUG INTOX 

2928 OTHER DRUG MENTAL DIS* 

29281 DRUG-INDUCED DELIRIUM 

29282 DRUG-INDUCED DEMENTIA 

29283 DRUG AMNESTIC SYNDROME

29284 DRUG DEPRESSIVE SYNDROME 

29289 DRUG MENTAL DISORDER NEC 

2929 DRUG MENTAL DISORDER NOS 

293 TRANSIENT ORG MENTAL DIS* 

2930 ACUTE DELIRIUM 

2931 SUBACUTE DELIRIUM 

2938 OTH TRANSIENT ORG MENTAL* 

29381 ORGANIC DELUSIONAL SYND 

29382 ORGANIC HALLUCINOSIS SYN 

29383 ORGANIC AFFECTIVE SYND 

29384 ORGANIC ANXIETY SYNDROME 

29389 TRANSIENT ORG MENTAL NEC 

2939 TRANSIENT ORG MENTAL NOS 

294 OTHER ORGANIC PSYCH COND* 

2940 AMNESTIC SYNDROME 

2941 DEMENTIA IN OTH DISEASES 

2948 ORGANIC BRAIN SYND NEC 

2949 ORGANIC BRAIN SYND NOS 

295 SCHIZOPHRENIC DISORDERS* 

2950 SIMPLE SCHIZOPHRENIA* 

29500 SIMPL SCHIZOPHREN-UNSPEC 

29501 SIMPL SCHIZOPHREN-SUBCHR 

29502 SIMPLE SCHIZOPHREN-CHR 

29503 SIMP SCHIZ-SUBCHR/EXACER 

29504 SIMPL SCHIZO-CHR/EXACERB 

29505 SIMPL SCHIZOPHREN-REMISS 

2951 HEBEPHRENIA* 

29510 HEBEPHRENIA-UNSPEC 

29511 HEBEPHRENIA-SUBCHRONIC 

29512 HEBEPHRENIA-CHRONIC 

29513 HEBEPHREN-SUBCHR/EXACERB 

29514 HEBEPHRENIA-CHR/EXACERB 

29515 HEBEPHRENIA-REMISSION 

2952 CATATONIC SCHIZOPHRENIA* 

29520 CATATONIA-UNSPEC 

29521 CATATONIA-SUBCHRONIC 

29522 CATATONIA-CHRONIC 

29523 CATATONIA-SUBCHR/EXACERB 

29524 CATATONIA-CHR/EXACERB 

29525 CATATONIA-REMISSION 

2953 PARANOID SCHIZOPHRENIA* 

29530 PARANOID SCHIZO-UNSPEC 

29531 PARANOID SCHIZO-SUBCHR 

29532 PARANOID SCHIZO-CHRONIC 

29533 PARAN SCHIZO-SUBCHR/EXAC 

29534 PARAN SCHIZO-CHR/EXACERB 

29535 PARANOID SCHIZO-REMISS 

2954 AC SCHIZOPHRENIC EPISODE* 

29540 AC SCHIZOPHRENIA-UNSPEC 

29541 AC SCHIZOPHRENIA-SUBCHR 

29542 AC SCHIZOPHRENIA-CHR 

29543 AC SCHIZO-SUBCHR/EXACERB 

29544 AC SCHIZOPHR-CHR/EXACERB 

29545 AC SCHIZOPHRENIA-REMISS 

2955 LATENT SCHIZOPHRENIA* 

29550 LATENT SCHIZOPHREN-UNSP 

29551 LAT SCHIZOPHREN-SUBCHR

29552 LATENT SCHIZOPHREN-CHR 

29553 LAT SCHIZO-SUBCHR/EXACER 

29554 LATENT SCHIZO-CHR/EXACER 

29555 LAT SCHIZOPHREN-REMISS 

2956 RESIDUAL SCHIZOPHRENIA* 

29560 RESID SCHIZOPHREN-UNSP 

29561 RESID SCHIZOPHREN-SUBCHR 

29562 RESIDUAL SCHIZOPHREN-CHR 

29563 RESID SCHIZO-SUBCHR/EXAC 

29564 RESID SCHIZO-CHR/EXACERB 

29565 RESID SCHIZOPHREN-REMISS 

2957 SCHIZOAFFECTIVE TYPE* 

29570 SCHIZOAFFECTIVE-UNSPEC 

29571 SCHIZOAFFECTIVE-SUBCHR 

29572 SCHIZOAFFECTIVE-CHRONIC 

29573 SCHIZOAFF-SUBCHR/EXACER 

29574 SCHIZOAFFECT-CHR/EXACER 

29575 SCHIZOAFFECTIVE-REMISS 

2958 SCHIZOPHRENIA NEC* 

29580 SCHIZOPHRENIA NEC-UNSPEC 

29581 SCHIZOPHRENIA NEC-SUBCHR 

29582 SCHIZOPHRENIA NEC-CHR 

29583 SCHIZO NEC-SUBCHR/EXACER 

29584 SCHIZO NEC-CHR/EXACERB 

29585 SCHIZOPHRENIA NEC-REMISS 

2959 SCHIZOPHRENIA NOS* 

29590 SCHIZOPHRENIA NOS-UNSPEC 

29591 SCHIZOPHRENIA NOS-SUBCHR 

29592 SCHIZOPHRENIA NOS-CHR 

29593 SCHIZO NOS-SUBCHR/EXACER 

29594 SCHIZO NOS-CHR/EXACERB 

29595 SCHIZOPHRENIA NOS-REMISS 

296 AFFECTIVE PSYCHOSES* 

2960 MANIC DIS, SINGL EPISODE* 

29600 MANIC DISORDER-UNSPEC 

29601 MANIC DISORDER-MILD 

29602 MANIC DISORDER-MOD 

29603 MANIC DISORDER-SEVERE 

29604 MANIC DIS-SEVERE W PSYCH 

29605 MANIC DIS-PARTIAL REMISS 

29606 MANIC DIS-FULL REMISSION 

2961 MANIC, RECURRENT EPISODE* 

29610 RECUR MANIC DIS-UNSPEC 

29611 RECUR MANIC DIS-MILD 

29612 RECUR MANIC DIS-MOD 

29613 RECUR MANIC DIS-SEVERE 

29614 RECUR MANIC-SEV W PSYCHO 

29615 RECUR MANIC-PART REMISS 

29616 RECUR MANIC-FULL REMISS 

2962 DEPR PSYCH, SINGL EPISOD* 

29620 DEPRESS PSYCHOSIS-UNSPEC 

29621 DEPRESS PSYCHOSIS-MILD 

29622 DEPRESSIVE PSYCHOSIS-MOD 

29623 DEPRESS PSYCHOSIS-SEVERE 

29624 DEPR PSYCHOS-SEV W PSYCH 

29625 DEPR PSYCHOS-PART REMISS 

29626 DEPR PSYCHOS-FULL REMISS

2963 DEPR PSYCH, RECUR EPISOD* 

29630 RECURR DEPR PSYCHOS-UNSP 

29631 RECURR DEPR PSYCHOS-MILD 

29632 RECURR DEPR PSYCHOS-MOD 

29633 RECUR DEPR PSYCH-SEVERE 

29634 REC DEPR PSYCH-PSYCHOTIC 

29635 RECUR DEPR PSYC-PART REM 

29636 RECUR DEPR PSYC-FULL REM 

2964 BIPOLAR AFFECTIVE, MANIC* 

29640 BIPOL AFF, MANIC-UNSPEC 

29641 BIPOLAR AFF, MANIC-MILD 

29642 BIPOLAR AFFEC, MANIC-MOD 

29643 BIPOL AFF, MANIC-SEVERE 

29644 BIPOL MANIC-SEV W PSYCH 

29645 BIPOL AFF MANIC-PART REM 

29646 BIPOL AFF MANIC-FULL REM 

2965 BIPOLAR AFFECT, DEPRESS* 

29650 BIPOLAR AFF, DEPR-UNSPEC 

29651 BIPOLAR AFFEC, DEPR-MILD 

29652 BIPOLAR AFFEC, DEPR-MOD 

29653 BIPOL AFF, DEPR-SEVERE 

29654 BIPOL DEPR-SEV W PSYCH 

29655 BIPOL AFF DEPR-PART REM 

29656 BIPOL AFF DEPR-FULL REM 

2966 BIPOLAR AFFECTIVE, MIXED* 

29660 BIPOL AFF, MIXED-UNSPEC 

29661 BIPOLAR AFF, MIXED-MILD 

29662 BIPOLAR AFFEC, MIXED-MOD 

29663 BIPOL AFF, MIXED-SEVERE 

29664 BIPOL MIXED-SEV W PSYCH 

29665 BIPOL AFF, MIX-PART REM 

29666 BIPOL AFF, MIX-FULL REM 

2967 BIPOLAR AFFECTIVE NOS 

2968 MANIC-DEPRESSIVE NEC/NOS* 

29680 MANIC-DEPRESSIVE NOS 

29681 ATYPICAL MANIC DISORDER 

29682 ATYPICAL DEPRESSIVE DIS 

29689 MANIC-DEPRESSIVE NEC 

2969 AFFECT PSYCHOSES NEC/NOS* 

29690 AFFECTIVE PSYCHOSIS NOS 

29699 AFFECTIVE PSYCHOSES NEC 

297 PARANOID STATES* 

2970 PARANOID STATE, SIMPLE 

2971 PARANOIA 

2972 PARAPHRENIA 

2973 SHARED PARANOID DISORDER 

2978 PARANOID STATES NEC 

2979 PARANOID STATE NOS 

298 OTH NONORGANIC PSYCHOSES* 

2980 REACT DEPRESS PSYCHOSIS 

2981 EXCITATIV TYPE PSYCHOSIS 

2982 REACTIVE CONFUSION 

2983 ACUTE PARANOID REACTION 

2984 PSYCHOGEN PARANOID PSYCH 

2988 REACT PSYCHOSIS NEC/NOS 

2989 PSYCHOSIS NOS 

299 PSYCHOSES OF CHILDHOOD*

2990 INFANTILE AUTISM* 

29900 INFANTILE AUTISM-ACTIVE 

29901 INFANTILE AUTISM-RESID 

2991 DISINTEGRATIVE PSYCHOSIS* 

29910 DISINTEGR PSYCH-ACTIVE 

29911 DISINTEGR PSYCH-RESIDUAL 

2998 EARLY CHLD PSYCHOSES NEC* 

29980 CHILD PSYCHOS NEC-ACTIVE 

29981 CHILD PSYCHOS NEC-RESID 

2999 EARLY CHLD PSYCHOSIS NOS* 

29990 CHILD PSYCHOS NOS-ACTIVE 

29991 CHILD PSYCHOS NOS-RESID 

300 NEUROTIC DISORDERS* 

3000 ANXIETY STATES* 

30000 ANXIETY STATE NOS 

30001 PANIC DISORDER 

30002 GENERALIZED ANXIETY DIS 

30009 ANXIETY STATE NEC 

3001 HYSTERIA* 

30010 HYSTERIA NOS 

30011 CONVERSION DISORDER 

30012 PSYCHOGENIC AMNESIA 

30013 PSYCHOGENIC FUGUE 

30014 MULTIPLE PERSONALITY 

30015 DISSOCIATIVE REACT NOS 

30016 FACTITIOUS ILL W SYMPTOM 

30019 FACTITIOUS ILL NEC/NOS 

3002 PHOBIC DISORDERS* 

30020 PHOBIA NOS 

30021 AGORAPHOBIA WITH PANIC 

30022 AGORAPHOBIA W/O PANIC 

30023 SOCIAL PHOBIA 

30029 ISOLATED PHOBIAS NEC 

3003 OBSESSIVE-COMPULSIVE DIS 

3004 NEUROTIC DEPRESSION 

3005 NEURASTHENIA 

3006 DEPERSONALIZATION SYND 

3007 HYPOCHONDRIASIS 

3008 NEUROTIC DISORDERS NEC* 

30081 SOMATIZATION DISORDER 

30082 UNDIFF SOMATOFORM DISRDR 

30089 NEUROTIC DISORDERS NEC 

3009 NEUROTIC DISORDER NOS 

301 PERSONALITY DISORDERS* 

3010 PARANOID PERSONALITY 

3011 AFFECTIVE PERSONALITY* 

30110 AFFECTIV PERSONALITY NOS 

30111 CHRONIC HYPOMANIC PERSON 

30112 CHR DEPRESSIVE PERSON 

30113 CYCLOTHYMIC DISORDER 

3012 SCHIZOID PERSONALITY* 

30120 SCHIZOID PERSONALITY NOS 

30121 INTROVERTED PERSONALITY 

30122 SCHIZOTYPAL PERSONALITY 

3013 EXPLOSIVE PERSONALITY 

3014 COMPULSIVE PERSONALITY 

3015 HISTRIONIC PERSONALITY*

30150 HISTRIONIC PERSON NOS 

30151 CHR FACTITIOUS ILLNESS 

30159 HISTRIONIC PERSON NEC 

3016 DEPENDENT PERSONALITY 

3017 ANTISOCIAL PERSONALITY 

3018 OTHER PERSONALITY DIS* 

30181 NARCISSISTIC PERSONALITY 

30182 AVOIDANT PERSONALITY 

30183 BORDERLINE PERSONALITY 

30184 PASSIVE-AGGRESSIV PERSON 

30189 PERSONALITY DISORDER NEC 

3019 PERSONALITY DISORDER NOS 

302 SEXUAL DISORDERS* 

3020 EGO-DYSTONIC HOMOSEXLTY 

3021 ZOOPHILIA 

3022 PEDOPHILIA 

3023 TRANSVESTISM 

3024 EXHIBITIONISM 

3025 TRANS-SEXUALISM* 

30250 TRANS-SEXUALISM NOS 

30251 TRANS-SEXUALISM, ASEXUAL 

30252 TRANS-SEXUAL, HOMOSEXUAL 

30253 TRANS-SEX, HETEROSEXUAL 

3026 PSYCHOSEX IDENTITY DIS 

3027 PSYCHOSEXUAL DYSFUNCTION* 

30270 PSYCHOSEXUAL DYSFUNC NOS 

30271 INHIBITED SEXUAL DESIRE 

30272 INHIBITED SEX EXCITEMENT 

30273 INHIBITED FEMALE ORGASM 

30274 INHIBITED MALE ORGASM 

30275 PREMATURE EJACULATION 

30276 FUNCTIONAL DYSPAREUNIA 

30279 PSYCHOSEXUAL DYSFUNC NEC 

3028 PSYCHOSEXUAL DIS NEC* 

30281 FETISHISM 

30282 VOYEURISM 

30283 SEXUAL MASOCHISM 

30284 SEXUAL SADISM 

30285 GEND IDEN DIS,ADOL/ADULT 

30289 PSYCHOSEXUAL DIS NEC 

3029 PSYCHOSEXUAL DIS NOS 

303 ALCOHOL DEPENDENCE SYNDR* 

3030 AC ALCOHOL INTOXICATION* 

30300 AC ALCOHOL INTOX-UNSPEC 

30301 AC ALCOHOL INTOX-CONTIN 

30302 AC ALCOHOL INTOX-EPISOD 

30303 AC ALCOHOL INTOX-REMISS 

3039 ALCOHOL DEPEND NEC/NOS* 

30390 ALCOH DEP NEC/NOS-UNSPEC 

30391 ALCOH DEP NEC/NOS-CONTIN 

30392 ALCOH DEP NEC/NOS-EPISOD 

30393 ALCOH DEP NEC/NOS-REMISS 

304 DRUG DEPENDENCE* 

3040 OPIOID TYPE DEPENDENCE* 

30400 OPIOID DEPENDENCE-UNSPEC 

30401 OPIOID DEPENDENCE-CONTIN 

30402 OPIOID DEPENDENCE-EPISOD

30403 OPIOID DEPENDENCE-REMISS 

3041 BARBITURATE DEPENDENCE* 

30410 BARBITURAT DEPEND-UNSPEC 

30411 BARBITURAT DEPEND-CONTIN 

30412 BARBITURAT DEPEND-EPISOD 

30413 BARBITURAT DEPEND-REMISS 

3042 COCAINE DEPENDENCE* 

30420 COCAINE DEPEND-UNSPEC 

30421 COCAINE DEPEND-CONTIN 

30422 COCAINE DEPEND-EPISODIC 

30423 COCAINE DEPEND-REMISS 

3043 CANNABIS DEPENDENCE* 

30430 CANNABIS DEPEND-UNSPEC 

30431 CANNABIS DEPEND-CONTIN 

30432 CANNABIS DEPEND-EPISODIC 

30433 CANNABIS DEPEND-REMISS 

3044 AMPHETAMINE DEPENDENCE* 

30440 AMPHETAMIN DEPEND-UNSPEC 

30441 AMPHETAMIN DEPEND-CONTIN 

30442 AMPHETAMIN DEPEND-EPISOD 

30443 AMPHETAMIN DEPEND-REMISS 

3045 HALLUCINOGEN DEPENDENCE* 

30450 HALLUCINOGEN DEP-UNSPEC 

30451 HALLUCINOGEN DEP-CONTIN 

30452 HALLUCINOGEN DEP-EPISOD 

30453 HALLUCINOGEN DEP-REMISS 

3046 DRUG DEPENDENCE NEC* 

30460 DRUG DEPEND NEC-UNSPEC 

30461 DRUG DEPEND NEC-CONTIN 

30462 DRUG DEPEND NEC-EPISODIC 

30463 DRUG DEPEND NEC-IN REM 

3047 OPIOID/OTHER DRUG DEPEND* 

30470 OPIOID/OTHER DEP-UNSPEC 

30471 OPIOID/OTHER DEP-CONTIN 

30472 OPIOID/OTHER DEP-EPISOD 

30473 OPIOID/OTHER DEP-REMISS 

3048 COMB DRUG DEPENDENCE NEC* 

30480 COMB DRUG DEP NEC-UNSPEC 

30481 COMB DRUG DEP NEC-CONTIN 

30482 COMB DRUG DEP NEC-EPISOD 

30483 COMB DRUG DEP NEC-REMISS 

3049 DRUG DEPENDENCE NOS* 

30490 DRUG DEPEND NOS-UNSPEC 

30491 DRUG DEPEND NOS-CONTIN 

30492 DRUG DEPEND NOS-EPISODIC 

30493 DRUG DEPEND NOS-REMISS 

305 NONDEPENDENT DRUG ABUSE* 

3050 ALCOHOL ABUSE* 

30500 ALCOHOL ABUSE-UNSPEC 

30501 ALCOHOL ABUSE-CONTINUOUS 

30502 ALCOHOL ABUSE-EPISODIC 

30503 ALCOHOL ABUSE-IN REMISS 

3051 TOBACCO USE DISORDER 

3052 CANNABIS ABUSE* 

30520 CANNABIS ABUSE-UNSPEC 

30521 CANNABIS ABUSE-CONTIN 

30522 CANNABIS ABUSE-EPISODIC

30523 CANNABIS ABUSE-IN REMISS 

3053 HALLUCINOGEN ABUSE* 

30530 HALLUCINOG ABUSE-UNSPEC 

30531 HALLUCINOG ABUSE-CONTIN 

30532 HALLUCINOG ABUSE-EPISOD 

30533 HALLUCINOG ABUSE-REMISS 

3054 BARBITURATE ABUSE* 

30540 BARBITURATE ABUSE-UNSPEC 

30541 BARBITURATE ABUSE-CONTIN 

30542 BARBITURATE ABUSE-EPISOD 

30543 BARBITURATE ABUSE-REMISS 

3055 OPIOID ABUSE* 

30550 OPIOID ABUSE-UNSPEC 

30551 OPIOID ABUSE-CONTINUOUS 

30552 OPIOID ABUSE-EPISODIC 

30553 OPIOID ABUSE-IN REMISS 

3056 COCAINE ABUSE* 

30560 COCAINE ABUSE-UNSPEC 

30561 COCAINE ABUSE-CONTINUOUS 

30562 COCAINE ABUSE-EPISODIC 

30563 COCAINE ABUSE-IN REMISS 

3057 AMPHETAMINE ABUSE* 

30570 AMPHETAMINE ABUSE-UNSPEC 

30571 AMPHETAMINE ABUSE-CONTIN 

30572 AMPHETAMINE ABUSE-EPISOD 

30573 AMPHETAMINE ABUSE-REMISS 

3058 ANTIDEPRESSANT ABUSE* 

30580 ANTIDEPRESS ABUSE-UNSPEC 

30581 ANTIDEPRESS ABUSE-CONTIN 

30582 ANTIDEPRESS ABUSE-EPISOD 

30583 ANTIDEPRESS ABUSE-REMISS 

3059 DRUG ABUSE NEC/NOS* 

30590 DRUG ABUSE NEC-UNSPEC 

30591 DRUG ABUSE NEC-CONTIN 

30592 DRUG ABUSE NEC-EPISODIC 

30593 DRUG ABUSE NEC-IN REMISS 

306 PSYCHOPHYSIOLOGIC DIS* 

3060 PSYCHOGEN MUSCULSKEL DIS 

3061 PSYCHOGENIC RESPIR DIS 

3062 PSYCHOGEN CARDIOVASC DIS 

3063 PSYCHOGENIC SKIN DISEASE 

3064 PSYCHOGENIC GI DISEASE 

3065 PSYCHOGENIC GU DISEASE* 

30650 PSYCHOGENIC GU DIS NOS 

30651 PSYCHOGENIC VAGINISMUS 

30652 PSYCHOGENIC DYSMENORRHEA 

30653 PSYCHOGENIC DYSURIA 

30659 PSYCHOGENIC GU DIS NEC 

3066 PSYCHOGEN ENDOCRINE DIS 

3067 PSYCHOGENIC SENSORY DIS 

3068 PSYCHOGENIC DISORDER NEC 

3069 PSYCHOGENIC DISORDER NOS 

307 SPECIAL SYMPTOM NEC* 

3070 STAMMERING & STUTTERING 

3071 ANOREXIA NERVOSA 

3072 TICS* 

30720 TIC DISORDER NOS

30721 TRANSIENT TIC, CHILDHOOD 

30722 CHRONIC MOTOR TIC DIS 

30723 GILLES TOURETTE DISORDER 

3073 STEREOTYPED MOVEMENTS 

3074 NONORGANIC SLEEP DISORD* 

30740 NONORGANIC SLEEP DIS NOS 

30741 TRANSIENT INSOMNIA 

30742 PERSISTENT INSOMNIA 

30743 TRANSIENT HYPERSOMNIA 

30744 PERSISTENT HYPERSOMNIA 

30745 DISRUPT SLEEP-WAKE CYCLE 

30746 SOMNAMBULISM/NGHT TERROR 

30747 SLEEP STAGE DYSFUNC NEC 

30748 REPETIT SLEEP INTRUSION 

30749 NONORGANIC SLEEP DIS NEC 

3075 EATING DISORDERS NEC/NOS* 

30750 EATING DISORDER NOS 

30751 BULIMIA 

30752 PICA 

30753 PSYCHOGENIC RUMINATION 

30754 PSYCHOGENIC VOMITING 

30759 EATING DISORDER NEC 

3076 ENURESIS 

3077 ENCOPRESIS 

3078 PSYCHALGIA* 

30780 PSYCHOGENIC PAIN NOS 

30781 TENSION HEADACHE 

30789 PSYCHOGENIC PAIN NEC 

3079 SPECIAL SYMPTOM NEC/NOS 

308 ACUTE REACTION TO STRESS* 

3080 STRESS REACT, EMOTIONAL 

3081 STRESS REACTION, FUGUE 

3082 STRESS REACT, PSYCHOMOT 

3083 ACUTE STRESS REACT NEC 

3084 STRESS REACT, MIXED DIS 

3089 ACUTE STRESS REACT NOS 

309 ADJUSTMENT REACTION* 

3090 BRIEF DEPRESSIVE REACT 

3091 PROLONG DEPRESSIVE REACT 

3092 ADJUST REACT/OTH EMOTION* 

30921 SEPARATION ANXIETY 

30922 EMANCIPATION DISORDER 

30923 ACADEMIC/WORK INHIBITION 

30924 ADJ REACT-ANXIOUS MOOD 

30928 ADJ REACT-MIXED EMOTION 

30929 ADJ REACT-EMOTION NEC 

3093 ADJUST REACT-CONDUCT DIS 

3094 ADJ REACT-EMOTION/CONDUC 

3098 OTHER ADJUST REACTION* 

30981 PROLONG POSTTRAUM STRESS 

30982 ADJUST REACT-PHYS SYMPT 

30983 ADJUST REACT-WITHDRAWAL 

30989 ADJUSTMENT REACTION NEC 

3099 ADJUSTMENT REACTION NOS 

310 NONPSYCHOTIC BRAIN SYND* 

3100 FRONTAL LOBE SYNDROME 

3101 ORGANIC PERSONALITY SYND

3102 POSTCONCUSSION SYNDROME 

3108 NONPSYCHOT BRAIN SYN NEC 

3109 NONPSYCHOT BRAIN SYN NOS 

311 DEPRESSIVE DISORDER NEC 

312 CONDUCT DISTURBANCE NEC* 

3120 UNSOCIALIZED AGGRESSION* 

31200 UNSOCIAL AGGRESS-UNSPEC 

31201 UNSOCIAL AGGRESSION-MILD 

31202 UNSOCIAL AGGRESSION-MOD 

31203 UNSOCIAL AGGRESS-SEVERE 

3121 UNSOCIALIZ, UNAGGRESSIVE* 

31210 UNSOCIAL UNAGGRESS-UNSP 

31211 UNSOCIAL UNAGGRESS-MILD 

31212 UNSOCIAL UNAGGRESS-MOD 

31213 UNSOCIAL UNAGGR-SEVERE 

3122 SOCIALIZED CONDUCT DIS* 

31220 SOCIAL CONDUCT DIS-UNSP 

31221 SOCIAL CONDUCT DIS-MILD 

31222 SOCIAL CONDUCT DIS-MOD 

31223 SOCIAL CONDUCT DIS-SEV 

3123 IMPULSE CONTROL DIS NEC* 

31230 IMPULSE CONTROL DIS NOS 

31231 PATHOLOGICAL GAMBLING 

31232 KLEPTOMANIA 

31233 PYROMANIA 

31234 INTERMITT EXPLOSIVE DIS 

31235 ISOLATED EXPLOSIVE DIS 

31239 IMPULSE CONTROL DIS NEC 

3124 MIX DIS CONDUCT/EMOTION 

3128 OTHER CONDUCT DISTURB* 

31281 CNDCT DSRDR CHLDHD ONST 

31282 CNDCT DSRDR ADLSCNT ONST 

31289 OTHER CONDUCT DISORDER 

3129 CONDUCT DISTURBANCE NOS 

313 EMOTIONAL DIS CHILD/ADOL* 

3130 OVERANXIOUS DISORDER 

3131 MISERY & UNHAPPINESS DIS 

3132 SENSITIVITY & WITHDRAWAL* 

31321 SHYNESS DISORDER-CHILD 

31322 INTROVERTED DIS-CHILD 

31323 ELECTIVE MUTISM 

3133 RELATIONSHIP PROBLEMS 

3138 OTH EMOTIONAL DIS CHILD* 

31381 OPPOSITIONAL DISORDER 

31382 IDENTITY DISORDER 

31383 ACADEMIC UNDERACHIEVMENT 

31389 EMOTIONAL DIS CHILD NEC 

3139 EMOTIONAL DIS CHILD NOS 

314 HYPERKINETIC SYNDROME* 

3140 ATTENTION DEFICIT DIS* 

31400 ATTN DEFIC NONHYPERACT 

31401 ATTN DEFICIT W HYPERACT 

3141 HYPERKINET W DEVEL DELAY 

3142 HYPERKINETIC CONDUCT DIS 

3148 OTHER HYPERKINETIC SYND 

3149 HYPERKINETIC SYND NOS 

315 SPECIFIC DEVELOP DELAYS*

3150 SPECIFIC READING DIS* 

31500 READING DISORDER NOS 

31501 ALEXIA 

31502 DEVELOPMENTAL DYSLEXIA 

31509 READING DISORDER NEC 

3151 ARITHMETICAL DISORDER 

3152 OTH LEARNING DIFFICULTY 

3153 SPEECH/LANGUAGE DISORDER* 

31531 DEVELOPMENT LANGUAGE DIS 

31532 RECEPTIVE LANGUAGE DISRD 

31539 SPEECH/LANGUAGE DIS NEC 

3154 COORDINATION DISORDER 

3155 MIXED DEVELOPMENT DIS 

3158 DEVELOPMENT DELAYS NEC 

3159 DEVELOPMENT DELAY NOS 

316 PSYCHIC FACTOR W OTH DIS 

317 MILD MENTAL RETARDATION 

318 OTHER MENTAL RETARDATION* 

3180 MOD MENTAL RETARDATION 

3181 SEVERE MENTAL RETARDAT 

3182 PROFOUND MENTAL RETARDAT 

319 MENTAL RETARDATION NOS 

320 BACTERIAL MENINGITIS* 

3200 HEMOPHILUS MENINGITIS 

3201 PNEUMOCOCCAL MENINGITIS 

3202 STREPTOCOCCAL MENINGITIS 

3203 STAPHYLOCOCC MENINGITIS 

3207 MENING IN OTH BACT DIS 

3208 BACTERIAL MENINGITIS NEC* 

32081 ANAEROBIC MENINGITIS 

32082 MNINGTS GRAM-NEG BCT NEC 

32089 MENINGITIS OTH SPCF BACT 

3209 BACTERIAL MENINGITIS NOS 

321 OTH ORGANISM MENINGITIS* 

3210 CRYPTOCOCCAL MENINGITIS 

3211 MENING IN OTH FUNGAL DIS 

3212 MENING IN OTH VIRAL DIS 

3213 TRYPANOSOMIASIS MENINGIT 

3214 MENINGIT D/T SARCOIDOSIS 

3218 MENING IN OTH NONBAC DIS 

322 MENINGITIS, UNSPECIFIED* 

3220 NONPYOGENIC MENINGITIS 

3221 EOSINOPHILIC MENINGITIS 

3222 CHRONIC MENINGITIS 

3229 MENINGITIS NOS 

323 ENCEPHALOMYELITIS* 

3230 ENCEPHALIT IN VIRAL DIS 

3231 RICKETTSIAL ENCEPHALITIS 

3232 PROTOZOAL ENCEPHALITIS 

3234 OTH ENCEPHALIT D/T INFEC 

3235 POSTIMMUNIZAT ENCEPHALIT 

3236 POSTINFECT ENCEPHALITIS 

3237 TOXIC ENCEPHALITIS 

3238 ENCEPHALITIS NEC 

3239 ENCEPHALITIS NOS 

324 CNS ABSCESS* 

3240 INTRACRANIAL ABSCESS

3241 INTRASPINAL ABSCESS 

3249 CNS ABSCESS NOS 

325 PHLEBITIS INTRCRAN SINUS 

326 LATE EFF CNS ABSCESS 

330 CEREBRAL DEGEN IN CHILD* 

3300 LEUKODYSTROPHY 

3301 CEREBRAL LIPIDOSES 

3302 CEREB DEGEN IN LIPIDOSIS 

3303 CERB DEG CHLD IN OTH DIS 

3308 CEREB DEGEN IN CHILD NEC 

3309 CEREB DEGEN IN CHILD NOS 

331 CEREBRAL DEGENERATION* 

3310 ALZHEIMER'S DISEASE 

3311 PICK'S DISEASE 

3312 SENILE DEGENERAT BRAIN 

3313 COMMUNICAT HYDROCEPHALUS 

3314 OBSTRUCTIV HYDROCEPHALUS 

3317 CEREB DEGEN IN OTH DIS 

3318 CEREB DEGENERATION NEC* 

33181 REYE'S SYNDROME 

33189 CEREB DEGENERATION NEC 

3319 CEREB DEGENERATION NOS 

332 PARKINSON'S DISEASE* 

3320 PARALYSIS AGITANS 

3321 SECONDARY PARKINSONISM 

333 EXTRAPYRAMIDAL DIS NEC* 

3330 DEGEN BASAL GANGLIA NEC 

3331 TREMOR NEC 

3332 MYOCLONUS 

3333 TICS OF ORGANIC ORIGIN 

3334 HUNTINGTON'S CHOREA 

3335 CHOREA NEC 

3336 IDIOPAT TORSION DYSTONIA 

3337 SYMPTOM TORSION DYSTONIA 

3338 FRAGMNT TORSION DYSTONIA* 

33381 BLEPHAROSPASM 

33382 OROFACIAL DYSKINESIA 

33383 SPASMODIC TORTICOLLIS 

33384 ORGANIC WRITERS' CRAMP 

33389 FRAGM TORSION DYSTON NEC 

3339 EXTRPYRMIDAL DIS NEC/NOS* 

33390 EXTRAPYRAMIDAL DIS NOS 

33391 STIFF-MAN SYNDROME 

33392 NEUROLEPTIC MALGNT SYND 

33393 BNIGN SHUDDERING ATTACKS 

33399 EXTRAPYRAMIDAL DIS NEC 

334 SPINOCEREBELLAR DISEASE* 

3340 FRIEDREICH'S ATAXIA 

3341 HERED SPASTIC PARAPLEGIA 

3342 PRIMARY CEREBELLAR DEGEN 

3343 CEREBELLAR ATAXIA NEC 

3344 CEREBEL ATAX IN OTH DIS 

3348 SPINOCEREBELLAR DIS NEC 

3349 SPINOCEREBELLAR DIS NOS 

335 ANT HORN CELL DISEASE* 

3350 WERDNIG-HOFFMANN DISEASE 

3351 SPINAL MUSCULAR ATROPHY*

33510 SPINAL MUSCL ATROPHY NOS 

33511 KUGELBERG-WELANDER DIS 

33519 SPINAL MUSCL ATROPHY NEC 

3352 MOTOR NEURON DISEASE* 

33520 AMYOTROPHIC SCLEROSIS 

33521 PROG MUSCULAR ATROPHY 

33522 PROGRESSIVE BULBAR PALSY 

33523 PSEUDOBULBAR PALSY 

33524 PRIM LATERAL SCLEROSIS 

33529 MOTOR NEURON DISEASE NEC 

3358 ANT HORN CELL DIS NEC 

3359 ANT HORN CELL DIS NOS 

336 SPINAL CORD DISEASE NEC* 

3360 SYRINGOMYELIA 

3361 VASCULAR MYELOPATHIES 

3362 COMB DEG CORD IN OTH DIS 

3363 MYELOPATHY IN OTH DIS 

3368 MYELOPATHY NEC 

3369 SPINAL CORD DISEASE NOS 

337 AUTONOMIC NERVE DISORDER* 

3370 IDIOPATH AUTO NEUROPATHY 

3371 AUT NEUROPTHY IN OTH DIS 

3372 REFLEX SYMPTH DYSTROPHY* 

33720 UNSP RFLX SYMPTH DYSTRPH 

33721 RFLX SYM DYSTRPH UP LIMB 

33722 RFLX SYM DYSTRPH LWR LMB 

33729 RFLX SYM DYSTRPH OTH ST 

3373 AUTONOMIC DYSREFLEXIA 

3379 AUTONOMIC NERVE DIS NEC 

340 MULTIPLE SCLEROSIS 

341 OTHER CNS DEMYELINATION* 

3410 NEUROMYELITIS OPTICA 

3411 SCHILDER'S DISEASE 

3418 CNS DEMYELINATION NEC 

3419 CNS DEMYELINATION NOS 

342 HEMIPLEGIA* 

3420 FLACCID HEMIPLEGIA* 

34200 FLCCD HMIPLGA UNSPF SIDE 

34201 FLCCD HMIPLGA DOMNT SIDE 

34202 FLCCD HMIPLG NONDMNT SDE 

3421 SPASTIC HEMIPLEGIA* 

34210 SPSTC HMIPLGA UNSPF SIDE 

34211 SPSTC HMIPLGA DOMNT SIDE 

34212 SPSTC HMIPLG NONDMNT SDE 

34280 OT SP HMIPLGA UNSPF SIDE 

34281 OT SP HMIPLGA DOMNT SIDE 

34282 OT SP HMIPLG NONDMNT SDE 

3429 HEMIPLEGIA NOS* 

34290 UNSP HEMIPLGA UNSPF SIDE 

34291 UNSP HEMIPLGA DOMNT SIDE 

34292 UNSP HMIPLGA NONDMNT SDE 

343 INFANTILE CEREBRAL PALSY* 

3430 CONGENITAL DIPLEGIA 

3431 CONGENITAL HEMIPLEGIA 

3432 CONGENITAL QUADRIPLEGIA 

3433 CONGENITAL MONOPLEGIA 

3434 INFANTILE HEMIPLEGIA

3438 CEREBRAL PALSY NEC 

3439 CEREBRAL PALSY NOS 

344 OTH PARALYTIC SYNDROMES* 

3440 QUADRIPLEGIA NOS* 

34400 QUADRIPLEGIA, UNSPECIFD 

34401 QUADRPLG C1-C4, COMPLETE 

34402 QUADRPLG C1-C4, INCOMPLT 

34403 QUADRPLG C5-C7, COMPLETE 

34404 QUADRPLG C5-C7, INCOMPLT 

34409 OTHER QUADRIPLEGIA 

3441 PARAPLEGIA NOS 

3442 DIPLEGIA OF UPPER LIMBS 

3443 MONOPLEGIA OF LOWER LIMB* 

34430 MONPLGA LWR LMB UNSP SDE 

34431 MONPLGA LWR LMB DMNT SDE 

34432 MNPLG LWR LMB NONDMNT SD 

3444 MONOPLEGIA OF UPPER LIMB* 

34440 MONPLGA UPR LMB UNSP SDE 

34441 MONPLGA UPR LMB DMNT SDE 

34442 MNPLG UPR LMB NONDMNT SD 

3445 MONOPLEGIA NOS 

3446 CAUDA EQUINA SYNDROME* 

34460 CAUDA EQUINA SYND NOS 

34461 NEUROGENIC BLADDER 

3448 PARALYTIC SYNDROMES NEC* 

34481 LOCKED-IN STATE 

34489 OTH SPCF PARALYTIC SYND 

3449 PARALYSIS NOS 

345 EPILEPSY* 

3450 GEN NONCONVULS EPILEPSY* 

34500 GEN NONCV EP W/O INTR EP 

34501 GEN NONCONV EP W INTR EP 

3451 GEN CONVULSIVE EPILEPSY* 

34510 GEN CNV EPIL W/O INTR EP 

34511 GEN CNV EPIL W INTR EPIL 

3452 PETIT MAL STATUS 

3453 GRAND MAL STATUS 

3454 PSYCHOMOTOR EPILEPSY* 

34540 PSYMOTR EPIL W/O INT EPI 

34541 PSYMOTR EPIL W INTR EPIL 

3455 PARTIAL EPILEPSY NEC* 

34550 PART EPIL W/O INTR EPIL 

34551 PART EPIL W INTR EPIL 

3456 INFANTILE SPASMS* 

34560 INF SPASM W/O INTR EPIL 

34561 INF SPASM W INTRACT EPIL 

3457 EPILEPS PARTIAL CONTINUA* 

34570 EPIL PAR CONT W/O INT EP 

34571 EPIL PAR CONT W INTR EPI 

3458 EPILEPSY NEC* 

34580 EPILEP NEC W/O INTR EPIL 

34581 EPILEPSY NEC W INTR EPIL 

3459 EPILEPSY NOS* 

34590 EPILEP NOS W/O INTR EPIL 

34591 EPILEPSY NOS W INTR EPIL 

346 MIGRAINE* 

3460 CLASSICAL MIGRAINE*

34600 CLSC MIGRNE WO NTRC MGRN 

34601 CLSC MGRN W NTRC MGR STD 

3461 COMMON MIGRAINE* 

34610 COMN MIGRNE WO NTRC MGRN 

34611 COMN MGRN W NTRC MGR STD 

3462 VARIANTS OF MIGRAINE* 

34620 VRNT MIGRNE WO NTRC MGRN 

34621 VRNT MGRN W NTRC MGR STD 

3468 MIGRAINE NEC* 

34680 OTHR MIGRNE WO NTRC MGRN 

34681 OTHR MGRN W NTRC MGR STD 

3469 MIGRAINE NOS* 

34690 MIGRNE UNSP WO NTRC MGRN 

34691 MGRN UNSP W NTRC MGR STD 

347 CATAPLEXY AND NARCOLEPSY 

348 OTHER BRAIN CONDITIONS* 

3480 CEREBRAL CYSTS 

3481 ANOXIC BRAIN DAMAGE 

3482 PSEUDOTUMOR CEREBRI 

3483 ENCEPHALOPATHY NOS 

3484 COMPRESSION OF BRAIN 

3485 CEREBRAL EDEMA 

3488 BRAIN CONDITIONS NEC 

3489 BRAIN CONDITION NOS 

349 CNS DISORDER NEC/NOS* 

3490 LUMBAR PUNCTURE REACTION 

3491 COMPLICATION CNS DEVICE 

3492 DISORDER OF MENINGES NEC 

3498 OTHER CNS DISORDERS* 

34981 CEREBROSPINAL RHINORRHEA 

34982 TOXIC ENCEPHALOPATHY 

34989 CNS DISORDER NEC 

3499 CNS DISORDER NOS 

350 TRIGEMINAL NERV DISORDER* 

3501 TRIGEMINAL NEURALGIA 

3502 ATYPICAL FACE PAIN 

3508 TRIGEMINAL NERVE DIS NEC 

3509 TRIGEMINAL NERVE DIS NOS 

351 FACIAL NERVE DISORDERS* 

3510 BELL'S PALSY 

3511 GENICULATE GANGLIONITIS 

3518 FACIAL NERVE DIS NEC 

3519 FACIAL NERVE DIS NOS 

352 DISORDER CRAN NERVE NEC* 

3520 OLFACTORY NERVE DISORDER 

3521 GLOSSOPHARYNG NEURALGIA 

3522 GLOSSOPHAR NERVE DIS NEC 

3523 PNEUMOGASTRIC NERVE DIS 

3524 ACCESSORY NERVE DISORDER 

3525 HYPOGLOSSAL NERVE DIS 

3526 MULT CRANIAL NERVE PALSY 

3529 CRANIAL NERVE DIS NOS 

353 NERVE ROOT/PLEXUS DIS* 

3530 BRACHIAL PLEXUS LESIONS 

3531 LUMBOSACRAL PLEX LESION 

3532 CERVICAL ROOT LESION NEC 

3533 THORACIC ROOT LESION NEC

3534 LUMBSACRAL ROOT LES NEC 

3535 NEURALGIC AMYOTROPHY 

3536 PHANTOM LIMB (SYNDROME) 

3538 NERV ROOT/PLEXUS DIS NEC 

3539 NERV ROOT/PLEXUS DIS NOS 

354 MONONEURITIS UPPER LIMB* 

3540 CARPAL TUNNEL SYNDROME 

3541 MEDIAN NERVE LESION NEC 

3542 ULNAR NERVE LESION 

3543 RADIAL NERVE LESION 

3544 CAUSALGIA UPPER LIMB 

3545 MONONEURITIS MULTIPLEX 

3548 MONONEURITIS ARM NEC 

3549 MONONEURITIS ARM NOS 

355 MONONEURITIS LEG* 

3550 SCIATIC NERVE LESION 

3551 MERALGIA PARESTHETICA 

3552 FEMORAL NERVE LESION NEC 

3553 LAT POPLITEAL NERVE LES 

3554 MED POPLITEAL NERVE LES 

3555 TARSAL TUNNEL SYNDROME 

3556 PLANTAR NERVE LESION 

3557 MONONEURITIS LEG NEC* 

35571 CAUSALGIA LOWER LIMB 

35579 OTH MONONEUR LOWER LIMB 

3558 MONONEURITIS LEG NOS 

3559 MONONEURITIS NOS 

356 HERED PERIPH NEUROPATHY* 

3560 HERED PERIPH NEUROPATHY 

3561 PERONEAL MUSCLE ATROPHY 

3562 HERED SENSORY NEUROPATHY 

3563 REFSUM'S DISEASE 

3564 IDIO PROG POLYNEUROPATHY 

3568 IDIO PERIPH NEURPTHY NEC 

3569 IDIO PERIPH NEURPTHY NOS 

357 INFLAM/TOXIC NEUROPATHY* 

3570 AC INFECT POLYNEURITIS 

3571 NEURPTHY IN COL VASC DIS 

3572 NEUROPATHY IN DIABETES 

3573 NEUROPATHY IN MALIG DIS 

3574 NEUROPATHY IN OTHER DIS 

3575 ALCOHOLIC POLYNEUROPATHY 

3576 NEUROPATHY DUE TO DRUGS 

3577 NEURPTHY TOXIC AGENT NEC 

3578 INFLAM/TOX NEUROPTHY NEC 

3579 INFLAM/TOX NEUROPTHY NOS 

358 MYONEURAL DISORDERS* 

3580 MYASTHENIA GRAVIS 

3581 MYASTHENIA IN OTH DIS 

3582 TOXIC MYONEURAL DISORDER 

3588 MYONEURAL DISORDERS NEC 

3589 MYONEURAL DISORDERS NOS 

359 MUSCULAR DYSTROPHIES* 

3590 CONG HERED MUSC DYSTRPHY 

3591 HERED PROG MUSC DYSTRPHY 

3592 MYOTONIC DISORDERS 

3593 FAMIL PERIODIC PARALYSIS

3594 TOXIC MYOPATHY 

3595 MYOPATHY IN ENDOCRIN DIS 

3596 INFL MYOPATHY IN OTH DIS 

3598 MYOPATHY NEC 

3599 MYOPATHY NOS 

360 DISORDERS OF THE GLOBE* 

3600 PURULENT ENDOPHTHALMITIS* 

36000 PURULENT ENDOPHTHALM NOS 

36001 ACUTE ENDOPHTHALMITIS 

36002 PANOPHTHALMITIS 

36003 CHRONIC ENDOPHTHALMITIS 

36004 VITREOUS ABSCESS 

3601 OTHER ENDOPHTHALMITIS* 

36011 SYMPATHETIC UVEITIS 

36012 PANUVEITIS 

36013 PARASITIC ENDOPHTHAL NOS 

36014 OPHTHALMIA NODOSA 

36019 ENDOPHTHALMITIS NEC 

3602 DEGENERATIVE GLOBE DIS* 

36020 DEGENERAT GLOBE DIS NOS 

36021 PROGRESSIVE HIGH MYOPIA 

36023 SIDEROSIS 

36024 OTHER METALLOSIS, EYE 

36029 DEGENERATIVE GLOBE NEC 

3603 HYPOTONY OF EYE* 

36030 HYPOTONY NOS, EYE 

36031 PRIMARY HYPOTONY 

36032 HYPOTONY DUE TO FISTULA 

36033 HYPOTONY W EYE DIS NEC 

36034 FLAT ANTERIOR CHAMBER 

3604 DEGENERATION OF EYE* 

36040 DEGENERATION OF EYE NOS 

36041 BLIND HYPOTENSIVE EYE 

36042 BLIND HYPERTENSIVE EYE 

36043 HEMOPHTHALMOS 

36044 LEUCOCORIA 

3605 OLD MAGNET FB, EYE* 

36050 OLD MAGNET FB, EYE NOS 

36051 OLD MAGNET FB, ANT CHAMB 

36052 OLD MAGNET FB, IRIS 

36053 OLD MAGNET FB, LENS 

36054 OLD MAGNET FB, VITREOUS 

36055 OLD MAGNET FB, POST WALL 

36059 OLD MAGNET FB, EYE NEC 

3606 OLD FOREIGN BODY EYE NOS* 

36060 INTRAOCULAR FB NOS 

36061 FB IN ANTERIOR CHAMBER 

36062 FB IN IRIS OR CILIARY 

36063 FOREIGN BODY IN LENS 

36064 FOREIGN BODY IN VITREOUS 

36065 FB IN POSTERIOR WALL 

36069 INTRAOCULAR FB NEC 

3608 OTH DISORDERS OF GLOBE* 

36081 LUXATION OF GLOBE 

36089 DISORDER OF GLOBE NEC 

3609 DISORDER OF GLOBE NOS 

361 RETINAL DETACHMENT*

3610 RETINAL DETACH W DEFECT* 

36100 DETACHMNT W DEFECT NOS 

36101 PART DETACH-SINGL DEFEC 

36102 PART DETACH-MULT DEFECT 

36103 PART DETACH-GIANT TEAR 

36104 PART DETACH-DIALYSIS 

36105 RECENT DETACHMENT, TOTAL 

36106 OLD DETACHMENT, PARTIAL 

36107 OLD DETACHMENT, TOTAL 

3611 RETINOSCHISIS* 

36110 RETINOSCHISIS NOS 

36111 FLAT RETINOSCHISIS 

36112 BULLOUS RETINOSCHISIS 

36113 PRIMARY RETINAL CYSTS 

36114 SECONDARY RETINAL CYSTS 

36119 RETINOSHISIS OR CYST NEC 

3612 SEROUS RETINA DETACHMENT 

3613 RETINA DEFECT W/O DETACH* 

36130 RETINAL DEFECT NOS 

36131 ROUND HOLE OF RETINA 

36132 HORSESHOE TEAR OF RETINA 

36133 MULT DEFECTS OF RETINA 

3618 OTHER RETINAL DETACHMENT* 

36181 RETINAL TRACTION DETACH 

36189 RETINAL DETACHMENT NEC 

3619 RETINAL DETACHMENT NOS 

362 RETINAL DISORDERS NEC* 

3620 DIABETIC RETINOPATHY* 

36201 DIABETIC RETINOPATHY NOS 

36202 PROLIF DIAB RETINOPATHY 

3621 BACKGRND RETINOPATHY NEC* 

36210 BACKGRND RETINOPATHY NOS 

36211 HYPERTENSIVE RETINOPATHY 

36212 EXUDATIVE RETINOPATHY 

36213 RETINAL VASCULAR CHANGES 

36214 RETINA MICROANEURYSM NOS 

36215 RETINAL TELANGIECTASIA 

36216 RETINAL NEOVASCULAR NOS 

36217 RETINAL VARICES 

36218 RETINAL VASCULITIS 

3622 OTH PROLIF RETINOPATHY* 

36221 RETROLENTAL FIBROPLASIA 

36229 PROLIF RETINOPATHY NEC 

3623 RETINAL VASC OCCLUSION* 

36230 RETINAL VASC OCCLUS NOS 

36231 CENT RETINA ARTERY OCCLU 

36232 ARTERIAL BRANCH OCCLUS 

36233 PART ARTERIAL OCCLUSION 

36234 TRANSIENT ARTERIAL OCCLU 

36235 CENT RETINAL VEIN OCCLUS 

36236 VENOUS TRIBUTARY OCCLUS 

36237 RETINA VENOUS ENGORGEMNT 

3624 RETINA LAYER SEPARATION* 

36240 RETINA LAYER SEPARAT NOS 

36241 CENT SEROUS RETINOPATHY 

36242 SEROUS DETACH PIGM EPITH 

36243 HEM DETACH PIGMNT EPITH

3625 DEGENERATION OF MACULA* 

36250 MACULAR DEGENERATION NOS 

36251 NONEXUDAT MACULAR DEGEN 

36252 EXUDATIVE MACULAR DEGEN 

36253 CYSTOID MACULAR DEGEN 

36254 MACULAR CYST OR HOLE 

36255 TOXIC MACULOPATHY 

36256 MACULAR PUCKERING 

36257 DRUSEN (DEGENERATIVE) 

3626 PERIPH RETINA DEGEN* 

36260 PERIPH RETINA DEGEN NOS 

36261 PAVING STONE DEGENERAT 

36262 MICROCYSTOID DEGENERAT 

36263 LATTICE DEGENERATION 

36264 SENILE RETICULAR DEGEN 

36265 SECONDRY PIGMENT DEGEN 

36266 SEC VITREORETINA DEGEN 

3627 HERED RETINAL DYSTROPHY* 

36270 HERED RETIN DYSTRPHY NOS 

36271 RET DYSTRPH IN LIPIDOSES 

36272 RET DYSTRPH IN SYST DIS 

36273 VITREORETINAL DYSTROPHY 

36274 PIGMENT RETINA DYSTROPHY 

36275 SENSORY RETINA DYSTROPHY 

36276 VITELLIFORM DYSTROPHY 

36277 BRUCH MEMBRANE DYSTROPHY 

3628 OTHER RETINAL DISORDERS* 

36281 RETINAL HEMORRHAGE 

36282 RETINA EXUDATES/DEPOSITS 

36283 RETINAL EDEMA 

36284 RETINAL ISCHEMIA 

36285 RETINAL NERV FIBER DEFEC 

36289 RETINAL DISORDERS NEC 

3629 RETINAL DISORDER NOS 

363 CHOROIDAL DISORDERS* 

3630 FOCAL CHORIORETINITIS* 

36300 FOCAL CHORIORETINIT NOS 

36301 JUXTAPAP FOC CHOROIDITIS 

36303 FOC CHOROIDITIS POST NEC 

36304 PERIPH FOCAL CHOROIDITIS 

36305 JUXTAPAP FOCAL RETINITIS 

36306 MACULAR FOCAL RETINITIS 

36307 FOC RETINITIS POST NEC 

36308 PERIPH FOCAL RETINITIS 

3631 DISSEMIN CHORIORETINITIS* 

36310 DISSEM CHORIORETINIT NOS 

36311 DISSEM CHOROIDITIS, POST 

36312 PERIPH DISEM CHOROIDITIS 

36313 GEN DISSEM CHOROIDITIS 

36314 METASTAT DISSEM RETINIT 

36315 PIGMENT EPITHELIOPATHY 

3632 CHORIORETINITIS NEC/NOS* 

36320 CHORIORETINITIS NOS 

36321 PARS PLANITIS 

36322 HARADA'S DISEASE 

3633 CHORIORETINAL SCARS* 

36330 CHORIORETINAL SCAR NOS

36331 SOLAR RETINOPATHY 

36332 MACULAR SCARS NEC 

36333 POSTERIOR POLE SCAR NEC 

36334 PERIPHERAL RETINAL SCARS 

36335 DISSEMINATED RETINA SCAR 

3634 CHOROIDAL DEGENERATIONS* 

36340 CHOROIDAL DEGEN NOS 

36341 SENILE ATROPHY, CHOROID 

36342 DIFUS SEC ATROPH CHOROID 

36343 ANGIOID STREAKS, CHOROID 

3635 HERED CHOROID DYSTROPHY* 

36350 HERED CHOROID ATROPH NOS 

36351 PRT CIRCMPAP CHOROID DYS 

36352 TOT CIRCMPAP CHOROID DYS 

36353 PART CENT CHOROID DYSTR 

36354 TOT CENT CHOROID ATROPHY 

36355 CHOROIDEREMIA 

36356 PRT GEN CHOROID DYST NEC 

36357 TOT GEN CHOROID DYST NEC 

3636 CHOROIDAL HEMORR/RUPTURE* 

36361 CHOROIDAL HEMORRHAGE NOS 

36362 EXPULSIVE CHOROID HEMORR 

36363 CHOROIDAL RUPTURE 

3637 CHOROIDAL DETACHMENT* 

36370 CHOROIDAL DETACHMENT NOS 

36371 SEROUS CHOROID DETACHMNT 

36372 HEMORR CHOROID DETACHMNT 

3638 DISORDERS OF CHOROID NEC 

3639 CHOROIDAL DISORDER NOS 

364 IRIS/CILIARY BODY DIS* 

3640 ACUTE IRIDOCYCLITIS* 

36400 ACUTE IRIDOCYCLITIS NOS 

36401 PRIMARY IRIDOCYCLITIS 

36402 RECURRENT IRIDOCYCLITIS 

36403 SECONDRY IRITIS, INFECT 

36404 SECOND IRITIS, NONINFEC 

36405 HYPOPYON 

3641 CHRONIC IRIDOCYCLITIS* 

36410 CHR IRIDOCYCLITIS NOS 

36411 CHR IRIDOCYL IN OTH DIS 

3642 IRIDOCYCLITIS NEC* 

36421 FUCH HETROCHROM CYCLITIS 

36422 GLAUCOMATOCYCLIT CRISES 

36423 LENS-INDUCED IRIDOCYCLIT 

36424 VOGT-KOYANAGI SYNDROME 

3643 IRIDOCYCLITIS NOS 

3644 VASCULR DIS IRIS/CILIARY* 

36441 HYPHEMA 

36442 RUBEOSIS IRIDIS 

3645 DEGENERAT IRIS/CILIARY* 

36451 PROGRESSIVE IRIS ATROPHY 

36452 IRIDOSCHISIS 

36453 PIGMENT IRIS DEGENERAT 

36454 PUPILLARY MARGIN DEGEN 

36455 MIOTIC CYST PUPIL MARGIN 

36456 DEGEN CHAMBER ANGLE 

36457 DEGEN CILIARY BODY

36459 IRIS ATROPHY NEC 

3646 ANTERIOR CHAMBER CYSTS* 

36460 IDIOPATHIC CYSTS 

36461 IMPLANTATION CYSTS 

36462 EXUD CYST IRIS/ANT CHAMB 

36463 PRIMARY CYST PARS PLANA 

36464 EXUDAT CYST PARS PLANA 

3647 ADHESN IRIS/CILIARY BODY* 

36470 ADHESIONS OF IRIS NOS 

36471 POSTERIOR SYNECHIAE 

36472 ANTERIOR SYNECHIAE 

36473 GONIOSYNECHIAE 

36474 PUPILLARY MEMBRANES 

36475 PUPILLARY ABNORMALITIES 

36476 IRIDODIALYSIS 

36477 RECESSION, CHAMBER ANGLE 

3648 IRIS/CILIARY DIS NEC 

3649 IRIS/CILIARY DIS NOS 

365 GLAUCOMA* 

3650 BORDERLINE GLAUCOMA* 

36500 PREGLAUCOMA NOS 

36501 OPN ANGL W BORDERLN FIND 

36502 ANATOMICAL NARROW ANGLE 

36503 STEROID RESPONDERS 

36504 OCULAR HYPERTENSION 

3651 OPEN-ANGLE GLAUCOMA* 

36510 OPEN-ANGLE GLAUCOMA NOS 

36511 PRIM OPEN ANGLE GLAUCOMA 

36512 LOW TENSION GLAUCOMA 

36513 PIGMENTARY GLAUCOMA 

36514 GLAUCOMA OF CHILDHOOD 

36515 RESIDUAL OPN ANG GLAUCMA 

3652 PRIM ANGL-CLOSURE GLAUC* 

36520 PRIM ANGL-CLOS GLAUC NOS 

36521 INTERMIT ANGL-CLOS GLAUC 

36522 ACUTE ANGL-CLOS GLAUCOMA 

36523 CHR ANGLE-CLOS GLAUCOMA 

36524 RESIDUAL ANGL-CLOS GLAUC 

3653 STEROID-INDUCED GLAUCOMA* 

36531 GLAUC STAGE-STER INDUCED 

36532 GLAUC RESID-STER INDUCED 

3654 GLAUCOM W CONGEN ANOMALY* 

36541 GLAUC W CHAMB ANGLE ANOM 

36542 GLAUCOMA W IRIS ANOMALY 

36543 GLAUC W ANT SEG ANOM NEC 

36544 GLAUCOMA W SYSTEMIC SYND 

3655 GLAUCOMA W LENS DISORDER* 

36551 PHACOLYTIC GLAUCOMA 

36552 PSEUDOEXFOLIAT GLAUCOMA 

36559 GLAUCOMA W LENS DIS NEC 

3656 GLAUC W OCULAR DIS NEC* 

36560 GLAUC W OCULAR DIS NOS 

36561 GLAUC W PUPILLARY BLOCK 

36562 GLAUCOMA W OCULAR INFLAM 

36563 GLAUCOMA W VASCULAR DIS 

36564 GLAUCOMA W TUMOR OR CYST 

36565 GLAUCOMA W OCULAR TRAUMA

3658 OTHER GLAUCOMA* 

36581 HYPERSECRETION GLAUCOMA 

36582 GLAUC W INC EPISCL PRESS 

36589 GLAUCOMA NEC 

3659 GLAUCOMA NOS 

366 CATARACT* 

3660 NONSENILE CATARACT* 

36600 NONSENILE CATARACT NOS 

36601 ANT SUBCAPS POL CATARACT 

36602 POST SUBCAPS POL CATARCT 

36603 CORTICAL CATARACT 

36604 NUCLEAR CATARACT 

36609 NONSENILE CATARACT NEC 

3661 SENILE CATARACT* 

36610 SENILE CATARACT NOS 

36611 PSEUDOEXFOL LENS CAPSULE 

36612 INCIPIENT CATARACT 

36613 ANT SUBCAPS SENILE CATAR 

36614 POST SUBCAP SENILE CATAR 

36615 CORTICAL SENILE CATARACT 

36616 SENILE NUCLEAR CATARACT 

36617 MATURE CATARACT 

36618 HYPERMATURE CATARACT 

36619 SENILE CATARACT NEC 

3662 TRAUMATIC CATARACT* 

36620 TRAUMATIC CATARACT NOS 

36621 LOCAL TRAUMATIC OPACITY 

36622 TOTAL TRAUMATIC CATARACT 

36623 PART RESOLV TRAUM CATAR 

3663 COMPLICATED CATARACT* 

36630 CATARACTA COMPLICATA NOS 

36631 GLAUCOMATOUS FLECKS 

36632 CATARACT IN INFLAM DIS 

36633 CATARACT W NEOVASCULIZAT 

36634 CATARACT IN DEGEN DIS 

3664 CATARACT W OTH DISORDER* 

36641 DIABETIC CATARACT 

36642 TETANIC CATARACT 

36643 MYOTONIC CATARACT 

36644 CATARACT W SYNDROME NEC 

36645 TOXIC CATARACT 

36646 CATARACT W RADIATION 

3665 AFTER-CATARACT* 

36650 AFTER-CATARACT NOS 

36651 SOEMMERING'S RING 

36652 AFTER-CATARACT NEC 

36653 AFTR-CATAR OBSCUR VISION 

3668 CATARACT NEC 

3669 CATARACT NOS 

367 DISORDERS OF REFRACTION* 

3670 HYPERMETROPIA 

3671 MYOPIA 

3672 ASTIGMATISM* 

36720 ASTIGMATISM NOS 

36721 REGULAR ASTIGMATISM 

36722 IRREGULAR ASTIGMATISM 

3673 ANISOMETROP/ANISEIKONIA*

36731 ANISOMETROPIA 

36732 ANISEIKONIA 

3674 PRESBYOPIA 

3675 ACCOMMODATION DISORDERS* 

36751 PARESIS OF ACCOMMODATION 

36752 TOT INTERN OPHTHALMOPLEG 

36753 SPASM OF ACCOMMODATION 

3678 REFRACTION DISORDER NEC* 

36781 TRANSIENT REFRACT CHANGE 

36789 REFRACTION DISORDER NEC 

3679 REFRACTION DISORDER NOS 

368 VISUAL DISTURBANCES* 

3680 AMBLYOPIA EX ANOPSIA* 

36800 AMBLYOPIA NOS 

36801 STRABISMIC AMBLYOPIA 

36802 DEPRIVATION AMBLYOPIA 

36803 REFRACTIVE AMBLYOPIA 

3681 SUBJECTVE VISUAL DISTURB* 

36810 SUBJ VISUAL DISTURB NOS 

36811 SUDDEN VISUAL LOSS 

36812 TRANSIENT VISUAL LOSS 

36813 VISUAL DISCOMFORT 

36814 DISTORTION OF SHAPE/SIZE 

36815 VISUAL DISTORTIONS NEC 

36816 PSYCHOPHYSIC VISUAL DIST 

3682 DIPLOPIA 

3683 BINOCULAR VISION DIS NEC* 

36830 BINOCULAR VISION DIS NOS 

36831 BINOCULAR VIS SUPPRESS 

36832 VISUAL PERCEPT W/O FUSN 

36833 FUSION W DEF STEREOPSIS 

36834 ABN RETINA CORRESPOND 

3684 VISUAL FIELD DEFECTS* 

36840 VISUAL FIELD DEFECT NOS 

36841 CENTRAL SCOTOMA 

36842 SCOTOMA OF BLIND SPOT 

36843 SECTOR OR ARCUATE DEFECT 

36844 VISUAL FIELD DEFECT NEC 

36845 GEN VISUAL CONTRACTION 

36846 HOMONYMOUS HEMIANOPSIA 

36847 HETERONYMOUS HEMIANOPSIA 

3685 COLOR VISION DEFICIENCY* 

36851 PROTAN DEFECT 

36852 DEUTAN DEFECT 

36853 TRITAN DEFECT 

36854 ACHROMATOPSIA 

36855 ACQ COLOR DEFICIENCY 

36859 COLOR DEFICIENCY NEC 

3686 NIGHT BLINDNESS* 

36860 NIGHT BLINDNESS NOS 

36861 CONGEN NIGHT BLINDNESS 

36862 ACQUIRED NIGHT BLINDNESS 

36863 ABN DARK ADAPTAT CURVE 

36869 NIGHT BLINDNESS NEC 

3688 VISUAL DISTURBANCES NEC 

3689 VISUAL DISTURBANCE NOS 

369 BLINDNESS AND LOW VISION*

3690 PROFOUND BLIND BOTH EYES* 

36900 BOTH EYES BLIND-WHO DEF 

36901 TOT IMPAIRMENT-BOTH EYES 

36902 ONE EYE-NEAR TOT/OTH-NOS 

36903 ONE EYE-NEAR TOT/OTH-TOT 

36904 NEAR-TOT IMPAIR-BOTH EYE 

36905 ONE EYE-PROFOUND/OTH-NOS 

36906 ONE EYE-PROFOUND/OTH-TOT 

36907 ONE EYE-PRFND/OTH-NR TOT 

36908 PROFOUND IMPAIR BOTH EYE 

3691 MOD/SEV W PROFND IMPAIR* 

36910 BLINDNESS/LOW VISION 

36911 1 EYE-SEV/OTH-BLIND NOS 

36912 ONE EYE-SEVERE/OTH-TOTAL 

36913 ONE EYE-SEV/OTH-NEAR TOT 

36914 ONE EYE-SEV/OTH-PRFND 

36915 ONE EYE-MOD/OTH-BLIND 

36916 ONE EYE-MODERATE/OTH-TOT 

36917 ONE EYE-MOD/OTH-NEAR TOT 

36918 ONE EYE-MOD/OTH-PROFOUND 

3692 MOD/SEV IMPAIR-BOTH EYES* 

36920 LOW VISION, 2 EYES NOS 

36921 ONE EYE-SEVERE/OTH-NOS 

36922 SEVERE IMPAIR-BOTH EYES 

36923 ONE EYE-MODERATE/OTH-NOS 

36924 ONE EYE-MODERATE/OTH-SEV 

36925 MODERATE IMPAIR-BOTH EYE 

3693 BLINDNESS NOS, BOTH EYES 

3694 LEGAL BLINDNESS-USA DEF 

3696 PROFOUND IMPAIR-ONE EYE* 

36960 BLINDNESS, ONE EYE 

36961 ONE EYE-TOTAL/OTH-UNKNWN 

36962 ONE EYE-TOT/OTH-NEAR NOR 

36963 ONE EYE-TOTAL/OTH-NORMAL 

36964 ONE EYE-NEAR TOT/OTH-NOS 

36965 NEAR-TOT IMP/NEAR-NORMAL 

36966 NEAR-TOTAL IMPAIR/NORMAL 

36967 ONE EYE-PRFOUND/OTH-UNKN 

36968 PROFND IMPAIR/NEAR NORM 

36969 PROFOUND IMPAIR/NORMAL 

3697 MOD/SEVERE IMPAIR, 1 EYE* 

36970 LOW VISION, ONE EYE 

36971 ONE EYE-SEVERE/OTH-UNKNW 

36972 ONE EYE-SEV/OTH-NR NORM 

36973 ONE EYE-SEVERE/OTH-NORM 

36974 ONE EYE-MOD/OTHER-UNKNWN 

36975 ONE EYE-MOD/OTH-NR NORM 

36976 ONE EYE-MOD/OTH NORMAL 

3698 VISUAL LOSS, ONE EYE NOS 

3699 VISUAL LOSS NOS 

370 KERATITIS* 

3700 CORNEAL ULCER* 

37000 CORNEAL ULCER NOS 

37001 MARGINAL CORNEAL ULCER 

37002 RING CORNEAL ULCER 

37003 CENTRAL CORNEAL ULCER 

37004 HYPOPYON ULCER

37005 MYCOTIC CORNEAL ULCER 

37006 PERFORATED CORNEAL ULCER 

37007 MOOREN'S ULCER 

3702 SUPERFICIAL KERATITIS* 

37020 SUPERFIC KERATITIS NOS 

37021 PUNCTATE KERATITIS 

37022 MACULAR KERATITIS 

37023 FILAMENTARY KERATITIS 

37024 PHOTOKERATITIS 

3703 SPEC TYPE KERATOCONJUNCT* 

37031 PHLYCTEN KERATOCONJUNCT 

37032 LIMBAR KERATOCONJUNCTIV 

37033 KERATOCONJUNCTIVIT SICCA 

37034 EXPSURE KERATOCONJUNCTIV 

37035 NEUROTROPH KERATOCONJUNC 

3704 KERATOCONJUNCTIV NEC/NOS* 

37040 KERATOCONJUNCTIVITIS NOS 

37044 KERATITIS IN EXANTHEMA 

37049 KERATOCONJUNCTIVITIS NEC 

3705 INTERSTITIAL KERATITIS* 

37050 INTERSTIT KERATITIS NOS 

37052 DIFFUS INTERSTIT KERATIT 

37054 SCLEROSING KERATITIS 

37055 CORNEAL ABSCESS 

37059 INTERSTIT KERATITIS NEC 

3706 CORNEAL NEOVASCULARIZAT* 

37060 CORNEA NEOVASCULARIZ NOS 

37061 LOCAL VASCULARIZA CORNEA 

37062 CORNEAL PANNUS 

37063 DEEP VASCULARIZA CORNEA 

37064 CORNEAL GHOST VESSELS 

3708 KERATITIS NEC 

3709 KERATITIS NOS 

371 CORNEAL OPACITY/DISORDER* 

3710 CORNEAL SCARS/OPACITIES* 

37100 CORNEAL OPACITY NOS 

37101 MINOR OPACITY OF CORNEA 

37102 PERIPH OPACITY OF CORNEA 

37103 CENTRAL OPACITY, CORNEA 

37104 ADHERENT LEUCOMA 

37105 PHTHISICAL CORNEA 

3711 CORNEAL PIGMENTATIONS* 

37110 CORNEAL DEPOSIT NOS 

37111 ANT CORNEA PIGMENTATION 

37112 STROMAL CORNEA PIGMENT 

37113 POST CORNEA PIGMENTATION 

37114 KAYSER-FLEISCHER RING 

37115 OTH DEPOSIT W METAB DIS 

37116 ARGENTOUS CORNEA DEPOSIT 

3712 CORNEAL EDEMA* 

37120 CORNEAL EDEMA NOS 

37121 IDIOPATHIC CORNEAL EDEMA 

37122 SECONDARY CORNEAL EDEMA 

37123 BULLOUS KERATOPATHY 

37124 EDEMA D/T CONTACT LENS 

3713 CORNEAL MEMBRANE CHANGES* 

37130 CORNEA MEMB CHANGE NOS

37131 FOLD OF BOWMAN MEMBRANE 

37132 FOLD IN DESCEMET MEMBRAN 

37133 RUPTURE DESCEMET MEMBRAN 

3714 CORNEAL DEGENERATIONS* 

37140 CORNEAL DEGENERATION NOS 

37141 SENILE CORNEAL CHANGES 

37142 RECURRENT CORNEA EROSION 

37143 BAND-SHAPED KERATOPATHY 

37144 CALCER CORNEA DEGEN NEC 

37145 KERATOMALACIA NOS 

37146 NODULAR CORNEA DEGEN 

37148 PERIPHERAL CORNEA DEGEN 

37149 CORNEA DEGENERATION NEC 

3715 HERED CORNEA DYSTROPHY* 

37150 CORNEAL DYSTROPHY NOS 

37151 JUV EPITH CORNEA DYSTRPH 

37152 ANT CORNEA DYSTROPHY NEC 

37153 GRANULAR CORNEA DYSTRPHY 

37154 LATTICE CORNEA DYSTROPHY 

37155 MACULAR CORNEA DYSTROPHY 

37156 STROM CORNEA DYSTRPH NEC 

37157 ENDOTHEL CORNEA DYSTRPHY 

37158 POST CORNEA DYSTRPHY NEC 

3716 KERATOCONUS* 

37160 KERATOCONUS NOS 

37161 KERATOCONUS, STABLE 

37162 KERATOCONUS, AC HYDROPS 

3717 CORNEAL DEFORMITIES NEC* 

37170 CORNEAL DEFORMITY NOS 

37171 CORNEAL ECTASIA 

37172 DESCEMETOCELE 

37173 CORNEAL STAPHYLOMA 

3718 OTHER CORNEAL DISORDERS* 

37181 CORNEAL ANESTHESIA 

37182 CORNEAL DSDR CONTCT LENS 

37189 CORNEAL DISORDER NEC 

3719 CORNEAL DISORDER NOS 

372 DISORDERS OF CONJUNCTIVA* 

3720 ACUTE CONJUNCTIVITIS* 

37200 ACUTE CONJUNCTIVITIS NOS 

37201 SEROUS CONJUNCTIVITIS 

37202 AC FOLLIC CONJUNCTIVITIS 

37203 MUCOPUR CONJUNCTIVIT NEC 

37204 PSEUDOMEMB CONJUNCTIVIT 

37205 AC ATOPIC CONJUNCTIVITIS 

3721 CHRONIC CONJUNCTIVITIS* 

37210 CHR CONJUNCTIVITIS NOS 

37211 SIMPL CHR CONJUNCTIVITIS 

37212 CHR FOLLIC CONJUNCTIVIT 

37213 VERNAL CONJUNCTIVITIS 

37214 CHR ALLRG CONJUNCTIV NEC 

37215 PARASITIC CONJUNCTIVITIS 

3722 BLEPHAROCONJUNCTIVITIS* 

37220 BLEPHAROCONJUNCTIVIT NOS 

37221 ANGULAR BLEPHAROCONJUNCT 

37222 CONTACT BLEPHAROCONJUNCT 

3723 CONJUNCTIVITIS NEC/NOS*

37230 CONJUNCTIVITIS NOS 

37231 ROSACEA CONJUNCTIVITIS 

37233 MUCOCUTAN DIS CONJUNCTIV 

37239 CONJUNCTIVITIS NEC 

3724 PTERYGIUM* 

37240 PTERYGIUM NOS 

37241 PERIPH STATION PTERYGIUM 

37242 PERIPH PROGESS PTERYGIUM 

37243 CENTRAL PTERYGIUM 

37244 DOUBLE PTERYGIUM 

37245 RECURRENT PTERYGIUM 

3725 CONJUNCTIVA DEGENERATION* 

37250 CONJUNCTIVAL DEGEN NOS 

37251 PINGUECULA 

37252 PSEUDOPTERYGIUM 

37253 CONJUNCTIVAL XEROSIS 

37254 CONJUNCTIVAL CONCRETIONS 

37255 CONJUNCTIVA PIGMENTATION 

37256 CONJUNCTIVAL DEPOSITS 

3726 CONJUNCTIVAL SCARS* 

37261 GRANULOMA OF CONJUNCTIVA 

37262 LOCAL CONJUNCTIVA ADHES 

37263 SYMBLEPHARON 

37264 SCARRING OF CONJUNCTIVA 

3727 CONJUNCTIVA VASC DIS* 

37271 HYPEREMIA OF CONJUNCTIVA 

37272 CONJUNCTIVAL HEMORRHAGE 

37273 CONJUNCTIVAL EDEMA 

37274 CONJUNCTIVA VASC ANOMALY 

37275 CONJUNCTIVAL CYSTS 

3728 CONJUNCTIVA DISORDER NEC 

3729 CONJUNCTIVA DISORDER NOS 

373 INFLAMMATION OF EYELIDS* 

3730 BLEPHARITIS* 

37300 BLEPHARITIS NOS 

37301 ULCERATIVE BLEPHARITIS 

37302 SQUAMOUS BLEPHARITIS 

3731 HORDEOLUM* 

37311 HORDEOLUM EXTERNUM 

37312 HORDEOLUM INTERNUM 

37313 ABSCESS OF EYELID 

3732 CHALAZION 

3733 NONINF DERMATOSES EYELID* 

37331 ECZEM DERMATITIS EYELID 

37332 CONTACT DERMATIT EYELID 

37333 XERODERMA OF EYELID 

37334 DISC LUP ERYTHEMATOS LID 

3734 INFECT DERM LID W DEFORM 

3735 INFEC DERMATITIS LID NEC 

3736 PARASITIC INFEST EYELID 

3738 INFLAMMATION EYELID NEC 

3739 INFLAMMATION EYELID NOS 

374 DISORDERS OF EYELIDS NEC* 

3740 ENTROPION/TRICHIASIS LID* 

37400 ENTROPION NOS 

37401 SENILE ENTROPION 

37402 MECHANICAL ENTROPION

37403 SPASTIC ENTROPION 

37404 CICATRICIAL ENTROPION 

37405 TRICHIASIS W/O ENTROPION 

3741 ECTROPION* 

37410 ECTROPION NOS 

37411 SENILE ECTROPION 

37412 MECHANICAL ECTROPION 

37413 SPASTIC ECTROPION 

37414 CICATRICIAL ECTROPION 

3742 LAGOPHTHALMOS* 

37420 LAGOPHTHALMOS NOS 

37421 PARALYTIC LAGOPHTHALMOS 

37422 MECHANICAL LAGOPHTHALMOS 

37423 CICATRICIAL LAGOPHTHALM 

3743 PTOSIS OF EYELID* 

37430 PTOSIS OF EYELID NOS 

37431 PARALYTIC PTOSIS 

37432 MYOGENIC PTOSIS 

37433 MECHANICAL PTOSIS 

37434 BLEPHAROCHALASIS 

3744 OTH EYELID FUNCTION DIS* 

37441 LID RETRACTION OR LAG 

37443 ABNORM INNERVATION SYND 

37444 SENSORY DISORDERS, LID 

37445 SENSORMOTR DISOR LID NEC 

37446 BLEPHAROPHIMOSIS 

3745 OTHER EYELID DEGEN DIS* 

37450 DEGEN DISORDER NOS, LID 

37451 XANTHELASMA 

37452 HYPERPIGMENTATION LID 

37453 HYPOPIGMENTATION LID 

37454 HYPERTRICHOSIS OF EYELID 

37455 HYPOTRICHOSIS OF EYELID 

37456 DEGEN DIS EYELID NEC 

3748 OTHER DISORDER OF EYELID* 

37481 HEMORRHAGE OF EYELID 

37482 EDEMA OF EYELID 

37483 ELEPHANTIASIS OF EYELID 

37484 CYSTS OF EYELIDS 

37485 VASCULAR ANOMALY, EYELID 

37486 OLD FOREIGN BODY, EYELID 

37487 DERMATOCHALASIS 

37489 DISORDERS OF EYELID NEC 

3749 DISORDER OF EYELID NOS 

375 LACRIMAL SYSTEM DISORDER* 

3750 DACRYOADENITIS* 

37500 DACRYOADENITIS NOS 

37501 ACUTE DACRYOADENITIS 

37502 CHRONIC DACRYOADENITIS 

37503 CH ENLARGMNT LACRIM GLND 

3751 LACRIMAL GLAND DIS NEC* 

37511 DACRYOPS 

37512 LACRIMAL GLAND CYST NEC 

37513 PRIMARY LACRIMAL ATROPHY 

37514 SECONDARY LACRIM ATROPHY 

37515 TEAR FILM INSUFFIC NOS 

37516 LACRIMAL GLAND DISLOCAT

3752 EPIPHORA* 

37520 EPIPHORA NOS 

37521 EPIPHORA D/T EXCESS TEAR 

37522 EPIPHORA D/T INSUF DRAIN 

3753 INFLAM LACRIM PASSGE NOS* 

37530 DACRYOCYSTITIS NOS 

37531 ACUTE CANALICULITIS 

37532 ACUTE DACRYOCYSTITIS 

37533 PHLEGMON DACRYOCYSTITIS 

3754 CHR INFL LACRIM PASSAGE* 

37541 CHRONIC CANALICULITIS 

37542 CHRONIC DACRYOCYSTITIS 

37543 LACRIMAL MUCOCELE 

3755 LACRIMAL PASSAG STENOSIS* 

37551 LACRIML PUNCTUM EVERSION 

37552 LACRIML PUNCTUM STENOSIS 

37553 LACRIM CANALIC STENOSIS 

37554 LACRIMAL SAC STENOSIS 

37555 NEONATAL NASOLACRML OBST 

37556 ACQ NASOLACRML STENOSIS 

37557 DACRYOLITH 

3756 OTH CHANGE LACRIM PASSGE* 

37561 LACRIMAL FISTULA 

37569 LACRIM PASSGE CHANGE NEC 

3758 OTH LACRIMAL SYSTEM DIS* 

37581 LACRIM PASSAGE GRANULOMA 

37589 LACRIMAL SYST DIS NEC 

3759 LACRIMAL SYST DIS NOS 

376 DISORDERS OF THE ORBIT* 

3760 AC INFLAMMATION, ORBIT* 

37600 ACUTE INFLAM NOS, ORBIT 

37601 ORBITAL CELLULITIS 

37602 ORBITAL PERIOSTITIS 

37603 ORBITAL OSTEOMYELITIS 

37604 ORBITAL TENONITIS 

3761 CHR INFLAM DIS ORBIT* 

37610 CHR INFLAM NOS, ORBIT 

37611 ORBITAL GRANULOMA 

37612 ORBITAL MYOSITIS 

37613 PARASITE INFEST, ORBIT 

3762 ENDOCRINE EXOPHTHALMOS* 

37621 THYROTOXIC EXOPHTHALMOS 

37622 EXOPHTHALM OPHTHALMOPLEG 

3763 EXOPHTHALMIC COND NEC* 

37630 EXOPHTHALMOS NOS 

37631 CONSTANT EXOPHTHALMOS 

37632 ORBITAL HEMORRHAGE 

37633 ORBITAL EDEMA 

37634 INTERMITTNT EXOPHTHALMOS 

37635 PULSATING EXOPHTHALMOS 

37636 LATERAL GLOBE DISPLACMNT 

3764 DEFORMITY OF ORBIT* 

37640 DEFORMITY OF ORBIT NOS 

37641 HYPERTELORISM OF ORBIT 

37642 EXOSTOSIS OF ORBIT 

37643 ORBT DEFORM D/T BONE DIS 

37644 CRANIOFACIAL-ORBIT DEFOR

37645 ATROPHY OF ORBIT 

37646 ENLARGEMENT OF ORBIT 

37647 ORBIT DEFORM D/T TRAUMA 

3765 ENOPHTHALMOS* 

37650 ENOPHTHALMOS NOS 

37651 ENOPHTH D/T ORBIT ATRPHY 

37652 ENOPHTHALMOS D/T TRAUMA 

3766 OLD FOREIGN BODY, ORBIT 

3768 OTHER ORBITAL DISORDERS* 

37681 ORBITAL CYSTS 

37682 EXTRAOCUL MUSCL MYOPATHY 

37689 ORBITAL DISORDERS NEC 

3769 ORBITAL DISORDER NOS 

377 DISORDERS OF OPTIC NERVE* 

3770 PAPILLEDEMA* 

37700 PAPILLEDEMA NOS 

37701 PAPILLEDEMA W INCR PRESS 

37702 PAPILLEDEMA W DECR PRESS 

37703 PAPILLEDEMA W RETINA DIS 

37704 FOSTER-KENNEDY SYNDROME 

3771 OPTIC ATROPHY* 

37710 OPTIC ATROPHY NOS 

37711 PRIMARY OPTIC ATROPHY 

37712 POSTINFLAM OPTIC ATROPHY 

37713 OPTIC ATRPH W RETIN DYST 

37714 CUPPING OF OPTIC DISC 

37715 PARTIAL OPTIC ATROPHY 

37716 HEREDITARY OPTIC ATROPHY 

3772 OPTIC DISC DISORDERS NEC* 

37721 DRUSEN OF OPTIC DISC 

37722 CRATER-LIKE HOLE OP DISC 

37723 COLOBOMA OF OPTIC DISC 

37724 PSEUDOPAPILLEDEMA 

3773 OPTIC NEURITIS* 

37730 OPTIC NEURITIS NOS 

37731 OPTIC PAPILLITIS 

37732 RETROBULBAR NEURITIS 

37733 NUTRITION OPTC NEUROPTHY 

37734 TOXIC OPTIC NEUROPATHY 

37739 OPTIC NEURITIS NEC 

3774 OTH OPTIC NERVE DISORDER* 

37741 ISCHEMIC OPTIC NEUROPTHY 

37742 OPTIC NERVE SHEATH HEMOR 

37749 OPTIC NERVE DISORDER NEC 

3775 OPTIC CHIASM DISORDERS* 

37751 OPT CHIASM W PITUIT DIS 

37752 OPT CHIASM DIS/NEOPL NEC 

37753 OPT CHIASM W VASCUL DIS 

37754 OP CHIASM DIS W INFL DIS 

3776 VISUAL PATHWAY DIS NEC* 

37761 VIS PATH DIS W NEOPLASMS 

37762 VIS PATH DIS W VASC DIS 

37763 VIS PATH DIS W INFL DIS 

3777 VISUAL CORTEX DISORDERS* 

37771 VIS CORTX DIS W NEOPLASM 

37772 VIS CORTX DIS W VASC DIS 

37773 VIS CORTEX DIS W INFLAM

37775 CORTICAL BLINDNESS 

3779 OPTIC NERVE DISORDER NOS 

378 STRABISMUS* 

3780 ESOTROPIA* 

37800 ESOTROPIA NOS 

37801 MONOCULAR ESOTROPIA 

37802 MONOC ESOTROP W A PATTRN 

37803 MONOC ESOTROP W V PATTRN 

37804 MONOC ESOTROP W X/Y PAT 

37805 ALTERNATING ESOTROPIA 

37806 ALT ESOTROPIA W A PATTRN 

37807 ALT ESOTROPIA W V PATTRN 

37808 ALT ESOTROP W X/Y PATTRN 

3781 EXOTROPIA* 

37810 EXOTROPIA NOS 

37811 MONOCULAR EXOTROPIA 

37812 MONOC EXOTROP W A PATTRN 

37813 MONOC EXOTROP W V PATTRN 

37814 MONOC EXOTROP W X/Y PAT 

37815 ALTERNATING EXOTROPIA 

37816 ALT EXOTROPIA W A PATTRN 

37817 ALT EXOTROPIA W V PATTRN 

37818 ALT EXOTROP W X/Y PATTRN 

3782 INTERMITTNT HETEROTROPIA* 

37820 INTERMIT HETEROTROP NOS 

37821 INTERMIT MONOC ESOTROPIA 

37822 INTERMIT ALTRN ESOTROPIA 

37823 INTERMIT MONOC EXOTROPIA 

37824 INTERMIT ALTRN EXOTROPIA 

3783 HETEROTROPIA NEC/NOS* 

37830 HETEROTROPIA NOS 

37831 HYPERTROPIA 

37832 HYPOTROPIA 

37833 CYCLOTROPIA 

37834 MONOFIXATION SYNDROME 

37835 ACCOMMODATIVE ESOTROPIA 

3784 HETEROPHORIA* 

37840 HETEROPHORIA NOS 

37841 ESOPHORIA 

37842 EXOPHORIA 

37843 VERTICAL HETEROPHORIA 

37844 CYCLOPHORIA 

37845 ALTERNATING HYPERPHORIA 

3785 PARALYTIC STRABISMUS* 

37850 PARALYTIC STRABISMUS NOS 

37851 PARTIAL THIRD NERV PALSY 

37852 TOTAL THIRD NERVE PALSY 

37853 FOURTH NERVE PALSY 

37854 SIXTH NERVE PALSY 

37855 EXTERNAL OPHTHALMOPLEGIA 

37856 TOTAL OPHTHALMOPLEGIA 

3786 MECHANICAL STRABISMUS* 

37860 MECHANICAL STRABISM NOS 

37861 BROWN'S SHEATH SYNDROME 

37862 MECH STRAB D/T MUSCL DIS 

37863 MECH STRAB W OTH CONDITN 

3787 STRABISMUS NEC*

37871 DUANE'S SYNDROME 

37872 PROG EXT OPHTHALMOPLEGIA 

37873 NEUROMUSCLE DIS STRABISM 

3788 OTH BINOCULAR MOVMNT DIS* 

37881 PALSY OF CONJUGATE GAZE 

37882 SPASM OF CONJUGATE GAZE 

37883 CONVERGENC INSUFFICIENCY 

37884 CONVERGENCE EXCESS 

37885 ANOMALIES OF DIVERGENCE 

37886 INTERNUCL OPHTHALMOPLEG 

37887 SKEW DEVIATION, EYE 

3789 EYE MOVEMNT DISORDER NOS 

379 EYE DISORDERS NEC* 

3790 SCLERITIS/EPISCLERITIS* 

37900 SCLERITIS NOS 

37901 EPISCLERIT PERIODIC FUGX 

37902 NODULAR EPISCLERITIS 

37903 ANTERIOR SCLERITIS 

37904 SCLEROMALACIA PERFORANS 

37905 SCLERITIS W CORNEA INVOL 

37906 BRAWNY SCLERITIS 

37907 POSTERIOR SCLERITIS 

37909 SCLERITIS NEC 

3791 OTH DISORDERS OF SCLERA* 

37911 SCLERAL ECTASIA 

37912 STAPHYLOMA POSTICUM 

37913 EQUATORIAL STAPHYLOMA 

37914 LOCAL ANTERIOR STAPHYLMA 

37915 RING STAPHYLOMA 

37916 SCLERAL DEGEN DIS NEC 

37919 DISORDER OF SCLERA NEC 

3792 VITREOUS BODY DISORDERS* 

37921 VITREOUS DEGENERATION 

37922 CRYSTAL DEPOSIT VITREOUS 

37923 VITREOUS HEMORRHAGE 

37924 VITREOUS OPACITIES NEC 

37925 VITREOUS MEMBRANES 

37926 VITREOUS PROLAPSE 

37929 VITREOUS DISORDERS NEC 

3793 OTHER LENS DISORDERS* 

37931 APHAKIA 

37932 SUBLUXATION OF LENS 

37933 ANT DISLOCATION OF LENS 

37934 POST DISLOCATION OF LENS 

37939 DISORDERS OF LENS NEC 

3794 PUPIL FUNCTION ANOMALIES* 

37940 ABN PUPIL FUNCTION NOS 

37941 ANISOCORIA 

37942 MIOSIS NOT D/T MIOTICS 

37943 MYDRIASIS NOT D/T MYDRTC 

37945 ARGYLL ROBERTSON PUPIL 

37946 TONIC PUPILLARY REACTION 

37949 PUPIL FUNCT ANOMALY NEC 

3795 IRREGULAR EYE MOVEMENTS* 

37950 NYSTAGMUS NOS 

37951 CONGENITAL NYSTAGMUS 

37952 LATENT NYSTAGMUS

37953 VISUAL DEPRIVATN NYSTAGM 

37954 NYSTAGMS W VESTIBULR DIS 

37955 DISSOCIATED NYSTAGMUS 

37956 NYSTAGMUS NEC 

37957 SACCADIC EYE MOVMNT DEF 

37958 SMOOTH PURSUIT MVMNT DEF 

37959 IRREGULAR EYE MVMNTS NEC 

3798 EYE DISORDERS NEC 

3799 EYE DISORDERS NOS* 

37990 EYE DISORDER NOS 

37991 PAIN IN OR AROUND EYE 

37992 SWELLING OR MASS OF EYE 

37993 REDNESS/DISCHARGE OF EYE 

37999 ILL-DEFINED EYE DIS NEC 

380 DISORDER OF EXTERNAL EAR* 

3800 PERICHONDRITIS OF PINNA* 

38000 PERICHONDRITIS PINNA NOS 

38001 AC PERICHONDRITIS PINNA 

38002 CHR PERICHONDRITIS PINNA 

3801 INFECTIVE OTITIS EXTERNA* 

38010 INFEC OTITIS EXTERNA NOS 

38011 ACUTE INFECTION OF PINNA 

38012 ACUTE SWIMMERS' EAR 

38013 AC INFECT EXTERN EAR NEC 

38014 MALIGNANT OTITIS EXTERNA 

38015 CHR MYCOT OTITIS EXTERNA 

38016 CHR INF OTIT EXTERNA NEC 

3802 OTITIS EXTERNA NEC* 

38021 CHOLESTEATOMA EXTERN EAR 

38022 ACUTE OTITIS EXTERNA NEC 

38023 CHR OTITIS EXTERNA NEC 

3803 NONINFECT DISORDER PINNA* 

38030 DISORDER OF PINNA NOS 

38031 HEMATOMA AURICLE/PINNA 

38032 ACQ DEFORM AURICLE/PINNA 

38039 NONINFECT DIS PINNA NEC 

3804 IMPACTED CERUMEN 

3805 ACQ STENOSIS EAR CANAL* 

38050 ACQ STENOS EAR CANAL NOS 

38051 STENOSIS EAR D/T TRAUMA 

38052 STENOSIS EAR D/T SURGERY 

38053 STENOSIS EAR D/T INFLAM 

3808 DISORD EXTERNAL EAR NEC* 

38081 EXOSTOSIS EXT EAR CANAL 

38089 DIS EXTERNAL EAR NEC 

3809 DIS EXTERNAL EAR NOS 

381 NONSUPPUR OTITIS MEDIA* 

3810 AC NONSUP OTITIS MEDIA* 

38100 AC NONSUP OTITIS MED NOS 

38101 AC SEROUS OTITIS MEDIA 

38102 AC MUCOID OTITIS MEDIA 

38103 AC SANGUIN OTITIS MEDIA 

38104 AC ALLERGIC SEROUS OM 

38105 AC ALLERGIC MUCOID OM 

38106 AC ALLERG SANGUINOUS OM 

3811 CHR SEROUS OTITIS MEDIA* 

38110 CHR SEROUS OM SIMP/NOS

38119 CHR SEROUS OM NEC 

3812 CHR MUCOID OTITIS MEDIA* 

38120 CHR MUCOID OM SIMP/NOS 

38129 CHR MUCOID OM NEC 

3813 CHR NONSUP OM NOS/NEC 

3814 NONSUPP OTITIS MEDIA NOS 

3815 EUSTACHIAN SALPINGITIS* 

38150 EUSTACHIAN SALPING NOS 

38151 AC EUSTACHIAN SALPING 

38152 CHR EUSTACHIAN SALPING 

3816 EUSTACHIAN TUBE OBSTRUCT* 

38160 OBSTR EUSTACH TUBE NOS 

38161 OSSEOUS EUSTACHIAN OBSTR 

38162 INTRINSIC EUSTACH OBSTR 

38163 EXTRINSIC EUSTACH OBSTR 

3817 PATULOUS EUSTACHIAN TUBE 

3818 DIS EUSTACHIAN TUBE NEC* 

38181 DYSFUNCT EUSTACHIAN TUBE 

38189 EUSTACHIAN TUBE DIS NEC 

3819 EUSTACHIAN TUBE DIS NOS 

382 OTITIS MEDIA, SUPPUR/NOS* 

3820 AC SUPPUR OTITIS MEDIA* 

38200 AC SUPP OTITIS MEDIA NOS 

38201 AC SUPP OM W DRUM RUPT 

38202 AC SUPP OM IN OTH DIS 

3821 CHR TUBOTYMPAN SUPPUR OM 

3822 CHR ATTICOANTRAL SUP OM 

3823 CHR SUP OTITIS MEDIA NOS 

3824 SUPPUR OTITIS MEDIA NOS 

3829 OTITIS MEDIA NOS 

383 MASTOIDITIS ET AL* 

3830 ACUTE MASTOIDITIS* 

38300 AC MASTOIDITIS W/O COMPL 

38301 SUBPERI MASTOID ABSCESS 

38302 AC MASTOIDITIS-COMPL NEC 

3831 CHRONIC MASTOIDITIS 

3832 PETROSITIS* 

38320 PETROSITIS NOS 

38321 ACUTE PETROSITIS 

38322 CHRONIC PETROSITIS 

3833 POSTMASTOIDECTOMY COMPL* 

38330 POSTMASTOID COMPL NOS 

38331 POSTMASTOID MUCOSAL CYST 

38332 POSTMASTOID CHOLESTEATMA 

38333 POSTMASTOID GRANULATIONS 

3838 OTHER MASTOID DISORDERS* 

38381 POSTAURICULAR FISTULA 

38389 DISORDERS OF MASTOID NEC 

3839 MASTOIDITIS NOS 

384 DISORD TYMPANIC MEMB NEC* 

3840 ACUTE MYRINGITIS* 

38400 ACUTE MYRINGITIS NOS 

38401 BULLOUS MYRINGITIS 

38409 ACUTE MYRINGITIS NEC 

3841 CHRONIC MYRINGITIS 

3842 PERFORATION TYMPAN MEMB* 

38420 PERFORAT TYMPAN MEMB NOS

38421 CENT PERF TYMPANIC MEMB 

38422 ATTIC PERF TYMPANIC MEMB 

38423 MARGINAL PERF TYMP NEC 

38424 MULT PERF TYMPANIC MEMB 

38425 TOTAL PERF TYMPANIC MEMB 

3848 DIS TYMPANIC MEMB NEC* 

38481 ATROPHIC FLACCID TYMPAN 

38482 ATROPHIC NONFLACCID TYMP 

3849 DIS TYMPANIC MEMB NOS 

385 DIS MID EAR/MASTOID NEC* 

3850 TYMPANOSCLEROSIS* 

38500 TYMPANOSCLEROSIS NOS 

38501 TYMPANOSCL-TYMPANIC MEMB 

38502 TYMPNOSCLER-TYMP/OSSICLE 

38503 TYMPANOSCLER-ALL PARTS 

38509 TYMPNSCLR-OTH SITE COMB 

3851 ADHESIVE MIDDLE EAR DIS* 

38510 ADHESIVE MID EAR DIS NOS 

38511 ADHESION TYMPANUM-INCUS 

38512 ADHESION TYMPANUM-STAPES 

38513 ADHESION TYMP-PROMONTOR 

38519 ADHESIVE MID EAR DIS NEC 

3852 ABNORMAL EAR OSSICLE NEC* 

38521 ANKYLOSIS MALLEUS 

38522 ANKYLOSIS EAR OSSICL NEC 

38523 DISLOCATION EAR OSSICLE 

38524 PARTIAL LOSS EAR OSSICLE 

3853 CHOLESTEATOMA* 

38530 CHOLESTEATOMA NOS 

38531 CHOLESTEATOMA OF ATTIC 

38532 CHOLESTEATOMA MIDDLE EAR 

38533 CHOLESTMA MID EAR/MSTOID 

38535 DIFFUSE CHOLESTEATOSIS 

3858 OTH MID EAR/MASTOID DIS* 

38582 CHOLESTERIN GRANULOMA 

38583 FOREIGN BODY MIDDLE EAR 

38589 DIS MID EAR/MASTOID NEC 

3859 DIS MID EAR/MASTOID NOS 

386 VERTIGINOUS SYNDROMES* 

3860 MENIERE'S DISEASE* 

38600 MENIERE'S DISEASE NOS 

38601 MENIERE DIS COCHLVESTIB 

38602 MENIERE DIS COCHLEAR 

38603 MENIERE DIS VESTIBULAR 

38604 INACTIVE MENIERE'S DIS 

3861 PERIPHER VERTIGO NEC/NOS* 

38610 PERIPHERAL VERTIGO NOS 

38611 BENIGN PARXYSMAL VERTIGO 

38612 VESTIBULAR NEURONITIS 

38619 PERIPHERAL VERTIGO NEC 

3862 CENTRAL ORIGIN VERTIGO 

3863 LABYRINTHITIS* 

38630 LABYRINTHITIS NOS 

38631 SEROUS LABYRINTHITIS 

38632 CIRCUMSCRI LABYRINTHITIS 

38633 SUPPURATIV LABYRINTHITIS 

38634 TOXIC LABYRINTHITIS

38635 VIRAL LABYRINTHITIS 

3864 LABYRINTHINE FISTULA* 

38640 LABYRINTHINE FISTULA NOS 

38641 ROUND WINDOW FISTULA 

38642 OVAL WINDOW FISTULA 

38643 SEMICIRCUL CANAL FISTULA 

38648 LABYRINTH FISTULA COMB 

3865 LABYRINTHINE DYSFUNCTION* 

38650 LABYRINTHINE DYSFUNC NOS 

38651 HYPRACT LABYRINTH UNILAT 

38652 HYPERACT LABYRINTH BILAT 

38653 HYPOACT LABYRINTH UNILAT 

38654 HYPOACT LABYRINTH BILAT 

38655 LOSS LABYRN REACT UNILAT 

38656 LOSS LABYRIN REACT BILAT 

38658 LABYRINTHINE DYSFUNC NEC 

3868 DISORDERS LABYRINTH NEC 

3869 VERTIGINOUS SYND NOS 

387 OTOSCLEROSIS* 

3870 OTOSCLER-OVAL WND NONOBL 

3871 OTOSCLER-OVAL WNDW OBLIT 

3872 COCHLEAR OTOSCLEROSIS 

3878 OTOSCLEROSIS NEC 

3879 OTOSCLEROSIS NOS 

388 DISORDERS OF EAR NEC* 

3880 DEGEN/VASCULAR DIS EAR* 

38800 DEGEN/VASCUL DIS EAR NOS 

38801 PRESBYACUSIS 

38802 TRANS ISCHEMIC DEAFNESS 

3881 NOISE EFFECTS-INNER EAR* 

38810 NOISE EFFECT-EAR/NOS 

38811 ACOUSTIC TRAUMA 

38812 HEARING LOSS D/T NOISE 

3882 SUDDEN HEARING LOSS NOS 

3883 TINNITUS* 

38830 TINNITUS NOS 

38831 SUBJECTIVE TINNITUS 

38832 OBJECTIVE TINNITUS 

3884 OTH ABN AUDITORY PERCEPT* 

38840 ABN AUDITORY PERCEPT NOS 

38841 DIPLACUSIS 

38842 HYPERACUSIS 

38843 IMPAIRM AUDITORY DISCRIM 

38844 AUDITORY RECRUITMENT 

3885 ACOUSTIC NERVE DISORDERS 

3886 OTORRHEA* 

38860 OTORRHEA NOS 

38861 CEREBROSP FLUID OTORRHEA 

38869 OTORRHEA NEC 

3887 OTALGIA* 

38870 OTALGIA NOS 

38871 OTOGENIC PAIN 

38872 REFERRED PAIN OF EAR 

3888 DISORDERS OF EAR NEC 

3889 DISORDER OF EAR NOS 

389 HEARING LOSS* 

3890 CONDUCTIVE HEARING LOSS*

38900 CONDUCT HEARING LOSS NOS 

38901 CONDUC HEAR LOSS EXT EAR 

38902 CONDUCT HEAR LOSS TYMPAN 

38903 CONDUC HEAR LOSS MID EAR 

38904 COND HEAR LOSS INNER EAR 

38908 COND HEAR LOSS COMB TYPE 

3891 SENSORINEURAL HEAR LOSS* 

38910 SENSORNEUR HEAR LOSS NOS 

38911 SENSORY HEARING LOSS 

38912 NEURAL HEARING LOSS 

38914 CENTRAL HEARING LOSS 

38918 SENSORNEUR LOSS COMB TYP 

3892 MIXED HEARING LOSS 

3897 DEAF MUTISM NEC 

3898 HEARING LOSS NEC 

3899 HEARING LOSS NOS 

390 RHEUM FEV W/O HRT INVOLV 

391 RHEUM FEV W HEART INVOLV* 

3910 ACUTE RHEUMATIC PERICARD 

3911 ACUTE RHEUMATIC ENDOCARD 

3912 AC RHEUMATIC MYOCARDITIS 

3918 AC RHEUMAT HRT DIS NEC 

3919 AC RHEUMAT HRT DIS NOS 

392 RHEUMATIC CHOREA* 

3920 RHEUM CHOREA W HRT INVOL 

3929 RHEUMATIC CHOREA NOS 

393 CHR RHEUMATIC PERICARD 

394 DISEASES OF MITRAL VALVE* 

3940 MITRAL STENOSIS 

3941 RHEUMATIC MITRAL INSUFF 

3942 MITRAL STENOSIS W INSUFF 

3949 MITRAL VALVE DIS NEC/NOS 

395 DISEASES OF AORTIC VALVE* 

3950 RHEUMAT AORTIC STENOSIS 

3951 RHEUMATIC AORTIC INSUFF 

3952 RHEUM AORTIC STEN/INSUFF 

3959 RHEUM AORTIC DIS NEC/NOS 

396 MITRAL/AORTIC VALVE DIS* 

3960 MITRAL/AORTIC STENOSIS 

3961 MITRAL STENOS/AORT INSUF 

3962 MITRAL INSUF/AORT STENOS 

3963 MITRAL/AORTIC VAL INSUFF 

3968 MITR/AORTIC MULT INVOLV 

3969 MITRAL/AORTIC V DIS NOS 

397 ENDOCARDIAL DISEASE NEC* 

3970 TRICUSPID VALVE DISEASE 

3971 RHEUM PULMON VALVE DIS 

3979 RHEUM ENDOCARDITIS NOS 

398 OTH RHEUMATIC HEART DIS* 

3980 RHEUMATIC MYOCARDITIS 

3989 RHEUM HEART DIS NEC/NOS* 

39890 RHEUMATIC HEART DIS NOS 

39891 RHEUMATIC HEART FAILURE 

39899 RHEUMATIC HEART DIS NEC 

401 ESSENTIAL HYPERTENSION* 

4010 MALIGNANT HYPERTENSION 

4011 BENIGN HYPERTENSION

4019 HYPERTENSION NOS 

402 HYPERTENSIVE HEART DIS* 

4020 MAL HYPERTENSIVE HRT DIS* 

40200 MAL HYPERTEN HRT DIS NOS 

40201 MAL HYPERT HRT DIS W CHF 

4021 BENIGN HYPERTEN HRT DIS* 

40210 BEN HYPERTEN HRT DIS NOS 

40211 BENIGN HYP HRT DIS W CHF 

4029 HYPERTENSIVE HRT DIS NOS* 

40290 HYPERTENSIVE HRT DIS NOS 

40291 HYPERTEN HEART DIS W CHF 

403 HYPERTENSIVE RENAL DIS* 

4030 MAL HYPERTENS RENAL DIS* 

40300 MAL HYP REN W/O REN FAIL 

40301 MAL HYP REN W RENAL FAIL 

4031 BENIGN HYPERT RENAL DIS* 

40310 BEN HYP REN W/O REN FAIL 

40311 BEN HYP RENAL W REN FAIL 

4039 HYPERTENS RENAL DIS NOS* 

40390 HYP REN NOS W/O REN FAIL 

40391 HYP RENAL NOS W REN FAIL 

404 HYPERTEN HEART/RENAL DIS* 

4040 MAL HYPERT HRT/RENAL DIS* 

40400 MAL HY HT/REN W/O CHF/RF 

40401 MAL HYPER HRT/REN W CHF 

40402 MAL HY HT/REN W REN FAIL 

40403 MAL HYP HRT/REN W CHF&RF 

4041 BEN HYPERT HRT/RENAL DIS* 

40410 BEN HY HT/REN W/O CHF/RF 

40411 BEN HYPER HRT/REN W CHF 

40412 BEN HY HT/REN W REN FAIL 

40413 BEN HYP HRT/REN W CHF&RF 

4049 HYPERT HRT/RENAL DIS NOS* 

40490 HY HT/REN NOS W/O CHF/RF 

40491 HYPER HRT/REN NOS W CHF 

40492 HY HT/REN NOS W REN FAIL 

40493 HYP HT/REN NOS W CHF&RF 

405 SECONDARY HYPERTENSION* 

4050 MAL SECOND HYPERTENSION* 

40501 MAL RENOVASC HYPERTENS 

40509 MAL SECOND HYPERTEN NEC 

4051 BENIGN SECOND HYPERTENS* 

40511 BENIGN RENOVASC HYPERTEN 

40519 BENIGN SECOND HYPERT NEC 

4059 SECOND HYPERTENSION NOS* 

40591 RENOVASC HYPERTENSION 

40599 SECOND HYPERTENSION NEC 

410 ACUTE MYOCARDIAL INFARCT* 

4100 AMI ANTEROLATERAL WALL* 

41000 AMI ANTEROLATERAL,UNSPEC 

41001 AMI ANTEROLATERAL, INIT 

41002 AMI ANTEROLATERAL,SUBSEQ 

4101 AMI ANTERIOR WALL NEC* 

41010 AMI ANTERIOR WALL,UNSPEC 

41011 AMI ANTERIOR WALL, INIT 

41012 AMI ANTERIOR WALL,SUBSEQ 

4102 AMI INFEROLATERAL WALL*

41020 AMI INFEROLATERAL,UNSPEC 

41021 AMI INFEROLATERAL, INIT 

41022 AMI INFEROLATERAL,SUBSEQ 

4103 AMI INFEROPOSTERIOR WALL* 

41030 AMI INFEROPOST, UNSPEC 

41031 AMI INFEROPOST, INITIAL 

41032 AMI INFEROPOST, SUBSEQ 

4104 AMI INFERIOR WALL NEC* 

41040 AMI INFERIOR WALL,UNSPEC 

41041 AMI INFERIOR WALL, INIT 

41042 AMI INFERIOR WALL,SUBSEQ 

4105 AMI LATERAL WALL NEC* 

41050 AMI LATERAL NEC, UNSPEC 

41051 AMI LATERAL NEC, INITIAL 

41052 AMI LATERAL NEC, SUBSEQ 

4106 TRUE POSTERIOR INFARCT* 

41060 TRUE POST INFARCT,UNSPEC 

41061 TRUE POST INFARCT, INIT 

41062 TRUE POST INFARCT,SUBSEQ 

4107 SUBENDOCARDIAL INFARCT* 

41070 SUBENDO INFARCT, UNSPEC 

41071 SUBENDO INFARCT, INITIAL 

41072 SUBENDO INFARCT, SUBSEQ 

4108 MYOCARDIAL INFARCT NEC* 

41080 AMI NEC, UNSPECIFIED 

41081 AMI NEC, INITIAL 

41082 AMI NEC, SUBSEQUENT 

4109 MYOCARDIAL INFARCT NOS* 

41090 AMI NOS, UNSPECIFIED 

41091 AMI NOS, INITIAL 

41092 AMI NOS, SUBSEQUENT 

411 OTH AC ISCHEMIC HRT DIS* 

4110 POST MI SYNDROME 

4111 INTERMED CORONARY SYND 

4118 AC ISCHEMIC HRT DIS NEC* 

41181 CORONARY OCCLSN W/O MI 

41189 AC ISCHEMIC HRT DIS NEC 

412 OLD MYOCARDIAL INFARCT 

413 ANGINA PECTORIS* 

4130 ANGINA DECUBITUS 

4131 PRINZMETAL ANGINA 

4139 ANGINA PECTORIS NEC/NOS 

414 OTH CHR ISCHEMIC HRT DIS* 

4140 CORONARY ATHEROSCLEROSIS* 

41400 COR ATH UNSP VSL NTV/GFT 

41401 CRNRY ATHRSCL NATVE VSSL 

41402 CRN ATH ATLG VN BPS GRFT 

41403 CRN ATH NONATLG BLG GRFT 

41404 COR ATH ARTRY BYPAS GRFT 

41405 COR ATH BYPASS GRAFT NOS 

4141 ANEURYSM OF HEART* 

41410 ANEURYSM, HEART (WALL) 

41411 CORONARY VESSEL ANEURYSM 

41419 ANEURYSM OF HEART NEC 

4148 CHR ISCHEMIC HRT DIS NEC 

4149 CHR ISCHEMIC HRT DIS NOS 

415 ACUTE PULMONARY HRT DIS*

4150 ACUTE COR PULMONALE 

4151 PULMON EMBOLISM/INFARCT* 

41511 IATROGEN PULM EMB/INFARC 

41519 PULM EMBOL/INFARCT NEC 

416 CHR PULMONARY HEART DIS* 

4160 PRIM PULM HYPERTENSION 

4161 KYPHOSCOLIOTIC HEART DIS 

4168 CHR PULMON HEART DIS NEC 

4169 CHR PULMON HEART DIS NOS 

417 OTH PULMON CIRCULAT DIS* 

4170 ARTERIOVEN FISTU PUL VES 

4171 PULMON ARTERY ANEURYSM 

4178 PULMON CIRCULAT DIS NEC 

4179 PULMON CIRCULAT DIS NOS 

420 ACUTE PERICARDITIS* 

4200 AC PERICARDIT IN OTH DIS 

4209 AC PERICARDITIS NEC/NOS* 

42090 ACUTE PERICARDITIS NOS 

42091 AC IDIOPATH PERICARDITIS 

42099 ACUTE PERICARDITIS NEC 

421 AC/SUBAC ENDOCARDITIS* 

4210 AC/SUBAC BACT ENDOCARD 

4211 AC ENDOCARDIT IN OTH DIS 

4219 AC/SUBAC ENDOCARDIT NOS 

422 ACUTE MYOCARDITIS* 

4220 AC MYOCARDIT IN OTH DIS 

4229 AC MYOCARDITIS NEC/NOS* 

42290 ACUTE MYOCARDITIS NOS 

42291 IDIOPATHIC MYOCARDITIS 

42292 SEPTIC MYOCARDITIS 

42293 TOXIC MYOCARDITIS 

42299 ACUTE MYOCARDITIS NEC 

423 OTH PERICARDIAL DISEASE* 

4230 HEMOPERICARDIUM 

4231 ADHESIVE PERICARDITIS 

4232 CONSTRICTIV PERICARDITIS 

4238 PERICARDIAL DISEASE NEC 

4239 PERICARDIAL DISEASE NOS 

424 OTH ENDOCARDIAL DISEASE* 

4240 MITRAL VALVE DISORDER 

4241 AORTIC VALVE DISORDER 

4242 NONRHEUM TRICUSP VAL DIS 

4243 PULMONARY VALVE DISORDER 

4249 ENDOCARDITIS NOS* 

42490 ENDOCARDITIS NOS 

42491 ENDOCARDITIS IN OTH DIS 

42499 ENDOCARDITIS NEC 

425 CARDIOMYOPATHY* 

4250 ENDOMYOCARDIAL FIBROSIS 

4251 HYPERTR OBSTR CARDIOMYOP 

4252 OBSC AFRIC CARDIOMYOPATH 

4253 ENDOCARD FIBROELASTOSIS 

4254 PRIM CARDIOMYOPATHY NEC 

4255 ALCOHOLIC CARDIOMYOPATHY 

4257 METABOLIC CARDIOMYOPATHY 

4258 CARDIOMYOPATH IN OTH DIS 

4259 SECOND CARDIOMYOPATH NOS

426 CONDUCTION DISORDERS* 

4260 ATRIOVENT BLOCK COMPLETE 

4261 ATRIOVENT BLOCK NEC/NOS* 

42610 ATRIOVENT BLOCK NOS 

42611 ATRIOVENT BLOCK-1ST DEGR 

42612 ATRIOVEN BLOCK-MOBITZ II 

42613 AV BLOCK-2ND DEGREE NEC 

4262 LEFT BB HEMIBLOCK 

4263 LEFT BB BLOCK NEC 

4264 RT BUNDLE BRANCH BLOCK 

4265 BUNDL BRANCH BLK NEC/NOS* 

42650 BUNDLE BRANCH BLOCK NOS 

42651 RT BBB/LFT POST FASC BLK 

42652 RT BBB/LFT ANT FASC BLK 

42653 BILAT BB BLOCK NEC 

42654 TRIFASCICULAR BLOCK 

4266 OTHER HEART BLOCK 

4267 ANOMALOUS AV EXCITATION 

4268 CONDUCTION DISORDER NEC* 

42681 LOWN-GANONG-LEVINE SYND 

42689 CONDUCTION DISORDER NEC 

4269 CONDUCTION DISORDER NOS 

427 CARDIAC DYSRHYTHMIAS* 

4270 PAROX ATRIAL TACHYCARDIA 

4271 PAROX VENTRIC TACHYCARD 

4272 PAROX TACHYCARDIA NOS 

4273 ATRIAL FIBRILL/FLUTTER* 

42731 ATRIAL FIBRILLATION 

42732 ATRIAL FLUTTER 

4274 VENTRIC FIBRILL/FLUTTER* 

42741 VENTRICULAR FIBRILLATION 

42742 VENTRICULAR FLUTTER 

4275 CARDIAC ARREST 

4276 PREMATURE BEATS* 

42760 PREMATURE BEATS NOS 

42761 ATRIAL PREMATURE BEATS 

42769 PREMATURE BEATS NEC 

4278 CARDIAC DYSRHYTHMIAS NEC* 

42781 SINOATRIAL NODE DYSFUNCT 

42789 CARDIAC DYSRHYTHMIAS NEC 

4279 CARDIAC DYSRHYTHMIA NOS 

428 HEART FAILURE* 

4280 CONGESTIVE HEART FAILURE 

4281 LEFT HEART FAILURE 

4289 HEART FAILURE NOS 

429 ILL-DEFINED HEART DIS* 

4290 MYOCARDITIS NOS 

4291 MYOCARDIAL DEGENERATION 

4292 ASCVD 

4293 CARDIOMEGALY 

4294 HRT DIS POSTCARDIAC SURG 

4295 CHORDAE TENDINAE RUPTURE 

4296 PAPILLARY MUSCLE RUPTURE 

42971 ACQ CARDIAC SEPTL DEFECT 

42979 OTHER SEQUELAE OF MI NEC 

4298 ILL-DEFINED HRT DIS NEC* 

42981 PAPILLARY MUSCLE DIS NEC

42982 HYPERKINETIC HEART DIS 

42989 ILL-DEFINED HRT DIS NEC 

4299 HEART DISEASE NOS 

430 SUBARACHNOID HEMORRHAGE 

431 INTRACEREBRAL HEMORRHAGE 

432 INTRACRANIAL HEM NEC/NOS* 

4320 NONTRAUM EXTRADURAL HEM 

4321 SUBDURAL HEMORRHAGE 

4329 INTRACRANIAL HEMORR NOS 

433 PRECEREBRAL OCCLUSION* 

4330 BASILAR ARTERY OCCLUSION* 

43300 OCL BSLR ART WO INFRCT 

43301 OCL BSLR ART W INFRCT 

4331 CAROTID ARTERY OCCLUSION* 

43310 OCL CRTD ART WO INFRCT 

43311 OCL CRTD ART W INFRCT 

4332 VERTEBRAL ART OCCLUSION* 

43320 OCL VRTB ART WO INFRCT 

43321 OCL VRTB ART W INFRCT 

4333 MULT PRECEREB OCCLUSION* 

43330 OCL MLT BI ART WO INFRCT 

43331 OCL MLT BI ART W INFRCT 

4338 PRECEREB OCCLUSION NEC* 

43380 OCL SPCF ART WO INFRCT 

43381 OCL SPCF ART W INFRCT 

4339 PRECEREB OCCLUSION NOS* 

43390 OCL ART NOS WO INFRCT 

43391 OCL ART NOS W INFRCT 

434 CEREBRAL ARTERY OCCLUS* 

4340 CEREBRAL THROMBOSIS* 

43400 CRBL THRMBS WO INFRCT 

43401 CRBL THRMBS W INFRCT 

4341 CEREBRAL EMBOLISM* 

43410 CRBL EMBLSM WO INFRCT 

43411 CRBL EMBLSM W INFRCT 

4349 CEREBR ARTERY OCCLUS NOS* 

43490 CRBL ART OC NOS WO INFRC 

43491 CRBL ART OCL NOS W INFRC 

435 TRANSIENT CEREB ISCHEMIA* 

4350 BASILAR ARTERY SYNDROME 

4351 VERTEBRAL ARTERY SYNDROM 

4352 SUBCLAVIAN STEAL SYNDROM 

4353 VERTBROBASLR ARTERY SYND 

4358 TRANS CEREB ISCHEMIA NEC 

4359 TRANS CEREB ISCHEMIA NOS 

436 CVA 

437 OTH CEREBROVASC DISEASE* 

4370 CEREBRAL ATHEROSCLEROSIS 

4371 AC CEREBROVASC INSUF NOS 

4372 HYPERTENS ENCEPHALOPATHY 

4373 NONRUPT CEREBRAL ANEURYM 

4374 CEREBRAL ARTERITIS 

4375 MOYAMOYA DISEASE 

4376 NONPYOGEN THROMBOS SINUS 

4377 TRANSIENT GLOBAL AMNESIA 

4378 CEREBROVASC DISEASE NEC 

4379 CEREBROVASC DISEASE NOS

438 LATE EFF CEREBROVASC DIS* 

4380 LATE EF CV DIS-COGNF DEF 

43810 LATE EF-SPCH/LNG DEF NOS 

43811 LATE EFF CV DIS-APHASIA 

43812 LATE EFF CV DIS-DYSPHSIA 

43819 LATE EF-SPCH/LANG DF NEC 

43820 LATE EF-HEMPLGA SIDE NOS 

43821 LATE EF-HEMPLGA DOM SIDE 

43822 LATE EF-HEMIPLGA NON-DOM 

43830 LATE EF-MPLGA UP LMB NOS 

43831 LATE EF-MPLGA UP LMB DOM 

43832 LT EF-MPLGA UPLMB NONDOM 

43840 LTE EF-MPLGA LOW LMB NOS 

43841 LTE EF-MPLGA LOW LMB DOM 

43842 LT EF-MPLGA LOWLMB NONDM 

43850 LT EF OTH PARAL SIDE NOS 

43851 LT EF OTH PARAL DOM SIDE 

43852 LT EF OTH PARALS NON-DOM 

43853 LT EF OTH PARALS-BILAT 

43881 LATE EFF CV DIS-APRAXIA 

43882 LATE EF CV DIS DYSPHAGIA 

43889 LATE EFFECT CV DIS NEC 

4389 LATE EFFECT CV DIS NOS 

4588 HYPOTENSION NEC 

440 ATHEROSCLEROSIS* 

4400 AORTIC ATHEROSCLEROSIS 

4401 RENAL ARTERY ATHEROSCLER 

4402 ATHEROSCLEROS-EXTREMITY* 

44020 ATHSCL EXTRM NTV ART NOS 

44021 ATH EXT NTV AT W CLAUDCT 

44022 ATH EXT NTV AT W RST PN 

44023 ATH EXT NTV ART ULCRTION 

44024 ATH EXT NTV ART GNGRENE 

44029 ATHRSC EXTRM NTV ART OTH 

44030 ATHSCL EXTRM BPS GFT NOS 

44031 ATH EXT AUTOLOGS BPS GFT 

44032 ATH EXT NONAUTLG BPS GFT 

4408 ATHEROSCLEROSIS NEC 

4409 ATHEROSCLEROSIS NOS 

441 AORTIC ANEURYSM* 

4410 DISSECTING ANEURYSM* 

44100 DSCT OF AORTA UNSP SITE 

44101 DSCT OF THORACIC AORTA 

44102 DSCT OF ABDOMINAL AORTA 

44103 DSCT OF THORACOABD AORTA 

4411 RUPTUR THORACIC ANEURYSM 

4412 THORACIC AORTIC ANEURYSM 

4413 RUPT ABD AORTIC ANEURYSM 

4414 ABDOM AORTIC ANEURYSM 

4415 RUPT AORTIC ANEURYSM NOS 

4416 THORACOABD ANEURYSM RUPT 

4417 THRACABD ANURYSM WO RUPT 

4419 AORTIC ANEURYSM NOS 

442 OTHER ANEURYSM* 

4420 UPPER EXTREMITY ANEURYSM 

4421 RENAL ARTERY ANEURYSM 

4422 ILIAC ARTERY ANEURYSM

4423 LOWER EXTREMITY ANEURYSM 

4428 ANEURYSM NEC* 

44281 ANEURYSM OF NECK 

44282 SUBCLAVIAN ANEURYSM 

44283 SPLENIC ARTERY ANEURYSM 

44284 VISCERAL ANEURYSM NEC 

44289 ANEURYSM NEC 

4429 ANEURYSM NOS 

443 OTH PERIPH VASCULAR DIS* 

4430 RAYNAUD'S SYNDROME 

4431 THROMBOANGIIT OBLITERANS 

4438 PERIPH VASCULAR DIS NEC* 

44381 ANGIOPATHY IN OTHER DIS 

44389 PERIPH VASCULAR DIS NEC 

4439 PERIPH VASCULAR DIS NOS 

444 ARTERIAL EMBOLISM* 

4440 ABD AORTIC EMBOLISM 

4441 THORACIC AORTIC EMBOLISM 

4442 EMBOLISM OF EXTREMITY* 

44421 UPPER EXTREMITY EMBOLISM 

44422 LOWER EXTREMITY EMBOLISM 

4448 ARTERIAL EMBOLISM NEC* 

44481 ILIAC ARTERY EMBOLISM 

44489 ARTERIAL EMBOLISM NEC 

4449 ARTERIAL EMBOLISM NOS 

446 POLYARTERIT NODOSA ET AL* 

4460 POLYARTERITIS NODOSA 

4461 MUCOCUTAN LYMPH NODE SYN 

4462 HYPERSENSITIV ANGIITIS* 

44620 HYPERSENSIT ANGIITIS NOS 

44621 GOODPASTURE'S SYNDROME 

44629 HYPERSENSIT ANGIITIS NEC 

4463 LETHAL MIDLINE GRANULOMA 

4464 WEGENER'S GRANULOMATOSIS 

4465 GIANT CELL ARTERITIS 

4466 THROMBOT MICROANGIOPATHY 

4467 TAKAYASU'S DISEASE 

447 OTHER ARTERIAL DISEASE* 

4470 ACQ ARTERIOVEN FISTULA 

4471 STRICTURE OF ARTERY 

4472 RUPTURE OF ARTERY 

4473 RENAL ARTERY HYPERPLASIA 

4474 CELIAC ART COMPRESS SYN 

4475 NECROSIS OF ARTERY 

4476 ARTERITIS NOS 

4478 ARTERIAL DISEASE NEC 

4479 ARTERIAL DISEASE NOS 

448 DISEASE OF CAPILLARIES* 

4480 HEREDIT HEMORR TELANGIEC 

4481 NEVUS, NON-NEOPLASTIC 

4489 CAPILLARY DIS NEC/NOS 

451 THROMBOPHLEBITIS* 

4510 SUPERFIC PHLEBITIS-LEG 

4511 DEEP PHLEBITIS-LEG* 

45111 FEMORAL VEIN PHLEBITIS 

45119 DEEP PHLEBITIS-LEG NEC 

4512 THROMBOPHLEBITIS LEG NOS

4518 THROMBOPHLEBITIS NEC* 

45181 ILIAC THROMBOPHLEBITIS 

45182 PHLBTS SPRFC VN UP EXTRM 

45183 PHLBTS DEEP VN UP EXTRM 

45184 PHLBTS VN NOS UP EXTRM 

45189 THROMBOPHLEBITIS NEC 

4519 THROMBOPHLEBITIS NOS 

452 PORTAL VEIN THROMBOSIS 

453 OTH VENOUS THROMBOSIS* 

4530 BUDD-CHIARI SYNDROME 

4531 THROMBOPHLEBITIS MIGRANS 

4532 VENA CAVA THROMBOSIS 

4533 RENAL VEIN THROMBOSIS 

4538 VENOUS THROMBOSIS NEC 

4539 VENOUS THROMBOSIS NOS 

454 VARICOSE VEINS, LEG* 

4540 LEG VARICOSITY W ULCER 

4541 LEG VARICOSITY W INFLAM 

4542 VARICOS LEG ULCER/INFLAM 

4549 VARICOSE VEIN OF LEG NOS 

455 HEMORRHOIDS* 

4550 INT HEMORRHOID W/O COMPL 

4551 INT THROMBOS HEMORRHOID 

4552 INT HEMRRHOID W COMP NEC 

4553 EXT HEMORRHOID W/O COMPL 

4554 EXT THROMBOS HEMORRHOID 

4555 EXT HEMRRHOID W COMP NEC 

4556 HEMORRHOIDS NOS 

4557 THROMBOS HEMORRHOIDS NOS 

4558 HEMRRHOID NOS W COMP NEC 

4559 RESIDUAL HEMORRHOID TAGS 

456 VARICOSE VEINS NEC* 

4560 ESOPHAG VARICES W BLEED 

4561 ESOPH VARICES W/O BLEED 

4562 ESOPH VARICES IN OTH DIS* 

45620 BLEED ESOPH VAR OTH DIS 

45621 ESOPH VARICE OTH DIS NOS 

4563 SUBLINGUAL VARICES 

4564 SCROTAL VARICES 

4565 PELVIC VARICES 

4566 VULVAL VARICES 

4568 VARICES OF OTHER SITES 

457 NONINFECT LYMPHATIC DIS* 

4570 POSTMASTECT LYMPHEDEMA 

4571 OTHER LYMPHEDEMA 

4572 LYMPHANGITIS 

4578 NONINFECT LYMPH DIS NEC 

4579 NONINFECT LYMPH DIS NOS 

458 HYPOTENSION* 

4580 ORTHOSTATIC HYPOTENSION 

4581 CHRONIC HYPOTENSION 

4582 IATROGENIC HYPOTENSION 

4589 HYPOTENSION NOS 

459 OTH CIRCULATORY DISEASE* 

4590 HEMORRHAGE NOS 

4591 POSTPHLEBITIC SYNDROME 

4592 COMPRESSION OF VEIN

4598 OTH CIRCULATORY DISEASE* 

45981 VENOUS INSUFFICIENCY NOS 

45989 CIRCULATORY DISEASE NEC 

4599 CIRCULATORY DISEASE NOS 

460 ACUTE NASOPHARYNGITIS 

461 ACUTE SINUSITIS* 

4610 AC MAXILLARY SINUSITIS 

4611 AC FRONTAL SINUSITIS 

4612 AC ETHMOIDAL SINUSITIS 

4613 AC SPHENOIDAL SINUSITIS 

4618 OTHER ACUTE SINUSITIS 

4619 ACUTE SINUSITIS NOS 

462 ACUTE PHARYNGITIS 

463 ACUTE TONSILLITIS 

464 AC LARYNGITIS/TRACHEITIS* 

4640 ACUTE LARYNGITIS 

4641 ACUTE TRACHEITIS* 

46410 AC TRACHEITIS NO OBSTRUC 

46411 AC TRACHEITIS W OBSTRUCT 

4642 ACUTE LARYNGOTRACHEITIS* 

46420 AC LARYNGOTRACH NO OBSTR 

46421 AC LARYNGOTRACH W OBSTR 

4643 ACUTE EPIGLOTTITIS* 

46430 AC EPIGLOTTITIS NO OBSTR 

46431 AC EPIGLOTTITIS W OBSTR 

4644 CROUP 

465 AC URI MULT SITES/NOS* 

4650 ACUTE LARYNGOPHARYNGITIS 

4658 ACUTE URI MULT SITES NEC 

4659 ACUTE URI NOS 

466 AC BRONCHITIS/BRONCHIOL* 

4660 ACUTE BRONCHITIS 

4661 ACUTE BRONCHIOLITIS* 

46611 ACU BRONCHOLITIS D/T RSV 

46619 ACU BRNCHLTS D/T OTH ORG 

470 DEVIATED NASAL SEPTUM 

471 NASAL POLYPS* 

4710 POLYP OF NASAL CAVITY 

4711 POLYPOID SINUS DEGEN 

4718 NASAL SINUS POLYP NEC 

4719 NASAL POLYP NOS 

472 CHR PHARYNG/NASOPHARYNG* 

4720 CHRONIC RHINITIS 

4721 CHRONIC PHARYNGITIS 

4722 CHRONIC NASOPHARYNGITIS 

473 CHRONIC SINUSITIS* 

4730 CHR MAXILLARY SINUSITIS 

4731 CHR FRONTAL SINUSITIS 

4732 CHR ETHMOIDAL SINUSITIS 

4733 CHR SPHENOIDAL SINUSITIS 

4738 CHRONIC SINUSITIS NEC 

4739 CHRONIC SINUSITIS NOS 

474 CHR T & A DIS* 

4740 CHRONIC TONSILLITIS* 

47400 CHRONIC TONSILLITIS 

47401 CHRONIC ADENOIDITIS 

47402 CHRONIC TONSILS&ADENOIDS

4741 T & A HYPERTROPHY* 

47410 HYPERTROPHY T AND A 

47411 HYPERTROPHY TONSILS 

47412 HYPERTROPHY ADENOIDS 

4742 ADENOID VEGETATIONS 

4748 CHR T & A DIS NEC 

4749 CHR T & A DIS NOS 

475 PERITONSILLAR ABSCESS 

476 CHR LARYNG/LARYNGOTRACH* 

4760 CHRONIC LARYNGITIS 

4761 CHR LARYNGOTRACHEITIS 

477 ALLERGIC RHINITIS* 

4770 RHINITIS DUE TO POLLEN 

4778 ALLERGIC RHINITIS NEC 

4779 ALLERGIC RHINITIS NOS 

478 OTH UPPR RESPIRATORY DIS* 

4780 HYPERTRPH NASAL TURBINAT 

4781 NASAL & SINUS DIS NEC 

4782 DISEASE OF PHARYNX NEC* 

47820 DISEASE OF PHARYNX NOS 

47821 CELLULITIS OF PHARYNX 

47822 PARAPHARYNGEAL ABSCESS 

47824 RETROPHARYNGEAL ABSCESS 

47825 EDEMA PHARYNX/NASOPHARYX 

47826 CYST PHARYNX/NASOPHARYNX 

47829 DISEASE OF PHARYNX NEC 

4783 PARAL VOCAL CORD/LARYNX* 

47830 VOCAL CORD PARALYSIS NOS 

47831 VOCAL PARAL UNILAT PART 

47832 VOCAL PARAL UNILAT TOTAL 

47833 VOCAL PARAL BILAT PART 

47834 VOCAL PARAL BILAT TOTAL 

4784 VOCAL CORD/LARYNX POLYP 

4785 VOCAL CORD DISEASE NEC 

4786 EDEMA OF LARYNX 

4787 OTHER DISEASE OF LARYNX* 

47870 DISEASE OF LARYNX NOS 

47871 LARYNGEAL CELLULITIS 

47874 STENOSIS OF LARYNX 

47875 LARYNGEAL SPASM 

47879 DISEASE OF LARYNX NEC 

4788 URT HYPERSENS REACT NOS 

4789 UPPER RESP DIS NEC/NOS 

480 VIRAL PNEUMONIA* 

4800 ADENOVIRAL PNEUMONIA 

4801 RESP SYNCYT VIRAL PNEUM 

4802 PARINFLUENZA VIRAL PNEUM 

4808 VIRAL PNEUMONIA NEC 

4809 VIRAL PNEUMONIA NOS 

481 PNEUMOCOCCAL PNEUMONIA 

482 OTH BACTERIAL PNEUMONIA* 

4820 K. PNEUMONIAE PNEUMONIA 

4821 PSEUDOMONAL PNEUMONIA 

4822 H.INFLUENZAE PNEUMONIA 

4823 STREPTOCOCCAL PNEUMONIA* 

48230 STREPTOCOCCAL PNEUMN NOS 

48231 PNEUMONIA STRPTOCOCCUS A

48232 PNEUMONIA STRPTOCOCCUS B 

48239 PNEUMONIA OTH STREP 

4824 STAPHYLOCOCCAL PNEUMONIA* 

48240 STAPHYLOCOCCAL PNEU NOS 

48241 STAPH AUREUS PNEUMONIA 

48249 STAPH PNEUMONIA NEC 

4828 BACTERIAL PNEUMONIA NEC* 

48281 PNEUMONIA ANAEROBES 

48282 PNEUMONIA E COLI 

48283 PNEUMO OTH GRM-NEG BACT 

48284 LEGIONNAIRES' DISEASE 

48289 PNEUMONIA OTH SPCF BACT 

4829 BACTERIAL PNEUMONIA NOS 

483 PNEUMONIA: ORGANISM NEC* 

4831 PNEUMONIA D/T CHLAMYDIA 

4830 PNEU MYCPLSM PNEUMONIAE 

4838 PNEUMON OTH SPEC ORGNSM 

484 PNEUM IN OTH INFEC DIS* 

4841 PNEUM W CYTOMEG INCL DIS 

4843 PNEUMONIA IN WHOOP COUGH 

4845 PNEUMONIA IN ANTHRAX 

4846 PNEUM IN ASPERGILLOSIS 

4847 PNEUM IN OTH SYS MYCOSES 

4848 PNEUM IN INFECT DIS NEC 

485 BRONCHOPNEUMONIA ORG NOS 

486 PNEUMONIA, ORGANISM NOS 

487 INFLUENZA* 

4870 INFLUENZA WITH PNEUMONIA 

4871 FLU W RESP MANIFEST NEC 

4878 FLU W MANIFESTATION NEC 

490 BRONCHITIS NOS 

491 CHRONIC BRONCHITIS* 

4910 SIMPLE CHR BRONCHITIS 

4911 MUCOPURUL CHR BRONCHITIS 

4912 OBSTRUCT CHR BRONCHITIS* 

49120 OBS CHR BRNC W/O ACT EXA 

49121 OBS CHR BRNC W ACT EXA 

4918 CHRONIC BRONCHITIS NEC 

4919 CHRONIC BRONCHITIS NOS 

492 EMPHYSEMA* 

4920 EMPHYSEMATOUS BLEB 

4928 EMPHYSEMA NEC 

493 ASTHMA* 

4930 EXTRINSIC ASTHMA* 

49300 EXT ASTHMA W/O STAT ASTH 

49301 EXT ASTHMA W STATUS ASTH 

4931 INTRINSIC ASTHMA* 

49310 INT ASTHMA W/O STAT ASTH 

49311 INT ASTHMA W STATUS ASTH 

49320 CH OB ASTH W/O STAT ASTH 

49321 CH OB ASTHMA W STAT ASTH 

4939 ASTHMA NOS* 

49390 ASTHMA W/O STATUS ASTHM 

49391 ASTHMA W STATUS ASTHMAT 

494 BRONCHIECTASIS 

495 EXT ALLERGIC ALVEOLITIS* 

4950 FARMERS' LUNG

4951 BAGASSOSIS 

4952 BIRD-FANCIERS' LUNG 

4953 SUBEROSIS 

4954 MALT WORKERS' LUNG 

4955 MUSHROOM WORKERS' LUNG 

4956 MAPL BARK-STRIPPRS' LUNG 

4957 "VENTILATION" PNEUMONIT 

4958 ALLERG ALVEOL/PNEUM NEC 

4959 ALLERG ALVEOL/PNEUM NOS 

496 CHR AIRWAY OBSTRUCT NEC 

500 COAL WORKERS' PNEUMOCON 

501 ASBESTOSIS 

502 SILICA PNEUMOCON NEC 

503 INORG DUST PNEUMOCON NEC 

504 DUST PNEUMONOPATHY NEC 

505 PNEUMOCONIOSIS NOS 

506 FUM/VAPOR RESP DISEASES* 

5060 FUM/VAPOR BRONC/PNEUMON 

5061 FUM/VAPOR AC PULM EDEMA 

5062 FUM/VAPOR UP RESP INFLAM 

5063 FUM/VAP AC RESP COND NEC 

5064 FUM/VAPOR CHR RESP COND 

5069 FUM/VAPOR RESP COND NOS 

507 SOLID/LIQ PNEUMONITIS* 

5070 FOOD/VOMIT PNEUMONITIS 

5071 OIL/ESSENCE PNEUMONITIS 

5078 SOLID/LIQ PNEUMONIT NEC 

508 RESP COND D/T EXT AGENT* 

5080 AC PUL MANIF D/T RADIAT 

5081 CHR PUL MANIF D/T RADIAT 

5088 RESP COND: EXT AGENT NEC 

5089 RESP COND: EXT AGENT NOS 

510 EMPYEMA* 

5100 EMPYEMA WITH FISTULA 

5109 EMPYEMA W/O FISTULA 

511 PLEURISY* 

5110 PLEURISY W/O EFFUS OR TB 

5111 BACT PLEUR/EFFUS NOT TB 

5118 PLEURAL EFFUS NEC NOT TB 

5119 PLEURAL EFFUSION NOS 

512 PNEUMOTHORAX* 

5120 SPONT TENS PNEUMOTHORAX 

5121 IATROGENIC PNEUMOTHORAX 

5128 SPONT PNEUMOTHORAX NEC 

513 LUNG/MEDIASTINUM ABSCESS* 

5130 ABSCESS OF LUNG 

5131 ABSCESS OF MEDIASTINUM 

514 PULM CONGEST/HYPOSTASIS 

515 POSTINFLAM PULM FIBROSIS 

516 OTH ALVEOL PNEUMONOPATHY* 

5160 PUL ALVEOLAR PROTEINOSIS 

5161 IDIO PULM HEMOSIDEROSIS 

5162 PULM ALVEOLAR MICROLITH 

5163 IDIO FIBROS ALVEOLITIS 

5168 ALVEOL PNEUMONOPATHY NEC 

5169 ALVEOL PNEUMONOPATHY NOS 

517 LUNG INVOLV W OTH COND*

5171 RHEUMATIC PNEUMONIA 

5172 SYST SCLEROSIS LUNG DIS 

5178 LUNG INVOLV IN OTH DIS 

518 OTHER LUNG DISEASES* 

5180 PULMONARY COLLAPSE 

5181 INTERSTITIAL EMPHYSEMA 

5182 COMPENSATORY EMPHYSEMA 

5183 PULMONARY EOSINOPHILIA 

5184 ACUTE LUNG EDEMA NOS 

5185 POST TRAUM PULM INSUFFIC 

5186 ALRGC BRNCPUL ASPRGLOSIS 

51881 ACUTE RESPIRATRY FAILURE 

51882 OTHER PULMONARY INSUFF 

51883 CHRONIC RESPIRATORY FAIL 

51884 ACUTE & CHRONC RESP FAIL 

51889 OTHER LUNG DISEASE NEC 

519 OTH RESP SYSTEM DISEASES* 

5190 TRACHEOSTOMY COMPLIC* 

51900 TRACHEOSTOMY COMP NOS 

51901 TRACHEOSTOMY INFECTION 

51902 TRACHEOSTOMY - MECH COMP 

51909 TRACHEOSTOMY COMP NEC 

5191 TRACHEA/BRONCHUS DIS NEC 

5192 MEDIASTINITIS 

5193 MEDIASTINUM DISEASE NEC 

5194 DISORDERS OF DIAPHRAGM 

5198 RESP SYSTEM DISEASE NEC 

5199 RESP SYSTEM DISEASE NOS 

520 TOOTH DEVELOP/ERUPT DIS* 

5200 ANODONTIA 

5201 SUPERNUMERARY TEETH 

5202 ABNORMAL TOOTH SIZE/FORM 

5203 MOTTLED TEETH 

5204 TOOTH FORMATION DISTURB 

5205 HEREDIT TOOTH STRUCT NEC 

5206 TOOTH ERUPTION DISTURB 

5207 TEETHING SYNDROME 

5208 TOOTH DEVEL/ERUP DIS NEC 

5209 TOOTH DEVEL/ERUP DIS NOS 

521 HARD TISSUE DIS OF TEETH* 

5210 DENTAL CARIES 

5211 EXCESS ATTRITION-TEETH 

5212 ABRASION OF TEETH 

5213 EROSION OF TEETH 

5214 RESORPTION OF TEETH 

5215 HYPERCEMENTOSIS 

5216 ANKYLOSIS OF TEETH 

5217 POSTERUPT COLOR CHANGE 

5218 HARD TISS DIS TEETH NEC 

5219 HARD TISS DIS TEETH NOS 

522 PULP & PERIAPICAL DIS* 

5220 PULPITIS 

5221 NECROSIS OF TOOTH PULP 

5222 TOOTH PULP DEGENERATION 

5223 ABN HARD TISS-TOOTH PULP 

5224 AC APICAL PERIODONTITIS 

5225 PERIAPICAL ABSCESS

5226 CHR APICAL PERIODONTITIS 

5227 PERIAPICAL ABSC W SINUS 

5228 RADICULAR CYST 

5229 PULP/PERIAPICAL DIS NEC 

523 GINGIVAL/PERIODONTAL DIS* 

5230 ACUTE GINGIVITIS 

5231 CHRONIC GINGIVITIS 

5232 GINGIVAL RECESSION 

5233 ACUTE PERIODONTITIS 

5234 CHRONIC PERIODONTITIS 

5235 PERIODONTOSIS 

5236 ACCRETIONS ON TEETH 

5238 PERIODONTAL DISEASE NEC 

5239 GINGIV/PERIODONT DIS NOS 

524 DENTOFACIAL ANOMALIES* 

5240 MAJOR ANOM OF JAW SIZE* 

52400 UNSPCF ANOMALY JAW SIZE 

52401 MAXILLARY HYPERPLASIA 

52402 MANDIBULAR HYPERPLASIA 

52403 MAXILLARY HYPOPLASIA 

52404 MANDIBULAR HYPOPLASIA 

52405 MACROGENIA 

52406 MICROGENIA 

52409 OTH SPCF ANMLY JAW SIZE 

5241 JAW-CRANIAL BASE ANOMALY* 

52410 UNSPCF ANM JAW CRANL BSE 

52411 MAXILLARY ASYMMETRY 

52412 OTHER JAW ASYMMETRY 

52419 SPCFD ANOM JAW CRANL BSE 

5242 DENTAL ARCH ANOMALY 

5243 TOOTH POSITION ANOMALY 

5244 MALOCCLUSION NOS 

5245 ABN DENTOFACIAL FUNCTION 

5246 TEMPOROMANDIBULAR JT DIS* 

52460 TMJ DISORDERS NOS 

52461 ADHESNS/ANKYLOSIS - TMJ 

52462 ARTHRALGIA TMJ 

52463 ARTICULAR DISC DISORDER 

52469 OTHER SPECF TMJ DISORDRS 

52470 UNSPF DENT ALVELR ANMALY 

52471 ALVEOLAR MAXIL HYPRPLSIA 

52472 ALVEOLAR MANDIB HYPRPLAS 

52473 ALVEOLAR MAXIL HYPOPLSIA 

52474 ALVEOLAR MANDB HYPOPLSIA 

52479 OTH SPCF ALVEOLAR ANMALY 

5248 DENTOFACIAL ANOMALY NEC 

5249 DENTOFACIAL ANOMALY NOS 

525 OTHER DENTAL DISORDER* 

5250 EXFOLIATION OF TEETH 

5251 LOSS OF TEETH, ACQUIRED 

5252 ATROPHY ALVEOLAR RIDGE 

5253 RETAINED DENTAL ROOT 

5258 DENTAL DISORDER NEC 

5259 DENTAL DISORDER NOS 

526 JAW DISEASES* 

5260 DEVEL ODONTOGENIC CYSTS 

5261 FISSURAL CYSTS OF JAW

5262 CYSTS OF JAWS NEC 

5263 CENT GIANT CELL GRANULOM 

5264 INFLAMMATION OF JAW 

5265 ALVEOLITIS OF JAW 

5268 OTHER JAW DISEASES* 

52681 EXOSTOSIS OF JAW 

52689 JAW DISEASE NEC 

5269 JAW DISEASE NOS 

527 SALIVARY GLAND DISEASES* 

5270 SALIVARY GLAND ATROPHY 

5271 SALIVARY GLND HYPRTROPHY 

5272 SIALOADENITIS 

5273 SALIVARY GLAND ABSCESS 

5274 SALIVARY GLAND FISTULA 

5275 SIALOLITHIASIS 

5276 SALIVARY GLAND MUCOCELE 

5277 SALIVARY SECRETION DIS 

5278 SALIVARY GLAND DIS NEC 

5279 SALIVARY GLAND DIS NOS 

528 ORAL SOFT TISSUE DISEASE* 

5280 STOMATITIS 

5281 CANCRUM ORIS 

5282 ORAL APHTHAE 

5283 CELLULITIS/ABSCESS MOUTH 

5284 ORAL SOFT TISSUE CYST 

5285 DISEASES OF LIPS 

5286 LEUKOPLAKIA ORAL MUCOSA 

5287 ORAL EPITHELIUM DIS NEC 

5288 ORAL SUBMUCOSAL FIBROSIS 

5289 ORAL SOFT TISSUE DIS NEC 

529 TONGUE DISORDERS* 

5290 GLOSSITIS 

5291 GEOGRAPHIC TONGUE 

5292 MED RHOMBOID GLOSSITIS 

5293 HYPERTROPH TONGUE PAPILL 

5294 ATROPHY TONGUE PAPILLAE 

5295 PLICATED TONGUE 

5296 GLOSSODYNIA 

5298 TONGUE DISORDER NEC 

5299 TONGUE DISORDER NOS 

530 DISEASES OF ESOPHAGUS* 

5300 ACHALASIA & CARDIOSPASM 

5301 ESOPHAGITIS* 

53010 ESOPHAGITIS, UNSPECIFIED 

53011 REFLUX ESOPHAGITIS 

53019 OTHER ESOPHAGITIS 

5302 ULCER OF ESOPHAGUS 

5303 ESOPHAGEAL STRICTURE 

5304 PERFORATION OF ESOPHAGUS 

5305 DYSKINESIA OF ESOPHAGUS 

5306 ACQ ESOPHAG DIVERTICULUM 

5307 MALLORY-WEISS SYNDROME 

5308 ESOPHAGEAL DISORDER NEC* 

53081 ESOPHAGEAL REFLUX 

53082 ESOPHAGEAL HEMORRHAGE 

53083 ESOPHAGEAL LEUKOPLAKIA 

53084 TRACHEOESOPHAGEAL FSTULA

53089 OTHER DSRDERS ESOPHAGUS 

5309 ESOPHAGEAL DISORDER NOS 

531 GASTRIC ULCER* 

5310 AC STOMACH ULCER W HEM* 

53100 AC STOMACH ULCER W HEM 

53101 AC STOMAC ULC W HEM-OBST 

5311 AC STOMACH ULCER W PERF* 

53110 AC STOMACH ULCER W PERF 

53111 AC STOM ULC W PERF-OBST 

5312 AC STOMAC ULC W HEM/PERF* 

53120 AC STOMAC ULC W HEM/PERF 

53121 AC STOM ULC HEM/PERF-OBS 

5313 ACUTE STOMACH ULCER NOS* 

53130 ACUTE STOMACH ULCER NOS 

53131 AC STOMACH ULC NOS-OBSTR 

5314 CHR STOMACH ULC W HEM* 

53140 CHR STOMACH ULC W HEM 

53141 CHR STOM ULC W HEM-OBSTR 

5315 CHR STOMACH ULCER W PERF* 

53150 CHR STOMACH ULCER W PERF 

53151 CHR STOM ULC W PERF-OBST 

5316 CHR STOMACH ULC HEM/PERF* 

53160 CHR STOMACH ULC HEM/PERF 

53161 CHR STOM ULC HEM/PERF-OB 

5317 CHR STOMACH ULCER NOS* 

53170 CHR STOMACH ULCER NOS 

53171 CHR STOMACH ULC NOS-OBST 

5319 STOMACH ULCER NOS* 

53190 STOMACH ULCER NOS 

53191 STOMACH ULCER NOS-OBSTR 

532 DUODENAL ULCER* 

5320 AC DUODENAL ULCER W HEM* 

53200 AC DUODENAL ULCER W HEM 

53201 AC DUODEN ULC W HEM-OBST 

5321 AC DUODENAL ULCER W PERF* 

53210 AC DUODENAL ULCER W PERF 

53211 AC DUODEN ULC PERF-OBSTR 

5322 AC DUODEN ULC W HEM/PERF* 

53220 AC DUODEN ULC W HEM/PERF 

53221 AC DUOD ULC HEM/PERF-OBS 

5323 ACUTE DUODENAL ULCER NOS* 

53230 ACUTE DUODENAL ULCER NOS 

53231 AC DUODENAL ULC NOS-OBST 

5324 CHR DUODEN ULCER W HEM* 

53240 CHR DUODEN ULCER W HEM 

53241 CHR DUODEN ULC HEM-OBSTR 

5325 CHR DUODEN ULCER W PERF* 

53250 CHR DUODEN ULCER W PERF 

53251 CHR DUODEN ULC PERF-OBST 

5326 CHR DUODEN ULC HEM/PERF* 

53260 CHR DUODEN ULC HEM/PERF 

53261 CHR DUOD ULC HEM/PERF-OB 

5327 CHR DUODENAL ULCER NOS* 

53270 CHR DUODENAL ULCER NOS 

53271 CHR DUODEN ULC NOS-OBSTR 

5329 DUODENAL ULCER NOS* 

53290 DUODENAL ULCER NOS

53291 DUODENAL ULCER NOS-OBSTR 

533 PEPTIC ULCER, SITE NOS* 

5330 AC PEPTIC ULCER W HEMORR* 

53300 AC PEPTIC ULCER W HEMORR 

53301 AC PEPTIC ULC W HEM-OBST 

5331 AC PEPTIC ULCER W PERFOR* 

53310 AC PEPTIC ULCER W PERFOR 

53311 AC PEPTIC ULC W PERF-OBS 

5332 AC PEPTIC ULC W HEM/PERF* 

53320 AC PEPTIC ULC W HEM/PERF 

53321 AC PEPT ULC HEM/PERF-OBS 

5333 ACUTE PEPTIC ULCER NOS* 

53330 ACUTE PEPTIC ULCER NOS 

53331 AC PEPTIC ULCER NOS-OBST 

5334 CHR PEPTIC ULCER W HEM* 

53340 CHR PEPTIC ULCER W HEM 

53341 CHR PEPTIC ULC W HEM-OBS 

5335 CHR PEPTIC ULCER W PERF* 

53350 CHR PEPTIC ULCER W PERF 

53351 CHR PEPTIC ULC PERF-OBST 

5336 CHR PEPT ULC W HEM/PERF* 

53360 CHR PEPT ULC W HEM/PERF 

53361 CHR PEPT ULC HEM/PERF-OB 

5337 CHRONIC PEPTIC ULCER NOS* 

53370 CHRONIC PEPTIC ULCER NOS 

53371 CHR PEPTIC ULCER NOS-OBS 

5339 PEPTIC ULCER NOS* 

53390 PEPTIC ULCER NOS 

53391 PEPTIC ULCER NOS-OBSTRUC 

534 GASTROJEJUNAL ULCER* 

5340 AC MARGINAL ULCER W HEM* 

53400 AC MARGINAL ULCER W HEM 

53401 AC MARGIN ULC W HEM-OBST 

5341 AC MARGINAL ULCER W PERF* 

53410 AC MARGINAL ULCER W PERF 

53411 AC MARGIN ULC W PERF-OBS 

5342 AC MARGIN ULC W HEM/PERF* 

53420 AC MARGIN ULC W HEM/PERF 

53421 AC MARG ULC HEM/PERF-OBS 

5343 AC MARGINAL ULCER NOS* 

53430 AC MARGINAL ULCER NOS 

53431 AC MARGINAL ULC NOS-OBST 

5344 CHR MARGINAL ULCER W HEM* 

53440 CHR MARGINAL ULCER W HEM 

53441 CHR MARGIN ULC W HEM-OBS 

5345 CHR MARGINAL ULC W PERF* 

53450 CHR MARGINAL ULC W PERF 

53451 CHR MARGIN ULC PERF-OBST 

5346 CHR MARGIN ULC HEM/PERF* 

53460 CHR MARGIN ULC HEM/PERF 

53461 CHR MARG ULC HEM/PERF-OB 

5347 CHR MARGINAL ULCER NOS* 

53470 CHR MARGINAL ULCER NOS 

53471 CHR MARGINAL ULC NOS-OBS 

5349 GASTROJEJUNAL ULCER NOS* 

53490 GASTROJEJUNAL ULCER NOS 

53491 GASTROJEJUN ULC NOS-OBST

535 GASTRITIS AND DUODENITIS* 

5350 ACUTE GASTRITIS* 

53500 ACUTE GASTRTIS W/O HMRHG 

53501 ACUTE GASTRITIS W HMRHG 

5351 ATROPHIC GASTRITIS* 

53510 ATRPH GASTRTIS W/O HMRHG 

53511 ATRPH GASTRITIS W HMRHG 

5352 GASTR MUCOSAL HYPERTROPH* 

53520 GSTR MCSL HYPRT W/O HMRG 

53521 GSTR MCSL HYPRT W HMRG 

5353 ALCOHOLIC GASTRITIS* 

53530 ALCHL GASTRTIS W/O HMRHG 

53531 ALCHL GSTRITIS W HMRHG 

5354 GASTRITIS NEC* 

53540 OTH SPF GSTRT W/O HMRHG 

53541 OTH SPF GASTRT W HMRHG 

5355 GASTRITIS/DUODENITIS NOS* 

53550 GSTR/DDNTS NOS W/O HMRHG 

53551 GSTR/DDNTS NOS W HMRHG 

5356 DUODENITIS* 

53560 DUODENITIS W/O HMRHG 

53561 DUODENITIS W HMRHG 

536 STOMACH FUNCTION DISORD* 

5360 ACHLORHYDRIA 

5361 AC DILATION OF STOMACH 

5362 PERSISTENT VOMITING 

5363 GASTROPARESIS 

5364 GASTROSTOMY COMP* 

53640 GASTROSTOMY COMP NOS 

53641 GASTROSTOMY INFECTION 

53642 GASTROSTOMY COMP - MECH 

53649 GASTROSTOMY COMP NEC 

5368 STOMACH FUNCTION DIS NEC 

5369 STOMACH FUNCTION DIS NOS 

537 OTH GASTRODUODENAL DIS* 

5370 ACQ PYLORIC STENOSIS 

5371 GASTRIC DIVERTICULUM 

5372 CHRONIC DUODENAL ILEUS 

5373 DUODENAL OBSTRUCTION NEC 

5374 GASTRIC/DUODENAL FISTULA 

5375 GASTROPTOSIS 

5376 HOURGLASS STRICTURE STOM 

5378 GASTRODUODENAL DIS NEC* 

53781 PYLOROSPASM 

53782 ANGIO STM/DUDN W/O HMRHG 

53783 ANGIO STM/DUDN W HMRHG 

53789 GASTRODUODENAL DIS NEC 

5379 GASTRODUODENAL DIS NOS 

540 ACUTE APPENDICITIS* 

5400 AC APPEND W PERITONITIS 

5401 ABSCESS OF APPENDIX 

5409 ACUTE APPENDICITIS NOS 

541 APPENDICITIS NOS 

542 OTHER APPENDICITIS 

543 OTH DISEASES OF APPENDIX* 

5430 HYPERPLASIA OF APPENDIX 

5439 DISEASES OF APPENDIX NEC

550 INGUINAL HERNIA* 

5500 INGUIN HERNIA W GANGRENE* 

55000 UNILAT ING HERNIA W GANG 

55001 RECUR UNIL ING HERN-GANG 

55002 BILAT ING HERNIA W GANG 

55003 RECUR BIL ING HERN-GANG 

5501 INGUIN HERNIA W OBSTRUCT* 

55010 UNILAT ING HERNIA W OBST 

55011 RECUR UNIL ING HERN-OBST 

55012 BILAT ING HERNIA W OBST 

55013 RECUR BIL ING HERN-OBSTR 

5509 INGUINAL HERNIA NOS* 

55090 UNILAT INGUINAL HERNIA 

55091 RECUR UNILAT INGUIN HERN 

55092 BILAT INGUINAL HERNIA 

55093 RECUR BILAT INGUIN HERN 

551 OTH ABDOM HERNIA W GANGR* 

5510 FEMORAL HERNIA W GANGREN* 

55100 UNIL FEMORAL HERN W GANG 

55101 REC UNIL FEM HERN W GANG 

55102 BILAT FEM HERN W GANG 

55103 RECUR BIL FEM HERN-GANG 

5511 UMBILICAL HERNIA W GANGR 

5512 VENTRAL HERNIA W GANGREN* 

55120 GANGR VENTRAL HERNIA NOS 

55121 GANGR INCISIONAL HERNIA 

55129 GANG VENTRAL HERNIA NEC 

5513 DIAPHRAGM HERNIA W GANGR 

5518 HERNIA, SITE NEC W GANGR 

5519 HERNIA, SITE NOS W GANGR 

552 OTH ABDOM HERNIA W OBSTR* 

5520 FEMORAL HERNIA W OBSTRUC* 

55200 UNIL FEMORAL HERN W OBST 

55201 REC UNIL FEM HERN W OBST 

55202 BIL FEMORAL HERN W OBSTR 

55203 REC BIL FEM HERN W OBSTR 

5521 UMBILICAL HERNIA W OBSTR 

5522 VENTRAL HERNIA W OBSTRUC* 

55220 OBSTR VENTRAL HERNIA NOS 

55221 OBSTR INCISIONAL HERNIA 

55229 OBSTR VENTRAL HERNIA NEC 

5523 DIAPHRAGM HERNIA W OBSTR 

5528 HERNIA, SITE NEC W OBSTR 

5529 HERNIA, SITE NOS W OBSTR 

553 OTHER ABDOMINAL HERNIA* 

5530 FEMORAL HERNIA* 

55300 UNILAT FEMORAL HERNIA 

55301 RECUR UNIL FEMORAL HERN 

55302 BILATERAL FEMORAL HERNIA 

55303 RECUR BILAT FEMORAL HERN 

5531 UMBILICAL HERNIA 

5532 VENTRAL HERNIA* 

55320 VENTRAL HERNIA NOS 

55321 INCISIONAL HERNIA 

55329 VENTRAL HERNIA NEC 

5533 DIAPHRAGMATIC HERNIA 

5538 HERNIA NEC

5539 HERNIA NOS 

555 REGIONAL ENTERITIS* 

5550 REG ENTERITIS, SM INTEST 

5551 REG ENTERITIS, LG INTEST 

5552 REG ENTERIT SM/LG INTEST 

5559 REGIONAL ENTERITIS NOS 

556 IDIOPATHIC PROCTOCOLITIS* 

5560 ULCERATIVE ENTEROCOLITIS 

5561 ULCERATIVE ILEOCOLITIS 

5562 ULCERATIVE PROCTITIS 

5563 ULCERTVE PRCTOSIGMOIDTIS 

5564 PSEUDOPOLYPOSIS COLON 

5565 LFTSDED ULCERTVE COLITIS 

5566 UNIVRSL ULCERTVE COLITIS 

5568 OTHER ULCERATIVE COLITIS 

5569 ULCERATVE COLITIS UNSPCF 

557 VASC INSUFF INTESTINE* 

5570 AC VASC INSUFF INTESTINE 

5571 CHR VASC INSUFF INTEST 

5579 VASC INSUFF INTEST NOS 

558 OTH NONINF GASTROENTERIT* 

5581 RADIATION GASTROENTERIT 

5582 TOXIC GASTROENTERITIS 

5589 NONINF GASTROENTERIT NEC 

560 INTESTINAL OBSTRUCTION* 

5600 INTUSSUSCEPTION 

5601 PARALYTIC ILEUS 

5602 VOLVULUS OF INTESTINE 

5603 IMPACTION OF INTESTINE* 

56030 IMPACTION INTESTINE NOS 

56031 GALLSTONE ILEUS 

56039 IMPACTION INTESTINE NEC 

5608 OTH INTESTINAL OBSTRUCT* 

56081 INTESTINAL ADHES W OBSTR 

56089 INTESTINAL OBSTRUCT NEC 

5609 INTESTINAL OBSTRUCT NOS 

562 DIVERTICULA OF INTESTINE* 

5620 DIVERTICULA SM INTESTINE* 

56200 DVRTCLO SML INT W/O HMRG 

56201 DVRTCLI SML INT W/O HMRG 

56202 DVRTCLO SML INT W HMRHG 

56203 DVRTCLI SML INT W HMRHG 

5621 DIVERTICULA OF COLON* 

56210 DVRTCLO COLON W/O HMRHG 

56211 DVRTCLI COLON W/O HMRHG 

56212 DVRTCLO COLON W HMRHG 

56213 DVRTCLI COLON W HMRHG 

564 FUNCT DIGESTIVE DIS NEC* 

5640 CONSTIPATION 

5641 IRRITABLE COLON 

5642 POSTGASTRIC SURGERY SYND 

5643 VOMITING POST-GI SURGERY 

5644 POSTOP GI FUNCT DIS NEC 

5645 FUNCTIONAL DIARRHEA 

5646 ANAL SPASM 

5647 MEGACOLON NEC 

5648 FUNCT DIS INTESTINE NEC*

56481 NEUROGENIC BOWEL 

56489 FUNCT DIS INTESTINE NEC 

5649 FUNCT DIS INTESTINE NOS 

565 ANAL FISSURE & FISTULA* 

5650 ANAL FISSURE 

5651 ANAL FISTULA 

566 ANAL & RECTAL ABSCESS 

567 PERITONITIS* 

5670 PERITONITIS IN INFEC DIS 

5671 PNEUMOCOCCAL PERITONITIS 

5672 SUPPURAT PERITONITIS NEC 

5678 PERITONITIS NEC 

5679 PERITONITIS NOS 

568 OTH PERITONEAL DISORDERS* 

5680 PERITONEAL ADHESIONS 

5688 DIS OF PERITONEUM NEC* 

56881 HEMOPERITONEUM 

56882 PERITONEAL EFFUSION 

56889 PERITONEAL DISORDER NEC 

5689 PERITONEAL DISORDER NOS 

569 OTH INTESTINAL DISORDERS* 

5690 ANAL & RECTAL POLYP 

5691 RECTAL PROLAPSE 

5692 RECTAL & ANAL STENOSIS 

5693 RECTAL & ANAL HEMORRHAGE 

5694 OTHER RECTAL & ANAL DIS* 

56941 RECTAL & ANAL ULCER 

56942 ANAL OR RECTAL PAIN 

56949 RECTAL & ANAL DIS NEC 

5695 INTESTINAL ABSCESS 

5696 ENTEROSTOMY MALFUNCTION* 

56960 COLSTOMY/ENTER COMP NOS 

56961 COLOSTY/ENTEROST INFECTN 

56962 COLOSTY/ENTER COMP-MECH 

56969 COLSTMY/ENTEROS COMP NEC 

5698 INTESTINAL DISORDERS NEC* 

56981 INTESTINAL FISTULA 

56982 ULCERATION OF INTESTINE 

56983 PERFORATION OF INTESTINE 

56984 ANGIO INTES W/O HMRHG 

56985 ANGIO INTES W HMRHG 

56989 INTESTINAL DISORDERS NEC 

5699 INTESTINAL DISORDER NOS 

570 ACUTE NECROSIS OF LIVER 

571 CHR LIVER DIS/CIRRHOSIS* 

5710 ALCOHOLIC FATTY LIVER 

5711 AC ALCOHOLIC HEPATITIS 

5712 ALCOHOL CIRRHOSIS LIVER 

5713 ALCOHOL LIVER DAMAGE NOS 

5714 CHRONIC HEPATITIS* 

57140 CHRONIC HEPATITIS NOS 

57141 CHR PERSISTENT HEPATITIS 

57149 CHRONIC HEPATITIS NEC 

5715 CIRRHOSIS OF LIVER NOS 

5716 BILIARY CIRRHOSIS 

5718 CHRONIC LIVER DIS NEC 

5719 CHRONIC LIVER DIS NOS

572 SEQUELA OF CHR LIVER DIS* 

5720 ABSCESS OF LIVER 

5721 PORTAL PYEMIA 

5722 HEPATIC COMA 

5723 PORTAL HYPERTENSION 

5724 HEPATORENAL SYNDROME 

5728 OTH SEQUELA, CHR LIV DIS 

573 OTH LIVER DISORDERS* 

5730 CHR PASSIV CONGEST LIVER 

5731 HEPATITIS IN VIRAL DIS 

5732 HEPATITIS IN OTH INF DIS 

5733 HEPATITIS NOS 

5734 HEPATIC INFARCTION 

5738 LIVER DISORDERS NEC 

5739 LIVER DISORDER NOS 

574 CHOLELITHIASIS* 

5740 CHOLELITH W AC CHOLECYST* 

57400 CHOLELITH W AC CHOLECYST 

57401 CHOLELITH/AC GB INF-OBST 

5741 CHOLELITH W CHOLECYS NEC* 

57410 CHOLELITH W CHOLECYS NEC 

57411 CHOLELITH/GB INF NEC-OBS 

5742 CHOLELITHIASIS NOS* 

57420 CHOLELITHIASIS NOS 

57421 CHOLELITHIAS NOS W OBSTR 

5743 CHOLEDOCHOLITH/AC GB INF* 

57430 CHOLEDOCHOLITH/AC GB INF 

57431 CHOLEDOCHLITH/AC GB-OBST 

5744 CHOLEDOCHLITH/GB INF NEC* 

57440 CHOLEDOCHLITH/GB INF NEC 

57441 CHOLEDOCHLITH/GB NEC-OBS 

5745 CHOLEDOCHOLITHIASIS NOS* 

57450 CHOLEDOCHOLITHIASIS NOS 

57451 CHOLEDOCHLITH NOS W OBST 

57460 GALL&BIL CAL W/AC W/O OB 

57461 GALL&BIL CAL W/AC W OBS 

57470 GAL&BIL CAL W/OTH W/O OB 

57471 GALL&BIL CAL W/OTH W OBS 

57480 GAL&BIL CAL W/AC&CHR W/O 

57481 GAL&BIL CAL W/AC&CH W OB 

57490 GALL&BIL CAL W/O CHO W/O 

57491 GALL&BIL CAL W/O CH W OB 

575 OTH GALLBLADDER DISORDER* 

5750 ACUTE CHOLECYSTITIS 

5751 CHOLECYSTITIS NEC* 

57510 CHOLECYSTITIS NOS 

57511 CHRONIC CHOLECYSTITIS 

57512 ACTE & CHR CHOLECYSTITIS 

5752 OBSTRUCTION GALLBLADDER 

5753 HYDROPS OF GALLBLADDER 

5754 PERFORATION GALLBLADDER 

5755 FISTULA OF GALLBLADDER 

5756 GB CHOLESTEROLOSIS 

5758 DIS OF GALLBLADDER NEC 

5759 DIS OF GALLBLADDER NOS 

576 OTH DIS OF BILIARY TRACT* 

5760 POSTCHOLECYSTECTOMY SYND

5761 CHOLANGITIS 

5762 OBSTRUCTION OF BILE DUCT 

5763 PERFORATION OF BILE DUCT 

5764 FISTULA OF BILE DUCT 

5765 SPASM SPHINCTER OF ODDI 

5768 DIS OF BILIARY TRACT NEC 

5769 DIS OF BILIARY TRACT NOS 

577 DISEASES OF PANCREAS* 

5770 ACUTE PANCREATITIS 

5771 CHRONIC PANCREATITIS 

5772 PANCREAT CYST/PSEUDOCYST 

5778 PANCREATIC DISEASE NEC 

5779 PANCREATIC DISEASE NOS 

578 GASTROINTESTINAL HEMORR* 

5780 HEMATEMESIS 

5781 BLOOD IN STOOL 

5789 GASTROINTEST HEMORR NOS 

579 INTESTINAL MALABSORPTION* 

5790 CELIAC DISEASE 

5791 TROPICAL SPRUE 

5792 BLIND LOOP SYNDROME 

5793 INTEST POSTOP NONABSORB 

5794 PANCREATIC STEATORRHEA 

5798 INTEST MALABSORPTION NEC 

5799 INTEST MALABSORPTION NOS 

580 ACUTE NEPHRITIS* 

5800 AC PROLIFERAT NEPHRITIS 

5804 AC RAPIDLY PROGR NEPHRIT 

5808 AC NEPHRITIS W OTH LES* 

58081 AC NEPHRITIS IN OTH DIS 

58089 ACUTE NEPHRITIS NEC 

5809 ACUTE NEPHRITIS NOS 

581 NEPHROTIC SYNDROME* 

5810 NEPHROTIC SYN, PROLIFER 

5811 EPIMEMBRANOUS NEPHRITIS 

5812 MEMBRANOPROLIF NEPHROSIS 

5813 MINIMAL CHANGE NEPHROSIS 

5818 NEPHROTIC SYN W OTH LES* 

58181 NEPHROTIC SYN IN OTH DIS 

58189 NEPHROTIC SYNDROME NEC 

5819 NEPHROTIC SYNDROME NOS 

582 CHRONIC NEPHRITIS* 

5820 CHR PROLIFERAT NEPHRITIS 

5821 CHR MEMBRANOUS NEPHRITIS 

5822 CHR MEMBRANOPROLIF NEPHR 

5824 CHR RAPID PROGR NEPHRIT 

5828 CHR NEPHRITIS W OTH LES* 

58281 CHR NEPHRITIS IN OTH DIS 

58289 CHRONIC NEPHRITIS NEC 

5829 CHRONIC NEPHRITIS NOS 

583 NEPHRITIS NOS* 

5830 PROLIFERAT NEPHRITIS NOS 

5831 MEMBRANOUS NEPHRITIS NOS 

5832 MEMBRANOPROLIF NEPHR NOS 

5834 RAPIDLY PROG NEPHRIT NOS 

5836 RENAL CORT NECROSIS NOS 

5837 NEPHR NOS/MEDULL NECROS

5838 NEPHRITIS NOS W OTH LES* 

58381 NEPHRITIS NOS IN OTH DIS 

58389 NEPHRITIS NEC 

5839 NEPHRITIS NOS 

584 ACUTE RENAL FAILURE* 

5845 LOWER NEPHRON NEPHROSIS 

5846 AC RENAL FAIL, CORT NECR 

5847 AC REN FAIL, MEDULL NECR 

5848 AC RENAL FAILURE NEC 

5849 ACUTE RENAL FAILURE NOS 

585 CHRONIC RENAL FAILURE 

586 RENAL FAILURE NOS 

587 RENAL SCLEROSIS NOS 

588 IMPAIRED RENAL FUNCTION* 

5880 RENAL OSTEODYSTROPHY 

5881 NEPHROGEN DIABETES INSIP 

5888 IMPAIRED RENAL FUNCT NEC 

5889 IMPAIRED RENAL FUNCT NOS 

589 SMALL KIDNEY* 

5890 UNILATERAL SMALL KIDNEY 

5891 BILATERAL SMALL KIDNEYS 

5899 SMALL KIDNEY NOS 

590 KIDNEY INFECTION* 

5900 CHRONIC PYELONEPHRITIS* 

59000 CHR PYELONEPHRITIS NOS 

59001 CHR PYELONEPH W MED NECR 

5901 ACUTE PYELONEPHRITIS* 

59010 AC PYELONEPHRITIS NOS 

59011 AC PYELONEPHR W MED NECR 

5902 RENAL/PERIRENAL ABSCESS 

5903 PYELOURETERITIS CYSTICA 

5908 OTHER PYELONEPHRITIS* 

59080 PYELONEPHRITIS NOS 

59081 PYELONEPHRIT IN OTH DIS 

5909 INFECTION OF KIDNEY NOS 

591 HYDRONEPHROSIS 

592 RENAL/URETERAL CALCULUS* 

5920 CALCULUS OF KIDNEY 

5921 CALCULUS OF URETER 

5929 URINARY CALCULUS NOS 

593 OTH RENAL & URETERAL DIS* 

5930 NEPHROPTOSIS 

5931 HYPERTROPHY OF KIDNEY 

5932 CYST OF KIDNEY, ACQUIRED 

5933 STRICTURE OF URETER 

5934 URETERIC OBSTRUCTION NEC 

5935 HYDROURETER 

5936 POSTURAL PROTEINURIA 

5937 VESICOURETERAL REFLUX* 

59370 VESCOURETRL RFLUX UNSPCF 

59371 VSCURT RFLX NPHT UNILTRL 

59372 VSCOURTL RFLX NPHT BLTRL 

59373 VSCOURTL RFLX W NPHT NOS 

5938 OTH RENAL & URETERAL DIS* 

59381 RENAL VASCULAR DISORDER 

59382 URETERAL FISTULA 

59389 RENAL & URETERAL DIS NEC

5939 RENAL & URETERAL DIS NOS 

594 LOWER URIN TRACT CALCUL* 

5940 BLAD DIVERTICULUM CALCUL 

5941 BLADDER CALCULUS NEC 

5942 URETHRAL CALCULUS 

5948 LOWER URIN CALCUL NEC 

5949 LOWER URIN CALCUL NOS 

595 CYSTITIS* 

5950 ACUTE CYSTITIS 

5951 CHR INTERSTIT CYSTITIS 

5952 CHRONIC CYSTITIS NEC 

5953 TRIGONITIS 

5954 CYSTITIS IN OTH DIS 

5958 OTHER CYSTITIS* 

59581 CYSTITIS CYSTICA 

59582 IRRADIATION CYSTITIS 

59589 CYSTITIS NEC 

5959 CYSTITIS NOS 

596 OTHER BLADDER DISORDERS* 

5960 BLADDER NECK OBSTRUCTION 

5961 INTESTINOVESICAL FISTULA 

5962 VESICAL FISTULA NEC 

5963 DIVERTICULUM OF BLADDER 

5964 ATONY OF BLADDER 

5965 BLADDER DYSFUNCTION NEC* 

59651 HYPERTONICITY OF BLADDER 

59652 LOW BLADDER COMPLIANCE 

59653 PARALYSIS OF BLADDER 

59654 NEUROGENIC BLADDER NOS 

59655 DETRUSR SPHINC DYSSNRGIA 

59659 OTH FUNC DSDR BLADDER 

5966 BLADDER RUPT, NONTRAUM 

5967 BLADDER WALL HEMORRHAGE 

5968 BLADDER DISORDER NEC 

5969 BLADDER DISORDER NOS 

597 URETHRITIS/URETHRAL SYND* 

5970 URETHRAL ABSCESS 

5978 OTHER URETHRITIS* 

59780 URETHRITIS NOS 

59781 URETHRAL SYNDROME NOS 

59789 URETHRITIS NEC 

598 URETHRAL STRICTURE* 

5980 URETHRAL STRICT:INFECT* 

59800 URETHR STRICT:INFECT NOS 

59801 URETH STRICT:OTH INFECT 

5981 TRAUM URETHRAL STRICTURE 

5982 POSTOP URETHRAL STRICTUR 

5988 URETHRAL STRICTURE NEC 

5989 URETHRAL STRICTURE NOS 

599 OTH URINARY TRACT DISOR* 

5990 URIN TRACT INFECTION NOS 

5991 URETHRAL FISTULA 

5992 URETHRAL DIVERTICULUM 

5993 URETHRAL CARUNCLE 

5994 URETHRAL FALSE PASSAGE 

5995 PROLAPSE URETHRAL MUCOSA 

5996 URINARY OBSTRUCTION NOS

5997 HEMATURIA 

5998 URINARY TRACT DIS NEC* 

59981 URETHRAL HYPERMOBILITY 

59982 INTRINSC SPHNCTR DFICNCY 

59983 URETHRAL INSTABILITY 

59984 OTH SPCF DSDR URETHRA 

59989 OTH SPCF DSDR URNRY TRCT 

5999 URINARY TRACT DIS NOS 

600 HYPERPLASIA OF PROSTATE 

601 PROSTATIC INFLAMMATION* 

6010 ACUTE PROSTATITIS 

6011 CHRONIC PROSTATITIS 

6012 ABSCESS OF PROSTATE 

6013 PROSTATOCYSTITIS 

6014 PROSTATITIS IN OTH DIS 

6018 PROSTATIC INFLAM DIS NEC 

6019 PROSTATITIS NOS 

602 OTH PROSTATIC DISORDERS* 

6020 CALCULUS OF PROSTATE 

6021 PROSTATIC CONGEST/HEMORR 

6022 ATROPHY OF PROSTATE 

6028 PROSTATIC DISORDERS NEC 

6029 PROSTATIC DISORDER NOS 

603 HYDROCELE* 

6030 ENCYSTED HYDROCELE 

6031 INFECTED HYDROCELE 

6038 HYDROCELE NEC 

6039 HYDROCELE NOS 

604 ORCHITIS & EPIDIDYMITIS* 

6040 ORCHITIS WITH ABSCESS 

6049 ORCHITIS/EPIDIDYMIT NEC* 

60490 ORCHITIS/EPIDIDYMIT NOS 

60491 ORCHITIS IN OTH DISEASE 

60499 ORCHITIS/EPIDIDYMIT NEC 

605 REDUN PREPUCE & PHIMOSIS 

606 MALE INFERTILITY* 

6060 AZOOSPERMIA 

6061 OLIGOSPERMIA 

6068 MALE INFERTILITY NEC 

6069 MALE INFERTILITY NOS 

607 DISORDERS OF PENIS* 

6070 LEUKOPLAKIA OF PENIS 

6071 BALANOPOSTHITIS 

6072 INFLAM DIS, PENIS NEC 

6073 PRIAPISM 

6078 OTH DISORDERS OF PENIS* 

60781 BALANITIS XEROTICA OBLIT 

60782 VASCULAR DISORDER, PENIS 

60783 EDEMA OF PENIS 

60784 IMPOTENCE, ORGANIC ORIGN 

60789 DISORDER OF PENIS NEC 

6079 DISORDER OF PENIS NOS 

608 MALE GENITAL DIS NEC* 

6080 SEMINAL VESICULITIS 

6081 SPERMATOCELE 

6082 TORSION OF TESTIS 

6083 ATROPHY OF TESTIS

6084 MALE GEN INFLAM DIS NEC 

6088 MALE GENITAL DIS NEC* 

60881 MALE GEN DIS IN OTH DIS 

60883 MALE GEN VASCUL DIS NEC 

60884 CHYLOCELE, TUNIC VAGINAL 

60885 STRICTURE, MALE GEN ORGN 

60886 EDEMA, MALE GENITAL ORGN 

60889 MALE GENITAL DIS NEC 

6089 MALE GENITAL DIS NOS 

610 BENIGN MAMMARY DYSPLASIA* 

6100 SOLITARY CYST OF BREAST 

6101 DIFFUS CYSTIC MASTOPATHY 

6102 FIBROADENOSIS OF BREAST 

6103 FIBROSCLEROSIS OF BREAST 

6104 MAMMARY DUCT ECTASIA 

6108 BENIGN MAMM DYSPLAS NEC 

6109 BENIGN MAMM DYSPLAS NOS 

611 OTHER BREAST DISORDERS* 

6110 INFLAM DISEASE OF BREAST 

6111 HYPERTROPHY OF BREAST 

6112 FISSURE OF NIPPLE 

6113 FAT NECROSIS OF BREAST 

6114 ATROPHY OF BREAST 

6115 GALACTOCELE 

6116 GALACTORRHEA-NONOBSTET 

6117 SYMPTOMS IN BREAST* 

61171 MASTODYNIA 

61172 LUMP OR MASS IN BREAST 

61179 SYMPTOMS IN BREAST NEC 

6118 BREAST DISORDERS NEC 

6119 BREAST DISORDER NOS 

614 FEMALE PELVIC INFLAM DIS* 

6140 AC SALPINGO-OOPHORITIS 

6141 CHR SALPINGO-OOPHORITIS 

6142 SALPINGO-OOPHORITIS NOS 

6143 ACUTE PARAMETRITIS 

6144 CHRONIC PARAMETRITIS 

6145 AC PELV PERITONITIS-FEM 

6146 FEM PELVIC PERITON ADHES 

6147 CHR PELV PERITON NEC-FEM 

6148 FEM PELV INFLAM DIS NEC 

6149 FEM PELV INFLAM DIS NOS 

615 UTERINE INFLAMMATORY DIS* 

6150 AC UTERINE INFLAMMATION 

6151 CHR UTERINE INFLAMMATION 

6159 UTERINE INFLAM DIS NOS 

616 OTH FEMALE GEN INFLAM* 

6160 CERVICITIS 

6161 VAGINITIS* 

61610 VAGINITIS NOS 

61611 VAGINITIS IN OTH DISEASE 

6162 BARTHOLIN'S GLAND CYST 

6163 BARTHOLIN'S GLND ABSCESS 

6164 ABSCESS OF VULVA NEC 

6165 ULCERATION OF VULVA* 

61650 ULCERATION OF VULVA NOS 

61651 VULVAR ULCER IN OTH DIS

6168 FEMALE GEN INFLAM NEC 

6169 FEMALE GEN INFLAM NOS 

617 ENDOMETRIOSIS* 

6170 UTERINE ENDOMETRIOSIS 

6171 OVARIAN ENDOMETRIOSIS 

6172 TUBAL ENDOMETRIOSIS 

6173 PELV PERIT ENDOMETRIOSIS 

6174 VAGINAL ENDOMETRIOSIS 

6175 INTESTINAL ENDOMETRIOSIS 

6176 ENDOMETRIOSIS IN SCAR 

6178 ENDOMETRIOSIS NEC 

6179 ENDOMETRIOSIS NOS 

618 GENITAL PROLAPSE* 

6180 PROLAPSE OF VAGINAL WALL 

6181 UTERINE PROLAPSE 

6182 UTEROVAG PROLAPS-INCOMPL 

6183 UTEROVAG PROLAPS-COMPLET 

6184 UTERVAGINAL PROLAPSE NOS 

6185 POSTOP VAGINAL PROLAPSE 

6186 VAGINAL ENTEROCELE 

6187 OLD LACER PELVIC MUSCLE 

6188 GENITAL PROLAPSE NEC 

6189 GENITAL PROLAPSE NOS 

619 FEMALE GENITAL FISTULA* 

6190 URIN-GENITAL FISTUL, FEM 

6191 DIGEST-GENIT FISTUL, FEM 

6192 GENITAL-SKIN FISTUL, FEM 

6198 FEM GENITAL FISTULA NEC 

6199 FEM GENITAL FISTULA NOS 

620 NONINFLAM DIS OVAR/ADNEX* 

6200 FOLLICULAR CYST OF OVARY 

6201 CORPUS LUTEUM CYST 

6202 OVARIAN CYST NEC/NOS 

6203 ACQ ATROPHY OVARY & TUBE 

6204 PROLAPSE OF OVARY & TUBE 

6205 TORSION OF OVARY OR TUBE 

6206 BROAD LIGAMENT LACER SYN 

6207 BROAD LIGAMENT HEMATOMA 

6208 NONINFL DIS OVA/ADNX NEC 

6209 NONINFL DIS OVA/ADNX NOS 

621 DISORDERS OF UTERUS NEC* 

6210 POLYP OF CORPUS UTERI 

6211 CHR UTERINE SUBINVOLUTN 

6212 HYPERTROPHY OF UTERUS 

6213 ENDOMETRIAL HYPERPLASIA 

6214 HEMATOMETRA 

6215 INTRAUTERINE SYNECHIAE 

6216 MALPOSITION OF UTERUS 

6217 CHR INVERSION OF UTERUS 

6218 DISORDERS OF UTERUS NEC 

6219 DISORDER OF UTERUS NOS 

622 NONINFLAMM DIS CERVIX* 

6220 EROSION/ECTROPION CERVIX 

6221 DYSPLASIA OF CERVIX 

6222 LEUKOPLAKIA OF CERVIX 

6223 OLD LACERATION OF CERVIX 

6224 STRICTURE OF CERVIX

6225 INCOMPETENCE OF CERVIX 

6226 HYPERTROPHIC ELONG CERVX 

6227 MUCOUS POLYP OF CERVIX 

6228 NONINFLAM DIS CERVIX NEC 

6229 NONINFLAM DIS CERVIX NOS 

623 NONINFLAMM DIS VAGINA* 

6230 DYSPLASIA OF VAGINA 

6231 LEUKOPLAKIA OF VAGINA 

6232 STRICTURE OF VAGINA 

6233 TIGHT HYMENAL RING 

6234 OLD VAGINAL LACERATION 

6235 NONINFECT VAG LEUKORRHEA 

6236 VAGINAL HEMATOMA 

6237 POLYP OF VAGINA 

6238 NONINFLAM DIS VAGINA NEC 

6239 NONINFLAM DIS VAGINA NOS 

624 NONINFLAMM DIS VULVA* 

6240 DYSTROPHY OF VULVA 

6241 ATROPHY OF VULVA 

6242 HYPERTROPHY OF CLITORIS 

6243 HYPERTROPHY OF LABIA 

6244 OLD LACERATION OF VULVA 

6245 HEMATOMA OF VULVA 

6246 POLYP OF LABIA AND VULVA 

6248 NONINFLAM DIS VULVA NEC 

6249 NONINFLAM DIS VULVA NOS 

625 FEMALE GENITAL SYMPTOMS* 

6250 DYSPAREUNIA 

6251 VAGINISMUS 

6252 MITTELSCHMERZ 

6253 DYSMENORRHEA 

6254 PREMENSTRUAL TENSION 

6255 PELVIC CONGESTION SYND 

6256 FEM STRESS INCONTINENCE 

6258 FEM GENITAL SYMPTOMS NEC 

6259 FEM GENITAL SYMPTOMS NOS 

626 DISORDER OF MENSTRUATION* 

6260 ABSENCE OF MENSTRUATION 

6261 SCANTY MENSTRUATION 

6262 EXCESSIVE MENSTRUATION 

6263 PUBERTAL MENORRHAGIA 

6264 IRREGULAR MENSTRUATION 

6265 OVULATION BLEEDING 

6266 METRORRHAGIA 

6267 POSTCOITAL BLEEDING 

6268 MENSTRUAL DISORDER NEC 

6269 MENSTRUAL DISORDER NOS 

627 MENOPAUSAL DISORDERS* 

6270 PREMENOPAUSE MENORRHAGIA 

6271 POSTMENOPAUSAL BLEEDING 

6272 FEMALE CLIMACTERIC STATE 

6273 ATROPHIC VAGINITIS 

6274 ARTIFIC MENOPAUSE STATES 

6278 MENOPAUSAL DISORDER NEC 

6279 MENOPAUSAL DISORDER NOS 

628 FEMALE INFERTILITY* 

6280 INFERTILITY-ANOVULATION

6281 INFERTIL-PITUITARY ORIG 

6282 INFERTILITY-TUBAL ORIGIN 

6283 INFERTILITY-UTERINE ORIG 

6284 INFERTIL-CERVICAL ORIG 

6288 FEMALE INFERTILITY NEC 

6289 FEMALE INFERTILITY NOS 

629 OTH FEMALE GENITAL DIS* 

6290 HEMATOCELE, FEMALE NEC 

6291 HYDROCELE CANAL NUCK-FEM 

6298 FEMALE GENITAL DIS NEC 

6299 FEMALE GENITAL DIS NOS 

630 HYDATIDIFORM MOLE 

631 OTH ABN PROD CONCEPTION 

632 MISSED ABORTION 

633 ECTOPIC PREGNANCY* 

6330 ABDOMINAL PREGNANCY 

6331 TUBAL PREGNANCY 

6332 OVARIAN PREGNANCY 

6338 ECTOPIC PREGNANCY NEC 

6339 ECTOPIC PREGNANCY NOS 

634 SPONTANEOUS ABORTION* 

6340 SPON ABORT W PELVIC INF* 

63400 SPON ABOR W PEL INF-UNSP 

63401 SPON ABOR W PELV INF-INC 

63402 SPON ABOR W PEL INF-COMP 

6341 SPON ABORT W HEMORRHAGE* 

63410 SPON ABORT W HEMORR-UNSP 

63411 SPON ABORT W HEMORR-INC 

63412 SPON ABORT W HEMORR-COMP 

6342 SPON ABOR W PELVIC DAMAG* 

63420 SPON AB W PEL DAMAG-UNSP 

63421 SPON AB W PELV DAMAG-INC 

63422 SPON AB W PEL DAMAG-COMP 

6343 SPON ABORT W RENAL FAIL* 

63430 SPON AB W REN FAIL-UNSP 

63431 SPON AB W REN FAIL-INC 

63432 SPON AB W REN FAIL-COMP 

6344 SPON ABORT W METABOL DIS* 

63440 SPON AB W METAB DIS-UNSP 

63441 SPON AB W METAB DIS-INC 

63442 SPON AB W METAB DIS-COMP 

6345 SPON ABORTION W SHOCK* 

63450 SPON ABORT W SHOCK-UNSP 

63451 SPON ABORT W SHOCK-INC 

63452 SPON ABORT W SHOCK-COMP 

6346 SPON ABORTION W EMBOLISM* 

63460 SPON ABORT W EMBOL-UNSP 

63461 SPON ABORT W EMBOL-INC 

63462 SPON ABORT W EMBOL-COMP 

6347 SPON ABORT W COMPL NEC* 

63470 SPON AB W COMPL NEC-UNSP 

63471 SPON AB W COMPL NEC-INC 

63472 SPON AB W COMPL NEC-COMP 

6348 SPON ABORT W COMPL NOS* 

63480 SPON AB W COMPL NOS-UNSP 

63481 SPON AB W COMPL NOS-INC 

63482 SPON AB W COMPL NOS-COMP

6349 SPON ABORTION UNCOMPLIC* 

63490 SPON ABORT UNCOMPL-UNSP 

63491 SPON ABORT UNCOMPL-INC 

63492 SPON ABORT UNCOMPL-COMP 

635 LEGALLY INDUCED ABORTION* 

6350 LEGAL ABORT W PELVIC INF* 

63500 LEG ABOR W PELV INF-UNSP 

63501 LEG ABOR W PELV INF-INC 

63502 LEG ABOR W PELV INF-COMP 

6351 LEGAL ABORT W HEMORRHAGE* 

63510 LEGAL ABOR W HEMORR-UNSP 

63511 LEGAL ABORT W HEMORR-INC 

63512 LEGAL ABOR W HEMORR-COMP 

6352 LEGAL ABORT W PELV DAMAG* 

63520 LEG AB W PELV DAMAG-UNSP 

63521 LEG AB W PELV DAMAG-INC 

63522 LEG AB W PELV DAMAG-COMP 

6353 LEGAL ABORT W RENAL FAIL* 

63530 LEG ABOR W REN FAIL-UNSP 

63531 LEG ABOR W REN FAIL-INC 

63532 LEG ABOR W REN FAIL-COMP 

6354 LEGAL ABOR W METABOL DIS* 

63540 LEG AB W METAB DIS-UNSP 

63541 LEG AB W METAB DIS-INC 

63542 LEG AB W METAB DIS-COMP 

6355 LEGAL ABORTION W SHOCK* 

63550 LEGAL ABORT W SHOCK-UNSP 

63551 LEGAL ABORT W SHOCK-INC 

63552 LEGAL ABORT W SHOCK-COMP 

6356 LEGAL ABORT W EMBOLISM* 

63560 LEGAL ABORT W EMBOL-UNSP 

63561 LEGAL ABORT W EMBOL-INC 

63562 LEGAL ABORT W EMBOL-COMP 

6357 LEGAL ABORT W COMPL NEC* 

63570 LEG AB W COMPL NEC-UNSP 

63571 LEG AB W COMPL NEC-INC 

63572 LEG AB W COMPL NEC-COMP 

6358 LEGAL ABORT W COMPL NOS* 

63580 LEG AB W COMPL NOS-UNSP 

63581 LEG AB W COMPL NOS-INC 

63582 LEG AB W COMPL NOS-COMP 

6359 LEGAL ABORT UNCOMPLICAT* 

63590 LEGAL ABORT UNCOMPL-UNSP 

63591 LEGAL ABORT UNCOMPL-INC 

63592 LEGAL ABORT UNCOMPL-COMP 

636 ILLEGAL INDUCED ABORTION* 

6360 ILLEG ABORT W PELVIC INF* 

63600 ILLEG AB W PELV INF-UNSP 

63601 ILLEG AB W PELV INF-INC 

63602 ILLEG AB W PELV INF-COMP 

6361 ILLEG ABORT W HEMORRHAGE* 

63610 ILLEG AB W HEMORR-UNSPEC 

63611 ILLEG AB W HEMORR-INC 

63612 ILLEG AB W HEMORR-COMP 

6362 ILLEG ABORT W PELV DAMAG* 

63620 ILLEG AB W PEL DAMG-UNSP 

63621 ILLEG AB W PEL DAMAG-INC

63622 ILLEG AB W PEL DAMG-COMP 

6363 ILLEG ABORT W RENAL FAIL* 

63630 ILLEG AB W REN FAIL-UNSP 

63631 ILLEG AB W REN FAIL-INC 

63632 ILLEG AB W REN FAIL-COMP 

6364 ILLEG ABOR W METABOL DIS* 

63640 ILLEG AB W MET DIS-UNSP 

63641 ILLEG AB W METAB DIS-INC 

63642 ILLEG AB W MET DIS-COMP 

6365 ILLEGAL ABORTION W SHOCK* 

63650 ILLEG ABORT W SHOCK-UNSP 

63651 ILLEG ABORT W SHOCK-INC 

63652 ILLEG ABORT W SHOCK-COMP 

6366 ILLEGAL ABORT W EMBOLISM* 

63660 ILLEG AB W EMBOLISM-UNSP 

63661 ILLEG AB W EMBOLISM-INC 

63662 ILLEG AB W EMBOLISM-COMP 

6367 ILLEG ABORT W COMPL NEC* 

63670 ILLG AB W COMPL NEC-UNSP 

63671 ILLEG AB W COMPL NEC-INC 

63672 ILLG AB W COMPL NEC-COMP 

6368 ILLEG ABORT W COMPL NOS* 

63680 ILLG AB W COMPL NOS-UNSP 

63681 ILLEG AB W COMPL NOS-INC 

63682 ILLG AB W COMPL NOS-COMP 

6369 ILLEGAL ABORT UNCOMPLIC* 

63690 ILLEG ABORT UNCOMPL-UNSP 

63691 ILLEG ABORT UNCOMPL-INC 

63692 ILLEG ABORT UNCOMPL-COMP 

637 UNSPECIFIED ABORTION* 

6370 ABORT NOS W PELVIC INF* 

63700 ABORT NOS W PEL INF-UNSP 

63701 ABORT NOS W PEL INF-INC 

63702 ABORT NOS W PEL INF-COMP 

6371 ABORT NOS W HEMORRHAGE* 

63710 ABORT NOS W HEMORR-UNSP 

63711 ABORT NOS W HEMORR-INC 

63712 ABORT NOS W HEMORR-COMP 

6372 ABORT NOS W PELVIC DAMAG* 

63720 AB NOS W PELV DAMAG-UNSP 

63721 AB NOS W PELV DAMAG-INC 

63722 AB NOS W PELV DAMAG-COMP 

6373 ABORT NOS W RENAL FAIL* 

63730 AB NOS W RENAL FAIL-UNSP 

63731 AB NOS W RENAL FAIL-INC 

63732 AB NOS W RENAL FAIL-COMP 

6374 ABORT NOS W METABOL DIS* 

63740 AB NOS W METAB DIS-UNSP 

63741 AB NOS W METAB DIS-INC 

63742 AB NOS W METAB DIS-COMP 

6375 ABORTION NOS W SHOCK* 

63750 ABORT NOS W SHOCK-UNSP 

63751 ABORT NOS W SHOCK-INC 

63752 ABORT NOS W SHOCK-COMP 

6376 ABORTION NOS W EMBOLISM* 

63760 AB NOS W EMBOLISM-UNSP 

63761 AB NOS W EMBOLISM-INC

63762 AB NOS W EMBOLISM-COMP 

6377 ABORTION NOS W COMPL NEC* 

63770 AB NOS W COMPL NEC-UNSP 

63771 AB NOS W COMPL NEC-INC 

63772 AB NOS W COMPL NEC-COMP 

6378 ABORTION NOS W COMPL NOS* 

63780 AB NOS W COMPL NOS-UNSP 

63781 AB NOS W COMPL NOS-INC 

63782 AB NOS W COMPL NOS-COMP 

6379 ABORTION NOS UNCOMPLICAT* 

63790 AB NOS UNCOMPLICAT-UNSP 

63791 AB NOS UNCOMPLICAT-INC 

63792 AB NOS UNCOMPLICAT-COMP 

638 FAILED ATTEMPTED ABORT* 

6380 ATTEM ABORT W PELVIC INF 

6381 ATTEM ABORT W HEMORRHAGE 

6382 ATTEM ABORT W PELV DAMAG 

6383 ATTEM ABORT W RENAL FAIL 

6384 ATTEM ABOR W METABOL DIS 

6385 ATTEM ABORTION W SHOCK 

6386 ATTEMP ABORT W EMBOLISM 

6387 ATTEMP ABORT W COMPL NEC 

6388 ATTEMP ABORT W COMPL NOS 

6389 ATTEMPTED ABORT UNCOMPL 

639 COMPL FOLLOWING ABORTION* 

6390 POSTABORTION GU INFECT 

6391 POSTABORTION HEMORRHAGE 

6392 POSTABORT PELVIC DAMAGE 

6393 POSTABORT RENAL FAILURE 

6394 POSTABORT METABOLIC DIS 

6395 POSTABORTION SHOCK 

6396 POSTABORTION EMBOLISM 

6398 POSTABORTION COMPL NEC 

6399 POSTABORTION COMPL NOS 

640 HEMORRHAGE IN EARLY PREG* 

6400 THREATENED ABORTION* 

64000 THREATENED ABORT-UNSPEC 

64001 THREATENED ABORT-DELIVER 

64003 THREATEN ABORT-ANTEPART 

6408 HEMORR IN EARLY PREG NEC* 

64080 HEM EARLY PREG NEC-UNSP 

64081 HEM EARLY PREG NEC-DELIV 

64083 HEM EARLY PG NEC-ANTEPAR 

6409 HEMORR IN EARLY PREG NOS* 

64090 HEMORR EARLY PREG-UNSPEC 

64091 HEM EARLY PREG-DELIVERED 

64093 HEM EARLY PREG-ANTEPART 

641 ANTEPART HEM & PLAC PREV* 

6410 PLACENTA PREVIA W/O HEM* 

64100 PLACENTA PREVIA-UNSPEC 

64101 PLACENTA PREVIA-DELIVER 

64103 PLACENTA PREVIA-ANTEPART 

6411 HEMORR FROM PLACENT PREV* 

64110 PLACENTA PREV HEM-UNSPEC 

64111 PLACENTA PREV HEM-DELIV 

64113 PLACEN PREV HEM-ANTEPART 

6412 PREM SEPARATION PLACENTA*

64120 PREM SEPAR PLACEN-UNSPEC 

64121 PREM SEPAR PLACEN-DELIV 

64123 PREM SEPAR PLAC-ANTEPART 

6413 COAG DEF ANTEPART HEMORR* 

64130 COAG DEF HEMORR-UNSPEC 

64131 COAG DEF HEMORR-DELIVER 

64133 COAG DEF HEMORR-ANTEPART 

6418 ANTEPARTUM HEMORR NEC* 

64180 ANTEPART HEM NEC-UNSPEC 

64181 ANTEPARTUM HEM NEC-DELIV 

64183 ANTEPART HEM NEC-ANTEPAR 

6419 ANTEPARTUM HEMORR NOS* 

64190 ANTEPART HEM NOS-UNSPEC 

64191 ANTEPARTUM HEM NOS-DELIV 

64193 ANTEPART HEM NOS-ANTEPAR 

642 HYPERTENSION COMPL PREG* 

6420 ESSEN HYPERTEN COMP PREG* 

64200 ESSEN HYPERTEN PREG-UNSP 

64201 ESSEN HYPERTEN-DELIVERED 

64202 ESSEN HYPERTEN-DEL W P/P 

64203 ESSEN HYPERTEN-ANTEPART 

64204 ESSEN HYPERTEN-POSTPART 

6421 RENAL HYPERTEN OF PREG* 

64210 RENAL HYPERTEN PREG-UNSP 

64211 RENAL HYPERTEN PG-DELIV 

64212 RENAL HYPERTEN-DEL P/P 

64213 RENAL HYPERTEN-ANTEPART 

64214 RENAL HYPERTEN-POSTPART 

6422 OLD HYPERTEN PREG NEC* 

64220 OLD HYPERTEN PREG-UNSPEC 

64221 OLD HYPERTEN NEC-DELIVER 

64222 OLD HYPERTEN-DELIV W P/P 

64223 OLD HYPERTEN NEC-ANTEPAR 

64224 OLD HYPERTEN NEC-POSTPAR 

6423 TRANS HYPERTENSION PREG* 

64230 TRANS HYPERTEN PREG-UNSP 

64231 TRANS HYPERTEN-DELIVERED 

64232 TRANS HYPERTEN-DEL W P/P 

64233 TRANS HYPERTEN-ANTEPART 

64234 TRANS HYPERTEN-POSTPART 

6424 MILD/NOS PRE-ECLAMPSIA* 

64240 MILD/NOS PREECLAMP-UNSP 

64241 MILD/NOS PREECLAMP-DELIV 

64242 MILD PREECLAMP-DEL W P/P 

64243 MILD/NOS PREECLAMP-ANTEP 

64244 MILD/NOS PREECLAMP-P/P 

6425 SEVERE PRE-ECLAMPSIA* 

64250 SEVERE PREECLAMP-UNSPEC 

64251 SEVERE PREECLAMP-DELIVER 

64252 SEV PREECLAMP-DEL W P/P 

64253 SEV PREECLAMP-ANTEPARTUM 

64254 SEV PREECLAMP-POSTPARTUM 

6426 ECLAMPSIA* 

64260 ECLAMPSIA-UNSPECIFIED 

64261 ECLAMPSIA-DELIVERED 

64262 ECLAMPSIA-DELIV W P/P 

64263 ECLAMPSIA-ANTEPARTUM

64264 ECLAMPSIA-POSTPARTUM 

6427 TOXEMIA W OLD HYPERTEN* 

64270 TOX W OLD HYPERTEN-UNSP 

64271 TOX W OLD HYPERTEN-DELIV 

64272 TOX W OLD HYP-DEL W P/P 

64273 TOX W OLD HYPER-ANTEPART 

64274 TOX W OLD HYPER-POSTPART 

6429 HYPERTENS COMPL PREG NOS* 

64290 HYPERTEN PREG NOS-UNSPEC 

64291 HYPERTENS NOS-DELIVERED 

64292 HYPERTENS NOS-DEL W P/P 

64293 HYPERTENS NOS-ANTEPARTUM 

64294 HYPERTENS NOS-POSTPARTUM 

643 EXCESS VOMITING IN PREG* 

6430 MILD HYPEREMESIS GRAVID* 

64300 MILD HYPEREM GRAV-UNSPEC 

64301 MILD HYPEREM GRAV-DELIV 

64303 MILD HYPEREMESIS-ANTEPAR 

6431 HYPEREM GRAV W METAB DIS* 

64310 HYPEREM W METAB DIS-UNSP 

64311 HYPEREM W METAB DIS-DEL 

64313 HYPEREM W METAB-ANTEPART 

6432 LATE VOMITING PREGNANCY* 

64320 LATE VOMIT OF PREG-UNSP 

64321 LATE VOMIT OF PREG-DELIV 

64323 LATE VOMIT PREG-ANTEPART 

6438 VOMITING COMPL PREG NEC* 

64380 VOMIT COMPL PREG-UNSPEC 

64381 VOMIT COMPL PREG-DELIVER 

64383 VOMIT COMPL PREG-ANTEPAR 

6439 VOMITING PREGNANCY NOS* 

64390 VOMIT OF PREG NOS-UNSPEC 

64391 VOMIT OF PREG NOS-DELIV 

64393 VOMIT OF PG NOS-ANTEPART 

644 EARLY/THREATENED LABOR* 

6440 THREATEN PREMATURE LABOR* 

64400 THREAT PREM LABOR-UNSPEC 

64403 THRT PREM LABOR-ANTEPART 

6441 THREATENED LABOR NEC* 

64410 THREAT LABOR NEC-UNSPEC 

64413 THREAT LABOR NEC-ANTEPAR 

6442 EARLY ONSET OF DELIVERY* 

64420 EARLY ONSET DELIV-UNSPEC 

64421 EARLY ONSET DELIVERY-DEL 

645 PROLONGED PREGNANCY* 

64500 PROLONGED PREG-UNSPEC 

64501 PROLONGED PREG-DELIVERED 

64503 PROLONGED PREG-ANTEPART 

646 OTHER COMPL OF PREGNANCY* 

6460 PAPYRACEOUS FETUS* 

64600 PAPYRACEOUS FETUS-UNSPEC 

64601 PAPYRACEOUS FETUS-DELIV 

64603 PAPYRACEOUS FET-ANTEPAR 

6461 EDEMA IN PREGNANCY* 

64610 EDEMA IN PREG-UNSPEC 

64611 EDEMA IN PREG-DELIVERED 

64612 EDEMA IN PREG-DEL W P/P

64613 EDEMA IN PREG-ANTEPARTUM 

64614 EDEMA IN PREG-POSTPARTUM 

6462 RENAL DIS IN PREG NOS* 

64620 RENAL DIS PREG NOS-UNSP 

64621 RENAL DIS NOS-DELIVERED 

64622 RENAL DIS NOS-DEL W P/P 

64623 RENAL DIS NOS-ANTEPARTUM 

64624 RENAL DIS NOS-POSTPARTUM 

6463 HABITUAL ABORTER* 

64630 HABITUAL ABORTER-UNSPEC 

64631 HABITUAL ABORTER-DELIVER 

64633 HABITUAL ABORT-ANTEPART 

6464 PERIPHERAL NEURITIS PREG* 

64640 NEURITIS OF PREG-UNSPEC 

64641 NEURITIS-DELIVERED 

64642 NEURITIS-DELIVERED W P/P 

64643 NEURITIS OF PREG-ANTEPAR 

64644 NEURITIS OF PREG-POSTPAR 

6465 ASYMPT BACTERIURIA PREG* 

64650 BACTERIURIA PREG-UNSPEC 

64651 ASYM BACTERIURIA-DELIVER 

64652 ASY BACTERURIA-DEL W P/P 

64653 ASY BACTERIURIA-ANTEPART 

64654 ASY BACTERIURIA-POSTPART 

6466 GU TRACT INFECT IN PREG* 

64660 GU INFECT IN PREG-UNSPEC 

64661 GU INFECTION-DELIVERED 

64662 GU INFECTION-DELIV W P/P 

64663 GU INFECTION-ANTEPARTUM 

64664 GU INFECTION-POSTPARTUM 

6467 LIVER DISORDER IN PREG* 

64670 LIVER DIS IN PREG-UNSPEC 

64671 LIVER DISORDER-DELIVERED 

64673 LIVER DISORDER-ANTEPART 

6468 PREGNANCY COMPL NEC* 

64680 PREG COMPL NEC-UNSPEC 

64681 PREG COMPL NEC-DELIVERED 

64682 PREG COMPL NEC-DEL W P/P 

64683 PREG COMPL NEC-ANTEPART 

64684 PREG COMPL NEC-POSTPART 

6469 PREGNANCY COMPL NOS* 

64690 PREG COMPL NOS-UNSPEC 

64691 PREG COMPL NOS-DELIVERED 

64693 PREG COMPL NOS-ANTEPART 

647 INFECTIVE DIS IN PREG* 

6470 SYPHILIS IN PREGNANCY* 

64700 SYPHILIS IN PREG-UNSPEC 

64701 SYPHILIS-DELIVERED 

64702 SYPHILIS-DELIVERED W P/P 

64703 SYPHILIS-ANTEPARTUM 

64704 SYPHILIS-POSTPARTUM 

6471 GONORRHEA IN PREGNANCY* 

64710 GONORRHEA IN PREG-UNSPEC 

64711 GONORRHEA-DELIVERED 

64712 GONORRHEA-DELIVER W P/P 

64713 GONORRHEA-ANTEPARTUM 

64714 GONORRHEA-POSTPARTUM

6472 OTH VENEREAL DIS IN PREG* 

64720 OTHER VD IN PREG-UNSPEC 

64721 OTHER VD-DELIVERED 

64722 OTHER VD-DELIVERED W P/P 

64723 OTHER VD-ANTEPARTUM 

64724 OTHER VD-POSTPARTUM 

6473 TUBERCULOSIS IN PREG* 

64730 TB IN PREG-UNSPECIFIED 

64731 TUBERCULOSIS-DELIVERED 

64732 TUBERCULOSIS-DELIV W P/P 

64733 TUBERCULOSIS-ANTEPARTUM 

64734 TUBERCULOSIS-POSTPARTUM 

6474 MALARIA IN PREGNANCY* 

64740 MALARIA IN PREG-UNSPEC 

64741 MALARIA-DELIVERED 

64742 MALARIA-DELIVERED W P/P 

64743 MALARIA-ANTEPARTUM 

64744 MALARIA-POSTPARTUM 

6475 RUBELLA IN PREGNANCY* 

64750 RUBELLA IN PREG-UNSPEC 

64751 RUBELLA-DELIVERED 

64752 RUBELLA-DELIVERED W P/P 

64753 RUBELLA-ANTEPARTUM 

64754 RUBELLA-POSTPARTUM 

6476 OTHER VIRAL DIS IN PREG* 

64760 OTH VIRUS IN PREG-UNSPEC 

64761 OTH VIRAL DIS-DELIVERED 

64762 OTH VIRAL DIS-DEL W P/P 

64763 OTH VIRAL DIS-ANTEPARTUM 

64764 OTH VIRAL DIS-POSTPARTUM 

6478 INFECTIV DIS IN PREG NEC* 

64780 INF DIS IN PREG NEC-UNSP 

64781 INFECT DIS NEC-DELIVERED 

64782 INFECT DIS NEC-DEL W P/P 

64783 INFECT DIS NEC-ANTEPART 

64784 INFECT DIS NEC-POSTPART 

6479 INFECTION IN PREG NOS* 

64790 INFECT IN PREG NOS-UNSP 

64791 INFECT NOS-DELIVERED 

64792 INFECT NOS-DELIVER W P/P 

64793 INFECT NOS-ANTEPARTUM 

64794 INFECT NOS-POSTPARTUM 

648 OTH CURRENT COND IN PREG* 

6480 DIABETES MELLIT IN PREG* 

64800 DIABETES IN PREG-UNSPEC 

64801 DIABETES-DELIVERED 

64802 DIABETES-DELIVERED W P/P 

64803 DIABETES-ANTEPARTUM 

64804 DIABETES-POSTPARTUM 

6481 THYROID DYSFUNC IN PREG* 

64810 THYROID DYSFUN PREG-UNSP 

64811 THYROID DYSFUNC-DELIVER 

64812 THYROID DYSFUN-DEL W P/P 

64813 THYROID DYSFUNC-ANTEPART 

64814 THYROID DYSFUNC-POSTPART 

6482 ANEMIA IN PREGNANCY* 

64820 ANEMIA IN PREG-UNSPEC

64821 ANEMIA-DELIVERED 

64822 ANEMIA-DELIVERED W P/P 

64823 ANEMIA-ANTEPARTUM 

64824 ANEMIA-POSTPARTUM 

6483 DRUG DEPENDENCE IN PREG* 

64830 DRUG DEPEND PREG-UNSPEC 

64831 DRUG DEPENDENCE-DELIVER 

64832 DRUG DEPENDEN-DEL W P/P 

64833 DRUG DEPENDENCE-ANTEPART 

64834 DRUG DEPENDENCE-POSTPART 

6484 MENTAL DISORDERS IN PREG* 

64840 MENTAL DIS PREG-UNSPEC 

64841 MENTAL DISORDER-DELIVER 

64842 MENTAL DIS-DELIV W P/P 

64843 MENTAL DISORDER-ANTEPART 

64844 MENTAL DISORDER-POSTPART 

6485 CONG CARDIOVAS DIS IN PG* 

64850 CONGEN CV DIS PREG-UNSP 

64851 CONGEN CV DIS-DELIVERED 

64852 CONGEN CV DIS-DEL W P/P 

64853 CONGEN CV DIS-ANTEPARTUM 

64854 CONGEN CV DIS-POSTPARTUM 

6486 CARDIOVAS DIS NEC IN PG* 

64860 CV DIS NEC PREG-UNSPEC 

64861 CV DIS NEC PREG-DELIVER 

64862 CV DIS NEC-DELIVER W P/P 

64863 CV DIS NEC-ANTEPARTUM 

64864 CV DIS NEC-POSTPARTUM 

6487 BONE DISORDER IN PREG* 

64870 BONE DISORD IN PREG-UNSP 

64871 BONE DISORDER-DELIVERED 

64872 BONE DISORDER-DEL W P/P 

64873 BONE DISORDER-ANTEPARTUM 

64874 BONE DISORDER-POSTPARTUM 

6488 ABN GLUC TOLERAN IN PREG* 

64880 ABN GLUCOSE IN PREG-UNSP 

64881 ABN GLUCOSE TOLER-DELIV 

64882 ABN GLUCOSE-DELIV W P/P 

64883 ABN GLUCOSE-ANTEPARTUM 

64884 ABN GLUCOSE-POSTPARTUM 

6489 OTH CURRENT COND OF PREG* 

64890 OTH CURR COND PREG-UNSP 

64891 OTH CURR COND-DELIVERED 

64892 OTH CURR COND-DEL W P/P 

64893 OTH CURR COND-ANTEPARTUM 

64894 OTH CURR COND-POSTPARTUM 

650 NORMAL DELIVERY 

651 MULTIPLE GESTATION* 

6510 TWIN PREGNANCY* 

65100 TWIN PREGNANCY-UNSPEC 

65101 TWIN PREGNANCY-DELIVERED 

65103 TWIN PREGNANCY-ANTEPART 

6511 TRIPLET PREGNANCY* 

65110 TRIPLET PREGNANCY-UNSPEC 

65111 TRIPLET PREGNANCY-DELIV 

65113 TRIPLET PREG-ANTEPARTUM 

6512 QUADRUPLET PREGNANCY*

65120 QUADRUPLET PREG-UNSPEC 

65121 QUADRUPLET PREG-DELIVER 

65123 QUADRUPLET PREG-ANTEPART 

6513 TWINS W FETAL LOSS* 

65130 TWINS W FETAL LOSS-UNSP 

65131 TWINS W FETAL LOSS-DEL 

65133 TWINS W FETAL LOSS-ANTE 

6514 TRIPLETS W FETAL LOSS* 

65140 TRIPLETS W FET LOSS-UNSP 

65141 TRIPLETS W FET LOSS-DEL 

65143 TRIPLETS W FET LOSS-ANTE 

6515 QUADS W FETAL LOSS* 

65150 QUADS W FETAL LOSS-UNSP 

65151 QUADS W FETAL LOSS-DEL 

65153 QUADS W FETAL LOSS-ANTE 

6516 MULT GES W FETAL LOSS* 

65160 MULT GES W FET LOSS-UNSP 

65161 MULT GES W FET LOSS-DEL 

65163 MULT GES W FET LOSS-ANTE 

6518 MULTIPLE GESTATION NEC* 

65180 MULTI GESTAT NEC-UNSPEC 

65181 MULTI GESTAT NEC-DELIVER 

65183 MULTI GEST NEC-ANTEPART 

6519 MULTIPLE GESTATION NOS* 

65190 MULTI GESTAT NOS-UNSPEC 

65191 MULT GESTATION NOS-DELIV 

65193 MULTI GEST NOS-ANTEPART 

652 MALPOSITION OF FETUS* 

6520 UNSTABLE LIE* 

65200 UNSTABLE LIE-UNSPECIFIED 

65201 UNSTABLE LIE-DELIVERED 

65203 UNSTABLE LIE-ANTEPARTUM 

6521 CEPHALIC VERSION NOS* 

65210 CEPHALIC VERS NOS-UNSPEC 

65211 CEPHALIC VERS NOS-DELIV 

65213 CEPHAL VERS NOS-ANTEPART 

6522 BREECH PRESENTATION* 

65220 BREECH PRESENTAT-UNSPEC 

65221 BREECH PRESENTAT-DELIVER 

65223 BREECH PRESENT-ANTEPART 

6523 TRANSVERSE/OBLIQUE LIE* 

65230 TRANSV/OBLIQ LIE-UNSPEC 

65231 TRANSVER/OBLIQ LIE-DELIV 

65233 TRANSV/OBLIQ LIE-ANTEPAR 

6524 FACE OR BROW PRESENTAT* 

65240 FACE/BROW PRESENT-UNSPEC 

65241 FACE/BROW PRESENT-DELIV 

65243 FACE/BROW PRES-ANTEPART 

6525 HIGH HEAD AT TERM* 

65250 HIGH HEAD AT TERM-UNSPEC 

65251 HIGH HEAD AT TERM-DELIV 

65253 HIGH HEAD TERM-ANTEPART 

6526 MULT GEST W MALPRESENTAT* 

65260 MULT GEST MALPRESEN-UNSP 

65261 MULT GEST MALPRES-DELIV 

65263 MULT GES MALPRES-ANTEPAR 

6527 PROLAPSED ARM*

65270 PROLAPSED ARM-UNSPEC 

65271 PROLAPSED ARM-DELIVERED 

65273 PROLAPSED ARM-ANTEPART 

6528 MALPOSITION NEC* 

65280 MALPOSITION NEC-UNSPEC 

65281 MALPOSITION NEC-DELIVER 

65283 MALPOSITION NEC-ANTEPART 

6529 MALPOSITION NOS* 

65290 MALPOSITION NOS-UNSPEC 

65291 MALPOSITION NOS-DELIVER 

65293 MALPOSITION NOS-ANTEPART 

653 DISPROPORTION* 

6530 PELVIC DEFORMITY NOS* 

65300 PELVIC DEFORM NOS-UNSPEC 

65301 PELVIC DEFORM NOS-DELIV 

65303 PELV DEFORM NOS-ANTEPART 

6531 CONTRACTED PELVIS NOS* 

65310 CONTRACT PELV NOS-UNSPEC 

65311 CONTRACT PELV NOS-DELIV 

65313 CONTRAC PELV NOS-ANTEPAR 

6532 INLET CONTRACTION PELVIS* 

65320 INLET CONTRACTION-UNSPEC 

65321 INLET CONTRACTION-DELIV 

65323 INLET CONTRACT-ANTEPART 

6533 OUTLET CONTRACT PELVIS* 

65330 OUTLET CONTRACTION-UNSP 

65331 OUTLET CONTRACTION-DELIV 

65333 OUTLET CONTRACT-ANTEPART 

6534 FETOPELVIC DISPROPORTION* 

65340 FETOPELV DISPROP-UNSPEC 

65341 FETOPELV DISPROPOR-DELIV 

65343 FETOPEL DISPROP-ANTEPART 

6535 FETAL DISPROPORTION NOS* 

65350 FETAL DISPROP NOS-UNSPEC 

65351 FETAL DISPROP NOS-DELIV 

65353 FETAL DISPRO NOS-ANTEPAR 

6536 HYDROCEPH FETUS W DISPRO* 

65360 HYDROCEPHAL FETUS-UNSPEC 

65361 HYDROCEPH FETUS-DELIVER 

65363 HYDROCEPH FETUS-ANTEPART 

6537 OTH FETAL ABN W DISPROP* 

65370 OTH ABN FET DISPROP-UNSP 

65371 OTH ABN FET DISPRO-DELIV 

65373 OTH ABN FET DISPRO-ANTEP 

6538 DISPROPORTION NEC* 

65380 DISPROPORTION NEC-UNSPEC 

65381 DISPROPORTION NEC-DELIV 

65383 DISPROPOR NEC-ANTEPARTUM 

6539 DISPROPORTION NOS* 

65390 DISPROPORTION NOS-UNSPEC 

65391 DISPROPORTION NOS-DELIV 

65393 DISPROPOR NOS-ANTEPARTUM 

654 ABN PELVIC ORGAN IN PREG* 

6540 CONG ABN UTERUS IN PREG* 

65400 CONG ABN UTER PREG-UNSP 

65401 CONGEN ABN UTERUS-DELIV 

65402 CONG ABN UTER-DEL W P/P

65403 CONGEN ABN UTER-ANTEPART 

65404 CONGEN ABN UTER-POSTPART 

6541 UTERINE TUMOR IN PREG* 

65410 UTER TUMOR IN PREG-UNSP 

65411 UTERINE TUMOR-DELIVERED 

65412 UTERINE TUMOR-DEL W P/P 

65413 UTERINE TUMOR-ANTEPARTUM 

65414 UTERINE TUMOR-POSTPARTUM 

6542 PREVIOUS C-SECTION NOS* 

65420 PREV C-DELIVERY UNSPEC 

65421 PREV C-DELIVERY-DELIVRD 

65423 PREV C-DELIVERY-ANTEPART 

6543 RETROVERT GRAVID UTERUS* 

65430 RETROVERT UTERUS-UNSPEC 

65431 RETROVERT UTERUS-DELIVER 

65432 RETROVERT UTER-DEL W P/P 

65433 RETROVERT UTER-ANTEPART 

65434 RETROVERT UTER-POSTPART 

6544 ABN SHAPE GRAVID UTERUS* 

65440 ABN GRAV UTERUS NEC-UNSP 

65441 ABN UTERUS NEC-DELIVERED 

65442 ABN UTERUS NEC-DEL W P/P 

65443 ABN UTERUS NEC-ANTEPART 

65444 ABN UTERUS NEC-POSTPART 

6545 CERVIX INCOMPET IN PREG* 

65450 CERV INCOMPET PREG-UNSP 

65451 CERVICAL INCOMPET-DELIV 

65452 CERV INCOMPET-DEL W P/P 

65453 CERV INCOMPET-ANTEPARTUM 

65454 CERV INCOMPET-POSTPARTUM 

6546 ABN CERVIX NEC IN PREG* 

65460 ABN CERVIX NEC PREG-UNSP 

65461 ABN CERVIX NEC-DELIVERED 

65462 ABN CERVIX NEC-DEL W P/P 

65463 ABN CERVIX NEC-ANTEPART 

65464 ABN CERVIX NEC-POSTPART 

6547 ABNORMAL VAGINA IN PREG* 

65470 ABN VAGINA IN PREG-UNSP 

65471 ABNORM VAGINA-DELIVERED 

65472 ABNORM VAGINA-DEL W P/P 

65473 ABNORM VAGINA-ANTEPARTUM 

65474 ABNORM VAGINA-POSTPARTUM 

6548 ABNORMAL VULVA IN PREG* 

65480 ABN VULVA IN PREG-UNSPEC 

65481 ABNORMAL VULVA-DELIVERED 

65482 ABNORMAL VULVA-DEL W P/P 

65483 ABNORMAL VULVA-ANTEPART 

65484 ABNORMAL VULVA-POSTPART 

6549 ABN PELV ORG NOS IN PREG* 

65490 ABN PEL NEC IN PREG-UNSP 

65491 ABN PELV ORG NEC-DELIVER 

65492 ABN PELV NEC-DELIV W P/P 

65493 ABN PELV ORG NEC-ANTEPAR 

65494 ABN PELV ORG NEC-POSTPAR 

655 FETAL ABN AFFECT MOTHER* 

6550 FETAL CNS MALFORMATION* 

65500 FETAL CNS MALFORM-UNSPEC

65501 FETAL CNS MALFORM-DELIV 

65503 FETAL CNS MALFOR-ANTEPAR 

6551 FETAL CHROMOSOMAL ABN* 

65510 FETAL CHROMOS ABN-UNSPEC 

65511 FETAL CHROMOSO ABN-DELIV 

65513 FET CHROMO ABN-ANTEPART 

6552 FAM HERED DIS AFF FETUS* 

65520 FAMIL HEREDIT DIS-UNSPEC 

65521 FAMIL HEREDIT DIS-DELIV 

65523 FAMIL HERED DIS-ANTEPART 

6553 FETAL DAMAGE D/T VIRUS* 

65530 FET DAMG D/T VIRUS-UNSP 

65531 FET DAMG D/T VIRUS-DELIV 

65533 FET DAMG D/T VIRUS-ANTEP 

6554 FETAL DAMAGE D/T OTH DIS* 

65540 FET DAMG D/T DIS-UNSPEC 

65541 FET DAMG D/T DIS-DELIVER 

65543 FET DAMG D/T DIS-ANTEPAR 

6555 FETAL DAMAGE D/T DRUG* 

65550 FETAL DAMG D/T DRUG-UNSP 

65551 FET DAMAG D/T DRUG-DELIV 

65553 FET DAMG D/T DRUG-ANTEPA 

6556 RADIATION FETAL DAMAGE* 

65560 RADIAT FETAL DAMAG-UNSP 

65561 RADIAT FETAL DAMAG-DELIV 

65563 RADIAT FET DAMAG-ANTEPAR 

65570 DECREASE FETL MOVMT UNSP 

65571 DECREASE FETAL MOVMT DEL 

65573 DEC FETAL MOVMT ANTEPART 

6558 FETAL ABNORMALITY NEC* 

65580 FETAL ABNORM NEC-UNSPEC 

65581 FETAL ABNORM NEC-DELIVER 

65583 FETAL ABNORM NEC-ANTEPAR 

6559 FETAL ABNORMALITY NOS* 

65590 FETAL ABNORM NOS-UNSPEC 

65591 FETAL ABNORM NOS-DELIVER 

65593 FETAL ABNORM NOS-ANTEPAR 

656 OTH FETAL PROB AFF MOTH* 

6560 FETAL-MATERNAL HEMORR* 

65600 FETAL-MATERNAL HEM-UNSP 

65601 FETAL-MATERNAL HEM-DELIV 

65603 FETAL-MATERN HEM-ANTEPAR 

6561 RHESUS ISOIMMUNIZATION* 

65610 RH ISOIMMUNIZATION-UNSP 

65611 RH ISOIMMUNIZAT-DELIVER 

65613 RH ISOIMMUNIZAT-ANTEPART 

6562 ABO ISOIMMUNIZATION* 

65620 ABO ISOIMMUNIZATION-UNSP 

65621 ABO ISOIMMUNIZAT-DELIVER 

65623 ABO ISOIMMUNIZAT-ANTEPAR 

6563 FETAL DISTRESS* 

65630 FETAL DISTRESS-UNSPEC 

65631 FETAL DISTRESS-DELIVERED 

65633 FETAL DISTRESS-ANTEPART 

6564 INTRAUTERINE DEATH* 

65640 INTRAUTERINE DEATH-UNSP 

65641 INTRAUTER DEATH-DELIVER

65643 INTRAUTER DEATH-ANTEPART 

6565 POOR FETAL GROWTH* 

65650 POOR FETAL GROWTH-UNSPEC 

65651 POOR FETAL GROWTH-DELIV 

65653 POOR FETAL GRTH-ANTEPART 

6566 EXCESSIVE FETAL GROWTH* 

65660 EXCESS FETAL GRTH-UNSPEC 

65661 EXCESS FETAL GRTH-DELIV 

65663 EXCESS FET GRTH-ANTEPART 

6567 OTH PLACENTAL CONDITIONS* 

65670 OTH PLACENT COND-UNSPEC 

65671 OTH PLACENT COND-DELIVER 

65673 OTH PLACENT COND-ANTEPAR 

6568 FETAL/PLACENTAL PROB NEC* 

65680 FET/PLAC PROB NEC-UNSPEC 

65681 FET/PLAC PROB NEC-DELIV 

65683 FET/PLAC PROB NEC-ANTEPA 

6569 FETAL/PLACENTAL PROB NOS* 

65690 FET/PLAC PROB NOS-UNSPEC 

65691 FET/PLAC PROB NOS-DELIV 

65693 FET/PLAC PROB NOS-ANTEPA 

657 POLYHYDRAMNIOS* 

65700 POLYHYDRAMNIOS-UNSPEC 

65701 POLYHYDRAMNIOS-DELIVERED 

65703 POLYHYDRAMNIOS-ANTEPART 

658 OTH AMNIOTIC CAVITY PROB* 

6580 OLIGOHYDRAMNIOS* 

65800 OLIGOHYDRAMNIOS-UNSPEC 

65801 OLIGOHYDRAMNIOS-DELIVER 

65803 OLIGOHYDRAMNIOS-ANTEPAR 

6581 PREMAT RUPTURE MEMBRANES* 

65810 PREM RUPT MEMBRAN-UNSPEC 

65811 PREM RUPT MEMBRAN-DELIV 

65813 PREM RUPT MEMB-ANTEPART 

6582 PROLONG RUPT MEMBRAN NOS* 

65820 PROLONG RUPT MEMB-UNSPEC 

65821 PROLONG RUPT MEMB-DELIV 

65823 PROLONG RUP MEMB-ANTEPAR 

6583 DELAY DEL POSTARTIF RUPT* 

65830 ARTIFIC RUPT MEMBR-UNSP 

65831 ARTIFIC RUPT MEMBR-DELIV 

65833 ARTIF RUPT MEMB-ANTEPART 

6584 INFECT AMNIOTIC CAVITY* 

65840 AMNIOTIC INFECTION-UNSP 

65841 AMNIOTIC INFECTION-DELIV 

65843 AMNIOTIC INFECT-ANTEPART 

6588 AMNIOTIC CAVITY PROB NEC* 

65880 AMNIOTIC PROB NEC-UNSPEC 

65881 AMNIOTIC PROB NEC-DELIV 

65883 AMNION PROB NEC-ANTEPART 

6589 AMNIOTIC CAVITY PROB NOS* 

65890 AMNIOTIC PROB NOS-UNSPEC 

65891 AMNIOTIC PROB NOS-DELIV 

65893 AMNION PROB NOS-ANTEPART 

659 OTH INDICAT CARE DELIVER* 

6590 FAIL MECHAN INDUCT LABOR* 

65900 FAIL MECHAN INDUCT-UNSP

65901 FAIL MECH INDUCT-DELIVER 

65903 FAIL MECH INDUCT-ANTEPAR 

6591 FAIL INDUCTION LABOR NOS* 

65910 FAIL INDUCTION NOS-UNSP 

65911 FAIL INDUCTION NOS-DELIV 

65913 FAIL INDUCT NOS-ANTEPART 

6592 MATERN PYREXIA LABOR NOS* 

65920 PYREXIA IN LABOR-UNSPEC 

65921 PYREXIA IN LABOR-DELIVER 

65923 PYREXIA IN LABOR-ANTEPAR 

6593 SEPTICEMIA DURING LABOR* 

65930 SEPTICEMIA IN LABOR-UNSP 

65931 SEPTICEM IN LABOR-DELIV 

65933 SEPTICEM IN LABOR-ANTEPA 

6594 GRAND MULTIPARITY* 

65940 GRAND MULTIPARITY-UNSPEC 

65941 GRAND MULTIPARITY-DELIV 

65943 GRAND MULTIPARITY-ANTEPA 

6595 ELDERLY PRIMIGRAVIDA* 

65950 ELDERLY PRIMIGRAVID-UNSP 

65951 ELDERLY PRIMIGRAVIDA-DEL 

65953 ELDER PRIMIGRAVID-ANTEPA 

65960 ELDERLY MULTIGRAVIDA-UNS 

65961 ELDERLY MULTIGRAVIDA-DEL 

65963 ELDERLY MULTIGRAVD-ANTEP 

6597 ABN FTL HRT RATE* 

65970 ABN FTL HRT RATE/RHY-UNS 

65971 ABN FTL HRT RATE/RHY-DEL 

65973 ABN FTL HRT RATE/RHY-ANT 

6598 INDICAT CARE LAB/DEL NEC* 

65980 COMPLIC LABOR NEC-UNSP 

65981 COMPLIC LABOR NEC-DELIV 

65983 COMPL LABOR NEC-ANTEPART 

6599 INDICAT CARE LAB/DEL NOS* 

65990 COMPLIC LABOR NOS-UNSP 

65991 COMPLIC LABOR NOS-DELIV 

65993 COMPL LABOR NOS-ANTEPART 

660 OBSTRUCTED LABOR* 

6600 OBSTR BY MALPOSIT FETUS* 

66000 OBSTRUCT/FET MALPOS-UNSP 

66001 OBSTRUC/FET MALPOS-DELIV 

66003 OBSTRUC/FET MALPOS-ANTEP 

6601 OBSTRUCT BY BONY PELVIS* 

66010 BONY PELV OBSTRUC-UNSPEC 

66011 BONY PELV OBSTRUCT-DELIV 

66013 BONY PELV OBSTRUC-ANTEPA 

6602 OBSTR ABN PELV SOFT TISS* 

66020 ABN PELV TISS OBSTR-UNSP 

66021 ABN PELV TIS OBSTR-DELIV 

66023 ABN PELV TIS OBSTR-ANTEP 

6603 PERSISTENT OCCIPITOPOST* 

66030 PERSIST OCCIPITPOST-UNSP 

66031 PERSIST OCCIPTPOST-DELIV 

66033 PERSIST OCCIPTPOST-ANTEP 

6604 SHOULDER GIRDLE DYSTOCIA* 

66040 SHOULDER DYSTOCIA-UNSPEC 

66041 SHOULDER DYSTOCIA-DELIV

66043 SHOULDER DYSTOCIA-ANTEPA 

6605 LOCKED TWINS* 

66050 LOCKED TWINS-UNSPECIFIED 

66051 LOCKED TWINS-DELIVERED 

66053 LOCKED TWINS-ANTEPARTUM 

6606 FAILED TRIAL LABOR NOS* 

66060 FAIL TRIAL LAB NOS-UNSP 

66061 FAIL TRIAL LAB NOS-DELIV 

66063 FAIL TRIAL LAB NOS-ANTEP 

6607 FAIL FORCEP/VAC EXTR NOS* 

66070 FAILED FORCEP NOS-UNSPEC 

66071 FAILED FORCEPS NOS-DELIV 

66073 FAIL FORCEPS NOS-ANTEPAR 

6608 OBSTRUCTED LABOR NEC* 

66080 OBSTRUC LABOR NEC-UNSPEC 

66081 OBSTRUCT LABOR NEC-DELIV 

66083 OBSTRUC LABOR NEC-ANTEPA 

6609 OBSTRUCTED LABOR NOS* 

66090 OBSTRUC LABOR NOS-UNSPEC 

66091 OBSTRUCT LABOR NOS-DELIV 

66093 OBSTRUC LABOR NOS-ANTEPA 

661 ABNORMAL FORCES OF LABOR* 

6610 PRIMARY UTERINE INERTIA* 

66100 PRIM UTERINE INERT-UNSP 

66101 PRIM UTERINE INERT-DELIV 

66103 PRIM UTER INERT-ANTEPART 

6611 SECONDAR UTERINE INERTIA* 

66110 SEC UTERINE INERT-UNSPEC 

66111 SEC UTERINE INERT-DELIV 

66113 SEC UTERINE INERT-ANTEPA 

6612 UTERINE INERTIA NEC/NOS* 

66120 UTERINE INERTIA NEC-UNSP 

66121 UTERINE INERT NEC-DELIV 

66123 UTERINE INERT NEC-ANTEPA 

6613 PRECIPITATE LABOR* 

66130 PRECIPITATE LABOR-UNSPEC 

66131 PRECIPITATE LABOR-DELIV 

66133 PRECIPITATE LABOR-ANTEPA 

6614 UTERINE DYSTOCIA NOS* 

66140 UTER DYSTOCIA NOS-UNSPEC 

66141 UTER DYSTOCIA NOS-DELIV 

66143 UTER DYSTOCIA NOS-ANTEPA 

6619 ABNORMALITY OF LABOR NOS* 

66190 ABNORMAL LABOR NOS-UNSP 

66191 ABNORMAL LABOR NOS-DELIV 

66193 ABNORM LABOR NOS-ANTEPAR 

662 LONG LABOR* 

6620 PROLONGED FIRST STAGE* 

66200 PROLONGED 1ST STAGE-UNSP 

66201 PROLONG 1ST STAGE-DELIV 

66203 PROLONG 1ST STAGE-ANTEPA 

6621 PROLONGED LABOR NOS* 

66210 PROLONGED LABOR NOS-UNSP 

66211 PROLONG LABOR NOS-DELIV 

66213 PROLONG LABOR NOS-ANTEPA 

6622 PROLONGED SECOND STAGE* 

66220 PROLONGED 2ND STAGE-UNSP

66221 PROLONG 2ND STAGE-DELIV 

66223 PROLONG 2ND STAGE-ANTEPA 

6623 DELAY DELIVERY 2ND TWIN* 

66230 DELAY DEL 2ND TWIN-UNSP 

66231 DELAY DEL 2ND TWIN-DELIV 

66233 DELAY DEL 2 TWIN-ANTEPAR 

663 UMBILICAL CORD COMPLIC* 

6630 PROLAPSE OF CORD* 

66300 CORD PROLAPSE-UNSPEC 

66301 CORD PROLAPSE-DELIVERED 

66303 CORD PROLAPSE-ANTEPARTUM 

6631 COMPRESS CORD ROUND NECK* 

66310 CORD AROUND NECK-UNSPEC 

66311 CORD AROUND NECK-DELIVER 

66313 CORD AROUND NECK-ANTEPAR 

6632 CORD ENTANGL W COMPR NEC* 

66320 CORD COMPRESS NEC-UNSPEC 

66321 CORD COMPRESS NEC-DELIV 

66323 CORD COMPRES NEC-ANTEPAR 

6633 CORD ENTANGLE NEC/NOS* 

66330 CORD ENTANGLE NEC-UNSPEC 

66331 CORD ENTANGLE NEC-DELIV 

66333 CORD ENTANGL NEC-ANTEPAR 

6634 SHORT UMBILICAL CORD* 

66340 SHORT CORD-UNSPECIFIED 

66341 SHORT CORD-DELIVERED 

66343 SHORT CORD-ANTEPARTUM 

6635 VASA PREVIA* 

66350 VASA PREVIA-UNSPECIFIED 

66351 VASA PREVIA-DELIVERED 

66353 VASA PREVIA-ANTEPARTUM 

6636 VASCULAR LESIONS OF CORD* 

66360 VASC LESION CORD-UNSPEC 

66361 VASC LESION CORD-DELIVER 

66363 VASC LESION CORD-ANTEPAR 

6638 UMBILICAL CORD COMPL NEC* 

66380 CORD COMPLICAT NEC-UNSP 

66381 CORD COMPLICAT NEC-DELIV 

66383 CORD COMPL NEC-ANTEPART 

6639 UMBILICAL CORD COMPL NOS* 

66390 CORD COMPLICAT NOS-UNSP 

66391 CORD COMPLICAT NOS-DELIV 

66393 CORD COMPL NOS-ANTEPART 

664 PERINEAL TRAUM W DELIVER* 

6640 DELIVERY W 1 DEG LACERAT* 

66400 DEL W 1 DEG LACERAT-UNSP 

66401 DEL W 1 DEG LACERAT-DEL 

66404 DEL W 1 DEG LAC-POSTPART 









6643 DELIVERY W 4 DEG LACERAT*




6644 DELIV W PERINEAL LAC NOS* 

66440 OB PERINEAL LAC NOS-UNSP 

66441 OB PERINEAL LAC NOS-DEL 

66444 PERINEAL LAC NOS-POSTPAR 

6645 DELIV W PERINEAL HEMATOM* 

66450 OB PERINEAL HEMATOM-UNSP 

66451 OB PERINEAL HEMATOMA-DEL 

66454 PERIN HEMATOMA-POSTPART 

6648 DEL W PERINEAL TRAUM NEC* 

66480 OB PERIN TRAUM NEC-UNSP 

66481 OB PERINEAL TRAU NEC-DEL 

66484 PERIN TRAUM NEC-POSTPART 

6649 DEL W PERINEAL TRAUM NOS* 

66490 OB PERIN TRAUM NOS-UNSP 

66491 OB PERINEAL TRAU NOS-DEL 

66494 PERIN TRAUM NOS-POSTPART 

665 OTHER OBSTETRICAL TRAUMA* 

6650 RUPT UTERUS BEFORE LABOR* 

66500 PRELABOR RUPT UTER-UNSP 

66501 PRELABOR RUPT UTERUS-DEL 

66503 PRELAB RUPT UTER-ANTEPAR 

6651 RUPTURE OF UTERUS NOS* 

66510 RUPTURE UTERUS NOS-UNSP 

66511 RUPTURE UTERUS NOS-DELIV 

6652 INVERSION OF UTERUS* 

66520 INVERSION OF UTERUS-UNSP 

66522 INVERS UTERUS-DEL W P/P 

66524 INVERS UTERUS-POSTPART 

6653 LACERATION OF CERVIX* 

66530 LACERAT OF CERVIX-UNSPEC 

66531 LACERAT OF CERVIX-DELIV 

66534 LACER OF CERVIX-POSTPART 

6654 HIGH VAGINAL LACERATION* 

66540 HIGH VAGINAL LACER-UNSP 

66541 HIGH VAGINAL LACER-DELIV 

66544 HIGH VAGINAL LAC-POSTPAR 

6655 OTH INJURY PELVIC ORGANS* 

66550 OB INJ PELV ORG NEC-UNSP 

66551 OB INJ PELV ORG NEC-DEL 

66554 INJ PELV ORG NEC-POSTPAR 

6656 DAMAGE TO PELVIC JOINTS* 

66560 DAMAGE TO PELVIC JT-UNSP 

66561 DAMAGE TO PELVIC JT-DEL 

66564 DAMAGE PELVIC JT-POSTPAR 

6657 PELVIC HEMATOMA* 

66570 OB PELVIC HEMATOMA-UNSP 

66571 OB PELVIC HEMATOMA-DELIV 

66572 PELVIC HEMATOM-DEL W PP 

66574 PELVIC HEMATOMA-POSTPART 

6658 OBSTETRICAL TRAUMA NEC* 

66580 OB TRAUMA NEC-UNSPEC 

66581 OB TRAUMA NEC-DELIVERED 

66582 OB TRAUMA NEC-DEL W P/P 

66583 OB TRAUMA NEC-ANTEPARTUM

66584 OB TRAUMA NEC-POSTPARTUM 

6659 OBSTETRICAL TRAUMA NOS* 

66590 OB TRAUMA NOS-UNSPEC 

66591 OB TRAUMA NOS-DELIVERED 

66592 OB TRAUMA NOS-DEL W P/P 

66593 OB TRAUMA NOS-ANTEPARTUM 

66594 OB TRAUMA NOS-POSTPARTUM 

666 POSTPARTUM HEMORRHAGE* 

6660 THIRD-STAGE HEMORRHAGE* 

66600 THIRD-STAGE HEM-UNSPEC 

66602 THRD-STAGE HEM-DEL W P/P 

66604 THIRD-STAGE HEM-POSTPART 

6661 POSTPARTUM HEMORR NEC* 

66610 POSTPARTUM HEM NEC-UNSP 

66612 POSTPA HEM NEC-DEL W P/P 

66614 POSTPART HEM NEC-POSTPAR 

6662 DELAY POSTPARTUM HEMORR* 

66620 DELAY P/PART HEM-UNSPEC 

66622 DELAY P/P HEM-DEL W P/P 

66624 DELAY P/PART HEM-POSTPAR 

6663 POSTPART COAGULATION DEF* 

66630 POSTPART COAGUL DEF-UNSP 

66632 P/P COAG DEF-DEL W P/P 

66634 POSTPART COAG DEF-POSTPA 

667 RETAIN PLACENTA W/O HEM* 

6670 RETAIN PLACENTA W/O HEM* 

66700 RETAIN PLACENTA NOS-UNSP 

66702 RETND PLAC NOS-DEL W P/P 

66704 RETAIN PLAC NOS-POSTPART 

6671 RETAINED PRODUCT CONCEPT* 

66710 RETAIN PROD CONCEPT-UNSP 

66712 RET PROD CONC-DEL W P/P 

66714 RET PROD CONCEPT-POSTPAR 

668 COMPL ANESTH IN DELIVERY* 

6680 ANESTH PULM COMPL IN DEL* 

66800 PULM COMPL IN DEL-UNSPEC 

66801 PULM COMPL IN DEL-DELIV 

66802 PULM COMPLIC-DEL W P/P 

66803 PULM COMPLICAT-ANTEPART 

66804 PULM COMPLICAT-POSTPART 

6681 ANESTH CARD COMPL IN DEL* 

66810 HEART COMPL IN DEL-UNSP 

66811 HEART COMPL IN DEL-DELIV 

66812 HEART COMPL-DEL W P/P 

66813 HEART COMPLIC-ANTEPART 

66814 HEART COMPLIC-POSTPART 

6682 ANESTH CNS COMPL IN DEL* 

66820 CNS COMPL LABOR/DEL-UNSP 

66821 CNS COMPL LAB/DEL-DELIV 

66822 CNS COMPLIC-DEL W P/P 

66823 CNS COMPL IN DEL-ANTEPAR 

66824 CNS COMPL IN DEL-POSTPAR 

6688 OTH COMPL ANESTH IN DEL* 

66880 ANESTH COMP DEL NEC-UNSP 

66881 ANESTH COMPL NEC-DELIVER 

66882 ANESTH COMPL NEC-DEL P/P 

66883 ANESTH COMPL ANTEPARTUM

66884 ANESTH COMPL-POSTPARTUM 

6689 COMPL ANESTH NOS IN DEL* 

66890 ANESTH COMP DEL NOS-UNSP 

66891 ANESTH COMPL NOS-DELIVER 

66892 ANESTH COMPL NOS-DEL P/P 

66893 ANESTH COMPL-ANTEPARTUM 

66894 ANESTH COMPL-POSTPARTUM 

669 OTH COMPL LABOR/DELIVERY* 

6690 MATERNAL DISTRESS* 

66900 MATERNAL DISTRESS-UNSPEC 

66901 MATERNAL DISTRESS-DELIV 

66902 MATERN DISTRES-DEL W P/P 

66903 MATERN DISTRESS-ANTEPAR 

66904 MATERN DISTRESS-POSTPART 

6691 OBSTETRIC SHOCK* 

66910 OBSTETRIC SHOCK-UNSPEC 

66911 OBSTETRIC SHOCK-DELIVER 

66912 OBSTET SHOCK-DELIV W P/P 

66913 OBSTETRIC SHOCK-ANTEPAR 

66914 OBSTETRIC SHOCK-POSTPART 

6692 MATERNAL HYPOTENSION SYN* 

66920 MATERN HYPOTENS SYN-UNSP 

66921 MATERN HYPOTEN SYN-DELIV 

66922 MATERN HYPOTEN-DEL W P/P 

66923 MATERN HYPOTENS-ANTEPAR 

66924 MATERN HYPOTENS-POSTPART 

6693 AC RENAL FAIL W DELIVERY* 

66930 AC REN FAIL W DELIV-UNSP 

66932 AC REN FAIL-DELIV W P/P 

66934 AC RENAL FAILURE-POSTPAR 

6694 OTH OBSTETRIC SURG COMPL* 

66940 OTH OB SURG COMPL-UNSPEC 

66941 OTH OB COMPL-DELIVERED 

66942 OTH OB COMPL-DELIV W P/P 

66943 COMPLC OB SURG ANTEPRTM 

66944 OTH OB SURG COMPL-POSTPA 

6695 FORCEPS DELIVERY NOS* 

66950 FORCEP DELIV NOS-UNSPEC 

66951 FORCEP DELIV NOS-DELIVER 

6696 BREECH EXTRACTION NOS* 

66960 BREECH EXTR NOS-UNSPEC 

66961 BREECH EXTR NOS-DELIVER 

6697 CESAREAN DELIVERY NOS* 

66970 CESAREAN DELIV NOS-UNSP 

66971 CESAREAN DELIVERY NOS 

6698 COMPL LABOR/DELIVERY NEC* 

66980 COMPL LAB/DELIV NEC-UNSP 

66981 COMP LAB/DELIV NEC-DELIV 

66982 COMPL DEL NEC-DEL W P/P 

66983 COMPL DELIV NEC-ANTEPAR 

66984 COMPL DELIV NEC-POSTPART 

6699 COMPL LABOR/DELIVERY NOS* 

66990 COMPL LAB/DELIV NOS-UNSP 

66991 COMP LAB/DELIV NOS-DELIV 

66992 COMPL DEL NOS-DEL W P/P 

66993 COMPL DELIV NOS-ANTEPAR 

66994 COMPL DELIV NOS-POSTPART

670 MAJOR PUERPERAL INFECT* 

67000 MAJOR PUERP INFECT-UNSP 

67002 MAJOR PUERP INF-DEL P/P 

67004 MAJOR PUERP INF-POSTPART 

671 VENOUS COMPLIC IN PREG* 

6710 VARIC VEIN LEG IN PREG* 

67100 VARIC VEIN LEG PREG-UNSP 

67101 VARICOSE VEIN LEG-DELIV 

67102 VARIC VEIN LEG-DEL W P/P 

67103 VARIC VEIN LEG-ANTEPART 

67104 VARIC VEIN LEG-POSTPART 

6711 VARICOSE VULVA IN PREG* 

67110 VARIC VULVA PREG-UNSPEC 

67111 VARICOSE VULVA-DELIVERED 

67112 VARICOSE VULVA-DEL W P/P 

67113 VARICOSE VULVA-ANTEPART 

67114 VARICOSE VULVA-POSTPART 

6712 THROMBOPHLEBITIS IN PREG* 

67120 THROMBOPHLEB PREG-UNSPEC 

67121 THROMBOPHLEBITIS-DELIVER 

67122 THROMBOPHLEB-DELIV W P/P 

67123 THROMBOPHLEBIT-ANTEPART 

67124 THROMBOPHLEBIT-POSTPART 

6713 ANTEPAR DEEP VEIN THROMB* 

67130 DEEP THROMB ANTEPAR-UNSP 

67131 DEEP THROM ANTEPAR-DELIV 

67133 DEEP VEIN THROMB-ANTEPAR 

6714 DEEP VEIN THROMB-POSTPAR* 

67140 DEEP THROMB POSTPAR-UNSP 

67142 THROMB POSTPAR-DEL W P/P 

67144 DEEP VEIN THROMB-POSTPAR 

6715 OTH THROMBOS COMPL PREG* 

67150 THROMBOSIS NEC PREG-UNSP 

67151 THROMBOSIS NEC-DELIVERED 

67152 THROMB NEC-DELIV W P/P 

67153 THROMBOSIS NEC-ANTEPART 

67154 THROMBOSIS NEC-POSTPART 

6718 OTH VENOUS COMPL IN PREG* 

67180 VEN COMPL PREG NEC-UNSP 

67181 VENOUS COMPL NEC-DELIVER 

67182 VEN COMP NEC-DELIV W P/P 

67183 VENOUS COMPL NEC-ANTEPAR 

67184 VENOUS COMPL NEC-POSTPAR 

6719 VENOUS COMPL IN PREG NOS* 

67190 VEN COMPL PREG NOS-UNSP 

67191 VENOUS COMPL NOS-DELIVER 

67192 VEN COMP NOS-DELIV W P/P 

67193 VENOUS COMPL NOS-ANTEPAR 

67194 VENOUS COMPL NOS-POSTPAR 

672 PUERPERAL PYREXIA NOS* 

67200 PUERPERAL PYREXIA-UNSPEC 

67202 PUERP PYREXIA-DEL W P/P 

67204 PUERP PYREXIA-POSTPARTUM 

673 OB PULMONARY EMBOLISM* 

6730 OB AIR EMBOLISM* 

67300 OB AIR EMBOLISM-UNSPEC 

67301 OB AIR EMBOLISM-DELIVER

67302 OB AIR EMBOL-DELIV W P/P 

67303 OB AIR EMBOLISM-ANTEPART 

67304 OB AIR EMBOLISM-POSTPART 

6731 AMNIOTIC FLUID EMBOLISM* 

67310 AMNIOTIC EMBOLISM-UNSPEC 

67311 AMNIOTIC EMBOLISM-DELIV 

67312 AMNIOT EMBOL-DELIV W P/P 

67313 AMNIOTIC EMBOL-ANTEPART 

67314 AMNIOTIC EMBOL-POSTPART 

6732 OB BLOOD-CLOT EMBOLISM* 

67320 OB PULM EMBOL NOS-UNSPEC 

67321 PULM EMBOL NOS-DELIVERED 

67322 PULM EMBOL NOS-DEL W P/P 

67323 PULM EMBOL NOS-ANTEPART 

67324 PULM EMBOL NOS-POSTPART 

6733 OB PYEMIC/SEPTIC EMBOL* 

67330 OB PYEMIC EMBOL-UNSPEC 

67331 OB PYEMIC EMBOL-DELIVER 

67332 OB PYEM EMBOL-DEL W P/P 

67333 OB PYEMIC EMBOL-ANTEPART 

67334 OB PYEMIC EMBOL-POSTPART 

6738 OB PULMONARY EMBOL NEC* 

67380 OB PULMON EMBOL NEC-UNSP 

67381 PULMON EMBOL NEC-DELIVER 

67382 PULM EMBOL NEC-DEL W P/P 

67383 PULMON EMBOL NEC-ANTEPAR 

67384 PULMON EMBOL NEC-POSTPAR 

674 PUERPERAL COMPL NEC/NOS* 

6740 PUERPER CEREBROVASC DIS* 

67400 PUERP CEREBVASC DIS-UNSP 

67401 PUERP CEREBVAS DIS-DELIV 

67402 CEREBVAS DIS-DELIV W P/P 

67403 CEREBROVASC DIS-ANTEPART 

67404 CEREBROVASC DIS-POSTPART 

6741 DISRUPT CESAREAN WOUND* 

67410 DISRUPT C-SECT WND-UNSP 

67412 DISRUPT C-SECT-DEL W P/P 

67414 DISRUPT C-SECT-POSTPART 

6742 DISRUPT PERINEAL WOUND* 

67420 DISRUPT PERINEUM-UNSPEC 

67422 DISRUPT PERIN-DEL W P/P 

67424 DISRUPT PERINEUM-POSTPAR 

6743 OTH COMPL OB SURG WOUND* 

67430 OB SURG COMPL NEC-UNSPEC 

67432 OB SURG COMPL-DEL W P/P 

67434 OB SURG COMP NEC-POSTPAR 

6744 PLACENTAL POLYP* 

67440 PLACENTAL POLYP-UNSPEC 

67442 PLACENT POLYP-DEL W P/P 

67444 PLACENTAL POLYP-POSTPART 

6748 PUERPERAL COMPL NEC/NOS* 

67480 PUERP COMPL NEC-UNSPEC 

67482 PUERP COMP NEC-DEL W P/P 

67484 PUERP COMPL NEC-POSTPART 

6749 PUERPERAL COMPLIC NOS* 

67490 PUERP COMPL NOS-UNSPEC 

67492 PUERP COMP NOS-DEL W P/P

67494 PUERP COMPL NOS-POSTPART 

675 INFECT BREAST IN PREG* 

6750 INFECT OF NIPPLE IN PREG* 

67500 INFECT NIPPLE PREG-UNSP 

67501 INFECT NIPPLE-DELIVERED 

67502 INFECT NIPPLE-DEL W P/P 

67503 INFECT NIPPLE-ANTEPARTUM 

67504 INFECT NIPPLE-POSTPARTUM 

6751 BREAST ABSCESS IN PREG* 

67510 BREAST ABSCESS PREG-UNSP 

67511 BREAST ABSCESS-DELIVERED 

67512 BREAST ABSCESS-DEL W P/P 

67513 BREAST ABSCESS-ANTEPART 

67514 BREAST ABSCESS-POSTPART 

6752 MASTITIS IN PREG* 

67520 MASTITIS IN PREG-UNSPEC 

67521 MASTITIS-DELIVERED 

67522 MASTITIS-DELIV W P/P 

67523 MASTITIS-ANTEPARTUM 

67524 MASTITIS-POSTPARTUM 

6758 BREAST INFEC NEC IN PREG* 

67580 BREAST INF PREG NEC-UNSP 

67581 BREAST INFECT NEC-DELIV 

67582 BREAST INF NEC-DEL W P/P 

67583 BREAST INF NEC-ANTEPART 

67584 BREAST INF NEC-POSTPART 

6759 BREAST INFEC NOS IN PREG* 

67590 BREAST INF PREG NOS-UNSP 

67591 BREAST INFECT NOS-DELIV 

67592 BREAST INF NOS-DEL W P/P 

67593 BREAST INF NOS-ANTEPART 

67594 BREAST INF NOS-POSTPART 

676 OTH BREAST/LACT DIS PREG* 

6760 RETRACTED NIPPLE IN PREG* 

67600 RETRACT NIPPLE PREG-UNSP 

67601 RETRACTED NIPPLE-DELIVER 

67602 RETRACT NIPPLE-DEL W P/P 

67603 RETRACT NIPPLE-ANTEPART 

67604 RETRACT NIPPLE-POSTPART 

6761 CRACKED NIPPLE IN PREG* 

67610 CRACKED NIPPLE PREG-UNSP 

67611 CRACKED NIPPLE-DELIVERED 

67612 CRACKED NIPPLE-DEL W P/P 

67613 CRACKED NIPPLE-ANTEPART 

67614 CRACKED NIPPLE-POSTPART 

6762 ENGORGEMENT OF BREASTS* 

67620 BREAST ENGORGE-UNSPEC 

67621 BREAST ENGORGE-DELIVERED 

67622 BREAST ENGORGE-DEL W P/P 

67623 BREAST ENGORGE-ANTEPART 

67624 BREAST ENGORGE-POSTPART 

6763 BREAST DIS PREG NEC/NOS* 

67630 BREAST DIS PREG NEC-UNSP 

67631 BREAST DIS NEC-DELIVERED 

67632 BREAST DIS NEC-DEL W P/P 

67633 BREAST DIS NEC-ANTEPART 

67634 BREAST DIS NEC-POSTPART

6764 FAILURE OF LACTATION* 

67640 LACTATION FAIL-UNSPEC 

67641 LACTATION FAIL-DELIVERED 

67642 LACTATION FAIL-DEL W P/P 

67643 LACTATION FAIL-ANTEPART 

67644 LACTATION FAIL-POSTPART 

6765 SUPPRESSED LACTATION* 

67650 SUPPR LACTATION-UNSPEC 

67651 SUPPR LACTATION-DELIVER 

67652 SUPPR LACTAT-DEL W P/P 

67653 SUPPR LACTATION-ANTEPAR 

67654 SUPPR LACTATION-POSTPART 

6766 GALACTORRHEA IN PREG* 

67660 GALACTORRHEA PREG-UNSPEC 

67661 GALACTORRHEA-DELIVERED 

67662 GALACTORRHEA-DEL W P/P 

67663 GALACTORRHEA-ANTEPARTUM 

67664 GALACTORRHEA-POSTPARTUM 

6768 OTHER LACTATION DISORDER* 

67680 LACTATION DIS NEC-UNSPEC 

67681 LACTATION DIS NEC-DELIV 

67682 LACTAT DIS NEC-DEL W P/P 

67683 LACTAT DIS NEC-ANTEPART 

67684 LACTAT DIS NEC-POSTPART 

6769 LACTATION DISORDER NOS* 

67690 LACTATION DIS NOS-UNSPEC 

67691 LACTATION DIS NOS-DELIV 

67692 LACTAT DIS NOS-DEL W P/P 

67693 LACTAT DIS NOS-ANTEPART 

67694 LACTAT DIS NOS-POSTPART 

677 LATE EFFCT CMPLCATN PREG 

680 CARBUNCLE AND FURUNCLE* 

6800 CARBUNCLE OF FACE 

6801 CARBUNCLE OF NECK 

6802 CARBUNCLE OF TRUNK 

6803 CARBUNCLE OF ARM 

6804 CARBUNCLE OF HAND 

6805 CARBUNCLE OF BUTTOCK 

6806 CARBUNCLE OF LEG 

6807 CARBUNCLE OF FOOT 

6808 CARBUNCLE, SITE NEC 

6809 CARBUNCLE NOS 

681 CELLULITIS, FINGER/TOE* 

6810 CELLULITIS OF FINGER* 

68100 CELLULITIS, FINGER NOS 

68101 FELON 

68102 ONYCHIA OF FINGER 

6811 CELLULITIS OF TOE* 

68110 CELLULITIS, TOE NOS 

68111 ONYCHIA OF TOE 

6819 CELLULITIS OF DIGIT NOS 

682 OTHER CELLULITIS/ABSCESS* 

6820 CELLULITIS OF FACE 

6821 CELLULITIS OF NECK 

6822 CELLULITIS OF TRUNK 

6823 CELLULITIS OF ARM 

6824 CELLULITIS OF HAND

6825 CELLULITIS OF BUTTOCK 

6826 CELLULITIS OF LEG 

6827 CELLULITIS OF FOOT 

6828 CELLULITIS, SITE NEC 

6829 CELLULITIS NOS 

683 ACUTE LYMPHADENITIS 

684 IMPETIGO 

685 PILONIDAL CYST* 

6850 PILONIDAL CYST W ABSCESS 

6851 PILONIDAL CYST W/O ABSC 

686 OTH LOCAL SKIN INFECTION* 

6860 PYODERMA* 

68600 PYODERMA NOS 

68601 PYODERMA GANGRENOSUM 

68609 PYODERMA NEC 

6861 PYOGENIC GRANULOMA 

6868 LOCAL SKIN INFECTION NEC 

6869 LOCAL SKIN INFECTION NOS 

690 ERYTHEMATOSQUAMOUS DERM* 

69010 SEBRRHEIC DERMATITIS NOS 

69011 SEBORRHEA CAPITIS 

69012 SBRHEIC INFANTL DRMTITIS 

69018 SEBRRHEIC DERMATITIS NEC 

6908 ERYTHMTSQUAMOUS DERM NEC 

691 ATOPIC DERMATITIS* 

6910 DIAPER OR NAPKIN RASH 

6918 OTHER ATOPIC DERMATITIS 

692 CONTACT DERMATITIS* 

6920 DETERGENT DERMATITIS 

6921 OIL & GREASE DERMATITIS 

6922 SOLVENT DERMATITIS 

6923 TOPICAL MED DERMATITIS 

6924 CHEMICAL DERMATITIS NEC 

6925 TOPICAL FOOD DERMATITIS 

6926 DERMATITIS DUE TO PLANT 

6927 SOLAR RADIATION DERMAT* 

69270 SOLAR DERMATITIS NOS 

69271 SUNBURN 

69272 ACT DRMTITIS SOLAR RDIAT 

69273 ACTNC RETIC ACTNC GRNLMA 

69274 OTH CHR DRMTIT SOLAR RAD 

69279 OTH DERMATITIS SOLAR RAD 

6928 OTHER DERMATITIS* 

69281 COSMETIC DERMATITIS 

69282 DERMATITIS OTH RADIATION 

69283 DERMATITIS METALS 

69289 DERMATITIS NEC 

6929 DERMATITIS NOS 

693 DERMAT D/T INTERN AGENT* 

6930 DRUG DERMATITIS NOS 

6931 DERMAT D/T FOOD INGEST 

6938 DERMAT D/T INT AGENT NEC 

6939 DERMAT D/T INT AGENT NOS 

694 BULLOUS DERMATOSES* 

6940 DERMATITIS HERPETIFORMIS 

6941 SUBCORNEAL PUST DERMATOS 

6942 JUVEN DERMAT HERPETIFORM

6943 IMPETIGO HERPETIFORMIS 

6944 PEMPHIGUS 

6945 PEMPHIGOID 

6946 BEN MUCOUS MEMB PEMPHIG* 

69460 BN MUCOUS MEMB PEMPH NOS 

69461 OCULAR PEMPHIGUS 

6948 BULLOUS DERMATOSES NEC 

6949 BULLOUS DERMATOSES NOS 

695 ERYTHEMATOUS CONDITIONS* 

6950 TOXIC ERYTHEMA 

6951 ERYTHEMA MULTIFORME 

6952 ERYTHEMA NODOSUM 

6953 ROSACEA 

6954 LUPUS ERYTHEMATOSUS 

6958 OTH ERYTHEMATOUS COND* 

69581 RITTER'S DISEASE 

69589 ERYTHEMATOUS COND NEC 

6959 ERYTHEMATOUS COND NOS 

696 PSORIASIS/LIKE DISORDERS* 

6960 PSORIATIC ARTHROPATHY 

6961 OTHER PSORIASIS 

6962 PARAPSORIASIS 

6963 PITYRIASIS ROSEA 

6964 PITYRIASIS RUBRA PILARIS 

6965 PITYRIASIS NEC & NOS 

6968 PSORIAS RELATED DIS NEC 

697 LICHEN* 

6970 LICHEN PLANUS 

6971 LICHEN NITIDUS 

6978 LICHEN NEC 

6979 LICHEN NOS 

698 PRURITUS & LIKE COND* 

6980 PRURITUS ANI 

6981 PRURITUS OF GENITALIA 

6982 PRURIGO 

6983 LICHENIFICATION 

6984 DERMATITIS FACTITIA 

6988 PRURITIC CONDITIONS NEC 

6989 PRURITIC DISORDER NOS 

700 CORNS AND CALLOSITIES 

701 OTH SKIN HYPERTRO/ATROPH* 

7010 CIRCUMSCRIBE SCLERODERMA 

7011 KERATODERMA, ACQUIRED 

7012 ACQ ACANTHOSIS NIGRICANS 

7013 STRIAE ATROPHICAE 

7014 KELOID SCAR 

7015 ABNORMAL GRANULATION NEC 

7018 SKIN HYPERTRO/ATROPH NEC 

7019 SKIN HYPERTRO/ATROPH NOS 

702 OTHER DERMATOSES* 

7020 ACTINIC KERATOSIS 

7021 SEBORRHEIC KERATOSIS* 

70211 INFLAMED SBRHEIC KERATOS 

70219 OTHER SBORHEIC KERATOSIS 

7028 OTHER SPECF DERMATOSES 

703 DISEASES OF NAIL* 

7030 INGROWING NAIL

7038 DISEASES OF NAIL NEC 

7039 DISEASE OF NAIL NOS 

704 HAIR & FOLLICLE DISEASE* 

7040 ALOPECIA* 

70400 ALOPECIA NOS 

70401 ALOPECIA AREATA 

70402 TELOGEN EFFLUVIUM 

70409 ALOPECIA NEC 

7041 HIRSUTISM 

7042 ABNORMALITIES OF HAIR 

7043 VARIATIONS IN HAIR COLOR 

7048 HAIR DISEASES NEC 

7049 HAIR DISEASE NOS 

705 DISORDERS OF SWEAT GLAND* 

7050 ANHIDROSIS 

7051 PRICKLY HEAT 

7058 OTH SWEAT GLAND DISORDER* 

70581 DYSHIDROSIS 

70582 FOX-FORDYCE DISEASE 

70583 HIDRADENITIS 

70589 SWEAT GLAND DISORDER NEC 

7059 SWEAT GLAND DISORDER NOS 

706 SEBACEOUS GLAND DISEASE* 

7060 ACNE VARIOLIFORMIS 

7061 ACNE NEC 

7062 SEBACEOUS CYST 

7063 SEBORRHEA 

7068 SEBACEOUS GLAND DIS NEC 

7069 SEBACEOUS GLAND DIS NOS 

707 CHRONIC ULCER OF SKIN* 

7070 DECUBITUS ULCER 

7071 CHRONIC ULCER OF LEG 

7078 CHRONIC SKIN ULCER NEC 

7079 CHRONIC SKIN ULCER NOS 

708 URTICARIA* 

7080 ALLERGIC URTICARIA 

7081 IDIOPATHIC URTICARIA 

7082 URTICARIA FROM COLD/HEAT 

7083 DERMATOGRAPHIC URTICARIA 

7084 VIBRATORY URTICARIA 

7085 CHOLINERGIC URTICARIA 

7088 URTICARIA NEC 

7089 URTICARIA NOS 

709 OTHER SKIN DISORDERS* 

7090 DYSCHROMIA* 

70900 DYSCHROMIA, UNSPECIFIED 

70901 VITILIGO 

70909 OTHER DYSCHROMIA 

7091 VASCULAR DISORD OF SKIN 

7092 SCAR & FIBROSIS OF SKIN 

7093 DEGENERATIVE SKIN DISORD 

7094 FOREIGN BODY GRANUL-SKIN 

7098 SKIN DISORDERS NEC 

7099 SKIN DISORDER NOS 

710 DIFF CONNECTIVE TISS DIS* 

7100 SYST LUPUS ERYTHEMATOSUS 

7101 SYSTEMIC SCLEROSIS

7102 SICCA SYNDROME 

7103 DERMATOMYOSITIS 

7104 POLYMYOSITIS 

7105 EOSINOPHILIA MYALGIA SND 

7108 DIFF CONNECT TIS DIS NEC 

7109 DIFF CONNECT TIS DIS NOS 

711 ARTHROPATHY W INFECTION* 

7110 PYOGENIC ARTHRITIS* 

71100 PYOGEN ARTHRITIS-UNSPEC 

71101 PYOGEN ARTHRITIS-SHLDER 

71102 PYOGEN ARTHRITIS-UP/ARM 

71103 PYOGEN ARTHRITIS-FOREARM 

71104 PYOGEN ARTHRITIS-HAND 

71105 PYOGEN ARTHRITIS-PELVIS 

71106 PYOGEN ARTHRITIS-L/LEG 

71107 PYOGEN ARTHRITIS-ANKLE 

71108 PYOGEN ARTHRITIS NEC 

71109 PYOGEN ARTHRITIS-MULT 

7111 ARTHRITIS IN REITERS DIS* 

71110 REITER ARTHRITIS-UNSPEC 

71111 REITER ARTHRITIS-SHLDER 

71112 REITER ARTHRITIS-UP/ARM 

71113 REITER ARTHRITIS-FOREARM 

71114 REITER ARTHRITIS-HAND 

71115 REITER ARTHRITIS-PELVIS 

71116 REITER ARTHRITIS-L/LEG 

71117 REITER ARTHRITIS-ANKLE 

71118 REITER ARTHRITIS NEC 

71119 REITER ARTHRITIS-MULT 

7112 ARTHRITIS IN BEHCETS SYN* 

71120 BEHCET ARTHRITIS-UNSPEC 

71121 BEHCET ARTHRITIS-SHLDER 

71122 BEHCET ARTHRITIS-UP/ARM 

71123 BEHCET ARTHRITIS-FOREARM 

71124 BEHCET ARTHRITIS-HAND 

71125 BEHCET ARTHRITIS-PELVIS 

71126 BEHCET ARTHRITIS-L/LEG 

71127 BEHCET ARTHRITIS-ANKLE 

71128 BEHCET ARTHRITIS NEC 

71129 BEHCET ARTHRITIS-MULT 

7113 POSTDYSENTERIC ARTHRITIS* 

71130 DYSENTER ARTHRIT-UNSPEC 

71131 DYSENTER ARTHRIT-SHLDER 

71132 DYSENTER ARTHRIT-UP/ARM 

71133 DYSENTER ARTHRIT-FOREARM 

71134 DYSENTER ARTHRIT-HAND 

71135 DYSENTER ARTHRIT-PELVIS 

71136 DYSENTER ARTHRIT-L/LEG 

71137 DYSENTER ARTHRIT-ANKLE 

71138 DYSENTER ARTHRIT NEC 

71139 DYSENTER ARTHRIT-MULT 

7114 ARTHRIT IN OTH BACT DIS* 

71140 BACT ARTHRITIS-UNSPEC 

71141 BACT ARTHRITIS-SHLDER 

71142 BACT ARTHRITIS-UP/ARM 

71143 BACT ARTHRITIS-FOREARM 

71144 BACT ARTHRITIS-HAND

71145 BACT ARTHRITIS-PELVIS 

71146 BACT ARTHRITIS-L/LEG 

71147 BACT ARTHRITIS-ANKLE 

71148 BACT ARTHRITIS NEC 

71149 BACT ARTHRITIS-MULT 

7115 ARTHRITIS IN VIRAL DIS* 

71150 VIRAL ARTHRITIS-UNSPEC 

71151 VIRAL ARTHRITIS-SHLDER 

71152 VIRAL ARTHRITIS-UP/ARM 

71153 VIRAL ARTHRITIS-FOREARM 

71154 VIRAL ARTHRITIS-HAND 

71155 VIRAL ARTHRITIS-PELVIS 

71156 VIRAL ARTHRITIS-L/LEG 

71157 VIRAL ARTHRITIS-ANKLE 

71158 VIRAL ARTHRITIS NEC 

71159 VIRAL ARTHRITIS-MULT 

7116 MYCOTIC ARTHRITIS* 

71160 MYCOTIC ARTHRITIS-UNSPEC 

71161 MYCOTIC ARTHRITIS-SHLDER 

71162 MYCOTIC ARTHRITIS-UP/ARM 

71163 MYCOTIC ARTHRIT-FOREARM 

71164 MYCOTIC ARTHRITIS-HAND 

71165 MYCOTIC ARTHRITIS-PELVIS 

71166 MYCOTIC ARTHRITIS-L/LEG 

71167 MYCOTIC ARTHRITIS-ANKLE 

71168 MYCOTIC ARTHRITIS NEC 

71169 MYCOTIC ARTHRITIS-MULT 

7117 ARTHRIT IN HELMINTHIASIS* 

71170 HELMINTH ARTHRIT-UNSPEC 

71171 HELMINTH ARTHRIT-SHLDER 

71172 HELMINTH ARTHRIT-UP/ARM 

71173 HELMINTH ARTHRIT-FOREARM 

71174 HELMINTH ARTHRIT-HAND 

71175 HELMINTH ARTHRIT-PELVIS 

71176 HELMINTH ARTHRIT-L/LEG 

71177 HELMINTH ARTHRIT-ANKLE 

71178 HELMINTH ARTHRIT NEC 

71179 HELMINTH ARTHRIT-MULT 

7118 ARTHRIT IN OTH INFEC DIS* 

71180 INF ARTHRITIS NEC-UNSPEC 

71181 INF ARTHRITIS NEC-SHLDER 

71182 INF ARTHRITIS NEC-UP/ARM 

71183 INF ARTHRIT NEC-FOREARM 

71184 INF ARTHRITIS NEC-HAND 

71185 INF ARTHRITIS NEC-PELVIS 

71186 INF ARTHRITIS NEC-L/LEG 

71187 INF ARTHRITIS NEC-ANKLE 

71188 INF ARTHRIT NEC-OTH SITE 

71189 INF ARTHRITIS NEC-MULT 

7119 INFECTIVE ARTHRITIS NOS* 

71190 INF ARTHRITIS NOS-UNSPEC 

71191 INF ARTHRITIS NOS-SHLDER 

71192 INF ARTHRITIS NOS-UP/ARM 

71193 INF ARTHRIT NOS-FOREARM 

71194 INF ARTHRIT NOS-HAND 

71195 INF ARTHRIT NOS-PELVIS 

71196 INF ARTHRIT NOS-L/LEG

71197 INF ARTHRIT NOS-ANKLE 

71198 INF ARTHRIT NOS-OTH SITE 

71199 INF ARTHRITIS NOS-MULT 

712 CRYSTAL ARTHROPATHIES* 

7121 CHONDROCALC-DICALC PHOS* 

71210 DICALC PHOS CRYST-UNSPEC 

71211 DICALC PHOS CRYST-SHLDER 

71212 DICALC PHOS CRYST-UP/ARM 

71213 DICALC PHOS CRYS-FOREARM 

71214 DICALC PHOS CRYST-HAND 

71215 DICALC PHOS CRYST-PELVIS 

71216 DICALC PHOS CRYST-L/LEG 

71217 DICALC PHOS CRYST-ANKLE 

71218 DICALC PHOS CRY-SITE NEC 

71219 DICALC PHOS CRYST-MULT 

7122 CHONDROCALCIN-PYROPHOSPH* 

71220 PYROPHOSPH CRYST-UNSPEC 

71221 PYROPHOSPH CRYST-SHLDER 

71222 PYROPHOSPH CRYST-UP/ARM 

71223 PYROPHOSPH CRYST-FOREARM 

71224 PYROPHOSPH CRYST-HAND 

71225 PYROPHOSPH CRYST-PELVIS 

71226 PYROPHOSPH CRYST-L/LEG 

71227 PYROPHOSPH CRYST-ANKLE 

71228 PYROPHOS CRYST-SITE NEC 

71229 PYROPHOS CRYST-MULT 

7123 CHONDROCALCINOSIS NOS* 

71230 CHONDROCALCIN NOS-UNSPEC 

71231 CHONDROCALCIN NOS-SHLDER 

71232 CHONDROCALCIN NOS-UP/ARM 

71233 CHONDROCALC NOS-FOREARM 

71234 CHONDROCALCIN NOS-HAND 

71235 CHONDROCALCIN NOS-PELVIS 

71236 CHONDROCALCIN NOS-L/LEG 

71237 CHONDROCALCIN NOS-ANKLE 

71238 CHONDROCALC NOS-OTH SITE 

71239 CHONDROCALCIN NOS-MULT 

7128 CRYSTAL ARTHROPATHY NEC* 

71280 CRYST ARTHROP NEC-UNSPEC 

71281 CRYST ARTHROP NEC-SHLDER 

71282 CRYST ARTHROP NEC-UP/ARM 

71283 CRYS ARTHROP NEC-FOREARM 

71284 CRYST ARTHROP NEC-HAND 

71285 CRYST ARTHROP NEC-PELVIS 

71286 CRYST ARTHROP NEC-L/LEG 

71287 CRYST ARTHROP NEC-ANKLE 

71288 CRY ARTHROP NEC-OTH SITE 

71289 CRYST ARTHROP NEC-MULT 

7129 CRYSTAL ARTHROPATHY NOS* 

71290 CRYST ARTHROP NOS-UNSPEC 

71291 CRYST ARTHROP NOS-SHLDR 

71292 CRYST ARTHROP NOS-UP/ARM 

71293 CRYS ARTHROP NOS-FOREARM 

71294 CRYST ARTHROP NOS-HAND 

71295 CRYST ARTHROP NOS-PELVIS 

71296 CRYST ARTHROP NOS-L/LEG 

71297 CRYST ARTHROP NOS-ANKLE

71298 CRY ARTHROP NOS-OTH SITE 

71299 CRYST ARTHROP NOS-MULT 

713 ARTHROPATH IN OTHER DIS* 

7130 ARTHROP W ENDOCR/MET DIS 

7131 ARTHROP W NONINF GI DIS 

7132 ARTHROPATH W HEMATOL DIS 

7133 ARTHROPATHY W SKIN DIS 

7134 ARTHROPATHY W RESP DIS 

7135 ARTHROPATHY W NERVE DIS 

7136 ARTHROP W HYPERSEN REACT 

7137 ARTHROP W SYSTEM DIS NEC 

7138 ARTHROP W OTH DIS NEC 

714 OTH INFLAMM POLYARTHROP* 

7140 RHEUMATOID ARTHRITIS 

7141 FELTY'S SYNDROME 

7142 SYST RHEUM ARTHRITIS NEC 

7143 JUV CHRON POLYARTHRITIS* 

71430 JUV RHEUM ARTHRITIS NOS 

71431 POLYART JUV RHEUM ARTHR 

71432 PAUCIART JUV RHEUM ARTHR 

71433 MONOART JUV RHEUM ARTHR 

7144 CHR POSTRHEUM ARTHRITIS 

7148 INFLAM POLYARTHROP NEC* 

71481 RHEUMATOID LUNG 

71489 INFLAMM POLYARTHROP NEC 

7149 INFLAMM POLYARTHROP NOS 

715 OSTEOARTHROSIS ET AL* 

7150 GENERAL OSTEOARTHROSIS* 

71500 GENERAL OSTEOARTHROSIS 

71504 GEN OSTEOARTHROS-HAND 

71509 GENERAL OSTEOARTHROSIS 

7151 LOC PRIMARY OSTEOARTHROS* 

71510 LOC PRIM OSTEOART-UNSPEC 

71511 LOC PRIM OSTEOART-SHLDER 

71512 LOC PRIM OSTEOART-UP/ARM 

71513 LOC PRIM OSTEOART-FORARM 

71514 LOC PRIM OSTEOARTH-HAND 

71515 LOC PRIM OSTEOART-PELVIS 

71516 LOC PRIM OSTEOART-L/LEG 

71517 LOC PRIM OSTEOARTH-ANKLE 

71518 LOC PRIM OSTEOARTHR NEC 

7152 LOCAL 2NDRY OSTEOARTHROS* 

71520 LOC 2ND OSTEOARTH-UNSPEC 

71521 LOC 2ND OSTEOARTH-SHLDER 

71522 LOC 2ND OSTEOARTH-UP/ARM 

71523 LOC 2ND OSTEOART-FOREARM 

71524 LOC 2ND OSTEOARTHRO-HAND 

71525 LOC 2ND OSTEOARTH-PELVIS 

71526 LOC 2ND OSTEOARTHR-L/LEG 

71527 LOC 2ND OSTEOARTHR-ANKLE 

71528 LOC 2ND OSTEOARTHROS NEC 

7153 LOCAL OSTEOARTHROSIS NOS* 

71530 LOC OSTEOARTH NOS-UNSPEC 

71531 LOC OSTEOARTH NOS-SHLDER 

71532 LOC OSTEOARTH NOS-UP/ARM 

71533 LOC OSTEOART NOS-FOREARM 

71534 LOC OSTEOARTH NOS-HAND

71535 LOC OSTEOARTH NOS-PELVIS 

71536 LOC OSTEOARTH NOS-L/LEG 

71537 LOC OSTEOARTH NOS-ANKLE 

71538 LOC OSTEOAR NOS-SITE NEC 

7158 OSTEOARTHROSIS-MULT SITE* 

71580 OSTEOARTHROSIS-MULT SITE 

71589 OSTEOARTHROSIS-MULT SITE 

7159 OSTEOARTHROSIS NOS* 

71590 OSTEOARTHROS NOS-UNSPEC 

71591 OSTEOARTHROS NOS-SHLDER 

71592 OSTEOARTHROS NOS-UP/ARM 

71593 OSTEOARTHROS NOS-FOREARM 

71594 OSTEOARTHROS NOS-HAND 

71595 OSTEOARTHROS NOS-PELVIS 

71596 OSTEOARTHROS NOS-L/LEG 

71597 OSTEOARTHROS NOS-ANKLE 

71598 OSTEOARTHRO NOS-OTH SITE 

716 ARTHROPATHIES NEC/NOS* 

7160 KASCHIN-BECK DISEASE* 

71600 KASCHIN-BECK DIS-UNSPEC 

71601 KASCHIN-BECK DIS-SHLDER 

71602 KASCHIN-BECK DIS-UP/ARM 

71603 KASCHIN-BECK DIS-FOREARM 

71604 KASCHIN-BECK DIS-HAND 

71605 KASCHIN-BECK DIS-PELVIS 

71606 KASCHIN-BECK DIS-L/LEG 

71607 KASCHIN-BECK DIS-ANKLE 

71608 KASCHIN-BECK DIS NEC 

71609 KASCHIN-BECK DIS-MULT 

7161 TRAUMATIC ARTHROPATHY* 

71610 TRAUM ARTHROPATHY-UNSPEC 

71611 TRAUM ARTHROPATHY-SHLDER 

71612 TRAUM ARTHROPATHY-UP/ARM 

71613 TRAUM ARTHROPATH-FOREARM 

71614 TRAUM ARTHROPATHY-HAND 

71615 TRAUM ARTHROPATHY-PELVIS 

71616 TRAUM ARTHROPATHY-L/LEG 

71617 TRAUM ARTHROPATHY-ANKLE 

71618 TRAUM ARTHROPATHY NEC 

71619 TRAUM ARTHROPATHY-MULT 

7162 ALLERGIC ARTHRITIS* 

71620 ALLERG ARTHRITIS-UNSPEC 

71621 ALLERG ARTHRITIS-SHLDER 

71622 ALLERG ARTHRITIS-UP/ARM 

71623 ALLERG ARTHRITIS-FOREARM 

71624 ALLERG ARTHRITIS-HAND 

71625 ALLERG ARTHRITIS-PELVIS 

71626 ALLERG ARTHRITIS-L/LEG 

71627 ALLERG ARTHRITIS-ANKLE 

71628 ALLERG ARTHRITIS NEC 

71629 ALLERG ARTHRITIS-MULT 

7163 CLIMACTERIC ARTHRITIS* 

71630 CLIMACT ARTHRITIS-UNSPEC 

71631 CLIMACT ARTHRITIS-SHLDER 

71632 CLIMACT ARTHRITIS-UP/ARM 

71633 CLIMACT ARTHRIT-FOREARM 

71634 CLIMACT ARTHRITIS-HAND

71635 CLIMACT ARTHRITIS-PELVIS 

71636 CLIMACT ARTHRITIS-L/LEG 

71637 CLIMACT ARTHRITIS-ANKLE 

71638 CLIMACT ARTHRITIS NEC 

71639 CLIMACT ARTHRITIS-MULT 

7164 TRANSIENT ARTHROPATHY* 

71640 TRANS ARTHROPATHY-UNSPEC 

71641 TRANS ARTHROPATHY-SHLDER 

71642 TRANS ARTHROPATHY-UP/ARM 

71643 TRANS ARTHROPATH-FOREARM 

71644 TRANS ARTHROPATHY-HAND 

71645 TRANS ARTHROPATHY-PELVIS 

71646 TRANS ARTHROPATHY-L/LEG 

71647 TRANS ARTHROPATHY-ANKLE 

71648 TRANS ARTHROPATHY NEC 

71649 TRANS ARTHROPATHY-MULT 

7165 POLYARTHRITIS NOS* 

71650 POLYARTHRITIS NOS-UNSPEC 

71651 POLYARTHRITIS NOS-SHLDER 

71652 POLYARTHRITIS NOS-UP/ARM 

71653 POLYARTHRIT NOS-FOREARM 

71654 POLYARTHRITIS NOS-HAND 

71655 POLYARTHRITIS NOS-PELVIS 

71656 POLYARTHRITIS NOS-L/LEG 

71657 POLYARTHRITIS NOS-ANKLE 

71658 POLYARTHRIT NOS-OTH SITE 

71659 POLYARTHRITIS NOS-MULT 

7166 MONOARTHRITIS NOS* 

71660 MONOARTHRITIS NOS-UNSPEC 

71661 MONOARTHRITIS NOS-SHLDER 

71662 MONOARTHRITIS NOS-UP/ARM 

71663 MONOARTHRIT NOS-FOREARM 

71664 MONOARTHRITIS NOS-HAND 

71665 MONOARTHRITIS NOS-PELVIS 

71666 MONOARTHRITIS NOS-L/LEG 

71667 MONOARTHRITIS NOS-ANKLE 

71668 MONOARTHRIT NOS-OTH SITE 

7168 ARTHROPATHY NEC* 

71680 ARTHROPATHY NEC-UNSPEC 

71681 ARTHROPATHY NEC-SHLDER 

71682 ARTHROPATHY NEC-UP/ARM 

71683 ARTHROPATHY NEC-FOREARM 

71684 ARTHROPATHY NEC-HAND 

71685 ARTHROPATHY NEC-PELVIS 

71686 ARTHROPATHY NEC-L/LEG 

71687 ARTHROPATHY NEC-ANKLE 

71688 ARTHROPATHY NEC-OTH SITE 

71689 ARTHROPATHY NEC-MULT 

7169 ARTHROPATHY NOS* 

71690 ARTHROPATHY NOS-UNSPEC 

71691 ARTHROPATHY NOS-SHLDER 

71692 ARTHROPATHY NOS-UP/ARM 

71693 ARTHROPATHY NOS-FOREARM 

71694 ARTHROPATHY NOS-HAND 

71695 ARTHROPATHY NOS-PELVIS 

71696 ARTHROPATHY NOS-L/LEG 

71697 ARTHROPATHY NOS-ANKLE

71698 ARTHROPATHY NOS-OTH SITE 

71699 ARTHROPATHY NOS-MULT 

717 INTERNAL DERANGEMNT KNEE* 

7170 OLD BUCKET TEAR MED MEN 

7171 DERANG ANT MED MENISCUS 

7172 DERANG POST MED MENISCUS 

7173 DERANG MED MENISCUS NEC 

7174 DERANGEMENT LAT MENISCUS* 

71740 DERANG LAT MENISCUS NOS 

71741 OLD BUCKET TEAR LAT MEN 

71742 DERANGE ANT LAT MENISCUS 

71743 DERANG POST LAT MENISCUS 

71749 DERANG LAT MENISCUS NEC 

7175 DERANGEMENT MENISCUS NEC 

7176 LOOSE BODY IN KNEE 

7177 CHONDROMALACIA PATELLAE 

7178 OTH INT DERANGEMENT KNEE* 

71781 OLD DISRUPT LAT COLLAT 

71782 OLD DISRUPT MED COLLAT 

71783 OLD DISRUPT ANT CRUCIATE 

71784 OLD DISRUPT POST CRUCIAT 

71785 OLD DISRUPT KNEE LIG NEC 

71789 INT DERANGEMENT KNEE NEC 

7179 INT DERANGEMENT KNEE NOS 

718 OTHER JOINT DERANGEMENT* 

7180 ARTICULAR CARTILAGE DIS* 

71800 ARTIC CARTIL DIS-UNSPEC 

71801 ARTIC CARTIL DIS-SHLDER 

71802 ARTIC CARTIL DIS-UP/ARM 

71803 ARTIC CARTIL DIS-FOREARM 

71804 ARTIC CARTIL DIS-HAND 

71805 ARTIC CARTIL DIS-PELVIS 

71807 ARTIC CARTIL DIS-ANKLE 

71808 ARTIC CARTIL DIS-JT NEC 

71809 ARTIC CARTIL DIS-MULT JT 

7181 LOOSE BODY IN JOINT* 

71810 LOOSE BODY-UNSPEC 

71811 LOOSE BODY-SHLDER 

71812 LOOSE BODY-UP/ARM 

71813 LOOSE BODY-FOREARM 

71814 LOOSE BODY-HAND 

71815 LOOSE BODY-PELVIS 

71817 LOOSE BODY-ANKLE 

71818 LOOSE BODY-JOINT NEC 

71819 LOOSE BODY-MULT JOINTS 

7182 PATHOLOGICAL DISLOCATION* 

71820 PATHOL DISLOCAT-UNSPEC 

71821 PATHOL DISLOCAT-SHLDER 

71822 PATHOL DISLOCAT-UP/ARM 

71823 PATHOL DISLOCAT-FOREARM 

71824 PATHOL DISLOCAT-HAND 

71825 PATHOL DISLOCAT-PELVIS 

71826 PATHOL DISLOCAT-L/LEG 

71827 PATHOL DISLOCAT-ANKLE 

71828 PATHOL DISLOCAT-JT NEC 

71829 PATHOL DISLOCAT-MULT JTS 

7183 RECURRENT DISLOCATION*

71830 RECUR DISLOCAT-UNSPEC 

71831 RECUR DISLOCAT-SHLDER 

71832 RECUR DISLOCAT-UP/ARM 

71833 RECUR DISLOCAT-FOREARM 

71834 RECUR DISLOCAT-HAND 

71835 RECUR DISLOCAT-PELVIS 

71836 RECUR DISLOCAT-L/LEG 

71837 RECUR DISLOCAT-ANKLE 

71838 RECUR DISLOCAT-JT NEC 

71839 RECUR DISLOCAT-MULT JTS 

7184 CONTRACTURE OF JOINT* 

71840 JT CONTRACTURE-UNSPEC 

71841 JT CONTRACTURE-SHLDER 

71842 JT CONTRACTURE-UP/ARM 

71843 JT CONTRACTURE-FOREARM 

71844 JT CONTRACTURE-HAND 

71845 JT CONTRACTURE-PELVIS 

71846 JT CONTRACTURE-L/LEG 

71847 JT CONTRACTURE-ANKLE 

71848 JT CONTRACTURE-JT NEC 

71849 JT CONTRACTURE-MULT JTS 

7185 ANKYLOSIS OF JOINT* 

71850 ANKYLOSIS-UNSPEC 

71851 ANKYLOSIS-SHOULDER 

71852 ANKYLOSIS-UPPER/ARM 

71853 ANKYLOSIS-FOREARM 

71854 ANKYLOSIS-HAND 

71855 ANKYLOSIS-PELVIS 

71856 ANKYLOSIS-LOWER/LEG 

71857 ANKYLOSIS-ANKLE 

71858 ANKYLOSIS-JOINT NEC 

71859 ANKYLOSIS-MULT JOINTS 

7186 PROTRUSIO ACETABULI NOS* 

71860 PROTRUSIO ACETAB-UNSPEC 

71865 PROTRUSIO ACETABULI NOS 

7188 JOINT DERANGEMENT NEC* 

71880 JT DERANGMNT NEC-UNSP JT 

71881 JT DERANGMENT NEC-SHLDER 

71882 JT DERANGMENT NEC-UP/ARM 

71883 JT DERANGMNT NEC-FOREARM 

71884 JT DERANGEMENT NEC-HAND 

71885 JT DERANGMENT NEC-PELVIS 

71886 JT DERANGEMENT NEC-L/LEG 

71887 JT DERANGEMENT NEC-ANKLE 

71888 JT DERANGMENT NEC-OTH JT 

71889 JT DERANGEMENT NEC-MULT 

7189 DERANGEMENT OF JOINT NOS* 

71890 JT DERANGMNT NOS-UNSP JT 

71891 JT DERANGMENT NOS-SHLDER 

71892 JT DERANGMENT NOS-UP/ARM 

71893 JT DERANGMNT NOS-FOREARM 

71894 JT DERANGEMENT NOS-HAND 

71895 JT DERANGMENT NOS-PELVIS 

71897 JT DERANGEMENT NOS-ANKLE 

71898 JT DERANGMENT NOS-OTH JT 

71899 JT DERANGEMENT NOS-MULT 

719 JOINT DISORDER NEC & NOS*

7190 EFFUSION OF JOINT* 

71900 JOINT EFFUSION-UNSPEC 

71901 JOINT EFFUSION-SHLDER 

71902 JOINT EFFUSION-UP/ARM 

71903 JOINT EFFUSION-FOREARM 

71904 JOINT EFFUSION-HAND 

71905 JOINT EFFUSION-PELVIS 

71906 JOINT EFFUSION-L/LEG 

71907 JOINT EFFUSION-ANKLE 

71908 JOINT EFFUSION-JT NEC 

71909 JOINT EFFUSION-MULT JTS 

7191 HEMARTHROSIS* 

71910 HEMARTHROSIS-UNSPEC 

71911 HEMARTHROSIS-SHLDER 

71912 HEMARTHROSIS-UP/ARM 

71913 HEMARTHROSIS-FOREARM 

71914 HEMARTHROSIS-HAND 

71915 HEMARTHROSIS-PELVIS 

71916 HEMARTHROSIS-L/LEG 

71917 HEMARTHROSIS-ANKLE 

71918 HEMARTHROSIS-JT NEC 

71919 HEMARTHROSIS-MULT JTS 

7192 VILLONODULAR SYNOVITIS* 

71920 VILLONOD SYNOVIT-UNSPEC 

71921 VILLONOD SYNOVIT-SHLDER 

71922 VILLONOD SYNOVIT-UP/ARM 

71923 VILLONOD SYNOVIT-FOREARM 

71924 VILLONOD SYNOVIT-HAND 

71925 VILLONOD SYNOVIT-PELVIS 

71926 VILLONOD SYNOVIT-L/LEG 

71927 VILLONOD SYNOVIT-ANKLE 

71928 VILLONOD SYNOVIT-JT NEC 

71929 VILLONOD SYNOVIT-MULT JT 

7193 PALINDROMIC RHEUMATISM* 

71930 PALINDROM RHEUM-UNSPEC 

71931 PALINDROM RHEUM-SHLDER 

71932 PALINDROM RHEUM-UP/ARM 

71933 PALINDROM RHEUM-FOREARM 

71934 PALINDROM RHEUM-HAND 

71935 PALINDROM RHEUM-PELVIS 

71936 PALINDROM RHEUM-L/LEG 

71937 PALINDROM RHEUM-ANKLE 

71938 PALINDROM RHEUM-JT NEC 

71939 PALINDROM RHEUM-MULT JTS 

7194 PAIN IN JOINT* 

71940 JOINT PAIN-UNSPEC 

71941 JOINT PAIN-SHLDER 

71942 JOINT PAIN-UP/ARM 

71943 JOINT PAIN-FOREARM 

71944 JOINT PAIN-HAND 

71945 JOINT PAIN-PELVIS 

71946 JOINT PAIN-L/LEG 

71947 JOINT PAIN-ANKLE 

71948 JOINT PAIN-JT NEC 

71949 JOINT PAIN-MULT JTS 

7195 STIFFNESS OF JOINT NEC* 

71950 JT STIFFNESS NEC-UNSPEC

71951 JT STIFFNESS NEC-SHLDER 

71952 JT STIFFNESS NEC-UP/ARM 

71953 JT STIFFNES NEC-FOREARM 

71954 JT STIFFNESS NEC-HAND 

71955 JT STIFFNESS NEC-PELVIS 

71956 JT STIFFNESS NEC-L/LEG 

71957 JT STIFFNESS NEC-ANKLE 

71958 JT STIFFNESS NEC-OTH JT 

71959 JT STIFFNESS NEC-MULT JT 

7196 JOINT SYMPTOMS NEC* 

71960 JOINT SYMPT NEC-UNSP JT 

71961 JOINT SYMPTOM NEC-SHLDER 

71962 JOINT SYMPTOM NEC-UP/ARM 

71963 JOINT SYMPT NEC-FOREARM 

71964 JOINT SYMPTOM NEC-HAND 

71965 JOINT SYMPTOM NEC-PELVIS 

71966 JOINT SYMPTOM NEC-L/LEG 

71967 JOINT SYMPTOM NEC-ANKLE 

71968 JOINT SYMPTOM NEC-OTH JT 

71969 JOINT SYMPT NEC-MULT JTS 

7197 DIFFICULTY IN WALKING* 

71970 DIFFICULT WALK-UNSPEC 

71975 DIFFICULT WALK-PELVIS 

71976 DIFFICULT WALK-LO/LEG 

71977 DIFFICULT WALK-FOOT 

71978 DIFFICULT WALK NEC 

71979 DIFFICULT WALK-MULT 

7198 JOINT DISORDERS NEC* 

71980 JOINT DIS NEC-UNSPEC 

71981 JOINT DIS NEC-SHLDER 

71982 JOINT DIS NEC-UP/ARM 

71983 JOINT DIS NEC-FOREARM 

71984 JOINT DIS NEC-HAND 

71985 JOINT DIS NEC-PELVIS 

71986 JOINT DIS NEC-L/LEG 

71987 JOINT DIS NEC-ANKLE 

71988 JOINT DIS NEC-OTH JT 

71989 JOINT DIS NEC-MULT JTS 

7199 JOINT DISORDER NOS* 

71990 JOINT DIS NOS-UNSPEC JT 

71991 JOINT DIS NOS-SHLDER 

71992 JOINT DIS NOS-UP/ARM 

71993 JOINT DIS NOS-FOREARM 

71994 JOINT DIS NOS-HAND 

71995 JOINT DIS NOS-PELVIS 

71996 JOINT DIS NOS-L/LEG 

71997 JOINT DIS NOS-ANKLE 

71998 JOINT DIS NOS-OTH JT 

71999 JOINT DIS NOS-MULT JTS 

720 INFLAM SPONDYLOPATHIES* 

7200 ANKYLOSING SPONDYLITIS 

7201 SPINAL ENTHESOPATHY 

7202 SACROILIITIS NEC 

7208 OTH INFLAM SPONDYLOPATHY* 

72081 SPONDYLOPATHY IN OTH DIS 

72089 INFLAM SPONDYLOPATHY NEC 

7209 INFLAM SPONDYLOPATHY NOS

721 SPONDYLOSIS ET AL* 

7210 CERVICAL SPONDYLOSIS 

7211 CERV SPONDYL W MYELOPATH 

7212 THORACIC SPONDYLOSIS 

7213 LUMBOSACRAL SPONDYLOSIS 

7214 THOR/LUM SPONDYL W MYELO* 

72141 SPOND COMPR THOR SP CORD 

72142 SPOND COMPR LUMB SP CORD 

7215 KISSING SPINE 

7216 ANKYL VERT HYPEROSTOSIS 

7217 TRAUMATIC SPONDYLOPATHY 

7218 SPINAL DISORDERS NEC 

7219 SPONDYLOSIS NOS* 

72190 SPONDYLOS NOS W/O MYELOP 

72191 SPONDYLOSIS NOS W MYELOP 

722 INTERVERTEBRAL DISC DIS* 

7220 CERVICAL DISC DISPLACMNT 

7221 THORAC/LUMB DISC DISPLAC* 

72210 LUMBAR DISC DISPLACEMENT 

72211 THORACIC DISC DISPLACMNT 

7222 DISC DISPLACEMENT NOS 

7223 SCHMORL'S NODES* 

72230 SCHMORL'S NODES NOS 

72231 SCHMORLS NODE-THORACIC 

72232 SCHMORLS NODE-LUMBAR 

72239 SCHMORLS NODE-REGION NEC 

7224 CERVICAL DISC DEGEN 

7225 THORAC/LUMBAR DISC DEGEN* 

72251 THORACIC DISC DEGEN 

72252 LUMB/LUMBOSAC DISC DEGEN 

7226 DISC DEGENERATION NOS 

7227 DISC DIS W MYELOPATHY* 

72270 DISC DIS W MYELOPATH NOS 

72271 CERV DISC DIS W MYELOPAT 

72272 THOR DISC DIS W MYELOPAT 

72273 LUMB DISC DIS W MYELOPAT 

7228 POSTLAMINECTOMY SYNDROME* 

72280 POSTLAMINECTOMY SYND NOS 

72281 POSTLAMINECT SYND-CERV 

72282 POSTLAMINECT SYND-THORAC 

72283 POSTLAMINECT SYND-LUMBAR 

7229 DISC DISORDER NEC/NOS* 

72290 DISC DIS NEC/NOS-UNSPEC 

72291 DISC DIS NEC/NOS-CERV 

72292 DISC DIS NEC/NOS-THORAC 

72293 DISC DIS NEC/NOS-LUMBAR 

723 OTHER CERVICAL SPINE DIS* 

7230 CERVICAL SPINAL STENOSIS 

7231 CERVICALGIA 

7232 CERVICOCRANIAL SYNDROME 

7233 CERVICOBRACHIAL SYNDROME 

7234 BRACHIAL NEURITIS NOS 

7235 TORTICOLLIS NOS 

7236 PANNICULITIS OF NECK 

7237 OSSIFICATION CERV LIG 

7238 CERVICAL SYNDROME NEC 

7239 NECK DISORDER/SYMPT NOS

724 BACK DISORDER NEC & NOS* 

7240 SPINAL STENOSIS NEC* 

72400 SPINAL STENOSIS NOS 

72401 SPINAL STENOSIS-THORACIC 

72402 SPINAL STENOSIS-LUMBAR 

72409 SPINAL STENOSIS-OTH SITE 

7241 PAIN IN THORACIC SPINE 

7242 LUMBAGO 

7243 SCIATICA 

7244 LUMBOSACRAL NEURITIS NOS 

7245 BACKACHE NOS 

7246 DISORDERS OF SACRUM 

7247 DISORDERS OF COCCYX* 

72470 DISORDER OF COCCYX NOS 

72471 HYPERMOBILITY OF COCCYX 

72479 DISORDER OF COCCYX NEC 

7248 OTHER BACK SYMPTOMS 

7249 BACK DISORDER NOS 

725 POLYMYALGIA RHEUMATICA 

726 PERIPH ENTHESOPATHIES* 

7260 ADHESIVE CAPSULIT SHLDER 

7261 ROTATOR CUFF SYNDR ET AL* 

72610 ROTATOR CUFF SYND NOS 

72611 CALCIF TENDINITIS SHLDER 

72612 BICIPITAL TENOSYNOVITIS 

72619 ROTATOR CUFF DIS NEC 

7262 SHOULDER REGION DIS NEC 

7263 ENTHESOPATHY OF ELBOW* 

72630 ELBOW ENTHESOPATHY NOS 

72631 MEDIAL EPICONDYLITIS 

72632 LATERAL EPICONDYLITIS 

72633 OLECRANON BURSITIS 

72639 ELBOW ENTHESOPATHY NEC 

7264 ENTHESOPATHY OF WRIST 

7265 ENTHESOPATHY OF HIP 

7266 ENTHESOPATHY OF KNEE* 

72660 ENTHESOPATHY OF KNEE NOS 

72661 PES ANSERINUS TENDINITIS 

72662 TIBIAL COLL LIG BURSITIS 

72663 FIBULA COLL LIG BURSITIS 

72664 PATELLAR TENDINITIS 

72665 PREPATELLAR BURSITIS 

72669 ENTHESOPATHY OF KNEE NEC 

7267 ENTHESOPATHY OF ANKLE* 

72670 ANKLE ENTHESOPATHY NOS 

72671 ACHILLES TENDINITIS 

72672 TIBIALIS TENDINITIS 

72673 CALCANEAL SPUR 

72679 ANKLE ENTHESOPATHY NEC 

7268 PERIPH ENTHESOPATHY NEC 

7269 ENTHESOPATHY NOS* 

72690 ENTHESOPATHY, SITE NOS 

72691 EXOSTOSIS, SITE NOS 

727 OTH DIS SYNOV/TEND/BURSA* 

7270 SYNOVITIS/TENOSYNOVITIS* 

72700 SYNOVITIS NOS 

72701 SYNOVITIS IN OTH DIS

72702 GIANT CELL TUMOR TENDON 

72703 TRIGGER FINGER 

72704 RADIAL STYLOID TENOSYNOV 

72705 TENOSYNOV HAND/WRIST NEC 

72706 TENOSYNOVITIS FOOT/ANKLE 

72709 SYNOVITIS NEC 

7271 BUNION 

7272 OCCUPATIONAL BURSITIS 

7273 BURSITIS NEC 

7274 JOINT OR TENDON GANGLION* 

72740 SYNOVIAL CYST NOS 

72741 GANGLION OF JOINT 

72742 GANGLION OF TENDON 

72743 GANGLION NOS 

72749 BURSAL CYST NEC 

7275 RUPTURE OF SYNOVIUM* 

72750 RUPTURE OF SYNOVIUM NOS 

72751 POPLITEAL SYNOVIAL CYST 

72759 RUPTURE OF SYNOVIUM NEC 

7276 NONTRAUM TENDON RUPTURE* 

72760 NONTRAUM TENDON RUPT NOS 

72761 ROTATOR CUFF RUPTURE 

72762 BICEPS TENDON RUPTURE 

72763 RUPT EXTEN TENDON HAND 

72764 RUPT FLEXOR TENDON HAND 

72765 RUPTURE QUADRICEP TENDON 

72766 RUPTURE PATELLAR TENDON 

72767 RUPTURE ACHILLES TENDON 

72768 RUPTURE TENDON FOOT NEC 

72769 NONTRAUM TENDON RUPT NEC 

7278 DIS SYNOV/TEND/BURSA NEC* 

72781 CONTRACTURE OF TENDON 

72782 CALCIUM DEPOSIT TENDON 

72789 SYNOV/TEND/BURSA DIS NEC 

7279 SYNOV/TEND/BURSA DIS NOS 

728 DIS OF MUSCLE/LIG/FASCIA* 

7280 INFECTIVE MYOSITIS 

7281 MUSCULAR CALCIFICATION* 

72810 MUSCULAR CALCIFICAT NOS 

72811 PROG MYOSITIS OSSIFICANS 

72812 TRAUM MYOSITIS OSSIFICAN 

72813 POSTOP HETEROTOPIC CALC 

72819 MUSCULAR CALCIFICAT NEC 

7282 MUSC DISUSE ATROPHY NEC 

7283 MUSCLE DISORDERS NEC 

7284 LAXITY OF LIGAMENT 

7285 HYPERMOBILITY SYNDROME 

7286 CONTRACTED PALMAR FASCIA 

7287 OTHER FIBROMATOSES* 

72871 PLANTAR FIBROMATOSIS 

72879 FIBROMATOSES NEC 

7288 OTH MUSCLE/LIGAMENT DIS* 

72881 INTERSTITIAL MYOSITIS 

72882 FB GRANULOMA OF MUSCLE 

72883 NONTRAUM MUSCLE RUPTURE 

72884 DIASTASIS OF MUSCLE 

72885 SPASM OF MUSCLE

72886 NECROTIZING FASCIITIS 

72889 MUSCLE/LIGAMENT DIS NEC 

7289 MUSCLE/LIGAMENT DIS NOS 

729 OTHER SOFT TISSUE DIS* 

7290 RHEUMATISM NOS 

7291 MYALGIA AND MYOSITIS NOS 

7292 NEURALGIA/NEURITIS NOS 

7293 PANNICULITIS NOS* 

72930 PANNICULITIS, UNSP SITE 

72931 HYPERTROPHY OF FAT PAD 

72939 PANNICULITIS, SITE NEC 

7294 FASCIITIS NOS 

7295 PAIN IN LIMB 

7296 OLD FB IN SOFT TISSUE 

7298 OTH MUSCSKEL SYMPT LIMB* 

72981 SWELLING OF LIMB 

72982 CRAMP IN LIMB 

72989 MUSCSKEL SYMPT LIMB NEC 

7299 SOFT TISSUE DIS NEC/NOS 

730 OSTEOMYELITIS* 

7300 ACUTE OSTEOMYELITIS* 

73000 AC OSTEOMYELITIS-UNSPEC 

73001 AC OSTEOMYELITIS-SHLDER 

73002 AC OSTEOMYELITIS-UP/ARM 

73003 AC OSTEOMYELITIS-FOREARM 

73004 AC OSTEOMYELITIS-HAND 

73005 AC OSTEOMYELITIS-PELVIS 

73006 AC OSTEOMYELITIS-L/LEG 

73007 AC OSTEOMYELITIS-ANKLE 

73008 AC OSTEOMYELITIS NEC 

73009 AC OSTEOMYELITIS-MULT 

7301 CHRONIC OSTEOMYELITIS* 

73010 CHR OSTEOMYELITIS-UNSP 

73011 CHR OSTEOMYELIT-SHLDER 

73012 CHR OSTEOMYELIT-UP/ARM 

73013 CHR OSTEOMYELIT-FOREARM 

73014 CHR OSTEOMYELIT-HAND 

73015 CHR OSTEOMYELIT-PELVIS 

73016 CHR OSTEOMYELIT-L/LEG 

73017 CHR OSTEOMYELIT-ANKLE 

73018 CHR OSTEOMYELIT NEC 

73019 CHR OSTEOMYELIT-MULT 

7302 OSTEOMYELITIS NOS* 

73020 OSTEOMYELITIS NOS-UNSPEC 

73021 OSTEOMYELITIS NOS-SHLDER 

73022 OSTEOMYELITIS NOS-UP/ARM 

73023 OSTEOMYELIT NOS-FOREARM 

73024 OSTEOMYELITIS NOS-HAND 

73025 OSTEOMYELITIS NOS-PELVIS 

73026 OSTEOMYELITIS NOS-L/LEG 

73027 OSTEOMYELITIS NOS-ANKLE 

73028 OSTEOMYELIT NOS-OTH SITE 

73029 OSTEOMYELITIS NOS-MULT 

7303 PERIOSTITIS* 

73030 PERIOSTITIS-UNSPEC 

73031 PERIOSTITIS-SHLDER 

73032 PERIOSTITIS-UP/ARM

73033 PERIOSTITIS-FOREARM 

73034 PERIOSTITIS-HAND 

73035 PERIOSTITIS-PELVIS 

73036 PERIOSTITIS-L/LEG 

73037 PERIOSTITIS-ANKLE 

73038 PERIOSTITIS NEC 

73039 PERIOSTITIS-MULT 

7307 POLIO OSTEOPATHY* 

73070 POLIO OSTEOPATHY-UNSPEC 

73071 POLIO OSTEOPATHY-SHLDER 

73072 POLIO OSTEOPATHY-UP/ARM 

73073 POLIO OSTEOPATHY-FOREARM 

73074 POLIO OSTEOPATHY-HAND 

73075 POLIO OSTEOPATHY-PELVIS 

73076 POLIO OSTEOPATHY-L/LEG 

73077 POLIO OSTEOPATHY-ANKLE 

73078 POLIO OSTEOPATHY NEC 

73079 POLIO OSTEOPATHY-MULT 

7308 BONE INFECT IN OTH DIS* 

73080 BONE INFECT NEC-UNSPEC 

73081 BONE INFECT NEC-SHLDER 

73082 BONE INFECT NEC-UP/ARM 

73083 BONE INFECT NEC-FOREARM 

73084 BONE INFECT NEC-HAND 

73085 BONE INFECT NEC-PELVIS 

73086 BONE INFECT NEC-L/LEG 

73087 BONE INFECT NEC-ANKLE 

73088 BONE INFECT NEC-OTH SITE 

73089 BONE INFECT NEC-MULT 

7309 BONE INFECTION NOS* 

73090 BONE INFEC NOS-UNSP SITE 

73091 BONE INFECT NOS-SHLDER 

73092 BONE INFECT NOS-UP/ARM 

73093 BONE INFECT NOS-FOREARM 

73094 BONE INFECT NOS-HAND 

73095 BONE INFECT NOS-PELVIS 

73096 BONE INFECT NOS-L/LEG 

73097 BONE INFECT NOS-ANKLE 

73098 BONE INFECT NOS-OTH SITE 

73099 BONE INFECT NOS-MULT 

731 OSTEITIS DEFORMANS* 

7310 OSTEITIS DEFORMANS NOS 

7311 OSTEITIS DEF IN OTH DIS 

7312 HYPERTROPH OSTEOARTHROP 

7318 BONE INVOLV IN OTH DIS 

732 OSTEOCHONDROPATHIES* 

7320 JUV OSTEOCHONDROS SPINE 

7321 JUV OSTEOCHONDROS PELVIS 

7322 FEMORAL EPIPHYSIOLYSIS 

7323 JUV OSTEOCHONDROSIS ARM 

7324 JUV OSTEOCHONDROSIS LEG 

7325 JUV OSTEOCHONDROSIS FOOT 

7326 JUV OSTEOCHONDROSIS NEC 

7327 OSTEOCHONDRIT DISSECANS 

7328 OSTEOCHONDROPATHY NEC 

7329 OSTEOCHONDROPATHY NOS 

733 OTH BONE & CARTILAGE DIS*

7330 OSTEOPOROSIS* 

73300 OSTEOPOROSIS NOS 

73301 SENILE OSTEOPOROSIS 

73302 IDIOPATHIC OSTEOPOROSIS 

73303 DISUSE OSTEOPOROSIS 

73309 OSTEOPOROSIS NEC 

7331 PATHOLOGICAL FRACTURE* 

73310 PATH FX UNSPECIFIED SITE 

73311 PATH FX HUMERUS 

73312 PATH FX DSTL RADIUS ULNA 

73313 PATH FX VERTEBRAE 

73314 PATH FX NECK OF FEMUR 

73315 PATH FX OTH SPCF PRT FMR 

73316 PATH FX TIBIA FIBULA 

73319 PATH FX OTH SPECIF SITE 

7332 CYST OF BONE* 

73320 CYST OF BONE NOS 

73321 SOLITARY BONE CYST 

73322 ANEURYSMAL BONE CYST 

73329 BONE CYST NEC 

7333 HYPEROSTOSIS OF SKULL 

7334 ASEPTIC NECROSIS OF BONE* 

73340 ASEPT NECROSIS BONE NOS 

73341 ASEPTIC NECROSIS HUMERUS 

73342 ASEPTIC NECROSIS FEMUR 

73343 ASEPT NECRO FEMUR CONDYL 

73344 ASEPTIC NECROSIS TALUS 

73349 ASEPT NECROSIS BONE NEC 

7335 OSTEITIS CONDENSANS 

7336 TIETZE'S DISEASE 

7337 ALGONEURODYSTROPHY 

7338 MALUNION OR NONUNION FX* 

73381 MALUNION OF FRACTURE 

73382 NONUNION OF FRACTURE 

7339 BONE/CARTIL DIS NEC/NOS* 

73390 BONE & CARTILAGE DIS NOS 

73391 ARREST OF BONE GROWTH 

73392 CHONDROMALACIA 

73399 BONE & CARTILAGE DIS NEC 

734 FLAT FOOT 

735 ACQ DEFORMITIES OF TOE* 

7350 HALLUX VALGUS 

7351 HALLUX VARUS 

7352 HALLUX RIGIDUS 

7353 HALLUX MALLEUS 

7354 OTHER HAMMER TOE 

7355 CLAW TOE 

7358 ACQ DEFORMITY OF TOE NEC 

7359 ACQ DEFORMITY OF TOE NOS 

736 OTH ACQ LIMB DEFORMITIES* 

7360 ACQ FOREARM DEFORMITY* 

73600 FOREARM DEFORMITY NOS 

73601 CUBITUS VALGUS 

73602 CUBITUS VARUS 

73603 VALGUS DEFORMITY WRIST 

73604 VARUS DEFORMITY WRIST 

73605 WRIST DROP

73606 CLAW HAND 

73607 CLUB HAND, ACQUIRED 

73609 FOREARM DEFORMITY NEC 

7361 MALLET FINGER 

7362 OTH ACQ FINGER DEFORMITY* 

73620 ACQ FINGER DEFORMITY NOS 

73621 BOUTONNIERE DEFORMITY 

73622 SWAN-NECK DEFORMITY 

73629 ACQ FINGER DEFORMITY NEC 

7363 ACQUIRED HIP DEFORMITY* 

73630 ACQ HIP DEFORMITY NOS 

73631 COXA VALGA 

73632 COXA VARA 

73639 ACQ HIP DEFORMITY NEC 

7364 GENU VALGUM OR VARUM* 

73641 GENU VALGUM 

73642 GENU VARUM 

7365 GENU RECURVATUM 

7366 ACQ KNEE DEFORMITY NEC 

7367 OTH ACQ ANKLE-FOOT DEF* 

73670 ACQ ANKLE-FOOT DEF NOS 

73671 ACQ EQUINOVARUS 

73672 ACQ EQUINUS DEFORMITY 

73673 CAVUS DEFORMITY OF FOOT 

73674 CLAW FOOT, ACQUIRED 

73675 ACQ CAVOVARUS DEFORMITY 

73676 CALCANEUS DEFORMITY NEC 

73679 ACQ ANKLE-FOOT DEF NEC 

7368 ACQ LIMB DEFORMITIES NEC* 

73681 UNEQUAL LEG LENGTH 

73689 OTH ACQ LIMB DEFORMITY 

7369 ACQ LIMB DEFORMITY NOS 

737 CURVATURE OF SPINE* 

7370 ADOLES POSTURAL KYPHOSIS 

7371 KYPHOSIS* 

73710 KYPHOSIS NOS 

73711 RADIATION KYPHOSIS 

73712 POSTLAMINECTOMY KYPHOSIS 

73719 KYPHOSIS NEC 

7372 LORDOSIS* 

73720 LORDOSIS NOS 

73721 POSTLAMINECTOMY LORDOSIS 

73722 OTH POSTSURGERY LORDOSIS 

73729 LORDOSIS NEC 

7373 SCOLIOSIS* 

73730 IDIOPATHIC SCOLIOSIS 

73731 RESOLV IDIOPATH SCOLIOS 

73732 PROGR IDIOPATH SCOLIOSIS 

73733 RADIATION SCOLIOSIS 

73734 THORACOGENIC SCOLIOSIS 

73739 SCOLIOSIS NEC 

7374 SPINAL CURVAT IN OTH DIS* 

73740 SPIN CURV NOS IN OTH DIS 

73741 KYPHOSIS IN OTH DIS 

73742 LORDOSIS IN OTH DIS 

73743 SCOLIOSIS IN OTH DIS 

7378 CURVATURE OF SPINE NEC

7379 CURVATURE OF SPINE NOS 

738 OTHER ACQUIRED DEFORMITY* 

7380 ACQ NOSE DEFORMITY 

7381 ACQ HEAD DEFORMITY NEC* 

73810 UNSPF ACQ DEFORMITY HEAD 

73811 ZYGOMATIC HYPERPLASIA 

73812 ZYGOMATIC HYPOPLASIA 

73819 OTH SPCF DEFORMITY HEAD 

7382 ACQ NECK DEFORMITY 

7383 ACQ CHEST DEFORMITY 

7384 ACQ SPONDYLOLISTHESIS 

7385 OTHER ACQ BACK DEFORMITY 

7386 ACQ PELVIC DEFORMITY 

7387 CAULIFLOWER EAR 

7388 ACQ DEFORMITY NEC 

7389 ACQ DEFORMITY NOS 

739 SOMATIC DYSFUNCTION* 

7390 SOMAT DYS HEAD REGION 

7391 SOMAT DYSFUNC CERVIC REG 

7392 SOMAT DYSFUNC THORAC REG 

7393 SOMAT DYSFUNC LUMBAR REG 

7394 SOMAT DYSFUNC SACRAL REG 

7395 SOMAT DYSFUNC PELVIC REG 

7396 SOMAT DYSFUNC LOWER EXTR 

7397 SOMAT DYSFUNC UPPER EXTR 

7398 SOMAT DYSFUNC RIB CAGE 

7399 SOMATIC DYSFUNCTION NEC 

740 ANENCEPHALUS/SIMIL ANOM* 

7400 ANENCEPHALUS 

7401 CRANIORACHISCHISIS 

7402 INIENCEPHALY 

741 SPINA BIFIDA* 

7410 SPINA BIF W HYDROCEPHAL* 

74100 SPIN BIF W HYDROCEPH NOS 

74101 SPIN BIF W HYDRCEPH-CERV 

74102 SPIN BIF W HYDRCEPH-DORS 

74103 SPIN BIF W HYDRCEPH-LUMB 

7419 SPINA BIFIDA* 

74190 SPINA BIFIDA 

74191 SPINA BIFIDA-CERV 

74192 SPINA BIFIDA-DORSAL 

74193 SPINA BIFIDA-LUMBAR 

742 OTH NERVOUS SYSTEM ANOM* 

7420 ENCEPHALOCELE 

7421 MICROCEPHALUS 

7422 REDUCTION DEFORM, BRAIN 

7423 CONGENITAL HYDROCEPHALUS 

7424 BRAIN ANOMALY NEC 

7425 SPINAL CORD ANOMALY NEC* 

74251 DIASTEMATOMYELIA 

74253 HYDROMYELIA 

74259 SPINAL CORD ANOMALY NEC 

7428 NERVOUS SYSTEM ANOM NEC 

7429 NERVOUS SYSTEM ANOM NOS 

743 CONGENITAL EYE ANOMALY* 

7430 ANOPHTHALMOS* 

74300 CLINIC ANOPHTHALMOS NOS

74303 CONGEN CYSTIC EYEBALL 

74306 CRYPTOPHTHALMOS 

7431 MICROPHTHALMOS* 

74310 MICROPHTHALMOS NOS 

74311 SIMPLE MICROPHTHALMOS 

74312 MICROPHTH W OTH EYE ANOM 

7432 BUPHTHALMOS* 

74320 BUPHTHALMOS NOS 

74321 SIMPLE BUPHTHALMOS 

74322 BUPHTHAL W OTH EYE ANOM 

7433 CONG CATARACT/LENS ANOM* 

74330 CONGENITAL CATARACT NOS 

74331 CAPSULAR CATARACT 

74332 CORTICAL/ZONULAR CATARAC 

74333 NUCLEAR CATARACT 

74334 CONG TOT/SUBTOT CATARACT 

74335 CONGENITAL APHAKIA 

74336 ANOMALIES OF LENS SHAPE 

74337 CONGENITAL ECTOPIC LENS 

74339 CONG CATAR/LENS ANOM NEC 

7434 ANTERIOR SEGMNT ANOM NEC* 

74341 ANOM CORNEAL SIZE/SHAPE 

74342 CONG CORNEA OPAC AFF VIS 

74343 CONG CORNEAL OPACIT NEC 

74344 ANOM ANTER CHAMBER-EYE 

74345 ANIRIDIA 

74346 ANOM IRIS & CIL BODY NEC 

74347 ANOMALIES OF SCLERA 

74348 MULT ANOM ANTER SEG-EYE 

74349 ANOM ANTER SEG NEC-EYE 

7435 CONG ANOM POST SEG-EYE* 

74351 VITREOUS ANOMALIES 

74352 FUNDUS COLOBOMA 

74353 CONG CHORIORETINAL DEGEN 

74354 CONG FOLD/CYST POST EYE 

74355 CONG MACULAR CHANGE-EYE 

74356 CONG RETINAL CHANGES NEC 

74357 OPTIC DISC ANOMALIES 

74358 VASCULAR ANOM POST EYE 

74359 POST SEGMNT ANOM NEC-EYE 

7436 ANOM EYELID/LACRIMAL/ORB* 

74361 CONGENITAL PTOSIS 

74362 CONGENITAL EYELID DEFORM 

74363 SPEC ANOM OF EYELID NEC 

74364 SPEC LACRIMAL GLAND ANOM 

74365 SPEC LACRIMAL PASS ANOM 

74366 SPEC ANOMALY OF ORBIT 

74369 ANOM EYELID/LACR/ORB NEC 

7438 EYE ANOMALIES NEC 

7439 EYE ANOMALY NOS 

744 CONG ANOM EAR/FACE/NECK* 

7440 EAR ANOM W IMPAIR HEAR* 

74400 EAR ANOM NOS/IMPAIR HEAR 

74401 CONG ABSENCE EXT EAR 

74402 EX EAR ANM NEC-IMPR HEAR 

74403 MIDDLE EAR ANOMALY NEC 

74404 ANOMALIES EAR OSSICLES

74405 ANOMALIES OF INNER EAR 

74409 EAR ANOM NEC/IMPAIR HEAR 

7441 ACCESSORY AURICLE 

7442 EAR ANOMALIES NEC* 

74421 CONG ABSENCE OF EAR LOBE 

74422 MACROTIA 

74423 MICROTIA 

74424 EUSTACHIAN TUBE ANOM NEC 

74429 EAR ANOMALIES NEC 

7443 EAR ANOMALY NOS 

7444 BRANCHIAL CLEFT ANOM* 

74441 BRANCH CLEFT SINUS/FISTU 

74442 BRANCHIAL CLEFT CYST 

74443 CERVICAL AURICLE 

74446 PREAURICULAR SINUS/FISTU 

74447 PREAURICULAR CYST 

74449 BRANCHIAL CLEFT ANOM NEC 

7445 WEBBING OF NECK 

7448 CONG FACE/NECK ANOM NEC* 

74481 MACROCHEILIA 

74482 MICROCHEILIA 

74483 MACROSTOMIA 

74484 MICROSTOMIA 

74489 CONG FACE/NECK ANOM NEC 

7449 CONG FACE/NECK ANOM NOS 

745 CARDIAC SEPTAL CLOS ANOM* 

7450 COMMON TRUNCUS 

7451 TRANSPOS OF GREAT VESSEL* 

74510 COMPL TRANSPOS GREAT VES 

74511 DOUBLE OUTLET RT VENTRIC 

74512 CORRECT TRANSPOS GRT VES 

74519 TRANSPOS GREAT VESS NEC 

7452 TETRALOGY OF FALLOT 

7453 COMMON VENTRICLE 

7454 VENTRICULAR SEPT DEFECT 

7455 SECUNDUM ATRIAL SEPT DEF 

7456 ENDOCARD CUSHION DEFECTS* 

74560 ENDOCARD CUSHION DEF NOS 

74561 OSTIUM PRIMUM DEFECT 

74569 ENDOCARD CUSHION DEF NEC 

7457 COR BILOCULARE 

7458 SEPTAL CLOSURE ANOM NEC 

7459 SEPTAL CLOSURE ANOM NOS 

746 OTHER CONGEN HEART ANOM* 

7460 PULMONARY VALVE ANOMALY* 

74600 PULMONARY VALVE ANOM NOS 

74601 CONG PULMON VALV ATRESIA 

74602 CONG PULMON VALVE STENOS 

74609 PULMONARY VALVE ANOM NEC 

7461 CONG TRICUSP ATRES/STEN 

7462 EBSTEIN'S ANOMALY 

7463 CONG AORTA VALV STENOSIS 

7464 CONG AORTA VALV INSUFFIC 

7465 CONGEN MITRAL STENOSIS 

7466 CONG MITRAL INSUFFICIENC 

7467 HYPOPLAS LEFT HEART SYND 

7468 CONG HEART ANOMALY NEC*

74681 CONG SUBAORTIC STENOSIS 

74682 COR TRIATRIATUM 

74683 INFUNDIB PULMON STENOSIS 

74684 OBSTRUCT HEART ANOM NEC 

74685 CORONARY ARTERY ANOMALY 

74686 CONGENITAL HEART BLOCK 

74687 MALPOSITION OF HEART 

74689 CONG HEART ANOMALY NEC 

7469 CONG HEART ANOMALY NOS 

747 OTH CONG CIRC SYST ANOM* 

7470 PATENT DUCTUS ARTERIOSUS 

7471 COARCTATION OF AORTA* 

74710 COARCTATION OF AORTA 

74711 INTERRUPT OF AORTIC ARCH 

7472 CONG ANOM OF AORTA NEC* 

74720 CONG ANOM OF AORTA NOS 

74721 ANOMALIES OF AORTIC ARCH 

74722 AORTIC ATRESIA/STENOSIS 

74729 CONG ANOM OF AORTA NEC 

7473 PULMONARY ARTERY ANOM 

7474 ANOMALIES OF GREAT VEINS* 

74740 GREAT VEIN ANOMALY NOS 

74741 TOT ANOM PULM VEN CONNEC 

74742 PART ANOM PULM VEN CONN 

74749 GREAT VEIN ANOMALY NEC 

7475 UMBILICAL ARTERY ABSENCE 

7476 PERIPH VASCULAR ANOM NEC* 

74760 UNSP PRPHERL VASC ANOMAL 

74761 GSTRONTEST VESL ANOMALY 

74762 RENAL VESSEL ANOMALY 

74763 UPR LIMB VESSEL ANOMALY 

74764 LWR LIMB VESSEL ANOMALY 

74769 OTH SPCF PRPH VSCL ANOML 

7478 CIRCULATORY ANOMALY NEC* 

74781 CEREBROVASCULAR ANOMALY 

74782 SPINAL VESSEL ANOMALY 

74789 CIRCULATORY ANOMALY NEC 

7479 CIRCULATORY ANOMALY NOS 

748 RESPIRATORY SYST ANOMALY* 

7480 CHOANAL ATRESIA 

7481 NOSE ANOMALY NEC 

7482 LARYNGEAL WEB 

7483 LARYNGOTRACH ANOMALY NEC 

7484 CONGENITAL CYSTIC LUNG 

7485 AGENESIS OF LUNG 

7486 OTHER ANOMALIES OF LUNG* 

74860 LUNG ANOMALY NOS 

74861 CONGEN BRONCHIECTASIS 

74869 LUNG ANOMALY NEC 

7488 RESPIRATORY ANOMALY NEC 

7489 RESPIRATORY ANOMALY NOS 

749 CLEFT PALATE & CLEFT LIP* 

7490 CLEFT PALATE* 

74900 CLEFT PALATE NOS 

74901 UNILAT CLEFT PALATE-COMP 

74902 UNILAT CLEFT PALATE-INC 

74903 BILAT CLEFT PALATE-COMPL

74904 BILAT CLEFT PALATE-INC 

7491 CLEFT LIP* 

74910 CLEFT LIP NOS 

74911 UNILAT CLEFT LIP-COMPL 

74912 UNILAT CLEFT LIP-IMCOMPL 

74913 BILAT CLEFT LIP-COMPLETE 

74914 BILAT CLEFT LIP-INCOMPL 

7492 CLEFT PALATE W CLEFT LIP* 

74920 CLEFT PALATE & LIP NOS 

74921 UNIL CLEFT PALAT/LIP-COM 

74922 UNIL CLEFT PALAT/LIP-INC 

74923 BILAT CLFT PALAT/LIP-COM 

74924 BILAT CLFT PALAT/LIP-INC 

74925 CLEFT PALATE & LIP NEC 

750 OTHER UPPER GI ANOMALY* 

7500 TONGUE TIE 

7501 TONGUE ANOMALY NEC* 

75010 TONGUE ANOMALY NOS 

75011 AGLOSSIA 

75012 CONG ADHESIONS OF TONGUE 

75013 CONG FISSURE OF TONGUE 

75015 CONG MACROGLOSSIA 

75016 MICROGLOSSIA 

75019 TONGUE ANOMALY NEC 

7502 MOUTH & PHARYNX ANOM NEC* 

75021 SALIVARY GLAND ABSENCE 

75022 ACCESSORY SALIVARY GLAND 

75023 CONG ATRESIA, SALIV DUCT 

75024 CONG SALIVARY FISTULA 

75025 CONGENITAL LIP FISTULA 

75026 MOUTH ANOMALY NEC 

75027 DIVERTICULUM OF PHARYNX 

75029 PHARYNGEAL ANOMALY NEC 

7503 CONG ESOPH FISTULA/ATRES 

7504 ESOPHAGEAL ANOMALY NEC 

7505 CONG PYLORIC STENOSIS 

7506 CONGENITAL HIATUS HERNIA 

7507 GASTRIC ANOMALY NEC 

7508 UPPER GI ANOMALY NEC 

7509 UPPER GI ANOMALY NOS 

751 OTH ANOM DIGESTIVE SYST* 

7510 MECKEL'S DIVERTICULUM 

7511 ATRESIA SMALL INTESTINE 

7512 ATRESIA LARGE INTESTINE 

7513 HIRSCHSPRUNG'S DISEASE 

7514 INTESTINAL FIXATION ANOM 

7515 INTESTINAL ANOMALY NEC 

7516 BILIARY & LIVER ANOMALY* 

75160 BILIARY & LIVER ANOM NOS 

75161 BILIARY ATRESIA 

75162 CONG CYSTIC LIVER DIS 

75169 BILIARY & LIVER ANOM NEC 

7517 PANCREAS ANOMALIES 

7518 ANOM DIGESTIVE SYST NEC 

7519 ANOM DIGESTIVE SYST NOS 

752 GENITAL ORGAN ANOMALIES* 

7520 ANOMALIES OF OVARIES

7521 TUBAL/BROAD LIG ANOM* 

75210 TUBAL/BROAD LIG ANOM NOS 

75211 EMBRYONIC CYST OF ADNEXA 

75219 TUBAL/BROAD LIG ANOM NEC 

7522 DOUBLING OF UTERUS 

7523 UTERINE ANOMALY NEC 

7524 CERVIX/OTH FEM GEN ANOM* 

75240 CERVIX/FEM GEN ANOM NOS 

75241 EMBRYON CYST FEM GEN NEC 

75242 IMPERFORATE HYMEN 

75249 CERVIX/FEM GEN ANOM NEC 

7525 UNDESCENDED TESTICLE* 

75251 UNDESCENDED TESTIS 

75252 RETRACTILE TESTIS 

7526 MALE HYPOSPADIAS/EPISPAD* 

75261 HYPOSPADIAS 

75262 EPISPADIAS 

75263 CONGENITAL CHORDEE 

75264 MICROPENIS 

75265 HIDDEN PENIS 

75269 PENILE ANOMALIES NEC 

7527 INDETERMINATE SEX 

7528 GENITAL ORGAN ANOM NEC 

7529 GENITAL ORGAN ANOM NOS 

753 URINARY SYSTEM ANOMALIES* 

7530 RENAL AGENESIS 

7531 CYSTIC KIDNEY DISEASE* 

75310 CYSTIC KIDNEY DISEAS NOS 

75311 CONGENITAL RENAL CYST 

75312 POLYCYSTIC KIDNEY NOS 

75313 POLYCYST KID-AUTOSOM DOM 

75314 POLYCYST KID-AUTOSOM REC 

75315 RENAL DYSPLASIA 

75316 MEDULLARY CYSTIC KIDNEY 

75317 MEDULLARY SPONGE KIDNEY 

75319 CYSTIC KIDNEY DISEAS NEC 

7532 CONGEN URETERAL OBSTRUCT* 

75320 OBS DFCT REN PLV&URT NOS 

75321 CONGEN OBST URTROPLV JNC 

75322 CONG OBST URETEROVES JNC 

75323 CONGENITAL URETEROCELE 

75329 OBST DEF REN PLV&URT NEC 

7533 KIDNEY ANOMALY NEC 

7534 URETERAL ANOMALY NEC 

7535 BLADDER EXSTROPHY 

7536 CONGEN URETHRAL STENOSIS 

7537 ANOMALIES OF URACHUS 

7538 CYSTOURETHRAL ANOM NEC 

7539 URINARY ANOMALY NOS 

754 CONG MUSCULOSKEL DEFORM* 

7540 CONG SKULL/FACE/JAW DEF 

7541 CONGENITAL TORTICOLLIS 

7542 CONG POSTURAL DEFORMITY 

7543 CONGEN HIP DISLOCATION* 

75430 CONG HIP DISLOC, UNILAT 

75431 CONGEN HIP DISLOC, BILAT 

75432 CONG HIP SUBLUX, UNILAT

75433 CONG HIP SUBLUX, BILAT 

75435 CONG HIP DISLOC W SUBLUX 

7544 CONG GENU RECURVAT/BOWNG* 

75440 CONG GENU RECURVATUM 

75441 CONG KNEE DISLOCATION 

75442 CONGEN BOWING OF FEMUR 

75443 CONG BOWING TIBIA/FIBULA 

75444 CONG BOWING LEG NOS 

7545 CONG VARUS DEF OF FEET* 

75450 TALIPES VARUS 

75451 TALIPES EQUINOVARUS 

75452 METATARSUS PRIMUS VARUS 

75453 METATARSUS VARUS 

75459 CONG VARUS FOOT DEF NEC 

7546 CONG VALGUS DEF OF FEET* 

75460 TALIPES VALGUS 

75461 CONGENITAL PES PLANUS 

75462 TALIPES CALCANEOVALGUS 

75469 CONG VALGUS FOOT DEF NEC 

7547 OTH CONG FOOT DEFORM* 

75470 TALIPES NOS 

75471 TALIPES CAVUS 

75479 CONG FOOT DEFORM NEC 

7548 OTH NONTERATOGENIC ANOM* 

75481 PECTUS EXCAVATUM 

75482 PECTUS CARINATUM 

75489 NONTERATOGENIC ANOM NEC 

755 OTH CONGEN LIMB ANOMALY* 

7550 POLYDACTYLY* 

75500 POLYDACTYLY NOS 

75501 POLYDACTYLY, FINGERS 

75502 POLYDACTYLY, TOES 

7551 SYNDACTYLY* 

75510 SYNDACTYLY, MULTIPLE/NOS 

75511 SYNDACTYL FING-NO FUSION 

75512 SYNDACTYL FING W FUSION 

75513 SYNDACTYL TOE-NO FUSION 

75514 SYNDACTYL TOE W FUSION 

7552 REDUCT DEFORM UPPER LIMB* 

75520 REDUC DEFORM UP LIMB NOS 

75521 TRANSVERSE DEFIC ARM 

75522 LONGITUD DEFIC ARM NEC 

75523 COMBIN LONGIT DEFIC ARM 

75524 LONGITUDIN DEFIC HUMERUS 

75525 LONGITUD DEFIC RADIOULNA 

75526 LONGITUD DEFIC RADIUS 

75527 LONGITUDINAL DEFIC ULNA 

75528 LONGITUDINAL DEFIC HAND 

75529 LONGITUD DEFIC PHALANGES 

7553 REDUCT DEFORM LOWER LIMB* 

75530 REDUCTION DEFORM LEG NOS 

75531 TRANSVERSE DEFIC LEG 

75532 LONGITUDIN DEFIC LEG NEC 

75533 COMB LONGITUDIN DEF LEG 

75534 LONGITUDINAL DEFIC FEMUR 

75535 TIBIOFIBULA LONGIT DEFIC 

75536 LONGITUDINAL DEFIC TIBIA

75537 LONGITUDIN DEFIC FIBULA 

75538 LONGITUDINAL DEFIC FOOT 

75539 LONGITUD DEFIC PHALANGES 

7554 REDUCT DEFORM LIMB NOS 

7555 OTH UPPER LIMB ANOMALIES* 

75550 UPPER LIMB ANOMALY NOS 

75551 CONG DEFORMITY-CLAVICLE 

75552 CONG ELEVATION-SCAPULA 

75553 RADIOULNAR SYNOSTOSIS 

75554 MADELUNG'S DEFORMITY 

75555 ACROCEPHALOSYNDACTYLY 

75556 ACCESSORY CARPAL BONES 

75557 MACRODACTYLIA (FINGERS) 

75558 CONGENITAL CLEFT HAND 

75559 UPPER LIMB ANOMALY NEC 

7556 OTH LOWER LIMB ANOMALIES* 

75560 LOWER LIMB ANOMALY NOS 

75561 CONGENITAL COXA VALGA 

75562 CONGENITAL COXA VARA 

75563 CONG HIP DEFORMITY NEC 

75564 CONG KNEE DEFORMITY 

75565 MACRODACTYLIA OF TOES 

75566 ANOMALIES OF TOES NEC 

75567 ANOMALIES OF FOOT NEC 

75569 LOWER LIMB ANOMALY NEC 

7558 CONGEN LIMB ANOMALY NEC 

7559 CONGEN LIMB ANOMALY NOS 

756 OTH MUSCULOSKELET ANOMAL* 

7560 ANOMAL SKULL/FACE BONES 

7561 ANOMALIES OF SPINE* 

75610 ANOMALY OF SPINE NOS 

75611 LUMBOSACR SPONDYLOLYSIS 

75612 SPONDYLOLISTHESIS 

75613 CONG ABSENCE OF VERTEBRA 

75614 HEMIVERTEBRA 

75615 CONGEN FUSION OF SPINE 

75616 KLIPPEL-FEIL SYNDROME 

75617 SPINA BIFIDA OCCULTA 

75619 ANOMALY OF SPINE NEC 

7562 CERVICAL RIB 

7563 RIB & STERNUM ANOMAL NEC 

7564 CHONDRODYSTROPHY 

7565 OSTEODYSTROPHIES* 

75650 OSTEODYSTROPHY NOS 

75651 OSTEOGENESIS IMPERFECTA 

75652 OSTEOPETROSIS 

75653 OSTEOPOIKILOSIS 

75654 POLYOSTOTIC FIBROS DYSPL 

75655 CHONDROECTODERM DYSPLAS 

75656 MULT EPIPHYSEAL DYSPLAS 

75659 OSTEODYSTROPHY NEC 

7566 ANOMALIES OF DIAPHRAGM 

7567 ABDOMINAL WALL ANOMALIES* 

75670 CONGN ANOML ABD WALL NOS 

75671 PRUNE BELLY SYNDROME 

75679 CONGN ANOML ABD WALL NEC 

7568 SOFT TISSUE ANOMALY NEC*

75681 ABSENCE OF MUSCLE/TENDON 

75682 ACCESSORY MUSCLE 

75683 EHLERS-DANLOS SYNDROME 

75689 SOFT TISSUE ANOMALY NEC 

7569 MUSCULOSKEL ANOM NEC/NOS 

757 CONGEN SKIN ANOMALIES* 

7570 HEREDITARY EDEMA OF LEGS 

7571 ICHTHYOSIS CONGENITA 

7572 DERMATOGLYPHIC ANOMALIES 

7573 OTHER SKIN ANOMALIES* 

75731 CONG ECTODERMAL DYSPLAS 

75732 VASCULAR HAMARTOMAS 

75733 CONG SKIN PIGMENT ANOMAL 

75739 SKIN ANOMALY NEC 

7574 HAIR ANOMALIES NEC 

7575 NAIL ANOMALIES NEC 

7576 BREAST ANOMALIES NEC 

7578 OTH INTEGUMENT ANOMALIES 

7579 INTEGUMENT ANOMALY NOS 

758 CHROMOSOMAL ANOMALIES* 

7580 DOWN'S SYNDROME 

7581 PATAU'S SYNDROME 

7582 EDWARDS' SYNDROME 

7583 AUTOSOMAL DELETION SYND 

7584 BALANCE AUTOSOM TRANSLOC 

7585 AUTOSOMAL ANOMALIES NEC 

7586 GONADAL DYSGENESIS 

7587 KLINEFELTER'S SYNDROME 

7588 SEX CHROMOSOME ANOM NEC* 

75881 OTH COND DUE TO SEX CHRM 

75889 OTH CON D/T CHRM ANM NEC 

7589 CHROMOSOME ANOMALY NOS 

759 CONGEN ANOMALIES NEC/NOS* 

7590 ANOMALIES OF SPLEEN 

7591 ADRENAL GLAND ANOMALY 

7592 ENDOCRINE ANOMALY NEC 

7593 SITUS INVERSUS 

7594 CONJOINED TWINS 

7595 TUBEROUS SCLEROSIS 

7596 HAMARTOSES NEC 

7597 MULT CONGEN ANOMAL NEC 

7598 CONGENITAL ANOMALIES NEC* 

75981 PRADER-WILLI SYNDROME 

75982 MARFAN SYNDROME 

75983 FRAGILE X SYNDROME 

75989 SPECFIED CONG ANOMAL NEC 

7599 CONGENITAL ANOMALY NOS 

760 MATERN COND AFF FETUS/NB* 

7600 MATERN HYPERTEN AFF NB 

7601 MATERN URINE DIS AFF NB 

7602 MATERNAL INFEC AFF NB 

7603 MATERN CARDIORESP AFF NB 

7604 MATERN NUTRIT DIS AFF NB 

7605 MATERNAL INJURY AFF NB 

7606 SURG OP ON MOTHER AFF NB 

7607 NOXIOUS SUBSTANCE AFF NB* 

76070 NOXIOUS SUBST NOS AFF NB

76071 MATERNAL ALCOHOL AFF NB 

76072 MATERNAL NARCOTIC AFF NB 

76073 MATERNAL HALLUCIN AFF NB 

76074 MATERNAL ANTI-INF AFF NB 

76075 COCAINE - NXS INFL FETUS 

76076 FTS/NB AFCTD MTRNL DES 

76079 NOXIOUS SUBST NEC AFF NB 

7608 MATERNAL COND NEC AFF NB 

7609 MATERNAL COND NOS AFF NB 

761 MATERNAL COMPL AFF NB* 

7610 INCOMPETNT CERVIX AFF NB 

7611 PREMAT RUPT MEMB AFF NB 

7612 OLIGOHYDRAMNIOS AFF NB 

7613 POLYHYDRAMNIOS AFF NB 

7614 ECTOPIC PREGNANCY AFF NB 

7615 MULT PREGNANCY AFF NB 

7616 MATERNAL DEATH AFF NB 

7617 ANTEPART MALPRES AFF NB 

7618 MATERN COMPL NEC AFF NB 

7619 MATERN COMPL NOS AFF NB 

762 COMPL PLACEN/CORD AFF NB* 

7620 PLACENTA PREVIA AFF NB 

7621 PLACENTA HEM NEC AFF NB 

7622 ABN PLAC NEC/NOS AFF NB 

7623 PLACENT TRANSFUSION SYN 

7624 PROLAPSED CORD AFF NB 

7625 OTH UMBIL CORD COMPRESS 

7626 UMBIL COND NEC AFF NB 

7627 CHORIOAMNIONITIS AFF NB 

7628 ABN AMNION NEC AFF NB 

7629 ABN AMNION NOS AFF NB 

763 OTH COMPL DELIV AFF NB* 

7630 BREECH DEL/EXTRAC AFF NB 

7631 MALPOS/DISPRO NEC AFF NB 

7632 FORCEPS DELIVERY AFF NB 

7633 VACUUM EXTRAC DEL AFF NB 

7634 CESAREAN DELIVERY AFF NB 

7635 MAT ANESTH/ANALG AFF NB 

7636 PRECIPITATE DEL AFF NB 

7637 ABN UTERINE CONTR AFF NB 

7638 COMPL DELIV NEC AFF NB* 

76381 AB FTL HRT RT/RH B/F LAB 

76382 AB FTL HRT RT/RH DUR LAB 

76383 AB FTL HRT RT/RHY NOS 

76389 COMPL DEL NEC AFF NB 

7639 COMPL DELIV NOS AFF NB 

7640 LT-FOR-DATES W/O FET MAL* 

76400 LIGHT-FOR-DATES WTNOS 

76401 LIGHT-FOR-DATES

7641 LT-FOR-DATES W FETAL MAL* 

76410 LT-FOR-DATE W/MAL WTNOS 

76411 LT-FOR-DATE W/MAL

7661 HEAVY-FOR-DATE INFAN NEC 

7662 POST-TERM INFANT NOS 

767 BIRTH TRAUMA* 

7670 CEREBRAL HEM AT BIRTH 

7671 SCALP INJURY AT BIRTH 

7672 CLAVICLE FX AT BIRTH 

7673 BONE INJURY NEC AT BIRTH 

7674 SPINAL CORD INJ AT BIRTH 

7675 FACIAL NERVE INJ-BIRTH 

7676 BRACH PLEXUS INJ-BIRTH 

7677 NERVE INJ NEC AT BIRTH 

7678 BIRTH TRAUMA NEC 

7679 BIRTH TRAUMA NOS 

768 INTRAUTERINE ASPHYXIA* 

7680 FETAL DEATH-ANOXIA NOS 

7681 FET DEATH-ANOXIA DUR LAB 

7682 FET DISTRESS BEFOR LABOR 

7683 FETAL DISTRESS DUR LABOR 

7684 FETAL DISTRESS NOS 

7685 SEVERE BIRTH ASPHYXIA 

7686 MILD/MOD BIRTH ASPHYXIA 

7689 BIRTH ASPHYXIA NOS 

769 RESPIRATORY DISTRESS SYN 

770 OTH NB RESPIRATORY COND* 

7700 CONGENITAL PNEUMONIA 

7701 MECONIUM ASPIRATN SYNDRM 

7702 NB INTERSTIT EMPHYSEMA 

7703 NB PULMONARY HEMORRHAGE 

7704 PRIMARY ATELECTASIS 

7705 NB ATELECTASIS NEC/NOS 

7706 NB TRANSITORY TACHYPNEA 

7707 PERINATAL CHR RESP DIS 

7708 POST-BIRTH RESP PROB NEC 

7709 NB RESPIRATORY COND NOS 

771 PERINATAL INFECTION* 

7710 CONGENITAL RUBELLA 

7711 CONG CYTOMEGALOVIRUS INF 

7712 CONGENITAL INFEC NEC 

7713 TETANUS NEONATORUM 

7714 OMPHALITIS OF NEWBORN 

7715 NEONATAL INFEC MASTITIS 

7716 NEONATAL CONJUNCTIVITIS 

7717 NEONATAL CANDIDA INFECT 

7718 PERINATAL INFECTION NEC 

772 FETAL/NEONATAL HEMORRHAG* 

7720 FETAL BLOOD LOSS NEC 

7721 NB INTRAVENTRICULAR HEM 

7722 NB SUBARACHNOID HEMORR 

7723 POST-BIRTH UMBIL HEMORR 

7724 NB GI HEMORRHAGE 

7725 NB ADRENAL HEMORRHAGE 

7726 NB CUTANEOUS HEMORRHAGE 

7728 NEONATAL HEMORRHAGE NEC 

7729 NEONATAL HEMORRHAGE NOS 

773 NB HEMOLYT DIS:ISOIMMU* 

7730 NB HEMOLYT DIS:RH ISOIMM 

7731 NB HEMOLYT DIS-ABO ISOIM

7732 NB HEMOLYT DIS-ISOIM NEC 

7733 HYDROPS FETALIS:ISOIMM 

7734 NB KERNICTERUS:ISOIMMUN 

7735 NB LATE ANEMIA:ISOIMMUN 

774 OTHER PERINATAL JAUNDICE* 

7740 PERINAT JAUND-HERED ANEM 

7741 PERINAT JAUND:HEMOLYSIS 

7742 NEONAT JAUND PRETERM DEL 

7743 OTH DELAY CONJUGAT JAUND* 

77430 DELAY CONJUGAT JAUND NOS 

77431 NEONAT JAUND IN OTH DIS 

77439 DELAY CONJUGAT JAUND NEC 

7744 FETAL/NEONATAL HEPATITIS 

7745 PERINATAL JAUNDICE NEC 

7746 FETAL/NEONATAL JAUND NOS 

7747 NB KERNICTERUS 

775 NB ENDOCRIN/METABOL DIS* 

7750 INFANT DIABET MOTHER SYN 

7751 NEONAT DIABETES MELLITUS 

7752 NEONAT MYASTHENIA GRAVIS 

7753 NEONATAL THYROTOXICOSIS 

7754 HYPOCALCEM/HYPOMAGNES NB 

7755 NEONATAL DEHYDRATION 

7756 NEONATAL HYPOGLYCEMIA 

7757 LATE METAB ACIDOSIS NB 

7758 TRANSIENT MET DIS NB NEC 

7759 TRANSIENT MET DIS NB NOS 

776 HEMATOLOGICAL DIS OF NB* 

7760 NB HEMORRHAGIC DISEASE 

7761 NEONATAL THROMBOCYTOPEN 

7762 DISSEM INTRAVASC COAG NB 

7763 OTH NEONATAL COAG DIS 

7764 POLYCYTHEMIA NEONATORUM 

7765 CONGENITAL ANEMIA 

7766 ANEMIA OF PREMATURITY 

7767 NEONATAL NEUTROPENIA 

7768 TRANSIENT HEMAT DIS NEC 

7769 NB HEMATOLOGICAL DIS NOS 

777 PERINATAL GI SYSTEM DIS* 

7771 MECONIUM OBSTRUCTION 

7772 INTEST OBST-INSPISS MILK 

7773 SWALLOWED BLOOD SYNDROME 

7774 TRANSITORY ILEUS OF NB 

7775 NECROT ENTEROCOLITIS NB 

7776 PERINATAL INTEST PERFOR 

7778 PERINAT GI SYS DIS NEC 

7779 PERINAT GI SYS DIS NOS 

778 INTEGUMENT/TEMP COND NB* 

7780 HYDROPS FETALIS NO ISOIM 

7781 SCLEREMA NEONATORUM 

7782 NB COLD INJURY SYNDROME 

7783 NB HYPOTHERMIA NEC 

7784 NB TEMP REGULAT DIS NEC 

7785 EDEMA OF NEWBORN NEC/NOS 

7786 CONGENITAL HYDROCELE 

7787 NB BREAST ENGORGEMENT 

7788 NB INTEGUMENT COND NEC

7789 NB INTEGUMENT COND NOS 

779 OTH PERINATAL CONDITION* 

7790 CONVULSIONS IN NEWBORN 

7791 NB CEREB IRRIT NEC/NOS 

7792 CNS DYSFUNCTION SYN NB 

7793 NB FEEDING PROBLEMS 

7794 NB DRUG REACTION/INTOXIC 

7795 NB DRUG WITHDRAWAL SYNDR 

7796 TERMINATION OF PREGNANCY 

7798 PERINATAL CONDITION NEC 

7799 PERINATAL CONDITION NOS 

780 GENERAL SYMPTOMS* 

7800 COMA AND STUPOR* 

78001 COMA 

78002 TRANS ALTER AWARENESS 

78003 PERSISTENT VEGTV STATE 

78009 OTHER ALTER CONSCIOUSNES 

7801 HALLUCINATIONS 

7802 SYNCOPE AND COLLAPSE 

7803 CONVULSIONS* 

78031 FEBRILE CONVULSIONS 

78039 CONVULSIONS NEC 

7804 DIZZINESS AND GIDDINESS 

7805 SLEEP DISTURBANCES* 

78050 SLEEP DISTURBANCE NOS 

78051 INSOMNIA W SLEEP APNEA 

78052 INSOMNIA NEC 

78053 HYPERSOMNI W SLEEP APNEA 

78054 HYPERSOMNIA NEC 

78055 IRREG SLEEP-WAKE RHY NOS 

78056 SLEEP STAGE DYSFUNCTIONS 

78057 OTH UNSPCF SLEEP APNEA 

78059 SLEEP DISTURBANCES NEC 

7806 FEVER 

7807 MALAISE AND FATIGUE* 

78071 CHRONIC FATIGUE SYNDROME 

78079 MALAISE AND FATIGUE NEC 

7808 HYPERHIDROSIS 

7809 GENERAL SYMPTOMS NEC 

781 NERV/MUSCULSKEL SYS SYMP* 

7810 ABN INVOLUN MOVEMENT NEC 

7811 SMELL & TASTE DISTURB 

7812 ABNORMALITY OF GAIT 

7813 LACK OF COORDINATION 

7814 TRANSIENT LIMB PARALYSIS 

7815 CLUBBING OF FINGERS 

7816 MENINGISMUS 

7817 TETANY 

7818 NEUROLOGIC NEGLECT SYNDR 

7819 NERV/MUSCULSKEL SYM NEC 

782 SKIN/OTH INTEGUMENT SYMP* 

7820 SKIN SENSATION DISTURB 

7821 NONSPECIF SKIN ERUPT NEC 

7822 LOCAL SUPRFICIAL SWELLNG 

7823 EDEMA 

7824 JAUNDICE NOS 

7825 CYANOSIS

7826 PALLOR & FLUSHING* 

78261 PALLOR 

78262 FLUSHING 

7827 SPONTANEOUS ECCHYMOSES 

7828 CHANGES IN SKIN TEXTURE 

7829 INTEGUMENT TISS SYMP NEC 

783 NUTRIT/METAB/DEVEL SYMP* 

7830 ANOREXIA 

7831 ABNORMAL WEIGHT GAIN 

7832 ABNORMAL LOSS OF WEIGHT 

7833 FEEDING PROBLEM 

7834 LACK NORM PHYSIOL DEVEL 

7835 POLYDIPSIA 

7836 POLYPHAGIA 

7839 NUTR/METAB/DEVEL SYM NEC 

784 SYMPTOMS INVOL HEAD/NECK* 

7840 HEADACHE 

7841 THROAT PAIN 

7842 SWELLING IN HEAD & NECK 

7843 APHASIA 

7844 VOICE DISTURBANCE* 

78440 VOICE DISTURBANCE NOS 

78441 APHONIA 

78449 VOICE DISTURBANCE NEC 

7845 SPEECH DISTURBANCE NEC 

7846 OTH SYMBOLIC DYSFUNCTION* 

78460 SYMBOLIC DYSFUNCTION NOS 

78461 ALEXIA AND DYSLEXIA 

78469 SYMBOLIC DYSFUNCTION NEC 

7847 EPISTAXIS 

7848 HEMORRHAGE FROM THROAT 

7849 SYMP INVOL HEAD/NECK NEC 

785 CARDIOVASCULAR SYS SYMP* 

7850 TACHYCARDIA NOS 

7851 PALPITATIONS 

7852 CARDIAC MURMURS NEC 

7853 ABNORM HEART SOUNDS NEC 

7854 GANGRENE 

7855 SHOCK WITHOUT TRAUMA* 

78550 SHOCK NOS 

78551 CARDIOGENIC SHOCK 

78559 SHOCK W/O TRAUMA NEC 

7856 ENLARGEMENT LYMPH NODES 

7859 CARDIOVAS SYS SYMP NEC 

786 RESP SYS/OTH CHEST SYMP* 

7860 DYSPNEA/RESPIRATORY ABN* 

78600 RESPIRATORY ABNORM NOS 

78601 HYPERVENTILATION 

78602 ORTHOPNEA 

78603 APNEA 

78604 CHEYNE-STOKES RESPIRATN 

78605 SHORTNESS OF BREATH 

78606 TACHYPNEA 

78607 WHEEZING 

78609 RESPIRATORY ABNORM NEC 

7861 STRIDOR 

7862 COUGH

7863 HEMOPTYSIS 

7864 ABNORMAL SPUTUM 

7865 CHEST PAIN* 

78650 CHEST PAIN NOS 

78651 PRECORDIAL PAIN 

78652 PAINFUL RESPIRATION 

78659 CHEST PAIN NEC 

7866 CHEST SWELLING/MASS/LUMP 

7867 ABNORMAL CHEST SOUNDS 

7868 HICCOUGH 

7869 RESP SYS/CHEST SYMP NEC 

787 GI SYSTEM SYMPTOMS* 

7870 NAUSEA AND VOMITING* 

78701 NAUSEA WITH VOMITING 

78702 NAUSEA ALONE 

78703 VOMITING ALONE 

7871 HEARTBURN 

7872 DYSPHAGIA 

7873 FLATUL/ERUCTAT/GAS PAIN 

7874 VISIBLE PERISTALSIS 

7875 ABNORMAL BOWEL SOUNDS 

7876 INCONTINENCE OF FECES 

7877 ABNORMAL FECES 

7879 GI SYSTEM SYMPTOMS NEC* 

78791 DIARRHEA 

78799 DIGESTVE SYST SYMPTM NEC 

788 URINARY SYSTEM SYMPTOMS* 

7880 RENAL COLIC 

7881 DYSURIA 

7882 RETENTION OF URINE* 

78820 RETENTION URINE NOS 

78821 INCMPLET BLDDER EMPTYING 

78829 OTH SPCF RETENTION URINE 

7883 INCONTINENCE OF URINE* 

78830 URINARY INCONTINENCE NOS 

78831 URGE INCONTINENCE 

78832 STRESS INCONTINENCE MALE 

78833 MIXED INCONTINENCE 

78834 INCONTNCE WO SENSR AWARE 

78835 POST-VOID DRIBBLING 

78836 NOCTURNAL ENURESIS 

78837 CONTINUOUS LEAKAGE 

78839 OTH URINRY INCONTINENCE 

7884 FREQ URINATION/POLYURIA* 

78841 URINARY FREQUENCY 

78842 POLYURIA 

78843 NOCTURIA 

7885 OLIGURIA & ANURIA 

7886 URINATION ABNORM NEC* 

78861 SPLITTING URINARY STREAM 

78862 SLOWING URINARY STREAM 

78869 OTH ABNORMALT URINATION 

7887 URETHRAL DISCHARGE 

7888 EXTRAVASATION OF URINE 

7889 URINARY SYS SYMPTOM NEC 

789 OTH ABDOMEN/PELVIS SYMP* 

7890 ABDOMINAL PAIN*

78900 ABDMNAL PAIN UNSPCF SITE 

78901 ABDMNAL PAIN RT UPR QUAD 

78902 ABDMNAL PAIN LFT UP QUAD 

78903 ABDMNAL PAIN RT LWR QUAD 

78904 ABDMNAL PAIN LT LWR QUAD 

78905 ABDMNAL PAIN PERIUMBILIC 

78906 ABDMNAL PAIN EPIGASTRIC 

78907 ABDMNAL PAIN GENERALIZED 

78909 ABDMNAL PAIN OTH SPCF ST 

7891 HEPATOMEGALY 

7892 SPLENOMEGALY 

7893 ABDOM/PELVIC SWELLNG NEC* 

78930 ABDMNAL MASS UNSPCF SITE 

78931 ABDMNAL MASS RT UPR QUAD 

78932 ABDMNAL MASS LFT UP QUAD 

78933 ABDMNAL MASS RT LWR QUAD 

78934 ABDMNAL MASS LT LWR QUAD 

78935 ABDMNAL MASS PERIUMBILIC 

78936 ABDMNAL MASS EPIGASTRIC 

78937 ABDMNAL MASS GENERALIZED 

78939 ABDMNAL MASS OTH SPCF ST 

7894 ABDOMINAL RIGIDITY* 

78940 ABDMNAL RGDT UNSPCF SITE 

78941 ABDMNAL RGDT RT UPR QUAD 

78942 ABDMNAL RGDT LFT UP QUAD 

78943 ABDMNAL RGDT RT LWR QUAD 

78945 ABDMNAL RGDT PERIUMBILIC 

78946 ABDMNAL RGDT EPIGASTRIC 

78947 ABDMNAL RGDT GENERALIZED 

78949 ABDMNAL RGDT OTH SPCF ST 

7895 ASCITES 

78960 ABDMNAL TNDR UNSPCF SITE 

78961 ABDMNAL TNDR RT UPR QUAD 

78962 ABDMNAL TNDR LFT UP QUAD 

78963 ABDMNAL TNDR RT LWR QUAD 

78964 ABDMNAL TNDR LT LWR QUAD 

78965 ABDMNAL TNDR PERIUMBILIC 

78966 ABDMNAL TNDR EPIGASTRIC 

78967 ABDMNAL TNDR GENERALIZED 

78969 ABDMNAL TNDR OTH SPCF ST 

7899 ABDOMEN/PELVIS SYMP NEC 

790 ABNORMAL BLOOD FINDINGS* 

7900 ABNORM RED BLOOD CELL 

7901 ELEVATED SEDIMENT RATE 

7902 ABN GLUCOSE TOLERAN TEST 

7903 EXCESS BLOOD-ALCOHOL LEV 

7904 ELEV TRANSAMINASE/LDH 

7905 ABN SERUM ENZY LEVEL NEC 

7906 ABN BLOOD CHEMISTRY NEC 

7907 BACTEREMIA 

7908 VIREMIA NOS 

7909 ABN BLOOD FINDINGS NEC* 

79091 ABNRML ART BLOOD GASES 

79092 ABNRML COAGULTION PRFILE 

79093 ELVTD PRSTATE SPCF ANTGN 

79094 EUTHYROID SICK SYNDROME 

79099 OTH NSPCF FINDING BLOOD

791 ABNORMAL URINE FINDINGS* 

7910 PROTEINURIA 

7911 CHYLURIA 

7912 HEMOGLOBINURIA 

7913 MYOGLOBINURIA 

7914 BILIURIA 

7915 GLYCOSURIA 

7916 ACETONURIA 

7917 OTH CELLS/CASTS IN URINE 

7919 ABN URINE FINDINGS NEC 

792 ABN FIND-OTH BODY SUBST* 

7920 ABN FND-CEREBROSPINAL FL 

7921 ABN FIND-STOOL CONTENTS 

7922 ABN FINDINGS-SEMEN 

7923 ABN FIND-AMNIOTIC FLUID 

7924 ABN FINDINGS-SALIVA 

7929 ABN FIND-BODY SUBST NEC 

793 ABN FIND-BODY STRUCT NOS* 

7930 ABN FINDING-SKULL & HEAD 

7931 ABN FINDINGS-LUNG FIELD 

7932 ABN FD-INTRATHOR ORG NEC 

7933 ABN FIND-BILIARY TRACT 

7934 ABN FINDINGS-GI TRACT 

7935 ABN FINDINGS-GU ORGANS 

7936 ABN FIND-ABDOMINAL AREA 

7937 ABN FIND-MUSCULOSKEL SYS 

7938 ABNORMAL FINDINGS-BREAST 

7939 ABN FIND-BODY STRUCT NEC 

794 ABNORMAL FUNCTION STUDY* 

7940 ABN BRAIN/CNS FUNC STUDY* 

79400 ABN CNS FUNCT STUDY NOS 

79401 ABNORM ECHOENCEPHALOGRAM 

79402 ABN ELECTROENCEPHALOGRAM 

79409 ABN CNS FUNCT STUDY NEC 

7941 ABN PERIPHER NERVE STUDY* 

79410 ABN STIMUL RESPONSE NOS 

79411 ABN RETINAL FUNCT STUDY 

79412 ABNORM ELECTRO-OCULOGRAM 

79413 ABNORMAL VEP 

79414 ABN OCULOMOTOR STUDIES 

79415 ABN AUDITORY FUNCT STUDY 

79416 ABN VESTIBULAR FUNC STUD 

79417 ABNORM ELECTROMYOGRAM 

79419 ABN PERIPH NERV STUD NEC 

7942 ABN PULMONARY FUNC STUDY 

7943 ABN CARDIOVAS FUNC STUDY* 

79430 ABN CARDIOVASC STUDY NOS 

79431 ABNORM ELECTROCARDIOGRAM 

79439 ABN CARDIOVASC STUDY NEC 

7944 ABN KIDNEY FUNCT STUDY 

7945 ABN THYROID FUNCT STUDY 

7946 ABN ENDOCRINE STUDY NEC 

7947 ABN BASAL METABOL STUDY 

7948 ABN LIVER FUNCTION STUDY 

7949 ABN FUNCTION STUDY NEC 

795 ABN HISTOLOG/IMMUNO FIND* 

7950 ABN PAP SMEAR-CERVIX

7951 ABN PAP SMEAR-OTH SITE 

7952 ABN CHROMOSOMAL ANALYSIS 

7953 POSITIVE CULTURE FINDING 

7954 ABN HISTOLOGIC FIND NEC 

7955 TUBERCULIN TEST REACTION 

7956 FALSE POS SERO TEST-SYPH 

7957 IMMUNOLOGICAL FIND NEC* 

79571 NONSPCF SERLGC EVDNC HIV 

79579 OTH UNSPCF NSPF IMUN FND 

796 OTHER ABNORMAL FINDINGS* 

7960 ABN TOXICOLOGIC FINDING 

7961 ABNORMAL REFLEX 

7962 ELEV BL PRES W/O HYPERTN 

7963 LOW BLOOD PRESS READING 

7964 ABN CLINICAL FINDING NEC 

7965 ABN FIND ANTENATL SCREEN 

7969 ABNORMAL FINDINGS NEC 

797 SENILITY W/O PSYCHOSIS 

798 SUDDEN DEATH CAUSE UNKNW* 

7980 SUDDEN INFANT DEATH SYND 

7981 INSTANTANEOUS DEATH 

7982 DEATH WITHIN 24 HR SYMPT 

7989 UNATTENDED DEATH 

799 OTH ILL-DEF MORBID/MORTL* 

7990 ASPHYXIA 

7991 RESPIRATORY ARREST 

7992 NERVOUSNESS 

7993 DEBILITY NOS 

7994 CACHEXIA 

7998 ILL-DEFINE CONDITION NEC 

7999 UNKN CAUSE MORB/MORT NEC 

800 SKULL VAULT FRACTURE* 

8000 CLOSED SKULL VAULT FX* 

80000 CLOSED SKULL VAULT FX 

80001 CL SKULL VLT FX W/O COMA 

80002 CL SKULL VLT FX-BRF COMA 

80003 CL SKULL VLT FX-MOD COMA 

80004 CL SKL VLT FX-PROLN COMA 

80005 CL SKUL VLT FX-DEEP COMA 

80006 CL SKULL VLT FX-COMA NOS 

80009 CL SKL VLT FX-CONCUS NOS 

8001 CL SKL VLT FX/CEREBR LAC* 

80010 CL SKL VLT FX/CEREBR LAC 








8002 CL SKL VLT FX/MENING HEM* 

80020 CL SKL VLT FX/MENING HEM 





80025 CL SKUL VLT FX-DEEP COMA



8003 CL SKULL VLT FX/HEM NEC* 

80030 CL SKULL VLT FX/HEM NEC 








8004 CL SKL VLT FX/BR INJ NEC* 

80040 CL SKL VLT FX/BR INJ NEC 








8005 OPN SKULL VAULT FRACTURE* 

80050 OPN SKULL VAULT FRACTURE 

80051 OPN SKUL VLT FX W/O COMA 

80052 OPN SKUL VLT FX-BRF COMA 

80053 OPN SKUL VLT FX-MOD COMA 

80054 OPN SKL VLT FX-PROLN COM 

80055 OPN SKL VLT FX-DEEP COMA 

80056 OPN SKUL VLT FX-COMA NOS 

80059 OP SKL VLT FX-CONCUS NOS 

8006 OPN SKL VLT FX/CEREB LAC* 

80060 OPN SKL VLT FX/CEREB LAC 








8007 OPN SKL VLT FX/MENIN HEM* 

80070 OPN SKL VLT FX/MENIN HEM 








8008 OPN SKULL VLT FX/HEM NEC* 

80080 OPN SKULL VLT FX/HEM NEC 








8009 OP SKL VLT FX/BR INJ NEC*

80090 OP SKL VLT FX/BR INJ NEC 





80095 OP SKUL VLT FX-DEEP COMA 



801 SKULL BASE FRACTURE* 

8010 CLOS SKULL BASE FRACTURE* 

80100 CLOS SKULL BASE FRACTURE 

80101 CL SKUL BASE FX W/O COMA 

80102 CL SKUL BASE FX-BRF COMA 

80103 CL SKUL BASE FX-MOD COMA 

80104 CL SKL BASE FX-PROL COMA 

80105 CL SKL BASE FX-DEEP COMA 

80106 CL SKUL BASE FX-COMA NOS 

80109 CL SKULL BASE FX-CONCUSS 

8011 CL SKL BASE FX/CEREB LAC* 

80110 CL SKL BASE FX/CEREB LAC 








8012 CL SKL BASE FX/MENIN HEM* 

80120 CL SKL BASE FX/MENIN HEM 


80122 CL SKUL BASE FX/BRF COMA 






8013 CL SKULL BASE FX/HEM NEC* 

80130 CL SKULL BASE FX/HEM NEC 








8014 CL SK BASE FX/BR INJ NEC* 

80140 CL SK BASE FX/BR INJ NEC 








8015 OPEN SKULL BASE FRACTURE* 

80150 OPEN SKULL BASE FRACTURE 

80151 OPN SKL BASE FX W/O COMA

80152 OPN SKL BASE FX-BRF COMA 

80153 OPN SKL BASE FX-MOD COMA 

80154 OP SKL BASE FX-PROL COMA 

80155 OP SKL BASE FX-DEEP COMA 

80156 OPN SKL BASE FX-COMA NOS 

80159 OPN SKUL BASE FX-CONCUSS 

8016 OP SKL BASE FX/CEREB LAC* 

80160 OP SKL BASE FX/CEREB LAC 

80161 OPN SKL BASE FX W/O COMA 







8017 OP SKL BASE FX/MENIN HEM* 

80170 OP SKL BASE FX/MENIN HEM 








8018 OPN SKUL BASE FX/HEM NEC* 

80180 OPN SKUL BASE FX/HEM NEC 








8019 OP SK BASE FX/BR INJ NEC* 

80190 OP SK BASE FX/BR INJ NEC 

80191 OP SKUL BASE FX W/O COMA 







802 FRACTURE OF FACE BONES* 

8020 NASAL BONE FX-CLOSED 

8021 NASAL BONE FX-OPEN 

8022 MANDIBLE FRACTURE-CLOSED* 

80220 MANDIBLE FX NOS-CLOSED 

80221 FX CONDYL PROC MANDIB-CL 

80222 SUBCONDYLAR FX MANDIB-CL 

80223 FX CORON PROC MANDIB-CL 

80224 FX RAMUS NOS-CLOSED 

80225 FX ANGLE OF JAW-CLOSED 

80226 FX SYMPHY MANDIB BODY-CL 

80227 FX ALVEOLAR BORD MAND-CL 

80228 FX MANDIBLE BODY NEC-CL 

80229 MULT FX MANDIBLE-CLOSED 

8023 MANDIBLE FRACTURE-OPEN*

80230 MANDIBLE FX NOS-OPEN 

80231 FX CONDYL PROC MAND-OPEN 

80232 SUBCONDYL FX MANDIB-OPEN 

80233 FX CORON PROC MANDIB-OPN 

80234 FX RAMUS NOS-OPEN 

80235 FX ANGLE OF JAW-OPEN 

80236 FX SYMPHY MANDIB BDY-OPN 

80237 FX ALV BORD MAND BDY-OPN 

80238 FX MANDIBLE BODY NEC-OPN 

80239 MULT FX MANDIBLE-OPEN 

8024 FX MALAR/MAXILLARY-CLOSE 

8025 FX MALAR/MAXILLARY-OPEN 

8026 FX ORBITAL FLOOR-CLOSED 

8027 FX ORBITAL FLOOR-OPEN 

8028 FX FACIAL BONE NEC-CLOSE 

8029 FX FACIAL BONE NEC-OPEN 

803 OTHER SKULL FRACTURE* 

8030 CLOSE SKULL FRACTURE NEC* 

80300 CLOSE SKULL FRACTURE NEC 

80301 CL SKULL FX NEC W/O COMA 

80302 CL SKULL FX NEC-BRF COMA 

80303 CL SKULL FX NEC-MOD COMA 

80304 CL SKL FX NEC-PROLN COMA 

80305 CL SKUL FX NEC-DEEP COMA 

80306 CL SKULL FX NEC-COMA NOS 

80309 CL SKULL FX NEC-CONCUSS 

8031 CL SKL FX NEC/CEREBR LAC* 

80310 CL SKL FX NEC/CEREBR LAC 








8032 CL SKL FX NEC/MENING HEM* 

80320 CL SKL FX NEC/MENING HEM 








8033 CL SKULL FX NEC/HEM NEC* 

80330 CL SKULL FX NEC/HEM NEC 








8034 CL SKL FX NEC/BR INJ NEC* 

80340 CL SKL FX NEC/BR INJ NEC 


80342 CL SKULL FX NEC-BRF COMA






8035 OPEN SKULL FRACTURE NEC* 

80350 OPEN SKULL FRACTURE NEC 

80351 OPN SKUL FX NEC W/O COMA 

80352 OPN SKUL FX NEC-BRF COMA 

80353 OPN SKUL FX NEC-MOD COMA 

80354 OPN SKL FX NEC-PROL COMA 

80355 OPN SKL FX NEC-DEEP COMA 

80356 OPN SKUL FX NEC-COMA NOS 

80359 OPN SKULL FX NEC-CONCUSS 

8036 OPN SKL FX NEC/CEREB LAC* 

80360 OPN SKL FX NEC/CEREB LAC 




80364 OPN SKL FX NEC-PROLN COM 




8037 OPN SKL FX NEC/MENIN HEM* 

80370 OPN SKL FX NEC/MENIN HEM 








8038 OPN SKULL FX NEC/HEM NEC* 

80380 OPN SKULL FX NEC/HEM NEC 








8039 OP SKL FX NEC/BR INJ NEC* 

80390 OP SKL FX NEC/BR INJ NEC 








804 MULT FX SKULL W OTH BONE* 

8040 CL SKUL FX W OTH BONE FX* 

80400 CL SKUL FX W OTH BONE FX 

80401 CL SKL W OTH FX W/O COMA 

80402 CL SKL W OTH FX-BRF COMA 

80403 CL SKL W OTH FX-MOD COMA 

80404 CL SKL/OTH FX-PROLN COMA

80405 CL SKUL/OTH FX-DEEP COMA 

80406 CL SKL W OTH FX-COMA NOS 

80409 CL SKUL W OTH FX-CONCUSS 

8041 CL SK W OTH FX/CEREB LAC* 

80410 CL SK W OTH FX/CEREB LAC 




80414 CL SKL/OTH FX-PROLN COMA 




8042 CL SKL/OTH FX/MENING HEM* 

80420 CL SKL/OTH FX/MENING HEM 








8043 CL SKUL W OTH FX/HEM NEC* 

80430 CL SKUL W OTH FX/HEM NEC 








8044 CL SKL/OTH FX/BR INJ NEC* 

80440 CL SKL/OTH FX/BR INJ NEC 








8045 OPN SKULL FX/OTH BONE FX* 

80450 OPN SKULL FX/OTH BONE FX 

80451 OPN SKUL/OTH FX W/O COMA 

80452 OPN SKUL/OTH FX-BRF COMA 

80453 OPN SKUL/OTH FX-MOD COMA 

80454 OPN SKL/OTH FX-PROL COMA 

80455 OPN SKL/OTH FX-DEEP COMA 

80456 OPN SKUL/OTH FX-COMA NOS 

80459 OPN SKULL/OTH FX-CONCUSS 

8046 OPN SKL/OTH FX/CEREB LAC* 

80460 OPN SKL/OTH FX/CEREB LAC 







80469 OPN SKULL/OTH FX-CONCUSS

8047 OPN SKL/OTH FX/MENIN HEM* 

80470 OPN SKL/OTH FX/MENIN HEM 








8048 OPN SKL W OTH FX/HEM NEC* 

80480 OPN SKL W OTH FX/HEM NEC 








8049 OP SKL/OTH FX/BR INJ NEC* 

80490 OP SKL/OTH FX/BR INJ NEC 








805 VERTEBRL FX W/O CORD INJ* 

8050 FX CERVICAL VERTEBRA-CL* 

80500 FX CERVICAL VERT NOS-CL 

80501 FX C1 VERTEBRA-CLOSED 







80508 FX MULT CERVICAL VERT-CL 

8051 FX CERVICAL VERTEBRA-OPN* 

80510 FX CERVICAL VERT NOS-OPN 

80511 FX C1 VERTEBRA-OPEN 







80518 FX MLT CERVICAL VERT-OPN 

8052 FX DORSAL VERTEBRA-CLOSE 

8053 FX DORSAL VERTEBRA-OPEN 

8054 FX LUMBAR VERTEBRA-CLOSE 

8055 FX LUMBAR VERTEBRA-OPEN 

8056 FX SACRUM/COCCYX-CLOSED 

8057 FX SACRUM/COCCYX-OPEN 

8058 VERTEBRAL FX NOS-CLOSED 

8059 VERTEBRAL FX NOS-OPEN 

806 VERTEBRAL FX W CORD INJ*

8060 CLOS CERV FX W CORD INJ* 

80600 C1-C4 FX-CL/CORD INJ NOS 

80601 C1-C4 FX-CL/COM CORD LES 

80602 C1-C4 FX-CL/ANT CORD SYN 

80603 C1-C4 FX-CL/CEN CORD SYN 

80604 C1-C4 FX-CL/CORD INJ NEC 

80605 C5-C7 FX-CL/CORD INJ NOS 

80606 C5-C7 FX-CL/COM CORD LES 

80607 C5-C7 FX-CL/ANT CORD SYN 

80608 C5-C7 FX-CL/CEN CORD SYN 

80609 C5-C7 FX-CL/CORD INJ NEC 

8061 OPEN CERV FX W CORD INJ* 

80610 C1-C4 FX-OP/CORD INJ NOS 

80611 C1-C4 FX-OP/COM CORD LES 

80612 C1-C4 FX-OP/ANT CORD SYN 

80613 C1-C4 FX-OP/CEN CORD SYN 

80614 C1-C4 FX-OP/CORD INJ NEC 

80615 C5-C7 FX-OP/CORD INJ NOS 

80616 C5-C7 FX-OP/COM CORD LES 

80617 C5-C7 FX-OP/ANT CORD SYN 

80618 C5-C7 FX-OP/CEN CORD SYN 

80619 C5-C7 FX-OP/CORD INJ NEC 

8062 CL DORSAL FX W CORD INJ* 

80620 T1-T6 FX-CL/CORD INJ NOS 

80621 T1-T6 FX-CL/COM CORD LES 

80622 T1-T6 FX-CL/ANT CORD SYN 

80623 T1-T6 FX-CL/CEN CORD SYN 

80624 T1-T6 FX-CL/CORD INJ NEC 

80625 T7-T12 FX-CL/CRD INJ NOS 

80626 T7-T12 FX-CL/COM CRD LES 

80627 T7-T12 FX-CL/ANT CRD SYN 

80628 T7-T12 FX-CL/CEN CRD SYN 

80629 T7-T12 FX-CL/CRD INJ NEC 

8063 OPN DORSAL FX W CORD INJ* 

80630 T1-T6 FX-OP/CORD INJ NOS 

80631 T1-T6 FX-OP/COM CORD LES 

80632 T1-T6 FX-OP/ANT CORD SYN 

80633 T1-T6 FX-OP/CEN CORD SYN 

80634 T1-T6 FX-OP/CORD INJ NEC 

80635 T7-T12 FX-OP/CRD INJ NOS 

80636 T7-T12 FX-OP/COM CRD LES 

80637 T7-T12 FX-OP/ANT CRD SYN 

80638 T7-T12 FX-OP/CEN CRD SYN 

80639 T7-T12 FX-OP/CRD INJ NEC 

8064 CL LUMBAR FX W CORD INJ 

8065 OPN LUMBAR FX W CORD INJ 

8066 FX SACRUM-CL W CORD INJ* 

80660 FX SACRUM-CL/CRD INJ NOS 

80661 FX SACR-CL/CAUDA EQU LES 

80662 FX SACR-CL/CAUDA INJ NEC 

80669 FX SACRUM-CL/CRD INJ NEC 

8067 FX SACRUM-OPN W CORD INJ* 

80670 FX SACRUM-OP/CRD INJ NOS 

80671 FX SACR-OP/CAUDA EQU LES 

80672 FX SACR-OP/CAUDA INJ NEC 

80679 FX SACRUM-OP/CRD INJ NEC 

8068 VERT FX NOS-CL W CRD INJ

8069 VERT FX NOS-OP W CRD INJ 

807 FX RIB/STERN/LARYN/TRACH* 

8070 FRACTURE OF RIB-CLOSED* 

80700 FRACTURE RIB NOS-CLOSED 

80701 FRACTURE ONE RIB-CLOSED 

80702 FRACTURE TWO RIBS-CLOSED 

80703 FRACTURE THREE RIBS-CLOS 

80704 FRACTURE FOUR RIBS-CLOSE 

80705 FRACTURE FIVE RIBS-CLOSE 

80706 FRACTURE SIX RIBS-CLOSED 

80707 FRACTURE SEVEN RIBS-CLOS 

80708 FX EIGHT/MORE RIB-CLOSED 

80709 FX MULT RIBS NOS-CLOSED 

8071 FRACTURE OF RIB-OPEN* 

80710 FRACTURE RIB NOS-OPEN 

80711 FRACTURE ONE RIB-OPEN 

80712 FRACTURE TWO RIBS-OPEN 

80713 FRACTURE THREE RIBS-OPEN 

80714 FRACTURE FOUR RIBS-OPEN 

80715 FRACTURE FIVE RIBS-OPEN 

80716 FRACTURE SIX RIBS-OPEN 

80717 FRACTURE SEVEN RIBS-OPEN 

80718 FX EIGHT/MORE RIBS-OPEN 

80719 FX MULT RIBS NOS-OPEN 

8072 FRACTURE OF STERNUM-CLOS 

8073 FRACTURE OF STERNUM-OPEN 

8074 FLAIL CHEST 

8075 FX LARYNX/TRACHEA-CLOSED 

8076 FX LARYNX/TRACHEA-OPEN 

808 PELVIC FRACTURE* 

8080 FRACTURE ACETABULUM-CLOS 

8081 FRACTURE ACETABULUM-OPEN 

8082 FRACTURE OF PUBIS-CLOSED 

8083 FRACTURE OF PUBIS-OPEN 

8084 OTH PELVIC FRACTURE-CLOS* 

80841 FRACTURE OF ILIUM-CLOSED 

80842 FRACTURE ISCHIUM-CLOSED 

80843 PELV FX-CLOS/PELV DISRUP 

80849 PELVIC FRACTURE NEC-CLOS 

8085 OTH PELVIC FRACTURE-OPEN* 

80851 FRACTURE OF ILIUM-OPEN 

80852 FRACTURE OF ISCHIUM-OPEN 

80853 PELV FX-OPEN/PELV DISRUP 

80859 PELVIC FRACTURE NEC-OPEN 

8088 PELVIC FRACTURE NOS-CLOS 

8089 PELVIC FRACTURE NOS-OPEN 

809 FRACTURE OF TRUNK BONES* 

8090 FRACTURE TRUNK BONE-CLOS 

8091 FRACTURE TRUNK BONE-OPEN 

810 CLAVICLE FRACTURE* 

8100 FRACTURE CLAVICLE-CLOSED* 

81000 FX CLAVICLE NOS-CLOSED 

81001 FX CLAVICL, STERN END-CL 

81002 FX CLAVICLE SHAFT-CLOSED 

81003 FX CLAVICL, ACROM END-CL 

8101 FRACTURE CLAVICLE-OPEN* 

81010 FX CLAVICLE NOS-OPEN

81011 FX CLAVIC, STERN END-OPN 

81012 FX CLAVICLE SHAFT-OPEN 

81013 FX CLAVIC, ACROM END-OPN 

811 SCAPULA FRACTURE* 

8110 FRACTURE SCAPULA-CLOSED* 

81100 FX SCAPULA NOS-CLOSED 

81101 FX SCAPUL, ACROM PROC-CL 

81102 FX SCAPUL, CORAC PROC-CL 

81103 FX SCAP, GLEN CAV/NCK-CL 

81109 FX SCAPULA NEC-CLOSED 

8111 FRACTURE OF SCAPULA-OPEN* 

81110 FX SCAPULA NOS-OPEN 

81111 FX SCAPUL, ACROM PROC-OP 

81112 FX SCAPUL, CORAC PROC-OP 

81113 FX SCAP, GLEN CAV/NCK-OP 

81119 FX SCAPULA NEC-OPEN 

812 HUMERUS FRACTURE* 

8120 FX UPPER HUMERUS-CLOSED* 

81200 FX UP END HUMERUS NOS-CL 

81201 FX SURG NCK HUMERUS-CLOS 

81202 FX ANATOM NCK HUMERUS-CL 

81203 FX GR TUBEROS HUMERUS-CL 

81209 FX UPPER HUMERUS NEC-CL 

8121 FX UPPER HUMERUS-OPEN* 

81210 FX UPPER HUMERUS NOS-OPN 

81211 FX SURG NECK HUMERUS-OPN 

81212 FX ANAT NECK HUMERUS-OPN 

81213 FX GR TUBEROS HUMER-OPEN 

81219 FX UPPER HUMERUS NEC-OPN 

8122 FX HUMERUS SHAFT/NOS-CL* 

81220 FX HUMERUS NOS-CLOSED 

81221 FX HUMERUS SHAFT-CLOSED 

8123 FX HUMERUS SHAFT/NOS-OPN* 

81230 FX HUMERUS NOS-OPEN 

81231 FX HUMERUS SHAFT-OPEN 

8124 FX LOWER HUMERUS-CLOSED* 

81240 FX LOWER HUMERUS NOS-CL 

81241 SUPRCONDYL FX HUMERUS-CL 

81242 FX HUMER, LAT CONDYL-CL 

81243 FX HUMER, MED CONDYL-CL 

81244 FX HUMER, CONDYL NOS-CL 

81249 FX LOWER HUMERUS NEC-CL 

8125 FX LOWER HUMERUS-OPEN* 

81250 FX LOWER HUMER NOS-OPEN 

81251 SUPRACONDYL FX HUMER-OPN 

81252 FX HUMER, LAT CONDYL-OPN 

81253 FX HUMER, MED CONDYL-OPN 

81254 FX HUMER, CONDYL NOS-OPN 

81259 FX LOWER HUMER NEC-OPEN 

813 RADIUS & ULNA FRACTURE* 

8130 FX UPPER RADIUS/ULNA-CL* 

81300 FX UPPER FOREARM NOS-CL 

81301 FX OLECRAN PROC ULNA-CL 

81302 FX CORONOID PROC ULNA-CL 

81303 MONTEGGIA'S FX-CLOSED 

81304 FX UPPER ULNA NEC/NOS-CL 

81305 FX RADIUS HEAD-CLOSED

81306 FX RADIUS NECK-CLOSED 

81307 FX UP RADIUS NEC/NOS-CL 

81308 FX UP RADIUS W ULNA-CLOS 

8131 FX UPPER RADIUS/ULNA-OPN* 

81310 FX UPPER FOREARM NOS-OPN 

81311 FX OLECRAN PROC ULNA-OPN 

81312 FX CORONOID PRO ULNA-OPN 

81313 MONTEGGIA'S FX-OPEN 

81314 FX UP ULNA NEC/NOS-OPEN 

81315 FX RADIUS HEAD-OPEN 

81316 FX RADIUS NECK-OPEN 

81317 FX UP RADIUS NEC/NOS-OPN 

81318 FX UP RADIUS W ULNA-OPEN 

8132 FX RADIUS/ULNA SHAFT-CL* 

81320 FX SHAFT FOREARM NOS-CL 

81321 FX RADIUS SHAFT-CLOSED 

81322 FX ULNA SHAFT-CLOSED 

81323 FX SHAFT RAD W ULNA-CLOS 

8133 FX RADIUS/ULNA SHAFT-OPN* 

81330 FX SHAFT FOREARM NOS-OPN 

81331 FX RADIUS SHAFT-OPEN 

81332 FX ULNA SHAFT-OPEN 

81333 FX SHAFT RAD W ULNA-OPEN 

8134 FX LOWER RADIUS/ULNA-CL* 

81340 FX LOWER FOREARM NOS-CL 

81341 COLLES' FRACTURE-CLOSED 

81342 FX DISTAL RADIUS NEC-CL 

81343 FX DISTAL ULNA-CLOSED 

81344 FX LOW RADIUS W ULNA-CL 

8135 FX LOW RADIUS W/ULNA-OPN* 

81350 FX LOWER FOREARM NOS-OPN 

81351 COLLES' FRACTURE-OPEN 

81352 FX DISTAL RADIUS NEC-OPN 

81353 FX DISTAL ULNA-OPEN 

81354 FX LOW RADIUS W ULNA-OPN 

8138 FX RADIUS/ULNA NOS-CLOSE* 

81380 FX FOREARM NOS-CLOSED 

81381 FX RADIUS NOS-CLOSED 

81382 FRACTURE ULNA NOS-CLOSED 

81383 FX RADIUS W ULNA NOS-CL 

8139 FX RADIUS/ULNA NOS-OPEN* 

81390 FX FOREARM NOS-OPEN 

81391 FRACTURE RADIUS NOS-OPEN 

81392 FRACTURE ULNA NOS-OPEN 

81393 FX RADIUS W ULNA NOS-OPN 

814 CARPAL FRACTURE* 

8140 FRACTURE CARPAL BONE-CL* 

81400 FX CARPAL BONE NOS-CLOSE 

81401 FX NAVICULAR, WRIST-CLOS 

81402 FX LUNATE, WRIST-CLOSED 

81403 FX TRIQUETRAL, WRIST-CL 

81404 FX PISIFORM-CLOSED 

81405 FX TRAPEZIUM BONE-CLOSED 

81406 FX TRAPEZOID BONE-CLOSED 

81407 FX CAPITATE BONE-CLOSED 

81408 FX HAMATE BONE-CLOSED 

81409 FX CARPAL BONE NEC-CLOSE

8141 FRACTURE CARPAL BONE-OPN* 

81410 FX CARPAL BONE NOS-OPEN 

81411 FX NAVICULAR, WRIST-OPEN 

81412 FX LUNATE, WRIST-OPEN 

81413 FX TRIQUETRAL, WRIST-OPN 

81414 FX PISIFORM-OPEN 

81415 FX TRAPEZIUM BONE-OPEN 

81416 FX TRAPEZOID BONE-OPEN 

81417 FX CAPITATE BONE-OPEN 

81418 FX HAMATE BONE-OPEN 

81419 FX CARPAL BONE NEC-OPEN 

815 METACARPAL FRACTURE* 

8150 FRACTURE METACARPAL-CLOS* 

81500 FX METACARPAL NOS-CLOSED 

81501 FX 1ST METACARP BASE-CL 

81502 FX METACARP BASE NEC-CL 

81503 FX METACARPAL SHAFT-CLOS 

81504 FX METACARPAL NECK-CLOSE 

81509 MULT FX METACARPUS-CLOSE 

8151 FRACTURE METACARPAL-OPEN* 

81510 FX METACARPAL NOS-OPEN 

81511 FX 1ST METACARP BASE-OPN 

81512 FX METACARP BASE NEC-OPN 

81513 FX METACARPAL SHAFT-OPEN 

81514 FX METACARPAL NECK-OPEN 

81519 MULT FX METACARPUS-OPEN 

816 FRACTURE PHALANGES, HAND* 

8160 FX PHALANGES, HAND-CLOSE* 

81600 FX PHALANX, HAND NOS-CL 

81601 FX MID/PRX PHAL, HAND-CL 

81602 FX DIST PHALANX, HAND-CL 

81603 FX MULT PHALAN, HAND-CL 

8161 FX PHALANGES, HAND-OPEN* 

81610 FX PHALANX, HAND NOS-OPN 

81611 FX MID/PRX PHAL, HAND-OP 

81612 FX DISTAL PHAL, HAND-OPN 

81613 FX MULT PHALAN, HAND-OPN 

817 MULTIPLE HAND FRACTURES* 

8170 MULTIPLE FX HAND-CLOSED 

8171 MULTIPLE FX HAND-OPEN 

818 FRACTURE ARM MULT/NOS* 

8180 FX ARM MULT/NOS-CLOSED 

8181 FX ARM MULT/NOS-OPEN 

819 FX ARMS W RIB/STERNUM* 

8190 FX ARMS W RIB/STERNUM-CL 

8191 FX ARMS W RIB/STERN-OPEN 

820 FRACTURE NECK OF FEMUR* 

8200 TRANSCERV FX FEMUR-CLOSE* 

82000 FX FEMUR INTRCAPS NOS-CL 

82001 FX UP FEMUR EPIPHY-CLOS 

82002 FX FEMUR, MIDCERVIC-CLOS 

82003 FX BASE FEMORAL NCK-CLOS 

82009 FX FEMUR INTRCAPS NEC-CL 

8201 TRANSCERV FX FEMUR-OPEN* 

82010 FX FEMUR INTRCAP NOS-OPN 

82011 FX UP FEMUR EPIPHY-OPEN 

82012 FX FEMUR, MIDCERVIC-OPEN

82013 FX BASE FEMORAL NCK-OPEN 

82019 FX FEMUR INTRCAP NEC-OPN 

8202 PERTROCHANTERIC FX-CLOS* 

82020 TROCHANTERIC FX NOS-CLOS 

82021 INTERTROCHANTERIC FX-CL 

82022 SUBTROCHANTERIC FX-CLOSE 

8203 PERTROCHANTERIC FX-OPEN* 

82030 TROCHANTERIC FX NOS-OPEN 

82031 INTERTROCHANTERIC FX-OPN 

82032 SUBTROCHANTERIC FX-OPEN 

8208 FX NECK OF FEMUR NOS-CL 

8209 FX NECK OF FEMUR NOS-OPN 

821 OTHER FEMORAL FRACTURE* 

8210 FX FEMUR SHAFT/NOS-CLOSE* 

82100 FX FEMUR NOS-CLOSED 

82101 FX FEMUR SHAFT-CLOSED 

8211 FX FEMUR SHAFT/NOS-OPEN* 

82110 FX FEMUR NOS-OPEN 

82111 FX FEMUR SHAFT-OPEN 

8212 FX LOWER END FEMUR-CLOSE* 

82120 FX LOW END FEMUR NOS-CL 

82121 FX FEMORAL CONDYLE-CLOSE 

82122 FX LOW FEMUR EPIPHY-CLOS 

82123 SUPRACONDYL FX FEMUR-CL 

82129 FX LOW END FEMUR NEC-CL 

8213 FX LOWER END FEMUR-OPEN* 

82130 FX LOW END FEMUR NOS-OPN 

82131 FX FEMORAL CONDYLE-OPEN 

82132 FX LOW FEMUR EPIPHY-OPEN 

82133 SUPRACONDYL FX FEMUR-OPN 

82139 FX LOW END FEMUR NEC-OPN 

822 PATELLA FRACTURE* 

8220 FRACTURE PATELLA-CLOSED 

8221 FRACTURE PATELLA-OPEN 

823 TIBIA & FIBULA FRACTURE* 

8230 FX UPPER TIBIA/FIBULA-CL* 

82300 FX UPPER END TIBIA-CLOSE 

82301 FX UPPER END FIBULA-CLOS 

82302 FX UP TIBIA W FIBULA-CL 

8231 FX UPPER TIBIA/FIBULA-OP* 

82310 FX UPPER END TIBIA-OPEN 

82311 FX UPPER END FIBULA-OPEN 

82312 FX UP TIBIA W FIBULA-OPN 

8232 FX SHAFT TIB/FIB-CLOSED* 

82320 FX SHAFT TIBIA-CLOSED 

82321 FX SHAFT FIBULA-CLOSED 

82322 FX SHAFT FIB W TIB-CLOS 

8233 FX TIBIA/FIBULA SHAFT-OP* 

82330 FX TIBIA SHAFT-OPEN 

82331 FX FIBULA SHAFT-OPEN 

82332 FX SHAFT TIBIA W FIB-OPN 

8238 FX TIBIA/FIBULA NOS-CLOS* 

82380 FX TIBIA NOS-CLOSED 

82381 FX FIBULA NOS-CLOSED 

82382 FX TIBIA W FIBULA NOS-CL 

8239 FX TIBIA/FIBULA NOS-OPEN* 

82390 FX TIBIA NOS-OPEN

82391 FX FIBULA NOS-OPEN 

82392 FX TIBIA W FIB NOS-OPEN 

824 ANKLE FRACTURE* 

8240 FX MEDIAL MALLEOLUS-CLOS 

8241 FX MEDIAL MALLEOLUS-OPEN 

8242 FX LATERAL MALLEOLUS-CL 

8243 FX LATERAL MALLEOLUS-OPN 

8244 FX BIMALLEOLAR-CLOSED 

8245 FX BIMALLEOLAR-OPEN 

8246 FX TRIMALLEOLAR-CLOSED 

8247 FX TRIMALLEOLAR-OPEN 

8248 FX ANKLE NOS-CLOSED 

8249 FX ANKLE NOS-OPEN 

825 FX OF TARSAL/METATARSAL* 

8250 FRACTURE CALCANEUS-CLOSE 

8251 FRACTURE CALCANEUS-OPEN 

8252 FX TARSL/METATARS NEC-CL* 

82520 FX FOOT BONE NOS-CLOSED 

82521 FX ASTRAGALUS-CLOSED 

82522 FX NAVICULAR, FOOT-CLOS 

82523 FX CUBOID-CLOSED 

82524 FX CUNEIFORM, FOOT-CLOS 

82525 FX METATARSAL-CLOSED 

82529 FX FOOT BONE NEC-CLOSED 

8253 FX TARS/METATARS NEC-OPN* 

82530 FX FOOT BONE NOS-OPEN 

82531 FX ASTRAGALUS-OPEN 

82532 FX NAVICULAR, FOOT-OPEN 

82533 FX CUBOID-OPEN 

82534 FX CUNEIFORM, FOOT-OPEN 

82535 FX METATARSAL-OPEN 

82539 FX FOOT BONE NEC-OPEN 

826 FRACTURE PHALANGES, FOOT* 

8260 FX PHALANX, FOOT-CLOSED 

8261 FX PHALANX, FOOT-OPEN 

827 LOWER LIMB FRACTURE NEC* 

8270 FX LOWER LIMB NEC-CLOSED 

8271 FX LOWER LIMB NEC-OPEN 

828 FX LEGS W ARM/RIB* 

8280 FX LEGS W ARM/RIB-CLOSED 

8281 FX LEGS W ARM/RIB-OPEN 

829 FRACTURE NOS* 

8290 FRACTURE NOS-CLOSED 

8291 FRACTURE NOS-OPEN 

830 JAW DISLOCATION* 

8300 DISLOCATION JAW-CLOSED 

8301 DISLOCATION JAW-OPEN 

831 SHOULDER DISLOCATION* 

8310 DISLOCAT SHOULDER-CLOSED* 

83100 DISLOC SHOULDER NOS-CLOS 

83101 ANT DISLOC HUMERUS-CLOSE 

83102 POST DISLOC HUMERUS-CLOS 

83103 INFER DISLOC HUMERUS-CL 

83104 DISLOC ACROMIOCLAVIC-CL 

83109 DISLOC SHOULDER NEC-CLOS 

8311 DISLOCAT SHOULDER-OPEN* 

83110 DISLOC SHOULDER NOS-OPEN

83111 ANT DISLOC HUMERUS-OPEN 

83112 POST DISLOC HUMERUS-OPEN 

83113 INFER DISLOC HUMERUS-OPN 

83114 DISLOC ACROMIOCLAVIC-OPN 

83119 DISLOC SHOULDER NEC-OPEN 

832 ELBOW DISLOCATION* 

8320 DISLOCATION ELBOW-CLOSED* 

83200 DISLOCAT ELBOW NOS-CLOSE 

83201 ANT DISLOC ELBOW-CLOSED 

83202 POST DISLOC ELBOW-CLOSED 

83203 MED DISLOC ELBOW-CLOSED 

83204 LAT DISLOC ELBOW-CLOSED 

83209 DISLOCAT ELBOW NEC-CLOSE 

8321 DISLOCATION ELBOW-OPEN* 

83210 DISLOCAT ELBOW NOS-OPEN 

83211 ANT DISLOC ELBOW-OPEN 

83212 POST DISLOC ELBOW-OPEN 

83213 MED DISLOC ELBOW-OPEN 

83214 LAT DISLOCAT ELBOW-OPEN 

83219 DISLOCAT ELBOW NEC-OPEN 

833 WRIST DISLOCATION* 

8330 DISLOCATION WRIST-CLOSED* 

83300 DISLOC WRIST NOS-CLOSED 

83301 DISLOC DIST RADIOULN-CL 

83302 DISLOC RADIOCARPAL-CLOS 

83303 DISLOCA MIDCARPAL-CLOSED 

83304 DISLOC CARPOMETACARP-CL 

83305 DISLOC METACARPAL-CLOSED 

83309 DISLOC WRIST NEC-CLOSED 

8331 DISLOCATION WRIST-OPEN* 

83310 DISLOCAT WRIST NOS-OPEN 

83311 DISLOC DIST RADIOULN-OPN 

83312 DISLOC RADIOCARPAL-OPEN 

83313 DISLOCAT MIDCARPAL-OPEN 

83314 DISLOC CARPOMETACARP-OPN 

83315 DISLOCAT METACARPAL-OPEN 

83319 DISLOCAT WRIST NEC-OPEN 

834 DISLOCATION OF FINGER* 

8340 DISLOCAT FINGER-CLOSED* 

83400 DISL FINGER NOS-CLOSED 

83401 DISLOC METACARPOPHALN-CL 

83402 DISL INTERPHALN HAND-CL 

8341 DISLOCAT FINGER-OPEN* 

83410 DISLOC FINGER NOS-OPEN 

83411 DISL METACARPOPHALAN-OPN 

83412 DISL INTERPHALN HAND-OPN 

835 DISLOCATION OF HIP* 

8350 DISLOCATION HIP-CLOSED* 

83500 DISLOCAT HIP NOS-CLOSED 

83501 POSTERIOR DISLOC HIP-CL 

83502 OBTURATOR DISLOC HIP-CL 

83503 ANT DISLOC HIP NEC-CLOS 

8351 DISLOCATION HIP-OPEN* 

83510 DISLOCATION HIP NOS-OPEN 

83511 POSTERIOR DISLOC HIP-OPN 

83512 OBTURATOR DISLOC HIP-OPN 

83513 ANT DISLOC HIP NEC-OPEN

836 DISLOCATION OF KNEE* 

8360 TEAR MED MENISC KNEE-CUR 

8361 TEAR LAT MENISC KNEE-CUR 

8362 TEAR MENISCUS NEC-CURREN 

8363 DISLOCAT PATELLA-CLOSED 

8364 DISLOCATION PATELLA-OPEN 

8365 OTH DISLOCAT KNEE-CLOSED* 

83650 DISLOCAT KNEE NOS-CLOSED 

83651 ANT DISLOC PROX TIBIA-CL 

83652 POST DISL PROX TIBIA-CL 

83653 MED DISLOC PROX TIBIA-CL 

83654 LAT DISLOC PROX TIBIA-CL 

83659 DISLOCAT KNEE NEC-CLOSED 

8366 OTH DISLOCAT KNEE-OPEN* 

83660 DISLOCAT KNEE NOS-OPEN 

83661 ANT DISL PROX TIBIA-OPEN 

83662 POST DISL PROX TIBIA-OPN 

83663 MED DISL PROX TIBIA-OPEN 

83664 LAT DISL PROX TIBIA-OPEN 

83669 DISLOCAT KNEE NEC-OPEN 

837 DISLOCATION OF ANKLE* 

8370 DISLOCATION ANKLE-CLOSED 

8371 DISLOCATION ANKLE-OPEN 

838 DISLOCATION OF FOOT* 

8380 DISLOCATION FOOT-CLOSED* 

83800 DISLOCAT FOOT NOS-CLOSED 

83801 DISLOC TARSAL NOS-CLOSED 

83802 DISLOC MIDTARSAL-CLOSED 

83803 DISLOC TARSOMETATARS-CL 

83804 DISLOC METATARSAL NOS-CL 

83805 DISL METATARSOPHALANG-CL 

83806 DISL INTERPHALAN FOOT-CL 

83809 DISLOCAT FOOT NEC-CLOSED 

8381 DISLOCATION FOOT-OPEN* 

83810 DISLOCAT FOOT NOS-OPEN 

83811 DISLOC TARSAL NOS-OPEN 

83812 DISLOC MIDTARSAL-OPEN 

83813 DISL TARSOMETATARSAL-OPN 

83814 DISL METATARSAL NOS-OPEN 

83815 DISLOC METATARSOPHAL-OPN 

83816 DIS INTERPHALAN FOOT-OPN 

83819 DISLOCAT FOOT NEC-OPEN 

839 DISLOCATION NEC* 

8390 DISLOC CERVICAL VERT-CL* 

83900 DISLOC CERV VERT NOS-CL 

83901 DISLOC 1ST CERV VERT-CL 

83902 DISLOC 2ND CERV VERT-CL 

83903 DISLOC 3RD CERV VERT-CL 

83904 DISLOC 4TH CERV VERT-CL 




83908 DISLOC MULT CERV VERT-CL 

8391 DISLOC CERVICAL VERT-OPN* 

83910 DISLOC CERV VERT NOS-OPN 

83911 DISLOC LST CERV VERT-OPN 

83912 DISLOC 2ND CERV VERT-OPN

83913 DISLOC 3RD CERV VERT-OPN 

83914 DISLOC 4TH CERV VERT-OPN 




83918 DISLOC MLT CERV VERT-OPN 

8392 DISLOC THOR/LUMB VERT-CL* 

83920 DISLOCAT LUMBAR VERT-CL 

83921 DISLOC THORACIC VERT-CL 

8393 DISL THORA/LUMB VERT-OPN* 

83930 DISLOCAT LUMBAR VERT-OPN 

83931 DISLOC THORACIC VERT-OPN 

8394 OTH DISLOCAT VERTEBRA-CL* 

83940 DISLOCAT VERTEBRA NOS-CL 

83941 DISLOCAT COCCYX-CLOSED 

83942 DISLOCAT SACRUM-CLOSED 

83949 DISLOCAT VERTEBRA NEC-CL 

8395 OTH DISLOC VERTEBRA-OPEN* 

83950 DISLOC VERTEBRA NOS-OPEN 

83951 DISLOCAT COCCYX-OPEN 

83952 DISLOCAT SACRUM-OPEN 

83959 DISLOC VERTEBRA NEC-OPEN 

8396 DISLOCAT OTH SITE-CLOSED* 

83961 DISLOCAT STERNUM-CLOSED 

83969 DISLOCAT SITE NEC-CLOSED 

8397 DISLOCAT OTH SITE-OPEN* 

83971 DISLOCATION STERNUM-OPEN 

83979 DISLOCAT SITE NEC-OPEN 

8398 DISLOCATION NEC-CLOSED 

8399 DISLOCATION NEC-OPEN 

840 SPRAIN SHOULDER & ARM* 

8400 SPRAIN ACROMIOCLAVICULAR 

8401 SPRAIN CORACOCLAVICULAR 

8402 SPRAIN CORACOHUMERAL 

8403 SPRAIN INFRASPINATUS 

8404 SPRAIN ROTATOR CUFF 

8405 SPRAIN SUBSCAPULARIS 

8406 SPRAIN SUPRASPINATUS 

8408 SPRAIN SHOULDER/ARM NEC 

8409 SPRAIN SHOULDER/ARM NOS 

841 SPRAIN ELBOW & FOREARM* 

8410 SPRAIN RADIAL COLLAT LIG 

8411 SPRAIN ULNAR COLLAT LIG 

8412 SPRAIN RADIOHUMERAL 

8413 SPRAIN ULNOHUMERAL 

8418 SPRAIN ELBOW/FOREARM NEC 

8419 SPRAIN ELBOW/FOREARM NOS 

842 SPRAIN WRIST & HAND* 

8420 SPRAIN OF WRIST* 

84200 SPRAIN OF WRIST NOS 

84201 SPRAIN CARPAL 

84202 SPRAIN RADIOCARPAL 

84209 SPRAIN OF WRIST NEC 

8421 SPRAIN OF HAND* 

84210 SPRAIN OF HAND NOS 

84211 SPRAIN CARPOMETACARPAL 

84212 SPRAIN METACARPOPHALANG

84213 SPRAIN INTERPHALANGEAL 

84219 SPRAIN OF HAND NEC 

843 SPRAIN OF HIP & THIGH* 

8430 SPRAIN ILIOFEMORAL 

8431 SPRAIN ISCHIOCAPSULAR 

8438 SPRAIN HIP & THIGH NEC 

8439 SPRAIN HIP & THIGH NOS 

844 SPRAIN OF KNEE & LEG* 

8440 SPRAIN LATERAL COLL LIG 

8441 SPRAIN MEDIAL COLLAT LIG 

8442 SPRAIN CRUCIATE LIG KNEE 

8443 SPRAIN SUPER TIBIOFIBULA 

8448 SPRAIN OF KNEE & LEG NEC 

8449 SPRAIN OF KNEE & LEG NOS 

845 SPRAIN OF ANKLE & FOOT* 

8450 SPRAIN OF ANKLE* 

84500 SPRAIN OF ANKLE NOS 

84501 SPRAIN OF ANKLE DELTOID 

84502 SPRAIN CALCANEOFIBULAR 

84503 SPRAIN DISTAL TIBIOFIBUL 

84509 SPRAIN OF ANKLE NEC 

8451 SPRAIN OF FOOT* 

84510 SPRAIN OF FOOT NOS 

84511 SPRAIN TARSOMETATARSAL 

84512 SPRAIN METATARSOPHALANG 

84513 SPRAIN INTERPHALANG TOE 

84519 SPRAIN OF FOOT NEC 

846 SPRAIN SACROILIAC REGION* 

8460 SPRAIN LUMBOSACRAL 

8461 SPRAIN SACROILIAC 

8462 SPRAIN SACROSPINATUS 

8463 SPRAIN SACROTUBEROUS 

8468 SPRAIN SACROILIAC NEC 

8469 SPRAIN SACROILIAC NOS 

847 SPRAIN OF BACK NEC/NOS* 

8470 SPRAIN OF NECK 

8471 SPRAIN THORACIC REGION 

8472 SPRAIN LUMBAR REGION 

8473 SPRAIN OF SACRUM 

8474 SPRAIN OF COCCYX 

8479 SPRAIN OF BACK NOS 

848 SPRAIN NEC* 

8480 SPRAIN OF NASAL SEPTUM 

8481 SPRAIN OF JAW 

8482 SPRAIN OF THYROID REGION 

8483 SPRAIN OF RIBS 

8484 SPRAIN OF STERNUM* 

84840 SPRAIN OF STERNUM NOS 

84841 SPRAIN STERNOCLAVICULAR 

84842 SPRAIN CHONDROSTERNAL 

84849 SPRAIN OF STERNUM NEC 

8485 SPRAIN OF PELVIS 

8488 SPRAIN NEC 

8489 SPRAIN NOS 

850 CONCUSSION* 

8500 CONCUSSION W/O COMA 

8501 CONCUSSION-BRIEF COMA

8502 CONCUSSION-MODERATE COMA 

8503 CONCUSSION-PROLONG COMA 

8504 CONCUSSION-DEEP COMA 

8505 CONCUSSION W COMA NOS 

8509 CONCUSSION NOS 

851 CEREBRAL LACER/CONTUSION* 

8510 CORTEX CONTUSION* 

85100 CEREBRAL CORTX CONTUSION 

85101 CORTEX CONTUSION-NO COMA 

85102 CORTEX CONTUS-BRIEF COMA 

85103 CORTEX CONTUS-MOD COMA 

85104 CORTX CONTUS-PROLNG COMA 

85105 CORTEX CONTUS-DEEP COMA 

85106 CORTEX CONTUS-COMA NOS 

85109 CORTEX CONTUS-CONCUS NOS 

8511 CORTEX CONTUSION/OPN WND* 

85110 CORTEX CONTUSION/OPN WND 

85111 OPN CORTX CONTUS-NO COMA 

85112 OPN CORT CONTUS-BRF COMA 

85113 OPN CORT CONTUS-MOD COMA 

85114 OPN CORT CONTU-PROL COMA 

85115 OPN CORT CONTU-DEEP COMA 

85116 OPN CORT CONTUS-COMA NOS 

85119 OPN CORTX CONTUS-CONCUSS 

8512 CEREBRAL CORTEX LACERAT* 

85120 CEREBRAL CORTEX LACERAT 

85121 CORTEX LACERAT W/O COMA 

85122 CORTEX LACERA-BRIEF COMA 

85123 CORTEX LACERAT-MOD COMA 

85124 CORTEX LACERAT-PROL COMA 

85125 CORTEX LACERAT-DEEP COMA 

85126 CORTEX LACERAT-COMA NOS 

85129 CORTEX LACERAT-CONCUSS 

8513 CORTEX LACER W OPN WOUND* 

85130 CORTEX LACER W OPN WOUND 

85131 OPN CORTEX LACER-NO COMA 

85132 OPN CORTX LAC-BRIEF COMA 

85133 OPN CORTX LACER-MOD COMA 

85134 OPN CORTX LAC-PROLN COMA 

85135 OPN CORTEX LAC-DEEP COMA 

85136 OPN CORTX LACER-COMA NOS 

85139 OPN CORTX LACER-CONCUSS 

8514 CEREBEL/BRAIN STM CONTUS* 

85140 CEREBEL/BRAIN STM CONTUS 

85141 CEREBELL CONTUS W/O COMA 

85142 CEREBELL CONTUS-BRF COMA 

85143 CEREBELL CONTUS-MOD COMA 

85144 CEREBEL CONTUS-PROL COMA 

85145 CEREBEL CONTUS-DEEP COMA 

85146 CEREBELL CONTUS-COMA NOS 

85149 CEREBELL CONTUS-CONCUSS 

8515 CEREBEL CONTUS W OPN WND* 

85150 CEREBEL CONTUS W OPN WND 

85151 OPN CEREBE CONT W/O COMA 

85152 OPN CEREBE CONT-BRF COMA 

85153 OPN CEREBE CONT-MOD COMA 

85154 OPN CEREBE CONT-PROL COM

85155 OPN CEREBE CONT-DEEP COM 

85156 OPN CEREBE CONT-COMA NOS 

85159 OPN CEREBEL CONT-CONCUSS 

8516 CEREBEL/BRAIN STEM LACER* 

85160 CEREBEL/BRAIN STEM LACER 

85161 CEREBEL LACERAT W/O COMA 

85162 CEREBEL LACER-BRIEF COMA 

85163 CEREBEL LACERAT-MOD COMA 

85164 CEREBEL LACER-PROLN COMA 

85165 CEREBELL LACER-DEEP COMA 

85166 CEREBEL LACERAT-COMA NOS 

85169 CEREBEL LACER-CONCUSSION 

8517 CEREBEL LACER W OPEN WND* 

85170 CEREBEL LACER W OPEN WND 

85171 OPN CEREBEL LAC W/O COMA 

85172 OPN CEREBEL LAC-BRF COMA 

85173 OPN CEREBEL LAC-MOD COMA 

85174 OPN CEREBE LAC-PROL COMA 

85175 OPN CEREBE LAC-DEEP COMA 

85176 OPN CEREBEL LAC-COMA NOS 

85179 OPN CEREBELL LAC-CONCUSS 

8518 CEREBRAL LACERATION NEC* 

85180 BRAIN LACERATION NEC 

85181 BRAIN LACER NEC W/O COMA 

85182 BRAIN LAC NEC-BRIEF COMA 

85183 BRAIN LACER NEC-MOD COMA 

85184 BRAIN LAC NEC-PROLN COMA 

85185 BRAIN LAC NEC-DEEP COMA 

85186 BRAIN LACER NEC-COMA NOS 

85189 BRAIN LACER NEC-CONCUSS 

8519 BRAIN LAC NEC W OPEN WND* 

85190 BRAIN LAC NEC W OPEN WND 

85191 OPN BRAIN LACER W/O COMA 

85192 OPN BRAIN LAC-BRIEF COMA 

85193 OPN BRAIN LACER-MOD COMA 

85194 OPN BRAIN LAC-PROLN COMA 

85195 OPEN BRAIN LAC-DEEP COMA 

85196 OPN BRAIN LACER-COMA NOS 

85199 OPEN BRAIN LACER-CONCUSS 

852 MENINGEAL HEM FOLLOW INJ* 

8520 TRAUM SUBARACHNOID HEM* 

85200 TRAUM SUBARACHNOID HEM 

85201 SUBARACHNOID HEM-NO COMA 

85202 SUBARACH HEM-BRIEF COMA 

85203 SUBARACH HEM-MOD COMA 

85204 SUBARACH HEM-PROLNG COMA 

85205 SUBARACH HEM-DEEP COMA 

85206 SUBARACH HEM-COMA NOS 

85209 SUBARACH HEM-CONCUSSION 

8521 SUBARACH HEM W OPN WOUND* 

85210 SUBARACH HEM W OPN WOUND 

85211 OPN SUBARACH HEM-NO COMA 

85212 OP SUBARACH HEM-BRF COMA 

85213 OP SUBARACH HEM-MOD COMA 

85214 OP SUBARACH HEM-PROL COM 

85215 OP SUBARACH HEM-DEEP COM 

85216 OP SUBARACH HEM-COMA NOS

85219 OPN SUBARACH HEM-CONCUSS 

8522 TRAUMATIC SUBDURAL HEM* 

85220 TRAUMATIC SUBDURAL HEM 

85221 SUBDURAL HEM W/O COMA 

85222 SUBDURAL HEM-BRIEF COMA 

85223 SUBDURAL HEMORR-MOD COMA 

85224 SUBDURAL HEM-PROLNG COMA 

85225 SUBDURAL HEM-DEEP COMA 

85226 SUBDURAL HEMORR-COMA NOS 

85229 SUBDURAL HEM-CONCUSSION 

8523 SUBDURAL HEM W OPN WOUND* 

85230 SUBDURAL HEM W OPN WOUND 

85231 OPEN SUBDUR HEM W/O COMA 

85232 OPN SUBDUR HEM-BRF COMA 

85233 OPN SUBDUR HEM-MOD COMA 

85234 OPN SUBDUR HEM-PROL COMA 

85235 OPN SUBDUR HEM-DEEP COMA 

85236 OPN SUBDUR HEM-COMA NOS 

85239 OPN SUBDUR HEM-CONCUSS 

8524 TRAUMATIC EXTRADURAL HEM* 

85240 TRAUMATIC EXTRADURAL HEM 

85241 EXTRADURAL HEM W/O COMA 

85242 EXTRADUR HEM-BRIEF COMA 

85243 EXTRADURAL HEM-MOD COMA 

85244 EXTRADUR HEM-PROLN COMA 

85245 EXTRADURAL HEM-DEEP COMA 

85246 EXTRADURAL HEM-COMA NOS 

85249 EXTADURAL HEM-CONCUSS 

8525 EXTRADURAL HEM W OPN WND* 

85250 EXTRADURAL HEM W OPN WND 

85251 EXTRADURAL HEMOR-NO COMA 

85252 EXTRADUR HEM-BRIEF COMA 

85253 EXTRADURAL HEM-MOD COMA 

85254 EXTRADUR HEM-PROLN COMA 

85255 EXTRADUR HEM-DEEP COMA 

85256 EXTRADURAL HEM-COMA NOS 

85259 EXTRADURAL HEM-CONCUSS 

853 OTH TRAUMATIC BRAIN HEM* 

8530 TRAUMATIC BRAIN HEM NEC* 

85300 TRAUMATIC BRAIN HEM NEC 

85301 BRAIN HEM NEC W/O COMA 

85302 BRAIN HEM NEC-BRIEF COMA 

85303 BRAIN HEM NEC-MOD COMA 

85304 BRAIN HEM NEC-PROLN COMA 

85305 BRAIN HEM NEC-DEEP COMA 

85306 BRAIN HEM NEC-COMA NOS 

85309 BRAIN HEM NEC-CONCUSSION 

8531 BRAIN HEM NEC W OPN WND* 

85310 BRAIN HEM NEC W OPN WND 

85311 BRAIN HEM OPN W/O COMA 

85312 BRAIN HEM OPN-BRF COMA 

85313 BRAIN HEM OPEN-MOD COMA 

85314 BRAIN HEM OPN-PROLN COMA 

85315 BRAIN HEM OPEN-DEEP COMA 

85316 BRAIN HEM OPEN-COMA NOS 

85319 BRAIN HEM OPN-CONCUSSION 

854 OTHER BRAIN INJURY*

8540 BRAIN INJURY NEC* 

85400 BRAIN INJURY NEC 

85401 BRAIN INJURY NEC-NO COMA 

85402 BRAIN INJ NEC-BRIEF COMA 

85403 BRAIN INJ NEC-MOD COMA 

85404 BRAIN INJ NEC-PROLN COMA 

85405 BRAIN INJ NEC-DEEP COMA 

85406 BRAIN INJ NEC-COMA NOS 

85409 BRAIN INJ NEC-CONCUSSION 

8541 BRAIN INJ NEC W OPN WND* 

85410 BRAIN INJURY W OPN WND 

85411 OPN BRAIN INJ W/O COMA 

85412 OPN BRAIN INJ-BRIEF COMA 

85413 OPN BRAIN INJ-MOD COMA 

85414 OPN BRAIN INJ-PROLN COMA 

85415 OPN BRAIN INJ-DEEP COMA 

85416 OPEN BRAIN INJ-COMA NOS 

85419 OPN BRAIN INJ-CONCUSSION 

860 TRAUM PNEUMOHEMOTHORAX* 

8600 TRAUM PNEUMOTHORAX-CLOSE 

8601 TRAUM PNEUMOTHORAX-OPEN 

8602 TRAUM HEMOTHORAX-CLOSED 

8603 TRAUM HEMOTHORAX-OPEN 

8604 TRAUM PNEUMOHEMOTHOR-CL 

8605 TRAUM PNEUMOHEMOTHOR-OPN 

861 HEART & LUNG INJURY* 

8610 HEART INJURY-CLOSED* 

86100 HEART INJURY NOS-CLOSED 

86101 HEART CONTUSION-CLOSED 

86102 HEART LACERATION-CLOSED 

86103 HEART CHAMBER LACERAT-CL 

8611 HEART INJURY-OPEN* 

86110 HEART INJURY NOS-OPEN 

86111 HEART CONTUSION-OPEN 

86112 HEART LACERATION-OPEN 

86113 HEART CHAMBER LACER-OPN 

8612 LUNG INJURY-CLOSED* 

86120 LUNG INJURY NOS-CLOSED 

86121 LUNG CONTUSION-CLOSED 

86122 LUNG LACERATION-CLOSED 

8613 LUNG INJURY-OPEN* 

86130 LUNG INJURY NOS-OPEN 

86131 LUNG CONTUSION-OPEN 

86132 LUNG LACERATION-OPEN 

862 INTRATHORACIC INJURY NEC* 

8620 DIAPHRAGM INJURY-CLOSED 

8621 DIAPHRAGM INJURY-OPEN 

8622 OTH INTRATHORACIC INJ-CL* 

86221 BRONCHUS INJURY-CLOSED 

86222 ESOPHAGUS INJURY-CLOSED 

86229 INTRATHORACIC INJ NEC-CL 

8623 OTH INTRATHORAC INJ-OPEN* 

86231 BRONCHUS INJURY-OPEN 

86232 ESOPHAGUS INJURY-OPEN 

86239 INTRATHORAC INJ NEC-OPEN 

8628 INTRATHORACIC INJ NOS-CL 

8629 INTRATHORAC INJ NOS-OPEN

863 GI TRACT INJURY* 

8630 STOMACH INJURY-CLOSED 

8631 STOMACH INJURY-OPEN 

8632 SMALL INTESTINE INJ-CLOS* 

86320 SMALL INTEST INJ NOS-CL 

86321 DUODENUM INJURY-CLOSED 

86329 SMALL INTEST INJ NEC-CL 

8633 SMALL INTESTINE INJ-OPEN* 

86330 SMALL INTEST INJ NOS-OPN 

86331 DUODENUM INJURY-OPEN 

86339 SMALL INTEST INJ NEC-OPN 

8634 COLON INJURY-CLOSED* 

86340 COLON INJURY NOS-CLOSED 

86341 ASCENDING COLON INJ-CLOS 

86342 TRANSVERSE COLON INJ-CL 

86343 DESCENDING COLON INJ-CL 

86344 SIGMOID COLON INJ-CLOSED 

86345 RECTUM INJURY-CLOSED 

86346 COLON INJ MULT SITE-CLOS 

86349 COLON INJURY NEC-CLOSED 

8635 COLON INJURY-OPEN* 

86350 COLON INJURY NOS-OPEN 

86351 ASCENDING COLON INJ-OPEN 

86352 TRANSVERSE COLON INJ-OPN 

86353 DESCENDING COLON INJ-OPN 

86354 SIGMOID COLON INJ-OPEN 

86355 RECTUM INJURY-OPEN 

86356 COLON INJ MULT SITE-OPEN 

86359 COLON INJURY NEC-OPEN 

8638 GI INJURY NEC-CLOSED* 

86380 GI INJURY NOS-CLOSED 

86381 PANCREAS, HEAD INJ-CLOSE 

86382 PANCREAS, BODY INJ-CLOSE 

86383 PANCREAS, TAIL INJ-CLOSE 

86384 PANCREAS INJURY NOS-CLOS 

86385 APPENDIX INJURY-CLOSED 

86389 GI INJURY NEC-CLOSED 

8639 GI INJURY NEC-OPEN* 

86390 GI INJURY NOS-OPEN 

86391 PANCREAS, HEAD INJ-OPEN 

86392 PANCREAS, BODY INJ-OPEN 

86393 PANCREAS, TAIL INJ-OPEN 

86394 PANCREAS INJURY NOS-OPEN 

86395 APPENDIX INJURY-OPEN 

86399 GI INJURY NEC-OPEN 

864 LIVER INJURY* 

8640 LIVER INJURY-CLOSED* 

86400 LIVER INJURY NOS-CLOSED 

86401 LIVER HEMATOMA/CONTUSION 

86402 LIVER LACERATION, MINOR 

86403 LIVER LACERATION, MOD 

86404 LIVER LACERATION, MAJOR 

86405 LIVER LACERAT UNSPCF CLS 

86409 LIVER INJURY NEC-CLOSED 

8641 LIVER INJURY-OPEN* 

86410 LIVER INJURY NOS-OPEN 

86411 LIVER HEMATOM/CONTUS-OPN

86412 LIVER LACERAT, MINOR-OPN 

86413 LIVER LACERAT, MOD-OPEN 

86414 LIVER LACERAT, MAJOR-OPN 

86415 LIVER LACERAT UNSPCF OPN 

86419 LIVER INJURY NEC-OPEN 

865 SPLEEN INJURY* 

8650 SPLEEN INJURY-CLOSED* 

86500 SPLEEN INJURY NOS-CLOSED 

86501 SPLEEN HEMATOMA-CLOSED 

86502 SPLEEN CAPSULAR TEAR 

86503 SPLEEN PARENCHYMA LACER 

86504 SPLEEN DISRUPTION-CLOS 

86509 SPLEEN INJURY NEC-CLOSED 

8651 SPLEEN INJURY-OPEN* 

86510 SPLEEN INJURY NOS-OPEN 

86511 SPLEEN HEMATOMA-OPEN 

86512 SPLEEN CAPSULAR TEAR-OPN 

86513 SPLEEN PARNCHYM LAC-OPN 

86514 SPLEEN DISRUPTION-OPEN 

86519 SPLEEN INJURY NEC-OPEN 

866 KIDNEY INJURY* 

8660 KIDNEY INJURY-CLOSED* 

86600 KIDNEY INJURY NOS-CLOSED 

86601 KIDNEY HEMATOMA-CLOSED 

86602 KIDNEY LACERATION-CLOSED 

86603 KIDNEY DISRUPTION-CLOSED 

8661 KIDNEY INJURY-OPEN* 

86610 KIDNEY INJURY NOS-OPEN 

86611 KIDNEY HEMATOMA-OPEN 

86612 KIDNEY LACERATION-OPEN 

86613 KIDNEY DISRUPTION-OPEN 

867 PELVIC ORGAN INJURY* 

8670 BLADDER/URETHRA INJ-CLOS 

8671 BLADDER/URETHRA INJ-OPEN 

8672 URETER INJURY-CLOSED 

8673 URETER INJURY-OPEN 

8674 UTERUS INJURY-CLOSED 

8675 UTERUS INJURY-OPEN 

8676 PELVIC ORGAN INJ NEC-CL 

8677 PELVIC ORGAN INJ NEC-OPN 

8678 PELVIC ORGAN INJ NOS-CL 

8679 PELVIC ORGAN INJ NOS-OPN 

868 OTH INTRA-ABDOMINAL INJ* 

8680 OTH INTRA-ABD INJ-CLOSED* 

86800 INTRA-ABDOM INJ NOS-CLOS 

86801 ADRENAL GLAND INJURY-CL 

86802 BILIARY TRACT INJURY-CL 

86803 PERITONEUM INJURY-CLOSED 

86804 RETROPERITONEUM INJ-CL 

86809 INTRA-ABDOM INJ NEC-CLOS 

8681 OTH INTRA-ABD INJ-OPEN* 

86810 INTRA-ABDOM INJ NOS-OPEN 

86811 ADRENAL GLAND INJURY-OPN 

86812 BILIARY TRACT INJURY-OPN 

86813 PERITONEUM INJURY-OPEN 

86814 RETROPERITONEUM INJ-OPEN 

86819 INTRA-ABDOM INJ NEC-OPEN

869 INTERNAL INJURY NOS* 

8690 INTERNAL INJ NOS-CLOSED 

8691 INTERNAL INJURY NOS-OPEN 

870 OCULAR ADNEXA OPEN WOUND* 

8700 LAC EYELID SKN/PERIOCULR 

8701 FULL-THICKNES LAC EYELID 

8702 LAC EYELID INV LACRM PAS 

8703 PENETR WND ORBIT W/O FB 

8704 PENETRAT WND ORBIT W FB 

8708 OPN WND OCULAR ADNEX NEC 

8709 OPN WND OCULAR ADNEX NOS 

871 EYEBALL OPEN WOUND* 

8710 OCULAR LAC W/O PROLAPSE 

8711 OCULAR LACERA W PROLAPSE 

8712 RUPTURE EYE W TISSU LOSS 

8713 AVULSION OF EYE 

8714 LACERATION OF EYE NOS 

8715 PENETRAT MAGNET FB EYE 

8716 PENETRAT FB NEC EYE 

8717 OCULAR PENETRATION NOS 

8719 OPN WOUND OF EYEBALL NOS 

872 OPEN WOUND OF EAR* 

8720 OPEN WOUND EXTERNAL EAR* 

87200 OPN WOUND EXTERN EAR NOS 

87201 OPEN WOUND OF AURICLE 

87202 OPN WOUND AUDITORY CANAL 

8721 OPEN WOUND EXT EAR-COMPL* 

87210 OPN WND EX EAR NOS-COMPL 

87211 OPEN WOUND AURICLE-COMPL 

87212 OPEN WND AUD CANAL-COMPL 

8726 OPEN WOUND OF EAR NEC* 

87261 OPEN WOUND OF EAR DRUM 

87262 OPEN WOUND OF OSSICLES 

87263 OPEN WND EUSTACHIAN TUBE 

87264 OPEN WOUND OF COCHLEA 

87269 OPEN WOUND OF EAR NEC 

8727 OPEN WOUND EAR NEC-COMPL* 

87271 OPEN WND EAR DRUM-COMPL 

87272 OPEN WND OSSICLES-COMPL 

87273 OPN WND EUSTACH TB-COMPL 

87274 OPEN WOUND COCHLEA-COMPL 

87279 OPEN WOUND EAR NEC-COMPL 

8728 OPEN WOUND OF EAR NOS 

8729 OPEN WOUND EAR NOS-COMPL 

873 OTHER OPEN WOUND OF HEAD* 

8730 OPEN WOUND OF SCALP 

8731 OPEN WOUND SCALP-COMPL 

8732 OPEN WOUND OF NOSE* 

87320 OPEN WOUND OF NOSE NOS 

87321 OPEN WOUND NASAL SEPTUM 

87322 OPEN WOUND NASAL CAVITY 

87323 OPEN WOUND NASAL SINUS 

87329 MULT OPEN WOUND NOSE 

8733 OPEN WOUND NOSE-COMPL* 

87330 OPEN WND NOSE NOS-COMPL 

87331 OPN WND NAS SEPTUM-COMPL 

87332 OPEN WND NASAL CAV-COMPL

87333 OPEN WND NAS SINUS-COMPL 

87339 MULT OPEN WND NOSE-COMPL 

8734 OPEN WOUND OF FACE* 

87340 OPEN WOUND OF FACE NOS 

87341 OPEN WOUND OF CHEEK 

87342 OPEN WOUND OF FOREHEAD 

87343 OPEN WOUND OF LIP 

87344 OPEN WOUND OF JAW 

87349 OPEN WOUND OF FACE NEC 

8735 OPEN WOUND FACE-COMPL* 

87350 OPEN WND FACE NOS-COMPL 

87351 OPEN WOUND CHEEK-COMPL 

87352 OPEN WND FOREHEAD-COMPL 

87353 OPEN WOUND LIP-COMPLICAT 

87354 OPEN WOUND JAW-COMPLICAT 

87359 OPEN WND FACE NEC-COMPL 

8736 OPN WOUND INTERNAL MOUTH* 

87360 OPEN WOUND OF MOUTH NOS 

87361 OPEN WOUND BUCCAL MUCOSA 

87362 OPEN WOUND OF GUM 

87363 BROKEN TOOTH 

87364 OPN WND TONGUE/MOUTH FLR 

87365 OPEN WOUND OF PALATE 

87369 OPEN WOUND MOUTH NEC 

8737 OPEN WND INT MOUTH-COMPL* 

87370 OPEN WND MOUTH NOS-COMPL 

87371 OPN WND BUC MUCOSA-COMPL 

87372 OPEN WOUND GUM-COMPL 

87373 BROKEN TOOTH-COMPLICATED 

87374 OPEN WOUND TONGUE-COMPL 

87375 OPEN WOUND PALATE-COMPL 

87379 OPEN WND MOUTH NOS-COMPL 

8738 OPEN WOUND OF HEAD NEC 

8739 OPEN WND HEAD NEC-COMPL 

874 OPEN WOUND OF NECK* 

8740 OPN WOUND LARYNX/TRACHEA* 

87400 OPN WND LARYNX W TRACHEA 

87401 OPEN WOUND OF LARYNX 

87402 OPEN WOUND OF TRACHEA 

8741 OPN WND LARYN/TRACH-COMP* 

87410 OPN WND LARY W TRAC-COMP 

87411 OPEN WOUND LARYNX-COMPL 

87412 OPEN WOUND TRACHEA-COMPL 

8742 OPEN WOUND THYROID GLAND 

8743 OPEN WOUND THYROID-COMPL 

8744 OPEN WOUND OF PHARYNX 

8745 OPEN WOUND PHARYNX-COMPL 

8748 OPEN WOUND OF NECK NEC 

8749 OPN WOUND NECK NEC-COMPL 

875 OPEN WOUND OF CHEST* 

8750 OPEN WOUND OF CHEST 

8751 OPEN WOUND CHEST-COMPL 

876 OPEN WOUND OF BACK* 

8760 OPEN WOUND OF BACK 

8761 OPEN WOUND BACK-COMPL 

877 OPEN WOUND OF BUTTOCK* 

8770 OPEN WOUND OF BUTTOCK

8771 OPEN WOUND BUTTOCK-COMPL 

878 OPEN WOUND GENITAL ORGAN* 

8780 OPEN WOUND OF PENIS 

8781 OPEN WOUND PENIS-COMPL 

8782 OPN WOUND SCROTUM/TESTES 

8783 OPN WND SCROT/TEST-COMPL 

8784 OPEN WOUND OF VULVA 

8785 OPEN WOUND VULVA-COMPL 

8786 OPEN WOUND OF VAGINA 

8787 OPEN WOUND VAGINA-COMPL 

8788 OPEN WOUND GENITAL NEC 

8789 OPN WND GENITAL NEC-COMP 

879 OPEN WOUND SITE NEC* 

8790 OPEN WOUND OF BREAST 

8791 OPEN WOUND BREAST-COMPL 

8792 OPN WND ANTERIOR ABDOMEN 

8793 OPN WND ANT ABDOMEN-COMP 

8794 OPN WND LATERAL ABDOMEN 

8795 OPN WND LAT ABDOMEN-COMP 

8796 OPEN WOUND OF TRUNK NEC 

8797 OPEN WND TRUNK NEC-COMPL 

8798 OPEN WOUND SITE NOS 

8799 OPN WOUND SITE NOS-COMPL 

880 OPN WND SHOULDR/UPPR ARM* 

8800 OPN WND SHOULDR/UPPR ARM* 

88000 OPEN WOUND OF SHOULDER 

88001 OPEN WOUND OF SCAPULA 

88002 OPEN WOUND OF AXILLA 

88003 OPEN WOUND OF UPPER ARM 

88009 MULT OPEN WOUND SHOULDER 

8801 OPN WND SHLD/UP ARM-COMP* 

88010 OPEN WND SHOULDER-COMPL 

88011 OPEN WOUND SCAPULA-COMPL 

88012 OPEN WOUND AXILLA-COMPL 

88013 OPEN WND UPPER ARM-COMPL 

88019 MULT OPN WND SHOULD-COMP 

8802 OPN WND SHLD/UP ARM-TEND* 

88020 OPN WND SHOULDR W TENDON 

88021 OPN WND SCAPULA W TENDON 

88022 OPEN WND AXILLA W TENDON 

88023 OPEN WND UP ARM W TENDON 

88029 MLT OPN WND SHLDR W TEND 

881 OPEN WOUND OF LOWER ARM* 

8810 OPEN WOUND OF LOWER ARM* 

88100 OPEN WOUND OF FOREARM 

88101 OPEN WOUND OF ELBOW 

88102 OPEN WOUND OF WRIST 

8811 OPEN WOUND LOW ARM-COMPL* 

88110 OPEN WOUND FOREARM-COMPL 

88111 OPEN WOUND ELBOW-COMPLIC 

88112 OPEN WOUND WRIST-COMPLIC 

8812 OPN WND LOW ARM W TENDON* 

88120 OPEN WND FOREARM W TENDN 

88121 OPN WOUND ELBOW W TENDON 

88122 OPN WOUND WRIST W TENDON 

882 OPEN WOUND OF HAND* 

8820 OPEN WOUND OF HAND

8821 OPN WOUND HAND-COMPLICAT 

8822 OPEN WOUND HAND W TENDON 

883 OPEN WOUND OF FINGER* 

8830 OPEN WOUND OF FINGER 

8831 OPEN WOUND FINGER-COMPL 

8832 OPEN WND FINGER W TENDON 

884 OPEN WOUND ARM MULT/NOS* 

8840 OPEN WOUND ARM MULT/NOS 

8841 OPEN WOUND ARM NOS-COMPL 

8842 OPN WND ARM NOS W TENDON 

885 TRAUM AMPUTATION THUMB* 

8850 AMPUTATION THUMB 

8851 AMPUTATION THUMB-COMPL 

886 TRAUM AMPUTATION FINGER* 

8860 AMPUTATION FINGER 

8861 AMPUTATION FINGER-COMPL 

887 TRAUMATIC AMPUT ARM/HAND* 

8870 AMPUT BELOW ELB, UNILAT 

8871 AMP BELOW ELB, UNIL-COMP 

8872 AMPUT ABV ELBOW, UNILAT 

8873 AMPUT ABV ELB, UNIL-COMP 

8874 AMPUTAT ARM, UNILAT NOS 

8875 AMPUT ARM, UNIL NOS-COMP 

8876 AMPUTATION ARM, BILAT 

8877 AMPUTAT ARM, BILAT-COMPL 

890 OPEN WOUND OF HIP/THIGH* 

8900 OPEN WOUND OF HIP/THIGH 

8901 OPEN WND HIP/THIGH-COMPL 

8902 OPN WND HIP/THIGH W TEND 

891 OPEN WND KNEE/LEG/ANKLE* 

8910 OPEN WND KNEE/LEG/ANKLE 

8911 OPEN WND KNEE/LEG-COMPL 

8912 OPN WND KNEE/LEG W TENDN 

892 OPEN WOUND OF FOOT* 

8920 OPEN WOUND OF FOOT 

8921 OPEN WOUND FOOT-COMPL 

8922 OPEN WOUND FOOT W TENDON 

893 OPEN WOUND OF TOE* 

8930 OPEN WOUND OF TOE 

8931 OPEN WOUND TOE-COMPL 

8932 OPEN WOUND TOE W TENDON 

894 OPEN WOUND OF LEG NEC* 

8940 OPEN WOUND OF LEG NEC 

8941 OPEN WOUND LEG NEC-COMPL 

8942 OPN WND LEG NEC W TENDON 

895 TRAUMATIC AMPUTATION TOE* 

8950 AMPUTATION TOE 

8951 AMPUTATION TOE-COMPLICAT 

896 TRAUMATIC AMPUTAT FOOT* 

8960 AMPUTATION FOOT, UNILAT 

8961 AMPUT FOOT, UNILAT-COMPL 

8962 AMPUTATION FOOT, BILAT 

8963 AMPUTAT FOOT, BILAT-COMP 

897 TRAUMATIC AMPUTATION LEG* 

8970 AMPUT BELOW KNEE, UNILAT 

8971 AMPUTAT BK, UNILAT-COMPL 

8972 AMPUT ABOVE KNEE, UNILAT

8973 AMPUT ABV KN, UNIL-COMPL 

8974 AMPUTAT LEG, UNILAT NOS 

8975 AMPUT LEG, UNIL NOS-COMP 

8976 AMPUTATION LEG, BILAT 

8977 AMPUTAT LEG, BILAT-COMPL 

900 HEAD/NECK VESSEL INJURY* 

9000 CAROTID ARTERY INJURY* 

90000 INJUR CAROTID ARTERY NOS 

90001 INJ COMMON CAROTID ARTER 

90002 INJ EXTERNAL CAROTID ART 

90003 INJ INTERNAL CAROTID ART 

9001 INJ INTERNL JUGULAR VEIN 

9008 INJ HEAD/NECK VESSEL NEC* 

90081 INJ EXTERN JUGULAR VEIN 

90082 INJ MLT HEAD/NECK VESSEL 

90089 INJ HEAD/NECK VESSEL NEC 

9009 INJ HEAD/NECK VESSEL NOS 

901 THORAC BLOOD VESSEL INJ* 

9010 INJURY THORACIC AORTA 

9011 INJ INNOMIN/SUBCLAV ART 

9012 INJ SUPERIOR VENA CAVA 

9013 INJ INNOMIN/SUBCLAV VEIN 

9014 INJURY PULMONARY VESSEL* 

90140 INJ PULMONARY VESSEL NOS 

90141 INJURY PULMONARY ARTERY 

90142 INJURY PULMONARY VEIN 

9018 INJ THORACIC VESSEL NEC* 

90181 INJ INTERCOSTAL ART/VEIN 

90182 INJ INT MAMMARY ART/VEIN 

90183 INJ MULT THORACIC VESSEL 

90189 INJ THORACIC VESSEL NEC 

9019 INJ THORACIC VESSEL NOS 

902 ABDOM/PELVIS VESSEL INJ* 

9020 INJURY ABDOMINAL AORTA 

9021 INJ INFERIOR VENA CAVA* 

90210 INJ INFER VENA CAVA NOS 

90211 INJURY HEPATIC VEINS 

90219 INJ INFER VENA CAVA NEC 

9022 INJ CELIAC/MESENTER ART* 

90220 INJ CELIAC/MESEN ART NOS 

90221 INJURY GASTRIC ARTERY 

90222 INJURY HEPATIC ARTERY 

90223 INJURY SPLENIC ARTERY 

90224 INJURY CELIAC AXIS NEC 

90225 INJ SUPER MESENTERIC ART 

90226 INJ BRNCH SUP MESENT ART 

90227 INJ INFER MESENTERIC ART 

90229 INJ MESENTERIC VESS NEC 

9023 PORTAL/SPLENIC VEIN INJ* 

90231 INJ SUPERIOR MESENT VEIN 

90232 INJ INFERIOR MESENT VEIN 

90233 INJURY PORTAL VEIN 

90234 INJURY SPLENIC VEIN 

90239 INJ PORT/SPLEN VESS NEC 

9024 RENAL VESSEL INJURY* 

90240 INJURY RENAL VESSEL NOS 

90241 INJURY RENAL ARTERY

90242 INJURY RENAL VEIN 

90249 INJURY RENAL VESSEL NEC 

9025 ILIAC VESSEL INJURY* 

90250 INJURY ILIAC VESSEL NOS 

90251 INJ HYPOGASTRIC ARTERY 

90252 INJURY HYPOGASTRIC VEIN 

90253 INJURY ILIAC ARTERY 

90254 INJURY ILIAC VEIN 

90255 INJURY UTERINE ARTERY 

90256 INJURY UTERINE VEIN 

90259 INJURY ILIAC VESSEL NEC 

9028 INJ ABDOMINAL VESSEL NEC* 

90281 INJURY OVARIAN ARTERY 

90282 INJURY OVARIAN VEIN 

90287 INJ MULT ABD/PELV VESSEL 

90289 INJ ABDOMINAL VESSEL NEC 

9029 INJ ABDOMINAL VESSEL NOS 

903 ARM BLOOD VESSEL INJURY* 

9030 INJURY AXILLARY VESSELS* 

90300 INJ AXILLARY VESSEL NOS 

90301 INJURY AXILLARY ARTERY 

90302 INJURY AXILLARY VEIN 

9031 INJURY BRACHIAL VESSELS 

9032 INJURY RADIAL VESSELS 

9033 INJURY ULNAR VESSELS 

9034 INJURY PALMAR ARTERY 

9035 INJURY FINGER VESSELS 

9038 INJURY ARM VESSELS NEC 

9039 INJURY ARM VESSEL NOS 

904 BLOOD VESSEL INJURY NEC* 

9040 INJ COMMON FEMORAL ARTER 

9041 INJ SUPERFIC FEMORAL ART 

9042 INJURY FEMORAL VEIN 

9043 INJURY SAPHENOUS VEIN 

9044 INJURY POPLITEAL VESSEL* 

90440 INJ POPLITEAL VESSEL NOS 

90441 INJURY POPLITEAL ARTERY 

90442 INJURY POPLITEAL VEIN 

9045 INJURY TIBIAL VESSELS* 

90450 INJURY TIBIAL VESSEL NOS 

90451 INJ ANTER TIBIAL ARTERY 

90452 INJ ANTERIOR TIBIAL VEIN 

90453 INJ POST TIBIAL ARTERY 

90454 INJ POST TIBIAL VEIN 

9046 INJ DEEP PLANTAR VESSEL 

9047 INJURY LEG VESSELS NEC 

9048 INJURY LEG VESSEL NOS 

9049 BLOOD VESSEL INJURY NOS 

905 LATE EFF MUSCULOSKEL INJ* 

9050 LATE EFFEC SKULL/FACE FX 

9051 LATE EFF SPINE/TRUNK FX 

9052 LATE EFFECT ARM FX 

9053 LATE EFF FEMORAL NECK FX 

9054 LATE EFFECT LEG FX 

9055 LATE EFFECT FRACTURE NEC 

9056 LATE EFFECT DISLOCATION 

9057 LATE EFFEC SPRAIN/STRAIN

9058 LATE EFFEC TENDON INJURY 

9059 LATE EFF TRAUMAT AMPUTAT 

906 LATE EFF SKIN/SUBCUT INJ* 

9060 LT EFF OPN WND HEAD/TRNK 

9061 LATE EFF OPEN WND EXTREM 

9062 LATE EFF SUPERFICIAL INJ 

9063 LATE EFFECT OF CONTUSION 

9064 LATE EFFECT OF CRUSHING 

9065 LATE EFF HEAD/NECK BURN 

9066 LATE EFF WRIST/HAND BURN 

9067 LATE EFF BURN EXTREM NEC 

9068 LATE EFFECT OF BURNS NEC 

9069 LATE EFFECT OF BURN NOS 

907 LATE EFF NERV SYSTEM INJ* 

9070 LT EFF INTRACRANIAL INJ 

9071 LATE EFF CRAN NERVE INJ 

9072 LATE EFF SPINAL CORD INJ 

9073 LT EFF NERV INJ TRNK NEC 

9074 LT EFF NERV INJ SHLD/ARM 

9075 LT EFF NERV INJ PELV/LEG 

9079 LATE EFF NERVE INJ NEC 

908 LATE EFF INJURY NEC/NOS* 

9080 LATE EFF INT INJUR CHEST 

9081 LATE EFF INT INJ ABDOMEN 

9082 LATE EFF INT INJURY NEC 

9083 LATE EFF INJ PERIPH VESS 

9084 LT EFF INJ THOR/ABD VESS 

9085 LATE EFF FB IN ORIFICE 

9086 LATE EFF COMPLIC TRAUMA 

9089 LATE EFFECT INJURY NOS 

909 LATE EFF EXTER CAUSE NEC* 

9090 LATE EFF DRUG POISONING 

9091 LATE EFF NONMED SUBSTANC 

9092 LATE EFFECT OF RADIATION 

9093 LATE EFF SURG/MED COMPL 

9094 LATE EFF CERT EXT CAUSE 

9095 LTE EFCT ADVRS EFCT DRUG 

9099 LATE EFF EXTER CAUSE NEC 

910 SUPERFICIAL INJURY HEAD* 

9100 ABRASION HEAD 

9101 ABRASION HEAD-INFECTED 

9102 BLISTER HEAD 

9103 BLISTER HEAD-INFECTED 

9104 INSECT BITE HEAD 

9105 INSECT BITE HEAD-INFECT 

9106 FOREIGN BODY HEAD 

9107 FOREIGN BODY HEAD-INFECT 

9108 SUPERFIC INJ HEAD NEC 

9109 SUPERF INJ HEAD NEC-INF 

911 SUPERFICIAL INJURY TRUNK* 

9110 ABRASION TRUNK 

9111 ABRASION TRUNK-INFECTED 

9112 BLISTER TRUNK 

9113 BLISTER TRUNK-INFECTED 

9114 INSECT BITE TRUNK 

9115 INSECT BITE TRUNK-INFEC 

9116 FOREIGN BODY TRUNK

9117 FOREIGN BODY TRUNK-INFEC 

9118 SUPERFIC INJ TRUNK NEC 

9119 SUPERF INJ TRNK NEC-INF 

912 SUPERFIC INJ SHOULDR/ARM* 

9120 ABRASION SHOULDER/ARM 

9121 ABRASION SHLDR/ARM-INFEC 

9122 BLISTER SHOULDER & ARM 

9123 BLISTER SHOULDER/ARM-INF 

9124 INSECT BITE SHOULDER/ARM 

9125 INSECT BITE SHLD/ARM-INF 

9126 FOREIGN BODY SHOULDR/ARM 

9127 FB SHOULDER/ARM-INFECT 

9128 SUPERF INJ SHLDR/ARM NEC 

9129 SUPERF INJ SHLDR NEC-INF 

913 SUPERFICIAL INJ FOREARM* 

9130 ABRASION FOREARM 

9131 ABRASION FOREARM-INFECT 

9132 BLISTER FOREARM 

9133 BLISTER FOREARM-INFECTED 

9134 INSECT BITE FOREARM 

9135 INSECT BITE FOREARM-INF 

9136 FOREIGN BODY FOREARM 

9137 FOREIGN BODY FOREARM-INF 

9138 SUPERF INJ FOREARM NEC 

9139 SUPRF INJ FORARM NEC-INF 

914 SUPERFICIAL INJ OF HAND* 

9140 ABRASION HAND 

9141 ABRASION HAND-INFECTED 

9142 BLISTER HAND 

9143 BLISTER HAND-INFECTED 

9144 INSECT BITE HAND 

9145 INSECT BITE HAND-INFECT 

9146 FOREIGN BODY HAND 

9147 FOREIGN BODY HAND-INFECT 

9148 SUPERFICIAL INJ HAND NEC 

9149 SUPERF INJ HAND NEC-INF 

915 SUPERFICIAL INJ FINGER* 

9150 ABRASION FINGER 

9151 ABRASION FINGER-INFECTED 

9152 BLISTER FINGER 

9153 BLISTER FINGER-INFECTED 

9154 INSECT BITE FINGER 

9155 INSECT BITE FINGER-INFEC 

9156 FOREIGN BODY FINGER 

9157 FOREIGN BODY FINGER-INF 

9158 SUPERFIC INJ FINGER-NEC 

9159 SUPRF INJ FINGER NEC-INF 

916 SUPERFICIAL INJ HIP/LEG* 

9160 ABRASION HIP & LEG 

9161 ABRASION HIP/LEG-INFECT 

9162 BLISTER HIP & LEG 

9163 BLISTER HIP & LEG-INFECT 

9164 INSECT BITE HIP & LEG 

9165 INSECT BITE HIP/LEG-INF 

9166 FOREIGN BODY HIP/LEG 

9167 FOREIGN BDY HIP/LEG-INF 

9168 SUPERFIC INJ HIP/LEG NEC

9169 SUPERF INJ LEG NEC-INFEC 

917 SUPERFICIAL INJ FOOT/TOE* 

9170 ABRASION FOOT & TOE 

9171 ABRASION FOOT/TOE-INFEC 

9172 BLISTER FOOT & TOE 

9173 BLISTER FOOT & TOE-INFEC 

9174 INSECT BITE FOOT/TOE 

9175 INSECT BITE FOOT/TOE-INF 

9176 FOREIGN BODY FOOT & TOE 

9177 FOREIGN BDY FOOT/TOE-INF 

9178 SUPERF INJ FOOT/TOE NEC 

9179 SUPERF INJ FOOT NEC-INF 

918 SUPERFIC INJ EYE/ADNEXA* 

9180 SUPERFIC INJ PERIOCULAR 

9181 SUPERFICIAL INJ CORNEA 

9182 SUPERFIC INJ CONJUNCTIVA 

9189 SUPERFICIAL INJ EYE NEC 

919 SUPERFICIAL INJ OTH SITE* 

9190 ABRASION NEC 

9191 ABRASION NEC-INFECTED 

9192 BLISTER NEC 

9193 BLISTER NEC-INFECTED 

9194 INSECT BITE NEC 

9195 INSECT BITE NEC-INFECTED 

9196 SUPERFIC FOREIGN BDY NEC 

9197 SUPERFICIAL FB NEC-INFEC 

9198 SUPERFICIAL INJURY NEC 

9199 SUPERFIC INJ NEC-INFECT 

920 CONTUSION FACE/SCALP/NCK 

921 CONTUSION EYE & ADNEXA* 

9210 BLACK EYE NOS 

9211 CONTUSION PERIOCULAR 

9212 CONTUSION ORBITAL TISSUE 

9213 CONTUSION OF EYEBALL 

9219 CONTUSION OF EYE NOS 

922 CONTUSION OF TRUNK* 

9220 CONTUSION OF BREAST 

9221 CONTUSION OF CHEST WALL 

9222 CONTUSION ABDOMINAL WALL 

9223 CONTUSION OF BACK* 

92231 BACK CONTUSION 

92232 BUTTOCK CONTUSION 

92233 INTERSCPLR REG CONTUSION 

9224 CONTUSION GENITAL ORGANS 

9228 MULTIPLE CONTUSION TRUNK 

9229 CONTUSION TRUNK NOS 

923 CONTUSION OF UPPER LIMB* 

9230 CONTUSION SHOULDER/ARM* 

92300 CONTUSION SHOULDER REG 

92301 CONTUSION SCAPUL REGION 

92302 CONTUSION AXILLARY REG 

92303 CONTUSION OF UPPER ARM 

92309 CONTUSION SHOULDER & ARM 

9231 CONTUSION ELBOW/FOREARM* 

92310 CONTUSION OF FOREARM 

92311 CONTUSION OF ELBOW 

9232 CONTUSION OF WRIST/HAND*

92320 CONTUSION OF HAND(S) 

92321 CONTUSION OF WRIST 

9233 CONTUSION OF FINGER 

9238 MULTIPLE CONTUSION ARM 

9239 CONTUSION UPPER LIMB NOS 

924 CONTUSION LEG & OTH SITE* 

9240 CONTUSION OF HIP & THIGH* 

92400 CONTUSION OF THIGH 

92401 CONTUSION OF HIP 

9241 CONTUSION KNEE/LOWER LEG* 

92410 CONTUSION OF LOWER LEG 

92411 CONTUSION OF KNEE 

9242 CONTUSION ANKLE & FOOT* 

92420 CONTUSION OF FOOT 

92421 CONTUSION OF ANKLE 

9243 CONTUSION OF TOE 

9244 MULTIPLE CONTUSION LEG 

9245 CONTUSION LEG NOS 

9248 MULTIPLE CONTUSIONS NEC 

9249 CONTUSION NOS 

925 CRUSH INJ FACE/SCALP/NCK* 

9251 CRUSH INJ FACE SCALP 

9252 CRUSH INJ NECK 

926 CRUSHING INJURY OF TRUNK* 

9260 CRUSH INJ EXT GENITALIA 

9261 OTH TRUNK CRUSHING INJ* 

92611 CRUSHING INJURY BACK 

92612 CRUSHING INJURY BUTTOCK 

92619 CRUSHING INJ TRUNK NEC 

9268 MULT CRUSHING INJ TRUNK 

9269 CRUSHING INJ TRUNK NOS 

927 CRUSHING INJ UPPER LIMB* 

9270 CRUSH INJ SHOULDER & ARM* 

92700 CRUSH INJ SHOULDER REG 

92701 CRUSH INJ SCAPUL REGION 

92702 CRUSH INJ AXILLARY REG 

92703 CRUSHING INJ UPPER ARM 

92709 CRUSH INJ SHOULDER & ARM 

9271 CRUSH INJ ELBOW/FOREARM* 

92710 CRUSHING INJURY FOREARM 

92711 CRUSHING INJURY ELBOW 

9272 CRUSHING INJ WRIST/HAND* 

92720 CRUSHING INJURY OF HAND 

92721 CRUSHING INJURY OF WRIST 

9273 CRUSHING INJURY FINGER 

9278 MULT CRUSHING INJURY ARM 

9279 CRUSHING INJURY ARM NOS 

928 CRUSHING INJURY OF LEG* 

9280 CRUSHING INJ HIP/THIGH* 

92800 CRUSHING INJURY THIGH 

92801 CRUSHING INJURY HIP 

9281 CRUSH INJ KNEE/LOWER LEG* 

92810 CRUSHING INJ LOWER LEG 

92811 CRUSHING INJURY KNEE 

9282 CRUSHING INJ ANKLE/FOOT* 

92820 CRUSHING INJURY FOOT 

92821 CRUSHING INJURY ANKLE

9283 CRUSHING INJURY TOE 

9288 MULT CRUSHING INJURY LEG 

9289 CRUSHING INJURY LEG NOS 

929 CRUSH INJ MULT/UNSP SITE* 

9290 CRUSH INJ MULT SITE NEC 

9299 CRUSHING INJURY NOS 

930 FOREIGN BODY EXTERN EYE* 

9300 CORNEAL FOREIGN BODY 

9301 FB IN CONJUNCTIVAL SAC 

9302 FB IN LACRIMAL PUNCTUM 

9308 FOREIGN BDY EXT EYE NEC 

9309 FOREIGN BDY EXT EYE NOS 

931 FOREIGN BODY IN EAR 

932 FOREIGN BODY IN NOSE 

933 FB PHARYNX & LARYNX* 

9330 FOREIGN BODY IN PHARYNX 

9331 FOREIGN BODY IN LARYNX 

934 FB TRACHEA/BRONCHUS/LUNG* 

9340 FOREIGN BODY IN TRACHEA 

9341 FOREIGN BODY BRONCHUS 

9348 FB TRACH/BRONCH/LUNG NEC 

9349 FB RESPIRATORY TREE NOS 

935 FB MOUTH/ESOPHAG/STOMACH* 

9350 FOREIGN BODY IN MOUTH 

9351 FOREIGN BODY ESOPHAGUS 

9352 FOREIGN BODY IN STOMACH 

936 FB IN INTESTINE & COLON 

937 FOREIGN BODY ANUS/RECTUM 

938 FOREIGN BODY GI NOS 

939 FOREIGN BODY GU TRACT* 

9390 FB BLADDER & URETHRA 

9391 FOREIGN BODY UTERUS 

9392 FOREIGN BDY VULVA/VAGINA 

9393 FOREIGN BODY PENIS 

9399 FOREIGN BDY GU TRACT NOS 

940 BURN OF EYE & ADNEXA* 

9400 CHEMICAL BURN PERIOCULAR 

9401 BURN PERIOCULAR AREA NEC 

9402 ALKAL BURN CORNEA/CONJUN 

9403 ACID BURN CORNEA/CONJUNC 

9404 BURN CORNEA/CONJUNCT NEC 

9405 BURN W EYEBALL DESTRUCT 

9409 BURN EYE & ADNEXA NOS 

941 BURN OF HEAD/FACE/NECK* 

9410 BURN NOS HEAD/FACE/NECK* 

94100 BURN NOS HEAD-UNSPEC 

94101 BURN NOS EAR 

94102 BURN NOS EYE 

94103 BURN NOS LIP 

94104 BURN NOS CHIN 

94105 BURN NOS NOSE 

94106 BURN NOS SCALP 

94107 BURN NOS FACE NEC 

94108 BURN NOS NECK 

94109 BURN NOS HEAD-MULT 

9411 1ST DEGREE BURN HEAD* 

94110 1ST DEG BURN HEAD NOS

94111 1ST DEG BURN EAR 

94112 1ST DEG BURN EYE 

94113 1ST DEG BURN LIP 

94114 1ST DEG BURN CHIN 

94115 1ST DEG BURN NOSE 

94116 1ST DEG BURN SCALP 

94117 1ST DEG BURN FACE NEC 

94118 1ST DEG BURN NECK 

94119 1ST DEG BURN HEAD-MULT 

9412 2ND DEGREE BURN HEAD* 

94120 2ND DEG BURN HEAD NOS 

94121 2ND DEG BURN EAR 

94122 2ND DEG BURN EYE 

94123 2ND DEG BURN LIP 

94124 2ND DEG BURN CHIN 

94125 2ND DEG BURN NOSE 

94126 2ND DEG BURN SCALP 

94127 2ND DEG BURN FACE NEC 

94128 2ND DEG BURN NECK 

94129 2ND DEG BURN HEAD-MULT 

9413 3RD DEGREE BURN HEAD* 

94130 3RD DEG BURN HEAD NOS 

94131 3RD DEG BURN EAR 

94132 3RD DEG BURN EYE 

94133 3RD DEG BURN LIP 

94134 3RD DEG BURN CHIN 

94135 3RD DEG BURN NOSE 

94136 3RD DEG BURN SCALP 

94137 3RD DEG BURN FACE NEC 

94138 3RD DEG BURN NECK 

94139 3RD DEG BURN HEAD-MULT 

9414 DEEP 3RD DEG BURN HEAD* 

94140 DEEP 3 DEG BURN HEAD NOS 

94141 DEEP 3RD DEG BURN EAR 

94142 DEEP 3RD DEG BURN EYE 

94143 DEEP 3RD DEG BURN LIP 

94144 DEEP 3RD DEG BURN CHIN 

94145 DEEP 3RD DEG BURN NOSE 

94146 DEEP 3RD DEG BURN SCALP 

94147 DEEP 3RD BURN FACE NEC 

94148 DEEP 3RD DEG BURN NECK 

94149 DEEP 3 DEG BRN HEAD-MULT 

9415 3RD DEG BURN W LOSS-HEAD* 

94150 3RD BURN W LOSS-HEAD NOS 

94151 3RD DEG BURN W LOSS-EAR 

94152 3RD DEG BURN W LOSS-EYE 

94153 3RD DEG BURN W LOSS-LIP 

94154 3RD DEG BURN W LOSS-CHIN 

94155 3RD DEG BURN W LOSS-NOSE 

94156 3RD DEG BRN W LOSS-SCALP 

94157 3RD BURN W LOSS-FACE NEC 

94158 3RD DEG BURN W LOSS-NECK 

94159 3RD BRN W LOSS-HEAD MULT 

942 BURN OF TRUNK* 

9420 BURN NOS TRUNK* 

94200 BURN NOS TRUNK-UNSPEC 

94201 BURN NOS BREAST

94202 BURN NOS CHEST WALL 

94203 BURN NOS ABDOMINAL WALL 

94204 BURN NOS BACK 

94205 BURN NOS GENITALIA 

94209 BURN NOS TRUNK NEC 

9421 1ST DEGREE BURN TRUNK* 

94210 1ST DEG BURN TRUNK NOS 

94211 1ST DEG BURN BREAST 

94212 1ST DEG BURN CHEST WALL 

94213 1ST DEG BURN ABDOMN WALL 

94214 1ST DEG BURN BACK 

94215 1ST DEG BURN GENITALIA 

94219 1ST DEG BURN TRUNK NEC 

9422 2ND DEGREE BURN TRUNK* 

94220 2ND DEG BURN TRUNK NOS 

94221 2ND DEG BURN BREAST 

94222 2ND DEG BURN CHEST WALL 

94223 2ND DEG BURN ABDOMN WALL 

94224 2ND DEG BURN BACK 

94225 2ND DEG BURN GENITALIA 

94229 2ND DEG BURN TRUNK NEC 

9423 3RD DEGREE BURN TRUNK* 

94230 3RD DEG BURN TRUNK NOS 

94231 3RD DEG BURN BREAST 

94232 3RD DEG BURN CHEST WALL 

94233 3RD DEG BURN ABDOMN WALL 

94234 3RD DEG BURN BACK 

94235 3RD DEG BURN GENITALIA 

94239 3RD DEG BURN TRUNK NEC 

9424 DEEP 3RD DEG BURN TRUNK* 

94240 DEEP 3RD BURN TRUNK NOS 

94241 DEEP 3RD DEG BURN BREAST 

94242 DEEP 3RD BURN CHEST WALL 

94243 DEEP 3RD BURN ABDOM WALL 

94244 DEEP 3RD DEG BURN BACK 

94245 DEEP 3RD BURN GENITALIA 

94249 DEEP 3RD BURN TRUNK NEC 

9425 3 DEG BURN W LOSS-TRUNK* 

94250 3RD BRN W LOSS-TRUNK NOS 

94251 3RD BURN W LOSS-BREAST 

94252 3RD BRN W LOSS-CHEST WLL 

94253 3RD BRN W LOSS-ABDOM WLL 

94254 3RD DEG BURN W LOSS-BACK 

94255 3RD BRN W LOSS-GENITALIA 

94259 3RD BRN W LOSS-TRUNK NEC 

943 BURN OF ARM* 

9430 BURN NOS ARM* 

94300 BURN NOS ARM-UNSPEC 

94301 BURN NOS FOREARM 

94302 BURN NOS ELBOW 

94303 BURN NOS UPPER ARM 

94304 BURN NOS AXILLA 

94305 BURN NOS SHOULDER 

94306 BURN NOS SCAPULA 

94309 BURN NOS ARM-MULTIPLE 

9431 1ST DEGREE BURN ARM* 

94310 1ST DEG BURN ARM NOS

94311 1ST DEG BURN FOREARM 

94312 1ST DEG BURN ELBOW 

94313 1ST DEG BURN UPPER ARM 

94314 1ST DEG BURN AXILLA 

94315 1ST DEG BURN SHOULDER 

94316 1ST DEG BURN SCAPULA 

94319 1ST DEG BURN ARM-MULT 

9432 2ND DEGREE BURN ARM* 

94320 2ND DEG BURN ARM NOS 

94321 2ND DEG BURN FOREARM 

94322 2ND DEG BURN ELBOW 

94323 2ND DEG BURN UPPER ARM 

94324 2ND DEG BURN AXILLA 

94325 2ND DEG BURN SHOULDER 

94326 2ND DEG BURN SCAPULA 

94329 2ND DEG BURN ARM-MULT 

9433 3RD DEGREE BURN ARM* 

94330 3RD DEG BURN ARM NOS 

94331 3RD DEG BURN FOREARM 

94332 3RD DEG BURN ELBOW 

94333 3RD DEG BURN UPPER ARM 

94334 3RD DEG BURN AXILLA 

94335 3RD DEG BURN SHOULDER 

94336 3RD DEG BURN SCAPULA 

94339 3RD DEG BURN ARM-MULT 

9434 DEEP 3RD DEG BURN ARM* 

94340 DEEP 3 DEG BURN ARM NOS 

94341 DEEP 3 DEG BURN FOREARM 

94342 DEEP 3 DEG BURN ELBOW 

94343 DEEP 3 DEG BRN UPPER ARM 

94344 DEEP 3 DEG BURN AXILLA 

94345 DEEP 3 DEG BURN SHOULDER 

94346 DEEP 3 DEG BURN SCAPULA 

94349 DEEP 3 DEG BURN ARM-MULT 

9435 3RD DEG BURN W LOSS-ARM* 

94350 3RD BURN W LOSS-ARM NOS 

94351 3RD BURN W LOSS-FOREARM 

94352 3RD BURN W LOSS-ELBOW 

94353 3RD BRN W LOSS-UPPER ARM 

94354 3RD BURN W LOSS-AXILLA 

94355 3RD BURN W LOSS-SHOULDER 

94356 3RD BURN W LOSS-SCAPULA 

94359 3RD BURN W LOSS ARM-MULT 

944 BURN OF HAND & WRIST* 

9440 BURN NOS HAND & WRIST* 

94400 BURN NOS HAND-UNSPEC 

94401 BURN NOS FINGER 

94402 BURN NOS THUMB 

94403 BURN NOS MULT FINGERS 

94404 BURN NOS FINGER W THUMB 

94405 BURN NOS PALM 

94406 BURN NOS BACK OF HAND 

94407 BURN NOS WRIST 

94408 BURN NOS HAND-MULTIPLE 

9441 1ST DEGREE BURN HAND* 

94410 1ST DEG BURN HAND NOS 

94411 1ST DEG BURN FINGER

94412 1ST DEG BURN THUMB 

94413 1ST DEG BURN MULT FINGER 

94414 1 DEG BURN FINGR W THUMB 

94415 1ST DEG BURN PALM 

94416 1 DEG BURN BACK OF HAND 

94417 1ST DEG BURN WRIST 

94418 1ST DEG BURN HAND-MULT 

9442 2ND DEGREE BURN HAND* 

94420 2ND DEG BURN HAND NOS 

94421 2ND DEG BURN FINGER 

94422 2ND DEG BURN THUMB 

94423 2ND DEG BURN MULT FINGER 


94425 2ND DEG BURN PALM 


94427 2ND DEG BURN WRIST 

94428 2ND DEG BURN HAND-MULT 

9443 3RD DEGREE BURN HAND* 

94430 3RD DEG BURN HAND NOS 

94431 3RD DEG BURN FINGER 

94432 3RD DEG BURN THUMB 

94433 3RD DEG BURN MULT FINGER 


94435 3RD DEG BURN PALM 


94437 3RD DEG BURN WRIST 

94438 3RD DEG BURN HAND-MULT 

9444 DEEP 3RD DEG BURN HAND* 

94440 DEEP 3 DEG BRN HAND NOS 

94441 DEEP 3 DEG BURN FINGER 

94442 DEEP 3 DEG BURN THUMB 

94443 DEEP 3RD BRN MULT FINGER 

94444 DEEP 3RD BRN FNGR W THMB 

94445 DEEP 3 DEG BURN PALM 

94446 DEEP 3RD BRN BACK OF HND 

94447 DEEP 3 DEG BURN WRIST 

94448 DEEP 3 DEG BRN HAND-MULT 

9445 3RD DEG BURN W LOSS-HAND* 

94450 3RD BRN W LOSS-HAND NOS 

94451 3RD BURN W LOSS-FINGER 

94452 3RD BURN W LOSS-THUMB 

94453 3RD BRN W LOSS-MULT FNGR 

94454 3RD BRN W LOSS-FNGR/THMB 

94455 3RD BURN W LOSS-PALM 

94456 3RD BRN W LOSS-BK OF HND 

94457 3RD BURN W LOSS-WRIST 

94458 3RD BRN W LOSS HAND-MULT 

945 BURN OF LEG* 

9450 BURN NOS LEG* 

94500 BURN NOS LEG-UNSPEC 

94501 BURN NOS TOE 

94502 BURN NOS FOOT 

94503 BURN NOS ANKLE 

94504 BURN NOS LOWER LEG 

94505 BURN NOS KNEE 

94506 BURN NOS THIGH 

94509 BURN NOS LEG-MULTIPLE

9451 1ST DEGREE BURN LEG* 

94510 1ST DEG BURN LEG NOS 

94511 1ST DEG BURN TOE 

94512 1ST DEG BURN FOOT 

94513 1ST DEG BURN ANKLE 

94514 1ST DEG BURN LOWER LEG 

94515 1ST DEG BURN KNEE 

94516 1ST DEG BURN THIGH 

94519 1ST DEG BURN LEG-MULT 

9452 2ND DEGREE BURN LEG* 

94520 2ND DEG BURN LEG NOS 

94521 2ND DEG BURN TOE 

94522 2ND DEG BURN FOOT 

94523 2ND DEG BURN ANKLE 

94524 2ND DEG BURN LOWER LEG 

94525 2ND DEG BURN KNEE 

94526 2ND DEG BURN THIGH 

94529 2ND DEG BURN LEG-MULT 

9453 3RD DEGREE BURN LEG* 

94530 3RD DEG BURN LEG NOS 

94531 3RD DEG BURN TOE 

94532 3RD DEG BURN FOOT 

94533 3RD DEG BURN ANKLE 

94534 3RD DEG BURN LOW LEG 

94535 3RD DEG BURN KNEE 

94536 3RD DEG BURN THIGH 

94539 3RD DEG BURN LEG-MULT 

9454 DEEP 3RD DEGREE BURN LEG* 

94540 DEEP 3RD DEG BRN LEG NOS 

94541 DEEP 3RD DEG BURN TOE 

94542 DEEP 3RD DEG BURN FOOT 

94543 DEEP 3RD DEG BURN ANKLE 

94544 DEEP 3RD DEG BRN LOW LEG 

94545 DEEP 3RD DEG BURN KNEE 

94546 DEEP 3RD DEG BURN THIGH 

94549 DEEP 3 DEG BURN LEG-MULT 

9455 3RD DEG BURN W LOSS-LEG* 

94550 3 DEG BRN W LOSS-LEG NOS 

94551 3 DEG BURN W LOSS-TOE 

94552 3 DEG BURN W LOSS-FOOT 

94553 3 DEG BURN W LOSS-ANKLE 

94554 3 DEG BRN W LOSS-LOW LEG 

94555 3 DEG BURN W LOSS-KNEE 

94556 3 DEG BURN W LOSS-THIGH 

94559 3 DEG BRN W LOSS LEG-MLT 

946 BURN OF MULTIPLE SITE* 

9460 BURN NOS MULTIPLE SITE 

9461 1ST DEG BURN MULT SITE 

9462 2ND DEG BURN MULT SITE 

9463 3RD DEG BURN MULT SITE 

9464 DEEP 3 DEG BRN MULT SITE 

9465 3RD BRN W LOSS-MULT SITE 

947 BURN OF INTERNAL ORGANS* 

9470 BURN OF MOUTH & PHARYNX 

9471 BURN LARYNX/TRACHEA/LUNG 

9472 BURN OF ESOPHAGUS 

9473 BURN OF GI TRACT

9474 BURN OF VAGINA & UTERUS 

9478 BURN INTERNAL ORGAN NEC 

9479 BURN INTERNAL ORGAN NOS 

948 BURN BY % BODY SURFACE* 

9480 BODY SURFACE BURN < 10%* 

94800 BDY BRN < 10%/3D DEG NOS 

9481 10-19% BODY SURFACE BURN* 

94810 10-19% BDY BRN/3 DEG NOS 

94811 10-19% BDY BRN/10-19% 3D 


94820 20-29% BDY BRN/3 DEG NOS 

94821 20-29% BDY BRN/10-19% 3D 

94822 20-29% BDY BRN/20-29% 3D 


94830 30-39% BDY BRN/3 DEG NOS 

94831 30-39% BDY BRN/10-19% 3D 

94832 30-39% BDY BRN/20-29% 3D 

94833 30-39% BDY BRN/30-39% 3D 


94840 40-49% BDY BRN/3 DEG NOS 

94841 40-49% BDY BRN/10-19% 3D 

94842 40-49% BDY BRN/20-29% 3D 

94843 40-49% BDY BRN/30-39% 3D 

94844 40-49% BDY BRN/40-49% 3D 


94850 50-59% BDY BRN/3 DEG NOS 

94851 50-59% BDY BRN/10-19% 3D 

94852 50-59% BDY BRN/20-29% 3D 

94853 50-59% BDY BRN/30-39% 3D 

94854 50-59% BDY BRN/40-49% 3D 

94855 50-59% BDY BRN/50-59% 3D 


94860 60-69% BDY BRN/3 DEG NOS 

94861 60-69% BDY BRN/10-19% 3D 

94862 60-69% BDY BRN/20-29% 3D 

94863 60-69% BDY BRN/30-39% 3D 

94864 60-69% BDY BRN/40-49% 3D 

94865 60-69% BDY BRN/50-59% 3D 

94866 60-69% BDY BRN/60-69% 3D 


94870 70-79% BDY BRN/3 DEG NOS 

94871 70-79% BDY BRN/10-19% 3D 

94872 70-79% BDY BRN/20-29% 3D 

94873 70-79% BDY BRN/30-39% 3D 

94874 70-79% BDY BRN/40-49% 3D 

94875 70-79% BDY BRN/50-59% 3D 

94876 70-79% BDY BRN/60-69% 3D 

94877 70-79% BDY BRN/70-79% 3D 


94880 80-89% BDY BRN/3 DEG NOS 

94881 80-89% BDY BRN/10-19% 3D 

94882 80-89% BDY BRN/20-29% 3D 

94883 80-89% BDY BRN/30-39% 3D 

94884 80-89% BDY BRN/40-49% 3D 

94885 80-89% BDY BRN/50-59% 3D 

94886 80-89% BDY BRN/60-69% 3D 

94887 80-89% BDY BRN/70-79% 3D

94888 80-89% BDY BRN/80-89% 3D 

9489 90% OR MORE BDY SURF BRN* 

94890 90% + BDY BRN/3D DEG NOS 

94891 90% + BDY BRN/10-19% 3RD 

94892 90% + BDY BRN/20-29% 3RD 

94893 90% + BDY BRN/30-39% 3RD 

94894 90% + BDY BRN/40-49% 3RD 

94895 90% + BDY BRN/50-59% 3RD 

94896 90% + BDY BRN/60-69% 3RD 

94897 90% + BDY BRN/70-79% 3RD 

94898 90% + BDY BRN/80-89% 3RD 

94899 90% + BDY BRN/90% + 3RD 

949 BURN UNSPECIFIED* 

9490 BURN NOS 

9491 1ST DEGREE BURN NOS 

9492 2ND DEGREE BURN NOS 

9493 3RD DEGREE BURN NOS 

9494 DEEP 3RD DEG BURN NOS 

9495 3RD BURN W LOSS-SITE NOS 

950 INJ OPTIC NERV/PATHWAYS* 

9500 OPTIC NERVE INJURY 

9501 INJURY TO OPTIC CHIASM 

9502 INJURY TO OPTIC PATHWAYS 

9503 INJURY TO VISUAL CORTEX 

9509 INJ OPTIC NERV/PATH NOS 

951 CRANIAL NERVE INJURY NEC* 

9510 INJURY OCULOMOTOR NERVE 

9511 INJURY TROCHLEAR NERVE 

9512 INJURY TRIGEMINAL NERVE 

9513 INJURY ABDUCENS NERVE 

9514 INJURY TO FACIAL NERVE 

9515 INJURY TO ACOUSTIC NERVE 

9516 INJURY ACCESSORY NERVE 

9517 INJURY HYPOGLOSSAL NERVE 

9518 INJURY CRANIAL NERVE NEC 

9519 INJURY CRANIAL NERVE NOS 

952 SPINAL CORD INJ W/O FX* 

9520 CERVICAL SPINAL CORD INJ* 

95200 C1-C4 SPIN CORD INJ NOS 

95201 COMPLETE LES CORD/C1-C4 

95202 ANTERIOR CORD SYND/C1-C4 

95203 CENTRAL CORD SYND/C1-C4 

95204 C1-C4 SPIN CORD INJ NEC 

95205 C5-C7 SPIN CORD INJ NOS 

95206 COMPLETE LES CORD/C5-C7 

95207 ANTERIOR CORD SYND/C5-C7 

95208 CENTRAL CORD SYND/C5-C7 

95209 C5-C7 SPIN CORD INJ NEC 

9521 DORSAL SPINAL CORD INJUR* 

95210 T1-T6 SPIN CORD INJ NOS 

95211 COMPLETE LES CORD/T1-T6 

95212 ANTERIOR CORD SYND/T1-T6 

95213 CENTRAL CORD SYND/T1-T6 

95214 T1-T6 SPIN CORD INJ NEC 

95215 T7-T12 SPIN CORD INJ NOS 

95216 COMPLETE LES CORD/T7-T12 

95217 ANTERIOR CORD SYN/T7-T12

95218 CENTRAL CORD SYN/T7-T12 

95219 T7-T12 SPIN CORD INJ NEC 

9522 LUMBAR SPINAL CORD INJUR 

9523 SACRAL SPINAL CORD INJUR 

9524 CAUDA EQUINA INJURY 

9528 SPIN CORD INJ-MULT SITE 

9529 SPINAL CORD INJURY NOS 

953 INJ NERVE ROOT/SPIN PLEX* 

9530 CERVICAL ROOT INJURY 

9531 DORSAL ROOT INJURY 

9532 LUMBAR ROOT INJURY 

9533 SACRAL ROOT INJURY 

9534 BRACHIAL PLEXUS INJURY 

9535 LUMBOSACRAL PLEX INJURY 

9538 MULT NERVE ROOT/PLEX INJ 

9539 INJ NERVE ROOT/PLEX NOS 

954 INJURY OTH TRUNK NERVE* 

9540 INJ CERV SYMPATH NERVE 

9541 INJ SYMPATH NERVE NEC 

9548 INJURY TRUNK NERVE NEC 

9549 INJURY TRUNK NERVE NOS 

955 INJ PERIPH NERV SHLD/ARM* 

9550 INJURY AXILLARY NERVE 

9551 INJURY MEDIAN NERVE 

9552 INJURY ULNAR NERVE 

9553 INJURY RADIAL NERVE 

9554 INJ MUSCULOCUTAN NERVE 

9555 INJ CUTAN SENSO NERV/ARM 

9556 INJURY DIGITAL NERVE 

9557 INJ NERVE SHLDR/ARM NEC 

9558 INJ MULT NERVE SHLDR/ARM 

9559 INJ NERVE SHLDR/ARM NOS 

956 INJ PERIPH NERV PELV/LEG* 

9560 INJURY SCIATIC NERVE 

9561 INJURY FEMORAL NERVE 

9562 INJ POSTERIOR TIB NERVE 

9563 INJURY PERONEAL NERVE 

9564 INJ CUTAN SENSO NERV/LEG 

9565 INJ NERVE PELV/LEG NEC 

9568 INJ MULT NERVE PELV/LEG 

9569 INJ NERVE PELV/LEG NOS 

957 INJURY TO NERVE NEC/NOS* 

9570 INJ SUPERF NERV HEAD/NCK 

9571 INJURY TO NERVE NEC 

9578 INJURY TO MULT NERVES 

9579 INJURY TO NERVE NOS 

958 EARLY COMPLIC OF TRAUMA* 

9580 AIR EMBOLISM 

9581 FAT EMBOLISM 

9582 SECONDARY/RECUR HEMORR 

9583 POSTTRAUM WND INFEC NEC 

9584 TRAUMATIC SHOCK 

9585 TRAUMATIC ANURIA 

9586 VOLKMANN'S ISCH CONTRACT 

9587 TRAUM SUBCUTAN EMPHYSEMA 

9588 EARLY COMPLIC TRAUMA NEC 

959 INJURY NEC/NOS*

9590 FACE AND NECK INJURY NOS* 

95901 HEAD INJURY NOS 

95909 FACE & NECK INJURY 

9591 TRUNK INJURY NOS 

9592 SHLDR/UPPER ARM INJ NOS 

9593 ELB/FOREARM/WRST INJ NOS 

9594 HAND INJURY NOS 

9595 FINGER INJURY NOS 

9596 HIP & THIGH INJURY NOS 

9597 LOWER LEG INJURY NOS 

9598 INJURY MLT SITE/SITE NEC 

9599 INJURY-SITE NOS 

960 POISONING BY ANTIBIOTICS* 

9600 POISONING-PENICILLINS 

9601 POIS-ANTIFUNGAL ANTIBIOT 

9602 POISON-CHLORAMPHENICOL 

9603 POIS-ERYTHROMYC/MACROLID 

9604 POISONING-TETRACYCLINE 

9605 POIS-CEPHALOSPORIN GROUP 

9606 POIS-ANTIMYCOBAC ANTIBIO 

9607 POIS-ANTINEOP ANTIBIOTIC 

9608 POISONING-ANTIBIOTIC NEC 

9609 POISONING-ANTIBIOTIC NOS 

961 POISONING-ANTI-INFEC NEC* 

9610 POISONING-SULFONAMIDES 

9611 POIS-ARSENIC ANTI-INFEC 

9612 POIS-HEAV MET ANTI-INFEC 

9613 POIS-QUINOLINE/HYDROXYQU 

9614 POISONING-ANTIMALARIALS 

9615 POIS-ANTIPROTOZ DRUG NEC 

9616 POISONING-ANTHELMINTICS 

9617 POISONING-ANTIVIRAL DRUG 

9618 POIS-ANTIMYCOBAC DRG NEC 

9619 POIS-ANTI-INFECT NEC/NOS 

962 POISONING BY HORMONES* 

9620 POIS-CORTICOSTEROIDS 

9621 POISONING-ANDROGENS 

9622 POISONING-OVARIAN HORMON 

9623 POISON-INSULIN/ANTIDIAB 

9624 POIS-ANT PITUITARY HORM 

9625 POIS-POST PITUITARY HORM 

9626 POISONING-PARATHYROIDS 

9627 POISONING-THYROID/DERIV 

9628 POISON-ANTITHYROID AGENT 

9629 POISONING HORMON NEC/NOS 

963 POISONING-SYSTEMIC AGENT* 

9630 POIS-ANTIALLRG/ANTIEMET 

9631 POIS-ANTINEOPL/IMMUNOSUP 

9632 POISONING-ACIDIFYING AGT 

9633 POISONING-ALKALIZING AGT 

9634 POISONING-ENZYMES NEC 

9635 POISONING-VITAMINS NEC 

9638 POISONING-SYSTEM AGT NEC 

9639 POISONING-SYSTEM AGT NOS 

964 POIS-BLOOD AFFECTING AGT* 

9640 POISONING-IRON/COMPOUNDS 

9641 POISON-LIVER/ANTIANEMICS

9642 POISONING-ANTICOAGULANTS 

9643 POISONING-VITAMIN K 

9644 POISON-FIBRINOLYSIS AGNT 

9645 POISONING-COAGULANTS 

9646 POISONING-GAMMA GLOBULIN 

9647 POISONING-BLOOD PRODUCT 

9648 POISONING-BLOOD AGT NEC 

9649 POISONING-BLOOD AGT NOS 

965 POIS-ANALGESIC/ANTIPYRET* 

9650 POISONING-OPIATES* 

96500 POISONING-OPIUM NOS 

96501 POISONING-HEROIN 

96502 POISONING-METHADONE 

96509 POISONING-OPIATES NEC 

9651 POISONING-SALICYLATES 

9654 POIS-AROM ANALGESICS NEC 

9655 POISONING-PYRAZOLE DERIV 

9656 POISONING-ANTIRHEUMATICS* 

96561 POIS-PROPIONIC ACID DERV 

96569 POISON-ANTIRHEUMATIC NEC 

9657 POIS-NO-NARC ANALGES NEC 

9658 POIS-ANALGES/ANTIPYR NEC 

9659 POIS-ANALGES/ANTIPYR NOS 

966 POISON-ANTICONVULSANTS* 

9660 POISON-OXAZOLIDINE DERIV 

9661 POISON-HYDANTOIN DERIVAT 

9662 POISONING-SUCCINIMIDES 

9663 POIS-ANTICONVUL NEC/NOS 

9664 POIS-ANTI-PARKINSON DRUG 

967 POISON-SEDATIVE/HYPNOTIC* 

9670 POISONING-BARBITURATES 

9671 POISONING-CHLORAL HYDRAT 

9672 POISONING-PARALDEHYDE 

9673 POISONING-BROMINE COMPND 

9674 POISONING-METHAQUALONE 

9675 POISONING-GLUTETHIMIDE 

9676 POISON-MIX SEDATIVE NEC 

9678 POIS-SEDATIVE/HYPNOT NEC 

9679 POIS-SEDATIVE/HYPNOT NOS 

968 POISONING-CNS DEPRESSANT* 

9680 POIS-CNS MUSCLE DEPRESS 

9681 POISONING-HALOTHANE 

9682 POISON-GAS ANESTHET NEC 

9683 POISON-INTRAVEN ANESTHET 

9684 POIS-GEN ANESTH NEC/NOS 

9685 POIS-TOPIC/INFILT ANESTH 

9686 POIS-NERVE/PLEX-BLK ANES 

9687 POISON-SPINAL ANESTHETIC 

9689 POIS-LOCAL ANEST NEC/NOS 

969 POISON-PSYCHOTROPIC AGT* 

9690 POISONING-ANTIDEPRESSANT 

9691 POIS-PHENOTHIAZINE TRANQ 

9692 POIS-BUTYROPHENONE TRANQ 

9693 POISON-ANTIPSYCHOTIC NEC 

9694 POIS-BENZODIAZEPINE TRAN 

9695 POISON-TRANQUILIZER NEC 

9696 POISONING-HALLUCINOGENS

9697 POISON-PSYCHOSTIMULANTS 

9698 POISON-PSYCHOTROPIC NEC 

9699 POISON-PSYCHOTROPIC NOS 

970 POISONING-CNS STIMULANTS* 

9700 POISONING-ANALEPTICS 

9701 POISON-OPIATE ANTAGONIST 

9708 POIS-CNS STIMULANTS NEC 

9709 POIS-CNS STIMULANT NOS 

971 POISON-AUTONOMIC AGENT* 

9710 POIS-PARASYMPATHOMIMETIC 

9711 POIS-PARASYMPATHOLYTICS 

9712 POISON-SYMPATHOMIMETICS 

9713 POISONING-SYMPATHOLYTICS 

9719 POIS-AUTONOMIC AGENT NOS 

972 POISON-CARDIOVASC AGENT* 

9720 POIS-CARD RHYTHM REGULAT 

9721 POISONING-CARDIOTONICS 

9722 POISONING-ANTILIPEMICS 

9723 POIS-GANGLION BLOCK AGT 

9724 POIS-CORONARY VASODILAT 

9725 POISON-VASODILATOR NEC 

9726 POIS-ANTIHYPERTEN AGENT 

9727 POISON-ANTIVARICOSE DRUG 

9728 POISON-CAPILLARY ACT AGT 

9729 POIS-CARDIOVASC AGT NEC 

973 POISONING-GI AGENTS* 

9730 POIS-ANTACID/ANTIGASTRIC 

9731 POIS-IRRITANT CATHARTICS 

9732 POIS-EMOLLIENT CATHARTIC 

9733 POISONING-CATHARTIC NEC 

9734 POISONING-DIGESTANTS 

9735 POISONING-ANTIDIARRH AGT 

9736 POISONING-EMETICS 

9738 POISONING-GI AGENTS NEC 

9739 POISONING-GI AGENT NOS 

974 POIS-WATER/MIN/METAB AGT* 

9740 POIS-MERCURIAL DIURETICS 

9741 POIS-PURINE DIURETICS 

9742 POIS-H2CO3 ANHYDRA INHIB 

9743 POISONING-SALURETICS 

9744 POISONING-DIURETICS NEC 

9745 POIS-ELECTRO/CAL/WAT AGT 

9746 POISON-MINERAL SALTS NEC 

9747 POIS-URIC ACID METABOL 

975 POISONING-MUSCLE AGENT* 

9750 POISONING-OXYTOCIC AGENT 

9751 POIS-SMOOTH MUSCLE RELAX 

9752 POIS-SKELET MUSCLE RELAX 

9753 POISON-MUSCLE AGENT NEC 

9754 POISONING-ANTITUSSIVES 

9755 POISONING-EXPECTORANTS 

9756 POIS-ANTI-COLD DRUGS 

9757 POISONING-ANTIASTHMATICS 

9758 POIS-RESPIR DRUG NEC/NOS 

976 POIS-SKIN/EENT/DENT AGT* 

9760 POIS-LOCAL ANTI-INFECT 

9761 POISONING-ANTIPRURITICS

9762 POIS-LOC ASTRING/DETERG 

9763 POIS-EMOL/DEMUL/PROTECT 

9764 POISON-HAIR/SCALP PREP 

9765 POIS-EYE ANTI-INFEC/DRUG 

9766 POISON-ENT PREPARATION 

9767 POIS-TOPICAL DENTAL DRUG 

9768 POIS-SKIN/MEMBR AGNT NEC 

9769 POIS-SKIN/MEMBR AGNT NOS 

977 POIS-MEDICINAL NEC/NOS* 

9770 POISONING-DIETETICS 

9771 POISON-LIPOTROPIC DRUGS 

9772 POISONING-ANTIDOTES NEC 

9773 POISON-ALCOHOL DETERRENT 

9774 POIS-PHARMACEUT EXCIPIEN 

9778 POISON-MEDICINAL AGT NEC 

9779 POISON-MEDICINAL AGT NOS 

978 POISONING-BACT VACCINES* 

9780 POISONING-BCG VACCINE 

9781 POIS-TYPH/PARATYPH VACC 

9782 POISONING-CHOLERA VACCIN 

9783 POISONING-PLAGUE VACCINE 

9784 POISONING-TETANUS VACCIN 

9785 POIS-DIPHTHERIA VACCINE 

9786 POIS-PERTUSSIS VACCINE 

9788 POIS-BACT VACCIN NEC/NOS 

9789 POIS-MIX BACTER VACCINES 

979 POIS-OTH VACCINE/BIOLOG* 

9790 POISON-SMALLPOX VACCINE 

9791 POISON-RABIES VACCINE 

9792 POISON-TYPHUS VACCINE 

9793 POIS-YELLOW FEVER VACCIN 

9794 POISONING-MEASLES VACCIN 

9795 POIS-POLIOMYELIT VACCINE 

9796 POIS-VIRAL/RICK VACC NEC 

9797 POISONING-MIXED VACCINE 

9799 POIS-VACCINE/BIOLOG NEC 

980 ALCOHOL TOXICITY* 

9800 TOXIC EFF ETHYL ALCOHOL 

9801 TOXIC EFF METHYL ALCOHOL 

9802 TOXIC EFF ISOPROPYL ALC 

9803 TOXIC EFFECT FUSEL OIL 

9808 TOXIC EFFECT ALCOHOL NEC 

9809 TOXIC EFFECT ALCOHOL NOS 

981 TOXIC EFF PETROLEUM PROD 

982 TOXIC EFFECT SOLVENT NEC* 

9820 TOXIC EFFECT BENZENE 

9821 TOXIC EFF CARBON TETRACH 

9822 TOXIC EFF CARBON DISULFI 

9823 TX EF CL-HYDCARB SLV NEC 

9824 TOXIC EFFECT NITROGLYCOL 

9828 TOXIC EFF NONPETROL SOLV 

983 TOXIC EFFECT CAUSTICS* 

9830 TOX EFF CORROSIVE AROMAT 

9831 TOXIC EFFECT ACIDS 

9832 TOXIC EFF CAUSTIC ALKALI 

9839 TOXIC EFFECT CAUSTIC NOS 

984 TOXIC EFF LEAD & COMPND*

9840 TX EFF INORG LEAD COMPND 

9841 TOX EFF ORG LEAD COMPND 

9848 TOX EFF LEAD COMPND NEC 

9849 TOX EFF LEAD COMPND NOS 

985 TOXIC EFFECT OTH METALS* 

9850 TOXIC EFFECT MERCURY 

9851 TOXIC EFFECT ARSENIC 

9852 TOXIC EFFECT MANGANESE 

9853 TOXIC EFFECT BERYLLIUM 

9854 TOXIC EFFECT ANTIMONY 

9855 TOXIC EFFECT CADMIUM 

9856 TOXIC EFFECT CHROMIUM 

9858 TOXIC EFFECT METALS NEC 

9859 TOXIC EFFECT METAL NOS 

986 TOX EFF CARBON MONOXIDE 

987 TOXIDE EFF GAS/VAPOR NEC* 

9870 TOXIC EFF LIQ PETROL GAS 

9871 TOX EF HYDROCARB GAS NEC 

9872 TOXIC EFF NITROGEN OXIDE 

9873 TOXIC EFF SULFUR DIOXIDE 

9874 TOXIC EFFECT FREON 

9875 TOX EFF LACRIMOGENIC GAS 

9876 TOXIC EFF CHLORINE GAS 

9877 TOX EFF HYDROCYAN ACD GS 

9878 TOXIC EFF GAS/VAPOR NEC 

9879 TOXIC EFF GAS/VAPOR NOS 

988 TOXIC EFF NOXIOUS FOOD* 

9880 TOXIC EFF FISH/SHELLFISH 

9881 TOXIC EFFECT MUSHROOMS 

9882 TOX EFF BERRY/PLANT NEC 

9888 TOX EFF NOXIOUS FOOD NEC 

9889 TOX EFF NOXIOUS FOOD NOS 

989 TOX EFF OTH NONMED SUBST* 

9890 TOXIC EFFECT CYANIDES 

9891 TOXIC EFFECT STRYCHNINE 

9892 TOX EFF CHLOR HYDROCARB 

9893 TOX EFF ORGANPHOS/CARBAM 

9894 TOXIC EFF PESTICIDES NEC 

9895 TOXIC EFFECT VENOM 

9896 TOXIC EFF SOAP/DETERGENT 

9897 TOX EFF AFLATOX/MYCOTOX 

9898 TOX EFF NONMED SUBST NEC* 

98981 TOXIC EFFECT OF ASBESTOS 

98982 TOXIC EFFECT OF LATEX 

98983 TOXIC EFFECT OF SILICONE 

98984 TOXIC EFFECT OF TOBACCO 

98989 TOX EFF NONMED SUBST NEC 

9899 TOX EFF NONMED SUBST NOS 

990 EFFECTS RADIATION NOS 

991 EFF REDUCED TEMPERATURE* 

9910 FROSTBITE OF FACE 

9911 FROSTBITE OF HAND 

9912 FROSTBITE OF FOOT 

9913 FROSTBITE NEC/NOS 

9914 IMMERSION FOOT 

9915 CHILBLAINS 

9916 HYPOTHERMIA

9918 EFFECT REDUCED TEMP NEC 

9919 EFFECT REDUCED TEMP NOS 

992 EFFECT OF HEAT/LIGHT* 

9920 HEAT STROKE & SUNSTROKE 

9921 HEAT SYNCOPE 

9922 HEAT CRAMPS 

9923 HEAT EXHAUST-ANHYDROTIC 

9924 HEAT EXHAUST-SALT DEPLE 

9925 HEAT EXHAUSTION NOS 

9926 HEAT FATIGUE, TRANSIENT 

9927 HEAT EDEMA 

9928 HEAT EFFECT NEC 

9929 HEAT EFFECT NOS 

993 EFFECTS OF AIR PRESSURE* 

9930 BAROTRAUMA, OTITIC 

9931 BAROTRAUMA, SINUS 

9932 EFF HIGH ALTITUD NEC/NOS 

9933 CAISSON DISEASE 

9934 EFF AIR PRESS BY EXPLOS 

9938 EFFECT AIR PRESSURE NEC 

9939 EFFECT AIR PRESSURE NOS 

994 EFFECT EXTERNAL CAUS NEC* 

9940 EFFECTS OF LIGHTNING 

9941 DROWNING/NONFATAL SUBMER 

9942 EFFECTS OF HUNGER 

9943 EFFECTS OF THIRST 

9944 EXHAUSTION-EXPOSURE 

9945 EXHAUSTION-EXCESS EXERT 

9946 MOTION SICKNESS 

9947 ASPHYXIATION/STRANGULAT 

9948 EFFECTS ELECTRIC CURRENT 

9949 EFFECT EXTERNAL CAUS NEC 

995 CERTAIN ADVERSE EFF NEC* 

9950 ANAPHYLACTIC SHOCK 

9951 ANGIONEUROTIC EDEMA 

9952 ADV EFF MED/BIOL SUB NOS 

9953 ALLERGY, UNSPECIFIED 

9954 SHOCK DUE TO ANESTHESIA 

9955 CHILD MALTREATMENT SYND* 

99550 CHILD ABUSE NOS 

99551 CHILD EMOTNL/PSYCH ABUSE 

99552 CHILD NEGLECT-NUTRITION 

99553 CHILD SEXUAL ABUSE 

99554 CHILD PHYSICAL ABUSE 

99555 SHAKEN INFANT SYNDROME 

99559 CHILD ABUSE/NEGLECT NEC 

99560 ANPHYLCT SHK FOOD NOS 

99561 ANPHYLCT SHK PEANUTS 

99562 ANPHYLCT SHK CRSTACNS 

99563 ANPHYLCT SHK FRTS VEG 

99564 ANPHYLCT SHK TR NTS SEED 

99565 ANPHYLCT SHK FISH 

99566 ANPHYLCT SHK FOOD ADDTV 

99567 ANPHYLCT SHK MILK PROD 

99568 ANPHYLCT SHK EGGS 

99569 ANPHYLCT SHK OT SPF FOOD 

9958 ADVERSE EFFECT NEC*

99580 ADULT MALTREATMENT NOS 

99581 ADULT PHYSICAL ABUSE 

99582 ADULT EMOTNL/PSYCH ABUSE 

99583 ADULT SEXUAL ABUSE 

99584 ADULT NEGLECT-NUTRITION 

99585 OTH ADULT ABUSE/NEGLECT 

99586 MALIGNANT HYPERTHERMIA 

99589 ADVERSE EFFECT NEC 

996 REPLACE & GRAFT COMPLIC* 

9960 MALFUNC CARD DEVIC/GRAFT* 

99600 MALFUNC CARD DEV/GRF NOS 

99601 MALFUNC CARDIAC PACEMAKE 

99602 MALFUNC PROSTH HRT VALVE 

99603 MALFUNC CORON BYPASS GRF 

99604 MCH CMP AUTM MPLNT DFBRL 

99609 MALFUNC CARD DEV/GRF NEC 

9961 MALFUNC VASC DEVICE/GRAF 

9962 MALFUN NEURO DEVICE/GRAF 

9963 MALFUNC GU DEVICE/GRAFT* 

99630 MALFUNC GU DEV/GRAFT NOS 

99631 MALFUNC URETHRAL CATH 

99632 MALFUNCTION IUD 

99639 MALFUNC GU DEV/GRAFT NEC 

9964 MALF INT ORTHPED DEV/GRF 

99651 CORNEAL GRFT MALFUNCTION 

99652 OTH TISSUE GRAFT MALFUNC 

99653 LENS PROSTHESIS MALFUNC 

99654 BREAST PROSTH MALFUNC 

99655 COMP-ARTIFICIAL SKIN GRF 

99656 COMP-PERITON DIALYS CATH 

99659 MALFUNC OTH DEVICE/GRAFT 

9966 INFEC/INFLAM-DEVIC/GRAFT* 

99660 REACTION-UNSP DEVIC/GRFT 

99661 REACT-CARDIAC DEV/GRAFT 

99662 REACT-OTH VASC DEV/GRAFT 

99663 REACT-NERV SYS DEV/GRAFT 

99664 REACT-INDWELL URIN CATH 

99665 REACT-OTH GENITOURIN DEV 

99666 REACT-INTER JOINT PROST 

99667 REACT-OTH INT ORTHO DEV 

99668 REACT-PERITON DIALY CATH 

99669 REACT-INT PROS DEVIC NEC 

9967 COMPLIC DEVICE/GRAFT NEC* 

99670 COMP-UNSP DEVICE/GRAFT 

99671 COMP-HEART VALVE PROSTH 

99672 COMP-OTH CARDIAC DEVICE 

99673 COMP-REN DIALYS DEV/GRFT 

99674 COMP-OTH VASC DEV/GRAFT 

99675 COMP-NERV SYS DEV/GRAFT 

99676 COMP-GENITOURIN DEV/GRFT 

99677 COMP-INTERNAL JOINT PROS 

99678 COMP-OTH INT ORTHO DEVIC 

99679 COMP-INT PROST DEVIC NEC 

99680 COMP ORGAN TRANSPLNT NOS 

99681 COMPL KIDNEY TRANSPLANT 

99682 COMPL LIVER TRANSPLANT 

99683 COMPL HEART TRANSPLANT

99684 COMPL LUNG TRANSPLANT 

99685 COMPL MARROW TRANSPLANT 

99686 COMPL PANCREAS TRANSPLNT 

99689 COMP OTH ORGAN TRANSPLNT 

9969 COMPL REATTACHED PART* 

99690 COMP REATTACH EXTREM NOS 

99691 COMPL REATTACHED FOREARM 

99692 COMPL REATTACHED HAND 

99693 COMPL REATTACHED FINGER 

99694 COMPL REATTACHED ARM NEC 

99695 COMPL REATTACHED FOOT 

99696 COMPL REATTACHED LEG NEC 

99699 COMPL REATTACH PART NEC 

997 SURG COMPL-BODY SYST NEC* 

9970 SURG COMPLICATION-CNS* 

99700 NERVOUS SYST COMPLC NOS 

99701 SURG COMPLICATION - CNS 

99702 IATROGEN CV INFARC/HMRHG 

99709 SURG COMP NERV SYSTM NEC 

9971 SURG COMPL-HEART 

9972 SURG COMP-PERI VASC SYST 

9973 SURG COMPLIC-RESPIR SYST 

9974 SURG COMP-DIGESTV SYSTEM 

9975 SURG COMPL-URINARY TRACT 

9976 LATE AMPUTATION COMPLIC* 

99760 AMPUTAT STUMP COMPL NOS 

99761 NEUROMA AMPUTATION STUMP 

99762 INFECTION AMPUTAT STUMP 

99769 AMPUTAT STUMP COMPL NEC 

9979 SURG COMPL-BODY SYST NEC* 

99791 SURG COMP - HYPERTENSION 

99799 SURG COMPL-BODY SYST NEC 

998 OTH SURGICAL COMPL NEC* 

9980 POSTOPERATIVE SHOCK 

9981 HEMORR COMPLIC PROCEDURE* 

99811 HEMORRHAGE COMPLIC PROC 

99812 HEMATOMA COMPLIC PROC 

99813 SEROMA COMPLICTING PROC 

9982 ACCIDENTAL OP LACERATION 

9983 POSTOP WOUND DISRUPTION 

9984 FB LEFT DURING PROCEDURE 

9985 POSTOPERATIVE INFECTION* 

99851 INFECTED POSTOP SEROMA 

99859 OTHER POSTOP INFECTION 

9986 PERSIST POSTOP FISTULA 

9987 POSTOP FORGN SUBST REACT 

9988 SURGICAL COMPLICAT NEC* 

99881 EMPHYSEMA RSULT FRM PROC 

99882 CTRCT FRGMT FRM CTR SURG 

99883 NON-HEALING SURGCL WOUND 

99889 OTH SPCF CMPLC PROCD NEC 

9989 SURGICAL COMPLICAT NOS 

999 COMPLIC MEDICAL CARE NEC* 

9990 GENERALIZED VACCINIA 

9991 AIR EMBOL COMP MED CARE 

9992 VASC COMP MED CARE NEC 

9993 INFEC COMPL MED CARE NEC

9994 ANAPHYLACTIC SHOCK-SERUM 

9995 SERUM REACTION NEC 

9996 ABO INCOMPATIBILITY REAC 

9997 RH INCOMPATIBILITY REACT 

9998 TRANSFUSION REACTION NEC 

9999 COMPLIC MED CARE NEC/NOS 

E800 RR COLLISION NOS* 

E8000 RR COLLISION NOS-EMPLOY 

E8001 RR COLL NOS-PASSENGER 

E8002 RR COLL NOS-PEDESTRIAN 

E8003 RR COLL NOS-PED CYCLIST 

E8008 RR COLL NOS-PERSON NEC 

E8009 RR COLL NOS-PERSON NOS 

E801 RR COLL W OTH OBJECT* 

E8010 RR COLL W OTH OBJ-EMPLOY 

E8011 RR COLL W OTH OBJ-PASNGR 

E8012 RR COLL W OTH OBJ-PEDEST 

E8013 RR COLL W OTH OBJ-CYCL 

E8018 RR COL W OTH OBJ-PER NEC 

E8019 RR COL W OTH OBJ-PER NOS 

E802 RR ACCIDENT W DERAILMENT* 

E8020 RR ACC W DERAIL-EMPLOYEE 

E8021 RR ACC W DERAIL-PASSENG 

E8022 RR ACC W DERAIL-PEDEST 

E8023 RR ACC W DERAIL-PED CYCL 

E8028 RR ACC W DERAIL-PERS NEC 

E8029 RR ACC W DERAIL-PERS NOS 

E803 RR ACCIDENT W EXPLOSION* 

E8030 RR ACC W EXPLOSION-EMPL 

E8031 RR ACC W EXPLOS-PASNGR 

E8032 RR ACC W EXPLOS-PEDEST 

E8033 RR ACC W EXPLOS-PED CYCL 

E8038 RR ACC W EXPLOS-PERS NEC 

E8039 RR ACC W EXPLOS-PERS NOS 

E804 FALL ON/FROM TRAIN* 

E8040 FALL ON/FROM TRAIN-EMPL 

E8041 FALL FROM TRAIN-PASSENGR 

E8042 FALL FROM TRAIN-PEDEST 

E8043 FALL FROM TRAIN-PED CYCL 

E8048 FALL FROM TRAIN-PERS NEC 

E8049 FALL FROM TRAIN-PERS NOS 

E805 HIT BY ROLLING STOCK* 

E8050 HIT BY TRAIN-EMPLOYEE 

E8051 HIT BY TRAIN-PASSENGER 

E8052 HIT BY TRAIN-PEDESTRIAN 

E8053 HIT BY TRAIN-PED CYCLIST 

E8058 HIT BY TRAIN-PERSON NEC 

E8059 HIT BY TRAIN-PERSON NOS 

E806 RAILWAY ACCIDENT NEC* 

E8060 RR ACC NEC-EMPLOYEE 

E8061 RR ACC NEC-PASSENGER 

E8062 RR ACC NEC-PEDESTRIAN 

E8063 RR ACC NEC-PED CYCLIST 

E8068 RR ACC NEC-PERSON NEC 

E8069 RR ACC NEC-PERSON NOS 

E807 RAILWAY ACCIDENT NOS* 

E8070 RR ACCIDENT NOS-EMPLOYEE

E8071 RR ACC NOS-PASSENGER 

E8072 RR ACC NOS-PEDESTRIAN 

E8073 RR ACC NOS-PED CYCLIST 

E8078 RR ACC NOS-PERSON NEC 

E8079 RR ACC NOS-PERSON NOS 

E810 VEHICLE-TRAIN COLLISION* 

E8100 MV-TRAIN COLL-DRIVER 

E8101 MV-TRAIN COLL-PASNGR 

E8102 MV-TRAIN COLL-MOTORCYCL 

E8103 MV-TRAIN COLL-MCYCL PSGR 

E8104 MV-TRAIN COLL-ST CAR 

E8105 MV-TRAIN COLL-ANIM RID 

E8106 MV-TRAIN COLL-PED CYCL 

E8107 MV-TRAIN COLL-PEDEST 

E8108 MV-TRAIN COLL-PERS NEC 

E8109 MV-TRAIN COLL-PERS NOS 

E811 MV REENTRANT COLLISION* 

E8110 REENTRANT MV COLL-DRIVER 

E8111 REENTRANT MV COLL-PASNGR 

E8112 REENTRANT COLL-MOTCYCL 

E8113 REENTRANT COLL-MCYC PSGR 

E8114 REENTRANT COLL-ST CAR 

E8115 REENTRANT COLL-ANIM RID 

E8116 REENTRANT COLL-PED CYCL 

E8117 REENTRANT COLL-PEDEST 

E8118 REENTRANT COLL-PERS NEC 

E8119 REENTRANT COLL-PERS NOS 

E812 MOT VEHIC COLLISION NOS* 

E8120 MV COLLISION NOS-DRIVER 

E8121 MV COLLISION NOS-PASNGR 

E8122 MV COLLIS NOS-MOTORCYCL 

E8123 MV COLL NOS-MCYCL PSNGR 

E8124 MV COLLISION NOS-ST CAR 

E8125 MV COLL NOS-ANIM RID 

E8126 MV COLL NOS-PED CYCL 

E8127 MV COLLISION NOS-PEDEST 

E8128 MV COLLIS NOS-PERS NEC 

E8129 MV COLLIS NOS-PERS NOS 

E813 MV-OTH VEHICLE COLLISION* 

E8130 MV-OTH VEH COLL-DRIVER 

E8131 MV-OTH VEH COLL-PASNGR 

E8132 MV-OTH VEH COLL-MOTCYCL 

E8133 MV-OTH VEH COLL-MCYC PSG 

E8134 MV-OTH VEH COLL-ST CAR 

E8135 MV-OTH VEH COLL-ANIM RID 

E8136 MV-OTH VEH COLL-PED CYCL 

E8137 MV-OTH VEH COLL-PEDEST 

E8138 MV-OTH VEH COLL-PERS NEC 

E8139 MV-OTH VEH COLL-PERS NOS 

E814 MV COLLISION W PEDEST* 

E8140 MV COLL W PEDEST-DRIVER 

E8141 MV COLL W PEDEST-PASNGR 

E8142 MV COLL W PEDEST-MOTCYCL 

E8143 MV COLL W PED-MCYCL PSGR 

E8144 MV COLL W PEDEST-ST CAR 

E8145 MV COLL W PED-ANIM RID 

E8146 MV COLL W PED-PED CYCL

E8147 MV COLL W PEDEST-PEDEST 

E8148 MV COLL W PEDES-PERS NEC 

E8149 MV COLL W PEDES-PERS NOS 

E815 MV COLLISION W OTH OBJ* 

E8150 MV COLL W OTH OBJ-DRIVER 

E8151 MV COLL W OTH OBJ-PASNGR 

E8152 MV COLL W OTH OBJ-MOCYCL 

E8153 MV COLL W OBJ-MCYCL PSGR 

E8154 MV COLL W OBJ-ST CAR 

E8155 MV COLL W OBJ-ANIM RIDER 

E8156 MV COLL W OBJ-PED CYCL 

E8157 MV COLL W OBJ-PEDEST 

E8158 MV COLL W OBJ-PERS NEC 

E8159 MV COLL W OBJ-PERS NOS 

E816 LOSS OF CONTROL MV ACC* 

E8160 LOSS CONTROL MV ACC-DRIV 

E8161 LOSS CONTROL MV ACC-PSGR 

E8162 LOSS CONTROL MV-MOCYCL 

E8163 LOSS CONTROL MV-MCYC PSG 

E8164 LOSS CONT MV ACC-ST CAR 

E8165 LOSS CONT MV-ANIM RIDER 

E8166 LOSS CONTROL MV-PED CYCL 

E8167 LOSS CONTROL MV-PEDEST 

E8168 LOSS CONTROL MV-PERS NEC 

E8169 LOSS CONTROL MV-PERS NOS 

E817 MV TRAF ACC-BOARD/ALIGHT* 

E8170 MV ACC BOARD/ALIGHT-DRIV 

E8171 MV ACC BOARD/ALIGHT-PSGR 

E8172 MV BOARD/ALIGHT-MOTCYCL 

E8173 MV BRD/ALIGHT-MCYCL PSGR 

E8174 MV ACC BRD/ALIGHT-ST CAR 

E8175 MV BRD/ALIGHT-ANIM RIDER 

E8176 MV BRD/ALIGHT-PED CYCL 

E8177 MV BRD/ALIGHT-PEDESTRIAN 

E8178 MV BOARD/ALIGHT-PERS NEC 

E8179 MV BOARD/ALIGHT-PERS NOS 

E818 MV TRAFFIC ACCIDENT NEC* 

E8180 MV TRAFF ACC NEC-DRIVER 

E8181 MV TRAFF ACC NEC-PASNGR 

E8182 MV TRAFF ACC NEC-MOCYCL 

E8183 MV TRAFF ACC-MCYCL PSGR 

E8184 MV TRAFF ACC NEC-ST CAR 

E8185 MV TRAFF ACC-ANIM RIDER 

E8186 MV TRAFF ACC-PED CYC 

E8187 MV TRAFF ACC NEC-PEDEST 

E8188 MV TRAFF ACC-PERS NEC 

E8189 MV TRAFF ACC-PERS NOS 

E819 MV TRAFFIC ACCIDENT NOS* 

E8190 TRAFFIC ACC NOS-DRIVER 

E8191 TRAFFIC ACC NOS-PASNGR 

E8192 TRAFFIC ACC NOS-MOTCYCL 

E8193 TRAFF ACC NOS-MCYCL PSGR 

E8194 TRAFFIC ACC NOS-ST CAR 

E8195 TRAFF ACC NOS-ANIM RIDER 

E8196 TRAFFIC ACC NOS-PED CYCL 

E8197 TRAFFIC ACC NOS-PEDEST 

E8198 TRAFFIC ACC NOS-PERS NEC

E8199 TRAFFIC ACC NOS-PERS NOS 

E820 SNOW VEHICLE ACCIDENT* 

E8200 SNOW VEH ACC-DRIVER 

E8201 SNOW VEH ACC-PASNGR 

E8202 SNOW VEH ACC-MOTORCYCL 

E8203 SNOW VEH ACC-MCYCL PSGR 

E8204 SNOW VEH ACC-ST CAR 

E8205 SNOW VEH ACC-ANIM RIDER 

E8206 SNOW VEH ACC-PED CYCL 

E8207 SNOW VEH ACC-PEDEST 

E8208 SNOW VEH ACC-PERS NEC 

E8209 SNOW VEH ACC-PERS NOS 

E821 OTH OFF-RD MV N-TRAF ACC* 

E8210 OTH OFF-ROAD MV ACC-DRIV 

E8211 OTH OFF-ROAD MV ACC-PSGR 

E8212 OTH OFF-ROAD MV-MOCYCL 

E8213 OTH OFF-ROAD MV-MCYC PSG 

E8214 OTH OFF-ROAD MV-ST CAR 

E8215 OTH OFF-ROAD MV-ANIM RID 

E8216 OTH OFF-ROAD MV-PED CYCL 

E8217 OTH OFF-ROAD MV-PEDEST 

E8218 OTH OFF-ROAD MV-PERS NEC 

E8219 OTH OFF-ROAD MV-PERS NOS 

E822 OTH MV COLL W MOVING OBJ* 

E8220 OTH COLL W MOV OBJ-DRIV 

E8221 OTH COLL W MOV OBJ-PSGR 

E8222 OTH COLL MOV OBJ-MOCYCL 

E8223 OTH COLL MOV OBJ-CYC PSG 

E8224 OTH COLL MOV OBJ-ST CAR 

E8225 OTH COLL MOV OBJ-RIDER 

E8226 OTH COLL MOV OBJ-PED CYC 

E8227 OTH COLL MOV OBJ-PEDEST 

E8228 OTH COLL MOV OBJ-PER NEC 

E8229 OTH COLL MOV OBJ-PER NOS 

E823 OTH MV COLL W STNDNG OBJ* 

E8230 OTH COLL STNDNG OBJ-DRIV 

E8231 OTH COLL STNDNG OBJ-PSGR 

E8232 OTH COLL STND OBJ-MOCYCL 

E8233 OTH COLL STN OBJ-CYC PSG 

E8234 OTH COLL STND OBJ-ST CAR 

E8235 OTH COLL STND OBJ-RIDER 

E8236 OTH COLL STN OBJ-PED CYC 

E8237 OTH COLL STND OBJ-PEDEST 

E8238 OTH COLL STN OBJ-PER NEC 

E8239 OTH COL-STND-OBJ-PER NOS 

E824 MV N-TRAFF BOARD/ALIGHT* 

E8240 N-TRAF BOARD/ALIGHT-DRIV 

E8241 N-TRAF BOARD/ALIGHT-PSGR 

E8242 N-TRAF BRD/ALIGHT-MOCYCL 

E8243 N-TRAF BRD/ALIT-MCYC PSG 

E8244 N-TRAF BRD/ALIT-ST CAR 

E8245 N-TRAF BRD/ALIT-ANIM RID 

E8246 N-TRAF BRD/ALIT-PED CYCL 

E8247 N-TRAF BRD/ALIT-PEDEST 

E8248 N-TRAF BRD/ALIT-PERS NEC 

E8249 N-TRAF BRD/ALIT-PERS NOS 

E825 MV N-TRAFFIC ACC NEC/NOS*

E8250 MV N-TRAFF ACC NEC-DRIV 

E8251 MV N-TRAFF NEC/NOS-PSGR 

E8252 MV N-TRAF ACC NEC-MOCYCL 

E8253 MV N-TRAFF NEC-MCYC PSGR 

E8254 MV N-TRAFF NEC-ST CAR 

E8255 MV N-TRAF NEC-ANIM RIDER 

E8256 MV N-TRAFF NEC-PED CYCL 

E8257 MV N-TRAFF NEC-PEDEST 

E8258 MV N-TRAFF NEC-PERS NEC 

E8259 MV N-TRAFF NEC-PERS NOS 

E826 PEDAL CYCLE ACCIDENT* 

E8260 PEDAL CYCLE ACC-PEDEST 

E8261 PED CYCL ACC-PED CYCLIST 

E8262 PED CYCLE ACC-ANIM RIDER 

E8263 PED CYC ACC-OCC ANIM VEH 

E8264 PED CYCLE ACC-OCC ST CAR 

E8268 PED CYCLE ACC-PERS NEC 

E8269 PED CYCLE ACC-PERS NOS 

E827 ANIMAL DRAWN VEHICLE ACC* 

E8270 ANIMAL DRAWN VEH-PEDEST 

E8272 ANIM DRAWN VEH-ANIM RID 

E8273 ANIMAL DRAWN VEH-OCCUPAN 

E8274 ANIM DRAWN-OCC ST CAR 

E8278 ANIM DRAWN VEH-PERS NEC 

E8279 ANIM DRAWN VEH-PERS NOS 

E828 RIDDEN ANIMAL ACCIDENT* 

E8280 RIDDEN ANIMAL ACC-PEDEST 

E8282 RIDDEN ANIMAL ACC-RIDER 

E8284 RIDDEN ANIMAL ACC-ST CAR 

E8288 RIDDEN ANIM ACC-PERS NEC 

E8289 RIDDEN ANIM ACC-PERS NOS 

E829 OTHER ROAD VEHICLE ACC* 

E8290 OTH ROAD VEH ACC-PEDEST 

E8294 OTH RD VEH ACC-ST CAR 

E8298 OTH RD VEH ACC-PERS NEC 

E8299 OTH RD VEH ACC-PERS NOS 

E830 BOAT ACC W SUBMERSION* 

E8300 BOAT ACC W SUBMERS-UNPOW 

E8301 BOAT ACC W SUBMERS-POWER 

E8302 BOAT ACC W SUBMERS-CREW 

E8303 BOAT ACC W SUBMERS-PSGR 

E8304 BOAT SUBMERS-WATER SKIER 

E8305 BOAT SUBMERS-SWIMMER 

E8306 BOAT SUBMERS-DOCKERS 

E8308 BOAT SUBMERS-PERS NEC 

E8309 BOAT SUBMERS-PERS NOS 

E831 BOAT ACC W OTH INJURY* 

E8310 BOAT ACC INJ NEC-UNPOWER 

E8311 BOAT ACC INJ NEC-POWER 

E8312 BOAT ACC INJ NEC-CREW 

E8313 BOAT ACC INJ NEC-PASSENG 

E8314 BOAT ACC INJ NEC-SKIER 

E8315 BOAT ACC INJ NEC-SWIM 

E8316 BOAT ACC INJ NEC-DOCKER 

E8318 BOAT INJ NEC-PERSON NEC 

E8319 BOAT INJ NEC-PERSON NOS 

E832 BOAT ACC W SUBMERS NEC*

E8320 SUBMERS NEC-UNPOW BOAT 

E8321 SUBMERS NEC-POWER BOAT 

E8322 SUBMERS NEC-CREW 

E8323 SUBMERS NEC-PASSENGER 

E8324 SUBMERS NEC-WATER SKIER 

E8325 SUBMERS NEC-SWIMMER 

E8326 SUBMERS NEC-DOCKER 

E8328 SUBMERS NEC-PERSON NEC 

E8329 SUBMERS NEC-PERSON NOS 

E833 WATERCRAFT STAIRWAY FALL* 

E8330 W/CRAFT STAIR FALL-UNPOW 

E8331 W/CRAFT STAIR FALL-POWER 

E8332 WTRCRAFT STAIR FALL-CREW 

E8333 WTRCRAFT STAIR FALL-PSGR 

E8334 W/CRAFT STAIR FALL-SKIER 

E8335 W/CRAFT STAIR FALL-SWIM 

E8336 W/CRF STAIR FALL-DOCKER 

E8338 W/CRF STAIR FALL-PER NEC 

E8339 W/CRF STAIR FALL-PER NOS 

E834 FALL IN WATERCRAFT NEC* 

E8340 W/CRAFT FALL NEC-UNPOW 

E8341 W/CRAFT FALL NEC-POWER 

E8342 WATERCRAFT FALL NEC-CREW 

E8343 WTRCRAFT FALL NEC-PASNGR 

E8344 W/CRAFT FALL NEC-SKIER 

E8345 W/CRAFT FALL NEC-SWIM 

E8346 WTRCRAFT FALL NEC-DOCKER 

E8348 W/CRFT FALL NEC-PERS NEC 

E8349 W/CRFT FALL NEC-PERS NOS 

E835 FALL IN WATERCRAFT NOS* 

E8350 W/CRAFT FALL NOS-UNPOW 

E8351 W/CRAFT FALL NOS-POWER 

E8352 WTRCRAFT FALL NOS-CREW 

E8353 WTRCRAFT FALL NOS-PASNGR 

E8354 W/CRAFT FALL NOS-SKIER 

E8355 W/CRAFT FALL NOS-SWIM 

E8356 WTRCRAFT FALL NOS-DOCKER 

E8358 W/CRFT FALL NOS-PERS NEC 

E8359 W/CRFT FALL NOS-PERS NOS 

E836 WATERCRAFT MACHINERY ACC* 

E8360 MACHINE ACC-UNPOW BOAT 

E8361 MACH ACC-OCC POWER BOAT 

E8362 MACHINERY ACCIDENT-CREW 

E8363 MACHINERY ACC-PASNGR 

E8364 MACHINE ACCIDENT-SKIER 

E8365 MACHINE ACCIDENT-SWIM 

E8366 MACHINERY ACC-DOCKER 

E8368 MACHINERY ACC-PERS NEC 

E8369 MACHINERY ACC-PERS NOS 

E837 WATERCRAFT EXPLOSION* 

E8370 EXPLOSION-OCC UNPOW BOAT 

E8371 EXPLOSION-OCC POWER BOAT 

E8372 WATERCRAFT EXPLOS-CREW 

E8373 WATERCRAFT EXPLOS-PASNGR 

E8374 WATERCRAFT EXPLOS-SKIER 

E8375 WATERCRAFT EXPLOS-SWIM 

E8376 WATERCRAFT EXPLOS-DOCKER

E8378 WATERCRAFT EXPL-PERS NEC 

E8379 WATERCRAFT EXPL-PERS NOS 

E838 WATERCRAFT ACC NEC/NOS* 

E8380 WATERCRAFT ACC NEC-UNPOW 

E8381 WATERCRAFT ACC NEC-POWER 

E8382 WATERCRAFT ACC NEC-CREW 

E8383 WATERCRFT ACC NEC-PASNGR 

E8384 WATERCRAFT ACC NEC-SKIER 

E8385 WATRCRFT ACC NEC-SWIMMER 

E8386 WATERCRFT ACC NEC-DOCKER 

E8388 WTRCRFT ACC NEC-PERS NEC 

E8389 WTRCRFT ACC NEC-PERS NOS 

E840 TAKEOFF/LANDING ACCIDENT* 

E8400 TK OFF/LAND-SPCRFT 

E8401 TK OFF/LAND-MILIT CRAFT 

E8402 TK OFF/LAND-CREW AIRCRFT 

E8403 TK OFF/LAND-PSNG AIRCRFT 

E8404 TK OFF/LAND-COMM CRF NEC 

E8405 TK OFF/LAND-AIRCRAFT NEC 

E8406 TK OFF/LAND-UNP AIRCRFT 

E8407 TK OFF/LAND-PARACHUTIST 

E8408 TK OFF/LAND-GROUND CREW 

E8409 TK OFF/LAND-PERS NEC 

E841 POWERED AIRCRAFT ACC NEC* 

E8410 POW AIRCRAFT ACC-SPCRFT 

E8411 POWER AIRCRAFT ACC-MILIT 

E8412 POWER AIRCRAFT ACC-CREW 

E8413 POWER AIRCRAFT ACC-PSNGR 

E8414 AIRCRAF ACC-OCC COMM NEC 

E8415 OTH POWERED AIRCRAFT ACC 

E8416 POW AIRC ACC-UNP AIRCR 

E8417 AIRCRAFT ACC-PARACHUTIST 

E8418 AIRCRAFT ACC-GROUND CREW 

E8419 AIRCRFT ACC NOS-PERS NEC 

E842 UNPOWERED AIRCRAFT ACC* 

E8426 UNPOWER AIRCRAFT ACC-OCC 

E8427 UNPOW AIRCRF ACC-CHUTIST 

E8428 UNPOW AIRCRF ACC-GR CREW 

E8429 UNPOW AIRCRF ACC-PER NEC 

E843 FALL IN/ON/FROM AIRCRAFT* 

E8430 FALL-OCC SPACECRAFT 

E8431 FALL-MILIT AIRCRAFT OCCP 

E8432 FALL-CREW COMM AIRCRAFT 

E8433 FALL-PSNG COMM AIRCRAFT 

E8434 FALL-OCC COMM AIRCRF NEC 

E8435 FALL-OCCUP OTH AIRCRAFT 

E8436 FALL-OCC UNPOWER AIRCRAF 

E8437 FALL-PARACHUTIST 

E8438 AIRCRFT FALL-GROUND CREW 

E8439 AIRCRAFT FALL-PERSON NEC 

E844 AIR TRANSPORT ACC NEC* 

E8440 AIRCRFT ACC NEC-SPCRFT 

E8441 AIRCRFT ACC NEC-MILITARY 

E8442 AIRCRFT ACC NEC-CREW 

E8443 AIRCRFT ACC NEC-PASNGR 

E8444 AIRCRFT ACC NEC-COMM NEC 

E8445 AIRCRFT ACC NEC-OCCP NEC

E8446 AIRCR ACC NEC-UNP AIRCR 

E8447 AIRCRFT ACC-PARACHUTIST 

E8448 AIRCRFT ACC NEC-GRD CREW 

E8449 AIRCRFT ACC NEC-PERS NEC 

E845 SPACECRAFT ACCIDENT* 

E8450 SPACECRAFT ACC-OCCUPANT 

E8458 SPACECRAFT ACC-GRND CREW 

E8459 SPACECRAFT ACC-PERS NEC 

E846 INDUS VEH ACC ON PREMISE 

E847 CABL CAR ACC NOT ON RAIL 

E848 OTH VEHICLE ACC NEC 

E849 PLACE OF OCCURRENCE* 

E8490 ACCIDENT IN HOME 

E8491 ACCIDENT ON FARM 

E8492 ACCIDENT IN MINE/QUARRY 

E8493 ACC ON INDUSTR PREMISES 

E8494 ACCID IN RECREATION AREA 

E8495 ACCID ON STREET/HIGHWAY 

E8496 ACCIDENT IN PUBLIC BLDG 

E8497 ACCID IN RESIDENT INSTIT 

E8498 ACCIDENT IN PLACE NEC 

E8499 ACCIDENT IN PLACE NOS 

E850 ACC POISON-ANALGESIC* 

E8500 ACC POISON-HEROIN 

E8501 ACC POISON-METHADONE 

E8502 ACC POISON-OPIATES NEC 

E8503 ACC POISON-SALICYLATES 

E8504 ACC POISON-AROM ANALGESC 

E8505 ACC POISON-PYRAZOLE DERV 

E8506 ACC POISON-ANTIRHEUMATIC 

E8507 ACC POISON-NONNARC ANALG 

E8508 ACC POISON-ANALGESIC NEC 

E8509 ACC POISON-ANALGESIC NOS 

E851 ACC POISON-BARBITURATES 

E852 ACC POISON-SEDATIVES NEC* 

E8520 ACC POISN-CHLORL HYDRATE 

E8521 ACC POISON-PARALDEHYDE 

E8522 ACC POISON-BROMINE CMPND 

E8523 ACC POISON-METHAQUALONE 

E8524 ACC POISON-GLUTETHIMIDE 

E8525 ACC POISON-MIX SEDTV NEC 

E8528 ACC POISON-SEDATIVES NEC 

E8529 ACC POISON-SEDATIVES NOS 

E853 ACC POISON-TRANQUILIZERS* 

E8530 ACC POIS-PHENTHIAZ TRANQ 

E8531 ACC POIS-BUTYRPHEN TRANQ 

E8532 ACC POISN-BENZDIAZ TRANQ 

E8538 ACC POISN-TRANQUILZR NEC 

E8539 ACC POISN-TRANQUILZR NOS 

E854 ACC POISN-PSYCHTROPC NEC* 

E8540 ACC POISON-ANTIDEPRESSNT 

E8541 ACC POISON-HALLUCINOGENS 

E8542 ACC POISN-PSYCHSTIMULANT 

E8543 ACC POISON-CNS STIMULANT 

E8548 ACC POISN PSYCHOTROP NEC 

E855 ACC POISON-CNS DRUGS NEC* 

E8550 ACC POISN-ANTICONVULSANT

E8551 ACC POISN-CNS DEPRES NEC 

E8552 ACC POISN-LOCAL ANESTHET 

E8553 ACC POISON-CHOLINERGICS 

E8554 ACC POISN-ANTICHOLINERG 

E8555 ACC POISON-ADRENERGICS 

E8556 ACC POISN-SYMPATHOLYTICS 

E8558 ACC POISON-CNS DRUG NEC 

E8559 ACC POISON-CNS DRUG NOS 

E856 ACC POISON-ANTIBIOTICS 

E857 ACC POIS-OTH ANTI-INFECT 

E858 ACC POISONING-DRUGS NEC* 

E8580 ACC POISON-HORMONES 

E8581 ACC POISN-SYSTEMIC AGENT 

E8582 ACC POISON-BLOOD AGENT 

E8583 ACC POISN-CARDIOVASC AGT 

E8584 ACC POISON-GI AGENT 

E8585 ACC POISN-METABOL AGNT 

E8586 ACC POISN-MUSCL/RESP AGT 

E8587 ACC POISN-SKIN/EENT AGNT 

E8588 ACC POISONING-DRUG NEC 

E8589 ACC POISONING-DRUG NOS 

E860 ACC POISON-ALCOHOL NEC* 

E8600 ACC POISN-ALCOHOL BEVRAG 

E8601 ACC POISON-ETHYL ALCOHOL 

E8602 ACC POISN-METHYL ALCOHOL 

E8603 ACC POISN-ISOPROPYL ALC 

E8604 ACC POISON-FUSEL OIL 

E8608 ACC POISON-ALCOHOL NEC 

E8609 ACC POISON-ALCOHOL NOS 

E861 ACC POISN-CLEANSING AGNT* 

E8610 ACC POIS-SYNTH DETERGENT 

E8611 ACC POISON-SOAP PRODUCTS 

E8612 ACC POISON-POLISHES 

E8613 ACC POISON-CLEANSER NEC 

E8614 ACC POISON-DISINFECTANTS 

E8615 ACC POISON-LEAD PAINTS 

E8616 ACC POISON-PAINTS NEC 

E8619 ACC POISON-CLEANSER NOS 

E862 ACC POIS-PETRLEUM/SOLVNT* 

E8620 ACC POISN-PETROL SOLVENT 

E8621 ACC POISN-PETROLEUM FUEL 

E8622 ACC POIS-LUBRICATING OIL 

E8623 ACC POIS-PETROLEUM SOLID 

E8624 ACC POISN-SOLVENTS NEC 

E8629 ACC POISN-SOLVENT NOS 

E863 ACC POIS-AGRICUL AGT NEC* 

E8630 ACC POIS-CHLORINE PESTIC 

E8631 ACC POIS-PHOSPH PESTICID 

E8632 ACC POISON-CARBAMATES 

E8633 ACC POISN-MIXED PESTICID 

E8634 ACC POISON-PESTICIDE NEC 

E8635 ACC POISON-HERBICIDES 

E8636 ACC POISON-FUNGICIDES 

E8637 ACC POISON-RODENTICIDES 

E8638 ACC POISON-FUMIGANTS 

E8639 ACC POIS-AGRCULT NEC/NOS 

E864 ACC POISON-CAUSTIC NEC*

E8640 ACC POIS-CORROSIV AROMAT 

E8641 ACC POISON-ACIDS 

E8642 ACC POISN-CAUSTIC ALKALI 

E8643 ACC POISON-CAUSTIC NEC 

E8644 ACC POISON-CAUSTIC NOS 

E865 ACC POISON-FOOD & PLANTS* 

E8650 ACC POISON-MEAT 

E8651 ACC POISON-SHELLFISH 

E8652 ACC POISON-FISH NEC 

E8653 ACC POISON-BERRIES/SEEDS 

E8654 ACC POISON-PLANTS NEC 

E8655 ACC POISON-MUSHROOMS 

E8658 ACC POISON-FOOD NEC 

E8659 ACC POISN-FOOD/PLANT NOS 

E866 ACC POISN-SOLID/LIQ NEC* 

E8660 ACC POISONING-LEAD 

E8661 ACC POISONING-MERCURY 

E8662 ACC POISONING-ANTIMONY 

E8663 ACC POISONING-ARSENIC 

E8664 ACC POISON-METALS NEC 

E8665 ACC POISON-PLANT FOOD 

E8666 ACC POISON-GLUES 

E8667 ACC POISON-COSMETICS 

E8668 ACC POIS-SOLID/LIQ NEC 

E8669 ACC POIS-SOLID/LIQ NOS 

E867 ACC POISON-PIPED GAS 

E868 ACC POIS-UTIL GAS/CO NEC* 

E8680 ACC POIS-LIQ PETROL GAS 

E8681 ACC POIS-UTL GAS NEC/NOS 

E8682 ACC POISON-EXHAUST GAS 

E8683 ACC POIS-CO/DOMESTC FUEL 

E8688 ACC POIS-CARBN MONOX NEC 

E8689 ACC POIS-CARBN MONOX NOS 

E869 ACC POISON-GAS/VAPOR NEC* 

E8690 ACC POISN-NITROGEN OXIDE 

E8691 ACC POISN-SULFUR DIOXIDE 

E8692 ACC POISON-FREON 

E8693 ACC POISON-TEAR GAS 

E8694 SCNDHND TBCCO SMOKE 

E8698 ACC POISON-GAS/VAPOR NEC 

E8699 ACC POISON-GAS/VAPOR NOS 

E870 ACC CUT/HEM IN MED CARE* 

E8700 ACC CUT/HEM IN SURGERY 

E8701 ACC CUT/HEM IN INFUSION 

E8702 ACC CUT/HEM-PERFUSN NEC 

E8703 ACC CUT/HEM IN INJECTION 

E8704 ACC CUT/HEM W SCOPE EXAM 

E8705 ACC CUT/HEM W CATHETERIZ 

E8706 ACC CUT/HEM W HEART CATH 

E8707 ACC CUT/HEM W ENEMA 

E8708 ACC CUT IN MED CARE NEC 

E8709 ACC CUT IN MED CARE NOS 

E871 POST-OP FOREIGN BODY* 

E8710 POST-SURGICAL FORGN BODY 

E8711 POSTINFUSION FOREIGN BDY 

E8712 POSTPERFUSION FORGN BODY 

E8713 POSTINJECTION FORGN BODY

E8714 POSTENDOSCOPY FORGN BODY 

E8715 POSTCATHETER FORGN BODY 

E8716 FB POST HEART CATHETER 

E8717 FB POST-CATHETER REMOVAL 

E8718 POST-OP FOREIGN BODY NEC 

E8719 POST-OP FOREIGN BODY NOS 

E872 FAILURE STERILE PROCEDRE* 

E8720 FAILURE STERILE SURGERY 

E8721 FAILURE STERILE INFUSION 

E8722 FAIL STERILE PERFUSN NEC 

E8723 FAIL STERILE INJECTION 

E8724 FAIL STERILE ENDOSCOPY 

E8725 FAIL STERILE CATHETER 

E8726 FAIL STERILE HEART CATH 

E8728 FAIL STERILE PROCED NEC 

E8729 FAIL STERILE PROCED NOS 

E873 FAILURE IN DOSAGE* 

E8730 EXCESS FLUID IN INFUSION 

E8731 INCOR DILUT INFUSN FLUID 

E8732 THERAP RADIATION OVERDOS 

E8733 INADV RADIAT EXP-MEDICAL 

E8734 DOSAG FAIL-SHOCK THERAPY 

E8735 WRNG TEMP IN APPLIC/PACK 

E8736 NONADMIN NECESS MEDICINE 

E8738 FAILURE IN DOSAGE NEC 

E8739 FAILURE IN DOSAGE NOS 

E874 FAILURE OF INSTRUMENT* 

E8740 INSTRMNT FAIL IN SURGERY 

E8741 INSTRUMNT FAIL-INFUSION 

E8742 INSTRMNT FAIL-PERFUS NEC 

E8743 INSTRUMNT FAIL-ENDOSCOPY 

E8744 INSTRMNT FAIL-CATHETERIZ 

E8745 INSTRMNT FAIL-HEART CATH 

E8748 INSTRMNT FAIL-PROCED NEC 

E8749 INSTRMNT FAIL-PROCED NOS 

E875 CONTAMINATION* 

E8750 CONTAMINATED TRANSFUSION 

E8751 CONTAMINATED INJECTION 

E8752 CONTAMINATED DRUG NEC 

E8758 CONTAMINATION NEC 

E8759 CONTAMINATION NOS 

E876 MED MISADVENTURE NEC/NOS* 

E8760 MISMATCH BLOOD-TRANSFUSN 

E8761 WRONG FLUID IN INFUSION 

E8762 FAILURE IN SUTURE 

E8763 MISPLACED ENDOTRACH TUBE 

E8764 FAIL INTROD/REMOVE TUBE 

E8765 PERFORMANCE-INAPPROP OP 

E8768 MEDICAL MISADVENTURE NEC 

E8769 MEDICAL MISADVENTURE NOS 

E878 ABN REACTION TO SURGERY* 

E8780 ABN REACT-ORG TRANSPLANT 

E8781 ABN REACT-ARTIF IMPLANT 

E8782 ABN REACT-ANASTOM/GRAFT 

E8783 ABN REACT-EXTERNAL STOMA 

E8784 ABN REACT-PLAST SURG NEC 

E8785 ABN REACT-LIMB AMPUTAT

E8786 ABN REAC-ORGAN REM NEC 

E8788 ABN REACT-SURG PROC NEC 

E8789 ABN REACT-SURG PROC NOS 

E879 ABN REACTION TO OTH PROC* 

E8790 ABN REACT-CARDIAC CATH 

E8791 ABN REACT-RENAL DIALYSIS 

E8792 ABN REACT-RADIOTHERAPY 

E8793 ABN REACT-SHOCK THERAPY 

E8794 ABN REACT-FLUID ASPIRAT 

E8795 ABN REACT-GASTRIC SOUND 

E8796 ABN REACT-URINARY CATH 

E8797 ABN REACT-BLOOD SAMPLING 

E8798 ABN REACT-PROCEDURE NEC 

E8799 ABN REACT-PROCEDURE NOS 

E880 FALL ON STAIRS OR STEPS* 

E8800 FALL ON ESCALATOR 

E8801 FALL ON SIDEWALK CURB 

E8809 FALL ON STAIR/STEP NEC 

E881 FALL-LADDER OR SCAFFOLD* 

E8810 FALL FROM LADDER 

E8811 FALL FROM SCAFFOLDING 

E882 FALL FROM BUILDING 

E883 FALL INTO HOLE* 

E8830 DIVING ACCIDENT 

E8831 FALL INTO WELL 

E8832 FALL INTO STORM DRAIN 

E8839 FALL INTO OTHER HOLE 

E884 OTH FALL-1 LEVEL TO OTH* 

E8840 FALL FROM PLAYGRND EQUIP 

E8841 FALL FROM CLIFF 

E8842 FALL FROM CHAIR 

E8843 FALL FROM WHEELCHAIR 

E8844 FALL FROM BED 

E8845 FALL FROM FURNITURE NEC 

E8846 FALL FROM COMMODE 

E8849 FALL-1 LEVEL TO OTH NEC 

E885 FALL ON LEVEL-TRIPPING 

E886 FALL ON LEVEL-PUSHED* 

E8860 FALL IN SPORTS 

E8869 FALL ON LEVEL NEC/NOS 

E887 FRACTURE, CAUSE NOS 

E888 FALL NEC & NOS 

E890 FIRE IN PRIVATE DWELLING* 

E8900 PRIVAT DWELL FIRE-EXPLOS 

E8901 PRIV DWEL FIRE-PVC FUMES 

E8902 PRIV DWEL FIRE-FUMES NOS 

E8903 PRIV DWEL FIRE-BURNING 

E8908 PRIV DWEL FIRE-ACCID NEC 

E8909 PRIV DWEL FIRE-ACCID NOS 

E891 FIRE IN OTHER BUILDING* 

E8910 FIRE IN BLDG-EXPLOSION 

E8911 FIRE IN BLDG-PVC FUMES 

E8912 FIRE IN BLDG-FUMES NOS 

E8913 FIRE IN BLDG-BURNING 

E8918 FIRE IN BLDG-ACCID NEC 

E8919 FIRE IN BLDG-ACCID NOS 

E892 FIRE NOT IN BUILDING

E893 CLOTHING FIRE ACCIDENT* 

E8930 CLOTHING FIRE-PRIV DWELL 

E8931 CLOTHING FIRE-BLDG NEC 

E8932 CLOTHING FIRE NOT IN BLD 

E8938 CLOTHING FIRE NEC 

E8939 CLOTHING FIRE NOS 

E894 FIRE-HIGHLY INFLAM MATER 

E895 BURN ACC IN PRIVAT DWELL 

E896 BURN ACC IN BLDG NEC 

E897 BURN ACC NOT IN BLDG 

E898 OTHER FIRE ACCIDENT* 

E8980 BURNING BEDCLOTHES 

E8981 FIRE ACCIDENT NEC 

E899 FIRE ACCIDENT NOS 

E900 EXCESSIVE HEAT* 

E9000 EXCESSIVE HEAT: WEATHER 

E9001 EXCESSIVE HEAT, MAN-MADE 

E9009 EXCESSIVE HEAT NOS 

E901 EXCESSIVE COLD* 

E9010 EXCESSIVE COLD: WEATHER 

E9011 EXCESSIVE COLD, MAN-MADE 

E9018 EXCESSIVE COLD NEC 

E9019 EXCESSIVE COLD NOS 

E902 HIGH/LOW AIR PRESS ACCID* 

E9020 HIGH ALTITUDE RESIDENCE 

E9021 AIR PRESS CHNGE: AIRCRFT 

E9022 AIR PRESS CHANGE: DIVING 

E9028 AIR PRESSURE CHANGE NEC 

E9029 AIR PRESSURE CHANGE NOS 

E903 TRAVEL AND MOTION 

E904 HUNGER/THIRST/EXPOS/NEGL* 

E9040 ABANDONMENT/LACK OF CARE 

E9041 LACK OF FOOD 

E9042 LACK OF WATER 

E9043 EXPOSURE NEC 

E9049 PRIVATION NOS 

E905 VENOMOUS ANIMALS/PLANTS* 

E9050 VENOMOUS SNAKE BITE 

E9051 VENOMOUS SPIDER BITE 

E9052 SCORPION STING 

E9053 HORNET/WASP/BEE STING 

E9054 CENTIPEDE BITE 

E9055 VENOMOUS ARTHROPODS NEC 

E9056 VENOM SEA ANIMALS/PLANTS 

E9057 POISONING BY OTHER PLANT 

E9058 VENOMOUS BITE/STING NEC 

E9059 VENOMOUS BITE/STING NOS 

E906 OTH INJ CAUSED BY ANIMAL* 

E9060 DOG BITE 

E9061 RAT BITE 

E9062 NONVENOMOUS SNAKE BITE 

E9063 ANIMAL BITE NEC 

E9064 NONVENOM ARTHROPOD BITE 

E9065 ANIMAL BITE NOS 

E9068 INJ NEC CAUSED BY ANIMAL 

E9069 INJ NOS CAUSED BY ANIMAL 

E907 ACC DUE TO LIGHTNING

E908 CATACLYSMIC STORM/FLOOD* 

E9080 ACCIDENT D/T HURRICANE 

E9081 ACCIDENT D/T TORNADO 

E9082 ACCIDENT D/T FLOODS 

E9083 ACC D/T SNOW BLIZZARD 

E9084 ACCIDENT D/T DUST STORM 

E9088 ACCIDENT D/T STORM NEC 

E9089 ACC D/T STORM/FLOOD NOS 

E909 ACC D/T AVALANCH/EARTHQU* 

E9090 ACC D/T EARTHQUAKES 

E9091 ACC D/T VOLCANIC ERUPT 

E9092 ACC D/T AVALANCHE 

E9093 ACC D/T DAM COLLAPSE 

E9094 ACC D/T TIDALWAVE NOS 

E9098 ACC D/T ERUPTIONS NEC 

E9099 ACC D/T ERUPTIONS NOS 

E910 ACCIDENTAL DROWNING* 

E9100 WATER-SKIING ACCIDENT 

E9101 SKIN/SCUBA DIVING ACC 

E9102 SWIMMING ACCIDENT NOS 

E9103 SWIMMING/DIVING ACC NEC 

E9104 DROWNING IN BATHTUB 

E9108 ACCIDENTAL DROWNING NEC 

E9109 ACCIDENTAL DROWNING NOS 

E911 RESP OBSTR-FOOD INHAL 

E912 RESP OBSTR-INHAL OBJ NEC 

E913 ACC MECHANICAL SUFFOCAT* 

E9130 SUFFOCAT IN BED/CRADLE 

E9131 SUFFOCATION-PLASTIC BAG 

E9132 SUFFOCATION-LACK OF AIR 

E9133 CAVE-IN NOS 

E9138 SUFFOCATION NEC 

E9139 SUFFOCATION NOS 

E914 FB ENTERING EYE 

E915 FB ENTERING OTH ORIFICE 

E916 STRUCK BY FALLING OBJECT 

E917 STRUCK BY OBJECT/PERSON* 

E9170 STRUCK IN SPORTS 

E9171 CROWD ACCIDENT 

E9172 STRUCK IN RUNNING WATER 

E9179 STRUCK BY OBJ/PERSON NEC 

E918 CAUGHT BETWEEN OBJECTS 

E919 MACHINERY ACCIDENTS* 

E9190 MACHINE ACCID-AGRICULT 

E9191 MACHINE ACCID-MINING 

E9192 LIFTING MACHINE ACCIDENT 

E9193 METALWORKING MACHINE ACC 

E9194 WOODWORKING MACHINE ACC 

E9195 PRIME MOVER MACHINE ACC 

E9196 TRANSMISSION MACHINE ACC 

E9197 EARTH MOVING MACHINE ACC 

E9198 MACHINERY ACCIDENT NEC 

E9199 MACHINERY ACCIDENT NOS 

E920 CUTTING INSTRUMENT ACCID* 

E9200 ACC-POWERED LAWN MOWER 

E9201 ACC-POWER HAND TOOL NEC 

E9202 ACC-POWER HOUSE APPLIANC

E9203 KNIFE/SWORD/DAGGER ACC 

E9204 ACCID-OTHER HAND TOOLS 

E9205 ACC-HYPODERMIC NEEDLE 

E9208 ACC-CUTTING INSTRUM NEC 

E9209 ACC-CUTTING INSTRUM NOS 

E921 PRESSUR VESSEL EXPLOSION* 

E9210 BOILER EXPLOSION 

E9211 GAS CYLINDER EXPLOSION 

E9218 PRESS VESSEL EXPLOS NEC 

E9219 PRESS VESSEL EXPLOS NOS 

E922 FIREARM ACCIDENTS* 

E9220 HANDGUN ACCIDENT 

E9221 SHOTGUN ACCIDENT 

E9222 HUNTING RIFLE ACCIDENT 

E9223 MILITARY FIREARM ACCID 

E9224 ACCIDENT - AIR GUN 

E9228 FIREARM ACCIDENT NEC 

E9229 FIREARM ACCIDENT NOS 

E923 ACCIDENT D/T EXPLOSIVES* 

E9230 FIREWORKS ACCIDENT 

E9231 BLASTING MATERIALS ACCID 

E9232 EXPLOSIVE GASES ACCIDENT 

E9238 EXPLOSIVES ACCIDENT NEC 

E9239 EXPLOSIVES ACCIDENT NOS 

E924 HOT SUBSTANCE ACCIDENT* 

E9240 ACC-HOT LIQUID & STEAM 

E9241 ACCID-CAUSTIC SUBSTANCE 

E9242 ACC-HOT TAP WATER 

E9248 HOT SUBSTANCE ACCID NEC 

E9249 HOT SUBSTANCE ACCID NOS 

E925 ELECTRIC CURRENT ACCID* 

E9250 DOMESTIC WIRING ACCIDENT 

E9251 ELECTR POWER GENERAT ACC 

E9252 INDUST WIRING/MACHIN ACC 

E9258 ELECTRIC CURRENT ACC NEC 

E9259 ELECTRIC CURRENT ACC NOS 

E926 RADIATION EXPOSURE ACCID* 

E9260 RADIOFREQ RADIAT EXPOSUR 

E9261 INFRA-RED APPL RAD EXOS 

E9262 VIS/ULTRAVIOL LGHT EXPOS 

E9263 X-RAY/GAMMA RAY EXPOSURE 

E9264 LASER EXPOSURE 

E9265 RADIOACT ISOTOPE EXPOSUR 

E9268 RADIATION EXPOSURE NEC 

E9269 RADIATION EXPOSURE NOS 

E927 ACCID FROM OVEREXERTION 

E928 ACCIDENTS NEC & NOS* 

E9280 ACC D/T WEIGHTLESS ENVIR 

E9281 EXPOSURE TO NOISE 

E9282 EXPOSURE TO VIBRATION 

E9288 ACCIDENT NEC 

E9289 ACCIDENT NOS 

E929 LATE EFF OF ACCID INJURY* 

E9290 LATE EFF MOTOR VEHIC ACC 

E9291 LATE EFF TRANSPORT ACC 

E9292 LATE EFF ACC POISONING 

E9293 LATE EFF ACCIDENTAL FALL

E9294 LATE EFF FIRE ACC 

E9295 LATE EFF ENVIRONMENT ACC 

E9298 LATE EFF ACCIDENT NEC 

E9299 LATE EFF ACCIDENT NOS 

E930 ADV EFF ANTIBIOTICS* 

E9300 ADV EFF PENICILLINS 

E9301 ADV EFF ANTIFUNG ANTBIOT 

E9302 ADV EFF CHLORAMPHENICOL 

E9303 ADV EFF ERYTHROMYCIN 

E9304 ADV EFF TETRACYCLINE 

E9305 ADV EFF CEPHALOSPORIN 

E9306 ADV EFF ANTMYCOB ANTBIOT 

E9307 ADV EFF ANTINEOP ANTBIOT 

E9308 ADV EFF ANTIBIOTICS NEC 

E9309 ADV EFF ANTIBIOTIC NOS 

E931 ADV EFF ANTI-INFECTV NEC* 

E9310 ADV EFF SULFONAMIDES 

E9311 ADV EFF ARSENIC ANTI-INF 

E9312 ADV EFF METAL ANTI-INF 

E9313 ADV EFF QUINOLINE 

E9314 ADV EFF ANTIMALARIALS 

E9315 ADV EFF ANTPROTAZOAL NEC 

E9316 ADV EFF ANTHELMINTICS 

E9317 ADV EFF ANTIVIRAL DRUGS 

E9318 ADV EFF ANTIMYCOBAC NEC 

E9319 ADV EFF ANTINFCT NEC/NOS 

E932 ADVERSE EFFECT HORMONES* 

E9320 ADV EFF CORTICOSTEROIDS 

E9321 ADV EFF ANDROGENS 

E9322 ADV EFF OVARIAN HORMONES 

E9323 ADV EFF INSULIN/ANTIDIAB 

E9324 ADV EFF ANT PITUITARY 

E9325 ADV EFF POST PITUITARY 

E9326 ADV EFF PARATHYROID 

E9327 ADV EFF THYROID & DERIV 

E9328 ADV EFF ANTITHYROID AGNT 

E9329 ADV EFF HORMONES NEC/NOS 

E933 ADV EFF SYSTEMIC AGENTS* 

E9330 ADV EFF ANALLRG/ANTEMET 

E9331 ADV EFF ANTINEOPLASTIC 

E9332 ADV EFF ACIDIFYING AGENT 

E9333 ADV EFF ALKALIZING AGENT 

E9334 ADV EFF ENZYMES NEC 

E9335 ADV EFF VITAMINS NEC 

E9338 ADV EFF SYSTEMIC AGT NEC 

E9339 ADV EFF SYSTEMIC AGT NOS 

E934 ADV EFF BLOOD AGENT* 

E9340 ADV EFF IRON & COMPOUNDS 

E9341 ADV EFF LIVER/ANTIANEMIC 

E9342 ADV EFF ANTICOAGULANTS 

E9343 ADV EFF VITAMIN K 

E9344 ADV EFF FIBRINOLYSIS AGT 

E9345 ADV EFF COAGULANTS 

E9346 ADV EFF GAMMA GLOBULIN 

E9347 ADV EFF BLOOD PRODUCTS 

E9348 ADV EFF BLOOD AGENT NEC 

E9349 ADV EFF BLOOD AGENT NOS

E935 ADV EFF ANALGESICS* 

E9350 ADV EFF HEROIN 

E9351 ADV EFF METHADONE 

E9352 ADV EFF OPIATES 

E9353 ADV EFF SALICYLATES 

E9354 ADV EFF AROM ANALGSC NEC 

E9355 ADV EFF PYRAZOLE DERIV 

E9356 ADV EFF ANTIRHEUMATICS 

E9357 ADV EFF NON-NARC ANALGSC 

E9358 ADV EFF ANALGESICS NEC 

E9359 ADV EFF ANALGESIC NOS 

E936 ADV EFF ANTICONVULSANTS* 

E9360 ADV EFF OXAZOLIDIN DERIV 

E9361 ADV EFF HYDANTOIN DERIV 

E9362 ADV EFF SUCCINIMIDES 

E9363 ADV EFF ANTCONVL NEC/NOS 

E9364 ADV EFF ANTI-PARKINSON 

E937 ADV EFF SEDATIV/HYPNOTIC* 

E9370 ADV EFF BARBITURATES 

E9371 ADV EFF CHLORAL HYDRATE 

E9372 ADV EFF PARALDEHYDE 

E9373 ADV EFF BROMINE COMPNDS 

E9374 ADV EFF METHAQUALONE 

E9375 ADV EFF GLUTETHIMIDE 

E9376 ADV EFF MIX SEDATIVE 

E9378 ADV EFF SEDAT/HYPNOT NEC 

E9379 ADV EFF SEDAT/HYPNOT NOS 

E938 ADV EFF CNS DEPRESSANT* 

E9380 ADV EFF CNS MUSCL DEPRES 

E9381 ADV EFF HALOTHANE 

E9382 ADV EFF GAS ANESTHET NEC 

E9383 ADV EFF INTRAVEN ANESTH 

E9384 ADV EFF GEN ANES NEC/NOS 

E9385 ADV EFF TOPIC/INFIL ANES 

E9386 ADV EFF NERVE-BLOCK ANES 

E9387 ADV EFF SPINAL ANESTHET 

E9389 ADV EFF LOC ANES NEC/NOS 

E939 ADV EFF PSYCHOTROPIC AGT* 

E9390 ADV EFF ANTIDEPRESSANTS 

E9391 ADV EFF PHENOTHIAZ TRANQ 

E9392 ADV EFF BUTYROPHEN TRANQ 

E9393 ADV EFF ANTIPSYCHOTC NEC 

E9394 ADV EFF BENZODIAZ TRANQ 

E9395 ADV EFF TRANQUILIZER NEC 

E9396 ADV EFF HALLUCINOGENS 

E9397 ADV EFF PSYCHOSTIMULANTS 

E9398 ADV EFF PSYCHOTROPIC NEC 

E9399 ADV EFF PSYCHOTROPIC NOS 

E940 ADV EFF CNS STIMULANTS* 

E9400 ADV EFF ANALEPTICS 

E9401 ADV EFF OPIAT ANTAGONIST 

E9408 ADV EFF CNS STIMULNT NEC 

E9409 ADV EFF CNS STIMULNT NOS 

E941 ADV EFF AUTONOMIC AGENT* 

E9410 ADV EFF CHOLINERGICS 

E9411 ADV EFF PARASYMPATHOLYTC 

E9412 ADV EFF SYMPATHOMIMETICS

E9413 ADV EFF SYMPATHOLYTICS 

E9419 ADV EFF AUTONOM AGNT NOS 

E942 ADV EFF CARDIOVASC AGENT* 

E9420 ADV EFF CARD RHYTH REGUL 

E9421 ADV EFF CARDIOTONICS 

E9422 ADV EFF ANTILIPEMICS 

E9423 ADV EFF GANGLION-BLOCK 

E9424 ADV EFF CORONARY VASODIL 

E9425 ADV EFF VASODILATORS NEC 

E9426 ADV EFF ANTIHYPERTEN AGT 

E9427 ADV EFF ANTIVARICOSE 

E9428 ADV EFF CAPILLARY-ACT 

E9429 ADV EFF CARDIOVASC NEC 

E943 ADVERSE EFFECT GI AGENT* 

E9430 ADV EFF ANTACIDS 

E9431 ADV EFF IRRIT CATHARTIC 

E9432 ADV EFF EMOLL CATHARTICS 

E9433 ADV EFF CATHARTICS NEC 

E9434 ADV EFF DIGESTANTS 

E9435 ADV EFF ANTIDIARRHEA AGT 

E9436 ADV EFF EMETICS 

E9438 ADV EFF GI AGENT NEC 

E9439 ADV EFF GI AGENT NOS 

E944 ADV EFF WATER/MIN METAB* 

E9440 ADV EFF MERCURY DIURETIC 

E9441 ADV EFF PURINE DIURETICS 

E9442 ADV EFF ACETAZOLAMIDE 

E9443 ADV EFF SALURETICS 

E9444 ADV EFF DIURETICS NEC 

E9445 ADV EFF ELECTROLYTE AGNT 

E9446 ADV EFF MINERAL SALT NEC 

E9447 ADV EFF URIC ACID METAB 

E945 ADVERSE EFFECT MUSCL AGT* 

E9450 ADV EFF OXYTOCIC AGENTS 

E9451 ADV EFF SMOOTH MUSC RELX 

E9452 ADV EFF SKELET MUSC RELX 

E9453 ADV EFF MUSC AGT NEC/NOS 

E9454 ADV EFF ANTITUSSIVES 

E9455 ADV EFF EXPECTORANTS 

E9456 ADV EFF ANTI-COMMON COLD 

E9457 ADV EFF ANTIASTHMATICS 

E9458 ADV EFF RESP DRG NEC/NOS 

E946 ADV EFF SKIN/EENT AGENT* 

E9460 ADV EFF LOC ANTI-INFECTV 

E9461 ADV EFF ANTIPRURITICS 

E9462 ADV EFF LOCAL ASTRINGENT 

E9463 ADV EFF EMOLLIENT/DEMULC 

E9464 ADV EFF HAIR/SCALP PREP 

E9465 ADV EFF EYE ANTI-INF/DRG 

E9466 ADV EFF ENT ANTI-INF/DRG 

E9467 ADV EFF TOPIC DENTAL DRG 

E9468 ADV EFF SKIN AGENT NEC 

E9469 ADV EFF SKIN AGENT NOS 

E947 ADV EFF MEDICINE NEC/NOS* 

E9470 ADV EFF DIETETICS 

E9471 ADV EFF LIPOTROPIC DRUGS 

E9472 ADV EFF ANTIDOTES NEC

E9473 ADV EFF ALCOHOL DETER 

E9474 ADV EFF PHARMACEUT EXCIP 

E9478 ADV EFF MEDICINAL NEC 

E9479 ADV EFF MEDICINAL NOS 

E948 ADV EFF BACTERIA VACCINE* 

E9480 ADV EFF BCG VACCINE 

E9481 ADV EFF TYPHOID VACCINE 

E9482 ADV EFF CHOLERA VACCINE 

E9483 ADV EFF PLAGUE VACCINE 

E9484 ADV EFF TETANUS VACCINE 

E9485 ADV EFF DIPHTHER VACCINE 

E9486 ADV EFF PERTUSSIS VACCIN 

E9488 ADV EFF BACT VAC NEC/NOS 

E9489 ADV EFF MIX BACT VACCINE 

E949 ADV EFF VACCINES NEC* 

E9490 ADV EFF SMALLPOX VACCINE 

E9491 ADV EFF RABIES VACCINE 

E9492 ADV EFF TYPHUS VACCINE 

E9493 ADV EFF YELLOW FEVER VAC 

E9494 ADV EFF MEASLES VACCINE 

E9495 ADV EFF POLIO VACCINE 

E9496 ADV EFF VIRAL VACC NEC 

E9497 ADV EFF MIXED VIRAL-BACT 

E9499 ADV EFF BIOLOGIC NEC/NOS 

E950 SUIC/SELF-POIS W SOL/LIQ* 

E9500 POISON-ANALGESICS 

E9501 POISON-BARBITURATES 

E9502 POISON-SEDAT/HYPNOTIC 

E9503 POISON-PSYCHOTROPIC AGT 

E9504 POISON-DRUG/MEDICIN NEC 

E9505 POISON-DRUG/MEDICIN NOS 

E9506 POISON-AGRICULT AGENT 

E9507 POISON-CORROSIV/CAUSTIC 

E9508 POISON-ARSENIC 

E9509 POISON-SOLID/LIQUID NEC 

E951 POISON-UTILITY GAS* 

E9510 POISON-PIPED GAS 

E9511 POISON-GAS IN CONTAINER 

E9518 POISON-UTILITY GAS NEC 

E952 POISON-GAS/VAPOR NEC* 

E9520 POISON-EXHAUST GAS 

E9521 POISON-CO NEC 

E9528 POISON-GAS/VAPOR NEC 

E9529 POISON-GAS/VAPOR NOS 

E953 INJURY-STRANGUL/SUFFOC* 

E9530 INJURY-HANGING 

E9531 INJURY-SUFF W PLAS BAG 

E9538 INJURY-STRANG/SUFF NEC 

E9539 INJURY-STRANG/SUFF NOS 

E954 INJURY-SUBMERSION 

E955 INJURY-FIREARM/EXPLOSIV* 

E9550 INJURY-HANDGUN 

E9551 INJURY-SHOTGUN 

E9552 INJURY-HUNTING RIFLE 

E9553 INJURY-MILITARY FIREARM 

E9554 INJURY-FIREARM NEC 

E9555 INJURY-EXPLOSIVES

E9556 SELF INFLICT ACC-AIR GUN 

E9559 INJURY-FIREARM/EXPL NOS 

E956 INJURY-CUT INSTRUMENT 

E957 INJU-JUMP FROM HI PLACE* 

E9570 INJURY-JUMP FM RESIDENCE 

E9571 INJURY-JUMP FM STRUC NEC 

E9572 INJURY-JUMP FM NATUR SIT 

E9579 INJURY-JUMP NEC 

E958 INJURY/SELF-INJ NEC/NOS* 

E9580 INJURY-MOVING OBJECT 

E9581 INJURY-BURN, FIRE 

E9582 INJURY-SCALD 

E9583 INJURY-EXTREME COLD 

E9584 INJURY-ELECTROCUTION 

E9585 INJURY-MOTOR VEH CRASH 

E9586 INJURY-AIRCRAFT CRASH 

E9587 INJURY-CAUSTIC SUBSTANCE 

E9588 INJURY-NEC 

E9589 INJURY-NOS 

E959 LATE EFF OF SELF-INJURY 

E960 FIGHT, BRAWL, RAPE* 

E9600 UNARMED FIGHT OR BRAWL 

E9601 RAPE 

E961 ASSAULT-CORROSIV/CAUST 

E962 ASSAULT-POISONING* 

E9620 ASSAULT-POIS W MEDIC AGT 

E9621 ASSAULT-POIS W SOLID/LIQ 

E9622 ASSAULT-POIS W GAS/VAPOR 

E9629 ASSAULT-POISONING NOS 

E963 ASSAULT-HANGING/STRANGUL 

E964 ASSAULT-SUBMERSION 

E965 ASSAULT-FIREARM/EXPLOSIV* 

E9650 ASSAULT-HANDGUN 

E9651 ASSAULT-SHOTGUN 

E9652 ASSAULT-HUNTING RIFLE 

E9653 ASSAULT-MILITARY WEAPON 

E9654 ASSAULT-FIREARM NEC 

E9655 ASSAULT-ANTIPERSON BOMB 

E9656 ASSAULT-GASOLINE BOMB 

E9657 ASSAULT-LETTER BOMB 

E9658 ASSAULT-EXPLOSIVE NEC 

E9659 ASSAULT-EXPLOSIVE NOS 

E966 ASSAULT-CUTTING INSTR 

E967 CHILD BATTERING/MALTREAT* 

E9670 BATTER BY FATHER/STEPFTH 

E9671 CHILD ABUSE BY PERS NEC 

E9672 BATTER BY MOTHER/STEPMTH 

E9673 BATTER BY SPOUSE/PARTNER 

E9674 BATTERING BY CHILD 

E9675 BATTERING BY SIBLING 

E9676 BATTERING BY GRANDPARENT 

E9677 BATTER BY OTHER RELATIVE 

E9678 BATTER BY NON-RELATIVE 

E9679 CHILD ABUSE NOS 

E968 ASSAULT NEC & NOS* 

E9680 ASSAULT-FIRE 

E9681 ASSLT-PUSH FROM HI PLACE

E9682 ASSAULT-STRIKING W OBJ 

E9683 ASSAULT-HOT LIQUID 

E9684 ASSAULT-CRIMINAL NEGLECT 

E9685 ASSLT-TRANSPORT VEHICLE 

E9686 ASSAULT - AIR GUN 

E9688 ASSAULT NEC 

E9689 ASSAULT NOS 

E969 LATE EFFECT ASSAULT 

E970 LEGAL INTERVENT-FIREARM 

E971 LEGAL INTERVENT-EXPLOSIV 

E972 LEGAL INTERVENT-GAS 

E973 LEGAL INTERVEN-BLUNT OBJ 

E974 LEGAL INTERVEN-CUT INSTR 

E975 LEGAL INTERVENTION NEC 

E976 LEGAL INTERVENTION NOS 

E977 LATE EFF-LEGAL INTERVENT 

E978 LEGAL EXECUTION 

E980 UNDETERM POIS-SOL/LIQUID* 

E9800 UNDETERM POIS-ANALGESICS 

E9801 UNDETERM POIS-BARBITURAT 

E9802 UNDET POIS-SED/HYPN NEC 

E9803 UNDETERM POIS-PSYCHOTROP 

E9804 UNDET POIS-MED AGNT NEC 

E9805 UNDET POIS-MED AGNT NOS 

E9806 UNDET POIS-CORROS/CAUST 

E9807 UNDET POIS-AGRICULT AGNT 

E9808 UNDETER POIS-ARSENIC 

E9809 UNDETER POIS-SOL/LIQ NEC 

E981 UNDETER POIS-UTILITY GAS* 

E9810 UNDETER POIS-PIPED GAS 

E9811 UNDET POIS-CONTAINER GAS 

E9818 UNDET POIS-UTIL GAS NEC 

E982 UNDETERM POISON-GAS NEC* 

E9820 UNDETER POIS-EXHAUST GAS 

E9821 UNDETERMIN POISON-CO NEC 

E9828 UNDET POIS-GAS/VAPOR NEC 

E9829 UNDET POIS-GAS/VAPOR NOS 

E983 UNDETERM CIRC-SUFFOCATN* 

E9830 UNDETERMIN CIRC-HANGING 

E9831 UNDET CIRC-SUF PLAST BAG 

E9838 UNDET CIRC-SUFFOCATE NEC 

E9839 UNDET CIRC-SUFFOCATE NOS 

E984 UNDETERM CIRC-SUBMERSION 

E985 UNDET CIRC-FIREARM/EXPL* 

E9850 UNDETERMIN CIRC-HANDGUN 

E9851 UNDETERMIN CIRC-SHOTGUN 

E9852 UNDET CIRC-HUNTING RIFLE 

E9853 UNDET CIRC-MILITARY ARMS 

E9854 UNDETER CIRC-FIREARM NEC 

E9855 UNDETERM CIRC-EXPLOSIVE 

E9856 UNDETRMINE ACCID-AIR GUN 

E986 UNDET CIRC-CUT INSTRUMNT 

E987 UNDET CIRC-FALL HI PLACE* 

E9870 UNDET CIRC-FALL RESIDENC 

E9871 UNDET FALL STRUCTURE NEC 

E9872 UNDET FALL NATURAL SITE 

E9879 UNDET CIRC-FALL SITE NOS

E988 UNDETERMINED CIRCUM NEC* 

E9880 UNDETERM CIRC-MOVING OBJ 

E9881 UNDETERM CIRC-BURN, FIRE 

E9882 UNDETERM CIRC-SCALD 

E9883 UNDETERM CIRC-EXTRM COLD 

E9884 UNDETERM CIRC-ELECTROCUT 

E9885 UNDET CIRC-MOT VEH CRASH 

E9886 UNDET CIRC-AIRCRFT CRASH 

E9887 UNDET CIRC-CAUSTIC SUBST 

E9888 UNDETERMIN CIRCUMST NEC 

E9889 UNDETERMIN CIRCUMST NOS 

E989 LATE EFF INJ-UNDET CIRC 

E990 WAR INJURY:FIRE/CONFLAG* 

E9900 WAR INJ:GASOLINE BOMB 

E9909 WAR INJURY:FIRE NEC 

E991 WAR INJ:BULLETS/FRAGM* 

E9910 WAR INJ:RUBBER BULLET 

E9911 WAR INJURY:PELLETS 

E9912 WAR INJURY:BULLET NEC 

E9913 WAR INJ:ANTIPERSON BOMB 

E9919 WAR INJ:FRAGMENTS NEC 

E992 WAR INJ:MARINE EXPLOS 

E993 WAR INJURY:EXPLOS NEC 

E994 WAR INJ:AIRCRFT DESTRUC 

E995 WAR INJUR-CONVEN WAR NEC 

E996 WAR INJ:NUCLEAR WEAPONS 

E997 WAR INJ-UNCONVEN WAR NEC* 

E9970 WAR INJURY:LASERS 

E9971 WAR INJURY:BIOL WARFARE 

E9972 WAR INJURY:GAS/FUM/CHEM 

E9978 WAR INJ-UNCONVEN WAR NEC 

E9979 WAR INJ-UNCONVEN WAR NOS 

E998 WAR INJ:POST WAR OPERAT 

E999 LATE EFF OF WAR INJURY 

V01 COMMUNICABLE DIS CONTACT* 

V010 CHOLERA CONTACT 

V011 TUBERCULOSIS CONTACT 

V012 POLIOMYELITIS CONTACT 

V013 SMALLPOX CONTACT 

V014 RUBELLA CONTACT 

V015 RABIES CONTACT 

V016 VENEREAL DIS CONTACT 

V017 VIRAL DIS CONTACT NEC 

V018 COMMUNIC DIS CONTACT NEC 

V019 COMMUNIC DIS CONTACT NOS 

V02 INFECTIOUS DIS CARRIER* 

V020 CHOLERA CARRIER 

V021 TYPHOID CARRIER 

V022 AMEBIASIS CARRIER 

V023 GI PATHOGEN CARRIER NEC 

V024 DIPHTHERIA CARRIER 

V025 BACTERIA DIS CARRIER NEC* 

V0251 GROUP B STREPTOC CARRIER 

V0252 STREPTOCOCUS CARRIER NEC 

V0259 BACTERIA DIS CARRIER NEC 

V026 VIRAL HEPATITIS CARRIER* 

V0260 VIRAL HEP CARRIER NOS

V0261 HEPATITIS B CARRIER 

V0262 HEPATITIS C CARRIER 

V0269 VIRAL HEP CARRIER NEC 

V027 GONORRHEA CARRIER 

V028 VENEREAL DIS CARRIER NEC 

V029 CARRIER NEC 

V03 VACCIN FOR BACTERIAL DIS* 

V030 VACCIN FOR CHOLERA 

V031 VACC-TYPHOID-PARATYPHOID 

V032 VACCIN FOR TUBERCULOSIS 

V033 VACCIN FOR PLAGUE 

V034 VACCIN FOR TULAREMIA 

V035 VACCIN FOR DIPHTHERIA 

V036 VACCIN FOR PERTUSSIS 

V037 TETANUS TOXOID INOCULAT 

V038 VACCIN FOR BACT DIS NEC* 

V0381 ND VAC HMOPHLUS INFLNZ B 

V0382 ND VAC STRPTCS PNEUMNI B 

V0389 ND OTHER SPECF VACNATION 

V039 VACCIN FOR BACT DIS NOS 

V04 VACCIN FOR VIRAL DISEASE* 

V040 VACCIN FOR POLIOMYELITIS 

V041 VACCIN FOR SMALLPOX 

V042 VACCIN FOR MEASLES 

V043 VACCIN FOR RUBELLA 

V044 VACCIN FOR YELLOW FEVER 

V045 VACCIN FOR RABIES 

V046 VACCIN FOR MUMPS 

V047 VACCIN FOR COMMON COLD 

V048 VACCIN FOR INFLUENZA 

V05 OTH VACCIN FOR SINGL DIS* 

V050 ARBOVIRUS ENCEPH VACCIN 

V051 VACC ARBOVIRAL DIS NEC 

V052 VACCIN FOR LEISHMANIASIS 

V053 NEED PRPHYL VC VRL HEPAT 

V054 NEED PRPHYL VC VARICELLA 

V058 VACCIN FOR DISEASE NEC 

V059 VACCIN FOR SINGL DIS NOS 

V06 VAC FOR DIS COMBINATION* 

V060 VACCIN FOR CHOLERA + TAB 

V061 VACCIN FOR DTP 

V062 VACCIN FOR DTP + TAB 

V063 VACCIN FOR DTP + POLIO 

V064 VAC-MEASLE-MUMPS-RUBELLA 

V065 ND VAC TETANUS-DIPHTHRIA 

V066 ND VAC STRP PNUMN/INFLNZ 

V068 VAC-DIS COMBINATIONS NEC 

V069 VAC-DIS COMBINATIONS NOS 

V07 PROPHYLACTIC MEASURES* 

V070 PROPHYLACTIC ISOLATION 

V071 DESENSITIZA TO ALLERGENS 

V072 PROPHYLACT IMMUNOTHERAPY 

V073 PROPHYL CHEMOTHERAPY NEC* 

V0731 PROPHYLAC FLUORIDE ADMIN 

V0739 OTHER PROPHYLAC CHEMOTHR 

V074 NEED PSTMNPASL HRMN RPLC 

V078 PROPHYLACTIC MEASURE NEC

V079 PROPHYLACTIC MEASURE NOS 

V08 ASYMP HIV INFECTN STATUS 

V09 INFCT MCRG RESISTNT DRUG* 

V090 INF MCRG RSTN PNCLLINS 

V091 INF MCRG RSTN B-LACTAM 

V092 INF MCRG RSTN MACROLIDES 

V093 INF MCRG RSTN TTRCYCLN 

V094 INF MCRG RSTN AMNGLCSDS 

V095 INFCT MCRG RSTNT SULF* 

V0950 INF MCR RST QN FLR NT ML 

V0951 INF MCRG RSTN QN FLRQ ML 

V096 INF MCRG RSTN SULFNMIDES 

V0970 INF MCR RST OTH AG NT ML 

V0971 INF MCRG RSTN OTH AG MLT 

V0980 INF MCR RST OT DRG NT ML 

V0981 INF MCRG RSTN OTH DRG ML 

V0990 INFC MCRG DRGRST NT MULT 

V0991 INFC MCRG DRGRST MULT 

V10 HX OF MALIGNANT NEOPLASM* 

V100 HX OF GI MALIGNANCY* 

V1000 HX OF GI MALIGNANCY NOS 

V1001 HX OF TONGUE MALIGNANCY 

V1002 HX-ORAL/PHARYNX MALG NEC 

V1003 HX-ESOPHAGEAL MALIGNANCY 

V1004 HX OF GASTRIC MALIGNANCY 

V1005 HX OF COLONIC MALIGNANCY 

V1006 HX-RECTAL & ANAL MALIGN 

V1007 HX OF LIVER MALIGNANCY 

V1009 HX OF GI MALIGNANCY NEC 

V101 HX-TRACH/BRONCHOGEN MALG* 

V1011 HX-BRONCHOGENIC MALIGNAN 

V1012 HX-TRACHEAL MALIGNANCY 

V102 HX-OTH INTRATHORACIC MAL* 

V1020 HX-RESP ORG MALIGNAN NOS 

V1021 HX-LARYNGEAL MALIGNANCY 

V1022 HX-NOSE/EAR/SINUS MALIG 

V1029 HX-INTRATHORACIC MAL NEC 

V103 HX OF BREAST MALIGNANCY 

V104 HX-GENITAL MALIGNANCY* 

V1040 HX-FEMALE GENIT MALG NOS 

V1041 HX-CERVICAL MALIGNANCY 

V1042 HX-UTERUS MALIGNANCY NEC 

V1043 HX OF OVARIAN MALIGNANCY 

V1044 HX-FEMALE GENIT MALG NEC 

V1045 HX-MALE GENIT MALIG NOS 

V1046 HX-PROSTATIC MALIGNANCY 

V1047 HX-TESTICULAR MALIGNANCY 

V1048 HX-EPIDIDYMIS MALIGNANCY 

V1049 HX-MALE GENIT MALIG NEC 

V105 HX OF URINARY MALIGNANCY* 

V1050 HX-URINARY MALIGNAN NOS 

V1051 HX OF BLADDER MALIGNANCY 

V1052 HX OF KIDNEY MALIGNANCY 

V1059 HX-URINARY MALIGNAN NEC 

V106 HX OF LEUKEMIA* 

V1060 HX OF LEUKEMIA NOS 

V1061 HX OF LYMPHOID LEUKEMIA

V1062 HX OF MYELOID LEUKEMIA 

V1063 HX OF MONOCYTIC LEUKEMIA 

V1069 HX OF LEUKEMIA NEC 

V107 HX-OTH LYMPHATIC MALIGN* 

V1071 HX-LYMPHOSARCOMA 

V1072 HX-HODGKIN'S DISEASE 

V1079 HX-LYMPHATIC MALIGN NEC 

V108 HX-MALIGNANCY SITE NEC* 

V1081 HX OF BONE MALIGNANCY 

V1082 HX-MALIG SKIN MELANOMA 

V1083 HX-SKIN MALIGNANCY NEC 

V1084 HX OF EYE MALIGNANCY 

V1085 HX OF BRAIN MALIGNANCY 

V1086 HX-MALIGN NERVE SYST NEC 

V1087 HX OF THYROID MALIGNANCY 

V1088 HX-ENDOCRINE MALIGN NEC 

V1089 HX OF MALIGNANCY NEC 

V109 HX OF MALIGNANCY NOS 

V11 HX OF MENTAL DISORDER* 

V110 HX OF SCHIZOPHRENIA 

V111 HX OF AFFECTIVE DISORDER 

V112 HX OF NEUROSIS 

V113 HX OF ALCOHOLISM 

V118 HX-MENTAL DISORDER NEC 

V119 HX-MENTAL DISORDER NOS 

V12 HX OF DISEASE NEC* 

V120 HX-INFECT/PARASITIC DIS* 

V1200 PRSNL HST UNSP NFCT PRST 

V1201 PRSNL HST TUBERCULOSIS 

V1202 PRSNL HST POLIOMYELITIS 

V1203 PERSONAL HISTRY MALARIA 

V1209 PRSNL HST OTH NFCT PARST 

V121 HX-NUTRITION DEFICIENCY 

V122 HX-ENDOCR/META/IMMUN DIS 

V123 HX-BLOOD DISEASES 

V124 HX-NERV SYS/SENS ORG DIS* 

V1240 HX NERV SYS/SNSE ORG NOS 

V1241 HX BENIGN NEOPLASM BRAIN 

V1249 HX NERV SYS/SNSE ORG NEC 

V125 HX-CIRCULATORY SYS DIS* 

V1250 HX-CIRCULATORY DIS NOS 

V1251 HX-VEN THROMBOSIS/EMBOLS 

V1252 HX-THROMBOPHLEBITIS 

V1259 HX-CIRCULATORY DIS NEC 

V126 HX-RESPIRATORY SYS DIS 

V127 HX OF GI DISEASE* 

V1270 PRSNL HST UNSPC DGSTV DS 

V1271 PRSNL HST PEPTIC ULCR DS 

V1272 PRSNL HST COLONIC POLYPS 

V1279 PRSNL HST OT SPF DGST DS 

V13 HX OF OTHER DISEASES* 

V130 HX-URINARY SYSTEM DISORD* 

V1300 PRSNL HST URNR DSRD UNSP 

V1301 PRSNL HST URNR DSRD CALC 

V1309 PRSN HST OT SPF URN DSRD 

V131 HX-TROPHOBLASTIC DISEASE 

V132 HX-GENITAL/OBSTETRIC DIS

V133 HX-SKIN/SUBCUTAN TIS DIS 

V134 HX OF ARTHRITIS 

V135 HX-MUSCULOSKELET DIS NEC 

V136 HX-CONGENITAL MALFORM* 

V1361 HX-HYPOSPADIUS 

V1369 HX-CONGENITAL MALFOR NEC 

V137 HX-PERINATAL PROBLEMS 

V138 HX OF DISEASES NEC 

V139 HX OF DISEASE NOS 

V14 HX OF DRUG ALLERGY* 

V140 HX-PENICILLIN ALLERGY 

V141 HX-ANTIBIOT ALLERGY NEC 

V142 HX-SULFONAMIDES ALLERGY 

V143 HX-ANTI-INFECT ALLERGY 

V144 HX-ANESTHETIC ALLERGY 

V145 HX-NARCOTIC ALLERGY 

V146 HX-ANALGESIC ALLERGY 

V147 HX-VACCINE ALLERGY 

V148 HX-DRUG ALLERGY NEC 

V149 HX-DRUG ALLERGY NOS 

V15 OTH HX OF HEALTH HAZARDS* 

V150 HX OF ALLERGY NEC 

V151 HX-MAJOR CARDIOVASC SURG 

V152 HX-MAJOR ORGAN SURG NEC 

V153 HX OF IRRADIATION 

V154 HX-PSYCHOLOGICAL TRAUMA* 

V1541 HX OF PHYSICAL ABUSE 

V1542 HX OF EMOTIONAL ABUSE 

V1549 PSYCHOLOGICAL TRAUMA NEC 

V155 HX OF INJURY 

V156 HX OF POISONING 

V157 HX OF CONTRACEPTION 

V158 HX-OTHER HEALTH HAZARDS* 

V1581 HX OF PAST NONCOMPLIANCE 

V1582 HISTORY OF TOBACCO USE 

V1584 HX-EXPOSURE ASBESTOS 

V1585 HX-EXPS HAZRD BODY FLUID 

V1586 HX-EXPOSURE TO LEAD 

V1589 HX-HEALTH HAZARDS NEC 

V159 HX-HEALTH HAZARD NOS 

V16 FAMILY HX-MALIGNANCY* 

V160 FAMILY HX-GI MALIGNANCY 

V161 FM HX-TRACH/BRONCHOG MAL 

V162 FAM HX-INTRATHORACIC MAL 

V163 FAMILY HX-BREAST MALIG 

V164 FAMILY HX-GENITAL MALIG* 

V1640 FM HX GENITAL MALIG NOS 

V1641 FM HX OVARY MALIGNANCY 

V1642 FM HX PROSTATE MALIG 

V1643 FM HX TESTIS MALIG 

V1649 FM HX GENITAL MALIG NEC 

V165 FAMILY HX-URINARY MALIG* 

V1651 FAMILY HX-KIDNEY MALIG 

V1659 FAM HX-URINRY MALIG NEC 

V166 FAMILY HX-LEUKEMIA 

V167 FAM HX-LYMPH NEOPLAS NEC 

V168 FAMILY HX-MALIGNANCY NEC

V169 FAMILY HX-MALIGNANCY NOS 

V17 FAM HX-CHR DISABLING DIS* 

V170 FAM HX-PSYCHIATRIC COND 

V171 FAMILY HX-STROKE 

V172 FAM HX-NEUROLOG DIS NEC 

V173 FAM HX-ISCHEM HEART DIS 

V174 FAM HX-CARDIOVAS DIS NEC 

V175 FAMILY HX-ASTHMA 

V176 FAM HX-CHR RESP COND NEC 

V177 FAMILY HX-ARTHRITIS 

V178 FAM HX-MUSCLOSKL DIS NEC 

V18 FAM HX-OTH SPECIF COND* 

V180 FAM HX-DIABETES MELLITUS 

V181 FM HX-ENDO/METAB DIS NEC 

V182 FAMILY HX-ANEMIA 

V183 FAM HX-BLOOD DISORD NEC 

V184 FAM HX-MENTAL RETARDAT 

V185 FAMILY HX-GI DISORDERS 

V186 FAMILY HX-KIDNEY DISEASE* 

V1861 FAM HX-POLYCYSTIC KIDNEY 

V1869 FAM HX-KIDNEY DIS NEC 

V187 FAMILY HX-GU DISEASE NEC 

V188 FM HX-INFECT/PARASIT DIS 

V19 FAM HX-OTHER CONDITIONS* 

V190 FAMILY HX-BLINDNESS 

V191 FAMILY HX-EYE DISORD NEC 

V192 FAMILY HX-DEAFNESS 

V193 FAMILY HX-EAR DISORD NEC 

V194 FAMILY HX-SKIN CONDITION 

V195 FAM HX-CONGEN ANOMALIES 

V196 FAMILY HX-ALLERGIC DIS 

V197 CONSANGUINITY 

V198 FAMILY HX-CONDITION NEC 

V20 HEALTH SUPERVISION CHILD* 

V200 FOUNDLING HEALTH CARE 

V201 CARE OF HEALTHY CHLD NEC 

V202 ROUTIN CHILD HEALTH EXAM 

V21 CONSTITUT STATE IN DEVEL* 

V210 RAPID CHILDHOOD GROWTH 

V211 PUBERTY 

V212 ADOLESCENCE GROWTH NEC 

V218 CONSTIT STATE IN DEV NEC 

V219 CONSTIT STATE IN DEV NOS 

V22 NORMAL PREGNANCY* 

V220 SUPERVIS NORMAL 1ST PREG 

V221 SUPERVIS OTH NORMAL PREG 

V222 PREG STATE, INCIDENTAL 

V23 SUPERVIS HIGH-RISK PREG* 

V230 PREG W HX OF INFERTILITY 

V231 PREG W HX-TROPHOBLAS DIS 

V232 PREG W HX OF ABORTION 

V233 GRAND MULTIPARITY 

V234 PREG W POOR OBSTETRIC HX 

V235 PREG W POOR REPRODUCT HX 

V237 INSUFFICNT PRENATAL CARE 

V238 SUPRV HIGH-RISK PREG NEC* 

V2381 SUPRV ELDERLY PRIMIGRAV

V2382 SUPRV ELDERLY MULTIGRAV 

V2383 SUPRV YOUNG PRIMIGRAVIDA 

V2384 SUPRV YOUNG MULTIGRAVIDA 

V2389 SUPRV HIGH-RISK PREG NEC 

V239 SUPRV HIGH-RISK PREG NOS 

V24 POSTPARTUM CARE/EXAM* 

V240 POSTPART CARE AFTER DEL 

V241 POSTPART CARE-LACTATION 

V242 ROUT POSTPART FOLLOW-UP 

V25 CONTRACEPTIVE MANAGEMENT* 

V250 CONTRACEP MGMT-COUNSEL* 

V2501 PRESCRIP-ORAL CONTRACEPT 

V2502 INITIATE CONTRACEPT NEC 

V2509 CONTRACEPTIVE MANGMT NEC 

V251 INSERTION OF IUD 

V252 STERILIZATION 

V253 MENSTRUAL EXTRACTION 

V254 CONTRACEPT SURVEILLANCE* 

V2540 CONTRACEPT SURVEILL NOS 

V2541 CONTRACEPT PILL SURVEILL 

V2542 IUD SURVEILLANCE 

V2543 SRVL MPLNT SBDRM CNTRCEP 

V2549 CONTRACEPT SURVEILL NEC 

V255 NSRT MPLNT SBDRM CNTRCEP 

V258 CONTRACEPTIVE MANGMT NEC 

V259 CONTRACEPTIVE MANGMT NOS 

V26 PROCREATIVE MANAGEMENT* 

V260 TUBOPLASTY OR VASOPLASTY 

V261 ARTIFICIAL INSEMINATION 

V262 PROCREATIVE MGMT-INVEST 

V263 GENETIC COUNSELING 

V264 PROCREATIVE MGMT-COUNSEL 

V2651 TUBAL LIGATION STATUS 

V2652 VASECTOMY STATUS 

V268 PROCREATIVE MANGMT NEC 

V269 PROCREATIVE MANGMT NOS 

V27 OUTCOME OF DELIVERY* 

V270 DELIVER-SINGLE LIVEBORN 

V271 DELIVER-SINGLE STILLBORN 

V272 DELIVER-TWINS, BOTH LIVE 

V273 DEL-TWINS, 1 NB, 1 SB 

V274 DELIVER-TWINS, BOTH SB 

V275 DEL-MULT BIRTH, ALL LIVE 

V276 DEL-MULT BRTH, SOME LIVE 

V277 DEL-MULT BIRTH, ALL SB 

V279 OUTCOME OF DELIVERY NOS 

V28 ANTENATAL SCREENING* 

V280 SCREENING-CHROMOSOM ANOM 

V281 SCREEN-ALPHAFETOPROTEIN 

V282 SCREEN BY AMNIOCENT NEC 

V283 SCREEN-FETAL MALFORM 

V284 SCREEN-FETAL RETARDATION 

V285 SCREEN-ISOIMMUNIZATION 

V286 ANTENATAL SCREEN STREP B 

V288 ANTENATAL SCREENING NEC 

V289 ANTENATAL SCREENING NOS 

V290 NB OBSRV SUSPCT INFECT

V291 NB OBSRV SUSPCT NEURLGCL 

V292 OBSRV NB SUSPC RESP COND 

V293 NB OBS GENETC/METABL CND 

V298 NB OBSRV OTH SUSPCT COND 

V299 NB OBSRV UNSP SUSPCT CND 

V30 SINGLE LIVEBORN* 

V300 SINGLE LIVEBORN-IN HOSP* 

V3000 SINGLE LB IN-HOSP W/O CS 

V3001 SINGLE LB IN-HOSP W CS 

V301 SINGL LIVEBRN-BEFORE ADM 

V302 SINGLE LIVEBORN-NONHOSP 

V31 TWIN, MATE LIVEBORN* 

V310 TWIN, MATE LB-IN HOSP* 

V3100 TWIN-MATE LB-HOSP W/O CS 

V3101 TWIN-MATE LB-IN HOS W CS 

V311 TWIN, MATE LB-BEFORE ADM 

V312 TWIN, MATE LB-NONHOSP 

V32 TWIN, MATE STILLBORN* 

V320 TWIN, MATE SB-IN HOSP* 

V3200 TWIN-MATE SB-HOSP W/O CS 

V3201 TWIN-MATE SB-HOSP W CS 

V321 TWIN, MATE SB-BEFORE ADM 

V322 TWIN, MATE SB-NONHOSP 

V33 TWIN NOS* 

V330 TWIN NOS-IN HOSPITAL* 

V3300 TWIN-NOS-IN HOSP W/O CS 

V3301 TWIN-NOS-IN HOSP W CS 

V331 TWIN NOS-BEFORE ADMISSN 

V332 TWIN NOS-NONHOSP 

V34 OTH MULT BIRTH, ALL LIVE* 

V340 OTH MULTIPLE NB-IN HOSP* 

V3400 OTH MULT LB-HOSP W/O CS 

V3401 OTH MULT LB-IN HOSP W CS 

V341 OTH MULT NB-BEFORE ADM 

V342 OTH MULTIPLE NB-NONHOSP 

V35 OTH MULT BIRTH, ALL SB* 

V350 OTH MULTIPLE SB-IN HOSP* 

V3500 OTH MULT SB-HOSP W/O CS 

V3501 OTH MULT SB-IN HOSP W CS 

V351 OTH MULT SB-BEFORE ADM 

V352 OTH MULTIPLE SB-NONHOSP 

V36 OTH MULT BRTH, SOME LIVE* 

V360 MULTIPLE NB/SB-IN HOSP* 

V3600 MULT LB/SB-IN HOS W/O CS 

V3601 MULT LB/SB-IN HOSP W CS 

V361 MULT NB/SB-BEFORE ADM 

V362 MULTIPLE NB/SB-NONHOSP 

V37 OTH/UNSPEC MULTIPLE BRTH* 

V370 MULT BIRTH NOS-IN HOSP* 

V3700 MULT BRTH NOS-HOS W/O CS 

V3701 MULT BIRTH NOS-HOSP W CS 

V371 MULT BRTH NOS-BEFORE ADM 

V372 MULT BIRTH NOS-NONHOSP 

V39 LIVEBORN NOS* 

V390 LIVEBORN NOS-IN HOSP* 

V3900 LIVEBORN NOS-HOSP W/O CS 

V3901 LIVEBORN NOS-HOSP W CS

V391 LIVEBORN NOS-BEFORE ADM 

V392 LIVEBORN NOS-NONHOSP 

V40 MENTAL/BEHAVIORAL PROB* 

V400 PROBLEMS WITH LEARNING 

V401 PROB WITH COMMUNICATION 

V402 MENTAL PROBLEMS NEC 

V403 BEHAVIORAL PROBLEMS NEC 

V409 MENTAL/BEHAVIOR PROB NOS 

V41 PROB W SPECIAL FUNCTIONS* 

V410 PROBLEMS WITH SIGHT 

V411 EYE PROBLEMS NEC 

V412 PROBLEMS WITH HEARING 

V413 EAR PROBLEMS NEC 

V414 VOICE PRODUCTION PROBLEM 

V415 SMELL AND TASTE PROBLEM 

V416 PROBLEM W SWALLOWING 

V417 SEXUAL FUNCTION PROBLEM 

V418 PROBL W SPECIAL FUNC NEC 

V419 PROBL W SPECIAL FUNC NOS 

V42 ORGAN TRANSPLANT STATUS* 

V420 KIDNEY TRANSPLANT STATUS 

V421 HEART TRANSPLANT STATUS 

V422 HEART VALVE TRANSPLANT 

V423 SKIN TRANSPLANT STATUS 

V424 BONE TRANSPLANT STATUS 

V425 CORNEA TRANSPLANT STATUS 

V426 LUNG TRANSPLANT STATUS 

V427 LIVER TRANSPLANT STATUS 

V428 TRANSPLANT STATUS NEC* 

V4281 TRNSPL STATUS-BNE MARROW 

V4282 TRSPL STS-PERIP STM CELL 

V4283 TRNSPL STATUS-PANCREAS 

V4289 TRNSPL STATUS ORGAN NEC 

V429 TRANSPLANT STATUS NOS 

V43 ORGAN REPLACEMENT NEC* 

V430 EYE REPLACEMENT NEC 

V431 LENS REPLACEMENT NEC 

V432 HEART REPLACEMENT NEC 

V433 HEART VALVE REPLAC NEC 

V434 BLOOD VESSEL REPLAC NEC 

V435 BLADDER REPLACEMENT NEC 

V436 JOINT REPLACEMENT NEC* 

V4360 JOINT REPLACED UNSPCF 

V4361 JOINT REPLACED SHOULDER 

V4362 JOINT REPLACED ELBOW 

V4363 JOINT REPLACED WRIST 

V4364 JOINT REPLACED HIP 

V4365 JOINT REPLACED KNEE 

V4366 JOINT REPLACED ANKLE 

V4369 OTH SPCF JOINT REPLACED 

V437 LIMB REPLACEMENT NEC 

V438 ORGAN REPLACEMENT NEC* 

V4381 LARYNX REPLACEMENT 

V4382 BREAST REPLACEMENT 

V4383 ARTIFIC SKIN REPL STATUS 

V4389 ORGAN/TISS REPLACMNT NEC 

V44 ARTIFICIAL OPNING STATUS*

V440 TRACHEOSTOMY STATUS 

V441 GASTROSTOMY STATUS 

V442 ILEOSTOMY STATUS 

V443 COLOSTOMY STATUS 

V444 ENTEROSTOMY STATUS NEC 

V445 CYSTOSTOMY STATUS* 

V4450 CYSTOSTOMY STATUS NOS 

V4451 CUTANEOUS-VESICOS STATUS 

V4452 APPENDICO-VESICOS STATUS 

V4459 CYSTOSTOMY STATUS NEC 

V446 URINOSTOMY STATUS NEC 

V447 ARTIFICIAL VAGINA STATUS 

V448 ARTIF OPEN STATUS NEC 

V449 ARTIF OPEN STATUS NOS 

V45 OTH POSTSURGICAL STATES* 

V450 CARDIAC PACEMAKER STATUS* 

V4500 STATUS CARDC DVCE UNSPCF 

V4501 STATUS CARDIAC PACEMAKER 

V4502 STATUS AUTM CRD DFBRLTR 

V4509 STATUS OTH SPCF CRDC DVC 

V451 RENAL DIALYSIS STATUS 

V452 VENTRICULAR SHUNT STATUS 

V453 INTESTINAL BYPASS STATUS 

V454 ARTHRODESIS STATUS 

V455 PRESENCE OF IUD* 

V4551 PRSC NTRUTR CNTRCPTV DVC 

V4552 PRSC SBDRML CNTRCP MPLNT 

V4559 PRSC OTHER CNTRCPTV DVC 

V456 POSTSURGICAL STATE, EYE* 

V4561 CATARACT EXTRACT STATUS 

V4569 PST SRG STAT EYE/ADN NEC 

V4571 ACQUIRED ABSENCE BREAST 

V4572 ACQUIRE ABSNCE INTESTINE 

V4573 ACQUIRED ABSENCE KIDNEY 

V458 OTH POSTSURGICAL STATUS* 

V4581 AORTOCORONARY BYPASS 

V4582 STATUS-POST PTCA 

V4583 BREAST IMPL REMOV STATUS 

V4589 POSTSURGICAL STATES NEC 

V46 OTHER MACHINE DEPENDENCE* 

V460 DEPENDENCE ON ASPIRATOR 

V461 DEPENDENCE ON RESPIRATOR 

V468 MACHINE DEPENDENCE NEC 

V469 MACHINE DEPENDENCE NOS 

V47 OTH PROBL W INTERNAL ORG* 

V470 INTERN ORGAN DEFICIENCY 

V471 MECH PROB W INTERNAL ORG 

V472 CARDIORESPIRAT PROBL NEC 

V473 DIGESTIVE PROBLEMS NEC 

V474 URINARY PROBLEMS NEC 

V475 GENITAL PROBLEMS NEC 

V479 PROBL W INTERNAL ORG NOS 

V48 HEAD/NECK/TRUNK PROBLEMS* 

V480 DEFICIENCIES OF HEAD 

V481 DEFICIENCIES NECK/TRUNK 

V482 MECHANICAL PROB W HEAD 

V483 MECH PROB W NECK & TRUNK

V484 SENSORY PROBLEM W HEAD 

V485 SENSOR PROB W NECK/TRUNK 

V486 DISFIGUREMENTS OF HEAD 

V487 DISFIGUREMENT NECK/TRUNK 

V488 PROB-HEAD/NECK/TRUNK NEC 

V489 PROB-HEAD/NECK/TRUNK NOS 

V49 LIMB PROBLEM/PROBLEM NEC* 

V490 DEFICIENCIES OF LIMBS 

V491 MECHANICAL PROB W LIMBS 

V492 MOTOR PROBLEMS W LIMBS 

V493 SENSORY PROBLEMS W LIMBS 

V494 DISFIGUREMENTS OF LIMBS 

V495 LIMB PROBLEMS NEC 

V4960 STATUS AMPUT UP LMB NOS 

V4961 STATUS AMPUT THUMB 

V4962 STATUS AMPUT OTH FINGERS 

V4963 STATUS AMPUT HAND 

V4964 STATUS AMPUT WRIST 

V4965 STATUS AMPUT BELOW ELBOW 

V4966 STATUS AMPUT ABOVE ELBOW 

V4967 STATUS AMPUT SHOULDER 

V4970 STATUS AMPUT LWR LMB NOS 

V4971 STATUS AMPUT GREAT TOE 

V4972 STATUS AMPUT OTHR TOE(S) 

V4973 STATUS AMPUT FOOT 

V4974 STATUS AMPUT ANKLE 

V4975 STATUS AMPUT BELOW KNEE 

V4976 STATUS AMPUT ABOVE KNEE 

V4977 STATUS AMPUT HIP 

V498 PROBL INFLU HEALTH NEC 

V499 PROBL INFLU HEALTH NOS 

V50 OTHER ELECTIVE SURGERY* 

V500 HAIR TRANSPLANT 

V501 PLASTIC SURGERY NEC 

V502 ROUTINE CIRCUMCISION 

V503 EAR PIERCING 

V5041 PRPHYLCT ORGN RMVL BRST 

V5042 PRPHYLCT ORGN RMVL OVARY 

V5049 PRPHYLCT ORGN RMVL OTHER 

V508 ELECTIVE SURGERY NEC 

V509 ELECTIVE SURGERY NOS 

V51 AFTERCARE W PLASTIC SURG 

V52 FITTING OF PROSTHESIS* 

V520 FITTING ARTIFICIAL ARM 

V521 FITTING ARTIFICIAL LEG 

V522 FITTING ARTIFICIAL EYE 

V523 FITTING DENTAL PROSTHES 

V524 FIT/ADJ BREAST PROS/IMPL 

V528 FITTING PROSTHESIS NEC 

V529 FITTING PROSTHESIS NOS 

V53 ADJUSTMENT OF OTH DEVICE* 

V530 ADJUST NERV SYST DEVICE* 

V5301 ADJ CEREBRAL VENT SHUNT 

V5302 ADJUST NEUROPACEMAKER 

V5309 ADJ NERV SYST DEVICE NEC 

V531 FIT CONTACT LENS/GLASSES 

V532 ADJUSTMENT HEARING AID

V533 ADJUST CARDIAC PACEMAKER* 

V5331 FTNG CARDIAC PACEMAKER 

V5332 FTNG AUTMTC DFIBRILLATOR 

V5339 FTNG OTH CARDIAC DEVICE 

V534 FIT ORTHODONTIC DEVICE 

V535 FIT/ADJ INTES APPL NEC 

V536 FITTING URINARY DEVICES 

V537 FIT ORTHOPEDIC DEVICES 

V538 ADJUSTMENT OF WHEELCHAIR 

V539 ADJUSTMNT DEVICE NEC/NOS 

V54 OTH ORTHOPEDIC AFTERCARE* 

V540 REMOVAL INT FIXATION DEV 

V548 ORTHOPEDIC AFTERCARE NEC 

V549 ORTHOPEDIC AFTERCARE NOS 

V55 ATTEN TO ARTIFICIAL OPEN* 

V550 ATTEN TO TRACHEOSTOMY 

V551 ATTEN TO GASTROSTOMY 

V552 ATTEN TO ILEOSTOMY 

V553 ATTEN TO COLOSTOMY 

V554 ATTEN TO ENTEROSTOMY NEC 

V555 ATTEN TO CYSTOSTOMY 

V556 ATTEN TO URINOSTOMY NEC 

V557 ATTEN ARTIFICIAL VAGINA 

V558 ATTN TO ARTIF OPEN NEC 

V559 ATTN TO ARTIF OPEN NOS 

V56 DIALYSIS ENCOUNTER* 

V560 RENAL DIALYSIS ENCOUNTER 

V561 FT/ADJ XTRCORP DIAL CATH 

V562 FIT/ADJ PERIT DIAL CATH 

V568 DIALYSIS ENCOUNTER, NEC 

V57 REHABILITATION PROCEDURE* 

V570 BREATHING EXERCISES 

V571 PHYSICAL THERAPY NEC 

V572 OCCUPAT/VOCATION THERAPY* 

V5721 ENCNTR OCCUPATNAL THRPY 

V5722 ENCNTR VOCATIONAL THRPY 

V573 SPEECH THERAPY 

V574 ORTHOPTIC TRAINING 

V578 OTH REHABILITATION PROC* 

V5781 ORTHOTIC TRAINING 

V5789 REHABILITATION PROC NEC 

V579 REHABILITATION PROC NOS 

V58 ENCOUNTR PROC/AFTRCR NEC* 

V580 RADIOTHERAPY ENCOUNTER 

V581 CHEMOTHERAPY ENCOUNTER 

V582 BLOOD TRANSFUSION, NO DX 

V583 ATTEN-SURG DRESSNG/SUTUR 

V584 POSTSURG AFTERCARE NEC* 

V5841 ENCNTR PLND PO WND CLSR 

V5849 POSTOP OTH SPECFD AFTRCR 

V585 ORTHODONTICS AFTERCARE 

V5861 LONG-TERM USE ANTICOAGUL 

V5862 LONG-TERM USE ANTIBIOTIC 

V5869 LONG-TERM USE MEDS NEC 

V588 AFTERCARE NEC* 

V5881 FIT/ADJ VASCULAR CATHETR 

V5882 FIT/ADJ NON-VSC CATH NEC

V5889 OTHER SPECFIED AFTERCARE 

V589 AFTERCARE NOS 

V59 DONOR* 

V590 BLOOD DONOR* 

V5901 BLOOD DONOR-WHOLE BLOOD 

V5902 BLOOD DONOR-STEM CELLS 

V5909 BLOOD DONOR NEC 

V591 SKIN DONOR 

V592 BONE DONOR 

V593 BONE MARROW DONOR 

V594 KIDNEY DONOR 

V595 CORNEA DONOR 

V596 LIVER DONOR 

V598 ORG OR TISSUE DONOR NEC 

V599 ORG OR TISSUE DONOR NOS 

V60 HOUSEHOLD CIRCUMSTANCES* 

V600 LACK OF HOUSING 

V601 INADEQUATE HOUSING 

V602 ECONOMIC PROBLEM 

V603 PERSON LIVING ALONE 

V604 NO FAMILY ABLE TO CARE 

V605 HOLIDAY RELIEF CARE 

V606 PERSON IN RESIDENT INST 

V608 HOUSING/ECONO CIRCUM NEC 

V609 HOUSING/ECONO CIRCUM NOS 

V61 OTH FAMILY CIRCUMSTANCES* 

V610 FAMILY DISRUPTION 

V611 MARITAL PROBLEMS* 

V6110 CONSL PARTNER PROB 

V6111 CNSL VICTM PARTNER ABUSE 

V6112 CNSL PERP PARTNER ABUSE 

V612 PARENT-CHILD PROBLEMS* 

V6120 CNSL PRNT-CHLD PROB NOS 

V6121 CNSL VICTIM CHILD ABUSE 

V6122 CNSL PERP PARENT CHLD AB 

V6129 PARENT-CHILD PROBLEM NEC 

V613 PROBLEM W AGED PARENT 

V614 HEALTH PROBLEM IN FAMILY* 

V6141 ALCOHOLISM IN FAMILY 

V6149 FAMILY HEALTH PROBL NEC 

V615 MULTIPARITY 

V616 ILLEGITIMATE PREGNANCY 

V617 UNWANTED PREGNANCY NEC 

V618 FAMILY CIRCUMSTANCES NEC 

V619 FAMILY CIRCUMSTANCE NOS 

V62 OTH PSYCHOSOCIAL CIRCUM* 

V620 UNEMPLOYMENT 

V621 ADVERSE EFF-WORK ENVIRON 

V622 OCCUP CIRCUMSTANCES NEC 

V623 EDUCATIONAL CIRCUMSTANCE 

V624 SOCIAL MALADJUSTMENT 

V625 LEGAL CIRCUMSTANCES 

V626 REFUSAL OF TREATMENT 

V628 OTH PSYCHOLOGICAL STRESS* 

V6281 INTERPERSONAL PROBL NEC 

V6282 BEREAVEMENT, UNCOMPLICAT 

V6283 CNSL PERP PHYS/SEX ABUSE

V6289 PSYCHOLOGICAL STRESS NEC 

V629 PSYCHOSOCIAL CIRCUM NOS 

V63 NO MED FACILITY FOR CARE* 

V630 HOME REMOTE FROM HOSPITL 

V631 NO MEDICAL SERV IN HOME 

V632 WAIT ADM TO OTH FACILITY 

V638 NO MED FACILITIES NEC 

V639 NO MED FACILITIES NOS 

V64 PROCEDURES NOT DONE* 

V640 NO VACCIN/CONTRAINDICAT 

V641 NO PROC/CONTRAINDICATION 

V642 NO PROC/PATIENT DECISION 

V643 NO PROC FOR REASONS NEC 

V644 LAP SURG CONVERT TO OPEN 

V65 OTHER REASON FOR CONSULT* 

V650 HEALTHY PERSON W SICK 

V651 PERSON CONSULT FOR ANOTH 

V652 PERSON FEIGNING ILLNESS 

V653 DIETARY SURVEIL/COUNSEL 

V654 COUNSELING NEC* 

V6540 COUNSELING NOS 

V6541 EXERCISE COUNSELING 

V6542 COUNSLNG SBSTN USE ABUSE 

V6543 COUNSELING INJRY PREVENT 

V6544 HIV COUNSELING 

V6545 CONSLN OT SEX TRNSMT DIS 

V6549 OTHER SPECFD COUNSELING 

V655 PERSN W FEARED COMPLAINT 

V658 REASON FOR CONSULT NEC 

V659 REASON FOR CONSULT NOS 

V66 CONVALESCENCE* 

V660 SURGICAL CONVALESCENCE 

V661 RADIOTHERAPY CONVALESCEN 

V662 CHEMOTHERAPY CONVALESCEN 

V663 MENTAL DIS CONVALESCENCE 

V664 FRACTURE TREATMNT CONVAL 

V665 CONVALESCENCE NEC 

V666 COMB TREATMENT CONVALES 

V667 ENCOUNTR PALLIATIVE CARE 

V669 CONVALESCENCE NOS 

V67 FOLLOW-UP EXAMINATION* 

V670 SURGERY FOLLOW-UP 

V671 RADIOTHERAPY FOLLOW-UP 

V672 CHEMOTHERAPY FOLLOW-UP 

V673 PSYCHIATRIC FOLLOW-UP 

V674 FU EXAM TREATD HEALED FX 

V675 TREATMENT FOLLOW-UP NEC* 

V6751 HIGH-RISK RX NEC EXAM 

V6759 FOLLOW-UP EXAM NEC 

V676 COMB TREATMENT FOLLOW-UP 

V679 FOLLOW-UP EXAM NOS 

V68 ADMINISTRATIVE ENCOUNTER* 

V680 ISSUE MEDICAL CERTIFICAT 

V681 ISSUE REPEAT PRESCRIPT 

V682 REQUEST EXPERT EVIDENCE 

V688 OTH ADMINISTRTVE ENCOUNT* 

V6881 REFERRAL-NO EXAM/TREAT

V6889 ADMINISTRTVE ENCOUNT NEC 

V689 ADMINISTRTVE ENCOUNT NOS 

V690 LACK OF PHYSICAL EXERCSE 

V691 INAPPRT DIET EAT HABITS 

V692 HIGH-RISK SEXUAL BEHAVR 

V693 GAMBLING AND BETTING 

V698 OTH PRBLMS RLTD LFSTYLE 

V699 PRBLM RLTD LFSTYLE NOS 

V70 GENERAL MEDICAL EXAM* 

V700 ROUTINE MEDICAL EXAM 

V701 PSYCH EXAM-AUTHORITY REQ 

V702 GEN PSYCHIATRIC EXAM NEC 

V703 MED EXAM NEC-ADMIN PURP 

V704 EXAM-MEDICOLEGAL REASONS 

V705 HEALTH EXAM-GROUP SURVEY 

V706 HEALTH EXAM-POP SURVEY 

V707 EXAM-CLINICAL RESEARCH 

V708 GENERAL MEDICAL EXAM NEC 

V709 GENERAL MEDICAL EXAM NOS 

V71 OBSERVATION-SUSPECT COND* 

V710 OBSERVATION-MENTAL COND* 

V7101 OBSV-ADULT ANTISOC BEHAV 

V7102 OBSV-ADOLESC ANTISOC BEH 

V7109 OBSERV-MENTAL COND NEC 

V711 OBSV-SUSPCT MAL NEOPLASM 

V712 OBSERV-SUSPECT TB 

V713 OBSERV-WORK ACCIDENT 

V714 OBSERV-ACCIDENT NEC 

V715 OBSERV FOLLOWING RAPE 

V716 OBSERV-INFLICTED INJ NEC 

V717 OBS-SUSP CARDIOVASC DIS 

V718 OBSERV-SUSPECT COND NEC 

V719 OBSERV-SUSPECT COND NOS 

V72 SPECIAL EXAMINATIONS* 

V720 EYE & VISION EXAMINATION 

V721 EAR & HEARING EXAM 

V722 DENTAL EXAMINATION 

V723 GYNECOLOGIC EXAMINATION 

V724 PREG EXAM-PREG UNCONFIRM 

V725 RADIOLOGICAL EXAM NEC 

V726 LABORATORY EXAMINATION 

V727 SKIN/SENSITIZATION TESTS 

V728 EXAMINATION NEC* 

V7281 PREOP CARDIOVSCLR EXAM 

V7282 PREOP RESPIRATORY EXAM 

V7283 OTH SPCF PREOP EXAM 

V7284 PREOP EXAM UNSPCF 

V7285 OTH SPECIFIED EXAM 

V729 EXAMINATION NOS 

V73 SCREENING FOR VIRAL DIS* 

V730 SCREENING-POLIOMYELITIS 

V731 SCREENING FOR SMALLPOX 

V732 SCREENING FOR MEASLES 

V733 SCREENING FOR RUBELLA 

V734 SCREENING-YELLOW FEVER 

V735 SCREENING-ARBOVIRUS DIS 

V736 SCREENING FOR TRACHOMA

V738 SCREEN VRAL CHLM DIS NEC* 

V7388 SCRN OTH SPCF CHLMYD DIS 

V7389 SCRN OTH SPCF VIRAL DIS 

V739 SCREEN FOR VIRAL DIS NOS* 

V7398 SCRN UNSPCF CHLMYD DIS 

V7399 SCRN UNSPCF VIRAL DIS 

V74 SCREENING-BACTERIAL DIS* 

V740 SCREENING FOR CHOLERA 

V741 SCREENING-PULMONARY TB 

V742 SCREENING FOR LEPROSY 

V743 SCREENING FOR DIPHTHERIA 

V744 SCREEN-BACT CONJUNCTIVIT 

V745 SCREEN FOR VENERAL DIS 

V746 SCREENING FOR YAWS 

V748 SCREEN-BACTERIAL DIS NEC 

V749 SCREEN-BACTERIAL DIS NOS 

V75 SCREEN-OTH INFECTIVE DIS* 

V750 SCREEN-RICKETTSIAL DIS 

V751 SCREENING FOR MALARIA 

V752 SCREEN FOR LEISHMANIASIS 

V753 SCREEN-TRYPANOSOMIASIS 

V754 SCREEN-MYCOTIC INFECT 

V755 SCREEN-SCHISTOSOMIASIS 

V756 SCREEN FOR FILARIASIS 

V757 SCREEN FOR HELMINTHIASIS 

V758 SCREEN-PARASITIC DIS NEC 

V759 SCREEN FOR INFEC DIS NOS 

V76 SCREENING-MALIG NEOPLASM* 

V760 SCREEN MAL NEOP-RESP ORG 

V761 SCREEN MAL NEOP-BREAST* 

V7610 SCRN MAL NEO BREAST NOS 

V7611 SCREEN MAMMOGRAM HI RISK 

V7612 SCREEN MAMMOGRAM NEC 

V7619 SCRN MAL NEO BREAST NEC 

V762 SCREEN MAL NEOP-CERVIX 

V763 SCREEN MAL NEOP-BLADDER 

V764 SCREEN MAL NEOP-OTH SITE* 

V7641 SCREEN MAL NEOP-RECTUM 

V7642 SCREEN MAL NEOP-ORAL CAV 

V7643 SCREEN MAL NEOP-SKIN 

V7644 SCRN MALIG NEOP-PROSTATE 

V7645 SCREEN MALIG NEOP-TESTIS 

V7649 SCREEN MAL NEOP-SITE NEC 

V768 SCREEN-NEOPLASM NEC 

V769 SCREEN-NEOPLASM NOS 

V77 SCREEN-ENDO/NUTR/METAB* 

V770 SCREEN-THYROID DISORDER 

V771 SCREEN-DIABETES MELLITUS 

V772 SCREEN FOR MALNUTRITION 

V773 SCREEN-PHENYLKETONURIA 

V774 SCREEN FOR GALACTOSEMIA 

V775 SCREENING FOR GOUT 

V776 SCREEN-CYSTIC FIBROSIS 

V777 SCREEN-INBORN ERR METAB 

V778 SCREENING FOR OBESITY 

V779 SCREEN-ENDOC/NUT/MET NEC 

V78 SCREENING FOR BLOOD DIS*

V780 SCREEN-IRON DEFIC ANEMIA 

V781 SCREEN-DEFIC ANEMIA NEC 

V782 SCREEN-SICKLE CELL DIS 

V783 SCRN-HEMOGLOBINOPATH NEC 

V788 SCREEN-BLOOD DIS NEC 

V789 SCREEN-BLOOD DIS NOS 

V79 SCREENING-MENTAL DISORD* 

V790 SCREENING FOR DEPRESSION 

V791 SCREENING FOR ALCOHOLISM 

V792 SCREEN-MENTAL RETARDAT 

V793 SCREEN-DEVELOPMENT PROB 

V798 SCREEN-MENTAL DIS NEC 

V799 SCREEN-MENTAL DIS NOS 

V80 SCREEN-NEURO/EYE/EAR DIS* 

V800 SCREEN-NEUROLOGICAL COND 

V801 SCREENING FOR GLAUCOMA 

V802 SCREENING-EYE COND NEC 

V803 SCREENING FOR EAR DIS 

V81 SCREEN-HEART/RESP/GU DIS* 

V810 SCRN-ISCHEMIC HEART DIS 

V811 SCREEN FOR HYPERTENSION 

V812 SCREEN-CARDIOVASC NEC 

V813 SCREEN-BRONCH/EMPHYSEMA 

V814 SCREEN-RESPIR COND NEC 

V815 SCREEN FOR NEPHROPATHY 

V816 SCREEN FOR GU COND NEC 

V82 SCREEN-OTHER CONDITIONS* 

V820 SCREEN FOR SKIN COND 

V821 SCREEN-RHEUMATOID ARTHR 

V822 SCREEN-RHEUMAT DIS NEC 

V823 SCREEN-CONG HIP DISLOCAT 

V824 MAT PSTNTL SCR-CHRM ANOM 

V825 SCREEN-CONTAMINATION NEC 

V826 MULTIPHASIC SCREENING 

V828 SCREEN FOR CONDITION NEC 

V829 SCREEN FOR CONDITION NOS

Appendix Q International Classification of Diseases (ICD-9) Surgery Codes (v18) 


surg01 Surgical procedure claim code 1 

01 INCISE-EXCIS BRAIN/SKULL* 

010 CRANIAL PUNCTURE* 

0101 CISTERNAL PUNCTURE 

0102 VENTRICL SHUNT TUBE PUNC 

0109 CRANIAL PUNCTURE NEC 

011 SKULL/BRAIN DX PROCEDURE* 

0111 CLOS CEREB MENINGES BX 

0112 OPEN CEREB MENINGES BX 

0113 CLOSED BRAIN BIOPSY 

0114 OPEN BRAIN BIOPSY 

0115 SKULL BIOPSY 

0118 OTHER BRAIN DX PROCEDURE 

0119 OTHER SKULL DX PROCEDURE 

012 CRANIOTOMY & CRANIECTOMY* 

0121 CRANIAL SINUS I & D 

0122 REMOV INTRACRAN STIMULAT 

0123 REOPEN CRANIOTOMY SITE 

0124 OTHER CRANIOTOMY 

0125 OTHER CRANIECTOMY 

013 INCISE BRAIN & MENINGES* 

0131 INCISE CEREBRAL MENINGES 

0132 LOBOTOMY & TRACTOTOMY 

0139 OTHER BRAIN INCISION 

014 THALAMUS/GLOBUS PALL OP* 

0141 THALAMUS OPERATIONS 

0142 GLOBUS PALLIDUS OPS 

015 EXCISE BRAIN & MENINGES* 

0151 EX CEREB MENINGEAL LES 

0152 HEMISPHERECTOMY 

0153 BRAIN LOBECTOMY 

0159 OTHER BRAIN EXCISION 

016 EXCISE SKULL LESION 

02 OTHER SKULL/BRAIN OPS* 

020 CRANIOPLASTY* 

0201 LINEAR CRANIECTOMY 

0202 ELEVATE SKULL FX FRAGMNT 

0203 SKULL FLAP FORMATION 

0204 BONE GRAFT TO SKULL 

0205 SKULL PLATE INSERTION 

0206 CRANIAL OSTEOPLASTY NEC 

0207 SKULL PLATE REMOVAL 

021 CEREBRAL MENINGES REPAIR* 

0211 SIMPLE SUTURE OF DURA 

0212 BRAIN MENINGE REPAIR NEC 

0213 MENINGE VESSEL LIGATION 

0214 CHOROID PLEXECTOMY 

022 VENTRICULOSTOMY 

023 EXTRACRAN VENTRICL SHUNT* 

0231 VENTRICL SHUNT-HEAD/NECK 

0232 VENTRI SHUNT-CIRCULA SYS 

0233 VENTRICL SHUNT-THORAX

0234 VENTRICL SHUNT-ABDOMEN 

0235 VENTRI SHUNT-UNINARY SYS 

0239 OTHER VENTRICULAR SHUNT 

024 VENTRICLE SHUNT REVISION* 

0241 IRRIGATE VENTRICLE SHUNT 

0242 REPLACE VENTRICLE SHUNT 

0243 REMOVE VENTRICLE SHUNT 

029 SKULL & BRAIN OP NEC* 

0291 LYSIS CORTICAL ADHESION 

0292 BRAIN REPAIR 

0293 IMPLANT BRAIN STIMULATOR 

0294 INSERT/REPLAC SKULL TONG 

0295 REMOVE SKULL TONGS 

0296 INSERT SPHENOID ELECTROD 

0299 SKULL & BRAIN OP NEC 

03 SPINAL CORD & CANAL OPS* 

030 SPINAL CANAL EXPLORATION* 

0301 REMOVAL FB SPINAL CANAL 

0302 REOPEN LAMINECTOMY SITE 

0309 SPINAL CANAL EXPLOR NEC 

031 INTRASPIN NERVE ROOT DIV 

032 CHORDOTOMY* 

0321 PERCUTANEOUS CHORDOTOMY 

0329 OTHER CHORDOTOMY 

033 SPINAL CANAL DX PROC* 

0331 SPINAL TAP 

0332 SPINAL CORD/MENINGES BX 

0339 OTHER SPINAL DX PROC 

034 EXCIS SPINAL CORD LESION 

035 SPINAL CORD PLASTIC OP* 

0351 SPINE MENINGOCELE REPAIR 

0352 MYELOMENINGOCEL REPAIR 

0353 VERTEBRAL FX REPAIR 

0359 SPINAL STRUCT REPAIR NEC 

036 SPINAL CORD ADHESIOLYSIS 

037 SPINAL THECAL SHUNT* 

0371 SUBARACH-PERITON SHUNT 

0372 SUBARACH-URETERAL SHUNT 

0379 OTH SPINAL THECAL SHUNT 

038 DESTR INJECT-SPINE CANAL 

039 SPIN CANAL STRUCT OP NEC* 

0390 INSERT SPINAL CANAL CATH 

0391 ANESTH INJECT-SPIN CANAL 

0392 SPINAL CANAL INJECT NEC 

0393 INSERT SPINAL STIMULATOR 

0394 REMOVE SPINAL STIMULATOR 

0395 SPINAL PATCH 

0396 PERCUTAN FACET DENERVAT 

0397 REVISE SPINE THECA SHUNT 

0398 REMOVE SPINE THECA SHUNT 

0399 SPINE CANAL STRUC OP NEC 

04 CRAN & PERIPH NERVE OPS* 

040 PER NERV INCIS/DIV/EXCIS* 

0401 EXCISION ACOUSTC NEUROMA 

0402 TRIGEMINAL NERV DIVISION 

0403 PERIPH NERVE DIV NEC 

0404 PERIPH NERVE INCIS NEC

0405 GASSERIAN GANGLIONECTOMY 

0406 PERIPH GANGLIONECT NEC 

0407 PERIPH NERV EXCISION NEC 

041 PERIPH NERVE DX PROC* 

0411 CLOS PERIPH NERVE BIOPSY 

0412 OPEN PERIPH NERVE BIOPSY 

0419 PERIPH NERVE DX PROC NEC 

042 PERIPH NERVE DESTRUCTION 

043 PERIPHERAL NERVE SUTURE 

044 PERIPH NERV ADHESIOLYSIS* 

0441 DECOMPRESS TRIGEM ROOT 

0442 CRAN NERV ROOT DECOM NEC 

0443 CARPAL TUNNEL RELEASE 

0444 TARSAL TUNNEL RELEASE 

0449 PER NERVE ADHESIOLYS NEC 

045 PERIPHERAL NERVE GRAFT 

046 PERIPH NERVE TRANSPOSIT 

047 OTHER PERIPH NEUROPLASTY* 

0471 HYPOGLOSS-FACIAL ANASTOM 

0472 ACCESSORY-FACIAL ANASTOM 

0473 ACCESS-HYPOGLOSS ANASTOM 

0474 PERIPH NERV ANASTOM NEC 

0475 POSTOP REVIS PER NERV OP 

0476 LATE REPAIR PER NERV INJ 

0479 OTHER NEUROPLASTY 

048 PERIPHERAL NERVE INJECT* 

0480 PERIPH NERVE INJECT NOS 

0481 ANESTH INJEC PERIPH NERV 

0489 PERIPH NERVE INJECT NEC 

049 OTH PERIPHERAL NERVE OP* 

0491 NEURECTASIS 

0492 IMPLANT PERIPH STIMULAT 

0493 REMOVE PERIPH STIMULATOR 

0499 PERIPHERAL NERVE OPS NEC 

05 SYMPATHETIC NERVE OPS* 

050 SYMPATH NERVE DIVISION 

051 SYMPATH NERVE DX PROC* 

0511 SYMPATHETIC NERVE BIOPSY 

0519 SYMPATH NRV DX PROC NEC 

052 SYMPATHECTOMY* 

0521 SPHENOPALATIN GANGLIONEC 

0522 CERVICAL SYMPATHECTOMY 

0523 LUMBAR SYMPATHECTOMY 

0524 PRESACRAL SYMPATHECTOMY 

0525 PERIART SYMPATHECTOMY 

0529 OTHER SYMPATHECTOMY 

053 SYMPATH NERVE INJECTION* 

0531 ANESTH INJECT SYMP NERVE 

0532 NEUROLYT INJEC-SYMP NRV 

0539 SYMPATH NERVE INJECT NEC 

058 OTH SYMPATHETIC NERVE OP* 

0581 SYMPATHETIC NERVE REPAIR 

0589 SYMPATHETIC NERVE OP NEC 

059 OTHER NERVOUS SYSTEM OPS 

06 THYROID/PARATHYROID OPS* 

060 THYROID FIELD INCISION* 

0601 THYROID FIELD ASPIRATION

0602 REOPEN THYROID FIELD WND 

0609 INCIS THYROID FIELD NEC 

061 THYROID/PARATHY DX PROC* 

0611 CLOSED THYROID GLAND BX 

0612 OPEN THYROID GLAND BX 

0613 PARATHYROID BIOPSY 

0619 THYR/PARATHY DX PROC NEC 

062 UNILAT THYROID LOBECTOMY 

063 OTHER PART THYROIDECTOMY* 

0631 EXCISION THYROID LESION 

0639 PART THYROIDECTOMY NEC 

064 COMPLETE THYROIDECTOMY 

065 SUBSTERNAL THYROIDECTOMY* 

0650 SUBSTERN THYROIDECT NOS 

0651 PART SUBSTERN THYROIDECT 

0652 TOT SUBSTERN THYROIDECT 

066 LINGUAL THYROID EXCISION 

067 THYROGLOSS DUCT EXCISION 

068 PARATHYROIDECTOMY* 

0681 TOTAL PARATHYROIDECTOMY 

0689 OTHER PARATHYROIDECTOMY 

069 THYROID/PARATHY OP NEC* 

0691 THYROID ISTHMUS DIVISION 

0692 THYROID VESSEL LIGATION 

0693 THYROID SUTURE 

0694 THYROID REIMPLANTATION 

0695 PARATHYROID REIMPLANT 

0698 OTHER THYROID OPERATIONS 

0699 OTHER PARATHYROID OPS 

07 OTH ENDOCRINE GLND OPS* 

070 ADRENAL FIELD EXPLOR* 

0700 ADRENAL EXPLORATION NOS 

0701 UNILAT ADRENAL EXPLORAT 

0702 BILAT ADRENAL EXPLORAT 

071 OTHER ENDOCRINE DX PROCS* 

0711 CLOSED ADRENAL GLAND BX 

0712 OPEN ADRENAL GLAND BX 

0713 TRANSFRONT PITUITARY BX 

0714 TRANSPHEN PITUITARY BX 

0715 PITUITARY BIOPSY NOS 

0716 THYMUS BIOPSY 

0717 PINEAL BIOPSY 

0719 ENDOCRINE DX PROC NEC 

072 PARTIAL ADRENALECTOMY* 

0721 ADRENAL LESION EXCISION 

0722 UNILATERAL ADRENALECTOMY 

0729 PART ADRENALECTOMY NEC 

073 BILATERAL ADRENALECTOMY 

074 OTHER ADRENAL OPERATIONS* 

0741 ADRENAL INCISION 

0742 ADRENAL NERVE DIVISION 

0743 ADRENAL VESSEL LIGATION 

0744 ADRENAL REPAIR 

0745 ADRENAL REIMPLANTATION 

0749 ADRENAL OPERATION NEC 

075 PINEAL GLAND OPERATIONS* 

0751 PINEAL FIELD EXPLORATION

0752 PINEAL GLAND INCISION 

0753 PARTIAL PINEALECTOMY 

0754 TOTAL PINEALECTOMY 

0759 PINEAL OPERATION NEC 

076 HYPOPHYSECTOMY* 

0761 EXC PITUIT LES-TRANSFRON 

0762 EXC PITUIT LES-TRANSPHEN 

0763 PART EXCIS PITUITARY NOS 

0764 TOT EXC PITUIT-TRANSFRON 

0765 TOT EXC PITUIT-TRANSPHEN 

0768 TOTAL EXC PITUITARY NEC 

0769 TOTAL EXC PITUITARY NOS 

077 OTHER HYPOPHYSIS OPS* 

0771 PITUITARY FOSSA EXPLORAT 

0772 PITUITARY GLAND INCISION 

0779 PITUITARY OPERATION NEC 

078 THYMECTOMY* 

0780 THYMECTOMY NOS 

0781 PART EXCISION OF THYMUS 

0782 TOTAL EXCISION OF THYMUS 

079 OTHER THYMUS OPERATIONS* 

0791 THYMUS FIELD EXPLORATION 

0792 INCISION OF THYMUS 

0793 REPAIR OF THYMUS 

0794 THYMUS TRANSPLANTATION 

0799 THYMUS OPERATION NEC 

08 EYELID OPERATIONS* 

080 EYELID INCISION* 

0801 INCISION OF LID MARGIN 

0802 BLEPHARORRHAPHY SEVERING 

0809 OTHER EYELID INCISION 

081 DIAGNOSTIC PROC-EYELID* 

0811 EYELID BIOPSY 

0819 EYELID DX PROCEDURE NEC 

082 EXCIS/DESTRUC LID LESION* 

0820 REMOVE EYELID LESION NOS 

0821 CHALAZION EXCISION 

0822 EXCISE MINOR LES LID NEC 

0823 EXC MAJ LES LID PRT-THIC 

0824 EXC MAJ LES LID FUL-THIC 

0825 DESTRUCTION LID LESION 

083 PTOSIS/LID RETRACT REP* 

0831 PTOSIS REP-FRONT MUS SUT 

0832 PTOSIS REP-FRON MUS SLNG 

0833 PTOSIS REP-LEVAT MUS ADV 

0834 PTOSIS REP-LEVAT MUS NEC 

0835 PTOS REP-TARSAL TECHNIQ 

0836 BLEPHAROPTOS REPAIR NEC 

0837 REDUC OVERCORRECT PTOSIS 

0838 CORRECT LID RETRACTION 

084 ENTROPION/ECTROPION REP* 

0841 THERMOCAUT/ENTROPION REP 

0842 SUTURE ENTROPION REPAIR 

0843 WEDG RESEC ENTROPION REP 

0844 LID RECONS ENTROPION REP 

0849 ENTROPION/ECTROP REP NEC 

085 OTH ADJUST LID POSITION*

0851 CANTHOTOMY 

0852 BLEPHARORRHAPHY 

0859 ADJUST LID POSITION NEC 

086 LID RECONSTRUCT W GRAFT* 

0861 LID RECONST W SKIN GRAFT 

0862 LID RECONST W MUC GRAFT 

0863 LID RECONST W HAIR GRAFT 

0864 LID RECON-TARSOCONJ FLAP 

0869 LID RECONSTR W GRAFT NEC 

087 OTHER EYELID RECONSTRUCT* 

0870 LID RECONSTRUCTION NOS 

0871 LID MARG RECON-PART THIC 

0872 LID RECONS-PART THIC NEC 

0873 LID MARG RECONS FUL THIC 

0874 LID RECONST-FUL THIC NEC 

088 OTHER REPAIR OF EYELID* 

0881 LINEAR REP LID LACER 

0882 LID MARG LAC RX-PART TH 

0883 LID LACER RX-PRT TH NEC 

0884 LID MARG LAC RX-FUL THIC 

0885 LID LAC RX-FUL THIC NEC 

0886 LOWER LID RHYTIDECTOMY 

0887 UPPER LID RHYTIDECTOMY 

0889 EYELID REPAIR NEC 

089 OTHER EYELID OPERATIONS* 

0891 ELECTROSURG LID EPILAT 

0892 CRYOSURG LID EPILATION 

0893 EYELID EPILATION NEC 

0899 EYELID OPERATION NEC 

09 LACRIMAL SYSTEM OP* 

090 LACRIMAL GLAND INCISION 

091 LACRIMAL SYS DX PROC* 

0911 LACRIMAL GLAND BIOPSY 

0912 LACRIMAL SAC BIOPSY 

0919 LACRIMAL SYS DX PROC NEC 

092 LACRIMAL GLAND EXCISION* 

0920 EXC LACRIMAL GLAND NOS 

0921 EXCIS LES LACRIMAL GLAND 

0922 PART DACRYOADENECT NEC 

0923 TOTAL DACRYOADENECTOMY 

093 OTHER LACRIMAL GLAND OPS 

094 LAC PASSAGE MANIPULATION* 

0941 LACRIMAL PUNCTUM PROBE 

0942 LAC CANALICULI PROBE 

0943 NASOLACRIMAL DUCT PROBE 

0944 NASOLAC DUCT INTUBAT 

0949 LAC PASSAGE MANIP NEC 

095 INCISE LAC SAC/PASSAGES* 

0951 LAC PUNCTUM INCISION 

0952 LAC CANALICULI INCISION 

0953 LACRIMAL SAC INCISION 

0959 LACRIM PASSAGE INCIS NEC 

096 LACRIM SAC/PASSAGE EXCIS 

097 CANALICULUS/PUNCTUM REP* 

0971 CORRECT EVERTED PUNCTUM 

0972 PUNCTUM REPAIR NEC 

0973 CANALICULUS REPAIR

098 NASO-LACRIMAL FISTULIZAT* 

0981 DACRYOCYSTORHINOSTOMY 

0982 CONJUNCTIVOCYSTORHINOST 

0983 CONJUNCTIVORHINOS W TUBE 

099 OTH LACRIMAL SYST OPS* 

0991 LAC PUNCTUM OBLITERATION 

0999 LACRIMAL SYSTEM OP NEC 

10 CONJUNCTIVAL OPERATIONS* 

100 INCISE/REMOV CONJUNCT FB 

101 CONJUNCTIVA INCISION NEC 

102 CONJUNCTIVA DX PROC* 

1021 CONJUNCTIVAL BIOPSY 

1029 CONJUNCTIVA DX PROC NEC 

103 DESTRUCT CONJUNCT LESION* 

1031 EXCISE CONJUNCTIV LESION 

1032 DESTRUCT CONJUNC LES NEC 

1033 OTH CONJUNC DESTRUC PROC 

104 CONJUNCTIVOPLASTY* 

1041 SYMBLEPH REP W FREE GRFT 

1042 GRAFT CONJUNC CUL-DE-SAC 

1043 CONJUN CUL-DE-SAC RX NEC 

1044 CONJUNC FREE GRAFT NEC 

1049 CONJUNCTIVOPLASTY NEC 

105 CONJUNC/LID ADHESIOLYSIS 

106 REPAIR CONJUNCT LACERAT 

109 OTHER CONJUNCTIVAL OPS* 

1091 SUBCONJUNCTIVAL INJECT 

1099 CONJUNCTIVAL OP NEC 

11 OPERATIONS ON CORNEA* 

110 MAGNET REMOVAL CORNEA FB 

111 CORNEAL INCISION 

112 DX PROCEDURE ON CORNEA* 

1121 CORNEAL SCRAPE FOR SMEAR 

1122 CORNEAL BIOPSY 

1129 CORNEAL DX PROC NEC 

113 EXCISION OF PTERYGIUM* 

1131 PTERYGIUM TRANSPOSITION 

1132 PTERYG EXC W CORNEA GRFT 

1139 PTERYGIUM EXCISION NEC 

114 DESTRUCT CORNEAL LESION* 

1141 MECH REMOV CORNEA EPITH 

1142 THERMOCAUT CORNEA LESION 

1143 CRYOTHERAP CORNEA LESION 

1149 DESTRUCT CORNEA LES NEC 

115 CORNEAL REPAIR* 

1151 SUTURE CORNEA LACERATION 

1152 REP CORNEA POSTOP DEHISC 

1153 RX CORNEA LAC W CONJ FLP 

1159 CORNEAL REPAIR NEC 

116 CORNEAL TRANSPLANT* 

1160 CORNEAL TRANSPLANT NOS 

1161 LAM KERATPLAST W AUTGRFT 

1162 LAMELLAR KERATOPLAST NEC 

1163 PERF KERATOPL W AUTOGRFT 

1164 PERFORAT KERATOPLAST NEC 

1169 CORNEAL TRANSPLANT NEC 

117 OTH RECONST REFRAC SURG*

1171 KERATOMILEUSIS 

1172 KERATOPHAKIA 

1173 KERATOPROSTHESIS 

1174 THERMOKERATOPLASTY 

1175 RADIAL KERATOTOMY 

1176 EPIKERATOPHAKIA 

1179 CORNEA RECONSTRUCT NEC 

119 OTHER CORNEAL OPERATIONS* 

1191 CORNEAL TATTOOING 

1192 REMOVE CORNEAL IMPLANT 

1199 CORNEAL OPERATION NEC 

12 ANTERIOR SEGMENT OPS* 

120 REMOV INTRAOC FB ANT SEG* 

1200 REMOV ANT SEGMNT FB NOS 

1201 MAGNET REMOV ANT SEG FB 

1202 NONMAG REMOV ANT SEG FB 

121 IRIDOTOMY/SIMPLE IRIDECT* 

1211 IRIDOTOMY W TRANSFIXION 

1212 IRIDOTOMY NEC 

1213 PROLAPSED IRIS EXCISION 

1214 IRIDECTOMY NEC 

122 ANTERIOR SEGMENT DX PROC* 

1221 DX ASPIRAT-ANT CHAMBER 

1222 IRIS BIOPSY 

1229 ANT SEGMENT DX PROC NEC 

123 IRIDOPLASTY/COREOPLASTY* 

1231 GONIOSYNECHIAE LYSIS 

1232 ANT SYNECHIA LYSIS NEC 

1233 POST SYNECHIAE LYSIS 

1234 CORNEOVITREAL ADHESIOLYS 

1235 COREOPLASTY 

1239 IRIDOPLASTY NEC 

124 DESTR IRIS/CIL BODY LES* 

1240 REMOV ANT SEGMNT LES NOS 

1241 NONEXC DESTRUC IRIS LES 

1242 EXCISION OF IRIS LESION 

1243 NONEXC DESTR CIL BOD LES 

1244 EXCISE CILIARY BODY LES 

125 INTRAOCUL CIRC FACILITAT* 

1251 GONIOPUNCTURE 

1252 GONIOTOMY 

1253 GONIOTOMY W GONIOPUNCTUR 

1254 TRABECULOTOMY AB EXTERNO 

1255 CYCLODIALYSIS 

1259 FACILIT INTRAOC CIRC NEC 

126 SCLERAL FISTULIZATION* 

1261 TREPHIN SCLERA W IRIDECT 

1262 THERMCAUT SCLER W IRIDEC 

1263 IRIDENCLEISIS/IRIDOTASIS 

1264 TRABECULECTOM AB EXTERNO 

1265 SCLER FISTULIZ W IRIDECT 

1266 POSTOP REVIS SCL FISTUL 

1269 SCLER FISTULIZING OP NEC 

127 HI INTR-OC PRESS RELIEF* 

1271 CYCLODIATHERMY 

1272 CYCLOCRYOTHERAPY 

1273 CYCLOPHOTOCOAGULATION

1274 CIL BODY DIMINUTION NOS 

1279 GLAUCOMA PROCEDURE NEC 

128 OPERATIONS ON SCLERA* 

1281 SUTURE SCLERAL LACER 

1282 SCLERAL FISTULA REPAIR 

1283 REVIS ANT SEG OP WND NEC 

1284 DESTRUCT SCLERAL LESION 

1285 REPAIR STAPHYLOM W GRAFT 

1286 REP SCLER STAPHYLOMA NEC 

1287 GRAFT REINFORCE SCLERA 

1288 SCLERA REINFORCEMENT NEC 

1289 SCLERAL OPERATION NEC 

129 OTH ANTERIOR SEGMENT OPS* 

1291 THERAPEUT EVAC ANT CHAMB 

1292 ANTERIOR CHAMBER INJECT 

1293 REMOV EPITHEL DOWNGROWTH 

1297 IRIS OPERATION NEC 

1298 CILIARY BODY OP NEC 

1299 ANTERIOR CHAMBER OP NEC 

13 OPERATIONS ON LENS* 

130 REMOVE FB FROM LENS* 

1300 REMOVE FB LENS NOS 

1301 MAGNET REMOVE FB LENS 

1302 NONMAGNET REMOVE FB LENS 

131 INTRACAPSUL LENS EXTRAC* 

1311 TEMP-INF INTRCAP LENS EX 

1319 INTRACAPSUL LENS EXT NEC 

132 LINEAR EXTRACAP LENS EXT 

133 SIMPL ASPIR LENS EXTRACT 

134 FRAG-ASP XTRACAP LENS EX* 

1341 CATARAC PHACOEMULS/ASPIR 

1342 POST CATARAC FRAG/ASPIR 

1343 CATARACT FRAG/ASPIR NEC 

135 EXTRACAPS LENS EXTR NEC* 

1351 TEMP-INF XTRACAP LENS EX 

1359 EXTRACAP LENS EXTRAC NEC 

136 OTH CATARACT EXTRACTION* 

1364 AFTER-CATAR DISCISSION 

1365 AFTER-CATARACT EXCISION 

1366 AFTER CATAR FRAGMNTATION 

1369 CATARACT EXTRACTION NEC 

137 INSERT PROSTHETIC LENS* 

1370 INSERT PSEUDOPHAKOS NOS 

1371 INSERT LENS AT CATAR EXT 

1372 SECONDARY INSERT LENS 

138 IMPLANTED LENS REMOVAL 

139 OTHER OPERATIONS ON LENS 

14 POSTERIOR SEGMENT OPS* 

140 REMOVE POST SEGMENT FB* 

1400 REMOV POST SEGMNT FB NOS 

1401 MAGNET REMOV POST SEG FB 

1402 NONMAG REMOV POST SEG FB 

141 POSTERIOR SEG DIAGNOS OP* 

1411 DIAGNOST VITREOUS ASPIR 

1419 DX PROC POST SEG NEC 

142 RETINA-CHOR LES DESTRUCT* 

1421 CHORIORET LES DIATHERMY

1422 CHORIORETIN LES CRYOTHER 

1423 CHORIORET LES XENON COAG 

1424 CHORIORET LES LASER COAG 

1425 CHORIORET LES P/COAG NOS 

1426 CHORIORET LES RADIOTHER 

1427 CHORIORET LES RAD IMPLAN 

1429 CHORIORET LES DESTR NEC 

143 REPAIR OF RETINAL TEAR* 

1431 RETINAL TEAR DIATHERMY 

1432 RETINAL TEAR CRYOTHERAPY 

1433 RETINAL TEAR XENON COAG 

1434 RETINAL TEAR LASER COAG 

1435 RETINA TEAR PHOTOCOA NOS 

1439 RETINAL TEAR REPAIR NEC 

144 REP RETINA DETACH/BUCKLE* 

1441 SCLERAL BUCKLE W IMPLANT 

1449 SCLERAL BUCKLING NEC 

145 OTH REPAIR RETINA DETACH* 

1451 DETACH RETINA-DIATHERMY 

1452 DETACH RETINA-CRYOTHERAP 

1453 DETACH RETINA XENON COAG 

1454 DETACH RETINA LASER COAG 

1455 DETACH RET PHOTOCOAG NOS 

1459 REPAIR RETINA DETACH NEC 

146 REMOV PROS MAT POST SEG 

147 OPERATIONS ON VITREOUS* 

1471 ANTERIOR REMOV VITREOUS 

1472 VITREOUS REMOVAL NEC 

1473 ANTERIOR MECHAN VITRECT 

1474 MECH VITRECTOMY NEC 

1475 VITREOUS SUBSTITUT INJEC 

1479 VITREOUS OPERATION NEC 

149 OTHER POST SEGMENT OPS 

15 EXTRAOCULAR MUSCLE OPS* 

150 XTRAOC MUSC-TEND DX PROC* 

1501 EXTRAOC MUSC-TEND BIOPSY 

1509 EXTRAOC MUSC DX PROC NEC 

151 1 XTRAOC MUS OP W DETACH* 

1511 ONE EXTRAOC MUS RECESS 

1512 1 EXTRAOC MUSCL ADVANCE 

1513 1 EXTRAOC MUSCL RESECT 

1519 XTRAOC MUS OP/DETACH NEC 

152 OTH OPS ON 1 EXTROC MUSC* 

1521 LENGTHEN 1 EXTRAOC MUSC 

1522 SHORTEN 1 EXTRAOC MUSC 

1529 OP ON 1 EXTRAOC MUSC NEC 

153 TEMP DETACH >1 XTROC MUS 

154 OTH OP ON >L EXTRAOC MUS 

155 EXTRAOCUL MUS TRANSPOSIT 

156 REVIS EXTRAOC MUSC SURG 

157 EXTRAOC MUSC INJ REPAIR 

159 OTH EXTRAOC MUS-TEND OP 

16 ORBIT/EYEBALL OPS* 

160 ORBITOTOMY* 

1601 ORBITOTOMY W BONE FLAP 

1602 ORBITOTOMY W IMPLANT 

1609 ORBITOTOMY NEC

161 REMOVE PENETRAT FB EYE 

162 ORBIT & EYEBALL DX PROC* 

1621 OPHTHALMOSCOPY 

1622 DIAGNOSTIC ASP OF ORBIT 

1623 EYEBALL & ORBIT BIOPSY 

1629 EYEBAL/ORBIT DX PROC NEC 

163 EVISCERATION OF EYEBALL* 

1631 EYE EVISC W SYNCH IMPLAN 

1639 EYEBALL EVISCERATION NEC 

164 ENUCLEATION OF EYEBALL* 

1641 EYE ENUC/IMPLAN/MUSC ATT 

1642 EYE ENUC W IMPLANT NEC 

1649 EYEBALL ENUCLEATION NEC 

165 EXENTERATION OF ORBIT* 

1651 RADICAL ORBITOMAXILLECT 

1652 ORBIT EXENT W BONE REMOV 

1659 ORBITAL EXENTERATION NEC 

166 2NDRY OP POST EYE REMOVL* 

1661 2NDRY OCULAR IMP INSERT 

1662 REVIS/REINSERT OCUL IMP 

1663 REVIS ENUC SOCKET W GRFT 

1664 ENUC SOCKET REVIS NEC 

1665 2NDRY EXENT CAVITY GRAFT 

1666 REVIS EXENTER CAVITY NEC 

1669 2ND OP POST EYE REM NEC 

167 OCUL-ORBIT IMPLANT REMOV* 

1671 REMOVE OCULAR IMPLANT 

1672 REMOVE ORBITAL IMPLANT 

168 EYEBALL/ORBIT INJ REPAIR* 

1681 REPAIR OF ORBITAL WOUND 

1682 REPAIR EYEBALL RUPTURE 

1689 EYE/ORBIT INJ REPAIR NEC 

169 OTHER EYE & ORBIT OPS* 

1691 RETROBULBAR INJECTION 

1692 EXCISION ORBITAL LESION 

1693 EXCISION EYE LESION NOS 

1698 OPERATION ON ORBIT NEC 

1699 OPERATION ON EYEBALL NEC 

18 EXTERNAL EAR OPERATIONS* 

180 EXTERNAL EAR INCISION* 

1801 PIERCING OF EAR LOBE 

1802 EXT AUDITORY CANAL INCIS 

1809 EXTERNAL EAR INCIS NEC 

181 EXT EAR DIAGNOSTIC PROC* 

1811 OTOSCOPY 

1812 EXTERNAL EAR BIOPSY 

1819 EXT EAR DIAGNOS PROC NEC 

182 DESTRUCT EXT EAR LESION* 

1821 PREAURICULAR SINUS EXCIS 

1829 DESTRUCT EXT EAR LES NEC 

183 OTHER EXTERNAL EAR EXCIS* 

1831 RAD EXCIS EXT EAR LES 

1839 EXCIS EXTERNAL EAR NEC 

184 SUTURE EXT EAR LAC 

185 CORRECTION PROMINENT EAR 

186 EXT AUDIT CANAL RECONSTR 

187 OTH PLASTIC REP EXT EAR*

1871 CONSTRUCTION EAR AURICLE 

1872 REATTACH AMPUTATED EAR 

1879 PLASTIC REP EXT EAR NEC 

189 OTHER EXT EAR OPERATIONS 

19 MIDDLE EAR RECONSTRUCT* 

190 STAPES MOBILIZATION 

191 STAPEDECTOMY* 

1911 STAPEDECT W REPLAC INCUS 

1919 STAPEDECTOMY NEC 

192 STAPEDECTOMY REVISION* 

1921 REV STAPDEC W INCUS REPL 

1929 STAPEDECTOMY REVIS NEC 

193 OSSICULAR CHAIN OP NEC 

194 MYRINGOPLASTY 

195 OTHER TYMPANOPLASTY* 

1952 TYPE 2 TYMPANOPLASTY 




196 TYMPANOPLASTY REVISION 

199 MIDDLE EAR REPAIR NEC 

20 OTHER MID & INNER EAR OP* 

200 MYRINGOTOMY* 

2001 MYRINGOTOMY W INTUBATION 

2009 MYRINGOTOMY NEC 

201 TYMPANOSTOMY TUBE REMOVE 

202 MASTOID & MID EAR INCIS* 

2021 MASTOID INCISION 

2022 PETRUS PYRAM AIR CEL INC 

2023 MIDDLE EAR INCISION 

203 MID & INNER EAR DX PROC* 

2031 ELECTROCOCHLEOGRAPHY 

2032 MID & INNER EAR BIOPSY 

2039 MID/IN EAR DX PROC NEC 

204 MASTOIDECTOMY* 

2041 SIMPLE MASTOIDECTOMY 

2042 RADICAL MASTOIDECTOMY 

2049 MASTOIDECTOMY NEC 

205 OTH MIDDLE EAR EXCISION* 

2051 EXCISE MIDDLE EAR LESION 

2059 MIDDLE EAR EXCISION NEC 

206 INNER EAR FENESTRATION* 

2061 INNER EAR FENESTRATION 

2062 REVIS INNER EAR FENESTRA 

207 INCIS/EXCIS/DESTR IN EAR* 

2071 ENDOLYMPHATIC SHUNT 

2072 INNER EAR INJECTION 

2079 INC/EXC/DESTR IN EAR NEC 

208 EUSTACHIAN TUBE OPS 

209 OTHER MID-INNER EAR OPS* 

2091 TYMPANOSYMPATHECTOMY 

2092 MASTOIDECTOMY REVISION 

2093 REPAIR OVAL/ROUND WINDOW 

2094 TYMPANIC INJECTION 

2095 ELECMAG HEAR DEV IMPLANT 

2096 IMPLT COCHLEAR PROST NOS 

2097 IMP/REP SCHAN COCH PROS

2098 IMP/REP MCHAN COCHL PROS 

2099 MID-INNER EAR OPS NEC 

21 OPERATIONS ON NOSE* 

210 CONTROL OF EPISTAXIS* 

2100 CONTROL OF EPISTAXIS NOS 

2101 ANT NASAL PACK FOR EPIST 

2102 POST NASAL PAC FOR EPIST 

2103 CAUTERY TO STOP EPISTAX 

2104 ETHMOID ART LIGAT-EPIST 

2105 MAX ART LIG FOR EPISTAX 

2106 EXT CAROT ART LIG-EPIST 

2107 NASAL SEPT GRFT-EPISTAX 

2109 EPISTAXIS CONTROL NEC 

211 INCISION OF NOSE 

212 NASAL DIAGNOSTIC PROCED* 

2121 RHINOSCOPY 

2122 NASAL BIOPSY 

2129 NASAL DX PROC NEC 

213 NASAL LESION DESTRUCTION* 

2130 NASAL LESION EXCIS NOS 

2131 INTRANAS LES DESTRUCTION 

2132 NASAL LES DESTRUCT NEC 

214 RESECTION OF NOSE 

215 SUBMUC NASAL SEPT RESECT 

216 TURBINECTOMY* 

2161 DIATHER/CRYO TURBINECTOM 

2162 TURBINATE FRACTURE 

2169 TURBINECTOMY NEC 

217 NASAL FRACTURE REDUCTION* 

2171 CLOS REDUCTION NASAL FX 

2172 OPEN REDUCTION NASAL FX 

218 NASAL REPAIR & PLASTIC* 

2181 NASAL LACERATION SUTURE 

2182 NASAL FISTULA CLOSURE 

2183 TOT NASAL RECONSTRUCTION 

2184 REVISION RHINOPLASTY 

2185 AUGMENTATION RHINOPLASTY 

2186 LIMITED RHINOPLASTY 

2187 RHINOPLASTY NEC 

2188 SEPTOPLASTY NEC 

2189 NASAL REPAIR NEC 

219 OTHER NASAL OPERATIONS* 

2191 LYSIS OF NASAL ADHESIONS 

2199 NASAL OPERATION NEC 

22 NASAL SINUS OPERATIONS* 

220 NASAL SINUS ASPIR/LAVAGE* 

2200 SINUS ASPIRAT/LAVAGE NOS 

2201 SINUS PUNCT FOR LAVAGE 

2202 SINUS LAVAGE THRU OSTIUM 

221 NASAL SINUS DIAGNOS PROC* 

2211 CLOSED NASAL SINUS BX 

2212 OPEN BIOPSY NASAL SINUS 

2219 NASAL SINUS DX PROC NEC 

222 INTRANASAL ANTROTOMY 

223 EXT MAXILLARY ANTROTOMY* 

2231 RADICAL MAXILLARY ANTROT 

2239 EXT MAXILLARY ANTROT NEC

224 FRONT SINUSOT & SINUSECT* 

2241 FRONTAL SINUSOTOMY 

2242 FRONTAL SINUSECTOMY 

225 OTHER NASAL SINUSOTOMY* 

2250 SINUSOTOMY NOS 

2251 ETHMOIDOTOMY 

2252 SPHENOIDOTOMY 

2253 MULTIPLE SINUS INCISION 

226 OTHER NASAL SINUSECTOMY* 

2260 SINUSECTOMY NOS 

2261 C-LUC EXC MAX SINUS LES 

2262 EXC MAX SINUS LESION NEC 

2263 ETHMOIDECTOMY 

2264 SPHENOIDECTOMY 

227 NASAL SINUS REPAIR* 

2271 NASAL SINUS FISTULA CLOS 

2279 NASAL SINUS REPAIR NEC 

229 OTHER NASAL SINUS OPS 

23 TOOTH REMOVAL & RESTORAT* 

230 FORCEPS TOOTH EXTRACTION* 

2301 DECIDUOUS TOOTH EXTRACT 

2309 TOOTH EXTRACTION NEC 

231 SURG REMOVAL OF TOOTH* 

2311 RESIDUAL ROOT REMOVAL 

2319 SURG TOOTH EXTRACT NEC 

232 TOOTH RESTOR BY FILLING 

233 TOOTH RESTORAT BY INLAY 

234 OTHER DENTAL RESTORATION* 

2341 CROWN APPLICATION 

2342 FIXED BRIDGE INSERTION 

2343 INSERT REMOVABLE BRIDGE 

2349 DENTAL RESTORATION NEC 

235 TOOTH IMPLANTATION 

236 PROSTHET DENTAL IMPLANT 

237 ROOT CANAL RX & APICOECT* 

2370 ROOT CANAL NOS 

2371 ROOT CANAL W IRRIGATION 

2372 ROOT CANAL W APICOECTOMY 

2373 APICOECTOMY 

24 OTH OPS ON TEETH & GUMS* 

240 GUM OR ALVEOLAR INCISION 

241 TOOTH & GUM DIAGNOS PROC* 

2411 GUM BIOPSY 

2412 ALVEOLUS BIOPSY 

2419 TOOTH & GUM DX PROC NEC 

242 GINGIVOPLASTY 

243 OTHER OPERATIONS ON GUMS* 

2431 GUM LESION EXCISION 

2432 SUTURE OF GUM LACERATION 

2439 GUM OPERATION NEC 

244 EXC OF DENTAL LES OF JAW 

245 ALVEOLOPLASTY 

246 EXPOSURE OF TOOTH 

247 ORTHODON APPLIANC APPLIC 

248 OTHER ORTHODONTIC OPERAT 

249 OTHER DENTAL OPERATION* 

2491 EXTEN BUCCOLABIAL/SULCUS

2499 DENTAL OPERATION NEC 

25 OPERATIONS ON TONGUE* 

250 DX PROCEDURES ON TONGUE* 

2501 CLOSED BIOPSY OF TONGUE 

2502 OPEN BIOPSY OF TONGUE 

2509 TONGUE DX PROCEDURE NEC 

251 DESTRUCTION TONGUE LES 

252 PARTIAL GLOSSECTOMY 

253 COMPLETE GLOSSECTOMY 

254 RADICAL GLOSSECTOMY 

255 REPAIR OF TONGUE* 

2551 SUTURE OF TONGUE LACERAT 

2559 REPAIR OF TONGUE NEC 

259 OTHER TONGUE OPERATIONS* 

2591 LINGUAL FRENOTOMY 

2592 LINGUAL FRENECTOMY 

2593 LYSIS OF TONGUE ADHESION 

2594 OTHER GLOSSOTOMY 

2599 TONGUE OPERATION NEC 

26 SALIVARY GLAND OPERATION* 

260 INCIS SALIVARY GLND/DUCT 

261 SALIVARY DIAGNOSTIC PROC* 

2611 CLOS BX SALIV GLAND/DUCT 

2612 OPEN BX SALIV GLAND/DUCT 

2619 SALIV GLND DX PROC NEC 

262 EXCIS OF SALIV GLAND LES* 

2621 SALIVARY CYST MARSUPIAL 

2629 SALIV LESION EXCIS NEC 

263 SIALOADENECTOMY* 

2630 SIALOADENECTOMY NOS 

2631 PARTIAL SIALOADENECTOMY 

2632 COMPLETE SIALOADENECTOMY 

264 SALIV GLND & DUCT REPAIR* 

2641 SUTURE OF SALIV GLND LAC 

2642 SALIVARY FISTULA CLOSURE 

2649 SALIVARY REPAIR NEC 

269 OTH SALIVARY OPERATIONS* 

2691 SALIVARY DUCT PROBING 

2699 SALIVARY OPERATION NEC 

27 OTHER MOUTH & FACE OPS* 

270 DRAIN FACE & MOUTH FLOOR 

271 INCISION OF PALATE 

272 ORAL CAVITY DX PROCEDURE* 

2721 BONY PALATE BIOPSY 

2722 UVULA AND SOFT PALATE BX 

2723 LIP BIOPSY 

2724 MOUTH BIOPSY NOS 

2729 ORAL CAVITY DX PROC NEC 

273 EXCIS OF BONY PALATE LES* 

2731 LOC EXC BONY PALATE LES 

2732 WIDE EXC BONY PALATE LES 

274 OTHER EXCISION OF MOUTH* 

2741 LABIAL FRENUMECTOMY 

2742 WIDE EXCISION OF LIP LES 

2743 EXCISION OF LIP LES NEC 

2749 EXCISION OF MOUTH NEC 

275 PLASTIC REPAIR OF MOUTH*

2751 SUTURE OF LIP LACERATION 

2752 SUTURE OF MOUTH LAC NEC 

2753 CLOSURE OF MOUTH FISTULA 

2754 REPAIR OF CLEFT LIP 

2755 FULL-THICK GRFT TO MOUTH 

2756 SKIN GRAFT TO MOUTH NEC 

2757 PEDICLE ATTACH TO MOUTH 

2759 MOUTH REPAIR NEC 

276 PALATOPLASTY* 

2761 SUTURE OF PALATE LACERAT 

2762 CLEFT PALATE CORRECTION 

2763 REVIS CLEFT PALAT REPAIR 

2769 OTH PLASTIC REPAIR PALAT 

277 OPERATIONS ON UVULA* 

2771 INCISION OF UVULA 

2772 EXCISION OF UVULA 

2773 REPAIR OF UVULA 

2779 OTHER UVULA OPERATIONS 

279 OTHER MOUTH & FACE OPS* 

2791 LABIAL FRENOTOMY 

2792 MOUTH INCISION NOS 

2799 ORAL CAVITY OPS NEC 

28 TONSIL & ADENOID OPS* 

280 PERITONSILLAR I & D 

281 TONSIL&ADENOID DX PROC* 

2811 TONSIL&ADENOID BIOPSY 

2819 TONSIL&ADENOID DX OP NEC 

282 TONSILLECTOMY 

283 TONSILLECTOMY/ADENOIDEC 

284 EXCISION OF TONSIL TAG 

285 EXCISION LINGUAL TONSIL 

286 ADENOIDECTOMY 

287 HEMORR CONTRL POST T & A 

289 OTHER TONSIL/ADENOID OPS* 

2891 INCIS TO REMOV TONSIL FB 

2892 EXCIS TONSIL/ADENOID LES 

2899 TONSIL/ADENOID OPS NEC 

29 OPERATIONS ON PHARYNX* 

290 PHARYNGOTOMY 

291 PHARYNGEAL DX PROCEDURES* 

2911 PHARYNGOSCOPY 

2912 PHARYNGEAL BIOPSY 

2919 PHARYNGEAL DX PROC NEC 

292 EXC BRANCHIAL CLEFT CYST 

293 DESTRUCT PHARYNGEAL LES* 

2931 CRICOPHARYNGEAL MYOTOMY 

2932 PHARYNGEAL DIVERTICULEC 

2933 PHARYNGECTOMY 

2939 EXCIS/DESTR LES PHAR NEC 

294 PLASTIC OP ON PHARYNX 

295 OTHER PHARYNGEAL REPAIR* 

2951 SUTURE OF PHARYNGEAL LAC 

2952 CLOS BRANCH CLEFT FISTUL 

2953 CLOS PHARYNX FISTULA NEC 

2954 LYSIS PHARYNGEAL ADHES 

2959 PHARYNGEAL REPAIR NEC 

299 OTHER PHARYNGEAL OPS*

2991 PHARYNGEAL DILATION 

2992 DIVIS GLOSSOPHARYNG NERV 

2999 PHARYNGEAL OPERATION NEC 

30 EXCISION OF LARYNX* 

300 DESTROY LARYNGEAL LESION* 

3001 LARYNX CYST MARSUPIALIZ 

3009 DESTRUCT LARYNX LES NEC 

301 HEMILARYNGECTOMY 

302 PARTIAL LARYNGECTOMY NEC* 

3021 EPIGLOTTIDECTOMY 

3022 VOCAL CORDECTOMY 

3029 OTHER PART LARYNGECTOMY 

303 COMPLETE LARYNGECTOMY 

304 RADICAL LARYNGECTOMY 

31 LARYNX TRACHEA OPS NEC* 

310 INJECTION OF LARYNX 

311 TEMPORARY TRACHEOSTOMY 

312 PERMANENT TRACHEOSTOMY* 

3121 MEDIASTINAL TRACHEOSTOMY 

3129 OTHER PERM TRACHEOSTOMY 

313 INCIS LARYNX TRACHEA NEC 

314 LARYNX TRACHEA DX PROCS* 

3141 TRACHEOSCOPY THRU STOMA 

3142 LARYGNOSCOPY/TRACHEOSCOP 

3143 CLOSED BIOPSY LARYNX 

3144 CLOSED BIOPSY TRACHEA 

3145 OPN BX LARYNX OR TRACHEA 

3148 OTH LARYNX DX PROCEDURE 

3149 OTH TRACHEA DX PROCEDURE 

315 LOCAL DESTRUC TRACH LES 

316 REPAIR OF LARYNX* 

3161 SUTURE OF LARYNGEAL LAC 

3162 LARYNGEAL FISTULA CLOS 

3163 LARYNGOSTOMY REVISION 

3164 LARYNGEAL FX REPAIR 

3169 OTHER LARYNGEAL REPAIR 

317 REPAIR OF TRACHEA* 

3171 SUTURE OF TRACHEAL LACER 

3172 CLOSURE OF TRACHEOSTOMY 

3173 TRACHEA FISTULA CLOS NEC 

3174 REVISION OF TRACHEOSTOMY 

3175 TRACHEAL RECONSTRUCTION 

3179 OTHER TRACHEAL REPAIR 

319 LARYNX TRACHEA OPS NEC* 

3191 LARYNGEAL NERV DIVISION 

3192 LYSIS TRACH/LARYNX ADHES 

3193 REPLACE TRAC/LARYN STENT 

3194 TRACHEAL INJECTION 

3195 TRACHEOESOPH FISTULIZAT 

3198 OTH LARYNGEAL OPERATION 

3199 OTHER TRACHEAL OPERATION 

32 LUNG & BRONCHUS EXCISION* 

320 LOCAL DESTRUCT BRONC LES* 

3201 ENDOSC DESTRUC BRONC LES 

3209 OTHER DESTRUC BRONC LES 

321 OTHER BRONCHIAL EXCISION 

322 LOCAL DESTRUCT LUNG LES*

3221 EMPHYSEMA BLEB PLICATION 

3222 LUNG VOL REDUCTION SURG 

3228 ENDOSC DESTRUC LUNG LES 

3229 DESTROY LOC LUNG LES NEC 

323 SEGMENTAL LUNG RESECTION 

324 LOBECTOMY OF LUNG 

325 COMPLETE PNEUMONECTOMY 

326 RAD DISSEC THORAC STRUCT 

329 OTHER EXCISION OF LUNG 

33 OTHER BRONCHIAL/LUNG OPS* 

330 INCISION OF BRONCHUS 

331 INCISION OF LUNG 

332 BRONCHIAL/LUNG DX PROCS* 

3321 BRONCHOSCOPY THRU STOMA 

3322 FIBER-OPTIC BRONCHOSCOPY 

3323 OTHER BRONCHOSCOPY 

3324 CLOSED BRONCHIAL BIOPSY 

3325 OPEN BRONCHIAL BIOPSY 

3326 CLOSED LUNG BIOPSY 

3327 CLOS ENDOSCOPIC LUNG BX 

3328 OPEN LUNG BIOPSY 

3329 BRONCH/LUNG DX PROC NEC 

333 SURG COLLAPSE OF LUNG* 

3331 DESTR PHREN-LUNG COLLAPS 

3332 PNEMOTHORAX-LUNG COLLAPS 

3333 PNEUMOPERIT-LUNG COLLAPS 

3334 THORACOPLASTY 

3339 SURG COLLAPS OF LUNG NEC 

334 LUNG AND BRONCHUS REPAIR* 

3341 BRONCHIAL LACERAT SUTURE 

3342 BRONCHIAL FISTULA CLOS 

3343 LUNG LACERATION CLOSURE 

3348 BRONCHIAL REPAIR NEC 

3349 LUNG REPAIR NEC 

335 LUNG TRANSPLANT* 

3350 LUNG TRANSPLANT NOS 

3351 UNILAT LUNG TRANSPLANT 

3352 BILAT LUNG TRANSPLANT 

336 COMB HEART/LUNG TRANSPLA 

339 OTHER BRONCHIAL LUNG OPS* 

3391 BRONCHIAL DILATION 

3392 BRONCHIAL LIGATION 

3393 PUNCTURE OF LUNG 

3398 BRONCHIAL OPERATION NEC 

3399 LUNG OPERATION NEC 

34 THORAX OPS EXCEPT LUNG* 

340 INCIS CHEST WALL/PLEURA* 

3401 INCISION OF CHEST WALL 

3402 EXPLORATORY THORACOTOMY 

3403 REOPEN THORACOTOMY SITE 

3404 INSERT INTERCOSTAL CATH 

3405 PLEUROPERITONEAL SHUNT 

3409 OTHER PLEURAL INCISION 

341 INCISION OF MEDIASTINUM 

342 THORAX DX PROCEDURES* 

3421 TRANSPLEURA THORACOSCOPY 

3422 MEDIASTINOSCOPY

3423 CHEST WALL BIOPSY 

3424 PLEURAL BIOPSY 

3425 CLOS MEDIASTINAL BIOPSY 

3426 OPEN MEDIASTINAL BIOPSY 

3427 BIOPSY OF DIAPHRAGM 

3428 DX PROCEDURE THORAX NEC 

3429 DX PROC MEDIASTINUM NEC 

343 DESTRUCT MEDIASTIN LES 

344 DESTRUCT CHEST WALL LES 

345 PLEURECTOMY* 

3451 DECORTICATION OF LUNG 

3459 OTHER PLEURAL EXCISION 

346 SCARIFICATION OF PLEURA 

347 REPAIR OF CHEST WALL* 

3471 SUTURE CHEST WALL LACER 

3472 THORACOSTOMY CLOSURE 

3473 CLOS THORACIC FISTUL NEC 

3474 PECTUS DEFORMITY REPAIR 

3479 OTHER CHEST WALL REPAIR 

348 OPERATIONS ON DIAPHRAGM* 

3481 EXCISE DIAPHRAGM LESION 

3482 SUTURE DIAPHRAGM LACERAT 

3483 CLOSE DIAPHRAGM FISTULA 

3484 OTHER DIAPHRAGM REPAIR 

3485 IMPLANT DIAPHRA PACEMAKE 

3489 DIAPHRAGM OPERATION NEC 

349 OTHER OPS ON THORAX* 

3491 THORACENTESIS 

3492 INJECT INTO THORAX CAVIT 

3493 REPAIR OF PLEURA 

3499 THORACIC OPERATION NEC 

35 HEART VALVES & SEPTA OPS* 

350 CLOSED HEART VALVOTOMY* 

3500 CLOSED VALVOTOMY NOS 

3501 CLOSED AORTIC VALVOTOMY 

3502 CLOSED MITRAL VALVOTOMY 

3503 CLOSED PULMON VALVOTOMY 

3504 CLOSED TRICUSP VALVOTOMY 

351 OPEN HEART VALVULOPLASTY* 

3510 OPEN VALVULOPLASTY NOS 

3511 OPN AORTIC VALVULOPLASTY 

3512 OPN MITRAL VALVULOPLASTY 

3513 OPN PULMON VALVULOPLASTY 

3514 OPN TRICUS VALVULOPLASTY 

352 HEART VALVE REPLACEMENT* 

3520 REPLACE HEART VALVE NOS 

3521 REPLACE AORT VALV-TISSUE 

3522 REPLACE AORTIC VALVE NEC 

3523 REPLACE MITR VALV-TISSUE 

3524 REPLACE MITRAL VALVE NEC 

3525 REPLACE PULM VALV-TISSUE 

3526 REPLACE PULMON VALVE NEC 

3527 REPLACE TRIC VALV-TISSUE 

3528 REPLACE TRICUSP VALV NEC 

353 TISSUE ADJAC TO VALV OPS* 

3531 PAPILLARY MUSCLE OPS 

3532 CHORDAE TENDINEAE OPS

3533 ANNULOPLASTY 

3534 INFUNDIBULECTOMY 

3535 TRABECUL CARNEAE CORD OP 

3539 TISS ADJ TO VALV OPS NEC 

354 SEPTAL DEFECT PRODUCTION* 

3541 ENLARGE EXISTING SEP DEF 

3542 CREATE SEPTAL DEFECT 

355 PROSTH REPAIR HEART SEPT* 

3550 PROSTH REP HRT SEPTA NOS 

3551 PROS REP ATRIAL DEF-OPN 

3552 PROS REPAIR ATRIA DEF-CL 

3553 PROST REPAIR VENTRIC DEF 

3554 PROS REP ENDOCAR CUSHION 

356 GRAFT REPAIR HEART SEPTA* 

3560 GRFT REPAIR HRT SEPT NOS 

3561 GRAFT REPAIR ATRIAL DEF 

3562 GRAFT REPAIR VENTRIC DEF 

3563 GRFT REP ENDOCAR CUSHION 

357 HEART SEPTA REPAIR NEC* 

3570 HEART SEPTA REPAIR NOS 

3571 ATRIA SEPTA DEF REP NEC 

3572 VENTR SEPTA DEF REP NEC 

3573 ENDOCAR CUSHION REP NEC 

358 TOT REPAIR CONGEN ANOMAL* 

3581 TOT REPAIR TETRAL FALLOT 

3582 TOTAL REPAIR OF TAPVC 

3583 TOT REP TRUNCUS ARTERIOS 

3584 TOT COR TRANSPOS GRT VES 

359 VALVES & SEPTA OPS NEC* 

3591 INTERAT VEN RETRN TRANSP 

3592 CONDUIT RT VENT-PUL ART 

3593 CONDUIT LEFT VENTR-AORTA 

3594 CONDUIT ARTIUM-PULM ART 

3595 HEART REPAIR REVISION 

3596 PERC HEART VALVULOPLASTY 

3598 OTHER HEART SEPTA OPS 

3599 OTHER HEART VALVE OPS 

36 OPS ON HEART VESSELS* 

3601 PTCA-1 VES/ATH W/O AGENT 

3602 PTCA-1 VES/ATH W AGENT 

3603 OPEN CORONRY ANGIOPLASTY 

3604 INTRCORONRY THROMB INFUS 

3605 PTCA-MULTIPLE VESSEL/ATH 

3606 INSERT OF COR ART STENT 

3609 REM OF COR ART OBSTR NEC 

361 HEART REVASC BYPASS ANAS* 

3610 AORTOCORONARY BYPASS NOS 

3611 AORTOCOR BYPAS-1 COR ART 



3614 AORTCOR BYPAS-4+ COR ART 

3615 1 INT MAM-COR ART BYPASS 

3616 2 INT MAM-COR ART BYPASS 

3617 ABD-CORON ARTERY BYPASS 

3619 HRT REVAS BYPS ANAS NEC 

362 ARTERIAL IMPLANT REVASC 

363 HEART REVASCULARIZAT NEC*

3631 OPEN CHEST TRANS REVASC 

3632 OTH TRANSMYO REVASCULAR 

3639 OTH HEART REVASCULAR 

369 OTHER HEART VESSEL OPS* 

3691 CORON VESS ANEURYSM REP 

3699 HEART VESSEL OP NEC 

37 OTHER HEART/PERICARD OPS* 

370 PERICARDIOCENTESIS 

371 CARDIOTOMY & PERICARDIOT* 

3710 INCISION OF HEART NOS 

3711 CARDIOTOMY 

3712 PERICARDIOTOMY 

372 HEART & PERICARD DX PROC* 

3721 RT HEART CARDIAC CATH 

3722 LEFT HEART CARDIAC CATH 

3723 RT/LEFT HEART CARD CATH 

3724 PERICARDIAL BIOPSY 

3725 CARDIAC BIOPSY 

3726 CARDIAC ELECTROPHY STIM 

3727 CARDIAC MAPPING 

3729 HRT/PERICAR DX PROC NEC 

373 PERICARDIECT/EXC HRT LES* 

3731 PERICARDIECTOMY 

3732 HEART ANEURYSM EXCISION 

3733 EXC/DEST OTH HRT LESION 

3734 CATH ABLATION LES HEART 

3735 PARTIAL VENTRICULECTOMY 

374 HEART & PERICARD REPAIR 

375 HEART TRANSPLANTATION 

376 IMPLANT HRT ASSIST SYST* 

3761 PULSATION BALLOON IMPLAN 

3762 IMPLANT HRT ASST SYS NEC 

3763 REPLACE HRT ASSIST SYST 

3764 REMOVE HEART ASSIST SYS 

3765 IMP EXT PUL HRT ASST SYS 

3766 IMP IMP PUL HRT ASST SYS 

3767 IMP CARDIOMYOSTIMUL SYS 

377 INSERT CARD PACEMAK SYS* 

3770 INT INSERT PACEMAK LEAD 

3771 INT INSERT LEAD IN VENT 

3772 INT INSER LEAD ATRI-VENT 

3773 INT INSER LEAD IN ATRIUM 

3774 INT OR REPL LEAD EPICAR 

3775 REVISION OF LEAD 

3776 REPL TV ATRI-VENT LEAD 

3777 REMOVAL OF LEAD W/O REPL 

3778 INSER TEMP PACEMAKER SYS 

3779 REVIS OR RELOCATE POCKET 

378 REVISE & REMOV PACEMAKER* 

3780 INT OR REPL PERM PACEMKR 

3781 INT INSERT 1-CHAM, NON 

3782 INT INSERT 1-CHAM, RATE 

3783 INT INSERT DUAL-CHAM DEV 

3785 REPL PACEM W 1-CHAM, NON 

3786 REPL PACEM 1-CHAM, RATE 

3787 REPL PACEM W DUAL-CHAM 

3789 REVISE OR REMOVE PACEMAK

379 HEART & PERICARD OPS NEC* 

3791 OPN CHEST CARDIAC MASSAG 

3792 INJECTION INTO HEART 

3793 INJECTION INTO PERICARD 

3794 IMPLT/REPL CARDDEFIB TOT 

3795 IMPLT CARDIODEFIB LEADS 

3796 IMPLT CARDIODEFIB GENATR 

3797 REPL CARDIODEFIB LEADS 

3798 REPL CARDIODEFIB GENRATR 

3799 OTHER HEART/PERICARD OPS 

38 VESSEL INC/EXCIS/OCCLUS* 

380 INCISION OF VESSEL* 

3800 INCISION OF VESSEL NOS 

3801 INTRACRAN VESSEL INCIS 

3802 HEAD/NECK VES INCIS NEC 

3803 UPPER LIMB VESSEL INCIS 

3804 INCISION OF AORTA 

3805 THORACIC VESSEL INC NEC 

3806 ABDOMEN ARTERY INCISION 

3807 ABDOMINAL VEIN INCISION 

3808 LOWER LIMB ARTERY INCIS 

3809 LOWER LIMB VEIN INCISION 

381 ENDARTERECTOMY* 

3810 ENDARTERECTOMY NOS 

3811 INTRACRAN ENDARTERECTOMY 

3812 HEAD & NECK ENDARTER NEC 

3813 UPPER LIMB ENDARTERECTOM 

3814 ENDARTERECTOMY OF AORTA 

3815 THORACIC ENDARTERECTOMY 

3816 ABDOMINAL ENDARTERECTOMY 

3818 LOWER LIMB ENDARTERECT 

382 BLOOD VESSEL DX PROCS* 

3821 BLOOD VESSEL BIOPSY 

3822 PERCUTANEOUS ANGIOSCOPY 

3829 BLOOD VESSEL DX PROC NEC 

383 VESSEL RESECT & ANASTOM* 

3830 VESSEL RESECT/ANAST NOS 

3831 INTRACRAN VES RESEC-ANAS 

3832 HEAD/NECK VES RESEC-ANAS 

3833 ARM VESSEL RESECT/ANAST 

3834 AORTA RESECTION & ANAST 

3835 THOR VESSEL RESECT/ANAST 

3836 ABD VESSEL RESECT/ANAST 

3837 ABD VEIN RESECT & ANAST 

3838 LEG ARTERY RESECT/ANAST 

3839 LEG VEIN RESECT/ANASTOM 

384 VESSEL RESECT & REPLACE* 

3840 VESSEL RESECT/REPLAC NOS 

3841 INTRACRAN VES RESEC-REPL 

3842 HEAD/NECK VES RESEC-REPL 

3843 ARM VES RESECT W REPLACE 

3844 RESECT ABDM AORTA W REPL 

3845 RESECT THORAC VES W REPL 

3846 ABD ARTERY RESEC W REPLA 

3847 ABD VEIN RESECT W REPLAC 

3848 LEG ARTERY RESEC W REPLA 

3849 LEG VEIN RESECT W REPLAC

385 VARICOSE LIGAT & STRIP* 

3850 VARICOSE V LIG-STRIP NOS 

3851 INTCRAN VAR V LIG-STRIP 

3852 HEAD/NECK VAR V LIG-STR 

3853 ARM VARICOSE V LIG-STRIP 

3855 THORAC VAR V LIG-STRIP 

3857 ABD VARICOS V LIGA-STRIP 

3859 LEG VARICOS V LIGA-STRIP 

386 OTHER VESSEL EXCISION* 

3860 EXCISION OF VESSEL NOS 

3861 INTRACRAN VESSEL EXCIS 

3862 HEAD/NECK VESSEL EXCIS 

3863 ARM VESSEL EXCISION 

3864 EXCISION OF AORTA 

3865 THORACIC VESSEL EXCISION 

3866 ABDOMINAL ARTERY EXCIS 

3867 ABDOMINAL VEIN EXCISION 

3868 LEG ARTERY EXCISION 

3869 LEG VEIN EXCISION 

387 INTERRUPTION VENA CAVA 

388 OTHER SURG VESSEL OCCLUS* 

3880 SURG VESSEL OCCLUS NEC 

3881 OCCLUS INTRACRAN VES NEC 

3882 OCCLUS HEAD/NECK VES NEC 

3883 OCCLUDE ARM VESSEL NEC 

3884 OCCLUDE AORTA NEC 

3885 OCCLUDE THORACIC VES NEC 

3886 OCCLUDE ABD ARTERY NEC 

3887 OCCLUDE ABD VEIN NEC 

3888 OCCLUDE LEG ARTERY NEC 

3889 OCCLUDE LEG VEIN NEC 

389 PUNCTURE OF VESSEL* 

3891 ARTERIAL CATHETERIZATION 

3892 UMBILICAL VEIN CATH 

3893 VENOUS CATH NEC 

3894 VENOUS CUTDOWN 

3895 VEN CATH RENAL DIALYSIS 

3898 ARTERIAL PUNCTURE NEC 

3899 VENOUS PUNCTURE NEC 

39 OTHER OPS ON VESSELS* 

390 SYSTEMIC-PULM ART SHUNT 

391 INTRA-ABD VENOUS SHUNT 

392 OTHER SHUNT/VASC BYPASS* 

3921 CAVAL-PULMON ART ANASTOM 

3922 AORTA-SUBCLV-CAROT BYPAS 

3923 INTRATHORACIC SHUNT NEC 

3924 AORTA-RENAL BYPASS 

3925 AORTA-ILIAC-FEMOR BYPASS 

3926 INTRA-ABDOMIN SHUNT NEC 

3927 DIALYSIS ARTERIOVENOSTOM 

3928 EXTRACRAN-INTRACR BYPASS 

3929 VASC SHUNT & BYPASS NEC 

393 SUTURE OF VESSEL* 

3930 SUTURE OF VESSEL NOS 

3931 SUTURE OF ARTERY 

3932 SUTURE OF VEIN 

394 VASC PROCEDURE REVISION*

3941 POSTOP VASC OP HEM CONTR 

3942 REVIS REN DIALYSIS SHUNT 

3943 REMOV REN DIALYSIS SHUNT 

3949 VASC PROC REVISION NEC 

395 OTHER VESSEL REPAIR* 

3950 ANGIO/ATH NON-CORO VES 

3951 CLIPPING OF ANEURYSM 

3952 ANEURYSM REPAIR NEC 

3953 ARTERIOVEN FISTULA REP 

3954 RE-ENTRY OPERATION 

3955 REIMPLAN ABERR RENAL VES 

3956 REPAIR VESS W TIS PATCH 

3957 REP VESS W SYNTH PATCH 

3958 REPAIR VESS W PATCH NOS 

3959 REPAIR OF VESSEL NEC 

396 OPN HEART AUXILIARY PROC* 

3961 EXTRACORPOREAL CIRCULAT 

3962 HYPOTHERMIA W OPEN HEART 

3963 CARDIOPLEGIA 

3964 INTRAOP CARDIAC PACEMAK 

3965 EXTRACORPOREAL MEMB OXY 

3966 PER CARDIOPULMON BYPASS 

398 VASCULAR BODY OPERATIONS 

399 OTHER VESSEL OPERATIONS* 

3990 INS NON-CORO ART STENT 

3991 FREEING OF VESSEL 

3992 VEIN INJECT-SCLEROS AGNT 

3993 INSERT VES-TO-VES CANNUL 

3994 REPLAC VES-TO-VES CANNUL 

3995 HEMODIALYSIS 

3996 TOTAL BODY PERFUSION 

3997 OTHER PERFUSION 

3998 HEMORRHAGE CONTROL NOS 

3999 VESSEL OPERATION NEC 

40 LYMPHATIC SYSTEM OPS* 

400 INCIS LYMPHATIC STRUCTUR 

401 LYMPHATIC DX PROC* 

4011 LYMPHATIC STRUCT BIOPSY 

4019 LYMPHATIC DIAG PROC NEC 

402 SIMP EXCIS LYMPH STRUCT* 

4021 EXCIS DEEP CERVICAL NODE 

4022 EXCISE INT MAMMARY NODE 

4023 EXCISE AXILLARY NODE 

4024 EXCISE INGUINAL NODE 

4029 SIMP EXC LYMPH STRUC NEC 

403 REGIONAL LYMPH NODE EXC 

404 RAD CERVICAL NODE EXCIS* 

4040 RAD NECK DISSECTION NOS 

4041 UNILAT RAD NECK DISSECT 

4042 BILAT RAD NECK DISSECT 

405 OTH RAD NODE DISSECTION* 

4050 RAD NODE DISSECTION NOS 

4051 RAD DISSEC AXILLARY NODE 

4052 RAD DISSEC PERIAORT NODE 

4053 RAD DISSECT ILIAC NODES 

4054 RADICAL GROIN DISSECTION 

4059 RAD NODE DISSECTION NEC

406 THORACIC DUCT OPERATIONS* 

4061 THORAC DUCT CANNULATION 

4062 THORACIC DUCT FISTULIZAT 

4063 CLOSE THORACIC DUCT FIST 

4064 LIGATE THORACIC DUCT 

4069 THORACIC DUCT OP NEC 

409 LYMPH STRUCTURE OP NEC 

41 BONE MARROW & SPLEEN OPS* 

4100 BONE MARROW TRNSPLNT NOS 

4101 AUT BONE MARROW TRNSPLNT 

4102 ALO BONE MARROW TRNSPLNT 

4103 ALLOGRFT BONE MARROW NOS 

4104 AUT HEM STEM CELL TRANS 

4105 ALLO HEM STEM CELL TRANS 

4106 CORD BLD STEM CELL TRANS 

411 PUNCTURE OF SPLEEN 

412 SPLENOTOMY 

413 MARROW & SPLEEN DX PROC* 

4131 BONE MARROW BIOPSY 

4132 CLOSED SPLEEN BIOPSY 

4133 OPEN SPLEEN BIOPSY 

4138 MARROW DIAGNOST PROC NEC 

4139 SPLEEN DIAGNOST PROC NEC 

414 DESTRUCT SPLENIC TISSUE* 

4141 SPLENIC CYST MARSUPIAL 

4142 EXC SPLENIC LESION/TISS 

4143 PARTIAL SPLENECTOMY 

415 TOTAL SPLENECTOMY 

419 OTH SPLEEN & MARROW OPS* 

4191 DONOR MARROW ASPIRATION 

4192 INJECTION INTO MARROW 

4193 EXC OF ACCESSORY SPLEEN 

4194 SPLEEN TRANSPLANTATION 

4195 REPAIR OF SPLEEN 

4198 BONE MARROW OPS NEC 

4199 SPLEEN OPERATION NEC 

42 OPERATIONS ON ESOPHAGUS* 

420 ESOPHAGOTOMY* 

4201 ESOPHAGEAL WEB INCISION 

4209 ESOPHAGEAL INCISION NEC 

421 ESOPHAGOSTOMY* 

4210 ESOPHAGOSTOMY NOS 

4211 CERVICAL ESOPHAGOSTOMY 

4212 ESOPH POUCH EXTERIORIZAT 

4219 EXT FISTULIZAT ESOPH NEC 

422 ESOPHAGEAL DIAGNOS PROCS* 

4221 ESOPHAGOSCOPY BY INCIS 

4222 ESOPHAGOSCOPY THRU STOMA 

4223 ESOPHAGOSCOPY NEC 

4224 CLOSED BX OF ESOPHAGUS 

4225 OPEN BIOPSY OF ESOPHAGUS 

4229 ESOPHAGEAL DX PROC NEC 

423 ESOPHAG LESION DESTRUCT* 

4231 LOC EXCIS ESOPH DIVERTIC 

4232 LOCAL EXCIS ESOPHAG NEC 

4233 ENDOSC DESTRUC ESOPH LES 

4239 DESTRUCT ESOPHAG LES NEC

424 EXCISION OF ESOPHAGUS* 

4240 ESOPHAGECTOMY NOS 

4241 PARTIAL ESOPHAGECTOMY 

4242 TOTAL ESOPHAGECTOMY 

425 INTRATHOR ESOPH ANASTOM* 

4251 THORAC ESOPHAGOESOPHAGOS 

4252 THORAC ESOPHAGOGASTROST 

4253 THORAC SM BOWEL INTERPOS 

4254 THORAC ESOPHAGOENTER NEC 

4255 THORAC LG BOWEL INTERPOS 

4256 THORAC ESOPHAGOCOLOS NEC 

4258 THORAC INTERPOSITION NEC 

4259 THORAC ESOPHAG ANAST NEC 

426 ANTESTERN ESOPH ANASTOM* 

4261 STERN ESOPHAGOESOPHAGOST 

4262 STERN ESOPHAGOGASTROSTOM 

4263 STERN SM BOWEL INTERPOS 

4264 STERN ESOPHAGOENTER NEC 

4265 STERN LG BOWEL INTERPOS 

4266 STERN ESOPHAGOCOLOS NEC 

4268 STERN INTERPOSITION NEC 

4269 STERN ESOPHAG ANAST NEC 

427 ESOPHAGOMYOTOMY 

428 OTHER ESOPHAGEAL REPAIR* 

4281 INSERT PERM TUBE ESOPHAG 

4282 SUTURE ESOPHAGEAL LACER 

4283 ESOPHAGOSTOMY CLOSURE 

4284 ESOPH FISTULA REPAIR NEC 

4285 ESOPHAG STRICTURE REPAIR 

4286 PROD SUBQ TUNNEL NO ANAS 

4287 ESOPHAGEAL GRAFT NEC 

4289 ESOPHAGEAL REPAIR NEC 

429 OTHER ESOPHAGEAL OPS* 

4291 LIGATION ESOPH VARIX 

4292 ESOPHAGEAL DILATION 

4299 ESOPHAGEAL OPERATION NEC 

43 GASTRIC INCISION/EXCIS* 

430 GASTROTOMY 

431 GASTROSTOMY* 

4311 PERCU ENDOSC GASTROSTOMY 

4319 OTHER GASTROSTOMY 

433 PYLOROMYOTOMY 

434 LOCAL DESTRUCT GASTR LES* 

4341 ENDOSC DESTR STOMACH LES 

4342 LOCAL GASTR EXCISION NEC 

4349 LOCAL GASTR DESTRUCT NEC 

435 PROXIMAL GASTRECTOMY 

436 DISTAL GASTRECTOMY 

437 PART GASTREC W JEJ ANAST 

438 OTH PARTIAL GASTRECTOMY* 

4381 PART GAST W JEJ TRANSPOS 

4389 PARTIAL GASTRECTOMY NEC 

439 TOTAL GASTRECTOMY* 

4391 TOT GAST W INTES INTERPO 

4399 TOTAL GASTRECTOMY NEC 

44 OTHER GASTRIC OPERATIONS* 

440 VAGOTOMY*

4400 VAGOTOMY NOS 

4401 TRUNCAL VAGOTOMY 

4402 HIGHLY SELECT VAGOTOMY 

4403 SELECTIVE VAGOTOMY NEC 

441 GASTRIC DIAGNOST PROCED* 

4411 TRANSABDOMIN GASTROSCOPY 

4412 GASTROSCOPY THRU STOMA 

4413 GASTROSCOPY NEC 

4414 CLOSED GASTRIC BIOPSY 

4415 OPEN GASTRIC BIOPSY 

4419 GASTRIC DIAGNOS PROC NEC 

4421 DILATE PYLORUS, INCISION 

4422 ENDOSCOP DILATE PYLORUS 

4429 OTHER PYLOROPLASTY 

443 GASTROENTEROSTOMY* 

4431 HIGH GASTRIC BYPASS 

4439 GASTROENTEROSTOMY NEC 

444 CONTROL HEM STOMACH ULCE* 

4440 SUTURE PEPTIC ULCER NOS 

4441 SUT GASTRIC ULCER SITE 

4442 SUTURE DUODEN ULCER SITE 

4443 ENDOSC CONTROL GAST HEM 

4444 TRANSCATH EMBO GAST HEM 

4449 OTHER CONTROL GAST HEM 

445 REVISION GASTRIC ANASTOM 

446 OTHER GASTRIC REPAIR* 

4461 SUTURE GASTRIC LACERAT 

4462 GASTROSTOMY CLOSURE 

4463 CLOSE GASTRIC FISTUL NEC 

4464 GASTROPEXY 

4465 ESOPHAGOGASTROPLASTY 

4466 CREAT ESOPHAGASTR SPHINC 

4469 GASTRIC REPAIR NEC 

449 OTHER GASTRIC OPERATIONS* 

4491 LIGATE GASTRIC VARICES 

4492 INTRAOP GASTRIC MANIPUL 

4493 INSERT GASTRIC BUBBLE 

4494 REMOVE GASTRIC BUBBLE 

4499 GASTRIC OPERATION NEC 

45 INTEST INCIS/EXCIS/ANAST* 

450 ENTEROTOMY* 

4500 INTESTINAL INCISION NOS 

4501 DUODENAL INCISION 

4502 SMALL BOWEL INCISION NEC 

4503 LARGE BOWEL INCISION 

451 SMALL BOWEL DX PROC* 

4511 TRANSAB SM BOWEL ENDOSC 

4512 ENDOSC SM BOWEL THRU ST 

4513 SM BOWEL ENDOSCOPY NEC 

4514 CLOS SMALL BOWEL BIOPSY 

4515 OPEN SMALL BOWEL BIOPSY 

4516 EGD WITH CLOSED BIOPSY 

4519 SM BOWEL DX PROC NEC 

452 BOWEL DIAGNOS PROCS NEC* 

4521 TRANSAB LG BOWEL ENDOSC 

4522 ENDOSC LG BOWEL THRU ST 

4523 COLONOSCOPY

4524 FLEXIBLE SIGMOIDOSCOPY 

4525 CLOS LARGE BOWEL BIOPSY 

4526 OPEN LARGE BOWEL BIOPSY 

4527 INTESTINAL BIOPSY NOS 

4528 LG BOWEL DX PROCED NEC 

4529 BOWEL DIAGNOST PROC NEC 

453 LOCAL DESTRUCT SM BOWEL* 

4530 ENDOSC DESTRU DUODEN LES 

4531 OTH EXCISE DUODENUM LES 

4532 DESTRUCT DUODEN LES NEC 

4533 LOCAL EXCIS SM BOWEL NEC 

4534 DESTR SM BOWEL LES NEC 

454 LOCAL DESTRUCT LG BOWEL* 

4541 EXCISE LG INTESTINE LES 

4542 ENDO POLPECTOMY LRGE INT 

4543 ENDOSC DESTRU LG INT LES 

4549 DESTRUC LG BOWEL LES NEC 

455 INTESTINAL SEG ISOLATION* 

4550 INTEST SEG ISOLAT NOS 

4551 SM BOWEL SEGMENT ISOLAT 

4552 LG BOWEL SEGMENT ISOLAT 

456 OTHER SM BOWEL EXCISION* 

4561 MULT SEG SM BOWEL EXCIS 

4562 PART SM BOWEL RESECT NEC 

4563 TOTAL REMOVAL SM BOWEL 

457 PART LG BOWEL EXCISION* 

4571 MULT SEG LG BOWEL EXCIS 

4572 CECECTOMY 

4573 RIGHT HEMICOLECTOMY 

4574 TRANSVERSE COLON RESECT 

4575 LEFT HEMICOLECTOMY 

4576 SIGMOIDECTOMY 

4579 PART LG BOWEL EXCIS NEC 

458 TOT INTRA-ABD COLECTOMY 

459 INTESTINAL ANASTOMOSIS* 

4590 INTESTINAL ANASTOM NOS 

4591 SM-TO-SM BOWEL ANASTOM 

4592 SM BOWEL-RECT STUMP ANAS 

4593 SMALL-TO-LARGE BOWEL NEC 

4594 LG-TO-LG BOWEL ANASTOM 

4595 ANAL ANASTOMOSIS 

46 OTHER INTESTINAL OPS* 

460 EXTERIORIZATION OF BOWEL* 

4601 SM BOWEL EXTERIORIZATION 

4602 RESECT EXT SEG SM BOWEL 

4603 LG BOWEL EXTERIORIZATION 

4604 RESECT EXT SEG LG BOWEL 

461 COLOSTOMY* 

4610 COLOSTOMY NOS 

4611 TEMPORARY COLOSTOMY 

4613 PERMANENT COLOSTOMY 

4614 DELAY OPENING COLOSTOMY 

462 ILEOSTOMY* 

4620 ILEOSTOMY NOS 

4621 TEMPORARY ILEOSTOMY 

4622 CONTINENT ILEOSTOMY 

4623 PERMANENT ILEOSTOMY NEC

4624 DELAY OPENING ILEOSTOMY 

463 OTHER ENTEROSTOMY* 

4631 DELAY OPENING ENTEROSTOM 

4632 PERCU ENDOSC JEJUNOSTOMY 

4639 ENTEROSTOMY NEC 

464 INTEST STOMA REVISION* 

4640 INTEST STOMA REVIS NOS 

4641 SM BOWEL STOMA REVISION 

4642 PERICOLOST HERNIA REPAIR 

4643 LG BOWEL STOMA REVIS NEC 

465 INTESTINAL STOMA CLOSURE* 

4650 INTEST STOMA CLOSURE NOS 

4651 SM BOWEL STOMA CLOSURE 

4652 LG BOWEL STOMA CLOSURE 

466 FIXATION OF INTESTINE* 

4660 INTESTINAL FIXATION NOS 

4661 SM BOWEL-ABD WALL FIXAT 

4662 SMALL BOWEL FIXATION NEC 

4663 LG BOWEL-ABD WALL FIXAT 

4664 LARGE BOWEL FIXATION NEC 

467 OTHER INTESTINAL REPAIR* 

4671 DUODENAL LACERAT SUTURE 

4672 DUODENAL FISTULA CLOSURE 

4673 SMALL BOWEL SUTURE NEC 

4674 CLOSE SM BOWEL FIST NEC 

4675 SUTURE LG BOWEL LACERAT 

4676 CLOSE LG BOWEL FISTULA 

4679 REPAIR OF INTESTINE NEC 

468 DILATION MANIPUL INTEST* 

4680 INTRA-AB BOWEL MANIP NOS 

4681 INTRA-ABD SM BOWEL MANIP 

4682 INTRA-ABD LG BOWEL MANIP 

4685 DILATION OF INTESTINE 

469 OTHER INTESTINAL OPS* 

4691 MYOTOMY OF SIGMOID COLON 

4692 MYOTOMY OF COLON NEC 

4693 REVISE SM BOWEL ANASTOM 

4694 REVISE LG BOWEL ANASTOM 

4695 LOCAL SM BOWEL PERFUSION 

4696 LOCAL LG BOWEL PERFUSION 

4699 INTESTINAL OP NEC 

47 OPERATIONS ON APPENDIX* 

470 APPENDECTOMY* 

4701 LAP APPENDECTOMY 

4709 OTHER APPENDECTOMY 

471 INCIDENTAL APPENDECTOMY* 

4711 LAP INCID APPENDECTOMY 

4719 OTHER INCID APPENDECTOMY 

472 DRAIN APPENDICEAL ABSC 

479 OTHER APPENDICEAL OPS* 

4791 APPENDICOSTOMY 

4792 CLOSE APPENDICEAL FISTUL 

4799 APPENDICEAL OPS NEC 

48 RECTAL & PERIRECTAL OPS* 

480 PROCTOTOMY 

481 PROCTOSTOMY 

482 RECTAL/PERIRECT DX PROC*

4821 TRANSAB PROCTOSIGMOIDOSC 

4822 PROCTOSIGMOIDOSC THRU ST 

4823 RIGID PROCTOSIGMOIDOSCPY 

4824 CLOSED RECTAL BIOPSY 

4825 OPEN RECTAL BIOPSY 

4826 PERIRECTAL TISSUE BIOPSY 

4829 RECT/PERIRECT DX OP NEC 

483 LOCAL DESTRUC RECTAL LES* 

4831 RAD ELECTROCOAG-RECT LES 

4832 ELECTROCOAG RECT LES NEC 

4833 LASER DESTRUC RECTAL LES 

4834 CRYOSURG DESTR RECT LES 

4835 LOCAL EXCIS RECTAL LES 

4836 POLYPECTOMY OF RECTUM 

484 PULL-THRU RECT RESECTION* 

4841 SOAVE SUBMUC RECT RESECT 

4849 PULL-THRU RECT RESEC NEC 

485 ABD-PERINEAL RECT RESECT 

486 OTHER RECTAL RESECTION* 

4861 TRANSSAC RECTOSIGMOIDECT 

4862 ANT RECT RESECT W COLOST 

4863 ANTERIOR RECT RESECT NEC 

4864 POSTERIOR RECT RESECTION 

4865 DUHAMEL RECTAL RESECTION 

4869 RECTAL RESECTION NEC 

487 REPAIR OF RECTUM* 

4871 SUTURE OF RECTAL LACER 

4872 CLOSURE OF PROCTOSTOMY 

4873 CLOSE RECTAL FIST NEC 

4874 RECTORECTOSTOMY 

4875 ABDOMINAL PROCTOPEXY 

4876 PROCTOPEXY NEC 

4879 REPAIR OF RECTUM NEC 

488 PERIRECTAL INCIS/EXCIS* 

4881 PERIRECTAL INCISION 

4882 PERIRECTAL EXCISION 

489 OTH RECTAL/PERIRECT OP* 

4891 INCIS RECTAL STRICTURE 

4892 ANORECTAL MYOMECTOMY 

4893 REPAIR PERIRECT FISTULA 

4899 RECTAL PERIRECT OP NEC 

49 OPERATIONS ON ANUS* 

490 PERIANAL INCIS & EXCIS* 

4901 INCIS PERIANAL ABSCESS 

4902 PERIANAL INCISION NEC 

4903 EXCIS PERIANAL SKIN TAG 

4904 PERIANAL EXCISION NEC 

491 INCIS/EXCIS ANAL FISTULA* 

4911 ANAL FISTULOTOMY 

4912 ANAL FISTULECTOMY 

492 ANAL & PERIANAL DX PROC* 

4921 ANOSCOPY 

4922 PERIANAL BIOPSY 

4923 ANAL BIOPSY 

4929 ANAL/PERIAN DX PROC NEC 

493 LOC DESTR ANAL LES NEC* 

4931 ENDOSC DESTRUC ANUS LES

4939 OTHER DESTRUC ANUS LES 

494 HEMORRHOID PROCEDURES* 

4941 HEMORRHOID REDUCTION 

4942 HEMORRHOID INJECTION 

4943 HEMORRHOID CAUTERIZAT 

4944 HEMORRHOID CRYOTHERAPY 

4945 HEMORRHOID LIGATION 

4946 HEMORRHOIDECTOMY 

4947 HEMORRHOID EVACUATION 

4949 HEMORRHOID PROCEDURE NEC 

495 ANAL SPHINCTER DIVISION* 

4951 LEFT LAT SPHINCTEROTOMY 

4952 POST SPHINCTEROTOMY 

4959 ANAL SPHINCTEROTOMY NEC 

496 EXCISION OF ANUS 

497 REPAIR OF ANUS* 

4971 SUTURE ANAL LACERATION 

4972 ANAL CERCLAGE 

4973 CLOSURE OF ANAL FISTULA 

4974 GRACILIS MUSC TRANSPLAN 

4979 ANAL SPHINCT REPAIR NEC 

499 OTH OPERATIONS ON ANUS* 

4991 INCISION OF ANAL SEPTUM 

4992 INSERT SUBQ ANAL STIMUL 

4993 ANAL INCISION NEC 

4994 REDUCTION ANAL PROLAPSE 

4995 CONTROL ANAL HEMORRHAGE 

4999 ANAL OPERATION NEC 

50 OPERATIONS ON LIVER* 

500 HEPATOTOMY 

501 HEPATIC DIAGNOSTIC PROC* 

5011 CLOSED LIVER BIOPSY 

5012 OPEN LIVER BIOPSY 

5019 HEPATIC DX PROC NEC 

502 LOCAL DESTRUC LIVER LES* 

5021 MARSUPIALIZAT LIVER LES 

5022 PARTIAL HEPATECTOMY 

5029 DESTRUC HEPATIC LES NEC 

503 HEPATIC LOBECTOMY 

504 TOTAL HEPATECTOMY 

505 LIVER TRANSPLANT* 

5051 AUXILIARY LIVER TRANSPL 

5059 LIVER TRANSPLANT NEC 

506 REPAIR OF LIVER* 

5061 CLOSURE LIVER LACERAT 

5069 LIVER REPAIR NEC 

509 OTHER LIVER OPERATIONS* 

5091 PERCUTAN LIVER ASPIRAT 

5092 EXTRACORPOR HEPAT ASSIS 

5093 LOCAL PERFUSION LIVER 

5094 HEPATIC INJECTION NEC 

5099 LIVER OPERATION NEC 

51 BILIARY TRACT OPERATION* 

510 GALLBLADDER INCISION* 

5101 PERCUTAN ASPIRATION GB 

5102 TROCAR CHOLECYSTOSTOMY 

5103 CHOLECYSTOSTOMY NEC

5104 CHOLECYSTOTOMY NEC 

511 BILIARY TRACT DX PROCS* 

5110 ENDOSC RETRO CHOLANGIOPA 

5111 ENDOSC RETRO CHOLANGIO 

5112 PERCU BX GB/BILE DUCT 

5113 OPEN BILIARY TRACT BX 

5114 CLO ENDOSC BX BILE DUCT 

5115 SPHINCT OF ODDI MEASURE 

5119 BILIARY TR DX PROC NEC 

512 CHOLECYSTECTOMY* 

5121 OTH PART CHOLECYSTECTOMY 

5122 CHOLECYSTECTOMY 

5123 LAPAROSCOPIC CHOLECYSTEC 

5124 LAP PART CHOLECYSTECTOMY 

513 BILIARY TRACT ANASTOMOS* 

5131 GB-TO-HEPAT DUCT ANAST 

5132 GB-TO-INTESTINE ANASTOM 

5133 GB-TO-PANCREAS ANASTOM 

5134 GB-TO-STOMACH ANASTOMOS 

5135 GALLBLADDER ANASTOM NEC 

5136 CHOLEDOCHOENTEROSTOMY 

5137 HEPATIC DUCT-GI ANASTOM 

5139 BILE DUCT ANASTOMOS NEC 

514 INCIS OBSTRUC BILE DUCT* 

5141 CDE FOR CALCULUS REMOV 

5142 CDE FOR OBSTRUCTION NEC 

5143 CHOLEDOCHOHEPAT INTUBAT 

5149 INCIS OBSTR BILE DUC NEC 

515 OTH BILE DUCT INCISION* 

5151 COMMON DUCT EXPLORATION 

5159 BILE DUCT INCISION NEC 

516 DESTRUC BILE DUCTS LES* 

5161 EXCIS CYST DUCT REMNANT 

5162 EXCIS AMPULLA OF VATER 

5163 COMMON DUCT EXCIS NEC 

5164 ENDOSC DESTRU BILE LES 

5169 BILE DUCT EXCISION NEC 

517 REPAIR OF BILE DUCTS* 

5171 SIMPLE SUT-COMMON DUCT 

5172 CHOLEDOCHOPLASTY 

5179 BILE DUCT REPAIR NEC 

518 OTH OP BILE DUCT/SPHINC* 

5181 SPHINCTER OF ODDI DILAT 

5182 PANCREAT SPHINCTEROTOM 

5183 PANCREAT SPHINCTEROPLAS 

5184 ENDOSC DILATION AMPULLA 

5185 ENDOSC SPHINCTEROTOMY 

5186 ENDOSC INSER NASOBIL TUB 

5187 ENDOSC INSER STENT BILE 

5188 ENDOSC REMOVE BILE STONE 

5189 SPHINCT OF ODDI OP NEC 

519 OTHER BILIARY TRACT OPS* 

5191 REPAIR GB LACERATION 

5192 CLOSURE CHOLECYSTOSTOMY 

5193 CLOS BILIARY FISTUL NEC 

5194 REVIS BILE TRACT ANASTOM 

5195 REMOVE BILE DUCT PROSTH

5196 PERC EXTRAC COM DUC CALC 

5198 OTH PERC PROC BIL TRCT 

5199 BILIARY TRACT OP NEC 

52 OPERATIONS ON PANCREAS* 

520 PANCREATOTOMY* 

5201 CATH DRAIN-PANCREAT CYST 

5209 PANCREATOTOMY NEC 

521 PANCREATIC DIAGNOST PROC* 

5211 CLOSED PANCREATIC BIOPSY 

5212 OPEN PANCREATIC BIOPSY 

5213 ENDOSC RETRO PANCREATOG 

5214 CLO ENDOSC BX PANCRE DUC 

5219 PANCREATIC DX PROC NEC 

522 DESTRU PANCREATIC DUCT* 

5221 ENDOSC DESTR PANCREA LES 

5222 OTHER DESTRU PANCREA LES 

523 PANCREAT CYST MARSUPIALI 

524 INT DRAIN PANCREAT CYST 

525 PARTIAL PANCREATECTOMY* 

5251 PROXIMAL PANCREATECTOMY 

5252 DISTAL PANCREATECTOMY 

5253 RAD SUBTOT PANCREATECTOM 

5259 PARTIAL PANCREATECT NEC 

526 TOTAL PANCREATECTOMY 

527 RAD PANCREATICODUODENECT 

528 TRANSPLANT OF PANCREAS* 

5280 PANCREAT TRANSPLANT NOS 

5281 REIMPLANT PANCREATIC TIS 

5282 PANCREATIC HOMOTRANSPLAN 

5283 PANCREATIC HETEROTRANSPL 

5284 AUTOTRNSPLNT ISLETS LANG 

5285 ALLOTRNSPLNT ISLETS LANG 

5286 TRNSPLNT ISLETS LANG NOS 

529 OTHER OPS ON PANCREAS* 

5292 CANNULATION PANCREA DUC 

5293 ENDOSC INSER PANC STENT 

5294 ENDOSC REMOVE PANC STONE 

5295 PANCREATIC REPAIR NEC 

5296 PANCREATIC ANASTOMOSIS 

5297 ENDOSC INSER NASOPAN TUB 

5298 ENDOSC DIL PANCREAT DUCT 

5299 PANCREATIC OPERATION NEC 

53 REPAIR OF HERNIA* 

530 UNILAT ING HERNIA REPAIR* 

5300 UNILAT ING HERN REP NOS 

5301 REPAIR DIRECT ING HERNIA 

5302 REPAIR INDIR ING HERNIA 

5303 DIR ING HERNIA REP-GRAFT 

5304 IND ING HERNIA REP-GRAFT 

5305 ING HERNIA REP-GRAFT NOS 

531 BILAT ING HERNIA REPAIR* 

5310 BILAT ING HERNIA REP NOS 

5311 BILAT DIR ING HERN REP 

5312 BILAT IND ING HERN REP 

5313 BIL DIR/IND ING HRN REP 

5314 BIL DIR ING HRN REP-GRFT 

5315 BIL IND ING HRN REP-GRFT

5316 BIL DIR/IND ING HERN-PRO 

5317 BIL ING HRN REP-GRFT NOS 

532 UNILAT FEMOR HERNIA REP* 

5321 UNIL FEMOR HRN REP-GRFT 

5329 UNIL FEMOR HERN REP NEC 

533 BILAT FEMOR HERN REPAIR* 

5331 BIL FEM HERN REPAIR-GRFT 

5339 BIL FEM HERN REPAIR NEC 

534 UMBILICAL HERNIA REPAIR* 

5341 UMBIL HERNIA REPAIR-GRFT 

5349 UMBIL HERNIA REPAIR NEC 

535 REPAIR OTH ABD WALL HERN* 

5351 INCISIONAL HERNIA REPAIR 

5359 ABD WALL HERN REPAIR NEC 

536 REPAIR OTH ABD HERN-GRFT* 

5361 INCIS HERNIA REPAIR-GRFT 

5369 ABD HERN REPAIR-GRFT NEC 

537 ABD REPAIR-DIAPHR HERNIA 

538 THOR REPAIR-DIAPH HERNIA* 

5380 THOR REP-DIAPH HERN NOS 

5381 DIAPHRAGMATIC PLICATION 

5382 PARASTERN HERNIA REPAIR 

539 OTHER HERNIA REPAIR 

54 OTHER ABDOMEN REGION OPS* 

540 ABDOMINAL WALL INCISION 

541 LAPAROTOMY* 

5411 EXPLORATORY LAPAROTOMY 

5412 REOPEN RECENT LAP SITE 

5419 LAPAROTOMY NEC 

542 ABD REGION DIAGNOS PROCS* 

5421 LAPAROSCOPY 

5422 ABDOMINAL WALL BIOPSY 

5423 PERITONEAL BIOPSY 

5424 CLOSED INTRA-ABD MASS BX 

5425 PERITONEAL LAVAGE 

5429 ABD REGION DX PROC NEC 

543 DESTRUCT ABD WALL LESION 

544 DESTRUCT PERITONEAL TISS 

545 PERITONEAL ADHESIOLYSIS* 

5451 LAP PERITON ADHESIOLYSIS 

5459 OTH PERITON ADHESIOLYSIS 

546 ABD WALL PERITON SUTURE* 

5461 RECLOSE POST OP DISRUPT 

5462 DELAYED CLOS ABD WOUND 

5463 ABD WALL SUTURE NEC 

5464 PERITONEAL SUTURE 

547 OTH ABD WALL PERITON REP* 

5471 REPAIR OF GASTROSCHISIS 

5472 ABDOMEN WALL REPAIR NEC 

5473 PERITONEAL REPAIR NEC 

5474 OMENTAL REPAIR NEC 

5475 MESENTERIC REPAIR NEC 

549 OTHER ABDOMEN REGION OPS* 

5491 PERCU ABDOMINAL DRAINAGE 

5492 REMOVE FB FROM PERITON 

5493 CREATE CUTANPERITON FIST 

5494 CREAT PERITONEOVAS SHUNT

5495 PERITONEAL INCISION 

5496 INJEC AIR-PERITON CAVITY 

5497 INJ THERAP SUBST PERITON 

5498 PERITONEAL DIALYSIS 

5499 ABDOMEN REGION OPS NEC 

55 OPERATIONS ON KIDNEY* 

550 NEPHROTOMY & NEPHROSTOMY* 

5501 NEPHROTOMY 

5502 NEPHROSTOMY 

5503 PERCU NEPHROSTM W/O FRAG 

5504 PERCU NEPHROSTMY W FRAG 

551 PYELOTOMY & PYELOSTOMY* 

5511 PYELOTOMY 

5512 PYELOSTOMY 

552 RENAL DIAGNOSTIC PROCED* 

5521 NEPHROSCOPY 

5522 PYELOSCOPY 

5523 CLOSED RENAL BIOPSY 

5524 OPEN RENAL BIOPSY 

5529 RENAL DIAGNOST PROC NEC 

553 LOCAL DESTRUC RENAL LES* 

5531 RENAL LES MARSUPIALIZAT 

5539 LOC DESTR RENAL LES NEC 

554 PARTIAL NEPHRECTOMY 

555 COMPLETE NEPHRECTOMY* 

5551 NEPHROURETERECTOMY 

5552 SOLITARY KIDNEY NEPHRECT 

5553 REJECTED KIDNEY NEPHRECT 

5554 BILATERAL NEPHRECTOMY 

556 KIDNEY TRANSPLANT* 

5561 RENAL AUTOTRANSPLANT 

5569 KIDNEY TRANSPLANT NEC 

557 NEPHROPEXY 

558 OTHER KIDNEY REPAIR* 

5581 SUTURE KIDNEY LACERATION 

5582 CLOSE NEPHROST & PYELOST 

5583 CLOSE RENAL FISTULA NEC 

5584 REDUCE RENAL PEDICL TORS 

5585 SYMPHYSIOTOMY 

5586 RENAL ANASTOMOSIS 

5587 CORRECT URETEROPELV JUNC 

5589 RENAL REPAIR NEC 

559 OTHER RENAL OPERATIONS* 

5591 RENAL DECAPSULATION 

5592 PERCUTAN RENAL ASPIRAT 

5593 REPLACE NEPHROSTOMY TUBE 

5594 REPLACE PYELOSTOMY TUBE 

5595 LOCAL RENAL PERFUSION 

5596 RENAL INJECTION NEC 

5597 IMPLANT MECHANIC KIDNEY 

5598 REMOV MECHANICAL KIDNEY 

5599 RENAL OPERATION NEC 

56 OPERATIONS ON URETER* 

560 TU REMOV URETER OBSTRUCT 

561 URETERAL MEATOTOMY 

562 URETEROTOMY 

563 URETERAL DIAGNOST PROC*

5631 URETEROSCOPY 

5632 CLOSED URETERAL BIOPSY 

5633 CLOS ENDOSC URETERAL BX 

5634 OPEN URETERAL BIOPSY 

5635 ENDOSCOPIC ILEAL CONDUIT 

5639 URETERAL DX PROCEDUR NEC 

564 URETERECTOMY* 

5640 URETERECTOMY NOS 

5641 PARTIAL URETERECTOMY 

5642 TOTAL URETERECTOMY 

565 CUTAN URETERO-ILEOSTOMY* 

5651 FORM CUTAN ILEOURETEROST 

5652 REVIS CUTAN ILEOURETEROS 

566 EXT URIN DIVERSION NEC* 

5661 FORM CUTAN URETEROSTOMY 

5662 REVIS CUTAN URETEROS NEC 

567 OTHER URETERAL ANASTOMOS* 

5671 URIN DIVERSION TO BOWEL 

5672 REVIS URETEROENTEROSTOMY 

5673 NEPHROCYSTANASTOMOSI NOS 

5674 URETERONEOCYSTOSTOMY 

5675 TRANSURETEROURETEROSTOMY 

5679 URETERAL ANASTOMOSIS NEC 

568 REPAIR OF URETER* 

5681 INTRALUM URETE ADHESIOLY 

5682 SUTURE URETERAL LACERAT 

5683 URETEROSTOMY CLOSURE 

5684 CLOSE URETER FISTULA NEC 

5685 URETEROPEXY 

5686 REMOVE URETERAL LIGATURE 

5689 REPAIR OF URETER NEC 

569 OTHER URETERAL OPERATION* 

5691 URETERAL MEATUS DILATION 

5692 IMPLANT URETERAL STIMUL 

5693 REPLACE URETERAL STIMUL 

5694 REMOVE URETERAL STIMULAT 

5695 LIGATION OF URETER 

5699 URETERAL OPERATION NEC 

57 URINARY BLADDER OPS* 

570 TU BLADDER CLEARANCE 

571 CYSTOTOMY AND CYSTOSTOMY* 

5711 PERCUTAN BLADDER ASPIRAT 

5712 CYSTOTOMY & ADHESIOLYSIS 

5717 PERCUTANEOUS CYSTOSTOMY 

5718 OTHER SUPRAPU CYSTOSTOMY 

5719 CYSTOTOMY NEC 

572 VESICOSTOMY* 

5721 VESICOSTOMY 

5722 REVISE CLO VESICOSTOMY 

573 BLADDER DIAGNOSTIC PROC* 

5731 CYSTOSCOPY THRU STOMA 

5732 CYSTOSCOPY NEC 

5733 CLOS TRANSURETH BLADD BX 

5734 OPEN BLADDER BIOPSY 

5739 BLADDER DIAGNOS PROC NEC 

574 TU DESTRUCT BLADDER LES* 

5741 TU ADHESIOLYSIS BLADDER

5749 TU DESTRUC BLADD LES NEC 

575 BLADDER LES DESTRUCT NEC* 

5751 EXCISION OF URACHUS 

5759 BLADDER LES DESTRUCT NEC 

576 PARTIAL CYSTECTOMY 

577 TOTAL CYSTECTOMY* 

5771 RADICAL CYSTECTOMY 

5779 TOTAL CYSTECTOMY NEC 

578 OTHER BLADDER REPAIR* 

5781 SUTURE BLADDER LACERAT 

5782 CYSTOSTOMY CLOSURE 

5783 ENTEROVESICO FIST REPAIR 

5784 VESIC FISTULA REPAIR NEC 

5785 CYSTOURETHROPLASTY 

5786 BLADDER EXSTROPHY REPAIR 

5787 BLADDER RECONSTRUCTION 

5788 BLADDER ANASTOMOSIS NEC 

5789 BLADDER REPAIR NEC 

579 OTHER BLADDER OPERATIONS* 

5791 BLADDER SPHINCTEROTOMY 

5792 BLADDER NECK DILATION 

5793 CONTROL BLADD HEMORRHAGE 

5794 INSERT INDWELLING CATH 

5795 REPLACE INDWELLING CATH 

5796 IMPLANT BLADDER STIMULAT 

5797 REPLACE BLADDER STIMULAT 

5798 REMOVE BLADDER STIMULAT 

5799 BLADDER OPERATION NEC 

58 OPERATIONS ON URETHRA* 

580 URETHROTOMY 

581 URETHRAL MEATOTOMY 

582 URETHRAL DIAGNOSTIC PROC* 

5821 PERINEAL URETHROSCOPY 

5822 URETHROSCOPY NEC 

5823 URETHRAL BIOPSY 

5824 PERIURETHRAL BIOPSY 

5829 URETHRAL DX PROC NEC 

583 URETHRAL LES DESTRUCTION* 

5831 ENDOSC DESTR URETHRA LES 

5839 OTHER DESTRU URETHRA LES 

584 REPAIR OF URETHRA* 

5841 SUTURE URETHRAL LACERAT 

5842 URETHROSTOMY CLOSURE 

5843 CLOSE URETH FISTULA NEC 

5844 URETHRAL REANASTOMOSIS 

5845 HYPO-EPISPADIUS REPAIR 

5846 URETH RECONSTRUCTION NEC 

5847 URETHRAL MEATOPLASTY 

5849 URETHRAL REPAIR NEC 

585 URETH STRICTURE RELEASE 

586 URETHRAL DILATION 

589 OTH URETH/PERIURETH OPS* 

5891 PERIURETHRAL INCISION 

5892 PERIURETHRAL EXCISION 

5893 IMPLT ARTF URIN SPHINCT 

5899 URETH/PERIURETH OP NEC 

59 OTHER URINARY TRACT OPS*

590 RETROPERITONEAL DISSECT* 

5900 RETROPERIT DISSECT NOS 

5902 PERIREN ADHESIOLYS NEC 

5903 LAP LYS PERIREN/URET ADH 

5909 PERIREN/URETER INCIS NEC 

591 PERIVESICAL INCISION* 

5911 OTH LYS PERIVES ADHESIO 

5912 LAP LYS PERIVESURETH ADH 

5919 PERIVESICAL INCISION NEC 

592 PERIREN/URETER DX PROCS* 

5921 PERIREN/URETERAL BIOPSY 

5929 PERIREN/URET DX PROC NEC 

593 URETHROVES JUNCT PLICAT 

594 SUPRAPUBIC SLING OP 

595 RETROPUBIC URETH SUSPENS 

596 PARAURETHRAL SUSPENSION 

597 OTH URIN INCONTIN REPAIR* 

5971 LEVATOR MUSC SUSPENSION 

5972 INJECT IMPLANT URETHRA 

5979 URIN INCONTIN REPAIR NEC 

598 URETERAL CATHETERIZATION 

599 OTHER URINARY SYSTEM OPS* 

5991 PERIREN/VESICLE EXCISION 

5992 PERIREN/VESICLE OP NEC 

5993 REPLACE URETEROST TUBE 

5994 REPLACE CYSTOSTOMY TUBE 

5995 ULTRASON FRAGMENT-STONE 

5999 URINARY SYSTEM OP NEC 

60 PROSTATE & SEMIN VES OPS* 

600 INCISION OF PROSTATE 

601 PROST & SEM VES DX PROC* 

6011 CLOSED PROSTATIC BIOPSY 

6012 OPEN PROSTATIC BIOPSY 

6013 CLOS SEMINAL VESICLES BX 

6014 OPEN SEMINAL VESICLES BX 

6015 PERIPROSTATIC BIOPSY 

6018 PROSTATIC DX PROCED NEC 

6019 SEMIN VES DX PROCED NEC 

602 TRANSURETHRAL PROSTATECT* 

6021 TRANSURETH PROSTATECTOMY 

6029 OTH TRANSURETH PROSTATEC 

603 SUPRAPUBIC PROSTATECTOMY 

604 RETROPUBIC PROSTATECTOMY 

605 RADICAL PROSTATECTOMY 

606 OTHER PROSTATECTOMY* 

6061 LOS EXCIS PROSTATIC LES 

6062 PERINEAL PROSTATECTOMY 

6069 PROSTATECTOMY NEC 

607 SEMINAL VESICLE OPS* 

6071 PERCUT SEMIN VES ASPIRAT 

6072 SEMINAL VESICLE INCISION 

6073 SEMINAL VESICLE EXCISION 

6079 SEMINAL VESICLE OP NEC 

608 PERIPROSTAT INCIS & EXC* 

6081 PERIPROSTATIC INCISION 

6082 PERIPROSTATIC EXCISION 

609 OTHER PROSTATIC OPS*

6091 PERCUT PROSTATIC ASPIRAT 

6092 INJECTION INTO PROSTATE 

6093 REPAIR OF PROSTATE 

6094 CONTROL PROSTATE HEMORR 

6095 TRANS BAL DIL PROS URETH 

6099 PROSTATIC OPERATION NEC 

61 SCROTUM & TUNICA VAG OPS* 

610 SCROTUM & TUNICA I & D 

611 SCROTUM & TUNICA DX PROC* 

6111 SCROTUM & TUNICA BIOPSY 

6119 SCROT/TUNICA DX PROC NEC 

612 EXCISION OF HYDROCELE 

613 SCROTAL LES DESTRUCTION 

614 SCROTUM & TUNICA REPAIR* 

6141 SUTURE SCROTAL LACERAT 

6142 SCROTAL FISTULA REPAIR 

6149 SCROTUM/TUNIC REPAIR NEC 

619 OTHER SCROTUM/TUNIC OPS* 

6191 PERCUT TUNICA ASPIRATION 

6192 EXCISION TUNICA LES NEC 

6199 SCROTUM & TUNICA OP NEC 

62 OPERATIONS ON TESTES* 

620 INCISION OF TESTES 

621 TESTES DIAGNOSTIC PROCS* 

6211 CLOSED TESTICULAR BIOPSY 

6212 OPEN TESTICULAR BIOPSY 

6219 TESTES DX PROCEDURE NEC 

622 TESTICULAR LES DESTRUCT 

623 UNILATERAL ORCHIECTOMY 

624 BILATERAL ORCHIECTOMY* 

6241 REMOVE BOTH TESTES 

6242 REMOVE SOLITARY TESTIS 

625 ORCHIOPEXY 

626 REPAIR OF TESTES* 

6261 SUTURE TESTICULAR LACER 

6269 TESTICULAR REPAIR NEC 

627 INSERT TESTICULAR PROSTH 

629 OTHER TESTICULAR OPS* 

6291 ASPIRATION OF TESTES 

6292 INJECTION INTO TESTES 

6299 TESTICULAR OPERATION NEC 

63 SPERM CORD/EPID/VAS OPS* 

630 SPERMATIC CORD/VAS DX OP* 

6301 SPERMATIC CORD/VAS BIOPS 

6309 SPERMAT CORD/VAS DX NEC 

631 EXC SPERMATIC VARICOCELE 

632 EXCISE EPIDIDYMIS CYST 

633 EXCISE CORD/EPID LES NEC 

634 EPIDIDYMECTOMY 

635 CORD & EPIDIDYMIS REPAIR* 

6351 SUTURE CORD & EPID LACER 

6352 REDUCTION TORSION TESTES 

6353 TRANSPLANT SPERMAT CORD 

6359 CORD & EPIDID REPAIR NEC 

636 VASOTOMY 

637 VASECTOMY & VAS LIGATION* 

6370 MALE STERILIZATION NOS

6371 LIGATION OF VAS DEFERENS 

6372 SPERMATIC CORD LIGATION 

6373 VASECTOMY 

638 VAS & EPIDIDYMIS REPAIR* 

6381 SUTURE VAS & EPIDID LAC 

6382 POSTOP VAS RECONSTRUCT 

6383 EPIDIDYMOVASOSTOMY 

6384 REMOVAL VAS LIGATURE 

6385 REMOV VAS DEFERENS VALVE 

6389 VAS & EPIDIDY REPAIR NEC 

639 OTHER CORD/EPID/VAS OPS* 

6391 SPERMATOCELE ASPIRATION 

6392 EPIDIDYMOTOMY 

6393 SPERMATIC CORD INCISION 

6394 SPERM CORD ADHESIOLYSIS 

6395 INSERT VALVE IN VAS DEF 

6399 CORD/EPID/VAS OPS NEC 

64 OPERATIONS ON PENIS* 

640 CIRCUMCISION 

641 PENILE DIAGNOSTIC PROCS* 

6411 PENILE BIOPSY 

6419 PENILE DIAGNOST PROC NEC 

642 LOCAL EXCIS PENILE LES 

643 AMPUTATION OF PENIS 

644 PENILE REPAIR* 

6441 SUTURE PENILE LACERATION 

6442 RELEASE OF CHORDEE 

6443 CONSTRUCTION OF PENIS 

6444 RECONSTRUCTION OF PENIS 

6445 REPLANTATION OF PENIS 

6449 PENILE REPAIR NEC 

645 SEX TRANSFORMAT OP NEC 

649 OTHER MALE GENITAL OPS* 

6491 DORSAL/LAT SLIT PREPUCE 

6492 INCISION OF PENIS 

6493 DIVISION OF PENILE ADHES 

6494 FIT EXT PENILE PROSTHES 

6495 INS NONINFL PENIS PROSTH 

6496 REMOVE INT PENILE PROSTH 

6497 INS INFLATE PENIS PROSTH 

6498 PENILE OPERATION NEC 

6499 MALE GENITAL OP NEC 

65 OPERATIONS ON OVARY* 

650 OOPHOROTOMY* 

6501 LAPAROSCOPIC OOPHOROTOMY 

6509 OTHER OOPHOROTOMY 

651 OVARIAN DIAGNOST PROCS* 

6511 OVARIAN ASPIRAT BIOPSY 

6512 OVARIAN BIOPSY NEC 

6513 LAP BIOPSY OF OVARY 

6514 OTH LAP DX PROC OVARIES 

6519 OVARIAN DX PROCEDURE NEC 

652 LOCAL DESTRUCT OVARY LES* 

6521 OVARIAN CYST MARSUPIALIZ 

6522 OVARIAN WEDGE RESECTION 

6523 LAP MARSUP OVARIAN CYST 

6524 LAP WEDGE RESECT OVARY

6525 OTH LAP LOC EXC DEST OVA 

6529 LOCAL DESTR OVA LES NEC 

653 UNILATERAL OOPHORECTOMY* 

6531 LAP UNILAT OOPHORECTOMY 

6539 OTH UNILAT OOPHORECTOMY 

654 UNILAT SALPINGO-OOPHOREC* 

6541 LAP UNI SALPINGO-OOPHOR 

6549 OTH UNI SALPINGO-OOPHOR 

655 BILATERAL OOPHORECTOMY* 

6551 OTH REMOVE BOTH OVARIES 

6552 OTH REMOVE REMAIN OVARY 

6553 LAP REMOVE BOTH OVARIES 

6554 LAP REMOVE REMAIN OVARY 

656 BILAT SALPINGO-OOPHORECT* 

6561 OTH REMOVE OVARIES/TUBES 

6562 OTH REMOVE REM OVA/TUBE 

6563 LAP REMOVE OVARIES/TUBES 

6564 LAP REMOVE REM OVA/TUBE 

657 REPAIR OF OVARY* 

6571 OTH SIMPLE SUTURE OVARY 

6572 OTH REIMPLANT OF OVARY 

6573 OTH SALPINGO-OOPHOROPLAS 

6574 LAP SIMPLE SUTURE OVARY 

6575 LAP REIMPLANT OF OVARY 

6576 LAP SALPINGO-OOPHOROPLAS 

6579 REPAIR OF OVARY NEC 

658 TUBO-OVARIAN ADHESIOLYS* 

6581 LAP ADHESIOLYS OVA/TUBE 

6589 ADHESIOLYSIS OVARY/TUBE 

659 OTHER OVARIAN OPERATIONS* 

6591 ASPIRATION OF OVARY 

6592 TRANSPLANTATION OF OVARY 

6593 MANUAL RUPT OVARIAN CYST 

6594 OVARIAN DENERVATION 

6595 OVARIAN TORSION RELEASE 

6599 OVARIAN OPERATION NEC 

66 FALLOPIAN TUBE OPERATION* 

660 SALPINGOTOMY* 

6601 SALPINGOTOMY 

6602 SALPINGOSTOMY 

661 FALLOPIAN TUBE DX PROCS* 

6611 FALLOPIAN TUBE BIOPSY 

6619 FALLOP TUBE DX PROC NEC 

662 BILAT ENDOSC OCCL FALLOP* 

6621 BILAT ENDOSC CRUSH TUBE 

6622 BILAT ENDOSC DIVIS TUBE 

6629 BILAT ENDOS OCC TUBE NEC 

663 OTHER BILAT TUBE DESTRUC* 

6631 BILAT TUBAL CRUSHING NEC 

6632 BILAT TUBAL DIVISION NEC 

6639 BILAT TUBAL DESTRUCT NEC 

664 TOTAL UNILAT SALPINGECT 

665 TOTAL BILAT SALPINGECTOM* 

6651 REMOVE BOTH FALLOP TUBES 

6652 REMOVE SOLITARY FAL TUBE 

666 OTHER SALPINGECTOMY* 

6661 DESTROY FALLOP TUBE LES

6662 REMOV TUBE & ECTOP PREG 

6663 BILAT PART SALPINGEC NOS 

6669 PARTIAL SALPINGECTOM NEC 

667 REPAIR OF FALLOPIAN TUBE* 

6671 SIMPL SUTURE FALLOP TUBE 

6672 SALPINGO-OOPHOROSTOMY 

6673 SALPINGO-SALPINGOSTOMY 

6674 SALPINGO-UTEROSTOMY 

6679 FALLOP TUBE REPAIR NEC 

668 FALLOPIAN TUBE INSUFFLAT 

669 OTHER FALLOPIAN TUBE OPS* 

6691 FALLOPIAN TUBE ASPIRAT 

6692 UNILAT FALLOP TUBE DESTR 

6693 IMPL FALLOP TUBE PROSTH 

6694 REMOV FALLOP TUBE PROSTH 

6695 BLOW THERAPEUT INTO TUBE 

6696 FALLOPIAN TUBE DILATION 

6697 BURY FIMBRIAE IN UTERUS 

6699 FALLOPIAN TUBE OP NEC 

67 OPERATIONS ON CERVIX* 

670 CERVICAL CANAL DILATION 

671 CERVICAL DIAGNOSTIC PROC* 

6711 ENDOCERVICAL BIOPSY 

6712 CERVICAL BIOPSY NEC 

6719 CERVICAL DX PROCEDUR NEC 

672 CONIZATION OF CERVIX 

673 DESTROY CERVICAL LES NEC* 

6731 CERVICAL CYST MARSUPIAL 

6732 CERVICAL LES CAUTERIZAT 

6733 CERVICAL LES CRYOTHERAPY 

6739 CERVICAL LES DESTRUC NEC 

674 AMPUTATION OF CERVIX 

675 INT CERVICAL OS REPAIR 

676 OTHER REPAIR OF CERVIX* 

6761 SUTURE CERVICAL LACERAT 

6762 CERVICAL FISTULA REPAIR 

6769 CERVICAL REPAIR NEC 

68 OTHER UTERINE INCIS/EXC* 

680 HYSTEROTOMY 

681 UTERUS & SUPPORT DX PROC* 

6811 DIGITAL EXAM OF UTERUS 

6812 HYSTEROSCOPY 

6813 OPEN UTERINE BIOPSY 

6814 OPEN UTERINE LIGAMENT BX 

6815 CLOS UTERINE LIGAMENT BX 

6816 CLOSED UTERINE BIOPSY 

6819 UTERUS/ADNEX DX PROC NEC 

682 UTERINE LES DESTRUCTION* 

6821 ENDOMET SYNECHIAE DIVIS 

6822 INCISION UTERINE SEPTUM 

6823 ENDOMETRIAL ABLATION 

6829 UTERINE LES DESTRUCT NEC 

683 SUBTOT ABD HYSTERECTOMY 

684 TOTAL ABD HYSTERECTOMY 

685 VAGINAL HYSTERECTOMY* 

6851 LAP AST VAG HYSTERECTOMY 

6859 OTHER VAG HYSTERECTOMY

686 RADICAL ABD HYSTERECTOMY 

687 RADICAL VAG HYSTERECTOMY 

688 PELVIC EVISCERATION 

689 HYSTERECTOMY NEC/NOS 

69 OTHER UTERUS/SUPPORT OPS* 

690 UTERINE D & C* 

6901 D & C FOR PREG TERMINAT 

6902 D & C POST DELIVERY 

6909 D & C NEC 

691 DESTRUC UTER SUPPORT LES* 

6919 DESTRUC UTER SUPPORT NEC 

692 UTERINE SUPPORT REPAIR* 

6921 INTERPOSIT OP UTERIN LIG 

6922 UTERINE SUSPENSION NEC 

6923 VAG REPAIR INVERS UTERUS 

6929 UTERUS/ADNEXA REPAIR NEC 

693 PARACERV UTERINE DENERV 

694 UTERINE REPAIR* 

6941 SUTURE UTERINE LACERAT 

6942 CLOSURE UTERINE FISTULA 

6949 UTERINE REPAIR NEC 

695 ASPIRAT CURETTAGE UTERUS* 

6951 ASPIRAT CURET-PREG TERMI 

6952 ASPIRAT CURET-POST DELIV 

6959 ASPIR CURETT UTERUS NEC 

696 MENSTRUAL EXTRACTION 

697 INSERTION OF IUD 

699 OTHER UTERUS/SUPPORT OPS* 

6991 INSERT UTERINE DEVICE 

6992 ARTIFICIAL INSEMINATION 

6993 INSERTION OF LAMINARIA 

6994 MAN REPLACE INVERT UTER 

6995 INCISION OF CERVIX 

6996 REMOVE CERVICAL CERCLAGE 

6997 REMOVE PENETRAT CERV FB 

6998 UTERINE SUPPORT OP NEC 

6999 UTERINE OPERATION NEC 

70 VAGINA & CUL-DE-SAC OPS* 

700 CULDOCENTESIS 

701 INCIS VAGINA/CUL-DE-SAC* 

7011 HYMENOTOMY 

7012 CULDOTOMY 

7013 INTRALUM VAG ADHESIOLYS 

7014 VAGINOTOMY NEC 

702 VAGIN/CUL-DE-SAC DX PROC* 

7021 VAGINOSCOPY 

7022 CULDOSCOPY 

7023 CUL-DE-SAC BIOPSY 

7024 VAGINAL BIOPSY 

7029 VAGIN/CUL-DE-SAC DX NEC 

703 EXCIS VAG/CUL-DE-SAC LES* 

7031 HYMENECTOMY 

7032 EXCIS CUL-DE-SAC LESION 

7033 EXCISION VAGINAL LESION 

704 VAGINAL OBLITERATION 

705 CYSTOCEL/RECTOCEL REPAIR* 

7050 CYSTOCEL/RECTOCEL REPAIR

7051 CYSTOCELE REPAIR 

7052 RECTOCELE REPAIR 

706 VAG CONSTRUC/RECONSTRUC* 

7061 VAGINAL CONSTRUCTION 

7062 VAGINAL RECONSTRUCTION 

707 OTHER VAGINAL REPAIR* 

7071 SUTURE VAGINA LACERATION 

7072 REPAIR COLOVAGIN FISTULA 

7073 REPAIR RECTOVAG FISTULA 

7074 REP VAGINOENT FISTUL NEC 

7075 REPAIR VAG FISTULA NEC 

7076 HYMENORRHAPHY 

7077 VAGINAL SUSPENS & FIXAT 

7079 VAGINAL REPAIR NEC 

708 VAGINAL VAULT OBLITERAT 

709 OTH VAG & CUL-DE-SAC OPS* 

7091 VAGINAL OPERATION NEC 

7092 CUL-DE-SAC OPERATION NEC 

71 VULVAR & PERINEAL OPS* 

710 INCIS VULVA & PERINEUM* 

7101 VULVAR ADHESIOLYSIS 

7109 INCIS VULVA/PERINEUM NEC 

711 VULVAR DIAGNOSTIC PROCS* 

7111 VULVAR BIOPSY 

7119 VULVAR DIAGNOS PROC NEC 

712 BARTHOLIN'S GLAND OPS* 

7121 PERCUTAN BARTHOLIN ASPIR 

7122 INCISE BARTHOLIN'S GLAND 

7123 BARTHOLIN GLAND MARSUP 

7124 DESTRUC BARTHOLIN GLAND 

7129 BARTHOLIN'S GLAND OP NEC 

713 LOCAL VULVAR EXCIS NEC 

714 OPERATIONS ON CLITORIS 

715 RADICAL VULVECTOMY 

716 OTHER VULVECTOMY* 

7161 UNILATERAL VULVECTOMY 

7162 BILATERAL VULVECTOMY 

717 VULVAR & PERINEAL REPAIR* 

7171 SUTURE VULVAR LACERATION 

7172 REPAIR VULVAR FISTULA 

7179 VULVAR/PERIN REPAIR NEC 

718 OTHER VULVAR OPERATIONS 

719 OTHER FEMALE GENITAL OPS 

72 FORCEP/VAC/BREECH DELIV* 

720 LOW FORCEPS OPERATION 

721 LOW FORCEPS W EPISIOTOMY 

722 MID FORCEPS OPERATION* 

7221 MID FORCEPS W EPISIOTOMY 

7229 MID FORCEPS OP NEC 

723 HIGH FORCEPS OPERATION* 

7231 HIGH FORCEPS W EPISIOT 

7239 HIGH FORCEPS OP NEC 

724 FORCEPS ROTAT FETAL HEAD 

725 BREECH EXTRACTION* 

7251 PART BRCH EXTRAC W FORCP 

7252 PART BREECH EXTRACT NEC 

7253 TOT BRCH EXTRAC W FORCEP

7254 TOT BREECH EXTRAC NEC 

726 FORCEPS-AFTERCOMING HEAD 

727 VACUUM EXTRACTION DELIV* 

7271 VACUUM EXT DEL W EPISIOT 

7279 VACUUM EXTRACT DEL NEC 

728 INSTRUMENT DELIVERY NEC 

729 INSTRUMENT DELIVERY NOS 

73 ASSIST/INDUCE DELIV NEC* 

730 ARTIFICIAL RUPT MEMBRANE* 

7301 INDUCT LABOR-RUPT MEMB 

7309 ARTIF RUPT MEMBRANES NEC 

731 SURG INDUCT LABOR NEC 

732 INT/COMB VERSION/EXTRACT* 

7321 INT/COMB VERSION NO EXTR 

7322 INT/COMB VERSION W EXTR 

733 FAILED FORCEPS 

734 MEDICAL INDUCTION LABOR 

735 MANUALLY ASSISTED DELIV* 

7351 MANUAL ROTAT FETAL HEAD 

7359 MANUAL ASSIST DELIV NEC 

736 EPISIOTOMY 

738 FETAL OPS-FACILITATE DEL 

739 OTH OPS ASSISTING DELIV* 

7391 EXT VERSION-ASSIST DELIV 

7392 REPLACE PROLAPSED CORD 

7393 INCIS CX TO ASSIST DELIV 

7394 PUBIOTOMY TO ASSIST DEL 

7399 OPS ASSISTING DELIV NEC 

74 C-SECTION/REMOVAL FETUS* 

740 CLASSICAL C-SECTION 

741 LOW CERVICAL C-SECTION 

742 EXTRAPERITONEAL C-SECT 

743 REM EXTRATUB ECTOP PREG 

744 CESAREAN SECTION NEC 

749 CESAREAN SECTION NOS* 

7491 HYSTEROTOMY TO TERMIN PG 

7499 CESAREAN SECTION NOS 

75 OTHER OBSTETRIC OPS* 

750 INTRA-AMNION INJ FOR AB 

751 DIAGNOSTIC AMNIOCENTESIS 

752 INTRAUTERINE TRANSFUSION 

753 INTRAUT FETAL OPS NEC* 

7531 AMNIOSCOPY 

7532 FETAL EKG 

7533 FETAL BLOOD SAMPLE/BX 

7534 FETAL MONITORING NOS 

7535 DX PROC FETUS/AMNION NEC 

7536 CORRECTION FETAL DEFECT 

7537 AMNIOINFUSION 

754 MANUAL REMOVAL-PLACENTA 

755 REPAIR OB LACERAT UTERUS* 

7550 REPAIR OB LAC UTERUS NOS 

7551 REPAIR OB LACERAT CERVIX 

7552 REPAIR OB LAC CORP UTERI 

756 REPAIR OTH OB LACERATION* 

7561 REPAIR OB LAC BLAD/URETH 

7562 REPAIR OB LAC RECT/ANUS

7569 REPAIR OB LACERATION NEC 

757 MANUAL EXPLOR UTERUS P/P 

758 OB TAMPONADE UTERUS/VAG 

759 OTHER OBSTETRIC OPS* 

7591 EVAC OB INC HEMAT PERIN 

7592 EVAC OB HEMAT VULVA/VAG 

7593 SURG CORR INVERT UTERUS 

7594 MAN REPLAC INVERT UTERUS 

7599 OBSTETRIC OPERATION NEC 

76 FACIAL BONE & JOINT OPS* 

760 FACIAL BONE INCISION* 

7601 FACIAL BONE SEQUESTRECT 

7609 FACIAL BONE INCISION NEC 

761 DX PROC FACIAL BONE/JNT* 

7611 FACIAL BONE BIOPSY 

7619 FACIAL BONE DX PROC NEC 

762 DESTRUCT FACIAL BONE LES 

763 PARTIAL FACIAL OSTECTOMY* 

7631 PARTIAL MANDIBULECTOMY 

7639 PART FACIAL OSTECTOM NEC 

764 FACIAL BONE EXC & RECONS* 

7641 TOT MANDIBULEC W RECONST 

7642 TOTAL MANDIBULECTOMY NEC 

7643 MANDIBULAR RECONST NEC 

7644 TOT FACE OSTECT W RECONS 

7645 TOT FACE BONE OSTECT NEC 

7646 FACIAL BONE RECONSTR NEC 

765 TEMPOROMAND ARTHROPLASTY 

766 OTHER FACIAL BONE REPAIR* 

7661 CL OSTEOPLASTY MAND RAMI 

7662 OPEN OSTEOPLAS MAND RAMI 

7663 OSTEOPLASTY MANDIBLE BDY 

7664 MAND ORTHOGNATHIC OP NEC 

7665 SEG OSTEOPLASTY MAXILLA 

7666 TOT OSTEOPLASTY MAXILLA 

7667 REDUCTION GENIOPLASTY 

7668 AUGMENTATION GENIOPLASTY 

7669 FACIAL BONE REPAIR NEC 

767 REDUCTION OF FACIAL FX* 

7670 REDUCTION FACIAL FX NOS 

7671 CL REDUCT MALAR/ZYGO FX 

7672 OPN REDUCT MALAR/ZYGO FX 

7673 CL REDUCT MAXILLARY FX 

7674 OPEN REDUCT MAXILLARY FX 

7675 CL REDUCT MANDIBLE FX 

7676 OPEN REDUCT MANDIBLE FX 

7677 OPEN REDUCT ALVEOLAR FX 

7678 CL REDUCT FACIAL FX NEC 

7679 OPEN REDUCT FACE FX NEC 

769 OTH OPS FACIAL BONE/JNT* 

7691 BONE GRAFT TO FACE BONE 

7692 SYN IMPLANT TO FACE BONE 

7693 CLOS REDUCT TM DISLOCAT 

7694 OPEN REDUCT TM DISLOCAT 

7695 TM MANIPULATION NEC 

7696 INJEC THERAP SBST TM JNT 

7697 REMOVE INT FIX FACE BONE

7699 FACIAL BONE/JNT OP NEC 

77 INCIS/EXCIS/DIV BONE NEC* 

770 SEQUESTRECTOMY* 

7700 SEQUESTRECTOMY NOS 

7701 CHEST CAGE SEQUESTREC 

7702 HUMERUS SEQUESTRECTOMY 

7703 RADIUS & ULNA SEQUESTREC 

7704 METACARP/CARP SEQUESTREC 

7705 FEMORAL SEQUESTRECTOMY 

7706 PATELLAR SEQUESTRECTOMY 

7707 TIBIA/FIBULA SEQUESTREC 

7708 METATAR/TAR SEQUESTREC 

7709 SEQUESTRECTOMY NEC 

771 OTH BONE INCIS W/O DIVIS* 

7710 OTHER BONE INCISION NOS 

7711 OTHER CHEST CAGE INCIS 

7712 OTHER HUMERUS INCISION 

7713 OTHER RADIUS/ULNA INCIS 

7714 OTH METACARP/CARP INCIS 

7715 OTHER FEMORAL INCISION 

7716 OTHER PATELLAR INCISION 

7717 OTHER TIBIA/FIBULA INCIS 

7718 OTH METATARS/TARS INCIS 

7719 BONE INCIS W/O DIV NEC 

772 WEDGE OSTEOTOMY* 

7720 WEDGE OSTEOTOMY NOS 

7721 CHEST CAGE WEDG OSTEOTOM 

7722 HUMERUS WEDGE OSTEOTOMY 

7723 RADIUS/ULNA WEDG OSTEOTO 

7724 METACAR/CAR WEDG OSTEOTO 

7725 FEMORAL WEDGE OSTEOTOMY 

7726 PATELLAR WEDGE OSTEOTOMY 

7727 TIBIA/FIBUL WEDG OSTEOT 

7728 METATAR/TAR WEDG OSTEOT 

7729 WEDGE OSTEOTOMY NEC 

773 OTHER DIVISION OF BONE* 

7730 OTHER BONE DIVISION NOS 

7731 CHEST CAGE BONE DIV NEC 

7732 HUMERUS DIVISION NEC 

7733 RADIUS/ULNA DIVISION NEC 

7734 METACAR/CAR DIVISION NEC 

7735 FEMORAL DIVISION NEC 

7736 PATELLAR DIVISION NEC 

7737 TIBIA/FIBULA DIV NEC 

7738 METATAR/TAR DIVISION NEC 

7739 BONE DIVISION NEC 

774 BIOPSY OF BONE* 

7740 BONE BIOPSY NOS 

7741 CHEST CAGE BONE BIOPSY 

7742 HUMERUS BIOPSY 

7743 RADIUS & ULNA BIOPSY 

7744 METACARPAL/CARPAL BIOPSY 

7745 FEMORAL BIOPSY 

7746 PATELLAR BIOPSY 

7747 TIBIA & FIBULA BIOPSY 

7748 METATARSAL/TARSAL BIOPSY 

7749 BONE BIOPSY NEC

775 EXC REPAIR BUNION* 

7751 BUNIONECT/SFT/OSTEOTOMY 

7752 BUNIONECT/SFT/ARTHRODES 

7753 OTH BUNIONECT W SFT CORR 

7754 EXC CORRECT BUNIONETTE 

7756 REPAIR OF HAMMER TOE 

7757 REPAIR OF CLAW TOE 

7758 OTH EXC, FUS, REPAIR TOE 

7759 BUNIONECTOMY NEC 

776 LOC EXC BONE LESION* 

7760 LOC EXC BONE LESION NOS 

7761 EXC CHEST CAGE BONE LES 

7762 LOC EXC BONE LES HUMERUS 

7763 LOC EXC LES RADIUS/ULNA 

7764 LOC EXC LES METACAR/CAR 

7765 LOC EXC BONE LES FEMUR 

7766 LOC EXC BONE LES PATELLA 

7767 LOC EXC LES TIBIA/FIBULA 

7768 LOC EXC LES METATAR/TAR 

7769 LOC EXC BONE LESION NEC 

777 EXCISE BONE FOR GRAFT* 

7770 EXCISE BONE FOR GRFT NOS 

7771 EX CHEST CAGE BONE-GFT 

7772 EXCISE HUMERUS FOR GRAFT 

7773 EXCIS RADIUS/ULNA-GRAFT 

7774 EXCIS METACAR/CAR-GRAFT 

7775 EXCISE FEMUR FOR GRAFT 

7776 EXCISE PATELLA FOR GRAFT 

7777 EXCISE TIB/FIB FOR GRAFT 

7778 EXCIS METATAR/TAR-GRAFT 

7779 EXCISE BONE FOR GFT NEC 

778 OTHER PARTIAL OSTECTOMY* 

7780 OTH PART OSTECTOMY NOS 

7781 OTH CHEST CAGE OSTECTOMY 

7782 PARTIAL HUMERECTOMY NEC 

7783 PART OSTECT-RADIUS/ULNA 

7784 PART OSTECT-METACAR/CAR 

7785 PART OSTECTOMY-FEMUR 

7786 PARTIAL PATELLECTOMY 

7787 PART OSTECT-TIBIA/FIBULA 

7788 PART OSTECT-METATAR/TAR 

7789 PARTIAL OSTECTOMY NEC 

779 TOTAL OSTECTOMY* 

7790 TOTAL OSTECTOMY NOS 

7791 TOT CHEST CAGE OSTECTOMY 

7792 TOTAL OSTECTOMY-HUMERUS 

7793 TOT OSTECT-RADIUS/ULNA 

7794 TOT OSTECT-METACARP/CARP 

7795 TOT OSTECTOMY-FEMUR 

7796 TOTAL PATELLECTOMY 

7797 TOT OSTECT-TIBIA/FIBULA 

7798 TOT OSTECT-METATARS/TARS 

7799 TOTAL OSTECTOMY NEC 

78 OTH BONE OPS EXCPT FACE* 

780 BONE GRAFT* 

7800 BONE GRAFT NOS 

7801 BONE GRAFT TO CHEST CAGE

7802 BONE GRAFT TO HUMERUS 

7803 BONE GRAFT-RADIUS/ULNA 

7804 BONE GRFT TO METACAR/CAR 

7805 BONE GRAFT TO FEMUR 

7806 BONE GRAFT TO PATELLA 

7807 BONE GRAFT-TIBIA/FIBULA 

7808 BONE GRAFT-METATAR/TAR 

7809 BONE GRAFT NEC 

781 PERIOSTEAL SUTURE* 

7810 APPLIC EXT FIX DEV NOS 

7811 APPL EXT FIX-CHEST CAGE 

7812 APPLIC EXT FIX-HUMERUS 

7813 APPL EXT FIX-RADIUS/ULNA 

7814 APPL EXT FIX-METACAR/CAR 

7815 APPLIC EXT FIX DEV-FEMUR 

7816 APPL EXT FIX DEV-PATELLA 

7817 APPL EXT FIX-TIB/FIBULA 

7818 APPL EXT FIX-METATAR/TAR 

7819 APPLIC EXT FIX DEV NEC 

782 EPIPHYSEAL STAPLING* 

7820 LIMB SHORTEN PROC NOS 

7822 LIMB SHORT PROC-HUMERUS 

7823 LIMB SHORTEN-RADIUS/ULNA 

7824 LIMB SHORTEN-METACAR/CAR 

7825 LIMB SHORT PROC-FEMUR 

7827 LIMB SHORTEN-TIB/FIBULA 

7828 LIMB SHORTEN-METATAR/TAR 

7829 LIMB SHORTEN PROC NEC 

783 OTHER BONE LENGTH CHANGE* 

7830 LIMB LENGTHEN PROC NOS 

7832 LIMB LENGTH PROC-HUMERUS 

7833 LIMB LENGTH-RADIUS/ULNA 

7834 LIMB LENGTH-METACAR/CAR 

7835 LIMB LENGTH PROC-FEMUR 

7837 LIMB LENGTHEN-TIB/FIBULA 

7838 LIMB LENGTHN-METATAR/TAR 

7839 LIMB LENGTHEN PROC NEC 

784 OTHER BONE REPAIR* 

7840 OTH BONE REPAIR/PLAST OP 

7841 OTH CHEST CAGE REP/PLAST 

7842 OTH HUMERUS REPAIR/PLAST 

7843 OTH RAD/ULN REPAIR/PLAST 

7844 OTH METAC/CARP REP/PLAST 

7845 OTH FEMUR REPAIR/PLASTIC 

7846 OTH PATELLA REPAIR/PLAST 

7847 OTH TIB/FIB REPAIR/PLAST 

7848 OTH META/TAR REPA/PLAST 

7849 OTH BONE REPA/PLAST NEC 

785 INT FIX W/O FX REDUCTION* 

7850 INT FIX W/O FX REDUC NOS 

7851 INT FIXATION-CHEST CAGE 

7852 INT FIXATION-HUMERUS 

7853 INT FIXATION-RADIUS/ULNA 

7854 INT FIXATION-METACAR/CAR 

7855 INTERNAL FIXATION-FEMUR 

7856 INTERNAL FIX-PATELLA 

7857 INT FIXATION-TIBIA/FIBUL

7858 INT FIXATION-METATAR/TAR 

7859 INT FIX-NO FX REDUCT NEC 

786 REMOVE IMPLANT BONE DEV* 

7860 REMOVE IMP DEVICE NOS 

7861 REMOV IMP DEV-CHEST CAGE 

7862 REMOVE IMPL DEV-HUMERUS 

7863 REMOV IMP DEV-RADIUS/ULN 

7864 REMOV IMP DEV-METAC/CARP 

7865 REMOVE IMP DEVICE-FEMUR 

7866 REMOV IMP DEVICE-PATELLA 

7867 REMOV IMP DEV-TIB/FIBULA 

7868 REMOVE IMP DEV-METAT/TAR 

7869 REMOVE IMPL DEVICE NEC 

787 OSTEOCLASIS* 

7870 OSTEOCLASIS NOS 

7871 OSTEOCLASIS-CHEST CAGE 

7872 OSTEOCLASIS-HUMERUS 

7873 OSTEOCLASIS-RADIUS/ULNA 

7874 OSTEOCLASIS-METACAR/CAR 

7875 OSTEOCLASIS-FEMUR 

7876 OSTEOCLASIS-PATELLA 

7877 OSTEOCLASIS-TIBIA/FIBULA 

7878 OSTEOCLASIS-METATAR/TAR 

7879 OSTEOCLASIS NEC 

788 OTHER BONE DIAGNOST PROC* 

7880 OTHER BONE DX PROC NOS 

7881 OTH DX PROCED-CHEST CAGE 

7882 OTH DX PROCED-HUMERUS 

7883 OTH DX PROC-RADIUS/ULNA 

7884 OTH DX PROC-METACAR/CAR 

7885 OTH DX PROCED-FEMUR 

7886 OTH DX PROCED-PATELLA 

7887 OTH DX PROC-TIBIA/FIBULA 

7888 OTH DX PROC-METATAR/TAR 

7889 OTHER BONE DX PROC NEC 

789 OTHER BONE OPERATIONS* 

7890 INSERT BONE STIMUL NOS 

7891 INSERT BONE STIMUL-CHEST 

7892 INSERT BONE STIM-HUMERUS 

7893 INSER BONE STIM-RAD/ULNA 

7894 INSER BONE STIM-META/CAR 

7895 INSERT BONE STIM-FEMUR 

7896 INSERT BONE STIM-PATELLA 

7897 INSER BONE STIM-TIB/FIB 

7898 INSER BONE STIM-META/TAR 

7899 INSERT BONE STIMUL NEC 

79 REDUCTION FX/DISLOCATION* 

790 CLOSED FRACTURE REDUCT* 

7900 CLOSED FX REDUCTION NOS 

7901 CLOSED FX REDUCT HUMERUS 

7902 CL FX REDUC-RADIUS/ULNA 

7903 CL FX REDUC-METACAR/CAR 

7904 CL FX REDUC-FINGER 

7905 CL FX REDUC-FEMUR 

7906 CL FX REDUC-TIBIA/FIBULA 

7907 CL FX REDUC-METATAR/TAR 

7908 CL FX REDUC-TOE

7909 CLOSED FX REDUCTION NEC 

791 CL FX REDUC W INT FIX* 

7910 CL FX REDUC-INT FIX NOS 

7911 CLOS RED-INT FIX HUMERUS 

7912 CL RED-INT FIX RAD/ULNA 

7913 CL RED-INT FIX METAC/CAR 

7914 CLOSE RED-INT FIX FINGER 

7915 CLOSED RED-INT FIX FEMUR 

7916 CL RED-INT FIX TIB/FIBU 

7917 CL RED-INT FIX METAT/TAR 

7918 CLOSE RED-INT FIX TOE FX 

7919 CL FX REDUC-INT FIX NEC 

792 OPEN FRACTURE REDUCTION* 

7920 OPEN FX REDUCTION NOS 

7921 OPEN REDUC-HUMERUS FX 

7922 OPEN REDUC-RADIUS/ULN FX 

7923 OPEN REDUC-METAC/CAR FX 

7924 OPEN REDUCTION-FINGER FX 

7925 OPEN REDUCTION-FEMUR FX 

7926 OPEN REDUC-TIBIA/FIB FX 

7927 OPEN REDUC-METAT/TARS FX 

7928 OPEN REDUCTION-TOE FX 

7929 OPEN FX REDUCTION NEC 

793 OPEN FX REDUCT W INT FIX* 

7930 OPN FX RED W INT FIX NOS 

7931 OPEN RED-INT FIX HUMERUS 

7932 OP RED-INT FIX RAD/ULNA 

7933 OP RED-INT FIX METAC/CAR 

7934 OPEN RED-INT FIX FINGER 

7935 OPEN REDUC-INT FIX FEMUR 

7936 OP RED-INT FIX TIB/FIBUL 

7937 OP RED-INT FIX METAT/TAR 

7938 OPEN REDUCT-INT FIX TOE 

7939 OPN FX RED W INT FIX NEC 

794 CLOSED REDUCT-SEP EPIPHY* 

7940 CLS REDUC-SEP EPIPHY NOS 

7941 CLOSE RED-HUMERUS EPIPHY 

7942 CLS RED-RADIUS/UL EPIPHY 

7945 CLOSE REDUC-FEMUR EPIPHY 

7946 CLS RED-TIBIA/FIB EPIPHY 

7949 CLS REDUC-SEP EPIPHY NEC 

795 OPEN REDUC-SEP EPIPHY* 

7950 OPEN RED-SEP EPIPHY NOS 

7951 OPN RED-SEP EPIPHY-HUMER 

7952 OP RED-RADIUS/ULN EPIPHY 

7955 OPN RED-SEP EPIPHY-FEMUR 

7956 OP RED-TIBIA/FIB EPIPHYS 

7959 OPEN RED-SEP EPIPHY NEC 

796 OPEN FX SITE DEBRIDEMENT* 

7960 OPEN FX SITE DEBRIDE NOS 

7961 DEBRID OPEN FX-HUMERUS 

7962 DEBRID OPN FX-RADIUS/ULN 

7963 DEBRID OPN FX-METAC/CAR 

7964 DEBRID OPN FX-FINGER 

7965 DEBRID OPN FX-FEMUR 

7966 DEBRID OPN FX-TIBIA/FIB 

7967 DEBRID OPN FX-METAT/TAR

7968 DEBRID OPN FX-TOE 

7969 OPEN FX SITE DEBRIDE NEC 

797 CL REDUC DISLOCATION* 

7970 CL REDUC DISLOC NOS 

7971 CL REDUC DISLOC-SHOULDER 

7972 CL REDUC DISLOC-ELBOW 

7973 CL REDUC DISLOC-WRIST 

7974 CL REDUC DISLOC-HAND/FNG 

7975 CL REDUC DISLOC-HIP 

7976 CL REDUC DISLOC-KNEE 

7977 CL REDUC DISLOC-ANKLE 

7978 CL REDUC DISLOC-FOOT/TOE 

7979 CL REDUC DISLOCATION NEC 

798 OPN REDUC DISLOCATION* 

7980 OPEN REDUC-DISLOCAT NOS 

7981 OPN REDUC DISLOC-SHOULDR 

7982 OPEN REDUC-ELBOW DISLOC 

7983 OPEN REDUC-WRIST DISLOC 

7984 OPN REDUC DISLOC-HAND 

7985 OPEN REDUC-HIP DISLOCAT 

7986 OPEN REDUC-KNEE DISLOCAT 

7987 OPEN REDUC-ANKLE DISLOC 

7988 OPN REDUC DISLOC-FT/TOE 

7989 OPEN REDUC-DISLOCAT NEC 

799 BONE INJURY OP NOS* 

7990 UNSPEC OP BONE INJ NOS 

7991 HUMERUS INJURY OP NOS 

7992 RADIUS/ULNA INJ OP NOS 

7993 METACARP/CARP INJ OP NOS 

7994 FINGER INJURY OP NOS 

7995 FEMUR INJURY OP NOS 

7996 TIBIA/FIBULA INJ OP NOS 

7997 METATARS/TARS INJ OP NOS 

7998 TOE INJURY OPERATION NOS 

7999 UNSPEC OP-BONE INJ NEC 

80 INCISION/EXCISION JOINT* 

800 ARTHROTOMY-REMOVE PROSTH* 

8000 ARTHROT & PROS REMOV NOS 

8001 ARTHROT/PROS REMOV-SHLDR 

8002 ARTHROT/PROS REMOV-ELBOW 

8003 ARTHROT/PROS REMOV-WRIST 

8004 ARTHROT/PROS REMOV-HAND 

8005 ARTHROT/PROS REMOV-HIP 

8006 ARTHROT/PROS REMOV-KNEE 

8007 ARTHROT/PROS REMOV-ANKLE 

8008 ARTHROT/PROS REMOV-FOOT 

8009 ARTHROT & PROS REMOV NEC 

801 OTHER ARTHROTOMY* 

8010 OTHER ARTHROTOMY NOS 

8011 OTH ARTHROTOMY-SHOULDER 

8012 OTH ARTHROTOMY-ELBOW 

8013 OTH ARTHROTOMY-WRIST 

8014 OTH ARTHROTOMY-HAND/FNGR 

8015 OTH ARTHROTOMY-HIP 

8016 OTH ARTHROTOMY-KNEE 

8017 OTH ARTHROTOMY-ANKLE 

8018 OTH ARTHROTOMY-FOOT/TOE

8019 OTHER ARTHROTOMY NEC 

802 ARTHROSCOPY* 

8020 ARTHROSCOPY NOS 

8021 SHOULDER ARTHROSCOPY 

8022 ELBOW ARTHROSCOPY 

8023 WRIST ARTHROSCOPY 

8024 HAND & FINGER ARTHROSCOP 

8025 HIP ARTHROSCOPY 

8026 KNEE ARTHROSCOPY 

8027 ANKLE ARTHROSCOPY 

8028 FOOT & TOE ARTHROSCOPY 

8029 ARTHROSCOPY NEC 

803 BIOPSY JOINT STRUCTURE* 

8030 JOINT BIOPSY NOS 

8031 SHOULDER JOINT BIOPSY 

8032 ELBOW JOINT BIOPSY 

8033 WRIST JOINT BIOPSY 

8034 HAND/FINGER JOINT BIOPSY 

8035 HIP JOINT BIOPSY 

8036 KNEE JOINT BIOPSY 

8037 ANKLE JOINT BIOPSY 

8038 FOOT & TOE JOINT BIOPSY 

8039 JOINT BIOPSY NEC 

804 JT CAPSULE/LIG/CARTL DIV* 

8040 JT STRUCTUR DIVISION NOS 

8041 SHOULDER STRUCT DIVISION 

8042 ELBOW STRUCTURE DIVISION 

8043 WRIST STRUCTURE DIVISION 

8044 HAND JOINT STRUCT DIVIS 

8045 HIP STRUCTURE DIVISION 

8046 KNEE STRUCTURE DIVISION 

8047 ANKLE STRUCTURE DIVISION 

8048 FOOT JOINT STRUCT DIVIS 

8049 JT STRUCTUR DIVISION NEC 

8050 EXC/DEST INTVRT DISC NOS 

8051 EXCISION INTERVERT DISC 

8052 CHEMONUCLEOLYSIS IV DISC 

8059 OTH EXC/DEST INTVRT DISC 

806 EXCIS KNEE SEMILUN CARTL 

807 SYNOVECTOMY* 

8070 SYNOVECTOMY-SITE NOS 

8071 SHOULDER SYNOVECTOMY 

8072 ELBOW SYNOVECTOMY 

8073 WRIST SYNOVECTOMY 

8074 HAND SYNOVECTOMY 

8075 HIP SYNOVECTOMY 

8076 KNEE SYNOVECTOMY 

8077 ANKLE SYNOVECTOMY 

8078 FOOT SYNOVECTOMY 

8079 SYNOVECTOMY-SITE NEC 

808 OTH DESTRUCT JOINT LES* 

8080 DESTRUCT JOINT LES NOS 

8081 DESTRUC-SHOULDER LES NEC 

8082 DESTRUC-ELBOW LESION NEC 

8083 DESTRUC-WRIST LESION NEC 

8084 DESTRUC-HAND JT LES NEC 

8085 DESTRUCT-HIP LESION NEC

8086 DESTRUCT-KNEE LESION NEC 

8087 DESTRUC-ANKLE LESION NEC 

8088 DESTRUC-FOOT JT LES NEC 

8089 DESTRUCT JOINT LES NEC 

809 OTHER EXCISION OF JOINT* 

8090 EXCISION OF JOINT NOS 

8091 EXCISION OF SHOULDER NEC 

8092 EXCISION OF ELBOW NEC 

8093 EXCISION OF WRIST NEC 

8094 EXCISION HAND JOINT NEC 

8095 EXCISION OF HIP NEC 

8096 EXCISION OF KNEE NEC 

8097 EXCISION OF ANKLE NEC 

8098 EXCISION FOOT JOINT NEC 

8099 EXCISION OF JOINT NEC 

81 JOINT REPAIR* 

810 SPINAL FUSION* 

8100 SPINAL FUSION NOS 

8101 ATLAS-AXIS FUSION 

8102 OTHER CERVICAL FUS ANT 

8103 OTHER CERVICAL FUS POST 

8104 DORSAL/DORSOLUM FUS ANT 

8105 DORSAL/DORSOLUM FUS POST 

8106 LUMBAR/LUMBOSAC FUS ANT 

8107 LUMBAR/LUMBOSAC FUS LAT 

8108 LUMBAR/LUMBOSAC FUS POST 

8109 REFUSION OF SPINE 

811 FOOT & ANKLE ARTHRODESIS* 

8111 ANKLE FUSION 

8112 TRIPLE ARTHRODESIS 

8113 SUBTALAR FUSION 

8114 MIDTARSAL FUSION 

8115 TARSOMETATARSAL FUSION 

8116 METATARSOPHALANGEAL FUS 

8117 OTHER FUSION OF FOOT 

812 ARTHRODESIS OF OTH JOINT* 

8120 ARTHRODESIS NOS 

8121 ARTHRODESIS OF HIP 

8122 ARTHRODESIS OF KNEE 

8123 ARTHRODESIS OF SHOULDER 

8124 ARTHRODESIS OF ELBOW 

8125 CARPORADIAL FUSION 

8126 METACARPOCARPAL FUSION 

8127 METACARPOPHALANGEAL FUS 

8128 INTERPHALANGEAL FUSION 

8129 ARTHRODESIS NEC 

813 FOOT & TOE ARTHROPLASTY* 

814 OTH REPAIR JOINT LOW EXT* 

8140 REPAIR OF HIP, NEC 

8142 FIVE-IN-ONE KNEE REPAIR 

8143 TRIAD KNEE REPAIR 

8144 PATELLAR STABILIZATION 

8145 CRUCIATE LIG REPAIR NEC 

8146 COLLATERL LIG REPAIR NEC 

8147 OTHER REPAIR OF KNEE 

8149 OTHER REPAIR OF ANKLE 

815 JOINT REPL OF LOW EXT*

8151 TOTAL HIP REPLACEMENT 

8152 PARTIAL HIP REPLACEMENT 

8153 REVISE HIP REPLACEMENT 

8154 TOTAL KNEE REPLACEMENT 

8155 REVISE KNEE REPLACEMENT 

8156 TOTAL ANKLE REPLACEMENT 

8157 REPL JOINT OF FOOT, TOE 

8159 REV JT REPL LOW EXT NEC 

816 OTHER HIP ARTHROPLASTY* 

817 ARTHROPLAS HAN/FIN/WRIS* 

8171 ARTHROPLAS METACARP WIT 

8172 ARTHROPLASTY METACAR W/O 

8173 TOTAL WRIST REPLACEMENT 

8174 ARTHROPLASTY CARPAL WIT 

8175 ARTHROPLASTY CARPAL W/O 

8179 OTH REPAIR HAN/FIN/WRIS 

818 ARTHROPLASTY SHOUL/ELBOW* 

8180 TOTAL SHOULDER REPLACE 

8181 PARTIAL SHOULDER REPLACE 

8182 REP RECUR SHLDER DISLOC 

8183 SHOULDER ARTHROPLAST NEC 

8184 TOTAL ELBOW REPLACEMENT 

8185 ELBOW ARTHROPLASTY NEC 

819 OTHER JOINT STRUCTURE OP* 

8191 ARTHROCENTESIS 

8192 INJECTION INTO JOINT 

8193 SUTUR CAPSUL/LIGAMEN ARM 

8194 SUTURE CAPSUL/LIG ANK/FT 

8195 SUTUR CAPSUL/LIG LEG NEC 

8196 OTHER REPAIR OF JOINT 

8197 REV JT REPL UPPER EXTREM 

8198 OTHER JOINT DX PROCEDURE 

8199 JOINT STRUCTURE OP NEC 

82 HAND MUSCL/TEND/FASC OPS* 

820 INC HAND MUS/TEN/FAS/BUR* 

8201 EXPLOR TEND SHEATH-HAND 

8202 MYOTOMY OF HAND 

8203 BURSOTOMY OF HAND 

8204 I & D PALMAR/THENAR SPAC 

8209 INC SOFT TISSUE HAND NEC 

821 DIV HAND MUSC/TEND/FASC* 

8211 TENOTOMY OF HAND 

8212 FASCIOTOMY OF HAND 

8219 DIV SOFT TISSUE HAND NEC 

822 EXC LES HAND MUS/TEN/FAS* 

8221 EXC LES TEND SHEATH HAND 

8222 EXCISION HAND MUSCLE LES 

8229 EXC LES SFT TISS HND NEC 

823 OTH EXCIS HAND SOFT TISS* 

8231 BURSECTOMY OF HAND 

8232 EXCIS HAND TEND FOR GRFT 

8233 HAND TENONECTOMY NEC 

8234 EXC HND MUS/FAS FOR GRFT 

8235 HAND FASCIECTOMY NEC 

8236 OTHER MYECTOMY OF HAND 

8239 HAND SOFT TISSUE EXC NEC 

824 SUTURE HAND MUS/TEN/FASC*

8241 SUTURE TENDN SHEATH HAND 

8242 DELAY SUT FLEX TEND HAND 

8243 DELAY SUT HAND TEND NEC 

8244 SUTUR FLEX TEND HAND NEC 

8245 SUTURE HAND TENDON NEC 

8246 SUTURE HAND MUSCLE/FASC 

825 HAND MUSC/TEND TRANSPLAN* 

8251 HAND TENDON ADVANCEMENT 

8252 HAND TENDON RECESSION 

8253 HAND TENDON REATTACHMENT 

8254 HAND MUSCLE REATTACHMENT 

8255 CHNG HND MUS/TEN LNG NEC 

8256 TRANSPLANT HAND TEND NEC 

8257 TRANSPOSIT HAND TEND NEC 

8258 TRANSPLANT HAND MUSC NEC 

8259 TRANSPOSIT HAND MUSC NEC 

826 RECONSTRUCTION OF THUMB* 

8261 POLLICIZATION OPERATION 

8269 THUMB RECONSTRUCTION NEC 

827 PLAST OP HAND-GRFT/IMPLA* 

8271 HAND TEND PULLEY RECONST 

8272 PLAST OP HND-MUS/FAS GRF 

8279 PLAST OP HAND W GRFT NEC 

828 OTHER PLASTIC OPS HAND* 

8281 TRANSFER OF FINGER 

8282 REPAIR OF CLEFT HAND 

8283 REPAIR OF MACRODACTYLY 

8284 REPAIR OF MALLET FINGER 

8285 OTHER TENODESIS OF HAND 

8286 OTHER TENOPLASTY OF HAND 

8289 HAND PLASTIC OP NEC 

829 OTH HAND MUS/TEN/FAS OPS* 

8291 LYSIS OF HAND ADHESIONS 

8292 ASPIRATION BURSA OF HAND 

8293 ASPIR SOFT TISS HAND NEC 

8294 INJECT BURSA OF HAND 

8295 INJECT TENDON OF HAND 

8296 HAND SFT TISSU INJEC NEC 

8299 HAND MUS/TEN/FAS/OPS NEC 

83 OTHER MUS/TEN/FAS/BUR OP* 

830 INCIS MUS/TEND/FASC/BURS* 

8301 TENDON SHEATH EXPLORAT 

8302 MYOTOMY 

8303 BURSOTOMY 

8309 SOFT TISSUE INCISION NEC 

831 MUSCL/TEND/FASC DIVISION* 

8311 ACHILLOTENOTOMY 

8312 ADDUCTOR TENOTOMY OF HIP 

8313 OTHER TENOTOMY 

8314 FASCIOTOMY 

8319 SOFT TISSUE DIVISION NEC 

832 MUS/TEN/FAS/BURS DX PROC* 

8321 SOFT TISSUE BIOPSY 

8329 SOFT TISSUE DX PROC NEC 

833 EXC LES MUS/TEN/FAS/BURS* 

8331 EXCIS LES TENDON SHEATH 

8332 EXCIS LESION OF MUSCLE

8339 EXC LES SOFT TISSUE NEC 

834 OTHER EXCIS MUS/TEN/FASC* 

8341 TENDON EXCISION FOR GRFT 

8342 OTHER TENONECTOMY 

8343 MUSC/FASC EXCIS FOR GRFT 

8344 OTHER FASCIECTOMY 

8345 OTHER MYECTOMY 

8349 OTHER SOFT TISSUE EXCIS 

835 BURSECTOMY 

836 SUTURE MUSCL/TENDON/FASC* 

8361 TENDON SHEATH SUTURE 

8362 DELAYED TENDON SUTURE 

8363 ROTATOR CUFF REPAIR 

8364 OTHER SUTURE OF TENDON 

8365 OTHER MUSCLE/FASC SUTURE 

837 MUSCLE/TENDON RECONSTRUC* 

8371 TENDON ADVANCEMENT 

8372 TENDON RECESSION 

8373 TENDON REATTACHMENT 

8374 MUSCLE REATTACHMENT 

8375 TENDON TRNSFR/TRANSPLANT 

8376 OTHER TENDON TRANSPOSIT 

8377 MUSCLE TRNSFR/TRANSPLANT 

8379 OTHER MUSCLE TRANSPOSIT 

838 OTH MUS/TEN/FAS PLAST OP* 

8381 TENDON GRAFT 

8382 MUSCLE OR FASCIA GRAFT 

8383 TENDON PULLEY RECONSTRUC 

8384 CLUBFOOT RELEASE NEC 

8385 MUSC/TEND LNG CHANGE NEC 

8386 QUADRICEPSPLASTY 

8387 OTHER PLASTIC OPS MUSCLE 

8388 OTHER PLASTIC OPS TENDON 

8389 OTHER PLASTIC OPS FASCIA 

839 OTHER MUS/TEN/FAS/BUR OP* 

8391 ADHESIOLYSIS MUS/TEN/FAS 

8392 INSERT SKEL MUSC STIMULA 

8393 REMOV SKEL MUSC STIMULAT 

8394 ASPIRATION OF BURSA 

8395 SOFT TISSUE ASPIRAT NEC 

8396 INJECTION INTO BURSA 

8397 INJECTION INTO TENDON 

8398 SOFT TISSUE INJECT NEC 

8399 MUS/TEN/FAS/BUR OP NEC 

84 OTHER MUSCULOSKELET PROC* 

840 AMPUTATION OF UPPER LIMB* 

8400 UPPER LIMB AMPUTAT NOS 

8401 FINGER AMPUTATION 

8402 THUMB AMPUTATION 

8403 AMPUTATION THROUGH HAND 

8404 DISARTICULATION OF WRIST 

8405 AMPUTATION THRU FOREARM 

8406 DISARTICULATION OF ELBOW 

8407 AMPUTATION THRU HUMERUS 

8408 SHOULDER DISARTICULATION 

8409 FOREQUARTER AMPUTATION 

841 AMPUTATION OF LOWER LIMB*

8410 LOWER LIMB AMPUTAT NOS 

8411 TOE AMPUTATION 

8412 AMPUTATION THROUGH FOOT 

8413 DISARTICULATION OF ANKLE 

8414 AMPUTAT THROUGH MALLEOLI 

8415 BELOW KNEE AMPUTAT NEC 

8416 DISARTICULATION OF KNEE 

8417 ABOVE KNEE AMPUTATION 

8418 DISARTICULATION OF HIP 

8419 HINDQUARTER AMPUTATION 

842 EXTREMITY REATTACHMENT* 

8421 THUMB REATTACHMENT 

8422 FINGER REATTACHMENT 

8423 FOREARM/WRIST/HAND REATT 

8424 UPPER ARM REATTACHMENT 

8425 TOE REATTACHMENT 

8426 FOOT REATTACHMENT 

8427 LOWER LEG/ANKLE REATTACH 

8428 THIGH REATTACHMENT 

8429 REATTACHMENT NEC 

843 AMPUTATION STUMP REVIS 

844 IMPLANT/FIT PROSTH LIMB* 

8440 IMPLNT/FIT PROS LIMB NOS 

8441 FIT UP ARM/SHOULD PROSTH 

8442 FIT LO ARM/HAND PROSTHES 

8443 FIT ARM PROSTHESIS NOS 

8444 IMPLANT ARM PROSTHESIS 

8445 FIT ABOVE KNEE PROSTHES 

8446 FIT BELOW KNEE PROSTHES 

8447 FIT LEG PROSTHESIS NOS 

8448 IMPLANT LEG PROSTHESIS 

849 OTHER MUSCULOSKELETAL OP* 

8491 AMPUTATION NOS 

8492 SEPARAT EQUAL JOIN TWIN 

8493 SEPARAT UNEQUL JOIN TWIN 

8499 MUSCULOSKELETAL OP NEC 

85 OPERATIONS ON THE BREAST* 

850 MASTOTOMY 

851 BREAST DIAGNOSTIC PROCS* 

8511 CLOSED BREAST BIOPSY 

8512 OPEN BREAST BIOPSY 

8519 BREAST DX PROCEDURE NEC 

852 BREAST TISSUE DESTRUCT* 

8520 BREAST TISSU DESTRUC NOS 

8521 LOCAL EXCIS BREAST LES 

8522 QUADRANT RESECT BREAST 

8523 SUBTOTAL MASTECTOMY 

8524 EXC ECTOPIC BREAST TISSU 

8525 EXCISION OF NIPPLE 

853 RED MAMMOPL/SUBQ MAMMECT* 

8531 UNILAT REDUCT MAMMOPLAST 

8532 BILAT REDUCT MAMMOPLASTY 

8533 UNIL SUBQ MAMMECT-IMPLNT 

8534 UNILAT SUBQ MAMMECT NEC 

8535 BIL SUBQ MAMMECT-IMPLANT 

8536 BILAT SUBQ MAMMECTOM NEC 

854 MASTECTOMY*

8541 UNILAT SIMPLE MASTECTOMY 

8542 BILAT SIMPLE MASTECTOMY 

8543 UNILAT EXTEN SIMP MASTEC 

8544 BILAT EXTEND SIMP MASTEC 

8545 UNILAT RADICAL MASTECTOM 

8546 BILAT RADICAL MASTECTOMY 

8547 UNIL EXT RAD MASTECTOMY 

8548 BIL EXTEN RAD MASTECTOMY 

855 AUGMENTATION MAMMOPLASTY* 

8550 AUGMENT MAMMOPLASTY NOS 

8551 UNIL BREAST INJEC-AUGMEN 

8552 BIL BREAST INJEC-AUGMENT 

8553 UNILAT BREAST IMPLANT 

8554 BILATERAL BREAST IMPLANT 

856 MASTOPEXY 

857 TOTAL BREAST RECONSTRUCT 

858 OTHER BREAST REPAIR* 

8581 SUTURE BREAST LACERATION 

8582 BREAST SPLIT-THICK GRAFT 

8583 BREAST FULL-THICK GRAFT 

8584 BREAST PEDICLE GRAFT 

8585 BREAST MUSCLE FLAP GRAFT 

8586 TRANSPOSITION OF NIPPLE 

8587 NIPPLE REPAIR NEC 

8589 MAMMOPLASTY NEC 

859 OTHER BREAST OPERATIONS* 

8591 ASPIRATION OF BREAST 

8592 BREAST INJECTION 

8593 BREAST IMPLANT REVISION 

8594 BREAST IMPLANT REMOVAL 

8595 INSER BREAST TISSU EXPAN 

8596 REMOV BREAST TISSU EXPAN 

8599 BREAST OPERATION NEC 

86 SKIN & SUBQ OPERATIONS* 

860 INCISION SKIN & SUBQ* 

8601 ASPIRATION SKIN & SUBQ 

8602 SKIN DEFECT TATTOOING 

8603 INCISION PILONIDAL SINUS 

8604 OTHER SKIN & SUBQ I & D 

8605 SKIN INCIS & FB REMOVAL 

8606 INSERT INFUSION PUMP 

8607 INSERT VASC ACCESS DEV 

8609 SKIN & SUBQ INCISION NEC 

861 SKIN & SUBQ DIAGNOS PROC* 

8611 SKIN & SUBQ BIOPSY 

8619 SKIN & SUBQ DX PROC NEC 

862 DESTRUCT OF SKIN LESION* 

8621 EXCISION OF PILONID CYST 

8622 EXC WOUND DEBRIDEMENT 

8623 NAIL REMOVAL 

8624 SKIN CHEMOSURGERY 

8625 DERMABRASION 

8626 LIGATION DERMAL APPENDAG 

8627 DEBRIDEMENT OF NAIL 

8628 NONEXCIS DEBRIDEMENT WND 

863 OTHER LOCAL DESTRUC SKIN 

864 RADICAL EXCIS SKIN LES

865 SKIN & SUBQ SUTURE* 

8651 REPLANTATION OF SCALP 

8659 SKIN SUTURE NEC 

866 FREE SKIN GRAFT* 

8660 FREE SKIN GRAFT NOS 

8661 FULL-THICK HAND SKIN GRF 

8662 HAND SKIN GRAFT NEC 

8663 FULL-THICK SKIN GRFT NEC 

8664 HAIR TRANSPLANT 

8665 HETEROGRAFT TO SKIN 

8666 HOMOGRAFT TO SKIN 

8667 DERMAL RENER GRAFT 

8669 FREE SKIN GRAFT NEC 

867 PEDICLE GRAFTS OR FLAPS* 

8670 PEDICLE GRAFT/FLAP NOS 

8671 CUT & PREP PEDICLE GRAFT 

8672 PEDICLE GRAFT ADVANCEMEN 

8673 ATTACH PEDICLE TO HAND 

8674 ATTACH PEDICLE GRAFT NEC 

8675 REVISION OF PEDICLE GRFT 

868 OTHER SKIN & SUBQ REPAIR* 

8681 REPAIR FACIAL WEAKNESS 

8682 FACIAL RHYTIDECTOMY 

8683 SIZE REDUCT PLASTIC OP 

8684 RELAXATION OF SCAR 

8685 SYNDACTYLY CORRECTION 

8686 ONYCHOPLASTY 

8689 SKIN REPAIR & PLASTY NEC 

869 OTHER SKIN & SUBQ OPS* 

8691 SKIN EXCISION FOR GRAFT 

8692 EPILATION OF SKIN 

8693 INSERT TISSUE EXPANDER 

8699 SKIN & SUBQ OP NEC 

87 DIAGNOSTIC RADIOLOGY* 

870 HEAD/NECK SOFT TISS XRAY* 

8701 PNEUMOENCEPHALOGRAM 

8702 BRAIN/SKULL CONTRST XRAY 

8703 C.A.T. SCAN OF HEAD 

8704 HEAD TOMOGRAPHY NEC 

8705 CONTRAST DACRYOCYSTOGRAM 

8706 NASOPHARY CONTRAST X-RAY 

8707 CONTRAST LARYNGOGRAM 

8708 CERVICAL LYMPHANGIOGRAM 

8709 HEAD SOFT TISS X-RAY NEC 

871 OTHER HEAD/NECK X-RAY* 

8711 FULL-MOUTH X-RAY 

8712 DENTAL X-RAY NEC 

8713 TM CONTRAST ARTHROGRAM 

8714 CONTRAST X-RAY OF ORBIT 

8715 CONTRAST X-RAY OF SINUS 

8716 FACIAL BONE X-RAY NEC 

8717 SKULL X-RAY NEC 

872 X-RAY OF SPINE* 

8721 CONTRAST MYELOGRAM 

8722 CERVICAL SPINE X-RAY NEC 

8723 THORACIC SPINE X-RAY NEC 

8724 LUMBOSAC SPINE X-RAY NEC

8729 SPINAL X-RAY NEC 

873 THORAX SOFT TISSUE X-RAY* 

8731 ENDOTRACHEAL BRONCHOGRAM 

8732 CONTRAST BRONCHOGRAM NEC 

8733 MEDIASTINAL PNEUMOGRAM 

8734 INTRATHOR LYMPHANGIOGRAM 

8735 CONTR MAMMARY DUCTOGRAM 

8736 BREAST XEROGRAPHY 

8737 MAMMOGRAPHY NEC 

8738 CHEST WALL SINOGRAM 

8739 THORAX SFT TISS XRAY NEC 

874 OTHER X-RAY OF THORAX* 

8741 C.A.T. SCAN OF THORAX 

8742 THORACIC TOMOGRAPHY NEC 

8743 RIB/STERNUM/CLAVIC X-RAY 

8744 ROUTINE CHEST X-RAY 

8749 CHEST X-RAY NEC 

875 BILIARY TRACT X-RAY* 

8751 PERC HEPAT CHOLANGIOGRAM 

8752 INTRAVEN CHOLANGIOGRAM 

8753 INTRAOPER CHOLANGIOGRAM 

8754 CHOLANGIOGRAM NEC 

8759 BILIARY TRACT X-RAY NEC 

876 OTHER DIGESTIVE SYS XRAY* 

8761 BARIUM SWALLOW 

8762 UPPER GI SERIES 

8763 SMALL BOWEL SERIES 

8764 LOWER GI SERIES 

8765 INTESTINAL X-RAY NEC 

8766 CONTRAST PANCREATOGRAM 

8769 DIGESTIVE TRACT XRAY NEC 

877 X-RAY OF URINARY SYSTEM* 

8771 C.A.T. SCAN OF KIDNEY 

8772 NEPHROTOMOGRAM NEC 

8773 INTRAVENOUS PYELOGRAM 

8774 RETROGRADE PYELOGRAM 

8775 PERCUTANEOUS PYELOGRAM 

8776 RETROGR CYSTOURETHROGRAM 

8777 CYSTOGRAM NEC 

8778 ILEAL CONDUITOGRAM 

8779 URINARY SYSTEM X-RAY NEC 

878 FEMALE GENITAL X-RAY* 

8781 X-RAY OF GRAVID UTERUS 

8782 GAS HYSTEROSALPINGOGRAM 

8783 DYE HYSTEROSALPINGOGRAM 

8784 PERCUTANEOUS HYSTEROGRAM 

8785 TUBE & UTERUS X-RAY NEC 

8789 FEMALE GENITAL X-RAY NEC 

879 MALE GENITAL X-RAY* 

8791 CONTR SEMIN VESICULOGRAM 

8792 PROSTAT/SEM VES XRAY NEC 

8793 CONTRAST EPIDIDYMOGRAM 

8794 CONTRAST VASOGRAM 

8795 EPIDIDYMIS/VAS X-RAY NEC 

8799 MALE GENITAL X-RAY NEC 

88 OTHER DX RADIOLOGY* 

880 SOFT TISSUE X-RAY ABDOM*

8801 C.A.T. SCAN OF ABDOMEN 

8802 ABDOMINAL TOMOGRAPHY NEC 

8803 ABDOMINAL WALL SINOGRAM 

8804 ABDOMINAL LYMPHANGIOGRAM 

8809 ABDOMINAL WALL X-RAY NEC 

881 OTHER X-RAY OF ABDOMEN* 

8811 PELVIC DYE CONTRAST XRAY 

8812 PELVIC GAS CONTRAST XRAY 

8813 PERITON PNEUMOGRAM NEC 

8814 RETROPERITON FISTULOGRAM 

8815 RETROPERITON PNEUMOGRAM 

8816 RETROPERITONEAL XRAY NEC 

8819 ABDOMINAL X-RAY NEC 

882 SKEL XRAY-LIMBS & PELVIS* 

8821 SKL XRAY-SHOULDER/UP ARM 

8822 SKEL XRAY-ELBOW/FOREARM 

8823 SKEL XRAY-WRIST & HAND 

8824 SKEL XRAY-UPPER LIMB NOS 

8825 PELVIMETRY 

8826 SKEL XRAY-PELVIS/HIP NEC 

8827 SKEL XRAY-THIGH/KNEE/LEG 

8828 SKEL XRAY-ANKLE & FOOT 

8829 SKEL XRAY-LOWER LIMB NOS 

883 OTHER X-RAY* 

8831 SKELETAL SERIES X-RAY 

8832 CONTRAST ARTHROGRAM 

8833 OTHER SKELETAL X-RAY 

8834 UPPER LIMB LYMPHANGIOGRM 

8835 UP LIMB SFT TIS XRAY NEC 

8836 LOWER LIMB LYMPHANGIOGRM 

8837 LO LIMB SFT TIS XRAY NEC 

8838 OTHER C.A.T. SCAN 

8839 X-RAY NEC AND NOS 

884 CONTRAST ARTERIOGRAPHY* 

8840 CONTRAST ARTERIOGRAM NOS 

8841 CONTR CEREBR ARTERIOGRAM 

8842 CONTRAST AORTOGRAM 

8843 CONTR PULMON ARTERIOGRAM 

8844 CONTR THOR ARTERIOGR NEC 

8845 CONTRAST RENAL ARTERIOGR 

8846 CONTRAST PLACENTOGRAM 

8847 CONTR ABD ARTERIOGRM NEC 

8848 CONTRAST ARTERIOGRAM-LEG 

8849 CONTRAST ARTERIOGRAM NEC 

885 CONTRAST ANGIOCARDIOGRAM* 

8850 ANGIOCARDIOGRAPHY NOS 

8851 VENA CAV ANGIOCARDIOGRAM 

8852 RT HEART ANGIOCARDIOGRAM 

8853 LT HEART ANGIOCARDIOGRAM 

8854 RT & LT HEART ANGIOCARD 

8855 CORONAR ARTERIOGR-1 CATH 

8856 CORONAR ARTERIOGR-2 CATH 

8857 CORONARY ARTERIOGRAM NEC 

8858 NEGATVE-CONTR CARDIOGRAM 

886 PHLEBOGRAPHY* 

8860 CONTRAST PHLEBOGRAM NOS 

8861 CONTR PHLEBOGRAM-HD/NECK

8862 CONTR PHLEBOGRAM-PULMON 

8863 THORAC CONTR PHLEBOG NEC 

8864 PORTAL CONTR PHLEBOGRAM 

8865 ABD CONTR PHLEBOGRAM NEC 

8866 CONTRAST PHLEBOGRAM-LEG 

8867 CONTRAST PHLEBOGRAM NEC 

8868 IMPEDANCE PHLEBOGRAM 

887 DIAGNOSTIC ULTRASOUND* 

8871 DX ULTRASOUND-HEAD/NECK 

8872 DX ULTRASOUND-HEART 

8873 DX ULTRASOUND-THORAX NEC 

8874 DX ULTRASOUND-DIGESTIVE 

8875 DX ULTRASOUND-URINARY 

8876 DX ULTRASOUND-ABDOMEN 

8877 DX ULTRASOUND-VASCULAR 

8878 DX ULTRASOUND-GRAV UTER 

8879 DX ULTRASOUND NEC 

888 THERMOGRAPHY* 

8881 CEREBRAL THERMOGRAPHY 

8882 OCULAR THERMOGRAPHY 

8883 BONE THERMOGRAPHY 

8884 MUSCLE THERMOGRAPHY 

8885 BREAST THERMOGRAPHY 

8886 BLOOD VESSEL THERMOGRAPH 

8889 THERMOGRAPHY NEC 

8890 DIAGNOSTIC IMAGING NOS 

8891 MRI OF BRAIN & BRAINSTEM 

8892 MRI CHEST & HEART 

8893 MRI SPINAL CANAL 

8894 MRI MUSCULOSKELETAL 

8895 MRI PELVIS,PROSTATE,BLAD 

8897 MAGNETIC RES IMAGE UNSP 

8898 BONE MINERAL DENSITY 

89 INTERVIEW/CONSULT/EXAM* 

890 DX INTERVIEW/CONSUL/EXAM* 

8901 BRIEF INTERVIEW & EVALUA 

8902 LIMITED INTERVIEW/EVALUA 

8903 COMPREHEN INTERVIEW/EVAL 

8904 INTERVIEW & EVALUAT NEC 

8905 INTERVIEW & EVALUAT NOS 

8906 LIMITED CONSULTATION 

8907 COMPREHENSIVE CONSULTAT 

8908 CONSULTATION NEC 

8909 CONSULTATION NOS 

891 NERVOUS SYS-EXAMINATION* 

8910 INTRACAROT AMOBARB TEST 

8911 TONOMETRY 

8912 NASAL FUNCTION STUDY 

8913 NEUROLOGIC EXAMINATION 

8914 ELECTROENCEPHALOGRAM 

8915 NEUROLOGIC FUNC TEST NEC 

8916 SKULL TRANSILLUMINAT 

8917 POLYSOMNOGRAM 

8918 OTH SLEEP DIS FUNCT TEST 

8919 VIDEO/RADIO EEG MONITOR 

892 GU SYSTEM-EXAMINATION* 

8921 URINARY MANOMETRY

8922 CYSTOMETROGRAM 

8923 URETHRAL SPHINCTER EMG 

8924 UROFLOWMETRY 

8925 URETHRAL PRESSURE PROFIL 

8926 GYNECOLOGIC EXAMINATION 

8929 OTHER GU SYSTEM EXAMS 

893 OTHER EXAMINATIONS* 

8931 DENTAL EXAMINATION 

8932 ESOPHAGEAL MANOMETRY 

8933 DIGITAL ENTEROSTOMY EXAM 

8934 DIGITAL RECTAL EXAM 

8935 NASAL SINUS TRANSILLUMIN 

8936 MANUAL EXAM OF BREAST 

8937 VITAL CAPACITY DETERMIN 

8938 RESPIRATORY MEASURE NEC 

8939 NONOPERATIVE EXAMS NEC 

894 PACEMKR/CARD STRESS TEST* 

8941 TREADMILL STRESS TEST 

8942 MASTERS' 2-STEP TEST 

8943 BICYCLE ERGOMETER TEST 

8944 CARDIAC STRESS TEST NEC 

8945 PACEMAKER RATE CHECK 

8946 PACEMAKER WAVE FORM CHCK 

8947 PACEMAKER IMPEDANCE CHCK 

8948 PACEMAKER VOLT THRESHOLD 

895 OTHER CARDIAC FUNCT TEST* 

8950 AMBU CARDIAC MONITORING 

8951 RHYTHM ELECTROCARDIOGRAM 

8952 ELECTROCARDIOGRAM 

8953 VECTORCARDIOGRAM 

8954 ELECTROCARDIOGRAPH MONIT 

8955 PHONOCARDIOGRAM 

8956 CAROTID PULSE TRACING 

8957 APEXCARDIOGRAM 

8958 PLETHYSMOGRAM 

8959 NONOP CARDIAC/VASC EXAM 

896 CIRCULATORY MONITORING* 

8961 ARTERIAL PRESSURE MONIT 

8962 CVP MONITORING 

8963 PULMON ART PRESS MONITOR 

8964 PULMON ART WEDGE MONITOR 

8965 ARTERIAL BLD GAS MEASURE 

8966 MIX VENOUS BLD GAS MEAS 

8967 OXYGEN CONSUMPTION MONIT 

8968 OTH CARDIAC MON OUTPUT 

8969 CORONARY BLD FLOW MONIT 

897 GENERAL PHYSICAL EXAM 

898 AUTOPSY 

90 MICROSCOPIC EXAM--I* 

900 MICRO EXAM-NERVOUS SYST* 

9001 BACT SMEAR-NERVOUS SYST 

9002 CULTURE-NERVOUS SYST 

9003 C & S-NERVOUS SYST 

9004 PARASITOLOGY-NERV SYST 

9005 TOXICOLOGY-NERVOUS SYST 

9006 CELL BLK/PAP-NERVOUS SYS 

9009 MICRO EXAM-NERVOUS NEC

901 MICRO EXAM-ENDOCRINE* 

9011 BACT SMEAR-ENDOCRINE 

9012 CULTURE-ENDOCRINE 

9013 C & S-ENDOCRINE 

9014 PARASITOLOGY-ENDOCRINE 

9015 TOXICOLOGY-ENDOCRINE 

9016 CELL BLOCK/PAP-ENDOCRINE 

9019 MICRO EXAM-ENDOCRINE NEC 

902 MICRO EXAM-EYE* 

9021 BACT SMEAR-EYE 

9022 CULTURE-EYE 

9023 C & S-EYE 

9024 PARASITOLOGY-EYE 

9025 TOXICOLOGY-EYE 

9026 CELL BLOCK/PAP-EYE 

9029 MICRO EXAM-EYE NEC 

903 MICRO EXAM-ENT/LARYNX* 

9031 BACT SMEAR-ENT/LARYNX 

9032 CULTURE-ENT/LARYNX 

9033 C & S-ENT/LARYNX 

9034 PARASITOLOGY-ENT/LARYNX 

9035 TOXICOLOGY-ENT/LARYNX 

9036 CELL BLOCK/PAP-ENT/LARYN 

9039 MICRO EXAM-ENT/LARYN NEC 

904 MICRO EXAM-LOWER RESP* 

9041 BACT SMEAR-LOWER RESP 

9042 CULTURE-LOWER RESP 

9043 C & S-LOWER RESP 

9044 PARASITOLOGY-LOWER RESP 

9045 TOXICOLOGY-LOWER RESP 

9046 CELL BLOCK/PAP-LOWR RESP 

9049 MICRO EXAM-LOWR RESP NEC 

905 MICRO EXAM-BLOOD* 

9051 BACT SMEAR-BLOOD 

9052 CULTURE-BLOOD 

9053 C & S-BLOOD 

9054 PARASITOLOGY-BLOOD 

9055 TOXICOLOGY-BLOOD 

9056 CELL BLOCK/PAP-BLOOD 

9059 MICRO EXAM-BLOOD NEC 

906 MICRO EXAM-SPLEEN/MARROW* 

9061 BACT SMEAR-SPLEEN/MARROW 

9062 CULTURE-SPLEEN/MARROW 

9063 C & S-SPLEEN/MARROW 

9064 PARASITOL-SPLEEN/MARROW 

9065 TOXICOLOGY-SPLEEN/MARROW 

9066 CELL BLK/PAP-SPLEEN/MARR 

9069 MICRO EXAM-SPLN/MARR NEC 

907 MICRO EXAM-LYMPH SYSTEM* 

9071 BACT SMEAR-LYMPH SYSTEM 

9072 CULTURE-LYMPH SYSTEM 

9073 C & S-LYMPH SYSTEM 

9074 PARASITOLOGY-LYMPH SYS 

9075 TOXICOLOGY-LYMPH SYSTEM 

9076 CELL BLK/PAP-LYMPH SYS 

9079 MICRO EXAM-LYMPH SYS NEC 

908 MICRO EXAM-UPPER GI*

9081 BACT SMEAR-UPPER GI 

9082 CULTURE-UPPER GI 

9083 C & S-UPPER GI 

9084 PARASITOLOGY-UPPER GI 

9085 TOXICOLOGY-UPPER GI 

9086 CELL BLK/PAP-UPPER GI 

9089 MICRO EXAM-UPPER GI NEC 

909 MICRO EXAM-LOWER GI* 

9091 BACT SMEAR-LOWER GI 

9092 CULTURE-LOWER GI 

9093 C & S-LOWER GI 

9094 PARASITOLOGY-LOWER GI 

9095 TOXICOLOGY-LOWER GI 

9096 CELL BLK/PAP-LOWER GI 

9099 MICRO EXAM-LOWER GI NEC 

91 MICROSCOPIC EXAM--II* 

910 MICRO EXAM-BILI/PANCREAS* 

9101 BACT SMEAR-BILI/PANCREAS 

9102 CULTURE-BILI/PANCREAS 

9103 C & S-BILI/PANCREAS 

9104 PARASITOLOGY-BILI/PANCR 

9105 TOXICOLOGY-BILI/PANCREAS 

9106 CELL BLK/PAP-BILI/PANCRE 

9109 MICRO EXAM-BILI/PANC NEC 

911 MICRO EXAM-PERITONEUM* 

9111 BACT SMEAR-PERITONEUM 

9112 CULTURE-PERITONEUM 

9113 C & S-PERITONEUM 

9114 PARASITOLOGY-PERITONEUM 

9115 TOXICOLOGY-PERITONEUM 

9116 CELL BLK/PAP-PERITONEUM 

9119 MICRO EXAM-PERITON NEC 

912 MICRO EXAM-UPPER URINARY* 

9121 BACT SMEAR-UPPER URINARY 

9122 CULTURE-UPPER URINARY 

9123 C & S-UPPER URINARY 

9124 PARASITOLOGY-UPPER URIN 

9125 TOXICOLOGY-UPPER URINARY 

9126 CELL BLK/PAP-UPPER URIN 

9129 MICRO EXAM-UPPR URIN NEC 

913 MICRO EXAM-LOWER URINARY* 

9131 BACT SMEAR-LOWER URINARY 

9132 CULTURE-LOWER URINARY 

9133 C & S-LOWER URINARY 

9134 PARASITLOLGY-LOWER URIN 

9135 TOXICOLOGY-LOWER URINARY 

9136 CELL BLK/PAP-LOWER URIN 

9139 MICRO EXAM-LOW URIN NEC 

914 MICRO EXAM-FEMALE GENIT* 

9141 BACT SMEAR-FEMALE GENIT 

9142 CULTURE-FEMALE GENITAL 

9143 C & S-FEMALE GENITAL 

9144 PARASITOLOGY-FEMALE GEN 

9145 TOXICOLOGY-FEMALE GENIT 

9146 CELL BLK/PAP-FEMALE GEN 

9149 MICRO EXAM-FEMAL GEN NEC 

915 MICRO EXAM-MUSCULOSKEL*

9151 BACT SMEAR-MUSCULOSKEL 

9152 CULTURE-MUSCULOSKELETAL 

9153 C & S-MUSCULOSKELETAL 

9154 PARASITOLOGY-MUSCULOSKEL 

9155 TOXICOLOGY-MUSCULOSKEL 

9156 CELL BLK/PAP-MUSCULOSKEL 

9159 MICRO EXAM-MUSCULOSK NEC 

916 MICRO EXAM-INTEGUMENT* 

9161 BACT SMEAR-INTEGUMENT 

9162 CULTURE-INTEGUMENT 

9163 C & S-INTEGUMENT 

9164 PARASITOLOGY-INTEGUMENT 

9165 TOXICOLOGY-INTEGUMENT 

9166 CELL BLK/PAP-INTEGUMENT 

9169 MICRO EXAM-INTEGUMEN NEC 

917 MICRO EXAM-OP WOUND* 

9171 BACT SMEAR-OP WOUND 

9172 CULTURE-OP WOUND 

9173 C & S-OP WOUND 

9174 PARASITOLOGY-OP WOUND 

9175 TOXICOLOGY-OP WOUND 

9176 CELL BLK/PAP-OP WOUND 

9179 MICRO EXAM-OP WOUND NEC 

918 MICRO EXAM NEC* 

9181 BACT SMEAR NEC 

9182 CULTURE NEC 

9183 C & S NEC 

9184 PARASITOLOGY NEC 

9185 TOXICOLOGY NEC 

9186 CELL BLK/PAP NEC 

9189 MICRO EXAM NEC 

919 MICRO EXAM NOS* 

9191 BACT SMEAR NOS 

9192 CULTURE NOS 

9193 C & S NOS 

9194 PARASITOLOGY NOS 

9195 TOXICOLOGY NOS 

9196 CELL BLK/PAP NOS 

9199 MICRO EXAM NOS 

92 NUCLEAR MEDICINE* 

920 ISOTOPE SCAN & FUNCTION* 

9201 THYROID SCAN/ISOTOP FUNC 

9202 LIVER SCAN/ISOTOPE FUNCT 

9203 RENAL SCAN/ISOTOPE FUNCT 

9204 GI SCAN & ISOTOPE FUNCT 

9205 C-VASC SCAN/ISOTOP FUNCT 

9209 OTHER ISOTOPE FUNCTION 

921 OTHER RADIOISOTOPE SCAN* 

9211 CEREBRAL SCAN 

9212 HEAD SCAN NEC 

9213 PARATHYROID SCAN 

9214 BONE SCAN 

9215 PULMONARY SCAN 

9216 LYMPHATIC SYSTEM SCAN 

9217 PLACENTAL SCAN 

9218 TOTAL BODY SCAN 

9219 SCAN OF OTHER SITES

922 THERAP RADIOL & NUCL MED* 

9221 SUPERFICIAL RADIATION 

9222 ORTHOVOLTAGE RADIATION 

9223 RADIOISOT TELERADIOTHER 

9224 TELERADIO USING PHOTONS 

9225 ELECTRON TELERADIOTHERAP 

9226 PARTICUL TELERADIOTH NEC 

9227 RADIOACTIVE ELEM IMPLANT 

9228 ISOTOPE INJECT/INSTILL 

9229 RADIOTHERAPEUT PROC NEC 

923 STEREOTACT RADIOSURGERY* 

9230 STEREO RADIOSURGERY NOS 

9231 SING SOURCE RADIOSURGERY 

9232 MULTISOURCE RADIOSURGERY 

9233 PARTICULATE RADIOSURGERY 

9239 STEREO RADIOSURGERY NEC 

93 PT, REHAB & RELATED PROC* 

930 DIAGNOSTIC PHYSICAL THER* 

9301 FUNCTIONAL PT EVALUATION 

9302 ORTHOTIC EVALUATION 

9303 PROSTHETIC EVALUATION 

9304 MANUAL MUSCLE FUNCT TEST 

9305 RANGE OF MOTION TESTING 

9306 LIMB LENGTH MEASUREMENT 

9307 BODY MEASUREMENT 

9308 ELECTROMYOGRAPHY 

9309 OTHER DX PT PROCEDURE 

931 PHYS THERAPY EXERCISES* 

9311 ASSISTING EXERCISE 

9312 ACTIV MUSCULOSK EXER NEC 

9313 RESISTIVE EXERCISE 

9314 JOINT MOVEMENT TRAINING 

9315 MOBILIZATION OF SPINE 

9316 OTHER JOINT MOBILIZATION 

9317 PASS MUSCULOSK EXER NEC 

9318 PT BREATHING EXERCISE 

9319 PT EXERCISE NEC 

932 OTH PT MUSCULOSKEL MANIP* 

9321 MANUAL & MECHAN TRACTION 

9322 AMBULAT & GAIT TRAINING 

9323 ORTHOTIC DEVICE FITTING 

9324 PROSTHET/ORTHOT TRAINING 

9325 FORCED LIMB EXTENSION 

9326 MANUAL RUPT JOINT ADHES 

9327 MUSC OR TEND STRETCHING 

9328 STRETCHING OF FASCIA 

9329 FORCIB CORRECT DEFOR NEC 

933 OTHER PT THERAPEUT PROCS* 

9331 ASSISTED POOL EXERCISE 

9332 WHIRLPOOL TREATMENT 

9333 OTHER HYDROTHERAPY 

9334 DIATHERMY 

9335 OTHER HEAT THERAPY 

9336 CARDIAC RETRAINING 

9337 PRENATAL TRAINING 

9338 COMBINED PT NOS 

9339 PHYSICAL THERAPY NEC

934 SKELETAL & OTH TRACTION* 

9341 SPINE TRACT W SKULL DEV 

9342 OTHER SPINAL TRACTION 

9343 INTERMITT SKEL TRACTION 

9344 OTHER SKELETAL TRACTION 

9345 THOMAS' SPLINT TRACTION 

9346 LIMB SKIN TRACTION NEC 

935 OTH IMMOBILIZ/WOUND ATTN* 

9351 PLASTER JACKET APPLICAT 

9352 NECK SUPPORT APPLICATION 

9353 OTHER CAST APPLICATION 

9354 APPLICATION OF SPLINT 

9355 DENTAL WIRING 

9356 PRESSURE DRESSING APPLIC 

9357 DRESSING OF WOUND NEC 

9358 PRESSURE TROUSER APPLICA 

9359 IMMOBILIZ/WOUND ATTN NEC 

936 OSTEOPATHIC MANIPULATION* 

9361 OMT FOR GEN'L MOBILIZAT 

9362 OMT WITH HI-VEL,LO-AMPLI 

9363 OMT WITH LO-VEL,HI-AMPLI 

9364 OMT WITH ISOTON,ISOMETRI 

9365 OMT WITH INDIRECT FORCES 

9366 OMT TO MOVE TISSUE FLUID 

9367 OSTEOPATH MANIPULAT NEC 

937 SPEECH/READ/BLIND REHAB* 

9371 DYSLEXIA TRAINING 

9372 DYSPHASIA TRAINING 

9373 ESOPHAG SPEECH TRAINING 

9374 SPEECH DEFECT TRAINING 

9375 OTHER SPEECH THERAPY 

9376 TRAINING IN LEAD DOG USE 

9377 BRAILLE OR MOON TRAINING 

9378 REHAB FOR THE BLIND NEC 

938 OTHER REHAB THERAPY* 

9381 RECREATIONAL THERAPY 

9382 EDUCATIONAL THERAPY 

9383 OCCUPATIONAL THERAPY 

9384 MUSIC THERAPY 

9385 VOCATIONAL REHABILITAT 

9389 REHABILITATION NEC 

939 RESPIRATORY THERAPY* 

9390 CONT POS AIRWAY PRESSURE 

9391 IPPB 

9393 NONMECHAN RESUSCITATION 

9394 NEBULIZER THERAPY 

9395 HYPERBARIC OXYGENATION 

9396 OXYGEN ENRICHMENT NEC 

9397 DECOMPRESSION CHAMBER 

9398 ATMOS PRESS/COMPOS CONTR 

9399 OTHER RESP PROCEDURES 

94 PSYCHE RELATED PROCEDURE* 

940 PSYCHOLOG EVAL & TESTING* 

9401 INTELLIGENCE TEST ADMIN 

9402 PSYCHOLOGIC TEST ADMINIS 

9403 CHARACTER ANALYSIS 

9408 PSYCHOL EVAL & TEST NEC

9409 PSYCHOL MENTAL STAT NOS 

941 PSYCHIATRIC EVAL/CONSULT* 

9411 PSYCHIAT MENTAL DETERMIN 

9412 ROUTINE PSYCHIAT VISIT 

9413 PSYCHIA COMMITMENT EVAL 

9419 PSYCHIA INTERV/EVAL NEC 

942 PSYCHIATRIC SOMATOTHERAP* 

9421 NARCOANALYSIS 

9422 LITHIUM THERAPY 

9423 NEUROLEPTIC THERAPY 

9424 CHEMICAL SHOCK THERAPY 

9425 PSYCHIAT DRUG THERAP NEC 

9426 SUBCONVULSIVE EST 

9427 ELECTROSHOCK THERAPY NEC 

9429 PSYCHIATR SOMATOTHER NEC 

943 INDIVIDUAL PSYCHOTHERAPY* 

9431 PSYCHOANALYSIS 

9432 HYPNOTHERAPY 

9433 BEHAVIOR THERAPY 

9434 IND THERAP PSYCHSEX DYSF 

9435 CRISIS INTERVENTION 

9436 PLAY PSYCHOTHERAPY 

9437 EXPLOR VERBAL PSYCHOTHER 

9438 SUPPOR VERBAL PSYCHOTHER 

9439 INDIVID PSYCHOTHERAP NEC 

944 OTH PSYCHOTH/COUNSELLING* 

9441 GRP THERAP PSYCHSEX DYSF 

9442 FAMILY THERAPY 

9443 PSYCHODRAMA 

9444 OTHER GROUP THERAPY 

9445 DRUG ADDICT COUNSELLING 

9446 ALCOHOLISM COUNSELLING 

9449 OTHER COUNSELLING 

945 PSYCHOLOGIC REHAB REFERR* 

9451 REFERRAL FOR PSYCHOTHER 

9452 REFERRAL PSYCH AFTERCARE 

9453 REFERRAL ALCOHOL REHAB 

9454 REFERRAL FOR DRUG REHAB 

9455 REFERRAL VOCATION REHAB 

9459 REFERRAL PSYCH REHAB NEC 

9461 ALCOHOL REHABILITATION 

9462 ALCOHOL DETOXIFICATION 

9463 ALCOHOL REHAB/DETOX 

9464 DRUG REHABILITATION 

9465 DRUG DETOXIFICATION 

9466 DRUG REHAB/DETOX 

9467 COMB ALCOHOL/DRUG REHAB 

9468 COMB ALCOHOL/DRUG DETOX 

9469 COMB ALCO/DRUG REHA/DETO 

95 EYE & EAR DX/TREATMENT* 

950 GEN'L & SUBJECT EYE EXAM* 

9501 LIMITED EYE EXAMINATION 

9502 COMPREHENSIVE EYE EXAM 

9503 EXTENDED OPHTHAL WORK-UP 

9504 ANESTHETIZED EYE EXAM 

9505 VISUAL FIELD STUDY 

9506 COLOR VISION STUDY

9507 DARK ADAPTATION STUDY 

9509 EYE EXAMINATION NOS 

951 FORM & STRUCTUR EYE EXAM* 

9511 FUNDUS PHOTOGRAPHY 

9512 EYE FLUORESCEIN ANGIOGRA 

9513 ULTRASOUND STUDY OF EYE 

9514 X-RAY STUDY OF EYE 

9515 OCULAR MOTILITY STUDY 

9516 P32 & EYE TRACER NEC 

952 OBJECTV FUNCT EYE TESTS* 

9521 ELECTRORETINOGRAM 

9522 ELECTRO-OCULOGRAM 

9523 VISUAL EVOKED POTENTIAL 

9524 ELECTRONYSTAGMOGRAM 

9525 ELECTROMYOGRAM OF EYE 

9526 GLAUCOMA TESTING 

953 SPECIAL VISION SERVICES* 

9531 SPECTACLE FIT & DISPENSE 

9532 PERSCR/FIT/DISP CONTACTS 

9533 OTH LO VISION AID DISPEN 

9534 OCULAR PROSTHETICS 

9535 ORTHOPTIC TRAINING 

9536 OPHTH COUNSEL & INSTRUCT 

954 NON-OP HEARING PROCEDURE* 

9541 AUDIOMETRY 

9542 CLINICAL HEARING TEST 

9543 AUDIOLOGICAL EVALUATION 

9544 CLIN VESTIBUL FUNCT TEST 

9545 ROTATION TESTS 

9546 AUDIT & VESTIB TEST NEC 

9547 HEARING EXAMINATION NOS 

9548 FITTING OF HEARING AID 

9549 NON-OP HEARING PROC NEC 

96 NON-OP INTUBAT & IRRIGAT* 

960 NON-OP GI & RESP INTUBAT* 

9601 INSERT NASOPHARYN AIRWAY 

9602 INSERT OROPHARYN AIRWAY 

9603 INSERT ESOPH OBTU AIRWAY 

9604 INSERT ENDOTRACHEAL TUBE 

9605 RESP TRACT INTUBAT NEC 

9606 INSERT SENGSTAKEN TUBE 

9607 INSERT GASTRIC TUBE NEC 

9608 INSERT INTESTINAL TUBE 

9609 INSERT RECTAL TUBE 

961 OTHER NON-OP INSERTION* 

9611 PACK EXT AUDITORY CANAL 

9614 VAGINAL PACKING 

9615 VAGINAL MOLD INSERTION 

9616 OTHER VAGINAL DILATION 

9617 VAG DIAPHRAGM INSERTION 

9618 OTH VAGIN PESSARY INSERT 

9619 RECTAL PACKING 

962 NON-OP DILATION & MANIP* 

9621 DILAT FRONTONASAL DUCT 

9622 DILATION OF RECTUM 

9623 DILATION ANAL SPHINCTER 

9624 DILAT ENTEROSTOMY STOMA

9625 THERAPEUT DISTENT BLADD 

9626 MANUAL REDUC RECT PROLAP 

9627 MANUAL REDUCTION HERNIA 

9628 MANL REDUCT STOMA PROLAP 

9629 REDUCT INTUSS ALI TRACT 

963 NON-OP GI IRRIG & INSTIL* 

9631 GASTRIC COOLING 

9632 GASTRIC FREEZING 

9633 GASTRIC LAVAGE 

9634 GASTRIC TUBE IRRIGAT NEC 

9635 GASTRIC GAVAGE 

9636 GI OSTOMY IRRIGATION 

9637 PROCTOCLYSIS 

9638 IMPACTED FECES REMOVAL 

9639 OTHER TRANSANAL ENEMA 

964 DIGEST & GU IRRIG/INSTIL* 

9641 BILIARY TUBE IRRIGATION 

9642 PANCREATIC TUBE IRRIGAT 

9643 GI TRACT INSTILLAT NEC 

9644 VAGINAL DOUCHE 

9645 NEPHROST/PYELOST IRRIGAT 

9646 URTEROST/URETE CTH IRRIG 

9647 CYSTOSTOMY IRRIGATION 

9648 INDWELL CATH IRRIG NEC 

9649 OTHER GU INSTILLATION 

965 OTHER NON-OP IRRIGATION* 

9651 IRRIGATION OF EYE 

9652 IRRIGATION OF EAR 

9653 IRRIGATION OF NASAL PASS 

9654 DENTAL SCALING & DEBRIDE 

9655 TRACHEOSTOMY TOILETTE 

9656 BRONCH/TRACH LAVAGE NEC 

9657 VASCULAR CATH IRRIGATION 

9658 WOUND CATHETER IRRIGAT 

9659 WOUND IRRIGATION NEC 

966 ENTRAL INFUS NUTRIT SUB 

967 CONT MECH VENT* 

9670 CONT MECH VENT-UNSPC DUR 

9671 CONT MECH VENT < 96 HRS 

9672 CONT MECH VENT 96+ HRS 

97 REPLACE & REMOV DEVICES* 

970 GI APPLIANCE REPLACEMENT* 

9701 REPLACE GAST/ESOPH TUBE 

9702 REPLACE GASTROSTOMY TUBE 

9703 REPLACE SMALL BOWEL TUBE 

9704 REPLACE LARGE BOWEL TUBE 

9705 REPL STENT IN BILE DUCT 

971 REPLAC MUSCSKEL APPLIANC* 

9711 REPLACE UPPER LIMB CAST 

9712 REPLACE LOWER LIMB CAST 

9713 REPLACE CAST NEC 

9714 REPLAC M/S IMMOB DEV NEC 

9715 REPLACE WOUND CATHETER 

9716 REPLACE WOUND PACK/DRAIN 

972 OTHER NON-OP REPLACEMENT* 

9721 REPLACE NASAL PACKING 

9722 REPLACE DENTAL PACKING

9723 REPLACE TRACH TUBE 

9724 REPLACE VAG DIAPHRAGM 

9725 REPLACE VAGINAL PESSARY 

9726 REPLACE VAG/VULV PACKING 

9729 NON-OP REPLACEMENT NEC 

973 REMOV THERAP DEVICE-HEAD* 

9731 REMOVE EYE PROSTHESIS 

9732 REMOVE NASAL PACKING 

9733 REMOVE DENTAL WIRING 

9734 REMOVE DENTAL PACKING 

9735 REMOVE DENTAL PROSTHESIS 

9736 REMOVE EXT MAND FIX DEV 

9737 REMOVE TRACHEOSTOMY TUBE 

9738 REMOVE HEAD/NECK SUTURES 

9739 REMOVE HEAD/NECK DEV NEC 

974 REMOV THOR THERAP DEVICE* 

9741 REMOV THORACOTOMY TUBE 

9742 REMOV MEDIASTINAL DRAIN 

9743 REMOV THORAX SUTURES 

9749 REMOV THOR THER DEV NEC 

975 REMOV GI THERAPEU DEVIC* 

9751 REMOV GASTROSTOMY TUBE 

9752 REMOV SMALL BOWEL TUBE 

9753 REMOV LARGE BOWEL TUBE 

9754 REMOV CHOLECYSTOST TUBE 

9755 REMOV BILIARY/LIVER TUBE 

9756 REMOV PANCREATIC TUBE 

9759 REMOV OTHER GI DEVICE 

976 REMOV URIN THERAP DEVIC* 

9761 REMOV PYELOS/NEPHROS TUB 

9762 REMOV URETERAL DRAIN 

9763 REMOV CYSTOSTOMY TUBE 

9764 REMOV URIN DRAINAGE NEC 

9765 REMOV URETHRAL STENT 

9769 REMOV OTHER URIN DEVICE 

977 REMOVAL GENIT THERAP DEV* 

9771 REMOVAL IUD 

9772 REMOV INTRAUTERINE PACK 

9773 REMOV VAGINAL DIAPHRAGM 

9774 REMOVAL OTH VAG PESSARY 

9775 REMOV VAG/VULV PACKING 

9779 REMOV OTHER GENIT DEVICE 

978 OTHER NON-OP REMOVAL-DEV* 

9781 REMOV RETROPERITON DRAIN 

9782 REMOV PERITONEAL DRAIN 

9783 REMOV ABDOM WALL SUTURE 

9784 REMOV TRUNK SUTURE NEC 

9785 REMOV TRUNK PACKING NEC 

9786 REMOV ABDOMEN DEVICE NEC 

9787 REMOV TRUNK DEVICE NEC 

9788 REMOV EXT IMMOBILIZATION 

9789 REMOV THERAPEUT DEV NEC 

98 NONOP REMOVE FOREIGN BOD* 

980 REMOV INTRALUM GI FB* 

9801 REMOV INTRALUM MOUTH FB 

9802 REMOV INTRALUM ESOPH FB 

9803 REMOV INTRALUM GASTR FB

9804 REMOV INTRALUM COLON FB 

9805 REMOV INTRALUM RECT FB 

981 REMOV INTRALUM FB NEC* 

9811 REMOV INTRALUM EAR FB 

9812 REMOV INTRALUM NOSE FB 

9813 REMOV INTRALUM PHARYN FB 

9814 REMOV INTRALUM LARYN FB 

9815 REMOV INTRALUM TRACH FB 

9816 REMOV INTRALUM UTER FB 

9817 REMOV INTRALUM VAG FB 

9818 REMOV INTRALUM STOMA FB 

9819 REMOVE INTRALUM URETH FB 

982 REMOVE OTHER FB-NO INCIS* 

9820 REMOVAL OF FB NOS 

9821 REMOVAL SUPERFIC FB EYE 

9822 REMOVAL HEAD/NECK FB 

9823 REMOVAL VULVAR FB 

9824 REMOVAL SCROTAL/PENIS FB 

9825 REMOVAL TRUNK FB NEC 

9826 REMOVAL FB FROM HAND 

9827 REMOVAL FB FROM ARM 

9828 REMOVAL FB FROM FOOT 

9829 REMOVAL FB FROM LEG 

9851 ESWL KID/URETER/BLADDER 

9852 ESWL GB/BILE DUCT 

9859 ESWL OTHER SITES 

99 OTHER NONOPERATIVE PROC* 

990 BLOOD TRANSFUSION* 

9900 PERIOP AUT TRANS HOL BLD 

9901 EXCHANGE TRANSFUSION 

9902 TRANSFUS PREV AUTO BLOOD 

9903 WHOLE BLOOD TRANSFUS NEC 

9904 PACKED CELL TRANSFUSION 

9905 PLATELET TRANSFUSION 

9906 COAG FACTOR TRANSFUSION 

9907 SERUM TRANSFUSION NEC 

9908 BLOOD EXPANDER TRANSFUS 

9909 TRANSFUSION NEC 

991 INJ/INFUS THERAP SUBSTAN* 

9910 INJECT/INF THROMBO AGENT 

9911 INJECT RH IMMUNE GLOBUL 

9912 ALLERGY IMMUNIZATION 

9913 AUTOIMMUNE DIS IMMUNIZAT 

9914 INJECT GAMMA GLOBULIN 

9915 PARENT INFUS NUTRIT SUB 

9916 INJECT ANTIDOTE 

9917 INJECT INSULIN 

9918 INJECT/INFUSE ELECTROLYT 

9919 INJECT ANTICOAGULANT 

992 OTH INJ/INF THERAP SUBST* 

9920 INJ/INF PLATELET INHIBIT 

9921 INJECT ANTIBIOTIC 

9922 INJECT ANTI-INFECT NEC 

9923 INJECT STEROID 

9924 INJECT HORMONE NEC 

9925 INJECT CA CHEMOTHER NEC 

9926 INJECT TRANQUILIZER

9927 IONTOPHORESIS 

9928 IMMUNOTHERAPY AS ANTINEO 

9929 INJECT/INFUSE NEC 

993 PROPHYLACT IMMUN-BACTER* 

9931 CHOLERA VACCINATION 

9932 TYPHOID/PARATYPHOID VACC 

9933 TUBERCULOSIS VACCINATION 

9934 PLAGUE VACCINATION 

9935 TULAREMIA VACCINATION 

9936 DIPHTHERIA TOXOID ADMIN 

9937 PERTUSSIS VACCINATION 

9938 TETANUS TOXOID ADMINIST 

9939 DPT ADMINISTRATION 

994 VIRAL IMMUNIZATION* 

9941 POLIO VACCINE ADMINISTRA 

9942 SMALLPOX VACCINATION 

9943 YELLOW FEVER VACCINATION 

9944 RABIES VACCINATION 

9945 MEASLES VACCINATION 

9946 MUMPS VACCINATION 

9947 RUBELLA VACCINATION 

9948 MMR ADMINISTRATION 

995 OTHER IMMUNIZATION* 

9951 COMMON COLD VACCINATION 

9952 INFLUENZA VACCINATION 

9953 ARBOVIRUS ENCEPH VACCIN 

9954 ARBOVIRUS VACCINAT NEC 

9955 VACCINATION NEC 

9956 TETANUS ANTITOXIN ADMINI 

9957 BOTULISM ANTITOXIN ADMIN 

9958 ANTITOXIN ADMINISTRA NEC 

9959 VACCINATION/INNOCULA NEC 

996 CARDIAC RHYTH CONVERSION* 

9960 CARDIOPULM RESUSCITA NOS 

9961 ATRIAL CARDIOVERSION 

9962 HEART COUNTERSHOCK NEC 

9963 CLOSED CHEST CARD MASSAG 

9964 CAROTID SINUS STIUMLAT 

9969 CARDIAC RHYTHM CONV NEC 

997 THERAPEUTIC APHERESIS* 

9971 THERAPEU PLASMAPHERESIS 

9972 THERAPEUTC LEUKOPHERESIS 

9973 THERAPEU ERYTHROPHERESIS 

9974 THERAPEU PLATELTPHERESIS 

9979 OTHER THERAPEU APHERESIS 

998 MISC PHYSICAL PROCEDURES* 

9981 HYPOTHERMIA 

9982 ULTRAVIOLET LIGHT THERAP 

9983 OTHER PHOTOTHERAPY 

9984 ISOLATION 

9985 HYPERTHERMIA CA THERAPY 

9986 NON-INVASIVE BONE STIMUL 

9988 THERAPEUTC PHOTOPHERESIS 

999 OTHER MISC PROCEDURES* 

9991 ANESTHESIA ACUPUNCTURE 

9992 OTHER ACUPUNCTURE 

9993 RECTAL MASSAGE

9994 PROSTATIC MASSAGE 

9995 STRETCHING OF FORESKIN 

9996 SPERM COLLECTION 

9997 DENTURE FITTING 

9998 MILK EXTRACTION 

9999 NON-OP PROCEDURE NEC

Appendix R Diagnostic Related Group (DRG) Number Table (v18) 


mcostorg Cost report organ acquisition charges 

mdrg Diagnosis related group (DRG) code 


mcostorg Cost report organ acquisition charges 

mdrg01 Diagnosis related group (DRG) code 1 

001 MDC 01P CRANIOTOMY AGE >17 EXCEPT FOR TRAUMA 

002 MDC 01P CRANIOTOMY FOR TRAUMA AGE >17 

003 MDC 01P CRANIOTOMY AGE 0-17 

004 MDC 01P SPINAL PROCEDURES 

005 MDC 01P EXTRACRANIAL VASCULAR PROCEDURES 

006 MDC 01P CARPAL TUNNEL RELEASE 

007 MDC 01P PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC 

008 MDC 01P PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC 

009 MDC 01M SPINAL DISORDERS & INJURIES 

010 MDC 01M NERVOUS SYSTEM NEOPLASMS W CC 

011 MDC 01M NERVOUS SYSTEM NEOPLASMS W/O CC 

012 MDC 01M DEGENERATIVE NERVOUS SYSTEM DISORDERS 

013 MDC 01M MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA 

014 MDC 01M SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT TIA 

015 MDC 01M TRANSIENT ISCHEMIC ATTACK & PRECEREBRAL OCCLUSIONS 

016 MDC 01M NONSPECIFIC CEREBROVASCULAR DISORDERS W CC 

017 MDC 01M NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC 

018 MDC 01M CRANIAL & PERIPHERAL NERVE DISORDERS W CC 

019 MDC 01M CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC 

020 MDC 01M NERVOUS SYSTEM INFECTION EXCEPT VIRAL MENINGITIS 

021 MDC 01M VIRAL MENINGITIS 

022 MDC 01M HYPERTENSIVE ENCEPHALOPATHY 

023 MDC 01M NONTRAUMATIC STUPOR & COMA 

024 MDC 01M SEIZURE & HEADACHE AGE >17 W CC 

025 MDC 01M SEIZURE & HEADACHE AGE >17 W/O CC 

026 MDC 01M SEIZURE & HEADACHE AGE 0-17 

027 MDC 01M TRAUMATIC STUPOR & COMA, COMA >1 HR 

028 MDC 01M TRAUMATIC STUPOR & COMA, COMA 17 W CC 

029 MDC 01M TRAUMATIC STUPOR & COMA, COMA 17 W/O CC 

030 MDC 01M TRAUMATIC STUPOR & COMA, COMA 17 W CC 

032 MDC 01M CONCUSSION AGE >17 W/O CC 

033 MDC 01M CONCUSSION AGE 0-17 

034 MDC 01M OTHER DISORDERS OF NERVOUS SYSTEM W CC 

035 MDC 01M OTHER DISORDERS OF NERVOUS SYSTEM W/O CC 

036 MDC 02P RETINAL PROCEDURES 

037 MDC 02P ORBITAL PROCEDURES 

038 MDC 02P PRIMARY IRIS PROCEDURES 

039 MDC 02P LENS PROCEDURES WITH OR WITHOUT VITRECTOMY 

040 MDC 02P EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >17 

041 MDC 02P EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17 

042 MDC 02P INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS 

043 MDC 02M HYPHEMA 

044 MDC 02M ACUTE MAJOR EYE INFECTIONS 

045 MDC 02M NEUROLOGICAL EYE DISORDERS 

046 MDC 02M OTHER DISORDERS OF THE EYE AGE >17 W CC

047 MDC 02M OTHER DISORDERS OF THE EYE AGE >17 W/O CC 

048 MDC 02M OTHER DISORDERS OF THE EYE AGE 0-17 

049 MDC 03P MAJOR HEAD & NECK PROCEDURES 

050 MDC 03P SIALOADENECTOMY 

051 MDC 03P SALIVARY GLAND PROCEDURES EXCEPT SIALOADENECTOMY 

052 MDC 03P CLEFT LIP & PALATE REPAIR 

053 MDC 03P SINUS & MASTOID PROCEDURES AGE >17 

054 MDC 03P SINUS & MASTOID PROCEDURES AGE 0-17 

055 MDC 03P MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES 

056 MDC 03P RHINOPLASTY 

057 MDC 03P T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17 

058 MDC 03P T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17 

059 MDC 03P TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17 

060 MDC 03P TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17 

061 MDC 03P MYRINGOTOMY W TUBE INSERTION AGE >17 

062 MDC 03P MYRINGOTOMY W TUBE INSERTION AGE 0-17 

063 MDC 03P OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES 

064 MDC 03M EAR, NOSE, MOUTH & THROAT MALIGNANCY 

065 MDC 03M DYSEQUILIBRIUM 

066 MDC 03M EPISTAXIS 

067 MDC 03M EPIGLOTTITIS 

068 MDC 03M OTITIS MEDIA & URI AGE >17 W CC 

069 MDC 03M OTITIS MEDIA & URI AGE >17 W/O CC 

070 MDC 03M OTITIS MEDIA & URI AGE 0-17 

071 MDC 03M LARYNGOTRACHEITIS 

072 MDC 03M NASAL TRAUMA & DEFORMITY 

073 MDC 03M OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 

074 MDC 03M OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17 

075 MDC 04P MAJOR CHEST PROCEDURES 

076 MDC 04P OTHER RESP SYSTEM O.R. PROCEDURES W CC 

077 MDC 04P OTHER RESP SYSTEM O.R. PROCEDURES W/O CC 

078 MDC 04M PULMONARY EMBOLISM 

079 MDC 04M RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC 

080 MDC 04M RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC 

081 MDC 04M RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17 

082 MDC 04M RESPIRATORY NEOPLASMS 

083 MDC 04M MAJOR CHEST TRAUMA W CC 

084 MDC 04M MAJOR CHEST TRAUMA W/O CC 

085 MDC 04M PLEURAL EFFUSION W CC 

086 MDC 04M PLEURAL EFFUSION W/O CC 

087 MDC 04M PULMONARY EDEMA & RESPIRATORY FAILURE 

088 MDC 04M CHRONIC OBSTRUCTIVE PULMONARY DISEASE 

089 MDC 04M SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC 

090 MDC 04M SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC 

091 MDC 04M SIMPLE PNEUMONIA & PLEURISY AGE 0-17 

092 MDC 04M INTERSTITIAL LUNG DISEASE W CC 

093 MDC 04M INTERSTITIAL LUNG DISEASE W/O CC 

094 MDC 04M PNEUMOTHORAX W CC 

095 MDC 04M PNEUMOTHORAX W/O CC 

096 MDC 04M BRONCHITIS & ASTHMA AGE >17 W CC 

097 MDC 04M BRONCHITIS & ASTHMA AGE >17 W/O CC 

098 MDC 04M BRONCHITIS & ASTHMA AGE 0-17 

099 MDC 04M RESPIRATORY SIGNS & SYMPTOMS W CC 

100 MDC 04M RESPIRATORY SIGNS & SYMPTOMS W/O CC 

101 MDC 04M OTHER RESPIRATORY SYSTEM DIAGNOSES W CC 

102 MDC 04M OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC 

103 MDC 05P HEART TRANSPLANT

104 MDC 05P CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH 

105 MDC 05P CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH 

106 MDC 05P CORONARY BYPASS WITH PTCA 

107 MDC 05P CORONARY BYPASS W CARDIAC CATH 

108 MDC 05P OTHER CARDIOTHORACIC PROCEDURES 

109 MDC 05P CORONARY BYPASS W/O CARDIAC CATH 

110 MDC 05P MAJOR CARDIOVASCULAR PROCEDURES W CC 

111 MDC 05P MAJOR CARDIOVASCULAR PROCEDURES W/O CC 

112 MDC 05P PERCUTANEOUS CARDIOVASCULAR PROCEDURES 

113 MDC 05P AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE 

114 MDC 05P UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS 

115 MDC 05P PERM PACE IMPLNT W AMI,HRT FAIL OR SHOCK OR AICD LEAD OR GEN PROC 

116 MDC 05P OTH PERM CARDIAC PACEMAKER IMPLANT OR PTCA W CORONARY ART STENT 

117 MDC 05P CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT 

118 MDC 05P CARDIAC PACEMAKER DEVICE REPLACEMENT 

119 MDC 05P VEIN LIGATION & STRIPPING 

120 MDC 05P OTHER CIRCULATORY SYSTEM O.R. PROCEDURES 

121 MDC 05M CIRCULATORY DISORDERS W AMI & MAJOR COMP DISCH ALIVE 

122 MDC 05M CIRCULATORY DISORDERS W AMI W/O MAJOR COMP DISCH ALIVE 

123 MDC 05M CIRCULATORY DISORDERS W AMI, EXPIRED 

124 MDC 05M CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG 

125 MDC 05M CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG 

126 MDC 05M ACUTE & SUBACUTE ENDOCARDITIS 

127 MDC 05M HEART FAILURE & SHOCK 

128 MDC 05M DEEP VEIN THROMBOPHLEBITIS 

129 MDC 05M CARDIAC ARREST, UNEXPLAINED 

130 MDC 05M PERIPHERAL VASCULAR DISORDERS W CC 

131 MDC 05M PERIPHERAL VASCULAR DISORDERS W/O CC 

132 MDC 05M ATHEROSCLEROSIS W CC 

133 MDC 05M ATHEROSCLEROSIS W/O CC 

134 MDC 05M HYPERTENSION 

135 MDC 05M CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC 

136 MDC 05M CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W/O CC 

137 MDC 05M CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17 

138 MDC 05M CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC 

139 MDC 05M CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC 

140 MDC 05M ANGINA PECTORIS 

141 MDC 05M SYNCOPE & COLLAPSE W CC 

142 MDC 05M SYNCOPE & COLLAPSE W/O CC 

143 MDC 05M CHEST PAIN 

144 MDC 05M OTHER CIRCULATORY SYSTEM DIAGNOSES W CC 

145 MDC 05M OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC 

146 MDC 06P RECTAL RESECTION W CC 

147 MDC 06P RECTAL RESECTION W/O CC 

148 MDC 06P MAJOR SMALL & LARGE BOWEL PROCEDURES W CC 

149 MDC 06P MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC 

150 MDC 06P PERITONEAL ADHESIOLYSIS W CC 

151 MDC 06P PERITONEAL ADHESIOLYSIS W/O CC 

152 MDC 06P MINOR SMALL & LARGE BOWEL PROCEDURES W CC 

153 MDC 06P MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC 

154 MDC 06P STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W CC 

155 MDC 06P STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC 

156 MDC 06P STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17 

157 MDC 06P ANAL & STOMAL PROCEDURES W CC 

158 MDC 06P ANAL & STOMAL PROCEDURES W/O CC 

159 MDC 06P HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC 

160 MDC 06P HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC

161 MDC 06P INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W CC 

162 MDC 06P INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W/O CC 

163 MDC 06P HERNIA PROCEDURES AGE 0-17 

164 MDC 06P APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC 

165 MDC 06P APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC 

166 MDC 06P APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC 

167 MDC 06P APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC 

168 MDC 03P MOUTH PROCEDURES W CC 

169 MDC 03P MOUTH PROCEDURES W/O CC 

170 MDC 06P OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC 

171 MDC 06P OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC 

172 MDC 06M DIGESTIVE MALIGNANCY W CC 

173 MDC 06M DIGESTIVE MALIGNANCY W/O CC 

174 MDC 06M G.I. HEMORRHAGE W CC 

175 MDC 06M G.I. HEMORRHAGE W/O CC 

176 MDC 06M COMPLICATED PEPTIC ULCER 

177 MDC 06M UNCOMPLICATED PEPTIC ULCER W CC 

178 MDC 06M UNCOMPLICATED PEPTIC ULCER W/O CC 

179 MDC 06M INFLAMMATORY BOWEL DISEASE 

180 MDC 06M G.I. OBSTRUCTION W CC 

181 MDC 06M G.I. OBSTRUCTION W/O CC 

182 MDC 06M ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC 

183 MDC 06M ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC 

184 MDC 06M ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17 

185 MDC 03M DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17 

186 MDC 03M DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17 

187 MDC 03M DENTAL EXTRACTIONS & RESTORATIONS 

188 MDC 06M OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC 

189 MDC 06M OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC 

190 MDC 06M OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17 

191 MDC 07P PANCREAS, LIVER & SHUNT PROCEDURES W CC 

192 MDC 07P PANCREAS, LIVER & SHUNT PROCEDURES W/O CC 

193 MDC 07P BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC 

194 MDC 07P BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC 

195 MDC 07P CHOLECYSTECTOMY W C.D.E. W CC 

196 MDC 07P CHOLECYSTECTOMY W C.D.E. W/O CC 

197 MDC 07P CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC 

198 MDC 07P CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC 

199 MDC 07P HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR MALIGNANCY 

200 MDC 07P HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY 

201 MDC 07P OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES 

202 MDC 07M CIRRHOSIS & ALCOHOLIC HEPATITIS 

203 MDC 07M MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS 

204 MDC 07M DISORDERS OF PANCREAS EXCEPT MALIGNANCY 

205 MDC 07M DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC 

206 MDC 07M DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC 

207 MDC 07M DISORDERS OF THE BILIARY TRACT W CC 

208 MDC 07M DISORDERS OF THE BILIARY TRACT W/O CC 

209 MDC 08P MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF LOWER EXTREMITY 

210 MDC 08P HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC 

211 MDC 08P HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC 

212 MDC 08P HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17 

213 MDC 08P AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS 

214 MDC 08P NO LONGER VALID 


216 MDC 08P BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 

217 MDC 08P WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS

218 MDC 08P LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC 

219 MDC 08P LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC 

220 MDC 08P LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17 



223 MDC 08P MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC 

224 MDC 08P SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC 

225 MDC 08P FOOT PROCEDURES 

226 MDC 08P SOFT TISSUE PROCEDURES W CC 

227 MDC 08P SOFT TISSUE PROCEDURES W/O CC 

228 MDC 08P MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC 

229 MDC 08P HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O CC 

230 MDC 08P LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR 

231 MDC 08P LOCAL EXCISION & REMOVAL OF INT FIX DEVICES EXCEPT HIP & FEMUR 

232 MDC 08P ARTHROSCOPY 

233 MDC 08P OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC 

234 MDC 08P OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC 

235 MDC 08M FRACTURES OF FEMUR 

236 MDC 08M FRACTURES OF HIP & PELVIS 

237 MDC 08M SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH 

238 MDC 08M OSTEOMYELITIS 

239 MDC 08M PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY 

240 MDC 08M CONNECTIVE TISSUE DISORDERS W CC 

241 MDC 08M CONNECTIVE TISSUE DISORDERS W/O CC 

242 MDC 08M SEPTIC ARTHRITIS 

243 MDC 08M MEDICAL BACK PROBLEMS 

244 MDC 08M BONE DISEASES & SPECIFIC ARTHROPATHIES W CC 

245 MDC 08M BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC 

246 MDC 08M NON-SPECIFIC ARTHROPATHIES 

247 MDC 08M SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE 

248 MDC 08M TENDONITIS, MYOSITIS & BURSITIS 

249 MDC 08M AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 

250 MDC 08M FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W CC 

251 MDC 08M FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O CC 

252 MDC 08M FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE 0-17 

253 MDC 08M FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC 

254 MDC 08M FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC 

255 MDC 08M FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17 

256 MDC 08M OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES 

257 MDC 09P TOTAL MASTECTOMY FOR MALIGNANCY W CC 

258 MDC 09P TOTAL MASTECTOMY FOR MALIGNANCY W/O CC 

259 MDC 09P SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC 

260 MDC 09P SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC 

261 MDC 09P BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION 

262 MDC 09P BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY 

263 MDC 09P SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC 

264 MDC 09P SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC 

265 MDC 09P SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC 

266 MDC 09P SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC 

267 MDC 09P PERIANAL & PILONIDAL PROCEDURES 

268 MDC 09P SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES 

269 MDC 09P OTHER SKIN, SUBCUT TISS & BREAST PROC W CC 

270 MDC 09P OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC 

271 MDC 09M SKIN ULCERS 

272 MDC 09M MAJOR SKIN DISORDERS W CC 

273 MDC 09M MAJOR SKIN DISORDERS W/O CC 

274 MDC 09M MALIGNANT BREAST DISORDERS W CC

275 MDC 09M MALIGNANT BREAST DISORDERS W/O CC 

276 MDC 09M NON-MALIGANT BREAST DISORDERS 

277 MDC 09M CELLULITIS AGE >17 W CC 

278 MDC 09M CELLULITIS AGE >17 W/O CC 

279 MDC 09M CELLULITIS AGE 0-17 

280 MDC 09M TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC 

281 MDC 09M TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC 

282 MDC 09M TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE 0-17 

283 MDC 09M MINOR SKIN DISORDERS W CC 

284 MDC 09M MINOR SKIN DISORDERS W/O CC 

285 MDC 10P AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS 

286 MDC 10P ADRENAL & PITUITARY PROCEDURES 

287 MDC 10P SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS 

288 MDC 10P O.R. PROCEDURES FOR OBESITY 

289 MDC 10P PARATHYROID PROCEDURES 

290 MDC 10P THYROID PROCEDURES 

291 MDC 10P THYROGLOSSAL PROCEDURES 

292 MDC 10P OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC 

293 MDC 10P OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC 

294 MDC 10M DIABETES AGE >35 

295 MDC 10M DIABETES AGE 0-35 

296 MDC 10M NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC 

297 MDC 10M NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC 

298 MDC 10M NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17 

299 MDC 10M INBORN ERRORS OF METABOLISM 

300 MDC 10M ENDOCRINE DISORDERS W CC 

301 MDC 10M ENDOCRINE DISORDERS W/O CC 

302 MDC 11P KIDNEY TRANSPLANT 

303 MDC 11P KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM 

304 MDC 11P KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC 

305 MDC 11P KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC 

306 MDC 11P PROSTATECTOMY W CC 

307 MDC 11P PROSTATECTOMY W/O CC 

308 MDC 11P MINOR BLADDER PROCEDURES W CC 

309 MDC 11P MINOR BLADDER PROCEDURES W/O CC 

310 MDC 11P TRANSURETHRAL PROCEDURES W CC 

311 MDC 11P TRANSURETHRAL PROCEDURES W/O CC 

312 MDC 11P URETHRAL PROCEDURES, AGE >17 W CC 

313 MDC 11P URETHRAL PROCEDURES, AGE >17 W/O CC 

314 MDC 11P URETHRAL PROCEDURES, AGE 0-17 

315 MDC 11P OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES 

316 MDC 11M RENAL FAILURE 

317 MDC 11M ADMIT FOR RENAL DIALYSIS 

318 MDC 11M KIDNEY & URINARY TRACT NEOPLASMS W CC 

319 MDC 11M KIDNEY & URINARY TRACT NEOPLASMS W/O CC 

320 MDC 11M KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC 

321 MDC 11M KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC 

322 MDC 11M KIDNEY & URINARY TRACT INFECTIONS AGE 0-17 

323 MDC 11M URINARY STONES W CC, &/OR ESW LITHOTRIPSY 

324 MDC 11M URINARY STONES W/O CC 

325 MDC 11M KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC 

326 MDC 11M KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O CC 

327 MDC 11M KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE 0-17 

328 MDC 11M URETHRAL STRICTURE AGE >17 W CC 

329 MDC 11M URETHRAL STRICTURE AGE >17 W/O CC 

330 MDC 11M URETHRAL STRICTURE AGE 0-17 

331 MDC 11M OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC

332 MDC 11M OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC 

333 MDC 11M OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17 

334 MDC 12P MAJOR MALE PELVIC PROCEDURES W CC 

335 MDC 12P MAJOR MALE PELVIC PROCEDURES W/O CC 

336 MDC 12P TRANSURETHRAL PROSTATECTOMY W CC 

337 MDC 12P TRANSURETHRAL PROSTATECTOMY W/O CC 

338 MDC 12P TESTES PROCEDURES, FOR MALIGNANCY 

339 MDC 12P TESTES PROCEDURES, NON-MALIGNANCY AGE >17 

340 MDC 12P TESTES PROCEDURES, NON-MALIGNANCY AGE 0-17 

341 MDC 12P PENIS PROCEDURES 

342 MDC 12P CIRCUMCISION AGE >17 

343 MDC 12P CIRCUMCISION AGE 0-17 

344 MDC 12P OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY 

345 MDC 12P OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXCEPT FOR MALIGNANCY 

346 MDC 12M MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W CC 

347 MDC 12M MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W/O CC 

348 MDC 12M BENIGN PROSTATIC HYPERTROPHY W CC 

349 MDC 12M BENIGN PROSTATIC HYPERTROPHY W/O CC 

350 MDC 12M INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM 

351 MDC 12M STERILIZATION, MALE 

352 MDC 12M OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES 

353 MDC 13P PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY 

354 MDC 13P UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC 

355 MDC 13P UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC 

356 MDC 13P FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES 

357 MDC 13P UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY 

358 MDC 13P UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC 

359 MDC 13P UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC 

360 MDC 13P VAGINA, CERVIX & VULVA PROCEDURES 

361 MDC 13P LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION 

362 MDC 13P ENDOSCOPIC TUBAL INTERRUPTION 

363 MDC 13P D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY 

364 MDC 13P D&C, CONIZATION EXCEPT FOR MALIGNANCY 

365 MDC 13P OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES 

366 MDC 13M MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC 

367 MDC 13M MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC 

368 MDC 13M INFECTIONS, FEMALE REPRODUCTIVE SYSTEM 

369 MDC 13M MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS 

370 MDC 14P CESAREAN SECTION W CC 

371 MDC 14P CESAREAN SECTION W/O CC 

372 MDC 14M VAGINAL DELIVERY W COMPLICATING DIAGNOSES 

373 MDC 14M VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES 

374 MDC 14P VAGINAL DELIVERY W STERILIZATION &/OR D&C 

375 MDC 14P VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C 

376 MDC 14M POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE 

377 MDC 14P POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE 

378 MDC 14M ECTOPIC PREGNANCY 

379 MDC 14M THREATENED ABORTION 

380 MDC 14M ABORTION W/O D&C 

381 MDC 14P ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY 

382 MDC 14M FALSE LABOR 

383 MDC 14M OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS 

384 MDC 14M OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS 

385 MDC 15 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY 

386 MDC 15 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE 

387 MDC 15 PREMATURITY W MAJOR PROBLEMS 

388 MDC 15 PREMATURITY W/O MAJOR PROBLEMS

389 MDC 15 FULL TERM NEONATE W MAJOR PROBLEMS 

390 MDC 15 NEONATE W OTHER SIGNIFICANT PROBLEMS 

391 MDC 15 NORMAL NEWBORN 

392 MDC 16P SPLENECTOMY AGE >17 

393 MDC 16P SPLENECTOMY AGE 0-17 

394 MDC 16P OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS 

395 MDC 16M RED BLOOD CELL DISORDERS AGE >17 

396 MDC 16M RED BLOOD CELL DISORDERS AGE 0-17 

397 MDC 16M COAGULATION DISORDERS 

398 MDC 16M RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC 

399 MDC 16M RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC 

400 MDC 17P LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE 

401 MDC 17P LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC 

402 MDC 17P LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC 

403 MDC 17M LYMPHOMA & NON-ACUTE LEUKEMIA W CC 

404 MDC 17M LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC 

405 MDC 17 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17 

406 MDC 17P MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W CC 

407 MDC 17P MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W/O CC 

408 MDC 17P MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC 

409 MDC 17M RADIOTHERAPY 

410 MDC 17M CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS 

411 MDC 17M HISTORY OF MALIGNANCY W/O ENDOSCOPY 

412 MDC 17M HISTORY OF MALIGNANCY W ENDOSCOPY 

413 MDC 17M OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC 

414 MDC 17M OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC 

415 MDC 18P O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES 

416 MDC 18M SEPTICEMIA AGE >17 

417 MDC 18M SEPTICEMIA AGE 0-17 

418 MDC 18M POSTOPERATIVE & POST-TRAUMATIC INFECTIONS 

419 MDC 18M FEVER OF UNKNOWN ORIGIN AGE >17 W CC 

420 MDC 18M FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC 

421 MDC 18M VIRAL ILLNESS AGE >17 

422 MDC 18M VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17 

423 MDC 18M OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES 

424 MDC 19P O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS 

425 MDC 19M ACUTE ADJUST REACT & DISTURBANCES OF PSYCHOSOCIAL DYSFUNCTION 

426 MDC 19M DEPRESSIVE NEUROSES 

427 MDC 19M NEUROSES EXCEPT DEPRESSIVE 

428 MDC 19M DISORDERS OF PERSONALITY & IMPULSE CONTROL 

429 MDC 19M ORGANIC DISTURBANCES & MENTAL RETARDATION 

430 MDC 19M PSYCHOSES 

431 MDC 19M CHILDHOOD MENTAL DISORDERS 

432 MDC 19M OTHER MENTAL DISORDER DIAGNOSES 

433 MDC 20 ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA 

434 MDC 20 ALC/DRUG ABUSE OR DEPEND, DETOX OR OTH SYMPT TREAT W CC 

435 MDC 20 ALC/DRUG ABUSE OR DEPEND, DETOX OR OTH SYMPT TREAT W/O CC 

436 MDC 20 ALC/DRUG DEPENDENCE W REHABILITATION THERAPY 

437 MDC 20 ALC/DRUG DEPENDENCE, COMBINED REHAB & DETOX THERAPY 

438 MDC NO LONGER VALID 

439 MDC 21P SKIN GRAFTS FOR INJURIES 

440 MDC 21P WOUND DEBRIDEMENTS FOR INJURIES 

441 MDC 21P HAND PROCEDURES FOR INJURIES 

442 MDC 21P OTHER O.R. PROCEDURES FOR INJURIES W CC 

443 MDC 21P OTHER O.R. PROCEDURES FOR INJURIES W/O CC 

444 MDC 21M TRAUMATIC INJURY AGE >17 W CC 

445 MDC 21M TRAUMATIC INJURY AGE >17 W/O CC

446 MDC 21M TRAUMATIC INJURY AGE 0-17 

447 MDC 21M ALLERGIC REACTIONS AGE >17 

448 MDC 21M ALLERGIC REACTIONS AGE 0-17 

449 MDC 21M POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC 

450 MDC 21M POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC 

451 MDC 21M POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17 

452 MDC 21M COMPLICATIONS OF TREATMENT W CC 

453 MDC 21M COMPLICATIONS OF TREATMENT W/O CC 

454 MDC 21M OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC 

455 MDC 21M OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC 






461 MDC 23P O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES 

462 MDC 23M REHABILITATION 

463 MDC 23M SIGNS & SYMPTOMS W CC 

464 MDC 23M SIGNS & SYMPTOMS W/O CC 

465 MDC 23M AFTERCARE W HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS 

466 MDC 23M AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS 

467 MDC 23M OTHER FACTORS INFLUENCING HEALTH STATUS 

468 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 

469 PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS 

470 UNGROUPABLE 

471 MDC 08P BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY 


473 MDC 17 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17 


475 MDC 04M RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 

476 MDC P PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 

477 MDC P NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 

478 MDC 05P OTHER VASCULAR PROCEDURES W CC 

479 MDC 05P OTHER VASCULAR PROCEDURES W/O CC 

480 MDC P LIVER TRANSPLANT 

481 MDC P BONE MARROW TRANSPLANT 

482 MDC P TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES 

483 MDC P TRACHEOSTOMY EXCEPT FOR FACE,MOUTH & NECK DIAGNOSES 

484 MDC 24P CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA 

485 MDC 24P LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TR 

486 MDC 24P OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA 

487 MDC 24M OTHER MULTIPLE SIGNIFICANT TRAUMA 

488 MDC 25P HIV W EXTENSIVE O.R. PROCEDURE 

489 MDC 25M HIV W MAJOR RELATED CONDITION 

490 MDC 25M HIV W OR W/O OTHER RELATED CONDITION 

491 MDC 08P MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY 

492 MDC 17M CHEMOTHERAPY W ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS 

493 MDC 07P LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 

494 MDC 07P LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC 

495 MDC P LUNG TRANSPLANT 

496 MDC 08P COMBINED ANTERIOR/POSTERIOR SPINAL FUSION 

497 MDC 08P SPINAL FUSION W CC 

498 MDC 08P SPINAL FUSION W/O CC 

499 MDC 08P BACK & NECK PROCS EXCEPT SPINAL FUSION W CC 

500 MDC 08P BACK & NECK PROCS EXCEPT SPINAL FUSION W/O CC 

501 MDC 08P KNEE PROC W PDX OF INFECTION W CC 

502 MDC 08P KNEE PROC W PDX OF INFECTION W/O CC

503 MDC 08P KNEE PROCEDURES W/O PDX OF INFECTION 

504 MDC 22P EXTENSIVE 3RD DEGREE BURN W SKIN GRAFT 

505 MDC 22 EXTENSIVE 3RD DEGREE BURN W/O SKIN GRAFT 

506 MDC 22 FULL THICK BURN W SK GRAFT OR INHAL INJ W CC OR SIG TR 

507 MDC 22 FULL THICK BURN W SK GRAFT OR INHAL INJ W/O CC OR SIG TR 

508 MDC 22 FULL THICK BURN W/O SK GRAFT OR INHAL INJ W CC OR SIG TR 

509 MDC 22 FULL THICK BURN W/O SK GRAFT OR INHAL INJ W/O CC OR SIG TR 

510 MDC 22 NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA 

511 MDC 22 NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA

Appendix S Alpha-Numeric HCPCS Codes 


hcpcs01 HCFA Common Procedure Coding System code 1 

hcpcs Line HCFA Common Procedure Coding System code 

pc2md HCPCS second modifier code 

pc2md01 HCPCS second modifier code 1 

pc1md01 HCPCS initial modifier code 1 

pc1md HCPCS initial modifier code 


hcpcs01 HCFA Common Procedure Coding System code 1 

This list comprises the Level II HCPCS codes, with the exception of those beginning 

with the letter D. It is derived from file 01anweb.xls, the 2001 alpha-numeric 

HCPCS file, downloadable from http://hcfa.gov/stats/pufiles.htm#alphanu. 

These codes are revised annually. Discontinued codes are retained for four years. 

Since the data in Medicare Data Utilities are typically more than four years old, 

some records include codes not listed below. Such codes might be found in the 1999 

and 2000 HCPCS files, downloadable from the same location. 

Level II codes beginning D are copyrighted by the American Dental Association. They 

may be purchased as part of the alpha-numeric HCPCS file from the National Technical 

Information Service (703-487-4650) or the Government Printing Office (202-512-1800). 

Level I codes are copyrighted by the American Medical Association. They may be 

purchased from the AMA (800-621-8335). 

A0021 AMBULANCE SERVICE, OUTSIDE STATE PER MILE, TRANSPORT (MEDICAID ONLY) 

A0030 AMBULANCE SERVICE, CONVENTIONAL AIR SERVICE, TRANSPORT, ONE WAY 

A0040 AMBULANCE SERVICE, AIR, HELICOPTER SERVICE, TRANSPORT 

A0050 AMBULANCE SERVICE, EMERGENCY, WATER, SPECIAL TRANSPORTATION SERVICES 

A0080 NON-EMERGENCY TRANSPORTATION: PER MILE - VOLUNTEER, WITH NO VESTED OR PERSONAL 

INTEREST 

A0090 NON-EMERGENCY TRANSPORTATION: PER MILE - VOLUNTEER, INTERESTED INDIVIDUAL, 

NEIGHBOR 

A0100 NON-EMERGENCY TRANSPORTATION: TAXI - INTRA CITY 

A0110 NON-EMERGENCY TRANSPORTATION AND BUS, INTRA OR INTER STATE CARRIER 

A0120 NON-EMERGENCY TRANSPORTATION: MINI-BUS, MOUNTAIN AREA TRANSPORTS, OTHER 

NON-PROFIT TRANSPORTATION SYSTEMS 

A0130 NON-EMERGENCY TRANSPORTATION: WHEEL-CHAIR VAN 

A0140 NON-EMERGENCY TRANSPORTATION AND AIR TRAVEL (PRIVATE OR COMMERCIAL) INTRA OR 

INTER STATE 

A0160 NON-EMERGENCY TRANSPORTATION: PER MILE - CASE WORKER OR SOCIAL WORKER 

A0170 NON-EMERGENCY TRANSPORTATION: ANCILLARY: PARKING FEES, TOLLS, OTHER 

A0180 NON-EMERGENCY TRANSPORTATION: ANCILLARY: LODGING-RECIPIENT 

A0190 NON-EMERGENCY TRANSPORTATION: ANCILLARY: MEALS-RECIPIENT 

A0200 NON-EMERGENCY TRANSPORTATION: ANCILLARY: LODGING ESCORT 

A0210 NON-EMERGENCY TRANSPORTATION: ANCILLARY: MEALS-ESCORT 

A0225 AMBULANCE SERVICE, NEONATAL TRANSPORT, BASE RATE, EMERGENCY TRANSPORT, ONE WAY 

A0300 AMBULANCE SERVICE, BASIC LIFE SUPPORT (BLS), NON-EMERGENCY TRANSPORT, ALL 

INCLUSIVE (MILEAGE AND SUPPLIES) 

A0302 AMBULANCE SERVICE, BLS, EMERGENCY TRANSPORT, ALL INCLUSIVE (MILEAGE AND 

SUPPLIES) 

A0304 AMBULANCE SERVICE, ADVANCED LIFE SUPPORT (ALS), NON-EMERGENCY TRANSPORT, NO

SPECIALIZED ALS SERVICES RENDERED, ALL INCLUSIVE (MILEAGE AND SUPPLIES) 

A0306 AMBULANCE SERVICES, ALS, NON-EMERGENCY TRANSPORT, SPECIALIZED ALS SERVICES 

RENDERED, ALL INCLUSIVE (MILEAGE AND SUPPLIES) 

A0308 AMBULANCE SERVICE, ALS, EMERGENCY TRANSPORT, NO SPECIALIZED ALS SERVICES 

RENDERED, ALL INCLUSIVE (MILEAGE AND SUPPLIES) 

A0310 AMBULANCE SERVICE, ALS, EMERGENCY TRANSPORT, SPECIALIZED ALS SERVICES RENDERED, 

ALL INCLUSIVE (MILEAGE AND SUPPLIES) 

A0320 AMBUANCE SERVICE, BLS, NON-EMERGENCY TRANSPORT, SUPPLIES INCLUDED, MILEAGE 

SEPARATELY BILLED 

A0322 AMBULANCE SERVICE, BLS, EMERGENCY TRANSPORT, SUPPLIES INCLUDED, MILEAGE 


A0324 AMBULANCE SERVICE, ALS, NON-EMERGENCY TRANSPORT, NO SPECIALIZED ALS SERVICES 

RENDERED, SUPPLIES INCLUDED, MILEAGE SEPARATELY BILLED 

A0326 AMBULANCE SERVICE, ALS, NON-EMERGENCY TRANSPORT, SPECIALIZED ALS SERVICES 





SUPPLIES INCLUDED, MILEAGE SEPARATELY BILLED 

A0340 AMBULANCE SERVICE, BLS, NON-EMERGENCY TRANSPORT, MILEAGE INCLUDED, DISPOSABLE 

SUPPLIES SEPARATELY BILLED 

A0342 AMBULANCE SERVICE, BLS, EMERGENCY TRANSPORT, MILEAGE INCLUDED, DISPOSABLE 



RENDERED, MILEAGE INCLUDED, DISPOSABLE SUPPLIES SEPARATELY BILLED 






MILEAGE INCLUDED, DISPOSABLE SUPPLIES SEPARATELY BILLED 

A0360 AMBULANCE SERVICE, BLS, NON-EMERGENCY TRANSPORT, MILEAGE AND DISPOSABLE 


A0362 AMBULANCE SERVICE, BLS, EMERGENCY TRANSPORT, MILEAGE AND DISPOSABLE SUPPLIES 



RENDERED, MILEAGE AND DISPOSABLE SUPPLIES SEPARATELY BILLED 






MILEAGE AND DISPOSABLE SUPPLIES SEPARATELY BILLED 

A0380 BLS MILEAGE (PER MILE) 

A0382 BLS ROUTINE DISPOSABLE SUPPLIES 

A0384 BLS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; DEFIBRILLATION (USED BY ALS 

AMBULANCES AND BLS AMBULANCES IN JURISDICTIONS WHERE DEFIBRILLATION IS 

PERMITTED IN BLS AMBULANCES) 

A0390 ALS MILEAGE (PER MILE) 

A0392 ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; DEFIBRILLATION (TO BE USED ONLY IN 

JURISDICTIONS WHERE DEFIBRILLATION CANNOT BE PERFORMED IN BLS AMBULANCES) 

A0394 ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; IV DRUG THERAPY 

A0396 ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; ESOPHAGEAL INTUBATION 

A0398 ALS ROUTINE DISPOSABLE SUPPLIES 

A0420 AMBULANCE WAITING TIME (ALS OR BLS), ONE HALF (1/2) HOUR INCREMENTS 

A0422 AMBULANCE (ALS OR BLS) OXYGEN AND OXYGEN SUPPLIES, LIFE SUSTAINING SITUATION 

A0424 EXTRA AMBULANCE ATTENDANT, ALS OR BLS (REQUIRES MEDICAL REVIEW)

A0425 GROUND MILEAGE, PER STATUTE MILE 

A0426 AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NON-EMERGENCY TRANSPORT, LEVEL 1 (ALS 

1) 

A0427 AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 

(ALS1-EMERGENCY) 

A0428 AMBULANCE SERVICE, BASIC LIFE SUPPORT, NON-EMERGENCY TRANSPORT, (BLS) 

A0429 AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS-EMERGENCY) 

A0430 AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (FIXED WING) 

A0431 AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING) 

A0432 PARAMEDIC INTERCEPT (PI), RURAL AREA, TRANSPORT FURNISHED BY A VOLUNTEER 

AMBULANCE COMPANY WHICH IS PROHIBITED BY STATE LAW FROM BILLING THIRD PARTY 

PAYERS 

A0433 ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2) 

A0434 SPECIALTY CARE TRANSPORT (SCT) 

A0435 FIXED WING AIR MILEAGE, PER STATUTE MILE 

A0436 ROTARY WING AIR MILEAGE, PER STATUTE MILE 

A0888 NONCOVERED AMBULANCE MILEAGE, PER MILE (E.G., FOR MILES TRAVELED BEYOND CLOSEST 

APPROPRIATE FACILITY) 

A0999 UNLISTED AMBULANCE SERVICE 

A2000 MANIPULATION OF SPINE BY CHIROPRACTOR 

A4206 SYRINGE WITH NEEDLE, STERILE 1CC, EACH 



A4209 SYRINGE WITH NEEDLE, STERILE 5CC OR GREATER, EACH 

A4210 NEEDLE-FREE INJECTION DEVICE, EACH 

A4211 SUPPLIES FOR SELF-ADMINISTERED INJECTIONS 

A4212 NON-CORING NEEDLE OR STYLET WITH OR WITHOUT CATHETER 

A4213 SYRINGE, STERILE, 20 CC OR GREATER, EACH 

A4214 STERILE SALINE OR WATER, 30 CC VIAL 

A4215 NEEDLES ONLY, STERILE, ANY SIZE, EACH 

A4220 REFILL KIT FOR IMPLANTABLE INFUSION PUMP 

A4221 SUPPLIES FOR MAINTENANCE OF DRUG INFUSION CATHETER, PER WEEK (LIST DRUG 

SEPARATELY) 

A4222 SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUG 

SEPARATELY) 

A4230 INFUSION SET FOR EXTERNAL INSULIN PUMP, NON NEEDLE CANNULA TYPE 

A4231 INFUSION SET FOR EXTERNAL INSULIN PUMP, NEEDLE TYPE 

A4232 SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3CC 

A4244 ALCOHOL OR PEROXIDE, PER PINT 

A4245 ALCOHOL WIPES, PER BOX 

A4246 BETADINE OR PHISOHEX SOLUTION, PER PINT 

A4247 BETADINE OR IODINE SWABS/WIPES, PER BOX 

A4250 URINE TEST OR REAGENT STRIPS OR TABLETS (100 TABLETS OR STRIPS) 

A4253 BLOOD GLUCOSE TEST OR REAGENT STRIPS FOR HOME BLOOD GLUCOSE MONITOR, PER 50 

STRIPS 

A4254 REPLACEMENT BATTERY, ANY TYPE, FOR USE WITH MEDICALLY NECESSARY HOME BLOOD 

GLUCOSE MONITOR OWNED BY PATIENT, EACH 

A4255 PLATFORMS FOR HOME BLOOD GLUCOSE MONITOR, 50 PER BOX 

A4256 NORMAL, LOW AND HIGH CALIBRATOR SOLUTION / CHIPS 

A4258 SPRING-POWERED DEVICE FOR LANCET, EACH 

A4259 LANCETS, PER BOX OF 100 

A4260 LEVONORGESTREL (CONTRACEPTIVE) IMPLANTS SYSTEM, INCLUDING IMPLANTS AND SUPPLIES 

A4261 CERVICAL CAP FOR CONTRACEPTIVE USE 

A4262 TEMPORARY, ABSORBABLE LACRIMAL DUCT IMPLANT, EACH 

A4263 PERMANENT, LONG TERM, NON-DISSOLVABLE LACRIMAL DUCT IMPLANT, EACH 

A4265 PARAFFIN, PER POUND 

A4270 DISPOSABLE ENDOSCOPE SHEATH, EACH

A4280 ADHESIVE SKIN SUPPORT ATTACHMENT FOR USE WITH EXTERNAL BREAST PROSTHESIS, EACH 

A4290 SACRAL NERVE STIMULATION TEST LEAD, EACH 

A4300 IMPLANTABLE ACCESS CATHETER (VENOUS, ARTERIAL, EPIDURAL OR PERITONEAL), 

EXTERNAL ACCESS 

A4301 IMPLANTABLE ACCESS TOTAL SYSTEM; CATHETER, PORT/RESERVOIR (VENOUS, ARTERIAL OR 

EPIDURAL), PERCUTANEOUS ACCESS 

A4305 DISPOSABLE DRUG DELIVERY SYSTEM, FLOW RATE OF 50 ML OR GREATER PER HOUR 

A4306 DISPOSABLE DRUG DELIVERY SYSTEM, FLOW RATE OF 5 ML OR LESS PER HOUR 

A4310 INSERTION TRAY WITHOUT DRAINAGE BAG AND WITHOUT CATHETER (ACCESSORIES ONLY) 

A4311 INSERTION TRAY WITHOUT DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, 

TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER OR 

HYDROPHILIC, ETC.) 


TWO-WAY, ALL SILICONE 


THREE-WAY, FOR CONTINUOUS IRRIGATION 

A4314 INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY 

LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER OR HYDROPHILIC, ETC.) 

A4315 INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, 

ALL SILICONE 

A4316 INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, 

THREE-WAY, FOR CONTINUOUS IRRIGATION 

A4319 STERILE WATER IRRIGATION SOLUTION, 1000 ML 

A4320 IRRIGATION TRAY WITH BULB OR PISTON SYRINGE, ANY PURPOSE 

A4321 THERAPEUTIC AGENT FOR URINARY CATHETER IRRIGATION 

A4322 IRRIGATION SYRINGE, BULB OR PISTON, EACH 

A4323 STERILE SALINE IRRIGATION SOLUTION, 1000 ML. 

A4324 MALE EXTERNAL CATHETER, WITH ADHESIVE COATING, EACH 

A4325 MALE EXTERNAL CATHETER, WITH ADHESIVE STRIP, EACH 

A4326 MALE EXTERNAL CATHETER SPECIALTY TYPE, EG; INFLATABLE, FACEPLATE, ETC., EACH 

A4327 FEMALE EXTERNAL URINARY COLLECTION DEVICE; MEATAL CUP, EACH 

A4328 FEMALE EXTERNAL URINARY COLLECTION DEVICE; POUCH, EACH 

A4329 EXTERNAL CATHETER STARTER SET, MALE/FEMALE, INCLUDES CATHETERS/URINARY 

COLLECTION DEVICE, BAG/POUCH AND ACCESSORIES (TUBING, CLAMPS, ETC.), 7 DAY 

SUPPLY 

A4330 PERIANAL FECAL COLLECTION POUCH WITH ADHESIVE, EACH 

A4331 EXTENSION DRAINAGE TUBING, ANY TYPE, ANY LENGTH, WITH CONNECTOR/ADAPTOR, FOR 

USE WITH URINARY LEG BAG OR UROSTOMY POUCH, EACH 

A4332 LUBRICANT, INDIVIDUAL STERILE PACKET, FOR INSERTION OF URINARY CATHETER, EACH 

A4333 URINARY CATHETER ANCHORING DEVICE, ADHESIVE SKIN ATTACHMENT, EACH 

A4334 URINARY CATHETER ANCHORING DEVICE, LEG STRAP, EACH 

A4335 INCONTINENCE SUPPLY; MISCELLANEOUS 

A4338 INDWELLING CATHETER; FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, 

SILICONE ELASTOMER, OR HYDROPHILIC, ETC.), EACH 

A4340 INDWELLING CATHETER; SPECIALTY TYPE, EG; COUDE, MUSHROOM, WING, ETC.), EACH 

A4344 INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE, EACH 

A4346 INDWELLING CATHETER; FOLEY TYPE, THREE WAY FOR CONTINUOUS IRRIGATION, EACH 

A4347 MALE EXTERNAL CATHETER WITH OR WITHOUT ADHESIVE, WITH OR WITHOUT ANTI-REFLUX 

DEVICE; PER DOZEN 

A4348 MALE EXTERNAL CATHETER WITH INTEGRAL COLLECTION COMPARTMENT, EXTENDED WEAR, 

EACH (E.G., 2 PER MONTH) 

A4351 INTERMITTENT URINARY CATHETER; STRAIGHT TIP, EACH 

A4352 INTERMITTENT URINARY CATHETER; COUDE (CURVED) TIP, EACH 

A4353 INTERMITTENT URINARY CATHETER, WITH INSERTION SUPPLIES 

A4354 INSERTION TRAY WITH DRAINAGE BAG BUT WITHOUT CATHETER 

A4355 IRRIGATION TUBING SET FOR CONTINUOUS BLADDER IRRIGATION THROUGH A THREE-WAY 

INDWELLING FOLEY CATHETER, EACH

A4356 EXTERNAL URETHRAL CLAMP OR COMPRESSION DEVICE (NOT TO BE USED FOR CATHETER 

CLAMP), EACH 

A4357 BEDSIDE DRAINAGE BAG, DAY OR NIGHT, WITH OR WITHOUT ANTI-REFLUX DEVICE, WITH OR 

WITHOUT TUBE, EACH 

A4358 URINARY LEG BAG; VINYL, WITH OR WITHOUT TUBE, EACH 

A4359 URINARY SUSPENSORY WITHOUT LEG BAG, EACH 

A4361 OSTOMY FACEPLATE, EACH 

A4362 SKIN BARRIER; SOLID, 4 X 4 OR EQUIVALENT; EACH 

A4363 SKIN BARRIER; LIQUID (SPRAY, BRUSH, ETC.) POWDER OR PASTE; PER OZ. 

A4364 ADHESIVE, LIQUID, FOR USE WITH FACIAL PROSTHESIS ONLY, PER OUNCE 

A4365 ADHESIVE REMOVER WIPES, ANY TYPE, PER 50 

A4367 OSTOMY BELT, EACH 

A4368 OSTOMY FILTER, ANY TYPE, EACH 

A4369 OSTOMY SKIN BARRIER, LIQUID (SPRAY, BRUSH, ETC), PER OZ 

A4370 OSTOMY SKIN BARRIER, PASTE, PER OZ 

A4371 OSTOMY SKIN BARRIER, POWDER, PER OZ 

A4372 OSTOMY SKIN BARRIER, SOLID 4X4 OR EQUIVALENT, STANDARD WEAR, WITH BUILT-IN 

CONVEXITY, EACH 

A4373 OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), STANDARD WEAR, 

WITH BUILT-IN CONVEXITY, ANY SIZE, EACH 

A4374 OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, 

WITH BUILT-IN CONVEXITY, ANY SIZE, EACH 

A4375 OSTOMY POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, PLASTIC, EACH 

A4376 OSTOMY POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, RUBBER, EACH 

A4377 OSTOMY POUCH, DRAINABLE, FOR USE ON FACEPLATE, PLASTIC, EACH 

A4378 OSTOMY POUCH, DRAINABLE, FOR USE ON FACEPLATE, RUBBER, EACH 

A4379 OSTOMY POUCH, URINARY, WITH FACEPLATE ATTACHED, PLASTIC, EACH 

A4380 OSTOMY POUCH, URINARY, WITH FACEPLATE ATTACHED, RUBBER, EACH 

A4381 OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, PLASTIC, EACH 

A4382 OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, HEAVY PLASTIC, EACH 

A4383 OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, RUBBER, EACH 

A4384 OSTOMY FACEPLATE EQUIVALENT, SILICONE RING, EACH 

A4385 OSTOMY SKIN BARRIER, SOLID 4X4 OR EQUIVALENT, EXTENDED WEAR, WITHOUT BUILT-IN 


A4386 OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, 

WITHOUT BUILT-IN CONVEXITY, ANY SIZE, EACH 

A4387 OSTOMY POUCH CLOSED, WITH STANDARD WEAR BARRIER ATTACHED, WITH BUILT-IN 

CONVEXITY (1 PIECE), EACH 

A4388 OSTOMY POUCH, DRAINABLE, WITH EXTENDED WEAR BARRIER ATTACHED, WITHOUT BUILT-IN 

CONVEXITY (1 PIECE) 

A4389 OSTOMY POUCH, DRAINABLE, WITH STANDARD WEAR BARRIER ATTACHED, WITH BUILT-IN 


A4390 OSTOMY POUCH, DRAINABLE, WITH EXTENDED WEAR BARRIER ATTACHED, WITH BUILT-IN 


A4391 OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITHOUT BUILT-IN 


A4392 OSTOMY POUCH, URINARY, WITH STANDARD WEAR BARRIER ATTACHED, WITH BUILT-IN 


A4393 OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITH BUILT-IN 


A4394 OSTOMY DEODORANT FOR USE IN OSTOMY POUCH, LIQUID, PER FLUID OUNCE 

A4395 OSTOMY DEODORANT FOR USE IN OSTOMY POUCH, SOLID, PER TABLET 

A4396 OSTOMY BELT WITH PERISTOMAL HERNIA SUPPORT 

A4397 IRRIGATION SUPPLY; SLEEVE, EACH 

A4398 OSTOMY IRRIGATION SUPPLY; BAG, EACH 

A4399 OSTOMY IRRIGATION SUPPLY; CONE/CATHETER, INCLUDING BRUSH 

A4400 OSTOMY IRRIGATION SET

A4402 LUBRICANT, PER OUNCE 

A4404 OSTOMY RING, EACH 

A4421 OSTOMY SUPPLY; MISCELLANEOUS 

A4454 TAPE, ALL TYPES, ALL SIZES 

A4455 ADHESIVE REMOVER OR SOLVENT (FOR TAPE, CEMENT OR OTHER ADHESIVE), PER OUNCE 

A4460 ELASTIC BANDAGE, PER ROLL (E.G. COMPRESSION BANDAGE) 

A4462 ABDOMINAL DRESSING HOLDER/BINDER, EACH 

A4464 JOINT SUPPORTIVE DEVICE/GARMENT, ELASTIC OR EQUAL, EACH 

A4465 NON-ELASTIC BINDER FOR EXTREMITY 

A4470 GRAVLEE JET WASHER 

A4480 VABRA ASPIRATOR 

A4481 TRACHEOSTOMA FILTER, ANY TYPE, ANY SIZE, EACH 

A4483 MOISTURE EXCHANGER, DISPOSABLE, FOR USE WITH INVASIVE MECHANICAL VENTILATION 

A4490 SURGICAL STOCKINGS ABOVE KNEE LENGTH, EACH 

A4495 SURGICAL STOCKINGS THIGH LENGTH, EACH 

A4500 SURGICAL STOCKINGS BELOW KNEE LENGTH, EACH 

A4510 SURGICAL STOCKINGS FULL LENGTH, EACH 

A4550 SURGICAL TRAYS 

A4554 DISPOSABLE UNDERPADS, ALL SIZES, (E.G., CHUX'S) 

A4556 ELECTRODES, (E.G., APNEA MONITOR), PER PAIR 

A4557 LEAD WIRES, (E.G., APNEA MONITOR), PER PAIR 

A4558 CONDUCTIVE PASTE OR GEL 

A4560 PESSARY 

A4561 PESSARY, RUBBER, ANY TYPE 

A4562 PESSARY, NON RUBBER, ANY TYPE 

A4565 SLINGS 

A4570 SPLINT 

A4572 RIB BELT 

A4575 TOPICAL HYPERBARIC OXYGEN CHAMBER, DISPOSABLE 

A4580 CAST SUPPLIES (E.G. PLASTER) 

A4590 SPECIAL CASTING MATERIAL (E.G. FIBERGLASS) 

A4595 TENS SUPPLIES, 2 LEAD, PER MONTH 

A4608 TRANSTRACHEAL OXYGEN CATHETER, EACH 

A4611 BATTERY, HEAVY DUTY; REPLACEMENT FOR PATIENT OWNED VENTILATOR 

A4612 BATTERY CABLES; REPLACEMENT FOR PATIENT-OWNED VENTILATOR 

A4613 BATTERY CHARGER; REPLACEMENT FOR PATIENT-OWNED VENTILATOR 

A4614 PEAK EXPIRATORY FLOW RATE METER, HAND HELD 

A4615 CANNULA, NASAL 

A4616 TUBING (OXYGEN), PER FOOT 

A4617 MOUTH PIECE 

A4618 BREATHING CIRCUITS 

A4619 FACE TENT 

A4620 VARIABLE CONCENTRATION MASK 

A4621 TRACHEOTOMY MASK OR COLLAR 

A4622 TRACHEOSTOMY OR LARYNGECTOMY TUBE 

A4623 TRACHEOSTOMY, INNER CANNULA (REPLACEMENT ONLY) 

A4624 TRACHEAL SUCTION CATHETER, ANY TYPE, EACH 

A4625 TRACHEOSTOMY CARE KIT FOR NEW TRACHEOSTOMY 

A4626 TRACHEOSTOMY CLEANING BRUSH, EACH 

A4627 SPACER, BAG OR RESERVOIR, WITH OR WITHOUT MASK, FOR USE WITH METERED DOSE 

INHALER 

A4628 OROPHARYNGEAL SUCTION CATHETER, EACH 

A4629 TRACHEOSTOMY CARE KIT FOR ESTABLISHED TRACHEOSTOMY 

A4630 REPLACEMENT BATTERIES. MEDICALLY NECESSARY T.E.N.S. OWNED BY PATIENT 

A4631 REPLACEMENT, BATTERIES FOR MEDICALLY NECESSARY ELECTRONIC WHEEL CHAIR OWNED BY 

PATIENT 

A4635 UNDERARM PAD, CRUTCH, REPLACEMENT, EACH

A4636 REPLACEMENT, HANDGRIP, CANE, CRUTCH, OR WALKER, EACH 

A4637 REPLACEMENT, TIP, CANE, CRUTCH, WALKER, EACH. 

A4640 REPLACEMENT PAD FOR USE WITH MEDICALLY NECESSARY ALTERNATING PRESSURE PAD 

OWNED BY PATIENT 

A4641 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, NOT OTHERWISE 

CLASSIFIED 

A4642 SUPPLY OF SATUMOMAB PENDETIDE, RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, 

PER DOSE 

A4643 SUPPLY OF ADDITIONAL HIGH DOSE CONTRAST MATERIAL(S) DURING MAGNETIC RESONANCE 

IMAGING, E.G., GADOTERIDOL INJECTION 

A4644 SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (100-199 MGS OF IODINE) 



A4647 SUPPLY OF PARAMAGNETIC CONTRAST MATERIAL, EG., GADOLINIUM 

A4649 SURGICAL SUPPLY; MISCELLANEOUS 

A4650 CENTRIFUGE (INCLUDES CALIBRATED MICROCAPILLARY TUBES AND SEALEASE) 

A4655 NEEDLES AND SYRINGES FOR DIALYSIS 

A4660 SPHYGMOMANOMETER/BLOOD PRESSURE APPARATUS WITH CUFF AND STETHOSCOPE 

A4663 BLOOD PRESSURE CUFF ONLY 

A4670 AUTOMATIC BLOOD PRESSURE MONITOR 

A4680 ACTIVATED CARBON FILTERS FOR DIALYSIS 

A4690 DIALYZERS (ARTIFICIAL KIDNEYS) ALL BRANDS, ALL SIZES PER UNIT 

A4700 STANDARD DIALYSATE SOLUTION, EACH 

A4705 BICARBONATE DIALYSATE SOLUTION, EACH 

A4712 WATER, STERILE 

A4714 TREATED WATER (DEIONIZED, DISTILLED, REVERSE OSMOSIS) FOR USE IN DIALYSIS 

SYSTEM 

A4730 FISTULA CANNULATION SET FOR DIALYSIS ONLY 

A4735 LOCAL/TOPICAL ANESTHETICS FOR DIALYSIS ONLY 

A4740 SHUNT ACCESSORIES FOR DIALYSIS ONLY 

A4750 BLOOD TUBING, ARTERIAL OR VENOUS, EACH 

A4755 BLOOD TUBING, ARTERIAL AND VENOUS COMBINED 

A4760 DIALYSATE STANDARD TESTING SOLUTION, SUPPLIES 

A4765 DIALYSATE CONCENTRATE ADDITIVES, EACH 

A4770 BLOOD TESTING SUPPLIES (E.G. VACUTAINERS AND TUBES) 

A4771 SERUM CLOTTING TIME TUBE, PER BOX 

A4772 DEXTROSTICK OR GLUCOSE TEST STRIPS, PER BOX 

A4773 HEMOSTIX, PER BOTTLE 

A4774 AMMONIA TEST PAPER, PER BOX 

A4780 STERILIZING AGENT FOR DIALYSIS EQUIPMENT, PER GALLON 

A4790 CLEANSING AGENTS FOR EQUIPMENT FOR DIALYSIS ONLY 

A4800 HEPARIN FOR DIALYSIS AND ANTIDOTE, ANY STRENGTH, PORCINE OR BEEF, UP TO 1000 

UNITS, 10-30 ML (FOR PARENTERAL USE SEE B4216) 

A4820 HEMODIALYSIS KIT SUPPLIES 

A4850 HEMOSTATS WITH RUBBER TIPS FOR DIALYSIS 

A4860 DISPOSABLE CATHETER CAPS 

A4870 PLUMBING AND/OR ELECTRICAL WORK FOR HOME DIALYSIS EQUIPMENT 

A4880 STORAGE TANKS UTILIZED IN CONNECTION WITH WATER PURIFICATION SYSTEM, 

REPLACEMENT TANKS FOR DIALYSIS 

A4890 CONTRACTS, REPAIR AND MAINTENANCE, FOR HOME DIALYSIS EQUIPMENT (NON-COVERED) 

A4900 CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) SUPPLY KIT 

A4901 CONTINUOUS CYCLING PERITONEAL DIALYSIS (CCPD) SUPPLY KIT 

A4905 INTERMITTENT PERITONEAL DIALYSIS (IPD) SUPPLY KIT 

A4910 NON-MEDICAL SUPPLIES FOR DIALYSIS, (I.E., SCALE, SCISSORS, STOPWATCH, ETC.) 

A4912 GOMCO DRAIN BOTTLE 

A4913 MISCELLANEOUS DIALYSIS SUPPLIES, NOT IDENTIFIED ELSEWHERE, BY REPORT 

A4914 PREPARATION KITS

A4918 VENOUS PRESSURE CLAMPS, EACH 

A4919 DIALYZER HOLDER, EACH 

A4920 HARVARD PRESSURE CLAMP, EACH 

A4921 MEASURING CYLINDER, ANY SIZE, EACH 

A4927 GLOVES, STERILE OR NON-STERILE, PER PAIR 

A5051 POUCH, CLOSED; WITH BARRIER ATTACHED (1 PIECE) 

A5052 POUCH, CLOSED; WITHOUT BARRIER ATTACHED (1 PIECE) 

A5053 POUCH, CLOSED; FOR USE ON FACEPLATE 

A5054 POUCH, CLOSED; FOR USE ON BARRIER WITH FLANGE (2 PIECE) 

A5055 STOMA CAP 

A5061 POUCH, DRAINABLE; WITH BARRIER ATTACHED (1 PIECE) 

A5062 POUCH, DRAINABLE; WITHOUT BARRIER ATTACHED (1 PIECE) 

A5063 POUCH, DRAINABLE; FOR USE ON BARRIER WITH FLANGE (2 PIECE SYSTEM) 

A5064 POUCH, DRAINABLE, WITH FACEPLATE ATTACHED; PLASTIC OR RUBBER 

A5065 POUCH, DRAINABLE, FOR USE ON FACEPLATE; PLASTIC OR RUBBER 

A5071 POUCH, URINARY; WITH BARRIER ATTACHED (1 PIECE) 

A5072 POUCH, URINARY; WITHOUT BARRIER ATTACHED (1 PIECE) 

A5073 POUCH, URINARY; FOR USE ON BARRIER WITH FLANGE (2 PIECE) 

A5074 POUCH, URINARY, WITH FACEPLATE ATTACHED; PLASTIC OR RUBBER 

A5075 POUCH, URINARY, FOR USE ON FACEPLATE; PLASTIC OR RUBBER 

A5081 CONTINENT DEVICE; PLUG FOR CONTINENT STOMA 

A5082 CONTINENT DEVICE; CATHETER FOR CONTINENT STOMA 

A5093 OSTOMY ACCESSORY; CONVEX INSERT 

A5102 BEDSIDE DRAINAGE BOTTLE WITH OR WITHOUT TUBING, RIGID OR EXPANDABLE, EACH 

A5105 URINARY SUSPENSORY; WITH LEG BAG, WITH OR WITHOUT TUBE 

A5112 URINARY LEG BAG; LATEX 

A5113 LEG STRAP; LATEX, REPLACEMENT ONLY, PER SET 

A5114 LEG STRAP; FOAM OR FABRIC, REPLACEMENT ONLY, PER SET 

A5119 SKIN BARRIER; WIPES, BOX PER 50 

A5121 SKIN BARRIER; SOLID, 6 X 6 OR EQUIVALENT, EACH 

A5122 SKIN BARRIER; SOLID, 8 X 8 OR EQUIVALENT, EACH 

A5123 SKIN BARRIER; WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), ANY SIZE, EACH 

A5126 ADHESIVE OR NON-ADHESIVE; DISK OR FOAM PAD 

A5131 APPLIANCE CLEANER, INCONTINENCE AND OSTOMY APPLIANCES, PER 16 OZ. 

A5149 INCONTINENCE/OSTOMY SUPPLY; MISCELLANEOUS 

A5200 PERCUTANEOUS CATHETER/TUBE ANCHORING DEVICE, ADHESIVE SKIN ATTACHMENT 

A5500 FOR DIABETICS ONLY, FITTING (INCLUDING FOLLOW-UP), CUSTOM PREPARATION AND 

SUPPLY OF OFF-THE-SHELF DEPTH-INLAY SHOE MANUFACTURED TO ACCOMMODATE MULTI- 

DENSITY INSERT(S), PER SHOE. 

A5501 FOR DIABETICS ONLY, FITTING (INCLUDING FOLLOW-UP), CUSTOM PREPARATION AND 

SUPPLY OF SHOE MOLDED FROM CAST(S) OF PATIENT'S FOOT (CUSTOM MOLDED SHOE), PER 

SHOE 

A5502 FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT(S), PER SHOE 

A5503 FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF 

DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE WITH ROLLER OR RIGID ROCKER BOTTOM, PER 

SHOE 


DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE WITH WEDGE(S), PER SHOE 


DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE WITH METATARSAL BAR, PER SHOE 


DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE WITH OFF-SET HEEL(S), PER SHOE 

A5507 FOR DIABETICS ONLY, NOT OTHERWISE SPECIFIED MODIFICATION (INCLUDING FITTING) OF 

OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE, PER SHOE 

A5508 FOR DIABETICS ONLY, DELUXE FEATURE OF OFF-THE-SHELF DEPTH-INLAY SHOE OR 

CUSTOM-MOLDED SHOE, PER SHOE 

A6020 COLLAGEN BASED WOUND DRESSING, EACH DRESSING

A6021 COLLAGEN DRESSING, PAD SIZE 16 SQ. IN. OR LESS, EACH 

A6022 COLLAGEN DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 

SQ. IN., EACH 

A6023 COLLAGEN DRESSING, PAD SIZE MORE THAN 48 SQ. IN., EACH 

A6024 COLLAGEN DRESSING WOUND FILLER, PER 6 INCHES 

A6025 SILICONE GEL SHEET, EACH 

A6154 WOUND POUCH, EACH 

A6196 ALGINATE DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, EACH DRESSING 

A6197 ALGINATE DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR 

EQUAL TO 48 SQ. IN., EACH DRESSING 

A6198 ALGINATE DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., EACH DRESSING 

A6199 ALGINATE DRESSING, WOUND FILLER, PER 6 INCHES 

A6200 COMPOSITE DRESSING, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH 

DRESSING 

A6201 COMPOSITE DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 

SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING 

A6202 COMPOSITE DRESSING, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, 

EACH DRESSING 

A6203 COMPOSITE DRESSING, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, 

EACH DRESSING 

A6204 COMPOSITE DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 

SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING 

A6205 COMPOSITE DRESSING, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE 

BORDER, EACH DRESSING 

A6206 CONTACT LAYER, 16 SQ. IN. OR LESS, EACH DRESSING 

A6207 CONTACT LAYER, MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH 

DRESSING 

A6208 CONTACT LAYER, MORE THAN 48 SQ. IN., EACH DRESSING 

A6209 FOAM DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE 


A6210 FOAM DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR 

EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING 

A6211 FOAM DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE 


A6212 FOAM DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE 


A6213 FOAM DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR 

EQUAL TO 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING 

A6214 FOAM DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE 

ADHESIVE BORDER, EACH DRESSING 

A6215 FOAM DRESSING, WOUND FILLER, PER GRAM 

A6216 GAUZE, NON-IMPREGNATED, NON-STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT 


A6217 GAUZE, NON-IMPREGNATED, NON-STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS 

THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING 

A6218 GAUZE, NON-IMPREGNATED, NON-STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT 


A6219 GAUZE, NON-IMPREGNATED, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE 


A6220 GAUZE, NON-IMPREGNATED, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 

48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING 

A6221 GAUZE, NON-IMPREGNATED, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE 


A6222 GAUZE, IMPREGNATED WITH OTHER THAN WATER, NORMAL SALINE, OR HYDROGEL, PAD SIZE 

16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING 


MORE THAN 16 SQUARE INCHES, BUT LESS THAN OR EQUAL TO 48 SQUARE INCHES, WITHOUT



MORE THAN 48 SQUARE INCHES, WITHOUT ADHESIVE BORDER, EACH DRESSING 

A6228 GAUZE, IMPREGNATED, WATER OR NORMAL SALINE, PAD SIZE 16 SQ. IN. OR LESS, 

WITHOUT ADHESIVE BORDER, EACH DRESSING 

A6229 GAUZE, IMPREGNATED, WATER OR NORMAL SALINE, PAD SIZE MORE THAT 16 SQ. IN. BUT 

LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING 

A6230 GAUZE, IMPREGNATED, WATER OR NORMAL SALINE, PAD SIZE MORE THAN 48 SQ. IN., 


A6231 GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT, PAD SIZE 16 SQ. IN. OR 

LESS, EACH DRESSING 

A6232 GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT, PAD SIZE GREATER THAN 

16 SQ. IN., BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING 

A6233 GAUZE, IMPREGNATED, HYDROGEL FOR DIRECT WOUND CONTACT, PAD SIZE MORE THAN 48 

SQ. IN., EACH DRESSING 

A6234 HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT 


A6235 HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN 

OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING 

A6236 HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT 


A6237 HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE 


A6238 HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN 

OR EQUAL TO 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING 

A6239 HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY 

SIZE ADHESIVE BORDER, EACH DRESSING 

A6240 HYDROCOLLOID DRESSING, WOUND FILLER, PASTE, PER FLUID OUNCE 

A6241 HYDROCOLLOID DRESSING, WOUND FILLER, DRY FORM, PER GRAM 

A6242 HYDROGEL DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE 


A6243 HYDROGEL DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR 


A6244 HYDROGEL DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE 


A6245 HYDROGEL DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE 


A6246 HYDROGEL DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR 

EQUAL TO 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING 

A6247 HYDROGEL DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE 


A6248 HYDROGEL DRESSING, WOUND FILLER, GEL, PER FLUID OUNCE 

A6250 SKIN SEALANTS, PROTECTANTS, MOISTURIZERS, OINTMENTS, ANY TYPE, ANY SIZE 

A6251 SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, 


A6252 SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT 

LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING 

A6253 SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., 


A6254 SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITH 

ANY SIZE ADHESIVE BORDER, EACH DRESSING 

A6255 SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT 

LESS THAN OR EQUAL TO 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING 

A6256 SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITH 

ANY SIZE ADHESIVE BORDER, EACH DRESSING 

A6257 TRANSPARENT FILM, 16 SQ. IN. OR LESS, EACH DRESSING 

A6258 TRANSPARENT FILM, MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN.,

EACH DRESSING 

A6259 TRANSPARENT FILM, MORE THAN 48 SQ. IN., EACH DRESSING 

A6260 WOUND CLEANSERS, ANY TYPE, ANY SIZE 

A6261 WOUND FILLER, GEL/PASTE, PER FLUID OUNCE, NOT ELSEWHERE CLASSIFIED 

A6262 WOUND FILLER, DRY FORM, PER GRAM, NOT ELSEWHERE CLASSIFIED 

A6263 GAUZE, ELASTIC, NON-STERILE, ALL TYPES, PER LINEAR YARD 

A6264 GAUZE, NON-ELASTIC, NON-STERILE, PER LINEAR YARD 

A6265 TAPE, ALL TYPES, PER 18 SQUARE INCHES 

A6266 GAUZE, IMPREGNATED, OTHER THAN WATER OR NORMAL SALINE, ANY WIDTH, PER LINEAR 

YARD 

A6402 GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE 


A6403 GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE MORE THAN 16 SQ. IN. LESS THAN OR 


A6404 GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT 


A6405 GAUZE, ELASTIC, STERILE, ALL TYPES, PER LINEAR YARD 

A6406 GAUZE, NON-ELASTIC, STERILE, ALL TYPES, PER LINEAR YARD 

A7000 CANISTER, DISPOSABLE, USED WITH SUCTION PUMP, EACH 

A7001 CANISTER, NON-DISPOSABLE, USED WITH SUCTION PUMP, EACH 

A7002 TUBING, USED WITH SUCTION PUMP, EACH 

A7003 ADMINISTRATION SET, WITH SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, 

DISPOSABLE 

A7004 SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, DISPOSABLE 

A7005 ADMINISTRATION SET, WITH SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, 

NON-DISPOSABLE 

A7006 ADMINISTRATION SET, WITH SMALL VOLUME FILTERED PNEUMATIC NEBULIZER 

A7007 LARGE VOLUME NEBULIZER, DISPOSABLE, UNFILLED, USED WITH AEROSOL COMPRESSOR 

A7008 LARGE VOLUME NEBULIZER, DISPOSABLE, PREFILLED, USED WITH AEROSOL COMPRESSOR 

A7009 RESERVOIR BOTTLE, NON-DISPOSABLE, USED WITH LARGE VOLUME ULTRASONIC NEBULIZER 

A7010 CORRUGATED TUBING, DISPOSABLE, USED WITH LARGE VOLUME NEBULIZER, 100 FEET 

A7011 CORRUGATED TUBING, NON-DISPOSABLE, USED WITH LARGE VOLUME NEBULIZER, 10 FEET 

A7012 WATER COLLECTION DEVICE, USED WITH LARGE VOLUME NEBULIZER 

A7013 FILTER, DISPOSABLE, USED WITH AEROSOL COMPRESSOR 

A7014 FILTER, NONDISPOSABLE, USED WITH AEROSOL COMPRESSOR OR ULTRASONIC GENERATOR 

A7015 AEROSOL MASK, USED WITH DME NEBULIZER 

A7016 DOME AND MOUTHPIECE, USED WITH SMALL VOLUME ULTRASONIC NEBULIZER 

A7017 NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, NOT USED WITH 

OXYGEN 

A7018 WATER, DISTILLED, USED WITH LARGE VOLUME NEBULIZER, 1000 ML 

A7019 SALINE SOLUTION, PER 10 ML, METERED DOSE DISPENSER, FOR USE WITH INHALATION 

DRUGS 

A7020 STERILE WATER OR STERILE SALINE, 1000 ML, USED WITH LARGE VOLUME NEBULIZER 

A7501 TRACHEOSTOMA VALVE, INCLUDING DIAPHRAGM, EACH 

A7502 REPLACEMENT DIAPHRAGM/FACEPLATE FOR TRACHEOSTOMA VALVE, EACH 

A7503 FILTER HOLDER OR FILTER CAP, REUSABLE, FOR USE IN A TRACHEOSTOMA HEAT AND 

MOISTURE EXCHANGE SYSTEM, EACH 

A7504 FILTER FOR USE IN A TRACHEOSTOMA HEAT AND MOISTURE EXCHANGE SYSTEM, EACH 

A7505 HOUSING, REUSABLE WITHOUT ADHESIVE, FOR USE IN A HEAT AND MOISTURE EXCHANGE 

SYSTEM AND/OR WITH A TRACHEOSTOMA VALVE, EACH 

A7506 ADHESIVE DISC FOR USE IN A HEAT AND MOISTURE EXCHANGE SYSTEM AND/OR WITH 

TRACHEOSTOMA VALVE, ANY TYPE EACH 

A7507 FILTER HOLDER AND INTEGRATED FILTER WITHOUT ADHESIVE, FOR USE IN A TRACHEOSTOMA 

HEAT AND MOISTURE EXCHANGE SYSTEM, EACH 

A7508 HOUSING AND INTEGRATED ADHESIVE, FOR USE IN A TRACHEOSTOMA HEAT AND MOISTURE 

EXCHANGE SYSTEM AND/OR WITH A TRACHEOSTOMA VALVE, EACH 

A7509 FILTER HOLDER AND INTEGRATED FILTER HOUSING, AND ADHESIVE, FOR USE AS A

TRACHEOSTOMA HEAT AND MOISTURE EXCHANGE SYSTEM, EACH 

A9150 NON-PRESCRIPTION DRUGS 

A9160 NON-COVERED SVC. BY PODIATRIST 

A9170 NON-COVERED SVC. BY CHIROPRACTOR 

A9190 PERSONAL COMFORT ITEM 

A9270 NON-COVERED ITEM OR SERVICE 

A9300 EXERCISE EQUIPMENT 

A9500 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M 

SESTAMIBI, PER DOSE 


TETROFOSMIN, PER UNIT DOSE 

A9503 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M, 

MEDRONATE, UP TO 30 MCI 


APCITIDE 

A9505 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, THALLOUS CHLORIDE TL 

201, PER MCI 

A9507 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM IN 111 CAPROMAB 

PENDETIDE, PER DOSE 

A9508 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, IOBENGUANE SULFATE 

I-131, PER 0.5 MCI 

A9510 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M 

DISOFENIN, PER VIAL 

A9600 SUPPLY OF THERAPEUTIC RADIOPHARMACEUTICAL, STRONTIUM-89 CHLORIDE, PER MCI 

A9605 SUPPLY OF THERAPEUTIC RADIOPHARMACEUTICAL, SAMARIUM SM 153 LEXIDRONAMM, 50 MCI 

A9700 SUPPLY OF INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY 

A9900 MISCELLANEOUS DME SUPPLY, ACCESSORY, AND/OR SERVICE COMPONENT OF ANOTHER HCPCS 

CODE 

A9901 DME DELIVERY, SET UP, AND/OR DISPENSING SERVICE COMPONENT OF ANOTHER HCPCS CODE 

B4034 ENTERAL FEEDING SUPPLY KIT; SYRINGE, PER DAY 

B4035 ENTERAL FEEDING SUPPLY KIT; PUMP FED, PER DAY 

B4036 ENTERAL FEEDING SUPPLY KIT; GRAVITY FED, PER DAY 

B4081 NASOGASTRIC TUBING WITH STYLET 

B4082 NASOGASTRIC TUBING WITHOUT STYLET 

B4083 STOMACH TUBE - LEVINE TYPE 

B4084 GASTROSTOMY/JEJUNOSTOMY TUBING 

B4085 GASTROSTOMY TUBE, SILICONE WITH SLIDING RING, EACH 

B4150 ENTERAL FORMULAE; CATEGORY I; SEMI-SYNTHETIC INTACT PROTEIN/PROTEIN ISOLATES, 

ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT 

B4151 ENTERAL FORMULAE; CATEGORY I; NATURAL INTACT PROTEIN/PROTEIN ISOLATES, 


B4152 ENTERAL FORMULAE; CATEGORY II; INTACT PROTEIN/PROTEIN ISOLATES (CALORICALLY 

DENSE), ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT 

B4153 ENTERAL FORMULAE; CATEGORY III; HYDROLIZED PROTEIN/AMINO ACIDS, ADMINISTERED 

THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT 

B4154 ENTERAL FORMULAE; CATEGORY IV; DEFINED FORMULA FOR SPECIAL METABOLIC NEED, 


B4155 ENTERAL FORMULAE; CATEGORY V; MODULAR COMPONENTS, ADMINISTERED THROUGH AN 

ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT 

B4156 ENTERAL FORMULAE; CATEGORY VI; STANDARDIZED NUTRIENTS, ADMINISTERED THROUGH AN 

ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT 

B4164 PARENTERAL NUTRITION SOLUTION: CARBOHYDRATES (DEXTROSE), 50% OR LESS (500 ML = 

1 UNIT) - HOMEMIX 

B4168 PARENTERAL NUTRITION SOLUTION; AMINO ACID, 3.5%, (500 ML = 1 UNIT) - HOMEMIX 

B4172 PARENTERAL NUTRITION SOLUTION; AMINO ACID, 5.5% THROUGH 7%, (500 ML = 1 UNIT) - 

HOMEMIX 

B4176 PARENTERAL NUTRITION SOLUTION; AMINO ACID, 7% THROUGH 8.5%, (500 ML = 1 UNIT) -

HOMEMIX 

B4178 PARENTERAL NUTRITION SOLUTION: AMINO ACID, GREATER THAN 8.5% (500 ML = 1 UNIT) 

- HOMEMIX 

B4180 PARENTERAL NUTRITION SOLUTION; CARBOHYDRATES (DEXTROSE), GREATER THAN 50% (500 

ML=1 UNIT) - HOMEMIX 

B4184 PARENTERAL NUTRITION SOLUTION; LIPIDS, 10% WITH ADMINISTRATION SET (500 ML = 1 

UNIT) 

B4186 PARENTERAL NUTRITION SOLUTION, LIPIDS, 20% WITH ADMINISTRATION SET (500 ML = 1 

UNIT) 

B4189 PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH 

ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANY 

STRENGTH, 10 TO 51 GRAMS OF PROTEIN - PREMIX 



STRENGTH, 52 TO 73 GRAMS OF PROTEIN - PREMIX 


ELECTROLYTES, TRACE ELEMENTS AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 

74 TO 100 GRAMS OF PROTEIN - PREMIX 


ELECTROLYTES, TRACE ELEMENTS AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 

OVER 100 GRAMS OF PROTEIN - PREMIX 

B4216 PARENTERAL NUTRITION; ADDITIVES (VITAMINS, TRACE ELEMENTS, HEPARIN, 

ELECTROLYTES) HOMEMIX PER DAY 

B4220 PARENTERAL NUTRITION SUPPLY KIT; PREMIX, PER DAY 

B4222 PARENTERAL NUTRITION SUPPLY KIT; HOME MIX, PER DAY 

B4224 PARENTERAL NUTRITION ADMINISTRATION KIT, PER DAY 

B5000 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH 


STRENGTH, RENAL - AMIROSYN RF, NEPHRAMINE, RENAMINE - PREMIX 



STRENGTH, HEPATIC - FREAMINE HBC, HEPATAMINE - PREMIX 



STRENGTH, STRESS - BRANCH CHAIN AMINO ACIDS - PREMIX 

B9000 ENTERAL NUTRITION INFUSION PUMP - WITHOUT ALARM 

B9002 ENTERAL NUTRITION INFUSION PUMP - WITH ALARM 

B9004 PARENTERAL NUTRITION INFUSION PUMP, PORTABLE 

B9006 PARENTERAL NUTRITION INFUSION PUMP, STATIONARY 

B9998 NOC FOR ENTERAL SUPPLIES 

B9999 NOC FOR PARENTERAL SUPPLIES 

C1000 CLOSURE, ARTERIAL VASCULAR DEVICE, PERCLOSE CLOSER ARTERIAL VASCULAR CLOSURE 

DEVICE, PROSTAR ARTERIAL VASCULAR CLOSURE DEVICE 

C1001 CATHETER, DIAGNOSTIC ULTRASOUND, ACUNAV DIAGNOSTIC ULTRASOUND CATHETER 

C1003 CATHETER, ABLATION, LIVEWIRE TC ABLATION CATHETER 402132, 402133, 402134, 

402135, 402136, 402137, 402145, 402146, 402147, 402148, 402149, 402150, 402151, 

402152, 402153, 402154, 402155, 402156 

C1004 FAST-CATH, SWARTZ, SAFL, CSTA, SEPT, RAMP GUIDING INTRODUCER 

C1005 INTRAOCULAR LENS, SENSAR SOFT ACRYLIC ULTRAVIOLET LIGHT ABSORBING POSTERIOR 

CHAMBER INTRAOCULAR LENS 

C1006 INTRAOCULAR LENS, ARRAY MULTIFOCAL SILICONE POSTERIOR CHAMBER INTRAOCULAR LENS 

C1007 PROSTHESIS, PENILE, AMS 700 PENILE PROSTHESIS, AMS AMBICOR PENILE PROSTHESIS 

NOTE: ONLY THE AMS AMBICOR PENILE PROSTHESIS IS EFFECTIVE OCTOBER 1, 2000. THE 

AMS 700 PENILE PROSTHESIS WAS EFFECTIVE AUGUST 1, 2000. 

C1008 STENT, URETHRAL, PERMANENT, UROLUME 

C1009 PLASMA, CRYOPRECIPITATE REDUCED, EACH UNIT 

C1010 BLOOD, LEUKOREDUCED, CMV-NEGATIVE, EACH UNIT

C1011 PLATELET, HLA-MATCHED LEUKOREDUCED, APHERESIS/PHERESIS, EACH UNIT 

C1012 PLATELET CONCENTRATE, LEUKOREDUCED, IRRADIATED, EACH UNIT 

C1013 PLATELET CONCENTRATE, LEUKOREDUCED, EACH UNIT 

C1014 PLATELET, LEUKOREDUCED, APHERESIS/PHERESIS, EACH UNIT 

C1016 BLOOD, LEUKOREDUCED, FROZEN/DEGLYCEROL/WASHED, EACH UNIT 

C1017 PLATELET, LEUKOREDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT 

C1018 BLOOD, LEUKOREDUCED, IRRADIATED, EACH UNIT 

C1019 PLATELET, LEUKOREDUCED, IRRADIATED, APHERESIS/PHERESIS, EACH UNIT 

C1024 QUINOPRISTIN/DALFOPRISTIN, 10ML, SYNERCID IV 

C1025 CATHETER, MARINR CS CATHETER 

C1026 CATHETER ABLATION, RF PERFORMR, 5F RF MARINR 

C1027 STENT, CORONARY, MAGIC WALLSTENT EXTRA SHORT OR SHORT CORONARY SELF-EXPANDING 

STENT WITH DELIVERY SYSTEM, RADIUS 14MM SELF EXPANDING STENT WITH OVER THE WIRE 

DELIVERY SYSTEM 

C1028 SLING FIXATION SYSTEM FOR TREATMENT OF STRESS URINARY INCONTINENCE, PRECISION 

TWIST TRANSVAGINAL ANCHOR SYSTEM, PRECISION TACK TRANSVAGINAL ANCHOR SYSTEM, 

VESICA PRESS-IN ANCHOR SYSTEM, CAPIO CL (TVB/S) TRANSVAGINAL SUTURING DEVICE 

C1029 CATHETER, BALLOON DILATATION, CONTROLLED RADIAL EXPANSION (CRE) BALLOON 

DILATATION CATHETER WIRE GUIDED AND FIXED WIRE 

C1030 CATHETER, BALLOON DILATATION, MARSHAL, BLUE MAX 20, ULTRA-THIN DIAMOND 

C1031 ELECTRODE, NEEDLE, ABLATION, MR COMPATIBLE LEVEEN, MODIFIED LEVEEN NEEDLE 

ELECTRODE 

C1033 CATHETER, IMAGING, SONICATH ULTRA MODEL 37-410 ULTRASOUND IMAGING CATHETER 

C1034 CATHETER, CORONARY ANGIOPLASTY, SURPASS SUPERFUSION CATHETER, LONG 30 SURPASS 

SUPERFUSION CATHETER 

C1035 CATHETER, INTRACARDIAC ECHOCARDIOGRAPHY, ULTRA ICE 6F, 12.5 MHZ CATHETER (WITH 

DISPOSABLE SHEATH), ULTRA ICE 9F, 9 MHZ CATHETER (WITH DISPOSABLE SHEATH) 

C1036 PORT/RESERVOIR, VENOUS ACCESS DEVICE, VAXCEL IMPLANTABLE VASCULAR ACCESS 

SYSTEM, R PORT PREMIER VASCULAR ACCESS SYSTEM 

C1037 CATHETER, DIALYSIS, VAXCEL CHRONIC DIALYSIS CATHETER 

C1038 CATHETER, IMAGING, ULTRACROSS 2.9F 30MHZ CORONARY IMAGING CATHETER, ULTRACROSS 

3.2F MHZ CORONARY IMAGING CATHETER 

C1039 STENT, TRACHEOBRONCHIAL, WALLSTENT TRACHEOBRONCHIAL ENDOPROSTHESIS (COVERED), 

WALLSTENT TRACHEOBRONCHIAL ENDOPROSTHESIS WITH PERMALUME COVERING AND UNISTEP 

PLUS DELIVERY SYSTEM, WALLSTENT RP TRACHEOBRONCHIAL ENDOPROSTHESIS WITH UNISTEP 

PLUS DELIVERY SYSTEM NOTE: ONLY THE WALLSTENT RP TRACHEOBRONCHIAL 

ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY SYSTEM IS EFFECTIVE OCTOBER 1, 2000. 

THE WALLSTENT TRACHEOBRONCHIAL WAS EFFECTIVE AUGUST 1, 2000. 

C1040 STENT, SELF-EXPANDABLE FOR CREATION OF INTRAHEPATIC SHUNTS, WALLSTENT 

TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT (TIPS) WITH UNISTEP PLUS DELIVERY 

SYSTEM (40/42/60/68MM IN LENGTH), WALLSTENT RP ENDOPROSTHESIS WITH UNISTEP PLUS 

DELIVERY SYSTEM (42/68MM IN LENGTH) NOTE: ONLY THE WALLSTENT RP TIPS 


THE WALLSTENT TIPS ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY SYSTEM WAS 

EFFECTIVE AUGUST 1, 2000. 

C1042 STENT, BILIARY, WALLSTENT BILIARY ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY 

SYSTEM, WALLSTENT BILIARY ENDOPROSTHESIS WITH UNISTEP DELIVERY SYSTEM (BILIARY 

STENT AND CATHETER), WALLSTENT RP BILIARY ENDOPROSTHESIS WITH UNISTEP PLUS 

DELIVERY SYSTEM, ULTRAFLEX DIAMOND BILIARY STENT SYSTEM, NEW MICROVASIVE 

BILIARY STENT AND DELIVERY SYSTEM NOTE: ONLY THE WALLSTENT RP BILIARY 


THE WALLSTENT, ULTRAFLEX DIAMOND, NEW MICROVASIVE BILIARY STENT SYSTEMS WERE 


C1043 ATHERECTOMY SYSTEM, CORONARY, ROTABLATOR ROTALINK ATHERECTOMY CATHETER AND 

BURR, ROTABLATOR ROTALINK ROTATIONAL ATHERECTOMY SYSTEM ADVANCER AND GUIDE WIRE 

C1045 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, I-131 MIBG [IOBENGUANE 

SULFATE I-131], PER 0.5 MCI

C1047 CATHETER, DIAGNOSTIC, NAVI-STAR DIAGNOSTIC DEFLECTABLE TIP CATHETER, NOGA-STAR 

DIAGNOSTIC DEFLECTABLE TIP CATHETER 

C1048 GENERATOR, BIPOLAR PULSE, CYBERONICS NEUROCYBERNETIC PROSTHESIS GENERATOR 

C1050 PROTEIN A IMMUNOADSORPTION, PROSORBA COLUMN 

C1051 CATHETER, THROMBECTOMY, OASIS THROMBECTOMY CATHETER 

C1053 CATHETER, DIAGNOSTIC, ENSITE 3000 CATHETER 

C1054 CATHETER, THROMBECTOMY, HYDROLYSER 6F MECHANICAL THROMBECTOMY CATHETER, 

HYDROLYSER 7F MECHANICAL THROMBECTOMY CATHETER 

C1055 CATHETER, TRANSESOPHAGEAL 210 ATRIAL PACING CATHETER, TRANSESOPHAGEAL 210-S 

ATRIAL PACING CATHETER 

C1056 CATHETER, ABLATION, GYNECARE THERMACHOICE II CATHETER 

C1057 TISSUE MARKER, 11-GAUGE MICROMARK II TISSUE MARKER 

C1059 AUTOLOGOUS CULTRURED CHONDROCYTES, IMPLANTATION, CARTICEL 

C1060 STENT, CORONARY, ACS MULTI-LINK TRISTAR CORONARY STENT SYSTEM AND DELIVERY 

SYSTEM, ACS MULTI-LINK ULTRA CORONARY STENT SYSTEM NOTE: ACS MULTI-LINK ULTRA 

IS EFFECTIVE 01/01/01. ACS MULTI-LINK TRISTAR WAS EFFECTIVE 08/01/00. 

C1061 CATHETER, CORONARY GUIDE, ACS VIKING GUIDING CATHETER 

C1063 LEAD, DEFIBRILLATOR, ENDOTAK ENDURANCE EZ, ENDOTAK ENDURANCE RX, ENDOTAK 

ENDURANCE 0134, 0135, 0136 NOTE: ENDOTAK ENDURANCE IS EFFECTIVE 01/01/01. 

ENDOTAK ENDURANCE EZ AND RX WERE EFFECTIVE 08/01/00. 

C1067 STENT, BILIARY, MEGALINK BILIARY STENT 

C1068 PACEMAKER, DUAL CHAMBER, PULSAR DDD 

C1069 PACEMAKER, DUAL CHAMBER, DISCOVERY DR 

C1071 PACEMAKER, SINGLE CHAMBER, PULSAR MAX SR, PULSAR SR 

C1072 CATHETER, BALLOON DILATATION, CORONARY, RX ESPRIT, RX GEMINI, RX SOLARIS, OTW 

PHOTON, OTW SOLARIS 

C1073 MORCELLATOR, LAPAROSCOPIC, GYNECARE X-TRACT LAPARASCOPIC MORCELLATOR 

C1074 CATHETER, PERIPHERAL DILATATION, RX VIATRAC 14 PERIPHERAL DILATATION CATHETER, 

OTW VIATRAC 18 PERIPHERAL DILATATION CATHETER 

C1075 LEAD, PACEMAKER, SELUTE PICOTIP, SELUTE, SWEET PICOTIP RX, SWEET TIP RX, 

FINELINE, FINELINE EZ, THINLINE, THINLINE EZ 

C1076 DEFIBRILLATOR, SINGLE CHAMBER, AUTOMATIC, IMPLANTABLE, VENTAK MINI IV, VENTAK 

MINI IV+ (MODELS 1793, 1796), VENTAK MINI III HE, VENTAK MINI III HE+ (MODELS 

1788, 1789), VENTAK MINI III, VENTAK MINI III + (MODELS 1783, 1786) NOTE: ONLY 

THE VENTAK MINI IV+, VENTAK MINI III HE+ AND VENTAK MINI III+ ARE EFFECTIVE 

01/01/01. VENTAK MINI IV, VENTAK MINI III HE, AND VENTAK MINI III WERE 

EFFECTIVE 08/01/00. 

C1077 DEFIBRILLATOR, SINGLE CHAMBER, AUTOMATIC, IMPLANTABLE, VENTAK PRIZM VR, VENTAK 

VR 

C1078 DEFIBRILLATOR, DUAL CHAMBER, AUTOMATIC, IMPLANTABLE, VENTAK PRIZM, VENTAK AV 

III DR 

C1079 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, CYANOCOBALAMIN CO 

58/57, KIT, 0.5 MCI, NYCOMED CYANOCO CO57/CYANOCO CO 58 

C1084 DENILEUKIN DIFTITOX, 300 MCG, ONTAK IV 

C1086 TEMOZOLOMIDE, 5 MG, TEMODAR 

C1087 SUPPLY OF RADIOPHARMACEUTICAL IMAGING AGENT, SODIUM IODIDE 1-123 (CAPSULE), PER 

UCI 

C1088 LASER OPTIC TREATMENT SYSTEM, INDIGO LASEROPTIC TREATMENT SYSTEM 

C1089 SUPPLY OF RADIOHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, CYANOCOBALAMIN CO 57, 

0.5 MCI, CAPSULE 

C1090 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM IN 111 CHLORIDE, 

PER MCI 

C1091 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM IN 111 

OXYQUINOLINE, PER 5MCI 

C1092 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM IN 111 PENTETATE 

DISODIUM, PER 1.5 MCI 

C1094 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M

ALBUMIN AGGREGATED, PER VIAL 

C1095 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M 

DEPREOTIDE, PER VIAL 


EXAMETAZIME, PER DOSE 


MEBROFENIN, PER VIAL 


PENTETATE, PER VIAL 


PYROPHOSPHATE, PER VIAL 

C1100 GUIDE WIRE, PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY, MEDTRONIC AVE GT1 

GUIDE WIRE, MEDTRONIC AVE GT2 FUSION GUIDE WIRE 

C1101 CATHETER, PERCUTANEOUS TRANSLUMINAL CORONARY ANGIPLASTY GUIDE, MEDTRONIC AVE 

5F, 6F, 7F, 8F, 9F ZUMA GUIDE CATHETER, MEDTRONIC AVE Z2 5F, 6F, 7F, 8F, 9F 

ZUMA GUIDE CATHETER NOTE: ONLY THE MEDTRONIC AVE Z2 ZUMA GUIDE CATHETERS ARE 

EFFECTIVE OCTOBER 1, 2000. THE MEDTRONIC AVE ZUMA GUIDE CATHETERS WERE 


C1102 GENERATOR, PULSE, NEUROSTIMULATOR, MEDTRONIC SYNERGY NEUROSTIMULATOR GENERATOR 

AND EXTENSION 

C1103 DEFIBRILLATOR, IMPLANTABLE, MICRO JEWEL, MICRO JEWEL II 

C1104 CATHETER, ABLATION, RF CONDUCTR MC 4MM, RF CONDUCTR MC 5MM (MODELS 6042, 7544) 

NOTE: RF CONDUCTR MC 5MM IS EFFECTIVE 01/01/01. RF CONDUCTR MC 4MM WAS 


C1105 PACEMAKER, DUAL CHAMBER, SIGMA 300 VDD 

C1106 NEUROSTIMULATOR, PATIENT PROGRAMMER, SYNERGY EZ PATIENT PROGRAMMER 

C1107 CATHETER, DIAGNOSTIC, ELECTROPHYSIOLOGY, TORQR, SOLOIST 

C1109 ANCHOR, IMPLANTABLE, MITEK GII ANCHOR, MITEK KNOTLESS, MITEK TACIT, MITEK 

ROTATOR CUFF, MITEK GLS, MITEK MINI, MITEK FASTIN, MITEK SUPER, MITEK PANALOK, 

MITEK MICRO, MITEK PANALOK RC, MITEK FASTIN RC, INNOVASIVE ROC EZ, INNOVASIVE 

MINIROC, INNOVASIVE BIOROC, INNOVASIVE ROC XS, INNOVASIVE CONTACK 

C1110 CATHETER, DIAGNOSTIC, ELECTROPHYSIOLOGY, STABLE MAPPER 

C1111 STENT GRAFT SYSTEM, ANEURX AORTO-UNI-ILIAC-STENT GRAFT SYSTEM 

C1112 STENT GRAFT SYSTEM, ANEURX STENT GRAFT SYSTEM 

C1113 STENT GRAFT SYSTEM, TALENT ENDOLUMINAL SPRING STENT GRAFT SYSTEM 

C1114 STENT GRAFT SYSTEM, TALENT SPRING STENT GRAFT SYSTEM 

C1115 LEAD, PACEMAKER, 5038S, 5038, 5038L 

C1116 LEAD, PACEMAKER, CAPSURE SP NOVUS, CAPSURE SP, CAPSURE, EXCELLENCE +, S+, PS+, 

CAPSURE Z NOVUS, CAPSURE Z, IMPULSE 

C1117 ENDOGRAFT SYSTEM, ANCURE ENDOGRAFT DELIVERY SYSTEM 

C1118 PACEMAKER, DUAL CHAMBER, SIGMA 300 DR, LEGACY II DR 

C1119 LEAD, DEFIBRILLATOR, SPRINT 6932, SPRINT 6943 

C1120 LEAD, DEFIBRILLATOR, SPRINT 6942, SPRINT 6945 

C1121 DEFIBRILLATOR, IMPLANTABLE, GEM 


ARCITUMOMAB, PER VIAL 

C1123 DEFIBRILLATOR, IMPLANTABLE, GEM II VR 

C1124 LEAD, NEUROSTIMULATOR, KIT, INTERSTIM TEST STIMULATION LEAD KIT 

C1125 PACEMAKER, SINGLE CHAMBER, KAPPA 400 SR, TOPAZ II SR 

C1126 PACEMAKER, DUAL CHAMBER, KAPPA 700 DR (ALL MODELS) 

C1127 PACEMAKER, SINGLE CHAMBER, KAPPA 700 SR 

C1128 PACEMAKER, DUAL CHAMBER, KAPPA 700 D, RUBY II D 

C1129 PACEMAKER, KAPPA 700 VDD 

C1130 PACEMAKER, DUAL CHAMBER, SIGMA 200 D, LEGACY II D 

C1131 PACEMAKER, DUAL CHAMBER, SIGMA 200 DR 

C1132 PACEMAKER, SINGLE CHAMBER, SIGMA 200 SR, LEGACY II SR 

C1133 PACEMAKER, SINGLE CHAMBER, SIGMA 300 SR, VITA SR

C1134 PACEMAKER, DUAL CHAMBER, SIGMA 300 D 

C1135 PACEMAKER, DUAL CHAMBER, RATE-RESPONSIVE, ENTITY DR 5326L, ENTITY DR 5326R, 

ENTITY DR 5326 NOTE: ONLY THE ENTITY DR 5326 IS EFFECTIVE 01/01/01. ENTITY DR 

5326L AND 5326R WERE EFFECTIVE 08/01/00. 

C1136 PACEMAKER, DUAL CHAMBER, RATE-RESPONSIVE, AFFINITY DR 5330L, AFFINITY DR 5330R, 

AFFINITY DR 5330 NOTE: ONLY THE AFFINITY DR 5330 IS EFFECTIVE 01/01/01. 

AFFINITY DR 5330L AND 5330R WERE EFFECTIVE 08/01/00. 

C1137 SEPTAL DEFECT IMPLANT SYSTEM, CARDIOSEAL SEPTAL OCCLUSION SYSTEM, CARDIOSEAL 

OCCLUDER DELIVERY CATHETER 

C1143 PACEMAKER, DUAL CHAMBER, ADDVENT 2060BL 

C1144 PACEMAKER, SINGLE CHAMBER, RATE-RESPONSIVE, AFFINITY SR 5130, AFFINITY SR 

5130L, AFFINITY SR 5130R, INTEGRITY SR 5142 NOTE: ONLY THE AFFINITY SR 5130 IS 

EFFECTIVE 01/01/01. AFFINITY SR 5130L, AFFINITY SR 5130R, AND INTEGRITY SR 

5142 WERE EFFECTIVE 08/01/00. 

C1145 VASCULAR CLOSURE DEVICE, ANGIO-SEAL 6 FRENCH VASCULAR CLOSURE DEVICE 610091, 

ANGIO-SEAL 8 FRENCH VASCULAR CLOSURE DEVICE 610089, 610097 NOTE: MODEL 610097 

IS EFFECTIVE 01/01/01. MODELS 610091 AND 610089 WERE EFFECTIVE 08/01/00. 

C1146 ENDOTRACHEAL TUBE, VETT TRACHEOBRONCHIAL TUBE 

C1147 LEAD, PACEMAKER, AV PLUS DX 1368/52, AV PLUS DX 1368/58, AV PLUS DX 1368/65 

NOTE: THE AV PLUS DX 1368/65 IS EFFECTIVE 01/01/01. MODELS 1368/52 AND 1368/58 

WERE EFFECTIVE 08/01/00. 

C1148 DEFIBRILLATOR, SINGLE CHAMBER, IMPLANTABLE, CONTOUR MD V-175, CONTOUR MD 

V-175A, CONTOUR MD V-175AC, CONTOUR MD V-175B, CONTOUR MD V-175C, CONTOUR MD 

V-175D 

C1149 PACEMAKER, DUAL CHAMBER, NON-RATE RESPONSIVE, ENTITY DC 5226R, ENTITY DC 5226 

NOTE: MODEL 5226 IS EFFECTIVE 01/01/01. MODEL 5226R WAS EFFECTIVE 08/01/00. 

C1151 LEAD, PACEMAKER, PASSIVE PLUS DX 1343K/46, PASSIVE PLUS DX 1343K/52, PASSIVE 

PLUS DX 1345K/52, PASSIVE PLUS DX 1345K/58, PASSIVE PLUS DX 1336T/52, PASSIVE 

PLUS DX 1336T/58, PASSIVE PLUS DX 1342T/46, PASSIVE PLUS DX 1342T/52, PASSIVE 

PLUS DX 1346T/52, PASSIVE PLUS DX 1346T/58 

C1152 ACCESS SYSTEM, DIALYSIS, LIFESITE ACCESS SYSTEM 

C1153 PACEMAKER, SINGLE CHAMBER, REGENCY SC+ 2402L 

C1154 LEAD, DEFIBRILLATOR, SPL SP01, SP02, SPL 04 

C1155 REPLIFORM TISSUE REGENERATION MATRIX, PER 8 SQUARE CENTIMETERS 

C1156 PACEMAKER, SINGLE CHAMBER, AFFINITY SR 5131M/S, TEMPO VR 1102, TRILOGY SR+ 

2260L, TRILOGY SR+ 2264L 

C1157 PACEMAKER, DUAL CHAMBER, TRILOGY DC+2318L 

C1158 LEAD, DEFIBRILLATOR, TVL SV01, TVL SV02, TVL SV04 

C1159 LEAD, DEFIBRILLATOR, TVL RV02, TVL RV06, TVL RV07 

C1160 LEAD, DEFIBRILLATOR, TVL-ADX 1559/65 

C1161 LEAD, PACEMAKER, TENDRIL DX 1388K/46, TENDRIL DX 1388K/52, TENDRIL DX 1388K/58, 

TENDRIL DX 1388T/46, TENDRIL DX 1388T/52, TENDRIL DX 1388T/58, TENDRIL DX 

1388T/85, TENDRIL DX 1388T/100, TENDRIL DX 1388TC/46, TENDRIL DX 1388TC/52, 

TENDRIL DX 1388T/58 

C1162 PACEMAKER, DUAL-CHAMBER, AFFINITY DR 5331 M/S, TEMPO DR 2102, TRILOGY DR+ 

2360L, TRILOGY DR+ 2364L 

C1163 LEAD, PACEMAKER, TENDRIL SDX 1488T/46, TENDRIL SDX 1488T/52, TENDRIL SDX 

1488T/58, TENDRIL SDX 1488TC/46, TENDRIL SDX 1488TC/52, TENDRIL SDX 1488TC/58 

C1164 BRACHYTHERAPY SEED, I-125 SEED 

C1166 INJECTION, CYTARABINE LIPOSOME, 10 MG, DEPOCYT/LIPOSOMAL CYTARABINE 

C1167 INJECTION, EPIRUBICIN HYDROCHLORIDE, 2 MG 

C1170 BIOPSY DEVICE, BREAST, ABBI DEVICE 

C1171 SITE MARKER DEVIE, DISPOSABLE, AUTO SUTURE SITE MARKER DEVICE 

C1172 BALLOON, TISSUE DISSECTOR, SPACEMAKER TISSUE DISSECTION BALLOON, SPACEMAKER 

1000CC HERNIA BALLOON DISSECTOR NOTE: THE HERNIA BALLOON DISSECTOR IS 

EFFECTIVE 01/01/01. THE SPACEMAKER TISSUE DISSECTION BALLOON IS EFFECTIVE 

08/01/00.

C1173 STENT, CORONARY, S540 OVER-THE-WIRE CORONARY STENT SYSTEM, S670 WITH DISCRETE 

TECHNOLOGY OVER-THE-WIRE CORONARY STENT SYSTEM, S670 WITH DISCRETE TECHNOLOGY 

RAPID EXCHANGE CORONARY STENT SYSTEM 

C1174 NEEDLE, BRACHYTHERAPY, BARD BRACHYSTAR BRACHYTHERAPY NEEDLE 

C1175 BIOPSY DEVICE, MIBB DEVICE 

C1176 BIOPSY DEVICE, MAMMOTOME HH HAND-HELD PROBE WITH SMARTVAC VACUUM SYSTEM 

C1177 BIOPSY DEVICE, 11-GAUGE MAMMOTOME PROBE WITH VACUUM CANNISTER 

C1178 INJECTION, BUSULFAN (BUSULFEX IV) PER 6 MG 

C1179 BIOPSY DEVICE, 14-GAUGE MAMMOTOME PROBE WITH VACUUM CANNISTER 

C1180 PACEMAKER, SINGLE CHAMBER, VIGOR SR 

C1181 PACEMAKER, SINGLE CHAMBER, MERIDIAN SSI 

C1182 PACEMAKER, SINGLE CHAMBER, PULSAR SSI 

C1183 PACEMAKER, SINGLE CHAMBER, JADE II S, SIGMA 300 S 

C1184 PACEMAKER, SINGLE CHAMBER, SIGMA 200 S 

C1188 SODIUM IODIDE I-131, PER UCI 


SODIUM GLUCOHEPTONATE, PER VIAL 


SUCCIMER, PER VIAL 


SULFUR COLLOID, PER DOSE 

C1203 INJECTION, VISUDYNE (VERTEPORFIN) 


DISOFENIN, PER VIAL 

C1207 OCTREOTIDE ACETATE, 1 MG 

C1300 HYPERBARIC OXYGEN UNDER PRESSURE, FULL BODY CHAMBER, PER 30 MINUTE INTERVAL 

C1302 LEAD, DEFIBRILLATOR, TVL SQ01 

C1303 LEAD, DEFIBRILLATOR, CAPSURE FIX 6940, CAPSURE FIX 4068-110 

C1304 CATHETER, IMAGING, SONICATH ULTRA MODEL 37-416 ULTRASOUND IMAGING CATHETER, 

SONICATH ULTRA MODEL 37-418 ULTRASOUND IMAGING CATHETER 

C1305 APLIGRAF, PER 44 SQUARE CENTIMETERS 

C1306 LEAD, NEUROSTIMULATOR, CYBERONICS NEUROCYBERNETIC PROSTHESIS LEAD 

C1311 PACEMAKER, DUAL CHAMBER, TRILOGY DR+/DAO 

C1312 STENT, CORONARY, MAGIC WALLSTENT MINI CORONARY SELF EXPANDING STENT WITH 


C1313 STENT, CORONARY, MAGIC WALLSTENT MEDIUM CORONARY SELF EXPANDING STENT WITH 

DELIVERY SYSTEM, RADIUS 31MM SELF EXPANDING STNET WITH OVER THE WIRE DELIVERY 

SYSTEM 

C1314 STENT, CORONARY, MAGIC WALLSTENT LONG CORONARY SELF EXPANDING STENT WITH 


C1315 PACEMAKER, DUAL CHAMBER, VIGOR DR, MERIDIAN DR 

C1316 PACEMAKER, DUAL CHAMBER, MERIDIAN DDD 

C1317 PACEMAKER, SINGLE CHAMBER, DISCOVERY SR 

C1318 PACEMAKER, SINGLE CHAMBER, MERIDIAN SR 

C1319 STENT, ENTERAL, WALLSTENT ENTERAL ENDOPROSTHESIS AND UNISTEP DELIVERY SYSTEM 

(60MM IN LENGTH), ENTERAL WALLSTENT ENDOPROSTHESIS AND UNISTEP PLUS DELIVERY 

SYSTEM/SINGLE-USE COLONIC AND DUODENAL ENDOPROSTHESIS WITH UNISTEP PLUS 

DELIVERY SYSTEM (60MM IN LENGTH) NOTE: ONLY THE ENTERAL WALSLTENT 

ENDOPROSTHESIS AND UNISTEP PLUS DELIVERY SYSTEM IS EFFECTIVE OCTOBER 1, 2000. 

THE WALLSTENT ENTERAL ENDOPROSTHESIS AND UNISTEP DELIVERY SYSTEM WAS EFFECTIVE 

AUGUST 1, 2000. 

C1320 STENT, ILIAC, WALLSTENT ILIAC ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY SYSTEM, 

WALLSTENT RP ILIAC ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY SYSTEM NOTE: 

ONLY THE WALLSTENT RP ILIAC ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY SYSTEM IS 

EFFECTIVE OCTOBER 1, 2000. THE WALLSTENT ILIAC ENDOPROSTHESIS WITH UNISTEP 

PLUS DELIVERY SYSTEM WAS EFFECTIVE AUGUST 1, 2000. 

C1321 ELECTRODE, DISPOSABLE, PALATE SOMNOPLASTY COAGULATING ELECTRODE, BASE OF TONGUE

SOMNOPLASTY COAGULATING ELECTRODE 

C1322 ELECTRODE, DISPOSABLE, TURBINATE SOMNOPLASTY COAGULATING ELECTRODE 

C1323 ELECTRODE, DISPOSABLE, VAPR ELECTRODE, VAPR T THERMAL ELECTRODE 

C1324 ELECTRODE, DISPOSABLE, LIGASURE DISPOSABLE ELECTRODE 

C1325 BRACHYTHERAPY SEED, PALLADIUM-103 SEED 

C1326 CATHETER, THROMBECTOMY, ANGIOJET RHEOLYTIC THROMBECTOMY CATHETER 

C1328 EXTERNAL TRANSMITTER, NEUROSTIMULATION SYSTEM, ANS RENEW SPINAL CORD STIMULATOR 

SYSTEM 

C1329 ELECTRODE, DISPOSABLE, GYNECARE VERSAPOINT RESECTOSCOPIC SYSTEM BIPOLAR 

ELECTRODE 

C1333 STENT, BILIARY, PALMAZ CORINTHIAN TRANSHEPATIC BILIARY STENT AND DELIVERY 

SYSTEM 

C1334 STENT, CORONARY, PALMAZ-SCHATZ CROWN STENT, MINI-CROWN STENT, CROSSFLEX LC 

STENT 

C1335 MESH, HERNIA, PROLENE POLYPROPYLENE HERNIA SYSTEM 

C1336 INFUSION PUMP, IMPLANTABLE, NON-PROGRAMMABLE, CONSTANT FLOW IMPLANTABLE PUMP 

WITH BOLUS SAFETY VALVE MODEL 3000, MODEL 3000-16 (16ML), MODEL 3000-50 (50ML) 

NOTE: CONSTANT FLOW IMPLANTABLE PUMP MODEL 3000 WAS EFFECTIVE AUGUST 1, 2000. 

MODELS 3000-16 AND 3000-50 ARE EFFECTIVE OCTOBER 1, 2000 

C1337 INFUSION PUMP, IMPLANTABLE, NON-PROGRAMMABLE, ISOMED INFUSION PUMP MODEL 

8472-20, 8472-35, 8472-60 

C1348 SODIUM IODIDE I-131, PER MCI 

C1350 BRACHYTHERAPY, PER SOUCE, PROSTASEED I-125 

C1351 LEAD, PACEMAKER, CAPSUREFIX, SUREFIX, PIROUET +, S+ 

C1352 DEFIBRILLATOR, DUAL CHAMBER, IMPLANTABLE, GEM II DR 

C1353 NEUROSTIMULATOR, IMPLANTABLE, ITREL II/SOLETRA IMPLANTABLE NEUROSTIMULATOR AND 

EXTENSION, ITREL III IMPLANTABLE NEUROSTIMULATOR AND EXTENSION, INTERSTIM 

NEUROSTIMULATOR (IMPLANTABLE) AND EXTENSION 

C1354 PACEMAKER, DUAL CHAMBER, KAPPA 400 DR, DIAMOND II 820 DR 

C1355 PACEMAKER, DUAL CHAMBER, KAPPA 600 DR, VITA DR 

C1356 DEFIBRILLATOR, SINGLE CHAMBER, IMPLANTABLE, PROFILE MD V-186HV3 

C1357 DEFIBRILLATOR, SINGLE CHAMBER, IMPLANTABLE, ANGSTROM MD V-190HV3 

C1358 PACEMAKER, DUAL CHAMBER, NON-RATE RESPONSIVE, AFFINITY DC 5230R, AFFINITY DC 

5230 NOTE: MODEL 5230 IS EFFECTIVE 01/01/01. MODEL 5230R WAS EFFECTIVE 

08/01/00. 

C1359 PACEMAKER, DUAL CHAMBER, PULSAR DR, PULSAR MAX DR 

C1360 OCULAR PHOTODYNAMIC THERAPY 

C1361 RECORDER, CARDIAC EVENT, IMPLANTABLE, REVEAL, REVEAL PLUS 

C1362 STENT, BILIARY, RX HERCULINK 14 BILIARY STENT, OTW MEGALINK SDS BILIARY STENT 

C1363 DEFIBRILLATOR, IMPLANTABLE, DUAL CHAMBER, GEM DR 

C1364 DEFIBRILLATOR, DUAL CHAMBER, PHOTON DR V-230HV3 

C1365 GUIDE WIRE, PERIPHERAL, HI-TORQUE SPARTACORE 14 GUIDE WIRE, HI-TORQUE MEMCORE 

FIRM 14 GUIDE WIRE, HI-TORQUE STEELCORE 18 GUIDE WIRE, HI-TORQUE STEELCORE 18 

LT GUIDE WIRE, HI-TORQUE SUPRA CORE 35 GUIDE WIRE NOTE: ONLY THE HI-TORQUE 

STEELCORE 18 LT GUIDE WIRE IS EFFECTIVE OCTOBER 1, 2000. THE OTHER GUIDE WIRES 

WERE EFFECTIVE AUGUST 1, 2000. 

C1366 GUIDE WIRE, PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY, HI-TORQUE IRON MAN, 

HI-TORQUE BALANCE MIDDLEWEIGHT, HI-TORQUE ALL STAR, HI-TORQUE BALANCE 

HEAVYWEIGHT, HI-TORQUE BALANCE TREK 

C1367 GUIDE WIRE, PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY, HI-TORQUE CROSS IT, 

HI-TORQUE CROSS-IT 100XT, HI-TORQUE CROSS-IT 200XT, HI-TORQUE CROSS-IT 300XT, 

HI-TORQUE WIGGLE 

C1368 INFUSION SYSTEM, ON-Q PAIN MANAGEMENT SYSTEM, ON-Q SOAKER PAIN MANAGEMENT 

SYSTEM, AND PAINBUSTER PAIN MANAGEMENT SYSTEM NOTE: THE ON-Q PAIN MANAGEMENT 

SYSTEM, ON-Q SOAKER PAIN MANAGEMENT SYSTEM, AND PAINBUSTER PAIN MANAGEMENT 

SYSTEM ARE EFFECTIVE AUGUST 1, 2000. 

C1369 INTERNAL RECEIVER, NEUROSTIMULATION SYSTEM, ANS RENEW SPINAL CORD STIMULATOR

SYSTEM 

C1370 SINGLE USE DEVICE FOR TRATMENT OF FEMALE STRESS URINARY INCONTINENCE, 

TENSION-GREE VAGINAL TAPE SINGLE USE DEVICE 

C1371 STENT, BILIARY, SYMPHONY NITINOL STENT TRANSHEPATIC BILIARY SYSTEM, SYMPHONY 

NITINOL BILIARY STENT WITH RADIOPAQUE MARKERS 

C1372 STENT, BILIARY, SMAR CORDIS NITINOL STENT AND DELIVERY SYSTEM 

C1375 STENT, CORONARY, NIR ON RANGER STENT DELIVERY SYSTEM, NIR W/SOX STENT SYSTEM, 

NIR PRIMO PREMOUNTED STENT SYSTEM 

C1376 LEAD, NEUROSTIMULATOR, ANS RENEW SPINAL CORD STIMULATION SYSTEM LEAD (WITH OR 

WITHOUT EXTENSION) 

C1377 LEAD, NEUROSTIMULATOR, SPECIFY 3988 LEAD 

C1378 LEAD, NEUROSTIMULATOR, INERSTIM THERAPY 3080 LEAD, INTERSTIM THERAPY 3886 LEAD 

C1379 LEAD, NEUROSTIMULATOR, PISCES-QUAD COMPACT 3887 LEAD 

C1420 ANCHOR SYSTEM, STAPLETAC2 BONE ANCHOR SYSTEM WITH DERMIS 

C1421 ANCHOR SYSTEM, STAPLETAC2 BONE ANCHOR SYSTEM WITHOUT DERMIS 

C1450 ORTHOSPHERE SPHERICAL INTERPOSITIONAL ARTHROPLASTY 

C1451 ORTHOSPHERE SPHERICAL INTERPOSITIONAL ARTHROPLASTY KIT 

C1500 ATHERECTOMY SYSTEM, PERIPHERAL, ROTABLATOR ROTATIONAL ANGIOPLASTY SYSTEM WITH 

ROTALINK EXCHANGEABLE CATHETER, ADVANCER, AND GUIDE WIRE 

C1531 STENT, COLORECTAL, BARD MEMOTHERM COLORECTAL STENT MODEL S30R060 

C1700 NEEDLE, BRACHYTHERAPY NEEDLE, AUTHENTIC MICK TP BRACHYTHERAPY NEEDLE 

C1701 NEEDLE, BRACHYTHERAPY, MEDTEC MT-BT-5201-25 BRACHYTHERAPY NEEDLE 

C1702 NEEDLE, BRACHYTHERAPY, WWMT BRACHYTHERAPY NEEDLE 

C1703 NEEDLE, BRACHYTHERAPY, MENTOR PROSTATE BRACHYTHERAPY NEEDLE 

C1704 NEEDLE, BRACHYTHERAPY, MEDTEC MT-BT-5001-25, MT-BT-5051-25 

C1705 NEEDLE, BRACHYTHERAPY, BEST INDUSTRIES FLEXI NEEDLE BRACHYTHERAPY SEED 

IMPLANTATION (13G, 14G, 15G, 16G, 17G, 18G), BEST INDUSTRIES PROSTATE 

BRACHYTHERAPY NEEDLE 

C1706 NEEDLE, BRACHYTHERAPY, INDIGO PROSTATE SEEDING NEEDLE 

C1707 NEEDLE, BRACHYTHERAPY, VARISOURCE INTERSTITIAL IMPLANT NEEDLE 

C1708 NEEDLE, BRACHYTHERAPY, UROMED PROSTATE SEEDING NEEDLE 

C1709 NEEDLE, BRACHYTHERAPY, REMINGTON MEDICAL BRACHYTHERAPY NEEDLE 

C1710 NEEDLE, BRACHYTHERAPY, US BIOPSY PROSTATE SEEDING NEEDLE 

C1711 NEEDLE, BRACHYTHERAPY, MD TECH P.S.S. PROSTATE SEEDING SET (NEEDLE) 

C1712 NEEDLE, BRACHYTHERAPY, IMAGYN MEDICAL TECHNOLOGIES ISOSTAR PROSTATE 

BRACHYTHERAPY NEEDLE 

C1790 BRACHYTHERAPY SEED, NUCLETRON IRIDIUM 192 HDR 

C1791 BRACYTHERAPY SEED, NYCOMED AMERSHAM I-125 (ONCOSEED, RAPID STRAND) 

C1792 BRACHYTHERAPY SEED, UROMED SYMMETRA I-125 

C1793 BRACHYTHERAPY SEED, BARD INTERSOURCE 103 PALLADIUM SEED 1031L, 1031C 

C1794 BRACHYTHERAPY SEED, BARD ISOSEED 103 PALLADIUM SEED PD3S111L, PD3S111P 

C1795 BRACHYTHERAPY SEED, BARD BRACHYSOURCE 125 IODINE SEED 1251L, 1251C 

C1796 BRACHYTHERAPY SEED, SOURCE TECH MEDICAL I-125 SEED MODEL STM 1251 

C1797 BRACHYTHERAPY SEED, DRAXIMAGE I-125 SEED MODEL LS-1 

C1798 BRACHYTHERAPY SEED, SYNCOR I-125 PHARMASEED MODEL BT-125-1 

C1799 BRACHYTHERAPY SEED, I-PLANT IODINE 125 MODEL 3500 

C1800 BRACHYTHERAPY SEED, MENTOR PDGOLD PD-103 

C1801 BRACHYTHERAPY SEED, MENTOR IOGOLD I-125 

C1802 BRACHYTHERAPY SEED, BEST INDUSTRIES IRIDIUM 192 

C1803 BRACHYTHERAPY SEED, BEST INDUSTRIES IODINE 125 

C1804 BRACHYTHERAPY SEED, BEST INDUSTRIES PALLADIUM 103 

C1805 BRACHYTHERAPY SEED, IMAGYN ISOSTAR IODINE-125 INTERSTITIAL BRACHYTHERAPY SEED 

C1806 BRACHYTHERAPY SEED, BEST INDUSTRIES GOLD 198 

C1810 CATHETER, BALLOON DILATATION, D114S OVER-THE-WIRE BALLOON DILATATION CATHETER 

C1811 ANCHOR, SURGICAL DYNAMICS ANCHORSEW, SURGICAL DYNAMICS S.D. SORB EZ TAC, 

SURGICAL DYNAMICS S.D. SORB SUTURE ANCHOR 2.0MM, SURGICAL DYNAMICS S.D. SORB 

SUTURE ANCHOR 3.0MM

C1812 ANCHOR, OBL 2.0MM MINI TAC ACHOR, OBL 2.8MM HS ANCHOR, OBL 2.8MM S ANCHOR, OBL 

3.5MM TI ANCHOR, OBL RC5 ANCHOR, OBL PRC5 ANCHOR 

C1850 REPLIFORM TISSUE REGENERATION MATRIX, PER 24 OR 28 SQUARE CENTIMETERS 

C1851 REPLIFORM TISSUE REGENERATION MATRIX, PER 24 OR 28 SQUARE CENTIMETERS 

C1852 TRANSCYTE, PER 247 SQUARE CENTIMETERS 

C1853 SUSPEND TUTOPLAST PROCESSED FASCIA LATA, PER 8 OR 14 SQUARE CENTIMETERS 

C1854 SUSPEND TUTOPLAST PROCESSED FASCIA LATA, PER 24 OR 28 SQUARE CENTIMETERS 

C1855 SUSPEND TUTOPLAST PROCESSED FASCIA LATA, PER 36 SQUARE CENTIMETERS 



C1858 DURADERM ACELLULAR ALLOGRAFT, PER 8 OR 14 SQUARE CENTIMETERS 

C1859 DURADERM ACELLULAR ALLOGRAFT, PER 21, 24, OR 28 SQUARE CENTIMETERS 

C1860 DURADERM ACELLULAR ALLOGRAFT, PER 48 SQUARE CENTIMETERS 




C1864 BARD SPERMA TEX MESH, PER 13.44 SQUARE CENTIMETERS 

C1865 BARD FASLATA ALLOGRAFT TISSUE, PER 8 OR 14 SQUARE CENTIMETERS 



C1868 BARD FASLATA ALLOGRAFT TISSUE, PER 96 SQUARE CENTIMETERS 

C1869 GORE THYROPLASTY DEVICE, PER 8, 12, 30, OR 37.5 SQUARE CENTIMETERS (0.6MM) 

C1870 DERMMATRIX SURGICAL MESH, PER 16 SQUARE CENTIMETERS 

C1871 DERMMATRIX SURGICAL MESH, PER 32 OR 64 SQUARE CENTIMETERS 

C1872 DERMAGRAFT, PER 37.5 SQUARE CENTIMETERS 

C1873 BARD 3DMAX MESH, MEDIUM OR LARGE SIZE 

C1929 CATHETER, MAVERICK MONORAIL PTCA CATHETER, MAVERICK OVER-THE-WIRE PTCA CATHETER 

C1930 CATHETER, PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY, COYOTE DILATATION 

CATHETER 20MM/30MM/40MM 

C1931 CATHETER, TALON BALLOON DILATATION CATHETER 

C1932 CATHETER, SCIMED REMEDY CORONARY BALLOON DILATATION INFUSION CATHETER (20MM) 

C1933 CATHETER, OPTI-PLAST CENTURION 5.5F PTA CATHETER, SHAFT LENGTH 50 CM TO 120 CM, 

OPTI-PLAST XL 5.5F PTA CATHETER, SHAFT LENGTH 75 CM TO 120 CM 

C1934 CATHETER, ULTRAVERSE 3.5F BALLOON DILATATION CATHETER 

C1935 CATHETER, WORKHORSE PTA BALLOON CATHETER 

C1936 CATHETER, UROMAX ULTRA HIGH PRESSURE BALLOON DILATATION CATHETER WITH HYDROPLUS 

COATING 

C1937 CATHETER, SYNERGY BALLOON DILATATION CATHETER, EXPLORER ST 6F 

C1938 CATHETER, BARD UROFORCE BALLOON DILATATION CATHETER 

C1939 CATHETER, NINJA PTCA DILATATION CATHETER, RAPTOR PTCA DILATATION CATHETER, NC 

RAPTOR PTCA DILATATION CATHETER, CHARGER PTCA DILATATION CATHETER, TITAN PTCA 

DILATATION CATHETER, TITAN MEGA PTCA DILATATION CATHETER NOTE: ONLY THE NC 

RAPTOR, CHARGER, TITAN, AND TITAN MEGA PTCA DILATATION CATHETERS ARE EFFECTIVE 

01/01/01. THE NINJA AND RAPTOR PTCA DILATATION CATHETERS WERE EFFECTIVE 

10/01/00. 

C1940 CATHETER, CORDIS POWERFLEX EXTREME PTA BALLOON CATHETER, CORDIS POWERFLEX PLUS 

PTA BALLOON CATHETER, CORDIS OPTA LP PTA BALLOON CATHETER, CORDIS OPTA 5 PTA 

BALLOON CATHETER 

C1941 CATHETER, JUPITER PTA BALLOON DILATATION CATHETER 

C1942 CATHETER, CORDIS MAXI LD PTA BALLOON CATHETER 

C1943 CATHETER, RX CROSSSAIL CORONARY DILATATION CATHETER, OTW OPENSAIL CORONARY 

DILATATION CATHETER 

C1944 CATHETER, RAPID EXCHANGE SINGLE-USE BILIARY BALLOON DILATATION CATHETER 

C1945 CATHETER, CORDIS SAVVY PTA DILATATION CATHETER 

C1946 CATHETER, R1S RAPID EXCHANGE PRE-DILATATION BALLOON CATHETER 

C1947 CATHETER, GAZELLE BALLOON DILATATION CATHETER 

C1948 CATHETER, PURSUIT BALLOON ANGIOPLASTY CATHETER

C1949 CATHETER, ENDOSONICS ORACLE MEGASONICS FIVE-64 F/X PTCA CATHETER 

C1979 CATHETER, ENDOSONICS VISIONS PV 8.2F INTRAVASCULAR ULTRASOUND IMAGING CATHETER, 

ENDOSONICS AVANAR F/X INTRAVASCULAR ULTRASOUND IMAGING CATHETER 

C1980 CATHETER, ATLANTIS SR CORONARY IMAGING CATHETER 

C1981 CATHETER ,CORONARY ANGIOPLASTY BALLOON, ADANTE, BONNIE, BONNIE 15MM,BONNIE 

MONORAIL 30MM OR 40MM, BONNIE SLIDING RAIL, BYPASS SPEEDY, CHUBBY, CHUBBY 

SLIDING RAIL, COYOTE 20MM, COYOTE 9/15/25MM, LONG RANGER 30MM OR 40MM, MAXXUM, 

NC RANGER, NC RANGER 9MM, NC RANGER 16/18MM, NC RANGER 22/25/30MM, NC BIG 

RANGER, RANGER 20MM, QUANTUM RANGER, QUANTUM RANGER 1/4 SIZES, QUANTUM RANGER 

9/16/18MM, QUANTUM RANGER 22/30MM, QUANTUM RANGER 25MM, RANGER LP 20/30/40, 

VIVA/LONG VIVA NOTE: ONLY THE BONNIE MONORAIL 30MM OR 40MM, LONG RANGER 30MM 

OR 40MM, AND RANGER 20MM ARE EFFECTIVE 01/01/01. THE OTHER CATHETERS WERE 


C2000 CATHETER, ORBITER ST STEERABLE ELECTRODE CATHETER 

C2001 CATHETER, CONSTELLATION DIAGNOSTIC CATHETER 

C2002 CATHETER, IRVINE INQUIRY STEERABLE ELECTROPHYSIOLOGY 5F CATHETER 

C2003 CATHETER, IRVINE INQUIRY STEERABLE ELECTROPHYSIOLOGY 6F CATHETER 

C2004 CATHETER, ELECTROPHYSIOLOGY, EP DEFLECTABLE TIP CATHETER (OCTAPOLAR SMALL 

ANATOMY MODELS ONLY) 

C2005 CATHETER, ELECTROPHYSIOLOGY, EP DEFLECTABLE TIP CATHETER (HEXAPOLAR SMALL 


C2006 CATHETER, ELECTROPHYSIOLOGY, EP DEFLECTABLE TIP CATHETER (DECAPOLAR SMALL 


C2007 CATHETER, ELECTROPHYSIOLOGY, IRVINE LUMA-CATH 6F FIXED CURVE ELECTROPHYSIOLOGY 

CATHETER 

C2008 CATHETER, ELECTROPHYSIOLOGY, IRVINE LUMA-CATH 7F STEERABLE ELECTROPHYSIOLOGY 

CATHETER MODEL 81910, MODEL 81912, MODEL 81915 

C2009 CATHETER, ELECTROPHYSIOLOGY, IRVINE LUMA-CATH 7F STEERABLE ELECTROPHYSIOLOGY 

CATHETER MODEL 81920 

C2010 CATHETER, ELECTROPHYSIOLOGY, CORDIS FIXED CURVE CATHETER (DECAPOLAR, HEXAPOLAR, 

OCTAPOLAR, QUADRAPOLAR) 

C2011 CATHETER, ELECTROPHYSIOLOGY, DEFLECTABLE TIP CATHETER (QUADRAPOLAR SMALL 


C2012 CATHETER, ABLATION, BIOSENSE WEBSTER CELSIUS BRAIDED TIP ABLATION CATHETER, 

BIOSENSE WEBSTER CELSIUS 5MM TEMPERATURE ABLATION CATHETER, BIOSENSE WEBSTER 

CELSIUS TEMPERATURE SENSING DIAGNOSTIC/ABLATION TIP CATHETER, BIOSENSE WEBSTER 

CELSIUS LONG REACH ABLATION CATHETER NOTE: ONLY THE CELSIUS LONG REACH ABLAITON 

CATHETER IS EFFECTIVE 01/01/01. THE OTHER ABLATION CATHETERS WERE EFFECTIVE 

10/01/00. 

C2013 CATHETER, ABLATION, BIOSENSE WEBSTER CELSIUS LARGE DOME ABLATION CATHETER 

C2014 CATHETER, ABLATION, BIOSENSE WEBSTER CELSIUS II ASYMMETRICAL ABLATION CATHETER 

C2015 CATHETER, ABLATION, BIOSENSE WEBSTER CELSIUS II SYMMETRICAL ABLATION CATHETER 

C2016 CATHETER, ABLATION, NAVI-STAR DS DIAGNOSTIC/ABLATION CATHETER, NAVI-STAR 

THERMO-COOL TEMPERATURE DIAGNOSTIC/ABLATION CATHETER 

C2017 CATHETER, ABLATION, NAVI-STAR DIAGNOSTIC/ABLATION DEFLECTABLE TIP CATHETER 

C2018 CATHETER, ABLATION, POLARIS T ABLATION CATHETER 

C2019 CATHETER, EP MEDSYSTEMS DEFLECTABLE ELECTROPHYSIOLOGY CATHETER 

C2020 CATHETER, ABLATION, BLAZER II XP, BLAZER II 6F, BLAZER II HIGH TORQUE 

C2021 CATHETER, EP MEDSYSTEMS SILVERFLEX ELECTROPHYSIOLOGY CATHETER, NON-DEFLECTABLE 

C2022 CATHETER, ABLATION, CARDIAC PATHWAYS CHILLI COOLED ABLATION CATHETER MODELS 

41422, 41442, 45422, 45442, 43422, 43442 

C2023 CATHETER, ABLATION, CARDIAC PATHWAYS CHILLI COOLED ABLATION CATHETER, STANDARD 

CURVE 3005 OR LARGE CURVE 3006 

C2100 CATHETER, ELECTROPHYSIOLOGY, CARDIAC PATHWAYS CS REFERENCE CATHETER 

C2101 CATHETER, ELECTROPHYSIOLOGY, CARDIAC PATHWAYS RV REFERENCE CATHETER 

C2102 CATHETER, ELECTROPHYSIOLOGY, CARDIAC PATHWAYS 7F RADII CATHETER 

C2103 CATHETER, ELECTROPHYSIOLOGY, CARDIAC PATHWAYS 7F RADII CATHETER WITH TRACKING

C2104 CATHETER, ELECTROPHYSIOLOGY, LASSO DEFLECTABLE CIRCULAR TIP MAPPING CATHETER 

C2151 CATHETER, VERIPATH PERIPHERAL GUIDING CATHETER 

C2152 CATHETER, CORDIS 5F, 6F, 7F, 8F, 9F, 10F VISTA BRITE TIP GUIDING CATHETER 

C2153 CATHETER, ELECTROPHYSIOLOGY, BARD VIKING FIXED CURVE CATHETER (BIPOLAR, 

QUADRAPOLAR, AND ASP MODELS ONLY) 

C2200 CATHETER, ARROW-TREROTOLA PERCUTANEOUS THROMBOLYTIC DEVICE CATHETER 

C2300 CATHETER, VARISOURCE STANDARD CATHETER 

C2597 CATHETER, CLINICATH PERIPHERALLY INSERTED MIDLINE CATHETER (PICC) DUAL-LUMEN 

POLYFLOW POLYURETHANE CATHETER 18G/20G/24G (INCLUDES CATHETER AND INTRODUCER), 

CLINICATH PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) DUAL-LUMEN POLYFLOW 

POLYURETHANE 16G/18G (INCLUDES CATHETER AND INTRODUCER), CLINICATH PERIPHERALLY 

INSERTED CENTRAL CATHETER (PICC) SINGLE-LUMEN POLYFLOW POLYURETHANE 18G 

(INCLUDES CATHETER AND INTRODUCER) 

C2598 CATHETER, CLINICATH PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) SINGLE-LUMEN 

POLYFLOW POLYURETHANE CATHETER 18G/20G/24G (CATHETER AND INTRODUCER), CLINICATH 

PERIPHERALLY INSERTED MIDLINE CATHETER (PICC) SINGLE-LUMEN POLYFLOW 

POLYURETHANE CATHETER 20G/24G (CATHETER AND INTRODUCER) 

C2599 CATHETER, CLINICATH PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) DUAL-LUMEN 

POLYFLOW POLYURETHANE CATHETER 16G/18G (CATHETER AND INTRODUCER) 

C2600 CATHETER, GOLD PROBE SINGLE-USE ELECTROHEMOSTASIS CATHETER 

C2601 CATHETER, BARD 10F DUAL LUMEN URETERAL CATHETER 

C2602 CATHETER, SPECTRANETICS 1.4/1.7MM VITESSE COS CONCENTRIC LASER CATHETER 

C2603 CATHETER, SPECTRANETICS 2.0MM VITESSE COS CONCENTRIC LASER CATHETER 

C2604 CATHETER, SPECTRANETICS 2.0MM VITESSE E ECCENTRIC LASER CATHETER 

C2605 CATHETER, SPECTRANETICS EXTREME LASER CATHETER 

C2606 CATHETER, ORATEC SPINECATH XL INTRADISCAL CATHETER 

C2607 CATHETER, ORATEC SPINECATH INTRADISCAL CATHETER 

C2608 CATHETER, SCIMED 6F WISEGUIDE GUIDE CATHETER 

C2609 CATHETER, FLEXIMA BILIARY DRAINAGE CATHETER WITH LOCKING PIGTAIL, FLEXIMA 

BILIARY DRAINAGE CATHETER WITH TWIST LOC HUB, FLEXIMA BILARY DRAINAGE CATHETERS 

WITH TEMP TIP 

C2610 CATHETER, ARROW FLEX TIP PLUS INTRASPINAL CATHETER KIT 

C2611 CATHETER, MEDTRONIC PS MEDICAL ALGOLINE INTRASPINAL CATHETER SYSTEM/KIT 81102, 

81192 

C2612 CATHETER, INDURA INTRASPINAL CATHETER 

C2676 CATHETER, RESPONSE CV CATHETER 

C2700 DEFIBRILLATOR, SINGLE CHAMBER, IMPLANTABLE, MYCROPHYLAX PLUS 

C2701 DEFIBRILLATOR, SINGLE CHAMBER, IMPLANTABLE, PHYLAX XM 

C2702 DEFIBRILLATOR, SINGLE CHAMBER, IMPLANTABLE, VENTAK PRIZM 2 VR 1860 

C2703 DEFIBRILLATOR, SINGLE CHAMBER, IMPLANTABLE, VENTAK PRIZM VR HE 1857, 1858 

C2704 DEFIBRILLATOR, SINGLE CHAMBER, IMPLANTABLE, VENTAK MINI IV+ 1793, 1796 

C2801 DEFIBRILLATOR, DUAL CHAMBER, IMPLANTABLE, ELA MEDICAL DEFENDER IV DR MODEL 612 

C2802 DEFIBRILLATOR, DUAL CHAMBER, IMPLANTABLE, PHYLAX AV 

C2803 DEFIBRILLATOR, DUAL CHAMBER, IMPLANTABLE, VENTAK PRIZM DR HE 1852, 1853 

C2804 DEFIBRILLATOR, DUAL CHAMBER, IMPLANTABLE, VENTAK PRIZM 2 DR 1861 

C2805 DEFIBRILLATOR, DUAL CHAMBER, IMPLANTABLE, JEWEL AF 7250 

C2806 DEFIBRILLATOR, IMPLANTABLE, GEM VR 7227 

C2807 DEFIBRILLATOR, IMPLANTABLE, CONTAK CD 1823 

C2808 DEFIBRILLATOR, IMPLANTABLE, CONTAK TR 1241 

C3001 LEAD, DEFIBRILLATOR, IMPLANTABLE, KAINOX SL, KAINOX RV 

C3002 LEAD, DEFIBRILLATOR, IMPLANTABLE, EASYTRAK 4510, 4511, 4512, 4513 

C3003 LEAD, DEFIBRILLATOR, IMPLANTABLE, ENDOTAK SQ ARRAY XP 0085 

C3004 LEAD, DEFIBRILLATOR, IMPLANTABLE, INTERVENE 497-23, 497-24 

C3400 PROSTHESIS, BREAST, MENTOR SALINE-FILLED CONTOUR PROFILE, MENTOR SILTEX 

SPECTRUM MAMMARY PROSTHESIS 

C3401 PROSTHESIS, BREAST, MENTOR SALINE-FILLED SPECTRUM 

C3500 PROSTHESIS, MENTOR ALPHA I INFLATABLE PENILE PROSTHESIS, MENTOR ALPHA I

NARROW-BASE INFLATABLE PENILE PROSTHESIS NOTE: THE MENTOR ALPHA I NARROW-BASE 

INFLATABLE PENILE PROSTHESIS IS EFFECTIVE OCT 1, 2000. THE MENTOR ALPHA I 

INFLATABLE PENILE PROSTHESIS WAS EFFECTIVE AUG 1, 2000. 

C3510 PROSTHESIS, AMS SPHINCTER 800 URINARY PROSTHESIS 

C3551 GUIDE WIRE, PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY, CHOICE, LUGE, 

PATRIOT, PT GRAPHIX INTERMEDIATE, TROOPER, MAILMAN 182/300 CM 

C3552 GUIDE WIRE, CORONARY, HI-TORQUE WHISPER 

C3553 GUIDE WIRE, CORDIS STABILIZER MARKER WIRE STEERABLE GUIDEWIRE, CORDIS WIZDOM 

MARKER WIRE STEERABLE GUIDEWIRE, CORDIS ATW MARKER WIRE STEERALE GUIDEWIRE, 

CORDIS SHINOBI STEERABLE GUIDEWIRE 

C3554 GUIDE WIRE, JINDO TAPERED PERIPHERAL GUIDEWIRE 

C3555 GUIDE WIRE, WHOLEY HI-TORQUE PLUS GUIDE WIRE SYSTEM, 145CM, 190CM, 300CM 

C3556 GUIDE WIRE, ENDOSONICS CARDIOMETRICS WAVEWIRE PRESSURE GUIDE WIRE, 

CARDIOMETRICS FLOWIRE DOPPLER GUIDE WIRE 

C3557 GUIDEWIRE, HYTEK GUIDEWIRE 

C3800 INFUSION PUMP, IMPLANTABLE, PROGRAMMABLE, SYNCHROMED EL INFUSION PUMP 

C3801 INFUSION PUMP, ARROW/MICROJECT PCA SYSTEM 

C3851 INTRAOCULAR LENS, STAAR ELASTIC ULTRAVIOLET-ABSORBING SILICONE POSTERIOR 

CHAMBER INTRAOCULAR LENS WITH TORIC OPTIC MODEL AA-4203T, MODEL AA-4203TF, 

MODEL AA-4203TL 

C4000 PACEMAKER, SINGLE CHAMBER, ELA MEDICAL OPUS G MODEL 4621, 4624 

C4001 PACEMAKER, SINGLE CHAMBER, ELA MEDICAL OPUS S MODEL 4121, 4124 

C4002 PACEMAKER, SINGLE CHAMBER, ELA MEDICAL TALENT MODEL 113 

C4003 PACEMAKER, SINGLE CHAMBER, KAIROS SR 

C4004 PACEMAKER, SINGLE CHAMBER, ACTROS SR+, ACTROS SR-B+ 

C4005 PACEMAKER, SINGLE CHAMBER, PHILOS SR, PHILOS SR-B 

C4006 PACEMAKER, SINGLE CHAMBER, PULSAR MAX II SR 1180, 1181 

C4007 PACEMAKER, SINGLE CHAMBER, MARATHON SR 291-09, 292-09R, 292-09X 

C4008 PACEMAKER, SINGLE CHAMBER, DISCOVERY II SSI 481 

C4009 PACEMAKER, SINGLE CHAMBER, DISCOVERY II SR 1184, 1185, 1186, 1187 

C4300 PACEMAKER, DUAL CHAMBER, INTEGRITY AFX DR MODEL 5342 

C4301 PACEMAKER, DUAL CHAMBER, INTEGRITY AFX DR MODEL 5346 

C4302 PACEMAKER, DUAL CHAMBER, AFFINITY VDR 5430 

C4303 PACEMAKER, DUAL CHAMBER, ELA BRIO MODEL 112 PACEMAKER SYSTEM 

C4304 PACEMAKER, DUAL CHAMBER, ELA MEDICAL BRIO MODEL 212, TALENT MODEL 213, TALENT 

MODEL 223 

C4305 PACEMAKER, DUAL CHAMBER, ELA MEDICAL BRIO MODEL 222 

C4306 PACEMAKER, DUAL CHAMBER, ELA MEDICAL BRIO MODEL 220 

C4307 PACEMAKER, DUAL CHAMBER, KAIROS DR 

C4308 PACEMAKER, DUAL CHAMBER, INOS 2, INOS 2+ 

C4309 PACEMAKER, DUAL CHAMBER, ACTROS DR+, ACTROS D+, ACTROS DR-A+, ACTROS SLR+ 

C4310 PACEMAKER, DUAL CHAMBER, ACTROS DR-B+ 

C4311 PACEMAKER, DUAL CHAMBER, PHILOS DR, PHILOS DR-B, PHILOS SLR 

C4312 PACEMAKER, DUAL CHAMBER, PULSAR MAX II DR 1280 

C4313 PACEMAKER, DUAL CHAMBER, MARATHON DR 293-09, 294-09, 294-09R, 294-10 

C4314 PACEMAKER, DUAL CHAMBER, MOMENTUM DR 294-23 

C4315 PACEMAKER, DUAL CHAMBER, SELECTION AFM 902 SLC 902C 

C4316 PACEMAKER, DUAL CHAMBER, DISCOVERY II DR 1283, 1284, 1285, 1286 

C4317 PACEMAKER, DUAL CHAMBER, DISCOVERY II DDD 981 

C4600 LEAD, PACEMAKER, SYNOX, POLYROX, ELOX, RETROX, SL-BP, ELC 

C4601 LEAD, PACEMAKER, AESCULA LV 1055K 

C4602 LEAD, PACEMAKER, TENDRIL SDX 1488K/46, TENDRIL SDX 1488K/52, TENDRIL SDX 

1488K/58 

C4603 LEAD, PACEMAKER, OSCOR/FLEXION 4015, 4016, 4017, 4018 

C4604 LEAD, PACEMAKER, CRYSTALLINE ACTFIX ICD-09, CAPSUREFIX NOVUS 5076 

C4605 LEAD, PACEMAKER, CAPSURE EPI 4968 

C4606 LEAD, PACEMAKER, FLEXTEND 4080, 4081, 4082

C4607 LEAD, PACEMAKER, FINELINE II 4452, 4453, 4454, 4455, 4477, 4478, FINELINE II EZ 

4463, 4464, 4465, 4466, 4467, 4468, THINLINE II 430-25, 430-35, 432-35, 

THINLINE II EZ 438-25, 438-35 

C5000 STENT, BILIARY, BX VELOCITY WITH HEPACOAT ON RAPTOR STENT SYSTEM (28 OR 33MM IN 

LENGTH) 

C5001 STENT, BILIARY, BARD MEMOTHERM-FLEX BILIARY STENT, SMALL/MEDIUM DIAMETER 

C5002 STENT, BILIARY, BARD MEMOTHERM-FLEX BILIARY STENT, LARGE DIAMETER 

C5003 STENT, BILIARY, BARD MEMOTHERM-FLEX BILIARY STENT, X-LARGE DIAMETER 

C5004 STENT, BILIARY, CORDIS PALMAZ CORINTHIAN IQ TRANSHEPATIC BILIARY STENT 

C5005 STENT, BILIARY, CORDIS PALMAZ CORINTHIAN IQ TRANSHEPATIC BILIARY STENT AND 


C5006 STENT, BILIARY, CORDIS MEDIUM PALMAZ TRANSHEPATIC BILIARY STENT AND DELIVERY 

SYSTEM 

C5007 STENT, BILIARY, CORDIS PALMAZ XL TRANSHEPATIC BILIARY STENT (40MM LENGTH) 

C5008 STENT, BILIARY, CORDIS PALMAZ XL TRANSHEPATIC BILIARY STENT (50MM LENGTH) 

C5009 STENT, BILIARY, BILIARY VISTAFLEX STENT 

C5010 STENT, BILIARY, RAPID EXCHANGE SINGLE-USE BILIARY STENT SYSTEM 

C5011 STENT, BILIARY, INTRASTENT, INTRASTENT LP 

C5012 STENT, BILIARY, INTRASTENT DOUBLESTRUT LD 

C5013 STENT, BILIARY, INTRASTENT DOUBLESTRUT, INTRASTENT DOUBLESTRUT XS 

C5014 STENT, BILIARY, MEDTRONIC AVE BRIDGE STENT SYSTEM--BILIARY INDICATION (10MM, 

17MM, 28MM) 

C5015 STENT, BILIARY, MEDTRONIC AVE BRIDGE STENT SYSTEM--BILIARY INDICATION (40-60MM, 

80-100MM), MEDTRONIC AVE BRIDGE X3 BILIARY STENT SYSTEM (17MM) 

C5016 STENT, BILIARY, WALLSTENT SINGLE-USE COVERED BILIARY ENDOPROSTHESIS WITH 

UNISTEP PLUS DELIVERY SYSTEM 

C5017 STENT, BILIARY, WALLSTENT RP BILIARY ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY 

SYSTEM (20/40/42/60/68 MM IN LENGTH) 

C5018 STENT, BILIARY, WALLSTENT RP BILIARY ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY 

SYSTEM (80/94 MM IN LENGTH) 

C5019 STENT, BILIARY, FLEXIMA SINGLE-USE BILIARY STENT SYSTEM 

C5020 STENT, BILIARY, CORDIS SMART NITINOL STENT TRANSHEPATIC BILIARY SYSTEM (20MM 

IN LENGTH) 

C5021 STENT, BILIARY, CORDIS SMART NITINOL STENT TRANSHEPATIC BILIARY SYSTEM (40 OR 

60MM IN LENGTH) 

C5022 STENT, BILIARY, CORDIS SMART NITINOL STENT TRANSHEPATIC BILIARY SYSTEM (80MM IN 

LENGTH) 

C5023 STENT, BILIARY, BX VELOCITY TRANSHEPATIC BILIARY STENT AND DELIVERY SYSTEM (8 

OR 13MM IN LENGTH) 

C5024 STENT, BILIARY, BX VELOCITY TRANSHEPATIC BILIARY STENT AND DELIVERY SYSTEM 

(18MM IN LENGTH) 

C5025 STENT, BILIARY, BX VELOCITY TRANSHEPATIC BILIARY STENT AND DELIVERY SYSTEM 

(23MM IN LENGTH) 

C5026 STENT, BILIARY, BX VELOCITY TRANSHEPATIC BILIARY STENT AND DELIVERY SYSTEM (28 

0R 33MM IN LENGTH) 

C5027 STENT, BILIARY, BX VELOCITY WITH HEPACOAT ON RAPTOR STENT SYSTEM (8 OR 13MM IN 

LENGTH) 

C5028 STENT, BILIARY, BX VELOCITY WITH HEPACOAT ON RAPTOR STENT SYSTEM (18MM IN 

LENGTH) 

C5029 STENT, BILIARY, BX VELOCITY WITH HEPACOAT ON RAPTOR STENT SYSTEM (23MM IN 

LENGTH) 

C5030 STENT, CORONARY, S660 DISCRETE TECHNOLOGY OVER-THE-WIRE CORONARY STENT SYSTEM 

9MM, 12MM S660 WITH DISCRETE TECHNOLOGY RAPID EXCHANGE CORONARY STENT SYSTEM 

9MM, 12MM 



15MM, 18MM



24MM, 30MM 

C5033 STENT, CORONARY, NIROYAL ADVANCE PREMOUNTED STENT SYSTEM (9MM) 

C5034 STENT, CORONARY, NIROYAL ADVANCE PREMOUNTED STENT SYSTEM (12MM/15MM) 




C5038 STENT, CORONARY, BX VELOCITY BALLOON-EXPANDABLE STENT WITH RAPTOR OVER-THE-WIRE 


C5039 STENT, PERIPHERAL, INTRACOIL PERIPHERAL STENT (40MM STENT LENGTH) 

C5040 STENT, PERIPHERAL, INTRACOIL PERIPHERAL STENT (60MM STENT LENGTH) 

C5041 STENT, CORONARY, MEDTRONIC BESTENT 2 OVER-THE-WIRE CORONARY STENT SYSTEM (24MM, 

30MM) 

C5042 STENT, CORONARY, MEDTRONIC BESTENT 2 OVER-THE-WIRE CORONARY STENT SYSTEM (18MM) 

C5043 STENT, CORONARY, MEDTRONIC BESTENT 2 OVER-THE-WIRE CORONARY STENT (15MM) 

C5044 STENT, CORONARY, MEDTRONIC BESTENT 2 OVER-THE-WIRE CORONARY STENT SYSTEM (9MM, 

12MM) 

C5045 STENT, CORONARY, MULTILINK TETRA CORONARY STENT SYSTEM 

C5046 STENT, CORONARY, RADIUS 20MM SELF EXPANDING STENT WITH OVER THE WIRE DELIVERY 

SYSTEM 

C5047 STENT, CORONARY, NIROYAL ELITE PREMOUNTED STENT SYSTEM 15MM, 25MM, OR 31MM 

C5048 STENT, CORONARY, GR II CORONARY STENT 

C5130 STENT, COLON, WILSON-COOK COLONIC Z-STENT 




C5134 STENT, ENTERAL, WALLSTENT ENTERAL ENDOPROSTHESIS AND UNISTEP DELIVERY SYSTEM 

(90MM IN LENGTH), ENTERAL WALLSTENT ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY 

SYSTEM (90MM IN LENGTH) NOTE: ONLY THE ENTERAL WALLSTENT ENDOPROSTHESIS WITH 

UNISTEP PLUS DELIVERY SYSTEM IS EFFECTIVE OCTOBER 1, 2000. THE WALLSTENT 

ENTERAL AND UNISTEP DELIVERY SYSTEM WAS EFFECTIVE AUGUST 1, 2000. 

C5279 STENT, URETERAL, BOSTON SCIENTIFIC CONTOUR SOFT PERCUFLEX STENT WITH HYDROPLUS 

COATING (BRAIDED), CONTOUR SOFT PERCUFLEX STENT WITH HYDROPLUS COATING, CONTOUR 

VL VARIABLE LENGTH PERCUFLEX STENT WITH HYDROPLUS COATING, PERCUFLEX PLUS STENT 

WITH HYDROPLUS COATING, PERCUFLEX STENT (BRAIDED), CONTOUR CLOSED SOFT 

PERCUFLEX STENT WITH HYDROPLUS COATING, CONTOUR INJECTION SOFT PERCUFLEX STENT 

WITH HYDROPLUS COATING, SOFT PERCUFLEX STENT, PERCUFLEX TAIL PLUS TAPERED 

URETERAL STENT NOTE: THE CONTOUR CLOSED SOFT PERCUFLEX STENT, CONOUR INJECTION 

SOFT PERCUFLEX STENT, SOFT PERCUFLEX, AND PERCUFLEX TAIL PLUS TAPERED URETERAL 

STENT ARE EFFECTIVE 01/01/01. THE OTHER URETERAL STENTS WERE EFFECTIVE 

10/01/00. 

C5280 STENT, URETERAL, BARD INLAY DOUBLE PIGTAIL URETERAL STENT 

C5281 STENT, TRACHEOBRONCHIAL, WALLGRAFT TRACHEOBRONCHIAL ENDOPROSTHESIS WITH UNISTEP 

DELIVERY SYSTEM (70MM IN LENGTH) 

C5282 STENT, TRACHEOBRONCHIAL, WALLGRAFT TRACHEOBRONCHIAL ENDOPROSTHESIS WITH UNISTEP 

DELIVERY SYSTEM (20MM, 30MM, 50MM IN LENGTH) 

C5283 STENT, SELF-EXPANDABLE FOR CREATION OF INTRAHEPATIC SHUNTS, WALLSTENT 

TRANSJUGULAR INTRAHEPATIC PROTOSYSTEMIC SHUNT (TIPS) WITH UNISTEP PLUS DELIVERY 

SYSTEM (90/94MM IN LENGTH), WALLSTENT RP TIPS ENDOPROSTHESIS WITH UNISTEP PLUS 

DELIVERY SYSTEM (94MM IN LENGTH) NOTE: ONLY THE WALLSTENT RP TIPS 


THE WALLSTENT TIPS WITH UNISTEP PLUST DELIVERY SYSTEM WAS EFFECTIVE AUGUST 1, 

2000. 

C5284 STENT, TRACHEOBRONCHIAL, ULTRAFLEX TRACHEOBRONCHIAL ENDOPROSTHESIS (COVERED AND 

NON-COVERED) 

C5600 VASCULAR CLOSURE DEVICE, VASOSEAL ES (EXTRAVASCULAR SECURITY) DEVICE

C5601 VASCULAR CLOSURE DEVICE, VASCULAR SOLUTIONS DUETT SEALING DEVICE 1000 

C6001 MESH, HERNIA, BARD COMPOSIX MESH, PER 8 OR 18 INCHES 

C6002 MESH, HERNIA, BARD COMPOSIX MESH, PER 32 INCHES 





C6012 PELVICOL ACELLULAR COLLAGEN MATRIX, PER 8 OR 14 QUARE CENTIMETERS 

C6013 PELVICOL ACELLULAR COLLAGEN MATRIX, PER 21, 24, OR 28 SQUARE CENTIMETERS 

C6014 PELVICOL ACELLULAR COLLAGEN MATRIX, PER 40 SQUARE CENTIMETERS 



C6017 GORE-TEX DUALMESH BIOMATERIAL, PER 75 OR 96 SQUARE CENTIMETERS (1MM THICK) 

C6018 GORE-TEX DUALMESH BIOMATERIAL, PER 150 SQUARE CENTIMETERS OVAL SHAPED (1MM 

THICK) 

C6019 GORE-TEX DUALMESH BIOMATERIAL, PER 285 SQUARE CENTIMETERS OVAL SHAPED (1MM 

THICK) 

C6020 GORE-TEX DUALMESH BIOMATERIAL, PER 432 SQUARE CENTIMETERS (1MM THICK) 



C6023 GORE-TEX DUALMESH PLUS BIOMATERIAL, PER 75 OR 96 SQUARE CENTIMETERS (1MM THICK) 

C6024 GORE-TEX DUALMESH PLUS BIOMATERIAL, PER 150 SQUARE CENTIMETERS OVAL SHAPED (1MM 

THICK) 

C6025 GORE-TEX DUALMESH PLUS BIOMATERIAL, PER 285 SQUARE CENTIMETERS OVAL SHAPED 

(1MM THICK) 

C6026 GORE-TEX DUALMESH PLUS BIOMATERIAL, PER 432 SQUARE CENTIMETERS (1MM THICK) 

C6027 GORE-TEX DUALMESHPLUS BIOMATERIAL, PER 600 SQUARE CENTIMETERS (1MM THICK) 


THICK) 


THICK) 


THICK) 




C6034 BARD RECONIX EPTFE RECONSTRUCTION PATCH 150 SQUARE CENTIMETERS (2MM THICK) 

C6035 BARD RECONIX EPTFE RECONSTRUCTION PATCH 150 SQUARE CENTIMETERS (1MM THICK), 75 

SQUARE CENTIMETERS (2MM THICK) 

C6036 BARD RECONIX EPTFE RECONSTRUCTION PATCH 50/75 SQUARE CENTIMETERS (1MM THICK), 

50 SQUARE CENTIMETERS (2MM THICK) 

C6037 BARD RECONIX EPTFE RECONSTRUCTION PATCH 300 SQUARE CENTIMETERS (1 MM THICK) 

C6038 BARD RECONIX EPTFE RECONSTRUCTION PATCH 600 SQUARE CENTIMETERS (1MM THICK), 300 

SQUARE CENTIMETERS (2MM THICK) 

C6039 BARD RECONIX EPTFE RECONSTRUCTION PATCH 884 SQUARE CENTIMETERS OVAL SHAPED (1MM 

THICK) 

C6040 BARD RECONIX EPTFE RECONSTRUCTION PATCH 600 SQUARE CENTIMETERS (2MM THICK) 

C6041 BARD RECONIX EPTFE RECONSTRUCTION PATCH 884 SQUARE CENTIMETERS OVAL SHAPED (2MM 

THICK) 

C6050 SLING FIXATION SYSTEM FOR TREATMENT OF STRESS URINARY INCONTINENCE, FEMALE 

IN-FAST SLING FIXATION SYSTEM WITH ELECTRIC INSERTER WITH SLING MATERIAL, 

FEMALE IN-FAST SLING FIXATION SYSTEM WITH ELECTRIC INSERTER WITHOUT SLING 

MATERIAL 

C6051 STRATASIS URETHRAL SLING, 20/40 CM 

C6052 STRATASIS URETHRAL SLING, 60 CM 

C6053 SURGISIS SOFT TISSUE GRAFT, PER 70CM, 105CM, OR 140CM 

C6054 SURGISIS ENHANCED STRENGTH SOFT TISSUE GRAFT, PER 4.2CM, 20CM, 28CM OR 40CM

C6055 SURGISIS ENHANCED STRENGTH SOFT TISSUE GRAFT, PER 52.5CM, 60CM, OR 70CM 

C6056 SURGISIS ENHANCED STRENGTH SOFT TISSUE GRAFT, PER 105CM, 140CM 

C6057 SURGISIS HERNIA GRAFT, PER 195CM 

C6058 SUGIPRO HERNIA MATE PLUG, MEDIUM OR LARGE 

C6080 SLING FIXATION SYSTEM FOR TREATMENT OF STRESS URINARY INCONTINENCE, MALE 

STRAIGHT-IN FIXATION SYSTEM WITH ELECTRIC INSERTER WITH SLING MATERIAL AND 

DISPOSABLE PRESSURE SENSOR, MALE STRAIGHT-IN FIXATION SYSTEM WITH ELECTRIC 

INSERTER WITHOUT SLING MATERIAL AND DISPOSABLE PRESSURE SENSOR 

C6200 VASCULAR GRAFT, EXXCEL SOFT EPTFE VASCULAR GRAFT 

C6201 VASCULAR GRAFT, IMPRA VENAFLO VASCULAR GRAFT WITH CARBON, STRAIGHT GRAFT 10CM 

OR 20CM IN LENGTH 

C6202 VASCULAR GRAFT, IMPRA VENAFLO VASCULAR GRAFT WITH CARBON, STRAIGHT GRAFT 30CM 

OR 40CM IN LENGTH 

C6203 VASCULAR GRAFT, IMPRA VENAFLO VASCULAR GRAFT WITH CARBON, STRAIGHT GRAFT (50CM 

IN LENGTH) OR CENTERFLEX VENAFLO STEPPED GRAFT (45CM IN LENGTH) 

C6204 VASCULAR GRAFT, IMPRA VENAFLO VASCULAR GRAFT WITH CARBON, STEPPED GRAFT 20CM, 

25CM, 30CM, 35CM, 40CM, OR 45CM IN LENGTH 

C6205 VASCULAR GRAFT, IMPRA CARBOFLO VASCULAR GRAFT, STRAIGHT GRAFT 10CM IN LENGTH 

C6206 VASCULAR GRAFT, IMPRA CARBOFLO VASCULAR GRAFT, STRAIGHT GRAFT 20CM IN LENGTH 

C6207 VASCULAR GRAFT, IMPRA CARBOFLO VASCULAR GRAFT, STRAIGHT GRAFT 30CM, 35CM OR 

40CM IN LENGTH 

C6208 VASCULAR GRAFT, IMPRA CARBOFLO VASCULAR GRAFT, STRAIGHT GRAFT (50CM IN LENGTH), 

ACCESS TAPERED GRAFT (40CM IN LENGTH), OR STEPPED GRAFT (45 OR 50CM IN LENGTH) 

C6209 VASCULAR GRAFT, IMPRA CARBOFLO VASCULAR GRAFT, CENTERFLEX STRAIGHT GRAFT (40CM 

OR 50CM IN LENGTH) OR CENTERFLEX STEPPED GRAFT (40CM, 45CM, OR 50CM IN LENGTH) 

C6210 VASCULAR GRAFT, EXXCEL EPTFE VASCULAR GRAFT, LESS THAN 6MM IN DIAMETER 

C6300 STENT GRAFT SYSTEM, VANGUARD III BIFURCATED ENDOVASCULAR AORTIC GRAFT 

C6500 SHEATH, GUIDING, PREFACE BRAIDED GUIDING SHEAT (ANTERIOR CURVE, MULTIPURPOSE 

CURVE, POSTERIOR CURVE) 

C6501 SHEATH, SOFT-TIP SHEATHS 

C6525 SPECTRANETICS LASER SHEATH 12F 500-001, 14F 500-012, 16F 500-013 

C6600 PROBE, MICROVASIVE SWISS F/G LITHOCLAST FLEXIBLE PROBE .89MM, MICROVASIVE SWISS 

F/G LITHOCLAST FLEXIBLE PROBE II .89MM 

C6650 INTRODUCER, GUIDING, FAST-CATH TWO-PIECE GUIDING INTRODUCER 406869, 406892, 

406893, 406904 

C6651 INTRODUCER, GUIDING, SEAL-AWAY CS GUIDING INTRODUCER 407508, 407510 

C6652 INTRODUCER, BARD SAFETY EXCALIBUR INTRODUCER 

C6700 SYNTHETIC ABSORBABLE SEALANT, FOCAL SEAL-L 

C8099 SPECTRANETICS LEAD LOCKING DEVICE 518-018, 518-019, 518-020 

C8100 ADHESION BARRIER, ADCON-L 

C8102 SURGI-VISION ESOPHAGEAL STYLET INTERNAL COIL 

C8103 CAPIO SUTURE CAPTURING DEVICE, STANDARD OR OPEN ACCESS 

C8500 CATHETER, ATHERECTOMY, ATHEROCATH-GTO ATHERECTOMY CATHETER 

C8501 PACEMAKER, SINGLE CHAMBER, VIGOR SSI 

C8502 CATHETER, DIAGNOSTIC, ELECTROPHYSIOLOGY, LIVEWIRE STEERABLE ELECTROPHYSIOLOGY 

CATHETER 

C8503 CATHETER, SYNCHROMED VASCULAR CATHETER MODEL 8702 

C8504 CLOSURE DEVICE, VASOSEAL VASCULAR HEMOSTASIS DEVICE 

C8505 INFUSION PUMP, IMPLANTABLE, PROGRAMMABLE, SYNCHROMED INFUSION PUMP 

C8506 LEAD, PACEMAKER, 4057M, 4058M, 4557M, 4558M,5058 

C8507 LEAD, PACEMAKER,6721L, 6721M, 6721S, 6939 OVAL PATCH LEAD 

C8508 LEAD, DEFIBRILLATOR, CAPSURE 4965 

C8509 LEAD, DEFIBRILLATOR, TRANSVENE 6933, TRANSVENE 6937 

C8510 LEAD, DEFIBRILLATOR, DP-3238 

C8511 LEAD, DEFIBRILLATOR, ENDOTAK DSP 

C8512 LEAD, NEUROSTIMULATION, ON-POINT MODEL 3987, PISCES-QUAD PLUS MODEL 3888, 

RESUME TL MODEL 3986

C8513 LEAD, NEUROSTIMULATION, PISCES-QUAD MODEL 3487A, RESUME II MODEL 3587A 

C8514 PROSTHESIS, PENILE, DURA II PENILE PROSTHESIS 

C8515 PROSTHESIS, PENILE, MENTOR ALPHA I NARROW-BASE INFLATABLE PENILE PROSTHESIS 

C8516 PROSTHESIS, PENILE, MENTOR ACU-FORM MALLEABLE PENILE PROSTHESIS, MENTOR 

MALLEABLE PENILE PROSTHESIS 

C8517 PROSTHESIS, PENILE, AMBICOR PENILE PROSTHESIS 

C8518 PACEMAKER, DUAL CHAMBER, VIGOR DDD 

C8519 PACEMAKER, DUAL CHAMBER, VISTA DDD 

C8520 PACEMAKER, SINGLE CHAMBER, LEGACY II S 

C8521 RECEIVER/TRANSMITTER, NEUROSTIMULATOR, MEDTRONIC MATTRIX 

C8522 STENT, BILIARY, PALMAZ BALLOON EXPANDABLE STENT 

C8523 STENT, BILIARY, WALLSTENT TRANSHEPATIC BILIARY ENDOPROSTHESIS 

C8524 STENT, ESOPHAGEAL, WALLSTENT ESOPHAGEAL PROSTHESIS 

C8525 STENT, ESOPHAGEAL, WALLSTENT ESOPHAGEAL PROSTHESIS (DOUBLE) 

C8526 OPTIPLAST XT 5F PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY CATHETER (VARIOUS SIZES) 

C8528 MS CLASSIQUE BALLOON DILATATION CATHETER 

C8529 ISMUS CATH DEFLECTABLE 20-POLE CATHETER/CRISTA CATH II DEFLECTABLE 20-POLE 

CATHETER 

C8530 MENTOR SILTEX GEL-FILLED MAMMARY PROSTHESIS, SMOOTH-SURFACE GEL-FILLED MAMMARY 

PROSTHESIS 

C8531 WILSON-COOK ESOPHAGEAL Z METAL EXPANDABLE STENT 

C8532 STENT, ESOPHAGEAL, ULTRAFLEX ESOPHAGEAL STENT SYSTEM 

C8533 CATHETER, SYNCHROMED VASCULAR CATHETER MODEL 8700A, MODEL 8700V 

C8534 PROSTHESIS, PENILE, AMS MALLEABLE 650 PENILE PROSTHESIS 

C8535 STENT, BILIARY, SPIRAL Z BILIARY METAL EXPANDABLE STENT, ZA BILIARY METAL 

EXPANDABLE STENT 

C8536 STENT, ESOPHAGEAL, ESOPHAGEAL Z METAL EXPANDABLE STENT WITH DUA ANTI-REFLUX 

VALVE, ESOPHAGEAL Z METAL EXPANDABLE STENT WITH UNCOATED FLANGES 

C8539 WILSON-COOK QUANTUM DILATATION BALLOON 

C8540 FLEX-EZ (ESOPHAGEAL) BALLOON DILATOR 3302, 3304, 3306 

C8541 CARSON ZERO TIP BALLOON DILATATION CATHETERS WITH HYDROPLUS COATING KIT, 

PASSPORT BALLOON ON A WIRE DILATATION CATHETERS WITH HYDROPLUS COATING KIT 

C8542 URETHRAMAX HIGH PRESSURE URETHRAL BALLOON DILATATION CATHETER/KIT 

C8543 AMPLATZ RENAL DILATOR SET 

C8550 CATHETER, LIVEWIRE EP CATHETER, 7F CSM 401935, 5F DECAPOLAR 401938, 401939, 

401940, 401941 

C8551 CATHETER, LIVEWIRE EP CATHETER, 7F DUO-DECAPOLAR 401932 

C8552 CATHETER, SANTURO FIXED CURVE CATHETER 

C8597 GUIDE WIRE, CORDIS WISDOM ST STEERABLE GUIDEWIRE 537-114, 537-114J, 537-114X, 

537-114Y 

C8598 GUIDE WIRE, CORDIS SV GUIDEWIRE 5CM DISTAL TAPER CONFIGURATION (MODELS 503-558, 

503-558X), 8CM DISTAL TAPER CONFIGURATION (MODELS 503-658, 503-658X), 14CM 

DISTAL TAPER CONFIGURATION (MODELS 503-758, 503-758X) 

C8599 GUIDE WIRE, CORDIS STABILIZER XS STEERABLE GUIDEWIRE 527-914, 527-914J, 

527-914X, 527-914Y 

C8600 GUIDE WIRE, CORDIS SHINOBI PLUS STEERABLE GUIDEWIRE 547-214, 547-214X 

C8650 INTRODUCER, COOK EXTRA LARGE CHECK-FLO INTRODUCER 

C8724 LEAD, NEUROSTIMULATION, OCTAD LEAD 3898-33/389861 

C8725 LEAD, NEUROSTIMULATION, SYMMIX LEAD 3982 

C8748 LEAD, DEFIBRILLATOR, ENDOTAK SQ PATCH 0047, 0063 

C8749 LEAD, DEFIBRILLATOR, ENDOTAK SQ ARRAY 0048, 0049 

C8750 PACEMAKER, DUAL CHAMBER, UNITY VDDR 292-07 

C8775 LEAD, PACEMAKER, 2188 CORONARY SINUS LEAD 

C8776 LEAD, PACEMAKER, INNOMEDICA SUTURELESS MYOCARDIAL 4045, 4058, 4046, 4047 

C8777 LEAD, PACEMAKER, UNIPASS 425-02, 425-04, 425-06 

C8800 STENT, BILIARY, LARGE PALMAZ BALLOON EXPANDABLE STENT WITH DELIVERY SYSTEM 

C8801 STENT, BILIARY, COOK Z STENT GIANTURCO-ROSCH BILIARY DESIGN

C8802 STENT, BILIARY, COOK OASIS ONE ACTION STENT INTRODUCTORY SYSTEM 

C8830 STENT, CORONARY, COOK GIANTURCO-ROUBIN FLEX-STENT CORONARY STENT 

C8890 PERFLUORON, PER 2ML 

C8891 PERFLUORON, PER 5ML VIAL OR 7ML VIAL 

C9000 INJECTION, SODIUM CHROMATE CR51, PER 0.25 MCI 

C9001 LINEZOLID INJECTION, PER 200MG 

C9002 TENECTEPLASE, PER 50MG/VIAL 

C9003 PALIVIZUMAB-RSV-IGM, PER 50 MG 

C9004 INJECTION, GEMTUZUMAB OZOGAMICIN, PER 5 MG 

C9005 INJECTION, RETEPLASE, 18.8 MG (ONE SINGLE-USE VIAL) 

C9006 INJECTION, TACROLIMUS, PER 5 MG (1 AMP) 

C9007 BACLOFEN INTRATHECAL SCREENING KIT (1 AMP) 

C9008 BACLOFEN INTRATHECAL REFILL KIT, PER 500 MCG 

C9009 BACLOFEN REFILL KIT, PER 2000 MCG 

C9010 BACLOFEN INTRATHECAL REFILL KIT, PER 4000 MCG 

C9011 INJECTION, CAFFEINE CITRATE, PER 1ML 

C9100 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, IODINATED I-131 

ALBUMIN, PER MCI 

C9102 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, 51 SODIUM CHROMATE, PER 

50 MCI 

C9103 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, SODIUM IOTHALAMATE 

I-125 INJECTION, PER 10 UCI 

C9104 ANTI-THYMOCYTE GLOBULIN, PER 25 MG 

C9105 INJECTION, HEPATITIS B IMMUNE GLOBULIN, PER 1 ML 

C9106 SIROLIMUS, PER 1 MG/ML 

C9107 INJECTION, TINZAPARIN SODIUM, PER 2ML VIAL 

C9500 PLATELETS, IRRADIATED, EACH UNIT 

C9501 PLATELETS, PHERESIS, EACH UNIT 

C9502 PLATELETS, PHERESIS, IRRADIATED, EACH UNIT 

C9503 FRESH FROZEN PLASMA, DONOR RETESTED, EACH UNIT 

C9504 RED BLOOD CELLS, DEGLYCEROLIZED, EA UNIT 

C9505 RED BLOOD CELLS, IRRADIATED, EACH UNIT 

C9700 WATER INDUCED THERMOTHERAPY 

C9701 STRETTA SYSTEM 

C9702 CHECKMATE INTRAVASCULAR BRACHYTHERAPY SYSTEM 

E0100 CANE, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR FIXED, WITH TIP 

E0105 CANE, QUAD OR THREE PRONG, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR 

FIXED, WITH TIPS 

E0110 CRUTCHES, FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS, ADJUSTABLE OR FIXED, 

PAIR, COMPLETE WITH TIPS AND HANDGRIPS 

E0111 CRUTCH FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS, ADJUSTABLE OR FIXED, 

EACH, WITH TIP AND HANDGRIPS 

E0112 CRUTCHES UNDERARM, WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS AND 

HANDGRIPS 

E0113 CRUTCH UNDERARM, WOOD, ADJUSTABLE OR FIXED, EACH, WITH PAD, TIP AND HANDGRIP 

E0114 CRUTCHES UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS 

AND HANDGRIPS 

E0116 CRUTCH UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, EACH, WITH PAD, TIP AND 

HANDGRIP 

E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT 

E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT 

E0141 RIGID WALKER, WHEELED, WITHOUT SEAT 

E0142 RIGID WALKER, WHEELED, WITH SEAT 

E0143 FOLDING WALKER, WHEELED, WITHOUT SEAT 

E0144 ENCLOSED, FRAMED FOLDING WALKER, WHEELED, WITH POSTERIOR SEAT 

E0145 WALKER, WHEELED, WITH SEAT AND CRUTCH ATTACHMENTS 

E0146 FOLDING WALKER, WHEELED, WITH SEAT

E0147 HEAVY DUTY, MULTIPLE BREAKING SYSTEM, VARIABLE WHEEL RESISTANCE WALKER 

E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH 

E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE, EACH 

E0153 PLATFORM ATTACHMENT, FOREARM CRUTCH, EACH 

E0154 PLATFORM ATTACHMENT, WALKER, EACH 

E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR 

E0156 SEAT ATTACHMENT, WALKER 

E0157 CRUTCH ATTACHMENT, WALKER, EACH 

E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) 

E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH 

E0160 SITZ TYPE BATH OR EQUIPMENT, PORTABLE, USED WITH OR WITHOUT COMMODE 

E0161 SITZ TYPE BATH OR EQUIPMENT, PORTABLE, USED WITH OR WITHOUT COMMODE, WITH 

FAUCET ATTACHMENT/S 

E0162 SITZ BATH CHAIR 

E0163 COMMODE CHAIR, STATIONARY, WITH FIXED ARMS 

E0164 COMMODE CHAIR, MOBILE, WITH FIXED ARMS 

E0165 COMMODE CHAIR, STATIONARY, WITH DETACHABLE ARMS 

E0166 COMMODE CHAIR, MOBILE, WITH DETACHABLE ARMS 

E0167 PAIL OR PAN FOR USE WITH COMMODE CHAIR 

E0168 COMMODE CHAIR, EXTRA WIDE AND/OR HEAVY DUTY, STATIONARY OR MOBILE, WITH OR 

WITHOUT ARMS, ANY TYPE, EACH 

E0175 FOOT REST, FOR USE WITH COMMODE CHAIR, EACH 

E0176 AIR PRESSURE PAD OR CUSHION, NONPOSITIONING 

E0177 WATER PRESSURE PAD OR CUSHION, NONPOSITIONING 

E0178 GEL OR GEL-LIKE PRESSURE PAD OR CUSHION, NONPOSITIONING 

E0179 DRY PRESSURE PAD OR CUSHION, NONPOSITIONING 

E0180 PRESSURE PAD, ALTERNATING WITH PUMP 

E0181 PRESSURE PAD, ALTERNATING WITH PUMP, HEAVY DUTY 

E0182 PUMP FOR ALTERNATING PRESSURE PAD 

E0184 DRY PRESSURE MATTRESS 

E0185 GEL OR GEL-LIKE PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH 

E0186 AIR PRESSURE MATTRESS 

E0187 WATER PRESSURE MATTRESS 

E0188 SYNTHETIC SHEEPSKIN PAD 

E0189 LAMBSWOOL SHEEPSKIN PAD, ANY SIZE 

E0191 HEEL OR ELBOW PROTECTOR, EACH 

E0192 LOW PRESSURE AND POSITIONING EQUALIZATION PAD, FOR WHEELCHAIR 

E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) 

E0194 AIR FLUIDIZED BED 

E0196 GEL PRESSURE MATTRESS 

E0197 AIR PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH 

E0198 WATER PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH 

E0199 DRY PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH 

E0200 HEAT LAMP, WITHOUT STAND (TABLE MODEL), INCLUDES BULB, OR INFRARED ELEMENT 

E0202 PHOTOTHERAPY (BILIRUBIN) LIGHT WITH PHOTOMETER 

E0205 HEAT LAMP, WITH STAND, INCLUDES BULB, OR INFRARED ELEMENT 

E0210 ELECTRIC HEAT PAD, STANDARD 

E0215 ELECTRIC HEAT PAD, MOIST 

E0217 WATER CIRCULATING HEAT PAD WITH PUMP 

E0218 WATER CIRCULATING COLD PAD WITH PUMP 

E0220 HOT WATER BOTTLE 

E0225 HYDROCOLLATOR UNIT, INCLUDES PADS 

E0230 ICE CAP OR COLLAR 

E0235 PARAFFIN BATH UNIT, PORTABLE (SEE MEDICAL SUPPLY CODE A4265 FOR PARAFFIN) 

E0236 PUMP FOR WATER CIRCULATING PAD 

E0238 NON-ELECTRIC HEAT PAD, MOIST 

E0239 HYDROCOLLATOR UNIT, PORTABLE

E0241 BATH TUB WALL RAIL, EACH 

E0242 BATH TUB RAIL, FLOOR BASE 

E0243 TOILET RAIL, EACH 

E0244 RAISED TOILET SEAT 

E0245 TUB STOOL OR BENCH 

E0246 TRANSFER TUB RAIL ATTACHMENT 

E0249 PAD FOR WATER CIRCULATING HEAT UNIT 

E0250 HOSPITAL BED, FIXED HEIGHT, WITH ANY TYPE SIDE RAILS, WITH MATTRESS 

E0251 HOSPITAL BED, FIXED HEIGHT, WITH ANY TYPE SIDE RAILS, WITHOUT MATTRESS 

E0255 HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITH ANY TYPE SIDE RAILS, WITH MATTRESS 

E0256 HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITH ANY TYPE SIDE RAILS, WITHOUT 

MATTRESS 

E0260 HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITH ANY TYPE SIDE 

RAILS, WITH MATTRESS 

E0261 HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITH ANY TYPE SIDE 

RAILS, WITHOUT MATTRESS 

E0265 HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITH ANY TYPE 

SIDE RAILS, WITH MATTRESS 

E0266 HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITH ANY TYPE 

SIDE RAILS, WITHOUT MATTRESS 

E0270 HOSPITAL BED, INSTITUTIONAL TYPE INCLUDES: OSCILLATING, CIRCULATING AND STRYKER 

FRAME, WITH MATTRESS 

E0271 MATTRESS, INNERSPRING 

E0272 MATTRESS, FOAM RUBBER 

E0273 BED BOARD 

E0274 OVER-BED TABLE 

E0275 BED PAN, STANDARD, METAL OR PLASTIC 

E0276 BED PAN, FRACTURE, METAL OR PLASTIC 

E0277 POWERED PRESSURE-REDUCING AIR MATTRESS 

E0280 BED CRADLE, ANY TYPE 

E0290 HOSPITAL BED, FIXED HEIGHT, WITHOUT SIDE RAILS, WITH MATTRESS 

E0291 HOSPITAL BED, FIXED HEIGHT, WITHOUT SIDE RAILS, WITHOUT MATTRESS 

E0292 HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITHOUT SIDE RAILS, WITH MATTRESS 

E0293 HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITHOUT SIDE RAILS, WITHOUT MATTRESS 

E0294 HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITHOUT SIDE RAILS, 

WITH MATTRESS 

E0295 HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITHOUT SIDE RAILS, 

WITHOUT MATTRESS 

E0296 HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS). WITHOUT SIDE 

RAILS, WITH MATTRESS 

E0297 HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITHOUT SIDE 

RAILS, WITHOUT MATTRESS 

E0298 HOSPITAL BED, HEAVY DUTY, EXTRA WIDE, WITH ANY TYPE SIDE RAILS, WITH MATTRESS 

E0305 BED SIDE RAILS, HALF LENGTH 

E0310 BED SIDE RAILS, FULL LENGTH 

E0315 BED ACCESSORY: BOARD, TABLE, OR SUPPORT DEVICE, ANY TYPE 

E0325 URINAL; MALE, JUG-TYPE, ANY MATERIAL 

E0326 URINAL; FEMALE, JUG-TYPE, ANY MATERIAL 

E0350 CONTROL UNIT FOR ELECTRONIC BOWEL IRRIGATION/EVACUATION SYSTEM 

E0352 DISPOSABLE PACK (WATER RESERVOIR BAG, SPECULUM, VALVING MECHANISM AND 

COLLECTION BAG/BOX) FOR USE WITH THE ELECTRONIC BOWEL IRRIGATION/EVACUATION 

SYSTEM 

E0370 AIR PRESSURE ELEVATOR FOR HEEL 

E0371 NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD MATTRESS 

LENGTH AND WIDTH 

E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH 

E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS

E0424 STATIONARY COMPRESSED GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES CONTAINER, 

CONTENTS, REGULATOR, FLOWMETER, HUMIDIFIER, NEBULIZER, CANNULA OR MASK, AND 

TUBING 

E0425 STATIONARY COMPRESSED GAS SYSTEM, PURCHASE; INCLUDES REGULATOR, FLOWMETER, 

HUMIDIFIER, NEBULIZER, CANNULA OR MASK, AND TUBING 

E0430 PORTABLE GASEOUS OXYGEN SYSTEM, PURCHASE; INCLUDES REGULATOR, FLOWMETER, 

HUMIDIFIER, CANNULA OR MASK, AND TUBING 

E0431 PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, REGULATOR, 

FLOWMETER, HUMIDIFIER, CANNULA OR MASK, AND TUBING 

E0434 PORTABLE LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, SUPPLY 

RESERVOIR, HUMIDIFIER, FLOWMETER, REFILL ADAPTOR, CONTENTS GAUGE, CANNULA OR 

MASK, AND TUBING 

E0435 PORTABLE LIQUID OXYGEN SYSTEM, PURCHASE; INCLUDES PORTABLE CONTAINER, SUPPLY 

RESERVOIR, FLOWMETER, HUMIDIFIER, CONTENTS GAUGE, CANNULA OR MASK, TUBING AND 

REFILL ADAPTOR 

E0439 STATIONARY LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES CONTAINER, CONTENTS, 

REGULATOR, FLOWMETER, HUMIDIFIER, NEBULIZER, CANNULA OR MASK, & TUBING 

E0440 STATIONARY LIQUID OXYGEN SYSTEM, PURCHASE; INCLUDES USE OF RESERVOIR, CONTENTS 

INDICATOR, REGULATOR, FLOWMETER, HUMIDIFIER, NEBULIZER, CANNULA OR MASK, AND 

TUBING 

E0441 OXYGEN CONTENTS, GASEOUS (FOR USE WITH OWNED GASEOUS STATIONARY SYSTEMS OR WHEN 

BOTH A STATIONARY AND PORTABLE GASEOUS SYSTEM ARE OWNED) 

E0442 OXYGEN CONTENTS, LIQUID (FOR USE WITH OWNED LIQUID STATIONARY SYSTEMS OR WHEN 

BOTH A STATIONARY AND PORTABLE LIQUID SYSTEM ARE OWNED) 

E0443 PORTABLE OXYGEN CONTENTS, GASEOUS (FOR USE ONLY WITH PORTABLE GASEOUS SYSTEMS 

WHEN NO STATIONARY GAS OR LIQUID SYSTEM IS USED) 

E0444 PORTABLE OXYGEN CONTENTS, LIQUID (FOR USE ONLY WITH PORTABLE LIQUID SYSTEMS 

WHEN NO STATIONARY GAS OR LIQUID SYSTEM IS USED) 

E0450 VOLUME VENTILATOR, STATIONARY OR PORTABLE, WITH BACKUP RATE FEATURE, USED WITH 

INVASIVE INTERFACE (E.G., TRACHEOSTOMY TUBE) 

E0452 INTERMITTENT ASSIST DEVICE WITH CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE 

(CPAP) 

E0453 THERAPEUTIC VENTILATOR; SUITABLE FOR USE 12 HOURS OR LESS PER DAY 

E0455 OXYGEN TENT, EXCLUDING CROUP OR PEDIATRIC TENTS 

E0457 CHEST SHELL (CUIRASS) 

E0459 CHEST WRAP 

E0460 NEGATIVE PRESSURE VENTILATOR; PORTABLE OR STATIONARY 

E0462 ROCKING BED WITH OR WITHOUT SIDE RAILS 

E0480 PERCUSSOR, ELECTRIC OR PNEUMATIC, HOME MODEL 

E0500 IPPB MACHINE, ALL TYPES, WITH BUILT-IN NEBULIZATION; MANUAL OR AUTOMATIC 

VALVES; INTERNAL OR EXTERNAL POWER SOURCE 

E0550 HUMIDIFIER, DURABLE FOR EXTENSIVE SUPPLEMENTAL HUMIDIFICATION DURING IPPB 

TREATMENTS OR OXYGEN DELIVERY 

E0555 HUMIDIFIER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC BOTTLE TYPE, FOR USE WITH 

REGULATOR OR FLOWMETER 

E0560 HUMIDIFIER, DURABLE FOR SUPPLEMENTAL HUMIDIFICATION DURING IPPB TREATMENT OR 

OXYGEN DELIVERY 

E0565 COMPRESSOR, AIR POWER SOURCE FOR EQUIPMENT WHICH IS NOT SELF- CONTAINED OR 

CYLINDER DRIVEN 

E0570 NEBULIZER, WITH COMPRESSOR 

E0571 AEROSOL COMPRESSOR, BATTERY POWERED, FOR USE WITH SMALL VOLUME NEBULIZER 

E0572 AEROSOL COMPRESSOR, ADJUSTABLE PRESSURE, LIGHT DUTY FOR INTERMITTENT USE 

E0574 ULTRASONIC GENERATOR WITH SMALL VOLUME ULTRASONIC NEBULIZER 

E0575 NEBULIZER, ULTRASONIC, LARGE VOLUME 

E0580 NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, FOR USE WITH 

REGULATOR OR FLOWMETER 

E0585 NEBULIZER, WITH COMPRESSOR AND HEATER

E0590 DISPENSING FEE COVERED DRUG ADMINISTERED THROUGH DME NEBULIZER 

E0600 SUCTION PUMP, HOME MODEL, PORTABLE 

E0601 CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE 

E0602 BREAST PUMP, ALL TYPES 

E0605 VAPORIZER, ROOM TYPE 

E0606 POSTURAL DRAINAGE BOARD 

E0607 HOME BLOOD GLUCOSE MONITOR 

E0608 APNEA MONITOR 

E0609 BLOOD GLUCOSE MONITOR WITH SPECIAL FEATURES (EG., VOICE SYNTHESIZERS AUTOMATIC 

TIMERS, ETC.) 

E0610 PACEMAKER MONITOR, SELF-CONTAINED, (CHECKS BATTERY DEPLETION, INCLUDES AUDIBLE 

AND VISIBLE CHECK SYSTEMS) 

E0615 PACEMAKER MONITOR, SELF CONTAINED, CHECKS BATTERY DEPLETION AND OTHER PACEMAKER 

COMPONENTS, INCLUDES DIGITAL/VISIBLE CHECK SYSTEMS 

E0616 IMPLANTABLE CARDIAC EVENT RECORDER WITH MEMORY, ACTIVATOR AND PROGRAMMER 

E0617 EXTERNAL DEFIBRILLATOR WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS 

E0621 SLING OR SEAT, PATIENT LIFT, CANVAS OR NYLON 

E0625 PATIENT LIFT, KARTOP, BATHROOM OR TOILET 

E0627 SEAT LIFT MECHANISM INCORPORATED INTO A COMBINATION LIFT-CHAIR MECHANISM 

E0628 SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-ELECTRIC 

E0629 SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-NON-ELECTRIC 

E0630 PATIENT LIFT, HYDRAULIC, WITH SEAT OR SLING 

E0635 PATIENT LIFT, ELECTRIC WITH SEAT OR SLING 

E0650 PNEUMATIC COMPRESSOR, NON-SEGMENTAL HOME MODEL 

E0651 PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITHOUT CALIBRATED GRADIENT PRESSURE 

E0652 PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITH CALIBRATED GRADIENT PRESSURE 

E0655 NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF ARM 

E0660 NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEG 

E0665 NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARM 

E0666 NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEG 

E0667 SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEG 

E0668 SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARM 

E0669 SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEG 

E0671 SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL LEG 

E0672 SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL ARM 

E0673 SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, HALF LEG 

E0690 ULTRAVIOLET CABINET, APPROPRIATE FOR HOME USE 

E0700 SAFETY EQUIPMENT (E.G., BELT, HARNESS OR VEST) 

E0710 RESTRAINTS, ANY TYPE (BODY, CHEST, WRIST OR ANKLE) 

E0720 TENS, TWO LEAD, LOCALIZED STIMULATION 

E0730 TENS, FOUR LEAD, LARGER AREA/MULTIPLE NERVE STIMULATION 

E0731 FORM FITTING CONDUCTIVE GARMENT FOR DELIVERY OF TENS OR NMES (WITH CONDUCTIVE 

FIBERS SEPARATED FROM THE PATIENT'S SKIN BY LAYERS OF FABRIC) 

E0740 INCONTINENCE TREATMENT SYSTEM, PELVIC FLOOR STIMULATOR, MONITOR, SENSOR AND/OR 

TRAINER 

E0744 NEUROMUSCULAR STIMULATOR FOR SCOLIOSIS 

E0745 NEUROMUSCULAR STIMULATOR, ELECTRONIC SHOCK UNIT 

E0746 ELECTROMYOGRAPHY (EMG), BIOFEEDBACK DEVICE 

E0747 OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, OTHER THAN SPINAL 

APPLICATIONS 

E0748 OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, SPINAL APPLICATIONS 

E0749 OSTEOGENESIS STIMULATOR, ELECTRICAL, SURGICALLY IMPLANTED 

E0751 IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR, OR COMBINATION OF EXTERNAL 

TRANSMITTER WITH IMPLANTABLE RECEIVER (INCLUDES EXTENSION) 

E0753 IMPLANTABLE NEUROSTIMULATOR ELECTRODES, PER GROUP OF FOUR 

E0755 ELECTRONIC SALIVARY REFLEX STIMULATOR (INTRA-ORAL/NON-INVASIVE) 

E0756 IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR

E0757 IMPLANTABLE NEUROSTIMULATOR RADIOFREQUENCY RECEIVER 

E0758 RADIOFREQUENCY TRANSMITTER (EXTERNAL) FOR USE WITH IMPLANTABLE NEUROSTIMULATOR 

RADIOFREQUENCY RECEIVER 

E0760 OSTOGENESIS STIMULATOR, LOW INTENSITY ULTRASOUND, NON-INVASIVE 

E0765 FDA APPROVED NERVE STIMULATOR, WITH REPLACEABLE BATTERIES, FOR TREATMENT OF 

NAUSEA AND VOMITING 

E0776 IV POLE 

E0779 AMBULATORY INFUSION PUMP, MECHANICAL, REUSABLE, FOR INFUSION 8 HOURS OR GREATER 

E0780 AMBULATORY INFUSION PUMP, MECHANICAL, REUSABLE, FOR INFUSION LESS THAN 8 HOURS 

E0781 AMBULATORY INFUSION PUMP, SINGLE OR MULTIPLE CHANNELS, ELECTRIC OR BATTERY 

OPERATED, WITH ADMINISTRATIVE EQUIPMENT, WORN BY PATIENT 

E0782 INFUSION PUMP, IMPLANTABLE, NON-PROGRAMMABLE 

E0783 INFUSION PUMP SYSTEM, IMPLANTABLE, PROGRAMMABLE (INCLUDES ALL COMPONENTS, E.G., 

PUMP, CATHETER, CONNECTORS, ETC.) 

E0784 EXTERNAL AMBULATORY INFUSION PUMP, INSULIN 

E0785 IMPLANTABLE INTRASPINAL (EPIDURAL/INTRATHECAL) CATHETER USED WITH IMPLANTABLE 

INFUSION PUMP, REPLACEMENT 

E0786 IMPLANTABLE PROGRAMMABLE INFUSION PUMP, REPLACEMENT (EXCLUDES IMPLANTABLE 

INTRASPINAL CATHETER) 

E0791 PARENTERAL INFUSION PUMP, STATIONARY, SINGLE OR MULTI-CHANNEL 

E0830 AMBULATORY TRACTION DEVICE, ALL TYPES, EACH 

E0840 TRACTION FRAME, ATTACHED TO HEADBOARD, CERVICAL TRACTION 

E0850 TRACTION STAND, FREE STANDING, CERVICAL TRACTION 

E0855 CERVICAL TRACTION EQUIPMENT NOT REQUIRING ADDITIONAL STAND OR FRAME 

E0860 TRACTION EQUIPMENT, OVERDOOR, CERVICAL 

E0870 TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCK'S) 

E0880 TRACTION STAND, FREE STANDING, EXTREMITY TRACTION, (E.G., BUCK'S) 

E0890 TRACTION FRAME, ATTACHED TO FOOTBOARD, PELVIC TRACTION 

E0900 TRACTION STAND, FREE STANDING, PELVIC TRACTION, (E.G., BUCK'S) 

E0910 TRAPEZE BARS, A/K/A PATIENT HELPER, ATTACHED TO BED, WITH GRAB BAR 

E0920 FRACTURE FRAME, ATTACHED TO BED, INCLUDES WEIGHTS 

E0930 FRACTURE FRAME, FREE STANDING, INCLUDES WEIGHTS 

E0935 PASSIVE MOTION EXERCISE DEVICE 

E0940 TRAPEZE BAR, FREE STANDING, COMPLETE WITH GRAB BAR 

E0941 GRAVITY ASSISTED TRACTION DEVICE, ANY TYPE 

E0942 CERVICAL HEAD HARNESS/HALTER 

E0943 CERVICAL PILLOW 

E0944 PELVIC BELT/HARNESS/BOOT 

E0945 EXTREMITY BELT/HARNESS 

E0946 FRACTURE, FRAME, DUAL WITH CROSS BARS, ATTACHED TO BED, (E.G. BALKEN, 4 POSTER) 

E0947 FRACTURE FRAME, ATTACHMENTS FOR COMPLEX PELVIC TRACTION 

E0948 FRACTURE FRAME, ATTACHMENTS FOR COMPLEX CERVICAL TRACTION 

E0950 TRAY 

E0951 LOOP HEEL, EACH 

E0952 LOOP TOE, EACH 

E0953 PNEUMATIC TIRE, EACH 

E0954 SEMI-PNEUMATIC CASTER, EACH 

E0958 WHEELCHAIR ATTACHMENT TO CONVERT ANY WHEELCHAIR TO ONE ARM DRIVE 

E0959 AMPUTEE ADAPTER (DEVICE USED TO COMPENSATE FOR TRANSFER OF WEIGHT DUE TO LOST 

LIMBS TO MAINTAIN PROPER BALANCE) 

E0961 BRAKE EXTENSION, FOR WHEELCHAIR 

E0962 1" CUSHION, FOR WHEELCHAIR 




E0966 HOOK ON HEAD REST EXTENSION 

E0967 WHEELCHAIR HAND RIMS WITH 8 VERTICAL RUBBER TIPPED PROJECTIONS, PAIR

E0968 COMMODE SEAT, WHEELCHAIR 

E0969 NARROWING DEVICE, WHEELCHAIR 

E0970 NO.2 FOOTPLATES, EXCEPT FOR ELEVATING LEG REST 

E0971 ANTI-TIPPING DEVICE WHEELCHAIRS 

E0972 TRANSFER BOARD OR DEVICE 

E0973 ADJUSTABLE HEIGHT DETACHABLE ARMS, DESK OR FULL LENGTH, WHEELCHAIR 

E0974 "GRADE-AID" (DEVICE TO PREVENT ROLLING BACK ON AN INCLINE) FOR WHEELCHAIR 

E0975 REINFORCED SEAT UPHOLSTERY, WHEELCHAIR 

E0976 REINFORCED BACK, WHEELCHAIR, UPHOLSTERY OR OTHER MATERIAL 

E0977 WEDGE CUSHION, WHEELCHAIR 

E0978 BELT, SAFETY WITH AIRPLANE BUCKLE, WHEELCHAIR 

E0979 BELT, SAFETY WITH VELCRO CLOSURE, WHEELCHAIR 

E0980 SAFETY VEST, WHEELCHAIR 

E0990 ELEVATING LEG REST, EACH 

E0991 UPHOLSTERY SEAT 

E0992 SOLID SEAT INSERT 

E0993 BACK, UPHOLSTERY 

E0994 ARM REST, EACH 

E0995 CALF REST, EACH 

E0996 TIRE, SOLID, EACH 

E0997 CASTER WITH A FORK 

E0998 CASTER WITHOUT FORK 

E0999 PNEUMATIC TIRE WITH WHEEL 

E1000 TIRE, PNEUMATIC CASTER 

E1001 WHEEL, SINGLE 

E1031 ROLLABOUT CHAIR, ANY AND ALL TYPES WITH CASTORS 5" OR GREATER 

E1035 MULTI-POSITIONAL PATIENT TRANSFER SYSTEM, WITH INTEGRATED SEAT, OPERATED BY 

CARE GIVER 

E1050 FULLY-RECLINING WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE 

ELEVATING LEG RESTS 

E1060 FULLY-RECLINING WHEELCHAIR, DETACHABLE ARMS, DESK OR FULL LENGTH, SWING AWAY 

DETACHABLE ELEVATING LEGRESTS 

E1065 POWER ATTACHMENT (TO CONVERT ANY WHEELCHAIR TO MOTORIZED WHEELCHAIR, E.G., 

SOLO) 

E1066 BATTERY CHARGER 

E1069 DEEP CYCLE BATTERY 

E1070 FULLY-RECLINING WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY 

DETACHABLE FOOTREST 

E1083 HEMI-WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING LEG 

REST 

E1084 HEMI-WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH ARMS, SWING AWAY 

DETACHABLE ELEVATING LEG RESTS 

E1085 HEMI-WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOT RESTS 

E1086 HEMI-WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH, SWING AWAY DETACHABLE 

FOOTRESTS 

E1087 HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY 


E1088 HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH, 

SWING AWAY DETACHABLE ELEVATING LEG RESTS 

E1089 HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, FIXED LENGTH ARMS, SWING AWAY DETACHABLE 

FOOTREST 

E1090 HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH, 

SWING AWAY DETACHABLE FOOT RESTS 

E1091 YOUTH WHEELCHAIR, ANY TYPE 

E1092 WIDE HEAVY DUTY WHEEL CHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH), SWING AWAY 


E1093 WIDE HEAVY DUTY WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH ARMS, SWING

AWAY DETACHABLE FOOTRESTS 

E1100 SEMI-RECLINING WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE 

ELEVATING LEG RESTS 

E1110 SEMI-RECLINING WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) ELEVATING LEG 

REST 

E1130 STANDARD WHEELCHAIR, FIXED FULL LENGTH ARMS, FIXED OR SWING AWAY DETACHABLE 

FOOTRESTS 

E1140 WHEELCHAIR, DETACHABLE ARMS, DESK OR FULL LENGTH, SWING AWAY DETACHABLE 

FOOTRESTS 

E1150 WHEELCHAIR, DETACHABLE ARMS, DESK OR FULL LENGTH SWING AWAY DETACHABLE 

ELEVATING LEGRESTS 

E1160 WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING LEGRESTS 

E1170 AMPUTEE WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING 

LEGRESTS 

E1171 AMPUTEE WHEELCHAIR, FIXED FULL LENGTH ARMS, WITHOUT FOOTRESTS OR LEGREST 

E1172 AMPUTEE WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) WITHOUT FOOTRESTS OR 

LEGREST 

E1180 AMPUTEE WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE 

FOOTRESTS 

E1190 AMPUTEE WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE 

ELEVATING LEGRESTS 

E1195 HEAVY DUTY WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING 

LEGRESTS 

E1200 AMPUTEE WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST 

E1210 MOTORIZED WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING 

LEG RESTS 

E1211 MOTORIZED WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH SWING AWAY, 

DETACHABLE ELEVATING LEG REST 

E1212 MOTORIZED WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOT RESTS 

E1213 MOTORIZED WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH, SWING AWAY 

DETACHABLE FOOT RESTS 

E1220 WHEELCHAIR; SPECIALLY SIZED OR CONSTRUCTED, (INDICATE BRAND NAME, MODEL NUMBER, 

IF ANY) AND JUSTIFICATION 

E1221 WHEELCHAIR WITH FIXED ARM, FOOTRESTS 

E1222 WHEELCHAIR WITH FIXED ARM, ELEVATING LEGRESTS 

E1223 WHEELCHAIR WITH DETACHABLE ARMS, FOOTRESTS 

E1224 WHEELCHAIR WITH DETACHABLE ARMS, ELEVATING LEGRESTS 

E1225 SEMI-RECLINING BACK FOR CUSTOMIZED WHEEL CHAIR 

E1226 FULL RECLINING BACK FOR CUSTOMIZED WHEELCHAIR 

E1227 SPECIAL HEIGHT ARMS FOR WHEELCHAIR 

E1228 SPECIAL BACK HEIGHT FOR WHEELCHAIR 

E1230 POWER OPERATED VEHICLE (THREE OR FOUR WHEEL NONHIGHWAY) SPECIFY BRAND NAME AND 

MODEL NUMBER 

E1240 LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS, (DESK OR FULL LENGTH) SWING AWAY 

DETACHABLE, ELEVATING LEGREST 

E1250 LIGHTWEIGHT WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST 

E1260 LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY 


E1270 LIGHTWEIGHT WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING 

LEGRESTS 

E1280 HEAVY DUTY WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) ELEVATING LEGRESTS 

E1285 HEAVY DUTY WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST 

E1290 HEAVY DUTY WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY 


E1295 HEAVY DUTY WHEELCHAIR, FIXED FULL LENGTH ARMS, ELEVATING LEGREST 

E1296 SPECIAL WHEELCHAIR SEAT HEIGHT FROM FLOOR 

E1297 SPECIAL WHEELCHAIR SEAT DEPTH, BY UPHOLSTERY

E1298 SPECIAL WHEELCHAIR SEAT DEPTH AND/OR WIDTH, BY CONSTRUCTION 

E1300 WHIRLPOOL, PORTABLE (OVERTUB TYPE) 

E1310 WHIRLPOOL, NON-PORTABLE (BUILT-IN TYPE) 

E1340 REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL EQUIPMENT REQUIRING THE SKILL 

OF A TECHNICIAN, LABOR COMPONENT, PER 15 MINUTES 

E1353 REGULATOR 

E1355 STAND/RACK 

E1372 IMMERSION EXTERNAL HEATER FOR NEBULIZER 

E1375 NEBULIZER PORTABLE WITH SMALL COMPRESSOR, WITH LIMITED FLOW 

E1377 OXYGEN CONCENTRATOR, HIGH HUMIDITY SYSTEM EQUIV. TO 244 CU. FT. 








E1385 OXYGEN CONCENTRATOR, HIGH HUMIDITY SYSTEM EQUIV. TO OVER 1952 CU. FT. 

E1390 OXYGEN CONCENTRATOR, CAPABLE OF DELIVERING 85 PERCENT OR GREATER OXYGEN 

CONCENTRATION AT THE PRESCRIBED FLOW RATE 

E1399 DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS 

E1400 OXYGEN CONCENTRATOR, MANUFACTURER SPECIFIED MAXIMUM FLOW RATE DOES NOT EXCEED 2 

LITERS PER MINUTE, AT 85 PERCENT OR GREATER CONCENTRATION. 

E1401 OXYGEN CONCENTRATOR, MANUFACTURER SPECIFIED MAXIMUM FLOW RATE GREATER THAN 2 

LITERS PER MINUTE, DOES NOT EXCEED 3 LITERS PER MINUTE, AT 85 PERCENT OR 

GREATER CONCENTRATION 








LITERS PER MINUTE, AT 85 PERCENT OR GREATER CONCENTRATION 

E1405 OXYGEN AND WATER VAPOR ENRICHING SYSTEM WITH HEATED DELIVERY 

E1406 OXYGEN AND WATER VAPOR ENRICHING SYSTEM WITHOUT HEATED DELIVERY 

E1510 KIDNEY, DIALYSATE DELIVERY SYST. KIDNEY MACHINE, PUMP RECIRCULAT- ING, AIR 

REMOVAL SYST, FLOWRATE METER, POWER OFF, HEATER AND TEMPERATURE CONTROL WITH 

ALARM, I.V.POLES, PRESSURE GAUGE, CONCENTRATE CONTAINER 

E1520 HEPARIN INFUSION PUMP FOR DIALYSIS 

E1530 AIR BUBBLE DETECTOR FOR DIALYSIS 

E1540 PRESSURE ALARM FOR DIALYSIS 

E1550 BATH CONDUCTIVITY METER FOR DIALYSIS 

E1560 BLOOD LEAK DETECTOR FOR DIALYSIS 

E1570 ADJUSTABLE CHAIR, FOR ESRD PATIENTS 

E1575 TRANSDUCER PROTECTORS/FLUID BARRIERS, ANY SIZE, EACH 

E1580 UNIPUNCTURE CONTROL SYSTEM FOR DIALYSIS 

E1590 HEMODIALYSIS MACHINE 

E1592 AUTOMATIC INTERMITTENT PERITIONEAL DIALYSIS SYSTEM 

E1594 CYCLER DIALYSIS MACHINE FOR PERITONEAL DIALYSIS 

E1600 DELIVERY AND/OR INSTALLATION CHARGES FOR RENAL DIALYSIS EQUIPMENT 

E1610 REVERSE OSMOSIS WATER PURIFICATION SYSTEM 

E1615 DEIONIZER WATER PURIFICATION SYSTEM 

E1620 BLOOD PUMP FOR DIALYSIS 

E1625 WATER SOFTENING SYSTEM 

E1630 RECIPROCATING PERITONEAL DIALYSIS SYSTEM 

E1632 WEARABLE ARTIFICAL KIDNEY

E1635 COMPACT (PORTABLE) TRAVEL HEMODIALYZER SYSTEM 

E1636 SORBENT CARTRIDGES, PER CASE 

E1640 REPLACEMENT COMPONENTS FOR HEMODIALYSIS AND/OR PERITONEAL DIALYSIS MACHINES 

THAT ARE OWNED OR BEING PURCHASED BY THE PATIENT 

E1699 DIALYSIS EQUIPMENT, UNSPECIFIED, BY REPORT 

E1700 JAW MOTION REHABILITATION SYSTEM 

E1701 REPLACEMENT CUSHIONS FOR JAW MOTION REHABILITATION SYSTEM, PKG. OF 6 

E1702 REPLACEMENT MEASURING SCALES FOR JAW MOTION REHABILITATION SYSTEM, PKG. OF 200 

E1800 DYNAMIC ADJUSTABLE ELBOW EXTENSION/FLEXION DEVICE, OR EQUAL 

E1805 DYNAMIC ADJUSTABLE WRIST EXTENSION/FLEXION DEVICE, OR EQUAL 

E1810 DYNAMIC ADJUSTABLE KNEE EXTENSION/FLEXION DEVICE, OR EQUAL 

E1815 DYNAMIC ADJUSTABLE ANKLE EXTENSION/FLEXION DEVICE, OR EQUAL 

E1820 SOFT INTERFACE MATERIAL, DYNAMIC ADJUSTABLE EXTENSION/FLEXION DEVICE 

E1825 DYNAMIC ADJUSTABLE FINGER EXTENSION/FLEXION DEVICE, OR EQUAL 

E1830 DYNAMIC ADJUSTABLE TOE EXTENSION/FLEXION DEVICE, OR EQUAL 

E1900 SYNTHESIZED SPEECH AUGMENTATIVE COMMUNICATION DEVICE WITH DYNAMIC DISPLAY 

G0001 ROUTINE VENIPUNCTURE FOR COLLECTION OF SPECIMEN(S) 

G0002 OFFICE PROCEDURE, INSERTION OF TEMPORARY INDWELLING CATHETER, FOLEY TYPE 

(SEPARATE PROCEDURE) 

G0004 PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRE-SYMPTOM MEMORY LOOP 

AND 24 HOUR ATTENDED MONITORING, PER 30 DAY PERIOD; INCLUDES TRANSMISSION, 

PHYSICIAN REVIEW AND INTERPRETATION 


AND 24 HOUR ATTENDED MONITORING, PER 30 DAY PERIOD; RECORDING (INCLUDES 

HOOK-UP, RECORDING AND DISCONNECTION) 


AND 24 HOUR ATTENDED MONITORING, PER 30 DAY PERIOD; 24 HOUR ATTENDED 

MONITORING, RECEIPT OF TRANSMISSIONS, AND ANALYSIS 

G0007 PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRE-SYMPTON MEMORY LOOP 

AND 24 HOUR ATTENDED MONITORING, PER 30 DAY PERIOD; PHYSICIAN REVIEW AND 

INTERPRETATION ONLY 

G0008 ADMINISTRATION OF INFLUENZA VIRUS VACCINE 

G0009 ADMINISTRATION OF PNEUMOCOCCAL VACCINE 

G0010 ADMINISTRATION OF HEPATITIS B VACCINE 

G0015 POST-SYMPTOM TELEPHONIC TRANSMISSION OF ELECTROCARDIOGRAM RHYTHM STRIP(S) AND 

24 HOUR ATTENDED MONITORING, PER 30 DAY PERIOD; TRACING ONLY 

G0016 POST-SYMPTOM TELEPHONIC TRANSMISSION OF ELECTROCARDIOGRAM RHYTHM STRIPS(S) AND 

24 HOUR ATTENDED MONITORING, PER 30 DAY PERIOD; PHYSICIAN REVIEW AND 

INTERPRETATION ONLY 

G0025 COLLAGEN SKIN TEST KIT 

G0026 FECAL LEUCOCYTE EXAMINATION 

G0027 SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM EXCLUDING HUHNER 

G0030 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING PREVIOUS PET, G0030-G0047); SINGLE 

STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0031 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING PREVIOUS PET, G0030-G0047); 

MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0032 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST SPECT, 78464); SINGLE STUDY, 

REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0033 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST SPECT, 78464); MULTIPLE 

STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0034 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS SPECT, 78465); SINGLE 

STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0035 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS SPECT, 78465); MULTIPLE 


G0036 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING CORONARY ANGIOGRAPHY, 

93510-93529); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0037 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING CORONARY ANGIOGRAPHY,

93510-93529); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0038 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS PLANAR MYOCARDIAL 

PERFUSION, 78460); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0039 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS PLANAR MYOCARDIAL 

PERFUSION, 78460); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR 

PHARMACOLOGIC) 

G0040 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECHOCARDIOGRAM, 93350); 

SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0041 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECHOCARDIOGRAM, 93350); 

MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0042 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS NUCLEAR VENTRICULOGRAM, 

78481 OR 78483); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) 

G0043 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS NUCLEAR VENTRICULOGRAM, 

78481 OR 78483); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR 

PHARMACOLOGIC) 

G0044 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST ECG, 93000); SINGLE STUDY, 


G0045 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST ECG, 93000); MULTIPLE 


G0046 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECG, 93015); SINGLE STUDY, 


G0047 PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECG, 93015); MULTIPLE 


G0050 MEASUREMENT OF POST-VOIDING RESIDUAL URINE AND/OR BLADDER CAPACITY BY 

ULTRASOUND 

G0051 DESTRUCTION BY ANY METHOD, INCLUDING LASER, WITH OR WITHOUT SURGICAL 

CURETTEMENT OF ALL BENIGN OR PREMALIGNANT LESIONS (E.G. ACTINIC KERATOSIS), 

OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PROLIFERATIVE LESIONS, INCLUDING 

LOCAL ANESTHESIA; INITIAL LESION 




LOCAL ANESTHESIA; SECOND THROUGH 14 LESIONS, EACH (G0051 PLUS G0052 EQUAL 14 

LESIONS) 




LOCAL ANESTHESIA; 15 LESIONS OR MORE (INCLUDES G0051 AND G0052; THAT IS, G0053 

MAY NOT BE REPORTED IN ADDITION TO G0051 AND G0052) 

G0058 AUTOMATED MULTICHANNEL TEST; 20 CLINICAL CHEMISTRY TESTS 

G0059 AUTOMATED MULTICHANNEL TEST; 21 CLINICAL CHEMISTRY TESTS 

G0060 AUTOMATED MULTICHANNEL TEST, 22 CLINICAL CHEMISTRY TESTS 

G0062 PERIPHERAL SKELETAL BONE MINERAL DENSITY STUDIES (E.G., RADIUS, WRIST, HEEL). 

G0063 CENTRAL SKELETAL BONE MINERAL DENSITY STUDIES (E.G., SPINE, PELVIS). 

G0064 PHYSICIAN SUPERVISION OF A PATIENT UNDER CARE OF A HOME HEALTH AGENCY (PATIENT 

NOT PRESENT) REQUIRING COMPLEX AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING 

REGULAR PHYSICIAN DEVELOPMENT AND/OR REVISION OF CARE PLANS, REVIEW OF 

SUBSEQUENT REPORTS OF PATIENT STATUS, REVIEW OF RELATED LABORATORY AND OTHER 

STUDIES, COMMUNICATION (INCLUDING TELEPHONE CALLS) WITH OTHER HEALTH CARE 

PROFESSIONALS INVOLVED IN PATIENT'S CARE, INTEGRATION OF NEW INFORMATION INTO 

THE MEDICAL TREATMENT PLAN AND/OR ADJUSTMENT OF MEDICAL THERAPY, WITHIN A 

CALENDAR MONTH; 30 MINUTES OR MORE. 

G0065 PHYSICIAN SUPERVISION OF A HOSPICE PATIENT (PATIENT NOT PRESENT) REQUIRING 

COMPLEX AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING REGULAR PHYSICIAN 

DEVELOPMENT AND/OR REVISION OF CARE PLANS, REVIEW OF SUBSEQUENT REPORTS OF 

PATIENT STATUS, REVIEW OF RELATED LABORATORY AND OTHER STUDIES, COMMUNICATION 

(INCLUDING TELEPHONE CALLS) WITH OTHER HEALTH CARE PROFESSIONALS INVOLVED IN

PATIENT'S CARE, INTEGRATION OF NEW INFORMATION INTO THE MEDICAL TREATMENT PLAN 

AND/OR ADJUSTMENT OF MEDICAL THERAPY, WITHIN A CALENDAR MONTH; 30 MINUTES OR 

MORE. 

G0066 PHYSICIAN SUPERVISION OF A NURSING FACILITY PATIENT (PATIENT NOT PRESENT) 

REQUIRING COMPLEX AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING REGULAR 

PHYSICIAN DEVELOPMENT AND/OR REVISION OF CARE PLANS, REVIEW OF SUBSEQUENT 

REPORTS OF PATIENT STATUS, REVIEW OF RELATED LABORATORY AND OTHER STUDIES, 

COMMUNICATION (INCLUDING TELEPHONE CALLS) WITH OTHER HEALTH CARE PROFESSIONALS 

INVOLVED IN PATIENT'S CARE, INTEGRATION OF NEW INFORMATION INTO THE MEDICAL 

TREATMENT PLAN AND/OR ADJUSTMENT OF MEDICAL THERAPY, WITHIN A CALENDAR MONTH; 

30 MINUTES OR MORE. 

G0071 INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR 

SUPPORTIVE, IN AN OFFICE OR OUTPATIENT FACILITY, APPROXIMATELY 20 TO 30 MINUTES 

FACE-TO-FACE WITH THE PATIENT 



FACE-TO-FACE WITH THE PATIENT; WITH MEDICAL EVALUATION AND MANAGEMENT SERVICES 













G0077 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, IN AN OFFICE OR OUTPATIENT FACILITY, 

APPROXIMATELY 20 TO 30 MINUTES FACE-TO-FACE WITH THE PATIENT 


APPROXIMATELY 20 TO 30 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH MEDICAL 

EVALUATION AND MANAGEMENT SERVICES 

G0079 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE IN AN OFFICE OR OUTPATIENT FACILITY, 











SUPPORTIVE, IN AN INPATIENT HOSPITAL, PARTIAL HOSPITAL, OR RESIDENTIAL CARE 

SETTING, APPROXIMATELY 20 TO 30 MINUTES FACE-TO-FACE WITH THE PATIENT 



SETTING, APPROXIMATELY 20 TO 30 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH 

MEDICAL EVALUATION AND MANAGEMENT SERVICES 






SETTING, APPROXIMATELY 45 TO 50 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH







SETTING, APPROXIMATELY 75 TO 80 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH 


G0089 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, IN AN INPATIENT HOSPITAL, PARTIAL 

HOSPITAL, OR RESIDENTIAL CARE SETTING, APPROXIMATELY 20 TO 30 MINUTES 

















G0095 HEPATIC FUNCTION PANEL A ((WITH BILIRUBIN, TOTAL AND DIRECT); ALBUMIN, SERUM; 

BILIRUBIN, TOTAL AND DIRECT; PHOSPHATASE, ALKALINE; TRANSFERASE, ASPARTATE 

AMINO (AST)(SGOT); TRANSFERASE, ALANINE AMINO (ALT)(SGPT)) 

G0096 BASIC METABOLIC PANEL (CARBON DIOXIDE (BICARBONATE); CHLORIDE-BLOOD; 

CREATININE-BLOOD; GLUCOSE-QUANTITATIVE; POTASSIUM-SERUM; SODIUM-SERUM; UREA 

NITROGEN-QUANTITATIVE) 

G0097 ELECTROLYTES PANEL (CARBON DIOXIDE; CHLORIDE-BLOOD; POTASSIUM-SERUM; 

SODIUM-SERUM) 

G0098 COMPREHENSIVE METABOLIC PANEL (ALBUMIN-SERUM; BILIRUBIN-TOTAL; CALCIUM-TOTAL; 

CHLORIDE-BLOOD; CREATININE-BLOOD; GLUCOSE-QUANTITATIVE; PHOSPHATASE-ALKALINE; 

POTASSIUM-SERUM; PROTEIN-TOTAL, EXCEPT REFRACTOMETRY; SODIUM-SERUM; 

TRANSFERASE-ASPARTATE AMINO (AST) (SGOT); UREA NITROGEN-QUANTITATIVE) 

G0100 HIV-1, VIRAL LOAD QUANTITATIVE 

G0101 CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION 

G0102 PROSTATE CANCER SCREENING; DIGITAL RECTAL EXAMINATION 

G0103 PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA), TOTAL 

G0104 COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY 

G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK 

G0106 COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0104, SCREENING SIGMOIDOSCOPY, 

BARIUM ENEMA 

G0107 COLORECTAL CANCER SCREENING; FECAL-OCCULT BLOOD TEST, 1-3 SIMULTANEOUS 

DETERMINATIONS 

G0108 DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 

MINUTES 

G0109 DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR 

MORE), PER 30 MINUTES 

G0110 NETT PULM-REHAB; EDUCATION/SKILLS TRAINING, INDIVIDUAL 

G0111 NETT PULM-REHAB; EDUCATION/SKILLS TRAINING, GROUP 

G0112 NETT PULM-REHAB; NUTRITIONAL GUIDANCE, INITIAL 

G0113 NETT PULM-REHAB; NUTRITIONAL GUIDANCE, SUBSEQUENT 

G0114 NETT PULM-REHAB; PSYCHOSOCIAL CONSULTATION

G0115 NETT PULM-REHAB; PSYCHOLOGICAL TESTING 

G0116 NETT PULM-REHAB; PSYCHOSOCIAL COUNSELLING 

G0120 COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0105, SCREENING COLONOSCOPY, 

BARIUM ENEMA. 

G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR 

HIGH RISK 

G0122 COLORECTAL CANCER SCREENING; BARIUM ENEMA 

G0123 SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED 

IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY 

CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION 


IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, REQUIRING 

INTERPRETATION BY PHYSICIAN 

G0125 PET LUNG IMAGING OF SOLITARY PULMONARY NODULES, USING 

2-(FLUORINE-18)-FLUORO-2-DEOXY-D-GLUCOSE (FDG), FOLLOWING CT (71250/71260 OR 

71270) 

G0126 PET LUNG IMAGING OF SOLITARY PULMONARY NODULES, USING 

2-(FLUORINE-18)-FLUORO-2-DEOXY-D-GLUCOSE (FDG), FOLLOWING CT (71250/71260 OR 

71270); INITIAL STAGING OF PATHOLOGICALLY DIAGNOSED NON-SMALL CELL LUNG CANCER 

G0127 TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER 

G0128 DIRECT (FACE-TO-FACE WITH PATIENT) SKILLED NURSING SERVICES OF A REGISTERED 

NURSE PROVIDED IN A COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY, EACH 10 

MINUTES BEYOND THE FIRST 5 MINUTES 

G0129 OCCUPATIONAL THERAPY REQUIRING THE SKILLS OF A QUALIFIED OCCUPATIONAL 

THERAPIST, FURNISHED AS A COMPONENT OF A PARTIAL HOSPITALIZATION TREATMENT 

PROGRAM, PER DAY 

G0130 SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEXA) BONE DENSITY STUDY, ONE OR MORE 

SITES; APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL) 

G0131 COMPUTERIZED TOMOGRAPHY BONE MINERAL DENSITY STUDY, ONE OR MORE SITES; AXIAL 

SKELETON (EG, HIPS, PELVIS, SPINE) 

G0132 COMPUTERIZED TOMOGRAPHY BONE MINERAL DENSITY STUDY, ONE OR MORE SITES; 

APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL) 

G0133 ULTRA-SOUND BONE MINERAL STUDY, ONE OR MORE SITES, APPENDICULAR SKELETON 

(PERIPHERAL) (EG, RADIUS, WRIST, HEEL) 

G0141 SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED 

SYSTEM, WITH MANUAL RESCREENING, REQUIRING INTERPRETATION BY PHYSICIAN 


IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, WITH MANUAL SCREENING 

AND RESCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION 



AND COMPUTER-ASSISTED RESCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN 

SUPERVISION 



AND COMPUTER-ASSISTED RESCREENING USING CELL SELECTION AND REVIEW UNDER 

PHYSICIAN SUPERVISION 


SYSTEM UNDER PHYSICIAN SUPERVISION 


SYSTEM WITH MANUAL RESCREENING 

G0151 SERVICES OF PHYSICAL THERAPIST IN HOME HEALTH SETTING, EACH 15 MINUTES 

G0152 SERVICES OF OCCUPATIONAL THERAPIST IN HOME HEALTH SETTING, EACH 15 MINUTES 

G0153 SERVICES OF SPEECH AND LANGUAGE PATHOLOGIST IN HOME HEALTH SETTING, EACH 15 

MINUTES 

G0154 SERVICES OF SKILLED NURSE IN HOME HEALTH SETTING, EACH 15 MINUTES 

G0155 SERVICES OF CLINICAL SOCIAL WORKER IN HOME HEALTH SETTING, EACH 15 MINUTES

G0156 SERVICES OF HOME HEALTH AIDE IN HOME HEALTH SETTING, EACH 15 MINUTES 

G0159 PERCUTANEOUS THROMBECTOMY AND/OR REVISION, ARTERIOVENOUS FISTULA, AUTOGENOUS OR 

NONAUTOGENOUS DIALYSIS GRAFT 

G0160 CRYOSURGICAL ABLATION OF LOCALIZED PROSTATE CANCER, PRIMARY TREATMENT ONLY 

(POST OPERATIVE IRRIGATIONS AND ASPIRATION OF SLOUGHING TISSUE INCLUDED) 

G0161 ULTRASONIC GUIDANCE FOR INTERSTITIAL PLACEMENT OF CRYOSURGICAL PROBES 

G0163 POSITRON EMISSION TOMOGRAPHY (PET), WHOLE BODY, FOR RECURRENCE OF COLORECTAL 

METASTATIC CANCER 

G0164 POSITRON EMISSION TOMOGRAPHY (PET), WHOLE BODY, FOR STAGING AND 

CHARACTERIZATION OF LYMPHOMA 

G0165 POSITRON EMISSION TOMOGRAPHY (PET), WHOLE BODY, FOR RECURRENCE OF MELANOMA OR 

MELANOMA METASTATIC CANCER 

G0166 EXTERNAL COUNTERPULSATION, PER TREATMENT SESSION 

G0167 HYPERBARIC OXYGEN TREATMENT NOT REQUIRING PHYSICIAN ATTENDANCE, PER TREATMENT 

SESSION 

G0168 WOUND CLOSURE UTILIZING TISSUE ADHESIVE(S) ONLY 

G0169 REMOVAL OF DEVITALIZED TISSUE, WITHOUT USE OF ANESTHESIA (CONSCIOUS SEDATION, 

LOCAL, REGIONAL, GENERAL) 

G0170 APPLICATION OF TISSUE CULTURED SKIN GRAFTS, INCLUDING BILAMINATE SKIN 

SUBSTITUTES OR NEODERMIS, INCLUDING SITE PREPARATION, INITIAL 25 SQ CMS 

G0171 APPLICATION OF TISSUE CULTURED SKIN GRAFTS, INCLUDING BILAMINATE SKIN 

SUBSTITUTES OR NEODERMIS, INCLUDING SITE PREPARATION, EACH ADDITIONAL 25 SQ CMS 

G0172 TRAINING AND EDUCATIONAL SERVICES FURNISHED AS A COMPONENT OF A PARTIAL 

HOSPITALIZATION TREATMENT PROGRAM, PER DAY 

G0173 STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF THERAPY IN ONE SESSION 

G0174 [IMRT] INTENSITY MODULATED RADIATION THERAPY PLAN, PER SESSION 

G0175 SCHEDULED INTERDISCIPLINARY TEAM CONFERENCE (MINIMUM OF THREE EXCLUSIVE OF 

PATIENT CARE NURSING STAFF) WITH PATIENT PRESENT 

G0176 ACTIVITY THERAPY, SUCH AS MUSIC, DANCE, ART OR PLAY THERAPIES NOT FOR 

RECREATION, RELATED TO THE CARE AND TREATMENT OF PATIENT’S DISABLING MENTAL 

HEALTH PROBLEMS, PER SESSION (45 MINUTES OR MORE) 

G0177 TRAINING AND EDUCATIONAL SERVICES RELATED TO THE CARE AND TREATMENT OF 

PATIENT’S DISABLING MENTAL HEALTH PROBLEMS PER SESSION (45 MINUTES OR MORE) 

G0178 INTENSITY MODULATED RADIATION THERAPY (IMRT) DELIVERY TO MULTIPLE AREAS WITH 

TREATMENT SETUP AND VERIFICATION IMAGES 

G0179 INTENSITY MODULATED RADIATION THERAPY (IMRT) PLANNING, INCLUDES DOSE VOLUME 

NISTOGRAMS, INVERSE PLAN OPTIMIZATION, PLAN POSITIONAL ACCURACY AND DOSE 

VERIFICATION 

G0180 PHYSICIAN CERTIFICATION SERVICES FOR MEDICARE-COVERED SERVICES PROVIDED BY A 

PARTICIPATING HOME HEALTH AGENCY (PATIENT NOT PRESENT), INCLUDING REVIEW OF 

INITIAL OR SUBSEQUENT REPORTS OF PATIENT STATUS, REVIEW OF PATIENT’S RESPONSES 

TO THE OASIS ASSESSMENT INSTRUMENT, CONTACT WITH THE HOME HEALTH AGENCY TO 

ASCERTAIN THE INITIAL IMPLEMENTATION PLAN OF CARE, AND DOCUMENTATION IN THE 

PATIENT’S OFFICE RECORD, PER CERTIFICATION PERIOD 

G0181 PHYSICIAN SUPERVISION OF A PATIENT RECEIVING MEDICARE-COVERED SERVICES PROVIDED 

BY A PARTICIPATING HOME HEALTH AGENCY (PATIENT NOT PRESENT) REQUIRING COMPLEX 

AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING REGULAR PHYSICIAN DEVELOPMENT 

AND/OR REVISION OF CARE PLANS, REVIEW OF SUBSEQUENT REPORTS OF PATIENT STATUS, 

REVIEW OF LABORATORY AND OTHER STUDIES, COMMUNICATION (INCLUDING TELEPHONE 

CALLS) WITH OTHER HEALTH CARE PROFESSIONALS INVOLVED IN THE PATIENT’S CARE, 

INTEGRATION OF NEW INFORMATION INTO THE MEDICAL TREATMENT PLAN AND/OR 

ADJUSTMENT OF MEDICAL THERAPY, WITHIN A CALENDAR MONTH, 30 MINUTES OR MORE 

G0182 PHYSICIAN SUPERVISION OF A PATIENT UNDER A MEDICARE-APPROVED HOSPICE (PATIENT 

NOT PRESENT) REQUIRING COMPLEX AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING 

REGULAR PHYSICIAN DEVELOPMENT AND/OR REVISION OF CARE PLANS, REVIEW OF 

SUBSEQUENT REPORTS OF PATIENT STATUS, REVIEW OF LABORATORY AND OTHER STUDIES, 

COMMUNICATION (INCLUDING TELEPHONE CALLS) WITH OTHER HEALTH CARE PROFESSIONALS

INVOLVED IN THE PATIENT’S CARE, INTEGRATION OF NEW INFORMATION INTO THE MEDICAL 

TREATMENT PLAN AND/OR ADJUSTMENT OF MEDICAL THERAPY, WITHIN A CALENDAR MONTH, 

30 MINUTES OR MORE 

G0183 DESTRUCTION OF LOCALIZED LESION OF CHOROID (FOR EXAMPLE, CHOLOROIDAL 

NEOVASCULARIZATION); OCULAR PHOTODYNAMIC THERAPY (INCLUDES INTRAVENOUS 

INFUSION) 

G0184 DESTRUCTION OF LOCALIZED LESION OF CHOROID (FOR EXAMPLE, CHOROIDAL 

NEOVASCULARIZATION); PHOTOCOAGULATION, (FOR EXAMPLE BY LASER) ONE OR MORE 

SESSIONS 


NEOVASCULARIZATION); TRANSPUPILLARY THERMOTHERAPY (ONE OR MORE SESSIONS) 


NEOVASCULARIZATION); PHOTOCOAGULATION, FEEDER VESSEL TECHNIQUE (ONE OR MORE 

SESSIONS) 

G0187 DESTRUCTION OF MACULAR DRUSEN, PHOTOCOAGULATION (ONE OR MORE SESSIONS) 

G0188 FULL LENGTH RADIOGRAPHY OF LOWER EXTREMITY, WHICH INCLUDES HIP, KNEE AND ANKLE 

G0190 IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, 

INTRAMUSCULAR AND JET INJECTIONS; EACH ADDITIONAL VACCINE (SINGLE OR 

COMBINATION VACCINE/TOXOID) 

G0191 IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, 

INTRAMUSCULAR AND JET INJECTIONS); EACH ADDITIONAL VACCINE (SINGLE OR 

COMBINATION VACCINE/TOXOID) LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY 

PROCEDURE 

G0192 INTRANASAL OR ORAL ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION 

VACCINE/TOXOID) 

G0193 ENDOSCOPIC STUDY OF SWALLOWING FUNCTION (ALSO FIBEROPTIC ENDOSCOPIC EVALUATION 

OF SWALLOWING (FEES) 

G0194 SENSORY TESTING DURING ENDOSCOPIC STUDY OF SWALLOWING (ADD ON CODE) REFERRED 

TO AS FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING WITH SENSORY TESTING 

(FEEST) 

G0195 CLINICAL EVALUATION OF SWALLOWING FUNCTION (NOT INVOLVING INTERPRETATION OF 

DYNAMIC RADIOLOGICAL STUDIES OR ENDOSCOPIC STUDY OF SWALLOWING) 

G0196 EVALUATION OF SWALLOWING INVOLVING SWALLOWING OF RADIO-OPAQUE MATERIALS 

G0197 EVALUATION OF PATIENT FOR PRESCRIPTION OF SPEECH GENERATING DEVICES 

G0198 PATIENT ADAPTATION AND TRAINING FOR USE OF SPEECH GENERATING DEVICES 

G0199 RE-EVALUATION OF PATIENT USING SPEECH GENERATING DEVICES 

G0200 EVALUATION OF PATIENT FOR PRESCRIPTION OF VOICE PROSTHETIC 

G0201 MODIFICATION OR TRAINING IN USE OF VOICE PROSTHETIC 

G9001 COORDINATED CARE FEE, INITIAL RATE 

G9002 COORDINATED CARE FEE, MAINTENANCE RATE 

G9003 COORDINATED CARE FEE, RISK ADJUSTED HIGH, INITIAL 

G9004 COORDINATED CARE FEE, RISK ADJUSTED LOW, INITIAL 

G9005 COORDINATED CARE FEE, RISK ADJUSTED MAINTENANCE 

G9006 COORDINATED CARE FEE, HOME MONITORING 

G9007 COORDINATED CARE FEE, SCHEDULED TEAM CONFERENCE 

G9008 COORDINATED CARE FEE, PHYSICIAN COORDINATED CARE OVERSIGHT SERVICES 

G9016 SMOKING CESSATION COUNSELING, INDIVIDUAL, IN THE ABSENCE OF OR IN ADDITION TO 

ANY OTHER EVALUATION AND MANAGEMENT SERVICE, PER SESSION (6-10 MINUTES) [DEMO 

PROJECT CODE ONLY] 

H0001 ALCOHOL AND/OR DRUG ASSESSMENT 

H0002 ALCOHOL AND/OR DRUG SCREENING TO DETERMINE ELIGIBILITY FOR ADMISSION TO 

TREATMENT PROGRAM 

H0003 ALCOHOL AND/OR DRUG SCREENING; LABORATORY ANALYSIS OF SPECIMENS FOR PRESENCE OF 

ALCOHOL AND/OR DRUGS 

H0004 ALCOHOL AND/OR DRUG SERVICES; INDIVIDUAL COUNSELING BY A CLINICIAN 

H0005 ALCOHOL AND/OR DRUG SERVICES; GROUP COUNSELING BY A CLINICIAN 

H0006 ALCOHOL AND/OR DRUG SERVICES; CASE MANAGEMENT

H0007 ALCOHOL AND/OR DRUG SERVICES; CRISIS INTERVENTION (OUTPATIENT) 

H0008 ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (HOSPITAL INPATIENT) 

H0009 ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (HOSPITAL INPATIENT) 

H0010 ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION 

PROGRAM INPATIENT) 

H0011 ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION 

PROGRAM INPATIENT) 

H0012 ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION 

PROGRAM OUTPATIENT) 

H0013 ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION 

PROGRAM OUTPATIENT) 

H0014 ALCOHOL AND/OR DRUG SERVICES; AMBULATORY DETOXIFICATION 

H0015 ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT 

OPERATES AT LEAST 3 HOURS/DAY AND AT LEAST 3 DAYS/WEEK AND IS BASED ON AN 

INDIVIDUALIZED TREATMENT PLAN), INCLUDING ASSESSMENT, COUNSELING; CRISIS 

INTERVENTION, AND ACTIVITY THERAPIES OR EDUCATION 

H0016 ALCOHOL AND/OR DRUG SERVICES; MEDICAL/SOMATIC (MEDICAL INTERVENTION IN 

AMBULATORY SETTING) 

H0017 ALCOHOL AND/OR DRUG SERVICES; RESIDENTIAL (HOSPITAL RESIDENTIAL TREATMENT 

PROGRAM) 

H0018 ALCOHOL AND/OR DRUG SERVICES; SHORT-TERM RESIDENTIAL (NON-HOSPITAL RESIDENTIAL 

TREATMENT PROGRAM) 

H0019 ALCOHOL AND/OR DRUG SERVICES; LONG-TERM RESIDENTIAL (NON-MEDICAL, NON-ACUTE 

CARE IN RESIDENTIAL TREATMENT PROGRAM WHERE STAY IS TYPICALLY LONGER THAN 30 

DAYS) 

H0020 ALCOHOL AND/OR DRUG SERVICES; METHADONE ADMINISTRATION AND/OR SERVICE 

(PROVISION OF THE DRUG BY A LICENSED PROGRAM) 

H0021 ALCOHOL AND/OR DRUG TRAINING SERVICE (FOR STAFF AND PERSONNEL NOT EMPLOYED BY 

PROVIDERS) 

H0022 ALCOHOL AND/OR DRUG INTERVENTION SERVICE (PLANNED FACILITATION) 

H0023 ALCOHOL AND/OR DRUG OUTREACH SERVICE (PLANNED APPROACH TO REACH A TARGET 

POPULATION) 

H0024 ALCOHOL AND/OR DRUG PREVENTION INFORMATION DISSEMINATION SERVICE (ONE-WAY 

DIRECT OR NON-DIRECT CONTACT WITH SERVICE AUDIENCES TO AFFECT KNOWLEDGE OR 

ATTITUDE) 

H0025 ALCOHOL AND/OR DRUG PREVENTION EDUCATION SERVICE (DELIVERY OF SERVICES WITH 

TARGET POPULATION TO AFFECT KNOWLEDGE, ATTITUDE AND/OR BEHAVIOR) 

H0026 ALCOHOL AND/OR DRUG PREVENTION PROCESS SERVICE, COMMUNITY-BASED (DELIVERY OF 

SERVICES TO DEVELOP SKILLS OF IMPACTORS) 

H0027 ALCOHOL AND/OR DRUG PREVENTION ENVIRONMENTAL SERVICE (BROAD RANGE OF EXTERNAL 

ACTIVITIES GEARED TOWARD MODIFYING SYSTEMS IN ORDER TO MAINSTREAM PREVENTION 

THROUGH POLICY AND LAW) 

H0028 ALCOHOL AND/OR DRUG PREVENTION PROBLEM IDENTIFICATION AND REFERRAL SERVICE 

(E.G. STUDENT ASSISTANCE AND EMPLOYEE ASSISTANCE PROGRAMS), DOES NOT INCLUDE 

ASSESSMENT 

H0029 ALCOHOL AND/OR DRUG PREVENTION ALTERNATIVES SERVICE (SERVICES FOR POPULATIONS 

THAT EXCLUDE ALCOHOL AND OTHER DRUG USE E.G. ALCOHOL FREE SOCIAL EVENTS) 

H0030 ALCOHOL AND/OR DRUG HOTLINE SERVICE 

H5300 OCCUPATIONAL THERAPY, EXCLUDING INITIAL OR PERIODIC EVALUATION 

J0120 INJECTION, TETRACYCLINE, UP TO 250 MG 

J0130 INJECTION ABCIXIMAB, 10 MG 

J0150 INJECTION, ADENOSINE, 6 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE 

COMPOUNDS, INSTEAD USE A9270) 

J0151 INJECTION, ADENOSINE, 90 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE 


J0170 INJECTION, ADRENALIN, EPINEPHRINE, UP TO 1 ML AMPULE 

J0190 INJECTION, BIPERIDEN LACTATE, PER 5 MG

J0200 INJECTION, ALATROFLOXACIN MESYLATE, 100 MG 

J0205 INJECTION, ALGLUCERASE, PER 10 UNITS 

J0207 INJECTION, AMIFOSTINE, 500 MG 

J0210 INJECTION, METHYLDOPATE HCL, UP TO 250 MG 

J0256 INJECTION, ALPHA 1 - PROTEINASE INHIBITOR - HUMAN, 10 MG 

J0270 INJECTION, ALPROSTADIL, 1.25 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG 

ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG 

IS SELF ADMINISTERED) 

J0275 ALPROSTADIL URETHRAL SUPPOSITORY (CODE MAY BE USED FOR MEDICARE WHEN DRUG 



J0280 INJECTION, AMINOPHYLLIN, UP TO 250 MG 

J0282 INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG 

J0285 INJECTION, AMPHOTERICIN B, 50 MG 

J0286 INJECTION, AMPHOTERICIN B, ANY LIPID FORMULATION, 50 MG 

J0290 INJECTION, AMPICILLIN SODIUM, 500 MG 

J0295 INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM 

J0300 INJECTION, AMOBARBITAL, UP TO 125 MG 

J0330 INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG 

J0340 INJECTION, NANDROLONE PHENPROPIONATE, UP TO 50 MG 

J0350 INJECTION, ANISTREPLASE, PER 30 UNITS 

J0360 INJECTION, HYDRALAZINE HCL, UP TO 20 MG 

J0380 INJECTION, METARAMINOL BITARTRATE, PER 10 MG 

J0390 INJECTION, CHLOROQUINE HYDROCHLORIDE, UP TO 250 MG 

J0395 INJECTION, ARBUTAMINE HCL, 1 MG 

J0400 INJECTION, TRIMETHAPHAN CAMSYLATE, UP TO 500 MG 

J0456 INJECTION, AZITHROMYCIN, 500 MG 

J0460 INJECTION, ATROPINE SULFATE, UP TO 0.3 MG 

J0470 INJECTION, DIMERCAPROL, PER 100 MG 

J0475 INJECTION, BACLOFEN, 10 MG 

J0476 INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL 

J0500 INJECTION, DICYCLOMINE HCL, UP TO 20 MG 

J0510 INJECTION, BENZQUINAMIDE HCL, UP TO 50 MG 

J0515 INJECTION, BENZTROPINE MESYLATE, PER 1 MG 

J0520 INJECTION, BETHANECHOL CHLORIDE, MYOTONACHOL OR URECHOLINE, UP TO 5 MG 

J0530 INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 600,000 

UNITS 

J0540 INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 1,200,000 

UNITS 

J0550 INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 2,400,000 

UNITS 

J0560 INJECTION, PENICILLIN G BENZATHINE, UP TO 600,000 UNITS 

J0570 INJECTION, PENICILLIN G BENZATHINE, UP TO 1,200,000 UNITS 

J0580 INJECTION, PENICILLIN G BENZATHINE, UP TO 2,400,000 UNITS 

J0585 BOTULINUM TOXIN TYPE A, PER UNIT 

J0590 INJECTION, ETHYLNOREPINEPHRINE HCL, 1 ML 

J0600 INJECTION, EDETATE CALCIUM DISODIUM, UP TO 1000 MG 

J0610 INJECTION, CALCIUM GLUCONATE, PER 10 ML 

J0620 INJECTION, CALCIUM GLYCEROPHOSPHATE AND CALCIUM LACTATE, PER 10 ML 

J0630 INJECTION, CALCITONIN SALMON, UP TO 400 UNITS 

J0635 INJECTION, CALCITRIOL, 1 MCG AMP. 

J0640 INJECTION, LEUCOVORIN CALCIUM, PER 50 MG 

J0670 INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML 

J0690 INJECTION, CEFAZOLIN SODIUM, 500 MG 

J0694 INJECTION, CEFOXITIN SODIUM, 1 GM 

J0695 INJECTION, CEFONICID SODIUM, 1 GRAM 

J0696 INJECTION, CEFTRIAXONE SODIUM, PER 250 MG

J0697 INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG 

J0698 INJECTION, CEFOTAXIME SODIUM, PER GM 

J0702 INJECTION, BETAMETHASONE ACETATE AND BETAMETHASONE SODIUM PHOSPHATE, PER 3 MG 

J0704 INJECTION, BETAMETHASONE SODIUM PHOSPHATE, PER 4 MG 

J0710 INJECTION, CEPHAPIRIN SODIUM, UP TO 1 GM 

J0713 INJECTION, CEFTAZIDIME, PER 500 MG 

J0715 INJECTION, CEFTIZOXIME SODIUM, PER 500 MG 

J0720 INJECTION, CHLORAMPHENICOL SODIUM SUCCINATE, UP TO 1 GM 

J0725 INJECTION, CHORIONIC GONADOTROPIN, PER 1,000 USP UNITS 

J0730 INJECTION, CHLORPHENIRAMINE MALEATE, PER 10 MG 

J0735 INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG 

J0740 INJECTION, CIDOFOVIR, 375 MG 

J0743 INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG 

J0745 INJECTION, CODEINE PHOSPHATE, PER 30 MG 

J0760 INJECTION, COLCHICINE, PER 1MG 

J0770 INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG 

J0780 INJECTION, PROCHLORPERAZINE, UP TO 10 MG 

J0800 INJECTION, CORTICOTROPIN, UP TO 40 UNITS 

J0810 INJECTION, CORTISONE, UP TO 50 MG 

J0835 INJECTION, COSYNTROPIN, PER 0.25 MG 

J0850 INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN), PER VIAL 

J0895 INJECTION, DEFEROXAMINE MESYLATE, 500 MG 

J0900 INJECTION, TESTOSTERONE ENANTHATE AND ESTRADIOL VALERATE, UP TO 1 CC 

J0945 INJECTION, BROMPHENIRAMINE MALEATE, PER 10 MG 

J0970 INJECTION, ESTRADIOL VALERATE, UP TO 40 MG 

J1000 INJECTION, DEPO-ESTRADIOL CYPIONATE, UP TO 5 MG 

J1020 INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG 



J1050 INJECTION, MEDROXYPROGESTERONE ACETATE, 100 MG 

J1055 INJECTION, MEDROXYPROGESTERONE ACETATE FOR CONTRACEPTIVE USE, 150 MG 

J1060 INJECTION, TESTOSTERONE CYPIONATE AND ESTRADIOL CYPIONATE, UP TO 1 ML 

J1070 INJECTION, TESTOSTERONE CYPIONATE, UP TO 100 MG 

J1080 INJECTION, TESTOSTERONE CYPIONATE, 1 CC, 200 MG 

J1090 INJECTION, TESTOSTERONE CYPIONATE, 1 CC, 50 MG 

J1095 INJECTION, DEXAMETHASONE ACETATE, PER 8 MG 

J1100 INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1MG 

J1110 INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG 

J1120 INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG 

J1160 INJECTION, DIGOXIN, UP TO 0.5 MG 

J1165 INJECTION, PHENYTOIN SODIUM, PER 50 MG 

J1170 INJECTION, HYDROMORPHONE, UP TO 4 MG 

J1180 INJECTION, DYPHYLLINE, UP TO 500 MG 

J1190 INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG 

J1200 INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG 

J1205 INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG 

J1212 INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML 

J1230 INJECTION, METHADONE HCL, UP TO 10 MG 

J1240 INJECTION, DIMENHYDRINATE, UP TO 50 MG 

J1245 INJECTION, DIPYRIDAMOLE, PER 10 MG 

J1250 INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG 

J1260 INJECTION, DOLASETRON MESYLATE, 10 MG 

J1320 INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG 

J1325 INJECTION, EPOPROSTENOL, 0.5 MG 

J1327 INJECTION, EPTIFIBATIDE, 5 MG 

J1330 INJECTION, ERGONOVINE MALEATE, UP TO 0.2 MG 

J1362 INJECTION, ERYTHROMYCIN GLUCEPTATE, PER 250 MG

J1364 INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG 



J1410 INJECTION, ESTROGEN CONJUGATED, PER 25 MG 

J1435 INJECTION, ESTRONE, PER 1 MG 

J1436 INJECTION, ETIDRONATE DISODIUM, PER 300 MG 

J1438 INJECTION, ETANERCEPT, 25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG 



J1440 INJECTION, FILGRASTIM (G-CSF), 300 MCG 

J1441 INJECTION, FILGRASTIM (G-CSF), 480 MCG 

J1450 INJECTION FLUCONAZOLE, 200 MG 

J1452 INJECTION, FOMIVIRSEN SODIUM, INTRAOCULAR, 1.65 MG 

J1455 INJECTION, FOSCARNET SODIUM, PER 1000 MG 

J1460 INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC 










J1560 INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, OVER 10 CC 

J1561 INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, 500 MG 

J1562 INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, 5 GMS 

J1563 INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, 1G 

J1565 INJECTION, RESPIRATORY SYNCYTIAL VIRUS IMMUNE GLOBULIN, INTRAVENOUS, 50 MG 

J1570 INJECTION, GANCICLOVIR SODIUM, 500 MG 

J1580 INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG 

J1600 INJECTION, GOLD SODIUM THIOMALATE, UP TO 50 MG 

J1610 INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG 

J1620 INJECTION, GONADORELIN HYDROCHLORIDE, PER 100 MCG 

J1625 INJECTION, GRANISETRON HYDROCHLORIDE, PER 1 MG 

J1626 INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG 

J1630 INJECTION, HALOPERIDOL, UP TO 5 MG 

J1631 INJECTION, HALOPERIDOL DECANOATE, PER 50 MG 

J1642 INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS 

J1644 INJECTION, HEPARIN SODIUM, PER 1000 UNITS 

J1645 INJECTION, DALTEPARIN SODIUM, PER 2500 IU 

J1650 INJECTION, ENOXAPARIN SODIUM, 10 MG 

J1670 INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS 

J1690 INJECTION, PREDNISOLONE TEBUTATE, UP TO 20 MG 

J1700 INJECTION, HYDROCORTISONE ACETATE, UP TO 25 MG 

J1710 INJECTION, HYDROCORTISONE SODIUM PHOSPHATE, UP TO 50 MG 

J1720 INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG 

J1730 INJECTION, DIAZOXIDE, UP TO 300 MG 

J1739 INJECTION, HYDROXYPROGESTERONE CAPROATE 125 MG/ML 

J1741 INJECTION, HYDROXYPROGESTERONE CAPROATE, 250 MG/ML 

J1742 INJECTION, IBUTILIDE FUMARATE, 1 MG 

J1745 INJECTION INFLIXIMAB, 10 MG 

J1750 INJECTION, IRON DEXTRAN, 50 MG 

J1760 INJECTION, IRON DEXTRAN, 2 CC 



J1785 INJECTION, IMIGLUCERASE, PER UNIT

J1790 INJECTION, DROPERIDOL, UP TO 5 MG 

J1800 INJECTION, PROPRANOLOL HCL, UP TO 1 MG 

J1810 INJECTION, DROPERIDOL AND FENTANYL CITRATE, UP TO 2 ML AMPULE 

J1820 INJECTION, INSULIN, UP TO 100 UNITS 

J1825 INJECTION, INTERFERON BETA-1A, 33 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG 



J1830 INJECTION INTERFERON BETA-1B, 0.25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG 

ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN 

DRUG IS SELF ADMINISTERED) 

J1840 INJECTION, KANAMYCIN SULFATE, UP TO 500 MG 

J1850 INJECTION, KANAMYCIN SULFATE, UP TO 75 MG 

J1885 INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG 

J1890 INJECTION, CEPHALOTHIN SODIUM, UP TO 1 GRAM 

J1910 INJECTION, KUTAPRESSIN, UP TO 2 ML 

J1930 INJECTION, PROPIOMAZINE HCL, UP TO 20 MG 

J1940 INJECTION, FUROSEMIDE, UP TO 20 MG 

J1950 INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG 

J1955 INJECTION, LEVOCARNITINE, PER 1 GM 

J1956 INJECTION, LEVOFLOXACIN, 250 MG 

J1960 INJECTION, LEVORPHANOL TARTRATE, UP TO 2 MG 

J1970 INJECTION, METHOTRIMEPRAZINE, UP TO 20 MG 

J1980 INJECTION, HYOSCYAMINE SULFATE, UP TO 0.25 MG 

J1990 INJECTION, CHLORDIAZEPOXIDE HCL, UP TO 100 MG 

J2000 INJECTION, LIDOCAINE HCL, 50 CC 

J2010 INJECTION, LINCOMYCIN HCL, UP TO 300 MG 

J2060 INJECTION, LORAZEPAM, 2 MG 

J2150 INJECTION, MANNITOL, 25% IN 50 ML 

J2175 INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG 

J2180 INJECTION, MEPERIDINE AND PROMETHAZINE HCL, UP TO 50 MG 

J2210 INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG 

J2240 INJECTION, METOCURINE IODIDE, UP TO 2 MG 

J2250 INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG 

J2260 INJECTION, MILRINONE LACTATE, 5 MG 

J2270 INJECTION, MORPHINE SULFATE, UP TO 10 MG 

J2271 INJECTION, MORPHINE SULFATE, 100MG 

J2275 INJECTION, MORPHINE SULFATE (PRESERVATIVE-FREE STERILE SOLUTION), PER 10 MG 

J2300 INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG 

J2310 INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG 

J2320 INJECTION, NANDROLONE DECANOATE, UP TO 50 MG 



J2330 INJECTION, THIOTHIXENE, UP TO 4 MG 

J2350 INJECTION, NIACINAMIDE, NIACIN, UP TO 100 MG 

J2352 INJECTION, OCTREOTIDE ACETATE, 1 MG 

J2355 INJECTION, OPRELVEKIN, 5 MG 

J2360 INJECTION, ORPHENADRINE CITRATE, UP TO 60 MG 

J2370 INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML 

J2400 INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 30 ML 

J2405 INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG 

J2410 INJECTION, OXYMORPHONE HCL, UP TO 1 MG 

J2430 INJECTION, PAMIDRONATE DISODIUM, PER 30 MG 

J2440 INJECTION, PAPAVERINE HCL, UP TO 60 MG 

J2460 INJECTION, OXYTETRACYCLINE HCL, UP TO 50 MG 

J2480 INJECTION, HYDROCHLORIDES OF OPIUM ALKALOIDS, UP TO 20 MG 

J2500 INJECTION, PARICALCITOL, 5 MCG 

J2510 INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS

J2512 INJECTION, PENTAGASTRIN, PER 2 ML 

J2515 INJECTION, PENTOBARBITAL SODIUM, PER 50 MG 

J2540 INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS 

J2543 INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 

GRAMS) 

J2545 PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, PER 300 MG, ADMINISTERED THROUGH 

A DME 

J2550 INJECTION, PROMETHAZINE HCL, UP TO 50 MG 

J2560 INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG 

J2590 INJECTION, OXYTOCIN, UP TO 10 UNITS 

J2597 INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG 

J2640 INJECTION, PREDNISOLONE SODIUM PHOSPHATE, TO 20 MG 

J2650 INJECTION, PREDNISOLONE ACETATE, UP TO 1 ML 

J2670 INJECTION, TOLAZOLINE HCL, UP TO 25 MG 

J2675 INJECTION, PROGESTERONE, PER 50 MG 

J2680 INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG 

J2690 INJECTION, PROCAINAMIDE HCL, UP TO 1 GM 

J2700 INJECTION, OXACILLIN SODIUM, UP TO 250 MG 

J2710 INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG 

J2720 INJECTION, PROTAMINE SULFATE, PER 10 MG 

J2725 INJECTION, PROTIRELIN, PER 250 MCG 

J2730 INJECTION, PRALIDOXIME CHLORIDE, UP TO 1 GM 

J2760 INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG 

J2765 INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG 

J2770 INJECTION, QUINUPRISTIN/DALFOPRISTIN, 500 MG (150/350) 

J2780 INJECTION, RANITIDINE HYDROCHLORIDE, 25 MG 

J2790 INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, ONE DOSE PACKAGE 

J2792 INJECTION, RHO D IMMUNE GLOBULIN, INTRAVENOUS, HUMAN, SOLVENT DETERGENT, 100 IU 

J2795 INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG 

J2800 INJECTION, METHOCARBAMOL, UP TO 10 ML 

J2810 INJECTION, THEOPHYLLINE, PER 40 MG 

J2820 INJECTION, SARGRAMOSTIM (GM-CSF), 50 MCG 

J2860 INJECTION, SECOBARBITAL SODIUM, UP TO 250 MG 

J2910 INJECTION, AUROTHIOGLUCOSE, UP TO 50 MG 

J2912 INJECTION, SODIUM CHLORIDE, 0.9%, PER 2 ML 

J2915 INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 62.5 MG 

J2920 INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG 

J2930 INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG 

J2950 INJECTION, PROMAZINE HCL, UP TO 25 MG 

J2970 INJECTION, METHICILLIN SODIUM, UP TO 1 GM 

J2993 INJECTION, RETEPLASE, 18.8 MG 

J2994 INJECTION RETEPLASE, 37.6 MG (TWO SINGLE USE VIALS) 

J2995 INJECTION, STREPTOKINASE, PER 250,000 IU 

J2996 INJECTION, ALTEPLASE RECOMBINANT, PER 10 MG 

J2997 INJECTION, ALTEPLASE RECOMBINANT, 1 MG 

J3000 INJECTION, STREPTOMYCIN, UP TO 1 GM 

J3005 INJECTION, STRONTIUM-89 CHLORIDE, PER 10 ML 

J3010 INJECTION, FENTANYL CITRATE, 0.1 MG 

J3030 INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG 



J3070 INJECTION, PENTAZOCINE HCL, UP TO 30 MG 

J3080 INJECTION, CHLORPROTHIXENE, UP TO 50 MG 

J3105 INJECTION, TERBUTALINE SULFATE, UP TO 1 MG 

J3120 INJECTION, TESTOSTERONE ENANTHATE, UP TO 100 MG 

J3130 INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG 

J3140 INJECTION, TESTOSTERONE SUSPENSION, UP TO 50 MG

J3150 INJECTION, TESTOSTERONE PROPIONATE, UP TO 100 MG 

J3230 INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG 

J3240 INJECTION, THYROTROPIN ALFA, 0.9 MG 

J3245 INJECTION, TIROFIBAN HYDROCHLORIDE, 12.5 MG 

J3250 INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG 

J3260 INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG 

J3265 INJECTION, TORSEMIDE, 10 MG/ML 

J3270 INJECTION, IMIPRAMINE HCL, UP TO 25 MG 

J3280 INJECTION, THIETHYLPERAZINE MALEATE, UP TO 10 MG 

J3301 INJECTION, TRIAMCINOLONE ACETONIDE, PER 10MG 

J3302 INJECTION, TRIAMCINOLONE DIACETATE, PER 5MG 

J3303 INJECTION, TRIAMCINOLONE HEXACETONIDE, PER 5MG 

J3305 INJECTION, TRIMETREXATE GLUCURONATE, PER 25 MG 

J3310 INJECTION, PERPHENAZINE, UP TO 5 MG 

J3320 INJECTION, SPECTINOMYCIN DIHYDROCHLORIDE, UP TO 2 GM 

J3350 INJECTION, UREA, UP TO 40 GM 

J3360 INJECTION, DIAZEPAM, UP TO 5 MG 

J3364 INJECTION, UROKINASE, 5000 IU VIAL 

J3365 INJECTION, IV, UROKINASE, 250,000 I.U. VIAL 

J3370 INJECTION, VANCOMYCIN HCL, 500 MG 

J3390 INJECTION, METHOXAMINE HCL, UP TO 20 MG 

J3400 INJECTION, TRIFLUPROMAZINE HCL, UP TO 20 MG 

J3410 INJECTION, HYDROXYZINE HCL, UP TO 25 MG 

J3420 INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG 

J3430 INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG 

J3450 INJECTION, MEPHENTERMINE SULFATE, UP TO 30 MG 

J3470 INJECTION, HYALURONIDASE, UP TO 150 UNITS 

J3475 INJECTION, MAGNESIUM SULFATE, PER 500 MG 

J3480 INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ 

J3485 INJECTION, ZIDOVUDINE, 10 MG 

J3490 UNCLASSIFIED DRUGS 

J3520 EDETATE DISODIUM, PER 150 MG 

J3530 NASAL VACCINE INHALATION 

J3535 DRUG ADMINISTERED THROUGH A METERED DOSE INHALER 

J3570 LAETRILE, AMYGDALIN, VITAMIN B17 

J7030 INFUSION, NORMAL SALINE SOLUTION , 1000 CC 

J7040 INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT) 

J7042 5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT) 

J7050 INFUSION, NORMAL SALINE SOLUTION , 250 CC 

J7051 STERILE SALINE OR WATER, UP TO 5 CC 

J7060 5% DEXTROSE/WATER (500 ML = 1 UNIT) 

J7070 INFUSION, D5W, 1000 CC 

J7100 INFUSION, DEXTRAN 40, 500 ML 

J7110 INFUSION, DEXTRAN 75, 500 ML 

J7120 RINGERS LACTATE INFUSION, UP TO 1000 CC 

J7130 HYPERTONIC SALINE SOLUTION, 50 OR 100 MEQ, 20 CC VIAL 

J7190 FACTOR VIII (ANTIHEMOPHILIC FACTOR, HUMAN) PER I.U. 

J7191 FACTOR VIII (ANTIHEMOPHILIC FACTOR (PORCINE)), PER I.U. 

J7192 FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U. 

J7194 FACTOR IX, COMPLEX, PER I.U. 

J7196 OTHER HEMOPHILIA CLOTTING FACTORS, (E.G., ANTI-INHIBITORS), PER I.U. 

J7197 ANTITHROMBIN III (HUMAN), PER I.U. 

J7198 ANTI-INHIBITOR, PER I.U. 

J7199 HEMOPHILIA CLOTTING FACTOR, NOT OTHERWISE CLASSIFIED 

J7300 INTRAUTERINE COPPER CONTRACEPTIVE 

J7310 GANCICLOVIR, 4.5 MG, LONG-ACTING IMPLANT 

J7315 SODIUM HYALURONATE, 20 MG, FOR INTRA ARTICULAR INJECTION

J7320 HYLAN G-F 20, 16 MG, FOR INTRA ARTICULAR INJECTION 

J7330 AUTOLOGOUS CULTURED CHONDROCYTES, IMPLANT 

J7500 AZATHIOPRINE, ORAL, 50 MG 

J7501 AZATHIOPRINE, PARENTERAL, 100 MG 

J7502 CYCLOSPORINE, ORAL, 100 MG 

J7503 CYCLOSPORINE, PARENTERAL, PER 50 MG 

J7504 LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, PARENTERAL, 250 MG 

J7505 MUROMONAB-CD3, PARENTERAL, 5 MG 

J7506 PREDNISONE, ORAL, PER 5MG 

J7507 TACROLIMUS, ORAL, PER 1 MG 

J7508 TACROLIMUS, ORAL, PER 5 MG 

J7509 METHYLPREDNISOLONE ORAL, PER 4 MG 

J7510 PREDNISOLONE ORAL, PER 5 MG 

J7513 DACLIZUMAB, PARENTERAL, 25 MG 

J7515 CYCLOSPORINE, ORAL, 25 MG 

J7516 CYCLOSPORIN, PARENTERAL, 250 MG 

J7517 MYCOPHENOLATE MOFETIL, ORAL, 250 MG 

J7520 SIROLIMUS, ORAL, 1 MG 

J7525 TACROLIMUS, PARENTERAL, 5 MG 

J7599 IMMUNOSUPPRESSIVE DRUG, NOT OTHERWISE CLASSIFIED 

J7608 ACETYLCYSTEINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER GRAM 

J7610 ACETYLCYSTEINE, 10%, PER ML, INHALATION SOLUTION ADMINISTERED THROUGH DME 

J7615 ACETYLCYSTEINE, 20%, PER ML, INHALATION SOLUTION ADMINISTERED THROUGH DME 

J7618 ALBUTEROL, ALL FORMULATIONS INCLUDING SEPARATED ISOMERS, INHALATION SOLUTION 

ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER 1 MG 

J7619 ALBUTEROL, ALL FORMULATIONS INCLUDING SEPARATED ISOMERS, INHALATION SOLUTION 

ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 1 MG 

J7620 ALBUTEROL SULFATE, 0.083%, PER ML, INHALATION SOLUTION ADMINISTERED THROUGH DME 

J7625 ALBUTEROL SULFATE, 0.5%, PER ML, INHALATION SOLUTION ADMINISTERED THROUGH DME 

J7627 BITOLTEROL MESYLATE, 0.2%, PER 10 ML, INHALATION SOLUTION ADMINISTERED THROUGH 

DME 

J7628 BITOLTEROL MESYLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED 

FORM, PER MILLIGRAM 

J7629 BITOLTEROL MESYLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE 


J7630 CROMOLYN SODIUM, PER 20 MG, INHALATION SOLUTION ADMINISTERED THROUGH DME 

J7631 CROMOLYN SODIUM, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER 10 MILLIGRAMS 

J7635 ATROPINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER 

MILLIGRAM 

J7636 ATROPINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 

MILLIGRAM 

J7637 DEXAMETHASONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, 

PER MILLIGRAM 

J7638 DEXAMETHASONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER MILLIGRAM 

J7639 DORNASE ALPHA, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER MILLIGRAM 

J7640 EPINEPHRINE, 2.25%, PER ML, INHALATION SOLUTION ADMINISTERED THROUGH DME 

J7642 GLYCOPYRROLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED 


J7643 GLYCOPYRROLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER MILLIGRAM 

J7644 IPRATROPIUM BROMIDE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE 


J7645 IPRATROPIUM BROMIDE 0.02%, PER ML, INHALATION SOLUTION ADMINISTERED THROUGH A

DME 

J7648 ISOETHARINE HCL, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED 


J7649 ISOETHARINE HCL, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER MILLIGRAM 

J7650 ISOETHARINE HYDROCHLORIDE, 0.1%, PER ML, INHALATION SOLUTION ADMINISTERED 

THROUGH DME 


THROUGH DME 


THROUGH DME 


THROUGH DME 


THROUGH DME 


THROUGH DME 

J7658 ISOPROTERENOL HCL, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED 


J7659 ISOPROTERENOL HCL, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE 


J7660 ISOPROTERENOL HYDROCHLORIDE, 0.5%, PER ML, INHALATION SOLUTION ADMINISTERED 

THROUGH DME 

J7665 ISOPROTERENOL HYDROCHLORIDE, 1.0%, PER ML, INHALATION SOLUTION ADMINISTERED 

THROUGH DME 

J7668 METAPROTERENOL SULFATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, 

CONCENTRATED FORM, PER 10 MILLIGRAMS 

J7669 METAPROTERENOL SULFATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE 

FORM, PER 10 MILLIGRAMS 

J7670 METAPROTERENOL SULFATE, 0.4%, PER 2.5 ML, INHALATION SOLUTION ADMINISTERED 

THROUGH DME 

J7672 METAPROTERENOL SULFATE, 0.6%, PER 2.5 ML, INHALATION SOLUTION ADMINISTERED 

THROUGH DME 

J7675 METAPROTERENOL SULFATE, 5.0%, PER ML, INHALATION SOLUTION ADMINISTERED THROUGH 

DME 

J7680 TERBUTALINE SULFATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED 


J7681 TERBUTALINE SULFATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE 


J7682 TOBRAMYCIN, UNIT DOSE FORM, 300 MG, INHALATION SOLUTION, ADMINISTERED THROUGH 

DME 

J7683 TRIAMCINOLONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, 

PER MILLIGRAM 

J7684 TRIAMCINOLONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER MILLIGRAM 

J7699 NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME 

J7799 NOC DRUGS, OTHER THAN INHALATION DRUGS, ADMINISTERED THROUGH DME 

J8499 PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS 

J8510 BUSULFAN; ORAL, 2 MG 

J8520 CAPECITABINE, ORAL, 150 MG 

J8521 CAPECITABINE, ORAL, 500 MG 

J8530 CYCLOPHOSPHAMIDE; ORAL, 25 MG 

J8560 ETOPOSIDE; ORAL, 50 MG 

J8600 MELPHALAN; ORAL, 2 MG 

J8610 METHOTREXATE; ORAL, 2.5 MG 

J8700 TEMOZOLMIDE, ORAL, 5 MG 

J8999 PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS

J9000 DOXORUBICIN HCL, 10 MG 

J9001 DOXORUBICIN HYDROCHLORIDE, ALL LIPID FORMULATIONS, 10 MG 

J9015 ALDESLEUKIN, PER SINGLE USE VIAL 

J9020 ASPARAGINASE, 10,000 UNITS 

J9031 BCG (INTRAVESICAL) PER INSTILLATION 

J9040 BLEOMYCIN SULFATE, 15 UNITS 

J9045 CARBOPLATIN, 50 MG 

J9050 CARMUSTINE, 100 MG 

J9060 CISPLATIN, POWDER OR S0LUTION, PER 10 MG 

J9062 CISPLATIN, 50 MG 

J9065 INJECTION, CLADRIBINE, PER 1 MG 

J9070 CYCLOPHOSPHAMIDE, 100 MG 



J9091 CYCLOPHOSPHAMIDE, 1.0 GRAM 

J9092 CYCLOPHOSPHAMIDE, 2.0 GRAM 

J9093 CYCLOPHOSPHAMIDE, LYOPHILIZED, 100 MG 



J9096 CYCLOPHOSPHAMIDE, LYOPHILIZED, 1.0 GRAM 

J9097 CYCLOPHOSPHAMIDE, LYOPHILIZED, 2.0 GRAM 

J9100 CYTARABINE, 100 MG 

J9110 CYTARABINE, 500 MG 

J9120 DACTINOMYCIN, 0.5 MG 

J9130 DACARBAZINE, 100 MG 

J9140 DACARBAZINE, 200 MG 

J9150 DAUNORUBICIN, 10 MG 

J9151 DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG 

J9160 DENILEUKIN DIFTITOX, 300 MCG 

J9165 DIETHYLSTILBESTROL DIPHOSPHATE, 250 MG 

J9170 DOCETAXEL, 20 MG 

J9180 EPIRUBICIN HYDROCHLORIDE, 50 MG 

J9181 ETOPOSIDE, 10 MG 

J9182 ETOPOSIDE, 100 MG 

J9185 FLUDARABINE PHOSPHATE, 50 MG 

J9190 FLUOROURACIL, 500 MG 

J9200 FLOXURIDINE, 500 MG 

J9201 GEMCITABINE HCL, 200 MG 

J9202 GOSERELIN ACETATE IMPLANT, PER 3.6 MG 

J9206 IRINOTECAN, 20 MG 

J9208 IFOSFAMIDE, 1 GM 

J9209 MESNA, 200 MG 

J9211 IDARUBICIN HYDROCHLORIDE, 5 MG 

J9212 INJECTION, INTERFERON ALFACON-1, RECOMBINANT, 1 MCG 

J9213 INTERFERON, ALFA-2A, RECOMBINANT, 3 MILLION UNITS 

J9214 INTERFERON, ALFA-2B, RECOMBINANT, 1 MILLION UNITS 

J9215 INTERFERON, ALFA-N3, (HUMAN LEUKOCYTE DERIVED), 250,000 IU 

J9216 INTERFERON, GAMMA 1-B, 3 MILLION UNITS 

J9217 LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG 

J9218 LEUPROLIDE ACETATE, PER 1 MG 

J9219 LEUPROLIDE ACETATE IMPLANT, 65 MG 

J9230 MECHLORETHAMINE HYDROCHLORIDE, (NITROGEN MUSTARD), 10 MG 

J9245 INJECTION, MELPHALAN HYDROCHLORIDE, 50 MG 

J9250 METHOTREXATE SODIUM, 5 MG 

J9260 METHOTREXATE SODIUM, 50 MG 

J9265 PACLITAXEL, 30 MG 

J9266 PEGASPARGASE, PER SINGLE DOSE VIAL

J9268 PENTOSTATIN, PER 10 MG 

J9270 PLICAMYCIN, 2.5 MG 

J9280 MITOMYCIN, 5 MG 



J9293 INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG 

J9310 RITUXIMAB, 100 MG 

J9320 STREPTOZOCIN, 1 GM 

J9340 THIOTEPA, 15 MG 

J9350 TOPOTECAN, 4 MG 

J9355 TRASTUZUMAB, 10 MG 

J9357 VALRUBICIN, INTRAVESICAL, 200 MG 

J9360 VINBLASTINE SULFATE, 1 MG 

J9370 VINCRISTINE SULFATE, 1 MG 



J9390 VINORELBINE TARTRATE, PER 10 MG 

J9600 PORFIMER SODIUM, 75 MG 

J9999 NOT OTHERWISE CLASSIFIED, ANTINEOPLASTIC DRUGS 

K0001 STANDARD WHEELCHAIR 

K0002 STANDARD HEMI (LOW SEAT) WHEELCHAIR 

K0003 LIGHTWEIGHT WHEELCHAIR 

K0004 HIGH STRENGTH, LIGHTWEIGHT WHEELCHAIR 

K0005 ULTRALIGHTWEIGHT WHEELCHAIR 

K0006 HEAVY DUTY WHEELCHAIR 

K0007 EXTRA HEAVY DUTY WHEELCHAIR 

K0008 CUSTOM MANUAL WHEELCHAIR/BASE 

K0009 OTHER MANUAL WHEELCHAIR/BASE 

K0010 STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR 

K0011 STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR WITH PROGRAMMABLE CONTROL 

PARAMETERS FOR SPEED ADJUSTMENT, TREMOR DAMPENING, ACCELERATION CONTROL AND 

BRAKING 

K0012 LIGHTWEIGHT PORTABLE MOTORIZED/POWER WHEELCHAIR 

K0013 CUSTOM MOTORIZED/POWER WHEELCHAIR BASE 

K0014 OTHER MOTORIZED/POWER WHEELCHAIR BASE 

K0015 DETACHABLE, NON-ADJUSTABLE HEIGHT ARMREST, EACH 

K0016 DETACHABLE, ADJUSTABLE HEIGHT ARMREST, COMPLETE ASSEMBLY, EACH 

K0017 DETACHABLE, ADJUSTABLE HEIGHT ARMREST, BASE, EACH 

K0018 DETACHABLE, ADJUSTABLE HEIGHT ARMREST, UPPER PORTION, EACH 

K0019 ARM PAD, EACH 

K0020 FIXED, ADJUSTABLE HEIGHT ARMREST, PAIR 

K0021 ANTI-TIPPING DEVICE, EACH 

K0022 REINFORCED BACK UPHOLSTERY 

K0023 SOLID BACK INSERT, PLANAR BACK, SINGLE DENSITY FOAM, ATTACHED WITH STRAPS 

K0024 SOLID BACK INSERT, PLANAR BACK, SINGLE DENSITY FOAM, WITH ADJUSTABLE HOOK-ON 

HARDWARE 

K0025 HOOK-ON HEADREST EXTENSION 

K0026 BACK UPHOLSTERY FOR ULTRALIGHTWEIGHT OR HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR 

K0027 BACK UPHOLSTERY FOR WHEELCHAIR TYPE OTHER THAN ULTRALIGHTWEIGHT OR HIGH 

STRENGTH LIGHTWEIGHT WHEELCHAIR 

K0028 MANUAL, FULLY RECLINING BACK 

K0029 REINFORCED SEAT UPHOLSTERY 

K0030 SOLID SEAT INSERT, PLANAR SEAT, SINGLE DENSITY FOAM 

K0031 SAFETY BELT/PELVIC STRAP, EACH 

K0032 SEAT UPHOLSTERY FOR ULTRALIGHTWEIGHT OR HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR 

K0033 SEAT UPHOLSTERY FOR WHEELCHAIR TYPE OTHER THAN ULTRALIGHTWEIGHT OR HIGH 

STRENGTH LIGHTWEIGHT WHEELCHAIR

K0034 HEEL LOOP,EACH 

K0035 HEEL LOOP WITH ANKLE STRAP, EACH 

K0036 TOE LOOP, EACH 

K0037 HIGH MOUNT FLIP-UP FOOTREST, EACH 

K0038 LEG STRAP, EACH 

K0039 LEG STRAP, H STYLE, EACH 

K0040 ADJUSTABLE ANGLE FOOTPLATE, EACH 

K0041 LARGE SIZE FOOTPLATE, EACH 

K0042 STANDARD SIZE FOOTPLATE, EACH 

K0043 FOOTREST, LOWER EXTENSION TUBE, EACH 

K0044 FOOTREST, UPPER HANGER BRACKET, EACH 

K0045 FOOTREST, COMPLETE ASSEMBLY 

K0046 ELEVATING LEGREST, LOWER EXTENSION TUBE, EACH 

K0047 ELEVATING LEGREST, UPPER HANGER BRACKET, EACH 

K0048 ELEVATING LEGREST, COMPLETE ASSEMBLY 

K0049 CALF PAD, EACH 

K0050 RATCHET ASSEMBLY 

K0051 CAM RELEASE ASSEMBLY, FOOTREST OR LEGREST, EACH 

K0052 SWINGAWAY, DETACHABLE FOOTRESTS, EACH 

K0053 ELEVATING FOOTRESTS, ARTICULATING (TELESCOPING), EACH 

K0054 SEAT WIDTH OF 10", 11", 12", 15", 17", OR 20" FOR A HIGH STRENGTH, LIGHTWEIGHT 

OR ULTRALIGHTWEIGHT WHEELCHAIR 

K0055 SEAT DEPTH OF 15", 17", OR 18" FOR A HIGH STRENGTH, LIGHTWEIGHT OR 

ULTRALIGHTWEIGHT WHEELCHAIR 

K0056 SEAT HEIGHT LESS THAN 17" OR EQUAL TO OR GREATER THAN 21" FOR A HIGH 

STRENGTH, LIGHTWEIGHT, OR ULTRALIGHTWEIGHT WHEELCHAIR 

K0057 SEAT WIDTH 19" OR 20" FOR HEAVY DUTY OR EXTRA HEAVY DUTY CHAIR 

K0058 SEAT DEPTH 17" OR 18" FOR MOTORIZED/POWER WHEELCHAIR 

K0059 PLASTIC COATED HANDRIM, EACH 

K0060 STEEL HANDRIM, EACH 

K0061 ALUMINUM HANDRIM, EACH 

K0062 HANDRIM WITH 8-10 VERTICAL OR OBLIQUE PROJECTIONS, EACH 

K0063 HANDRIM WITH 12-16 VERTICAL OR OLBIQUE PROJECTIONS, EACH 

K0064 ZERO PRESSURE TUBE (FLAT FREE INSERTS), ANY SIZE, EACH 

K0065 SPOKE PROTECTORS, EACH 

K0066 SOLID TIRE, ANY SIZE, EACH 

K0067 PNEUMATIC TIRE, ANY SIZE, EACH 

K0068 PNEUMATIC TIRE TUBE, EACH 

K0069 REAR WHEEL ASSEMBLY, COMPLETE, WITH SOLID TIRE, SPOKES OR MOLDED, EACH 

K0070 REAR WHEEL ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, SPOKES OR MOLDED, EACH 

K0071 FRONT CASTER ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, EACH 

K0072 FRONT CASTER ASSEMBLY, COMPLETE, WITH SEMI-PNEUMATIC TIRE, EACH 

K0073 CASTER PIN LOCK,EACH 

K0074 PNEUMATIC CASTER TIRE, ANY SIZE, EACH 

K0075 SEMI-PNEUMATIC CASTER TIRE, ANY SIZE, EACH 

K0076 SOLID CASTER TIRE, ANY SIZE, EACH 

K0077 FRONT CASTER ASSEMBLY, COMPLETE, WITH SOLID TIRE, EACH 

K0078 PNEUMATIC CASTER TIRE TUBE, EACH 

K0079 WHEEL LOCK EXTENSION, PAIR 

K0080 ANTI-ROLLBACK DEVICE, PAIR 

K0081 WHEEL LOCK ASSEMBLY, COMPLETE, EACH 

K0082 22 NF DEEP CYCLE LEAD ACID BATTERY, EACH 

K0083 22 NF GEL CELL BATTERY, EACH 

K0084 GROUP 24 DEEP CYCLE LEAD ACID BATTERY, EACH 

K0085 GROUP 24 GEL CELL BATTERY, EACH 

K0086 U-1 LEAD ACID BATTERY, EACH 

K0087 U-1 GEL CELL BATTERY, EACH

K0088 BATTERY CHARGER, LEAD ACID OR GEL CELL 

K0089 BATTERY CHARGER, DUAL MODE 

K0090 REAR WHEEL TIRE FOR POWER WHEELCHAIR, ANY SIZE, EACH 

K0091 REAR WHEEL TIRE TUBE OTHER THAN ZERO PRESSURE FOR POWER WHEELCHAIR, ANY SIZE, 

EACH 

K0092 REAR WHEEL ASSEMBLY FOR POWER WHEELCHAIR, COMPLETE, EACH 

K0093 REAR WHEEL, ZERO PRESSURE TIRE TUBE (FLAT FREE INSERT) FOR POWER WHEELCHAIR, 

ANY SIZE, EACH 

K0094 WHEEL TIRE FOR POWER BASE, ANY SIZE, EACH 

K0095 WHEEL TIRE TUBE OTHER THAN ZERO PRESSURE FOR EACH BASE, ANY SIZE, EACH 

K0096 WHEEL ASSEMBLY FOR POWER BASE, COMPLETE, EACH 

K0097 WHEEL ZERO PRESSURE TIRE TUBE (FLAT FREE INSERT) FOR POWER BASE, ANY SIZE, EACH 

K0098 DRIVE BELT FOR POWER WHEELCHAIR 

K0099 FRONT CASTER FOR POWER WHEELCHAIR, EACH 

K0100 WHEELCHAIR ADAPTER FOR AMPUTEE, PAIR (DEVICE USED TO COMPENSATE FOR TRANSFER OF 

WEIGHT DUE TO LOST LIMBS TO MAINTAIN PROPER BALANCE) 

K0101 ONE-ARM DRIVE ATTACHMENT, EACH 

K0102 CRUTCH AND CANE HOLDER, EACH 

K0103 TRANSFER BOARD,

K0171 ADMINISTRATION SET, SMALL VOLUME FILTERED PNEUMATIC NEBULIZER 

K0172 LARGE VOLUME NEBULIZER, DISPOSABLE, UNFILLED, USED WITH AEROSOL COMPRESSOR 

K0173 LARGE VOLUME NEBULIZER, DISPOSABLE, PREFILLED, USED WITH AEROSOL COMPRESSOR 

K0174 RESERVOIR BOTTLE, NON-DISPOSABLE, USED WITH LARGE VOLUME ULTRASONIC NEBULIZER 

K0175 CORRUGATED TUBING, DISPOSABLE, USED WITH LARGE VOLUME NEBULIZER, 100 FEET 

K0176 CORRUGATED TUBING, NON-DISPOSABLE, USED WITH LARGE VOLUME NEBULIZER, 10 FEET 

K0177 WATER COLLECTION DEVICE, USED WITH LARGE VOLUME NEBULIZER 

K0178 FILTER, DISPOSABLE, USED WITH AEROSOL COMPRESSOR 

K0179 FILTER, NON-DISPOSABLE, USED WITH AEROSOL COMPRESSOR OR ULTRASONIC GENERATOR 

K0180 AEROSOL MASK, USED WITH DME NEBULIZER 

K0181 DOME AND MOUTHPIECE, USED WITH SMALL VOLUME ULTRASONIC NEBULIZER 

K0182 WATER, DISTILLED, USED WITH LARGE VOLUME NEBULIZER, 1000 ML 

K0183 NASAL APPLICATION DEVICE USED WITH POSITIVE AIRWAY PRESSURE DEVICE 

K0184 NASAL PILLOWS/SEALS, REPLACEMENT FOR NASAL APPLICATION DEVICE, PAIR 

K0185 HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE 

K0186 CHIN STRAP USED WITH POSITIVE AIRWAY PRESSURE DEVICE 

K0187 TUBING USED WITH POSITIVE AIRWAY PRESSURE DEVICE 

K0188 FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE 

K0189 FILTER, NON DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE 

K0190 CANISTER, DISPOSABLE, USED WITH SUCTION PUMP 

K0191 CANISTER, NON-DISPOSABLE, USED WITH SUCTION PUMP 

K0192 TUBING, USED WITH SUCTION PUMP 

K0193 CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE, WITH HUMIDIFIER 

K0194 INTERMITTENT ASSIST DEVICE WITH CONTINUOUS POSITIVE AIRWAY PRESSURE, WITH 

HUMIDIFIER 

K0195 ELEVATING LEG RESTS, PAIR (FOR USE WITH CAPPED RENTAL WHEELCHAIR BASE) 

K0268 HUMIDIFIER, NON-HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE 

K0269 AEROSOL COMPRESSOR, ADJUSTABLE PRESSURE, LIGHT DUTY FOR INTERMITTENT USE 

K0270 ULTRASONIC GENERATOR WITH SMALL VOLUME ULTRASONIC NEBULIZER 

K0277 SKIN BARRIER; SOLID 4X4 OR EQUIVALENT, STANDARD WEAR, WITH BUILT-IN CONVEXITY, 

EACH 

K0278 SKIN BARRIER; WITH FLANGE (SOLID, FLEXIBLE OR ACCORDIAN), STANDARD WEAR, WITH 

BUILT-IN CONVEXITY, ANY SIZE, EACH 

K0279 SKIN BARRIER; WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, WITH 

BUILT-IN CONVEXITY, ANY SIZE, EACH 

K0280 EXTENSION DRAINAGE TUBING, ANY TYPE, ANY LENGTH, WITH CONNECTOR/ADAPTOR, FOR 

USE WITH URINARY LEG BAG OR UROSTOMY POUCH, EACH 

K0281 LUBRICANT, INDIVIDUAL STERILE PACKET, FOR INSERTION OF URINARY CATHETER, EACH 

K0283 SALINE SOLUTION, PER 10 ML, METERED DOSE DISPENSER, FOR USE WITH INHALATION 

DRUGS 

K0284 EXTERNAL INFUSION PUMP, MECHANICAL, REUSABLE, FOR EXTENDED DRUG INFUSION 

K0400 ADHESIVE SKIN SUPPORT ATTACHMENT FOR USE WITH EXTERNAL BREAST PROSTHESIS, EACH 

K0401 FOR DIABETICS ONLY, DELUXE FEATURE OF OFF-THE SHELF DEPTH INLAY SHOE OR CUSTOM 

MOLDED SHOE, PER SHOE 

K0407 URINARY CATHETER ANCHORING DEVICE, ADHESIVE SKIN ATTACHMENT 

K0408 URINARY CATHETER ANCHORING DEVICE, LEG STRAP 

K0409 STERILE WATER IRRIGATION SOLUTION, 1000 ML 

K0410 MALE EXTERNAL CATHETER, WITH ADHESIVE COATING, EACH 

K0411 MALE EXTERNAL CATHETER, WITH ADHESIVE STRIP, EACH 

K0412 MYCOPHENOLATE MOFETIL, ORAL, 250 MG 

K0413 NON-POWERED, ADVANCED PRESSURE-REDUCING OVERLAY FOR MATTRESS, STANDARD MATTRESS 

LENGTH AND WIDTH 

K0414 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH 

K0415 PRESCRIPTION ANTIEMETIC DRUG, ORAL, PER 1 MG, FOR USE IN CONJUNCTION WITH ORAL 

ANTI-CANCER DRUG, NOT OTHERWISE SPECIFIED 

K0416 PRESCRIPTION ANTIEMETIC DRUG, RECTAL, PER 1 MG, FOR USE IN CONJUCTION WITH ORAL 

ANTI-CANCER DRUG, NOT OTHERWISE SPECIFIED

K0417 EXTERNAL INFUSION PUMP, MECHANICAL, REUSABLE, FOR SHORT TERM DRUG INFUSION 

K0418 CYCLOSPORIN, ORAL, PER 100 MG 

K0419 POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, PLASTIC, EACH 

K0420 POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, RUBBER, EACH 

K0421 POUCH, DRAINABLE, FOR USE ON FACEPLATE, PLASTIC, EACH 

K0422 POUCH, DRAINABLE, FOR USE ON FACEPLATE, RUBBER, EACH 

K0423 POUCH, URINARY, WITH FACEPLATE ATTACHED, PLASTIC, EACH 

K0424 POUCH, URINARY, WITH FACEPLATE ATTACHED, RUBBER, EACH 

K0425 POUCH, URINARY, FOR USE ON FACEPLATE, PLASTIC, EACH 

K0426 POUCH, URINARY, FOR USE ON FACEPLATE, HEAVY PLASTIC, EACH 

K0427 POUCH, URINARY, FOR USE ON FACEPLATE, RUBBER, EACH 

K0428 OSTOMY FACEPLATE EQUIVALENT, SILICONE RING, EACH 

K0429 SKIN BARRIER, SOLID 4X4 OR EQUIVALENT, EXTENDED WEAR, WITHOUT BUILT-IN 


K0430 SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, 

WITHOUT BUILT-IN CONVEXITY, ANY SIZE, EACH 

K0431 POUCH, CLOSED; WITH STANDARD WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 

PIECE), EACH 

K0432 POUCH, DRAINABLE, WITH EXTENDED WEAR BARRIER ATTACHED, WITHOUT BUILT-IN 


K0433 POUCH, DRAINABLE, WITH STANDARD WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY 

(1 PIECE), EACH 

K0434 POUCH, DRAINABLE, WITH EXTENDED WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY 


K0435 POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITHOUT BUILT-IN CONVEXITY 


K0436 POUCH, URINARY, WITH STANDARD WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 

PIECE), EACH 

K0437 POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY 

(1PIECE), EACH 

K0438 OSTOMY DEODORANT FOR USE IN OSTOMY POUCH, LIQUID, PER FLUID OUNCE 

K0439 OSTOMY DEODORANT FOR USE IN OSTOMY POUCH, SOLID, PER TABLET 

K0440 NASAL PROSTHESIS - PROVIDED BY A NON-PHYSICIAN 

K0441 MIDFACIAL PROSTHESIS - PROVIDED BY A NON-PHYSICIAN 

K0442 ORBITAL PROSTHESIS - PROVIDED BY A NON-PHYSICIAN 

K0443 UPPER FACIAL PROSTHESIS - PROVIDED BY A NON-PHYSICIAN 

K0444 HEMI-FACIAL PROSTHESIS - PROVIDED BY A NON-PHYSICIAN 

K0445 AURICULAR PROSTHESIS - PROVIDED BY A NON-PHYSICIAN 

K0446 PARTIAL FACIAL PROSTHESIS - PROVIDED BY A NON-PHYSICIAN 

K0447 NASAL SEPTAL PROSTHESIS - PROVIDED BY A NON-PHYSICIAN 

K0448 UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT - PROVIDED BY A NON-PHYSICIAN 

K0449 REPAIR OR MODIFICATION OF MAXILLOFACIAL PROSTHESIS, LABOR COMPONENT, 15 MINUTE 

INCREMENTS - PROVIDED BY A NON-PHYSICIAN 

K0450 ADHESIVE, LIQUID, FOR USE WITH FACIAL PROSTHESIS ONLY, PER OUNCE 

K0451 ADHESIVE REMOVER, WIPES, FOR USE WITH FACIAL PROSTHESIS, PER BOX OF 50 

K0452 WHEELCHAIR BEARINGS, ANY TYPE 

K0453 INJECTION, AMPHOTERICIN B, 50 MG 

K0454 NON-POWERED, ADVANCED PRESSURE-REDUCING MATTRESS 

K0455 INFUSION PUMP USED FOR UNINTERRUPTED ADMINISTRATION OF EPOPROSTENOL 

K0456 HOSPITAL BED, HEAVY DUTY, EXTRA WIDE, WITH ANY TYPE SIDE RAILS, WITH MATTRESS 

K0457 EXTRA WIDE/HEAVY DUTY COMMODE CHAIR, EACH 

K0458 HEAVY DUTY WALKER, WITHOUT WHEELS, EACH 

K0459 HEAVY DUTY WHEELED WALKER, EACH 

K0460 POWER ADD-ON, TO CONVERT MANUAL WHEELCHAIR TO MOTORIZED WHEELCHAIR, JOYSTICK 

CONTROL 

K0461 POWER ADD-ON, TO CONVERT MANUAL WHEELCHAIR TO POWER OPERATED VEHICLE, TILLER 

CONTROL

K0462 TEMPORARY REPLACEMENT FOR PATIENT OWNED EQUIPMENT BEING REPAIRED, ANY TYPE 

K0501 AEROSOL COMPRESSOR, BATTERY POWERED, FOR USE WITH SMALL VOLUME NEBULIZER 

K0503 ACETYLCYSTEINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER GRAM 

K0504 ALBUTEROL, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER 

MILLIGRAM 


MILLIGRAM 


MILLIGRAM 


MILLIGRAM 


MILLIGRAM 


MILLIGRAM 


MILLIGRAM 


MILLIGRAM 


MILLIGRAM 


MILLIGRAM 


MILLIGRAM 

K0516 GLYCOPYRROLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, 

PER MILLIGRAM 

K0518 IPRATROPIUM BROMIDE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE 






















K0529 STERILE WATER OR STERILE SALINE, 1000 ML, USED WITH LARGE VOLUME NEBULIZER 

K0530 NEBULIZER, DURABLE, GLASS , OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, NOT USED WITH 

OXYGEN 

K0531 HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE 

K0532 RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITHOUT BACKUP RATE 

FEATURE, USED WITH NONINVASIVE INTERFACE, E.G., NASAL OR FACIAL MASK 

(INTERMITTENT ASSIST DEVICE WITH CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE)

K0533 RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITH BACKUP RATE 

FEATURE, USED WITH NONINVASIVE INTERFACE, E.G., NASAL OR FACIAL MASK 

(INTERMITTENT ASSIST DEVICE WITH CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE) 

K0534 RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPACITY, WITH BACK UP RATE 

FEATURE, USED WITH INVASIVE INTERFACE, E.G., TRACHEOSTOMY TUBE (INTERMITTENT 

ASSIST DEVICE WITH CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE) 

K0535 GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT PAD SIZE 16 SQUARE INCH 

OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING 

K0536 GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT PAD SIZE MORE THAN 16 SQ 

IN, BUT LESS THAN OR EQUAL TO 48 SQ IN, WITHOUT ADHESIVE BORDER, EACH DRESSING 

K0537 GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT, PAD SIZE MORE THAN 48 

SQ IN, WITHOUT ADHESIVE BORDER, EACH DRESSING 

K0538 NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE 

K0539 DRESSING SET FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR 

PORTABLE, EACH 

K0540 CANISTER SET FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR 

PORTABLE, EACH 

K0541 SPEECH GENERATING DEVICE, DIGITIZED SPEECH USING PRE-RECORDED MESSAGES, LESS 

THAN OR EQUAL TO 8 MINUTES RECORDING TIME 

K0542 SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGES, 

GREATER THAN 8 MINUTES RECORDING TIME 

K0543 SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH, REQUIRING MESSAGE FORMULATION BY 

SPELLING AND ACCESS BY PHYSICAL CONTACT WITH THE DEVICE 

K0544 SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH, PERMITTING MULTIPLE METHODS OF 

MESSAGE FORMULATION AND MULTIPLE METHODS OF DEVICE ACCESS 

K0545 SPEECH GENERATING SOFTWARE PROGRAM, FOR PERSONAL COMPUTER OR PERSONAL DIGITAL 

ASSISTANT 

K0546 ACCESSORY FOR SPEECH GENERATING DEVICE, MOUNTING SYSTEM 

K0547 ACCESSORY FOR SPEECH GENERATING DEVICE, NOT OTHERWISE CLASSIFIED 

L0100 CERVICAL, CRANIOSTENOSIS, HELMET MOLDED TO PATIENT MODEL 

L0110 CERVICAL, CRANIOSTENOSIS, HELMET, NON-MOLDED 

L0120 CERVICAL, FLEXIBLE, NON-ADJUSTABLE (FOAM COLLAR) 

L0130 CERVICAL, FLEXIBLE, THERMOPLASTIC COLLAR, MOLDED TO PATIENT 

L0140 CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR) 

L0150 CERVICAL, SEMI-RIGID, ADJUSTABLE MOLDED CHIN CUP (PLASTIC COLLAR WITH 

MANDIBULAR/OCCIPITAL PIECE) 

L0160 CERVICAL, SEMI-RIGID, WIRE FRAME OCCIPITAL/MANDIBULAR SUPPORT 

L0170 CERVICAL, COLLAR, MOLDED TO PATIENT MODEL 

L0172 CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 

L0174 CERVICAL, COLLAR, SEMI-RIGID, THERMOPLASTIC FOAM, TWO PIECE WITH THORACIC 

EXTENSION 

L0180 CERVICAL, MULTIPLE POST COLLAR, OCCIPITAL/MANDIBULAR SUPPORTS, ADJUSTABLE 


CERVICAL BARS (SOMI, GUILFORD, TAYLOR TYPES) 


CERVICAL BARS, AND THORACIC EXTENSION 

L0210 THORACIC, RIB BELT 

L0220 THORACIC, RIB BELT, CUSTOM FABRICATED 

L0300 THORACIC-LUMBAR-SACRAL-ORTHOSIS (TLSO), FLEXIBLE (DORSO-LUMBAR SURGICAL 

SUPPORT) 

L0310 TLSO, FLEXIBLE, (DORSO-LUMBAR SURGICAL SUPPORT), CUSTOM FABRICATED 

L0315 TLSO, FLEXIBLE DORSO-LUMBAR SURGICAL SUPPORT, ELASTIC TYPE, WITH RIGID 

POSTERIOR PANEL 

L0317 TLSO, FLEXIBLE DORSO-LUMBAR SURGICAL SUPPORT, HYPEREXTENSION, ELASTIC TYPE, 

WITH RIGID POSTERIOR PANEL 

L0320 TLSO, ANTERIOR-POSTERIOR CONTROL (TAYLOR TYPE), WITH APRON FRONT 

L0330 TLSO, ANTERIOR-POSTERIOR-LATERAL CONTROL (KNIGHT-TAYLOR TYPE), WITH APRON FRONT

L0340 TLSO, ANTERIOR-POSTERIOR-LATERAL-ROTARY CONTROL (ARNOLD, MAGNUSON, STEINDLER 

TYPES), WITH APRON FRONT 

L0350 TLSO, ANTERIOR-POSTERIOR-LATERAL-ROTARY CONTROL, FLEXION COMPRESSION JACKET, 

CUSTOM FITTED 

L0360 TLSO, ANTERIOR-POSTERIOR-LATERAL-ROTARY CONTROL, FLEXION COMPRESSION JACKET 

MOLDED TO PATIENT MODEL 

L0370 TLSO, ANTERIOR-POSTERIOR-LATERAL-ROTARY CONTROL, HYPEREXTENSION (JEWETT, 

LENNOX, BAKER, CASH TYPES) 

L0380 TLSO, ANTERIOR-POSTERIOR-LATERAL-ROTARY CONTROL, WITH EXTENSIONS 

L0390 TLSO, ANTERIOR-POSTERIOR-LATERAL CONTROL MOLDED TO PATIENT MODEL 

L0400 TLSO, ANTERIOR-POSTERIOR-LATERAL CONTROL MOLDED TO PATIENT MODEL, WITH 

INTERFACE MATERIAL 

L0410 TLSO, ANTERIOR-POSTERIOR-LATERAL CONTROL, TWO-PIECE CONSTRUCTION , 


L0420 TLSO, ANTERIOR-POSTERIOR-LATERAL CONTROL, TWO PIECE CONSTRUCTION , 

MOLDED TO PATIENT MODEL, WITH INTERFACE MATERIAL 

L0430 TLSO, ANTERIOR-POSTERIOR-LATERAL CONTROL, WITH INTERFACE MATERIAL L 

CUSTOM FITTED 

L0440 TLSO, ANTERIOR-POSTERIOR-LATERAL CONTROL, WITH OVERLAPPING FRONT SECTION, 

SPRING STEEL FRONT, CUSTOM FITTED 

L0500 LUMBAR-SACRAL-ORTHOSIS (LSO), FLEXIBLE, (LUMBO-SACRAL SURGICAL SUPPORT) 

L0510 LSO, FLEXIBLE (LUMBO-SACRAL SURGICAL SUPPORT), CUSTOM FABRICATED 

L0515 LSO, FLEXIBLE, LUMBO-SACRAL SURGICAL SUPPORT ELASTIC TYPE, WITH RIGID POSTERIOR 

PANEL 

L0520 LSO, ANTERIOR-POSTERIOR-LATERAL CONTROL (KNIGHT, WILCOX TYPES), WITH APRON 

FRONT 

L0530 LSO, ANTERIOR-POSTERIOR CONTROL (MACAUSLAND TYPE), WITH APRON FRONT 

L0540 LSO, LUMBAR FLEXION (WILLIAMS FLEXION TYPE) 

L0550 LSO, ANTERIOR-POSTERIOR-LATERAL CONTROL, MOLDED TO PATIENT MODEL 

L0560 LSO, ANTERIOR-POSTERIOR-LATERAL CONTROL, MOLDED TO PATIENT MODEL, WITH 

INTERFACE MATERIAL 

L0565 LSO, ANTERIOR-POSTERIOR-LATERAL CONTROL, CUSTOM FITTED 

L0600 SACROILIAC, FLEXIBLE (SACROILIAC SURGICAL SUPPORT), 

L0610 SACROILIAC, FLEXIBLE (SACROILIAC SURGICAL SUPPORT), CUSTOM FABRICATED 

L0620 SACROILIAC, SEMI-RIGID (GOLDTHWAITE, OSGOOD TYPES), WITH APRON FRONT 

L0700 CERVICAL-THORACIC-LUMBAR-SACRAL-ORTHOSES (CTLSO), ANTERIOR-POSTERIOR-LATERAL 

CONTROL, MOLDED TO PATIENT MODEL, (MINERVA TYPE) 

L0710 CTLSO, ANTERIOR-POSTERIOR-LATERAL-CONTROL, MOLDED TO PATIENT MODEL, WITH 

INTERFACE MATERIAL, (MINERVA TYPE) 

L0810 HALO PROCEDURE, CERVICAL HALO INCORPORATED INTO JACKET VEST 

L0820 HALO PROCEDURE, CERVICAL HALO INCORPORATED INTO PLASTER BODY JACKET 

L0830 HALO PROCEDURE, CERVICAL HALO INCORPORATED INTO MILWAUKEE TYPE ORTHOSIS 

L0860 ADDITION TO HALO PROCEDURES, MAGNETIC REASONANCE IMAGE COMPATIBLE SYSTEM 

L0900 TORSO SUPPORT, PTOSIS SUPPORT 

L0910 TORSO SUPPORT, PTOSIS SUPPORT, CUSTOM FABRICATED 

L0920 TORSO SUPPORT, PENDULOUS ABDOMEN SUPPORT 

L0930 TORSO SUPPORT, PENDULOUS ABDOMEN SUPPORT, CUSTOM FABRICATED 

L0940 TORSO SUPPORT, POSTSURGICAL SUPPORT 

L0950 TORSO SUPPORT, POST SURGICAL SUPPORT, CUSTOM FABRICATED 

L0960 TORSO SUPPORT, POST SURGICAL SUPPORT, PADS FOR POST SURGICAL SUPPORT 

L0970 TLSO, CORSET FRONT 

L0972 LSO, CORSET FRONT 

L0974 TLSO, FULL CORSET 

L0976 LSO, FULL CORSET 

L0978 AXILLARY CRUTCH EXTENSION 

L0980 PERONEAL STRAPS, PAIR 

L0982 STOCKING SUPPORTER GRIPS, SET OF FOUR (4)

L0984 PROTECTIVE BODY SOCK, EACH 

L0999 ADDITION TO SPINAL ORTHOSIS, NOT OTHERWISE SPECIFIED 

L1000 CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) (MILWAUKEE), INCLUSIVE OF 

FURNISHING INITIAL ORTHOSIS, INCLUDING MODEL 

L1010 ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS 

ORTHOSIS, AXILLA SLING 

L1020 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, KYPHOSIS PAD 

L1025 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, KYPHOSIS PAD, FLOATING 

L1030 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, LUMBAR BOLSTER PAD 

L1040 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, LUMBAR OR LUMBAR RIB PAD 

L1050 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, STERNAL PAD 

L1060 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, THORACIC PAD 

L1070 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, TRAPEZIUS SLING 

L1080 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, OUTRIGGER 

L1085 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, OUTRIGGER, BILATERAL WITH VERTICAL 

EXTENSIONS 

L1090 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, LUMBAR SLING 

L1100 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, RING FLANGE, PLASTIC OR LEATHER 

L1110 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, RING FLANGE, PLASTIC OR LEATHER, 


L1120 ADDITION TO CTLSO, SCOLIOSIS ORTHOSIS, COVER FOR UPRIGHT, EACH 

L1200 THORACIC-LUMBAR-SACRAL-ORTHOSIS (TLSO), INCLUSIVE OF FURNISHING INITIAL 

ORTHOSIS ONLY 

L1210 ADDITION TO TLSO, (LOW PROFILE), LATERAL THORACIC EXTENSION 

L1220 ADDITION TO TLSO, (LOW PROFILE), ANTERIOR THORACIC EXTENSION 

L1230 ADDITION TO TLSO, (LOW PROFILE), MILWAUKEE TYPE SUPERSTRUCTURE 

L1240 ADDITION TO TLSO, (LOW PROFILE), LUMBAR DEROTATION PAD 

L1250 ADDITION TO TLSO, (LOW PROFILE), ANTERIOR ASIS PAD 

L1260 ADDITION TO TLSO, (LOW PROFILE), ANTERIOR THORACIC DEROTATION PAD 

L1270 ADDITION TO TLSO, (LOW PROFILE), ABDOMINAL PAD 

L1280 ADDITION TO TLSO, (LOW PROFILE), RIB GUSSET (ELASTIC), EACH 

L1290 ADDITION TO TLSO, (LOW PROFILE), LATERAL TROCHANTERIC PAD 

L1300 OTHER SCOLIOSIS PROCEDURE, BODY JACKET MOLDED TO PATIENT MODEL 

L1310 OTHER SCOLIOSIS PROCEDURE, POST-OPERATIVE BODY JACKET 

L1499 SPINAL ORTHOSIS, NOT OTHERWISE SPECIFIED 

L1500 THORACIC-HIP-KNEE-ANKLE ORTHOSIS (THKAO), MOBILITY FRAME (NEWINGTON, PARAPODIUM 

TYPES) 

L1510 THKAO, STANDING FRAME 

L1520 THKAO, SWIVEL WALKER 

L1600 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINTS, FLEXIBLE, FREJKA TYPE WITH 

COVER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1610 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINTS, FLEXIBLE, (FREJKA COVER ONLY), 

PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1620 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINTS, FLEXIBLE, (PAVLIK HARNESS), 


L1630 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINTS, SEMI-FLEXIBLE (VON ROSEN TYPE), 

CUSTOM-FABRICATED 

L1640 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINTS, STATIC, PELVIC BAND OR SPREADER 

BAR, THIGH CUFFS, CUSTOM-FABRICATED 

L1650 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINTS, STATIC, ADJUSTABLE, (ILFLED 

TYPE), PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1660 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINTS, STATIC, PLASTIC, PREFABRICATED, 

INCLUDES FITTING AND ADJUSTMENT 

L1680 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINTS, DYNAMIC, PELVIC CONTROL, 

ADJUSTABLE HIP MOTION CONTROL, THIGH CUFFS (RANCHO HIP ACTION TYPE), CUSTOM 

FABRICATED 

L1685 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINT, POSTOPERATIVE HIP ABDUCTION TYPE,

CUSTOM FABRICATED 

L1686 HIP ORTHOSIS, ABDUCTION CONTROL OF HIP JOINT, POSTOPERATIVE HIP ABDUCTION TYPE, 


L1690 COMBINATION, BILATERAL, LUMBO-SACRAL, HIP, FEMUR ORTHOSIS PROVIDING ADDUCTION 

AND INTERNAL ROTATION CONTROL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1700 LEGG PERTHES ORTHOSIS, (TORONTO TYPE), CUSTOM-FABRICATED 

L1710 LEGG PERTHES ORTHOSIS, (NEWINGTON TYPE), CUSTOM FABRICATED 

L1720 LEGG PERTHES ORTHOSIS, TRILATERAL, (TACHDIJAN TYPE), CUSTOM-FABRICATED 

L1730 LEGG PERTHES ORTHOSIS, (SCOTTISH RITE TYPE), CUSTOM-FABRICATED 

L1750 LEGG PERTHES ORTHOSIS, LEGG PERTHES SLING (SAM BROWN TYPE), PREFABRICATED, 


L1755 LEGG PERTHES ORTHOSIS, (PATTEN BOTTOM TYPE), CUSTOM-FABRICATED 

L1800 KNEE ORTHOSIS, ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L1810 KNEE ORTHOSIS, ELASTIC WITH JOINTS, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L1815 KNEE ORTHOSIS, ELASTIC OR OTHER ELASTIC TYPE MATERIAL WITH CONDYLAR PAD(S), 


L1820 KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, PREFABRICATED, INCLUDES 

FITTING AND ADJUSTMENT 

L1825 KNEE ORTHOSIS, ELASTIC KNEE CAP, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1830 KNEE ORTHOSIS, IMMOBILIZER, CANVAS LONGITUDINAL, PREFABRICATED, INCLUDES 


L1832 KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS, POSITIONAL ORTHOSIS, RIGID SUPPORT, 


L1834 KNEE ORTHOSIS, WITHOUT KNEE JOINT, RIGID, CUSTOM-FABRICATED 

L1840 KNEE ORTHOSIS, DEROTATION, MEDIAL-LATERAL, ANTERIOR CRUCIATE LIGAMENT, CUSTOM 

FABRICATED 

L1843 KNEE ORTHOSIS, SINGLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND 

EXTENSION JOINT, MEDIAL-LATERAL AND ROTATION CONTROL, PREFABRICATED, INCLUDES 


L1844 KNEE ORTHOSIS, SINGLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND 

EXTENSION JOINT, MEDIAL-LATERAL AND ROTATION CONTROL, CUSTOM FABRICATED 

L1845 KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND 

EXTENSION JOINT, MEDIAL-LATERAL AND ROTATION CONTROL, PREFABRICATED, INCLUDES 


L1846 KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND 

EXTENSION JOINT, MEDIAL-LATERAL AND ROTATION CONTROL, CUSTOM FABRICATED 

L1847 KNEE ORTHOSIS, DOUBLE UPRIGHT WITH ADJUSTABLE JOINT, WITH INFLATABLE AIR 

SUPPORT CHAMBER(S), PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1850 KNEE ORTHOSIS, SWEDISH TYPE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1855 KNEE ORTHOSIS, MOLDED PLASTIC, THIGH AND CALF SECTIONS, WITH DOUBLE UPRIGHT 

KNEE JOINTS, CUSTOM-FABRICATED 

L1858 KNEE ORTHOSIS, MOLDED PLASTIC, POLYCENTRIC KNEE JOINTS, PNEUMATIC KNEE PADS 

(CTI), CUSTOM-FABRICATED 

L1860 KNEE ORTHOSIS, MODIFICATION OF SUPRACONDYLAR PROSTHETIC SOCKET, 

CUSTOM-FABRICATED (SK) 

L1870 KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH AND CALF LACERS WITH KNEE JOINTS, 


L1880 KNEE ORTHOSIS, DOUBLE UPRIGHT, NON-MOLDED THIGH AND CALF CUFFS/LACERS WITH KNEE 

JOINTS, CUSTOM-FABRICATED 

L1885 KNEE ORTHOSIS, SINGLE OR DOUBLE UPRIGHT, THIGH AND CALF, WITH FUNCTIONAL ACTIVE 

RESISTANCE CONTROL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1900 ANKLE FOOT ORTHOSIS, SPRING WIRE, DORSIFLEXION ASSIST CALF BAND, 


L1902 ANKLE FOOT ORTHOSIS, ANKLE GAUNTLET, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT

L1904 ANKLE FOOT ORTHOSIS, MOLDED ANKLE GAUNTLET, CUSTOM-FABRICATED 

L1906 ANKLE FOOT ORTHOSIS, MULTILIGAMENTUS ANKLE SUPPORT, PREFABRICATED, INCLUDES 


L1910 ANKLE FOOT ORTHOSIS, POSTERIOR, SINGLE BAR, CLASP ATTACHMENT TO SHOE COUNTER, 


L1920 ANKLE FOOT ORTHOSIS, SINGLE UPRIGHT WITH STATIC OR ADJUSTABLE STOP (PHELPS OR 

PERLSTEIN TYPE), CUSTOM-FABRICATED 

L1930 ANKLE FOOT ORTHOSIS, PLASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L1940 ANKLE FOOT ORTHOSIS, PLASTIC, CUSTOM-FABRICATED 

L1945 ANKLE FOOT ORTHOSIS, PLASTIC, RIGID ANTERIOR TIBIAL SECTION (FLOOR REACTION), 


L1950 ANKLE FOOT ORTHOSIS, SPIRAL, (IRM TYPE), PLASTIC, CUSTOM-FABRICATED 

L1960 ANKLE FOOT ORTHOSIS, POSTERIOR SOLID ANKLE, PLASTIC, CUSTOM-FABRICATED 

L1970 ANKLE FOOT ORTHOSIS, PLASTIC WITH ANKLE JOINT, CUSTOM-FABRICATED 

L1980 ANKLE FOOT ORTHOSIS, SINGLE UPRIGHT FREE PLANTAR DORSIFLEXION, SOLID STIRRUP, 

CALF BAND/CUFF (SINGLE BAR ’BK’ ORTHOSIS), CUSTOM-FABRICATED 

L1990 ANKLE FOOT ORTHOSIS, DOUBLE UPRIGHT FREE PLANTAR DORSIFLEXION, SOLID STIRRUP, 

CALF BAND/CUFF (DOUBLE BAR ’BK’ ORTHOSIS), CUSTOM-FABRICATED 

L2000 KNEE ANKLE FOOT ORTHOSIS, SINGLE UPRIGHT, FREE KNEE, FREE ANKLE, SOLID STIRRUP, 

THIGH AND CALF BANDS/CUFFS (SINGLE BAR ’AK’ ORTHOSIS), CUSTOM-FABRICATED 

L2010 KNEE ANKLE FOOT ORTHOSIS, SINGLE UPRIGHT, FREE ANKLE, SOLID STIRRUP, THIGH AND 

CALF BANDS/CUFFS (SINGLE BAR ’AK’ ORTHOSIS), WITHOUT KNEE JOINT, 


L2020 KNEE ANKLE FOOT ORTHOSIS, DOUBLE UPRIGHT, FREE ANKLE, SOLID STIRRUP, THIGH AND 

CALF BANDS/CUFFS (DOUBLE BAR ’AK’ ORTHOSIS), CUSTOM-FABRICATED 

L2030 KNEE ANKLE FOOT ORTHOSIS, DOUBLE UPRIGHT, FREE ANKLE, SOLID STIRRUP, THIGH AND 

CALF BANDS/CUFFS, (DOUBLE BAR ’AK’ ORTHOSIS), WITHOUT KNEE JOINT, CUSTOM 

FABRICATED 

L2035 KNEE ANKLE FOOT ORTHOSIS, FULL PLASTIC, STATIC (PEDIATRIC SIZE), PREFABRICATED, 


L2036 KNEE ANKLE FOOT ORTHOSIS, FULL PLASTIC, DOUBLE UPRIGHT, FREE KNEE, 


L2037 KNEE ANKLE FOOT ORTHOSIS, FULL PLASTIC, SINGLE UPRIGHT, FREE KNEE, 


L2038 KNEE ANKLE FOOT ORTHOSIS, FULL PLASTIC, WITH KNEE JOINT, MULTI-AXIS ANKLE, 

(LIVELY ORTHOSIS OR EQUAL), CUSTOM-FABRICATED 

L2039 KNEE ANKLE FOOT ORTHOSIS, FULL PLASTIC, SINGLE UPRIGHT, POLY-AXIAL HINGE, 

MEDIAL LATERAL ROTATION CONTROL, CUSTOM-FABRICATED 

L2040 HIP KNEE ANKLE FOOT ORTHOSIS, TORSION CONTROL, BILATERAL ROTATION STRAPS, 

PELVIC BAND/BELT, CUSTOM FABRICATED 

L2050 HIP KNEE ANKLE FOOT ORTHOSIS, TORSION CONTROL, BILATERAL TORSION CABLES, HIP 

JOINT, PELVIC BAND/BELT, CUSTOM-FABRICATED 

L2060 HIP KNEE ANKLE FOOT ORTHOSIS, TORSION CONTROL, BILATERAL TORSION CABLES, BALL 

BEARING HIP JOINT, PELVIC BAND/ BELT, CUSTOM-FABRICATED 

L2070 HIP KNEE ANKLE FOOT ORTHOSIS, TORSION CONTROL, UNILATERAL ROTATION STRAPS, 

PELVIC BAND/BELT, CUSTOM FABRICATED 

L2080 HIP KNEE ANKLE FOOT ORTHOSIS, TORSION CONTROL, UNILATERAL TORSION CABLE, HIP 

JOINT, PELVIC BAND/BELT, CUSTOM-FABRICATED 

L2090 HIP KNEE ANKLE FOOT ORTHOSIS, TORSION CONTROL, UNILATERAL TORSION CABLE, BALL 

BEARING HIP JOINT, PELVIC BAND/ BELT, CUSTOM-FABRICATED 

L2102 ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, PLASTER 

TYPE CASTING MATERIAL, CUSTOM-FABRICATED 

L2104 ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, 

SYNTHETIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED 

L2106 ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, 

THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED 

L2108 ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS,


L2112 ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, SOFT, 


L2114 ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, SEMI-RIGID, 


L2116 ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, 


L2122 KNEE ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, 

PLASTER TYPE CASTING MATERIAL, CUSTOM-FABRICATED 


SYNTHETIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED 


THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED 



L2132 KAFO, FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, SOFT, PREFABRICATED, 


L2134 KAFO, FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, SEMI-RIGID, 


L2136 KAFO, FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, RIGID, PREFABRICATED, 


L2180 ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, PLASTIC SHOE INSERT WITH ANKLE 

JOINTS 

L2182 ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, DROP LOCK KNEE JOINT 

L2184 ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, LIMITED MOTION KNEE JOINT 

L2186 ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, ADJUSTABLE MOTION KNEE JOINT, 

LERMAN TYPE 

L2188 ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, QUADRILATERAL BRIM 

L2190 ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, WAIST BELT 

L2192 ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, HIP JOINT, PELVIC BAND, THIGH 

FLANGE, AND PELVIC BELT 

L2200 ADDITION TO LOWER EXTREMITY, LIMITED ANKLE MOTION, EACH JOINT 

L2210 ADDITION TO LOWER EXTREMITY, DORSIFLEXION ASSIST (PLANTAR FLEXION RESIST), EACH 

JOINT 

L2220 ADDITION TO LOWER EXTREMITY, DORSIFLEXION AND PLANTAR FLEXION ASSIST/RESIST, 

EACH JOINT 

L2230 ADDITION TO LOWER EXTREMITY, SPLIT FLAT CALIPER STIRRUPS AND PLATE ATTACHMENT 

L2240 ADDITION TO LOWER EXTREMITY, ROUND CALIPER AND PLATE ATTACHMENT 

L2250 ADDITION TO LOWER EXTREMITY, FOOT PLATE, MOLDED TO PATIENT MODEL, STIRRUP 

ATTACHMENT 

L2260 ADDITION TO LOWER EXTREMITY, REINFORCED SOLID STIRRUP (SCOTT-CRAIG TYPE) 

L2265 ADDITION TO LOWER EXTREMITY, LONG TONGUE STIRRUP 

L2270 ADDITION TO LOWER EXTREMITY, VARUS/VALGUS CORRECTION ('T') STRAP, PADDED/LINED 

OR MALLEOLUS PAD 

L2275 ADDITION TO LOWER EXTREMITY, VARUS/VALGUS CORRECTION, PLASTIC MODIFICATION, 

PADDED/LINED 

L2280 ADDITION TO LOWER EXTREMITY, MOLDED INNER BOOT 

L2300 ADDITION TO LOWER EXTREMITY, ABDUCTION BAR (BILATERAL HIP INVOLVEMENT), 

JOINTED, ADJUSTABLE 

L2310 ADDITION TO LOWER EXTREMITY, ABDUCTION BAR-STRAIGHT 

L2320 ADDITION TO LOWER EXTREMITY, NON-MOLDED LACER 

L2330 ADDITION TO LOWER EXTREMITY, LACER MOLDED TO PATIENT MODEL 

L2335 ADDITION TO LOWER EXTREMITY, ANTERIOR SWING BAND 

L2340 ADDITION TO LOWER EXTREMITY, PRE-TIBIAL SHELL, MOLDED TO PATIENT MODEL 

L2350 ADDITION TO LOWER EXTREMITY, PROSTHETIC TYPE, (BK) SOCKET, MOLDED TO PATIENT 

MODEL, (USED FOR 'PTB' 'AFO' ORTHOSES) 

L2360 ADDITION TO LOWER EXTREMITY, EXTENDED STEEL SHANK

L2370 ADDITION TO LOWER EXTREMITY, PATTEN BOTTOM 

L2375 ADDITION TO LOWER EXTREMITY, TORSION CONTROL, ANKLE JOINT AND HALF SOLID 

STIRRUP 

L2380 ADDITION TO LOWER EXTREMITY, TORSION CONTROL, STRAIGHT KNEE JOINT, EACH JOINT 

L2385 ADDITION TO LOWER EXTREMITY, STRAIGHT KNEE JOINT, HEAVY DUTY, EACH JOINT 

L2390 ADDITION TO LOWER EXTREMITY, OFFSET KNEE JOINT, EACH JOINT 

L2395 ADDITION TO LOWER EXTREMITY, OFFSET KNEE JOINT, HEAVY DUTY, EACH JOINT 

L2397 ADDITION TO LOWER EXTREMITY ORTHOSIS, SUSPENSION SLEEVE 

L2405 ADDITION TO KNEE JOINT, DROP LOCK, EACH JOINT 

L2415 ADDITION TO KNEE JOINT, CAM LOCK (SWISS, FRENCH, BAIL TYPES) EACH JOINT 

L2425 ADDITION TO KNEE JOINT, DISC OR DIAL LOCK FOR ADJUSTABLE KNEE FLEXION, EACH 

JOINT 

L2430 ADDITION TO KNEE JOINT, RATCHET LOCK FOR ACTIVE AND PROGRESSIVE KNEE EXTENSION, 

EACH JOINT 

L2435 ADDITION TO KNEE JOINT, POLYCENTRIC JOINT, EACH JOINT 

L2492 ADDITION TO KNEE JOINT, LIFT LOOP FOR DROP LOCK RING 

L2500 ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, GLUTEAL/ ISCHIAL WEIGHT 

BEARING, RING 

L2510 ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, QUADRI- LATERAL BRIM, MOLDED 

TO PATIENT MODEL 

L2520 ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, QUADRI- LATERAL BRIM, 

CUSTOM FITTED 

L2525 ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, ISCHIAL CONTAINMENT/NARROW 

M-L BRIM MOLDED TO PATIENT MODEL 

L2526 ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, ISCHIAL CONTAINMENT/NARROW 

M-L BRIM, CUSTOM FITTED 

L2530 ADDITION TO LOWER EXTREMITY, THIGH-WEIGHT BEARING, LACER, NON-MOLDED 

L2540 ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, LACER, MOLDED TO PATIENT 

MODEL 

L2550 ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, HIGH ROLL CUFF 

L2570 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, CLEVIS TYPE TWO 

POSITION JOINT, EACH 

L2580 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, PELVIC SLING 

L2600 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, CLEVIS TYPE, OR THRUST 

BEARING, FREE, EACH 

L2610 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, CLEVIS OR THRUST 

BEARING, LOCK, EACH 

L2620 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, HEAVY DUTY, EACH 

L2622 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, ADJUSTABLE FLEXION, 

EACH 

L2624 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, ADJUSTABLE FLEXION, 

EXTENSION, ABDUCTION CONTROL, EACH 

L2627 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, PLASTIC, MOLDED TO PATIENT MODEL, 

RECIPROCATING HIP JOINT AND CABLES 

L2628 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, METAL FRAME, RECIPROCATING HIP 

JOINT AND CABLES 

L2630 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, BAND AND BELT, UNILATERAL 

L2640 ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, BAND AND BELT, BILATERAL 

L2650 ADDITION TO LOWER EXTREMITY, PELVIC AND THORACIC CONTROL, GLUTEAL PAD, EACH 

L2660 ADDITION TO LOWER EXTREMITY, THORACIC CONTROL, THORACIC BAND 

L2670 ADDITION TO LOWER EXTREMITY, THORACIC CONTROL, PARASPINAL UPRIGHTS 

L2680 ADDITION TO LOWER EXTREMITY, THORACIC CONTROL, LATERAL SUPPORT UPRIGHTS 

L2750 ADDITION TO LOWER EXTREMITY ORTHOSIS, PLATING CHROME OR NICKEL, PER BAR 

L2755 ADDITION TO LOWER EXTREMITY ORTHOSIS, CARBON GRAPHITE LAMINATION 

L2760 ADDITION TO LOWER EXTREMITY ORTHOSIS, EXTENSION, PER EXTENSION, PER BAR (FOR 

LINEAL ADJUSTMENT FOR GROWTH) 

L2770 ADDITION TO LOWER EXTREMITY ORTHOSIS, ANY MATERIAL - PER BAR OR JOINT

L2780 ADDITION TO LOWER EXTREMITY ORTHOSIS, NON-CORROSIVE FINISH, PER BAR 

L2785 ADDITION TO LOWER EXTREMITY ORTHOSIS, DROP LOCK RETAINER, EACH 

L2795 ADDITION TO LOWER EXTREMITY ORTHOSIS, KNEE CONTROL, FULL KNEECAP 

L2800 ADDITION TO LOWER EXTREMITY ORTHOSIS, KNEE CONTROL, KNEE CAP, MEDIAL OR LATERAL 

PULL 

L2810 ADDITION TO LOWER EXTREMITY ORTHOSIS, KNEE CONTROL, CONDYLAR PAD 

L2820 ADDITION TO LOWER EXTREMITY ORTHOSIS, SOFT INTERFACE FOR MOLDED PLASTIC, BELOW 

KNEE SECTION 

L2830 ADDITION TO LOWER EXTREMITY ORTHOSIS, SOFT INTERFACE FOR MOLDED PLASTIC, ABOVE 

KNEE SECTION 

L2840 ADDITION TO LOWER EXTREMITY ORTHOSIS, TIBIAL LENGTH SOCK, FRACTURE OR EQUAL, 

EACH 

L2850 ADDITION TO LOWER EXTREMITY ORTHOSIS, FEMORAL LENGTH SOCK, FRACTURE OR EQUAL, 

EACH 

L2860 ADDITION TO LOWER EXTREMITY JOINT, KNEE OR ANKLE, CONCENTRIC ADJUSTABLE TORSION 

STYLE MECHANISM, EACH 

L2999 LOWER EXTREMITY ORTHOSES, NOT OTHERWISE SPECIFIED 

L3000 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, 'UCB' TYPE, BERKELEY SHELL, 

EACH 

L3001 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, SPENCO, EACH 

L3002 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, PLASTAZOTE OR EQUAL, EACH 

L3003 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, SILICONE GEL, EACH 

L3010 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, LONGITUDINAL ARCH SUPPORT, 

EACH 

L3020 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, LONGITUDINAL/ METATARSAL 

SUPPORT, EACH 

L3030 FOOT, INSERT, REMOVABLE, FORMED TO PATIENT FOOT, EACH 

L3040 FOOT, ARCH SUPPORT, REMOVABLE, PREMOLDED, LONGITUDINAL, EACH 

L3050 FOOT, ARCH SUPPORT, REMOVABLE, PREMOLDED, METATARSAL, EACH 

L3060 FOOT, ARCH SUPPORT, REMOVABLE, PREMOLDED, LONGITUDINAL/ METATARSAL, EACH 

L3070 FOOT, ARCH SUPPORT, NON-REMOVABLE ATTACHED TO SHOE, LONGITUDINAL, EACH 

L3080 FOOT, ARCH SUPPORT, NON-REMOVABLE ATTACHED TO SHOE, METATARSAL, EACH 

L3090 FOOT, ARCH SUPPORT, NON-REMOVABLE ATTACHED TO SHOE, LONGITUDINAL/METATARSAL, 

EACH 

L3100 HALLUS-VALGUS NIGHT DYNAMIC SPLINT 

L3140 FOOT, ABDUCTION ROTATION BAR, INCLUDING SHOES 

L3150 FOOT, ABDUCTION ROTATATION BAR, WITHOUT SHOES 

L3160 FOOT, ADJUSTABLE SHOE-STYLED POSITIONING DEVICE 

L3170 FOOT, PLASTIC HEEL STABILIZER 

L3201 ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, INFANT 

L3202 ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, CHILD 

L3203 ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, JUNIOR 

L3204 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, INFANT 

L3206 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, CHILD 

L3207 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, JUNIOR 

L3208 SURGICAL BOOT, EACH, INFANT 

L3209 SURGICAL BOOT, EACH, CHILD 

L3211 SURGICAL BOOT, EACH, JUNIOR 

L3212 BENESCH BOOT, PAIR, INFANT 

L3213 BENESCH BOOT, PAIR, CHILD 

L3214 BENESCH BOOT, PAIR, JUNIOR 

L3215 ORTHOPEDIC FOOTWEAR, LADIES SHOES, OXFORD 

L3216 ORTHOPEDIC FOOTWEAR, LADIES SHOES, DEPTH INLAY 

L3217 ORTHOPEDIC FOOTWEAR, LADIES SHOES, HIGHTOP, DEPTH INLAY 

L3218 ORTHOPEDIC FOOTWEAR, LADIES SURGICAL BOOT, EACH 

L3219 ORTHOPEDIC FOOTWEAR, MENS SHOES, OXFORD 

L3221 ORTHOPEDIC FOOTWEAR, MENS SHOES, DEPTH INLAY

L3222 ORTHOPEDIC FOOTWEAR, MENS SHOES, HIGHTOP, DEPTH INLAY 

L3223 ORTHOPEDIC FOOTWEAR, MENS SURGICAL BOOT, EACH 

L3224 ORTHOPEDIC FOOTWEAR, WOMAN'S SHOE, OXFORD, USED AS AN INTEGRAL PART OF A BRACE 

(ORTHOSIS) 

L3225 ORTHOPEDIC FOOTWEAR, MAN'S SHOE, OXFORD, USED AS AN INTEGRAL PART OF A BRACE 

(ORTHOSIS) 

L3230 ORTHOPEDIC FOOTWEAR, CUSTOM SHOES, DEPTH INLAY 

L3250 ORTHOPEDIC FOOTWEAR, CUSTOM MOLDED SHOE, REMOVABLE INNER MOLD, PROSTHETIC SHOE, 

EACH 

L3251 FOOT, SHOE MOLDED TO PATIENT MODEL, SILICONE SHOE, EACH 

L3252 FOOT, SHOE MOLDED TO PATIENT MODEL, PLASTAZOTE (OR SIMILAR), CUSTOM FABRICATED, 

EACH 

L3253 FOOT, MOLDED SHOE PLASTAZOTE (OR SIMILAR) CUSTOM FITTED, EACH 

L3254 NON-STANDARD SIZE OR WIDTH 

L3255 NON-STANDARD SIZE OR LENGTH 

L3257 ORTHOPEDIC FOOTWEAR, ADDITIONAL CHARGE FOR SPLIT SIZE 

L3260 AMBULATORY SURGICAL BOOT, EACH 

L3265 PLASTAZOTE SANDAL, EACH 

L3300 LIFT, ELEVATION, HEEL, TAPERED TO METATARSALS, PER INCH 

L3310 LIFT, ELEVATION, HEEL AND SOLE, NEOPRENE, PER INCH 

L3320 LIFT, ELEVATION, HEEL AND SOLE, CORK, PER INCH 

L3330 LIFT, ELEVATION, METAL EXTENSION (SKATE) 

L3332 LIFT, ELEVATION, INSIDE SHOE, TAPERED, UP TO ONE-HALF INCH 

L3334 LIFT, ELEVATION, HEEL, PER INCH 

L3340 HEEL WEDGE, SACH 

L3350 HEEL WEDGE 

L3360 SOLE WEDGE, OUTSIDE SOLE 

L3370 SOLE WEDGE, BETWEEN SOLE 

L3380 CLUBFOOT WEDGE 

L3390 OUTFLARE WEDGE 

L3400 METATARSAL BAR WEDGE, ROCKER 

L3410 METATARSAL BAR WEDGE, BETWEEN SOLE 

L3420 FULL SOLE AND HEEL WEDGE, BETWEEN SOLE 

L3430 HEEL, COUNTER, PLASTIC REINFORCED 

L3440 HEEL, COUNTER, LEATHER REINFORCED 

L3450 HEEL, SACH CUSHION TYPE 

L3455 HEEL, NEW LEATHER, STANDARD 

L3460 HEEL, NEW RUBBER, STANDARD 

L3465 HEEL, THOMAS WITH WEDGE 

L3470 HEEL, THOMAS EXTENDED TO BALL 

L3480 HEEL, PAD AND DEPRESSION FOR SPUR 

L3485 HEEL, PAD, REMOVABLE FOR SPUR 

L3500 ORTHOPEDIC SHOE ADDITION, INSOLE, LEATHER 

L3510 ORTHOPEDIC SHOE ADDITION, INSOLE, RUBBER 

L3520 ORTHOPEDIC SHOE ADDITION, INSOLE, FELT COVERED WITH LEATHER 

L3530 ORTHOPEDIC SHOE ADDITION, SOLE, HALF 

L3540 ORTHOPEDIC SHOE ADDITION, SOLE, FULL 

L3550 ORTHOPEDIC SHOE ADDITION, TOE TAP STANDARD 

L3560 ORTHOPEDIC SHOE ADDITION, TOE TAP, HORSESHOE 

L3570 ORTHOPEDIC SHOE ADDITION, SPECIAL EXTENSION TO INSTEP (LEATHER WITH EYELETS) 

L3580 ORTHOPEDIC SHOE ADDITION, CONVERT INSTEP TO VELCRO CLOSURE 

L3590 ORTHOPEDIC SHOE ADDITION, CONVERT FIRM SHOE COUNTER TO SOFT COUNTER 

L3595 ORTHOPEDIC SHOE ADDITION, MARCH BAR 

L3600 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, CALIPER PLATE, EXISTING 

L3610 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, CALIPER PLATE, NEW 

L3620 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, SOLID STIRRUP, EXISTING 

L3630 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, SOLID STIRRUP, NEW

L3640 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, DENNIS BROWNE SPLINT 

(RIVETON), BOTH SHOES 

L3649 ORTHOPEDIC SHOE, MODIFICATION, ADDITION OR TRANSFER, NOT OTHERWISE SPECIFIED 

L3650 SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, 


L3660 SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND 

WEBBING, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L3670 SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), PREFABRICATED, 


L3675 SHOULDER ORTHOSIS, VEST TYPE ABDUCTION RESTRAINER, CANVAS WEBBING TYPE OR 

EQUAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L3700 ELBOW ORTHOSIS, ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3710 ELBOW ORTHOSIS, ELASTIC WITH METAL JOINTS, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3720 ELBOW ORTHOSIS, DOUBLE UPRIGHT WITH FOREARM/ARM CUFFS, FREE MOTION, 


L3730 ELBOW ORTHOSIS, DOUBLE UPRIGHT WITH FOREARM/ARM CUFFS, EXTENSION/ FLEXION 

ASSIST, CUSTOM-FABRICATED 

L3740 ELBOW ORTHOSIS, DOUBLE UPRIGHT WITH FOREARM/ARM CUFFS, ADJUSTABLE POSITION LOCK 

WITH ACTIVE CONTROL, CUSTOM-FABRICATED 

L3760 ELBOW ORTHOSIS, WITH ADJUSTABLE POSITION LOCKING JOINT(S), PREFABRICATED, 

INCLUDES FITTING AND ADJUSTMENTS, ANY TYPE 

L3800 WRIST HAND FINGER ORTHOSIS, SHORT OPPONENS, NO ATTACHMENTS, CUSTOM-FABRICATED 

L3805 WRIST HAND FINGER ORTHOSIS, LONG OPPONENS, NO ATTACHMENT, CUSTOM-FABRICATED 

L3807 WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), PREFABRICATED, INCLUDES FITTING 

AND ADJUSTMENTS, ANY TYPE 

L3810 WHFO, ADDITION TO SHORT AND LONG OPPONENS, THUMB ABDUCTION ('C') BAR 

L3815 WHFO, ADDITION TO SHORT AND LONG OPPONENS, SECOND M.P. ABDUCTION ASSIST 

L3820 WHFO, ADDITION TO SHORT AND LONG OPPONENS, I.P. EXTENSION ASSIST, WITH M.P. 

EXTENSION STOP 

L3825 WHFO, ADDITION TO SHORT AND LONG OPPONENS, M.P. EXTENSION STOP 

L3830 WHFO, ADDITION TO SHORT AND LONG OPPONENS, M.P. EXTENSION ASSIST 

L3835 WHFO, ADDITION TO SHORT AND LONG OPPONENS, M.P. SPRING EXTENSION ASSIST 

L3840 WHFO, ADDITION TO SHORT AND LONG OPPONENS, SPRING SWIVEL THUMB 

L3845 WHFO, ADDITION TO SHORT AND LONG OPPONENS, THUMB I.P. EXTENSION ASSIST, WITH 

M.P. STOP 

L3850 WHO, ADDITION TO SHORT AND LONG OPPONENS, ACTION WRIST, WITH DORSIFLEXION 

ASSIST 

L3855 WHFO, ADDITION TO SHORT AND LONG OPPONENS, ADJUSTABLE M.P. FLEXION CONTROL 

L3860 WHFO, ADDITION TO SHORT AND LONG OPPONENS, ADJUSTABLE M.P. FLEXION CONTROL AND 

I.P. 

L3890 ADDITION TO UPPER EXTREMITY JOINT, WRIST OR ELBOW, CONCENTRIC ADJUSTABLE 

TORSION STYLE MECHANISM, EACH 

L3900 WRIST HAND FINGER ORTHOSIS, DYNAMIC FLEXOR HINGE, RECIPROCAL WRIST EXTENSION/ 

FLEXION, FINGER FLEXION/EXTENSION, WRIST OR FINGER DRIVEN, CUSTOM-FABRICATED 

L3901 WRIST HAND FINGER ORTHOSIS, DYNAMIC FLEXOR HINGE, RECIPROCAL WRIST EXTENSION/ 

FLEXION, FINGER FLEXION/EXTENSION, CABLE DRIVEN, CUSTOM-FABRICATED 

L3902 WRIST HAND FINGER ORTHOSIS, EXTERNAL POWERED, COMPRESSED GAS, CUSTOM-FABRICATED 

L3904 WRIST HAND FINGER ORTHOSIS, EXTERNAL POWERED, ELECTRIC, CUSTOM-FABRICATED 

L3906 WRIST HAND ORTHOSIS, WRIST GAUNTLET, CUSTOM-FABRICATED 

L3907 WRIST HAND FINGER ORTHOSIS, WRIST GAUNTLET WITH THUMB SPICA, CUSTOM-FABRICATED 

L3908 WRST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, 


L3910 WRIST HAND FINGER ORTHOSIS, SWANSON DESIGN, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3912 HAND FINGER ORTHOSIS, FLEXION GLOVE WITH ELASTIC FINGER CONTROL, PREFABRICATED,


L3914 WRIST HAND ORTHOSIS, WRIST EXTENSION COCK-UP, PREFABRICATED, INCLUDES 

FITTING/ADJUSTMENT 

L3916 WRIST HAND FINGER ORTHOSIS, WRIST EXTENSION COCK-UP WITH OUTRIGGER, 


L3918 HAND FINGER ORTHOSIS, KNUCKLE BENDER, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3920 HAND FINGER ORTHOSIS, KNUCKLE BENDER WITH OUTRIGGER, PREFABRICATED, INCLUDES 


L3922 HAND FINGER ORTHOSIS, KNUCKLE BENDER, TWO SEGMENT TO FLEX JOINTS, 


L3923 HAND FINGER ORTHOSIS, WITHOUT JOINT(S), PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENTS, ANY TYPE 

L3924 WRIST HAND FINGER ORTHOSIS, OPPENHEIMER, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTABLE 

L3926 WRIST HAND FINGER ORTHOSIS, THOMAS SUSPENSION, PREFABRICATED, INCLUDES FITTING 

AND ADJUSTMENT 

L3928 HAND FINGER ORTHOSIS, FINGER EXTENSION, WITH CLOCK SPRING, PREFABRICATED, 


L3930 WRIST HAND FINGER ORTHOSIS, FINGER EXTENSION, WITH WRIST SUPPORT, 


L3932 FINGER ORTHOSIS, SAFETY PIN, SPRING WIRE, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3934 FINGER ORTHOSIS, SAFETY PIN, MODIFIED, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3936 WRIST HAND FINGER ORTHOSIS, PALMER, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3938 WRIST HAND FINGER ORTHOSIS, DORSAL WRIST, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3940 WRIST HAND FINGER ORTHOSIS, DORSAL WRIST, WITH OUTRIGGER ATTACHMENT, 


L3942 HAND FINGER ORTHOSIS, REVERSE KNUCKLE BENDER, PREFABRICATED, INCLUDES FITTING 


L3944 HAND FINGER ORTHOSIS, REVERSE KNUCKLE BENDER, WITH OUTRIGGER, PREFABRICATED, 


L3946 HAND FINGER ORTHOSIS, COMPOSITE ELASTIC, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3948 FINGER ORTHOSIS, FINGER KNUCKLE BENDER, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3950 WRIST HAND FINGER ORTHOSIS, COMBINATION OPPENHEIMER, WITH KNUCKLE BENDER AND 

TWO ATTACHMENTS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L3952 WRIST HAND FINGER ORTHOSIS, COMBINATION OPPENHEIMER, WITH REVERSE KNUCKLE AND 

TWO ATTACHMENTS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L3954 HAND FINGER ORTHOSIS, SPREADING HAND, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3956 ADDITION OF JOINT TO UPPER EXTREMITY ORTHOSIS, ANY MATERIAL; PER JOINT 

L3960 SHOULDER ELBOW WRIST HAND ORTHOSIS, ABDUCTION POSITIONING, AIRPLANE DESIGN, 


L3962 SHOULDER ELBOW WRIST HAND ORTHOSIS, ABDUCTION POSITIONING, ERBS PALSEY DESIGN, 


L3963 SHOULDER ELBOW WRIST HAND ORTHOSIS, MOLDED SHOULDER, ARM, FOREARM AND WRIST, 

WITH ARTICULATING ELBOW JOINT, CUSTOM-FABRICATED 

L3964 SHOULDER ELBOW ORTHOSIS, MOBILE ARM SUPPORT ATTACHED TO WHEELCHAIR, BALANCED, 

ADJUSTABLE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 


ADJUSTABLE RANCHO TYPE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L3966 SHOULDER ELBOW ORTHOSIS, MOBILE ARM SUPPORT ATTACHED TO WHEELCHAIR, BALANCED,

RECLINING, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 


FRICTION ARM SUPPORT (FRICTION DAMPENING TO PROXIMAL AND DISTAL JOINTS), 


L3969 SHOULDER ELBOW ORTHOSIS, MOBILE ARM SUPPORT, MONOSUSPENSION ARM AND HAND 

SUPPORT, OVERHEAD ELBOW FOREARM HAND SLING SUPPORT, YOKE TYPE SUSPENSION 

SUPPORT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT 

L3970 SEO, ADDITION TO MOBILE ARM SUPPORT, ELEVATING PROXIMAL ARM 

L3972 SEO, ADDITION TO MOBILE ARM SUPPORT, OFFSET OR LATERAL ROCKER ARM WITH ELASTIC 

BALANCE CONTROL 

L3974 SEO, ADDITION TO MOBILE ARM SUPPORT, SUPINATOR 

L3980 UPPER EXTREMITY FRACTURE ORTHOSIS, HUMERAL, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3982 UPPER EXTREMITY FRACTURE ORTHOSIS, RADIUS/ULNAR, PREFABRICATED, INCLUDES 


L3984 UPPER EXTREMITY FRACTURE ORTHOSIS, WRIST, PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L3985 UPPER EXTREMITY FRACTURE ORTHOSIS, FOREARM, HAND WITH WRIST HINGE, 


L3986 UPPER EXTREMITY FRACTURE ORTHOSIS, COMBINATION OF HUMERAL, RADIUS/ULNAR, WRIST, 

(EXAMPLE--COLLES’ FRACTURE), CUSTOM FABRICATED 

L3995 ADDITION TO UPPER EXTREMITY ORTHOSIS, SOCK, FRACTURE OR EQUAL, EACH 

L3999 UPPER LIMB ORTHOSIS, NOT OTHERWISE SPECIFIED 

L4000 REPLACE GIRDLE FOR MILWAUKEE ORTHOSIS 

L4010 REPLACE TRILATERAL SOCKET BRIM 

L4020 REPLACE QUADRILATERAL SOCKET BRIM, MOLDED TO PATIENT MODEL 

L4030 REPLACE QUADRILATERAL SOCKET BRIM, CUSTOM FITTED 

L4040 REPLACE MOLDED THIGH LACER 

L4045 REPLACE NON-MOLDED THIGH LACER 

L4050 REPLACE MOLDED CALF LACER 

L4055 REPLACE NON-MOLDED CALF LACER 

L4060 REPLACE HIGH ROLL CUFF 

L4070 REPLACE PROXIMAL AND DISTAL UPRIGHT FOR KAFO 

L4080 REPLACE METAL BANDS KAFO, PROXIMAL THIGH 

L4090 REPLACE METAL BANDS KAFO-AFO, CALF OR DISTAL THIGH 

L4100 REPLACE LEATHER CUFF KAFO, PROXIMAL THIGH 

L4110 REPLACE LEATHER CUFF KAFO-AFO, CALF OR DISTAL THIGH 

L4130 REPLACE PRETIBIAL SHELL 

L4205 REPAIR OF ORTHOTIC DEVICE, LABOR COMPONENT, PER 15 MINUTES 

L4210 REPAIR OF ORTHOTIC DEVICE, REPAIR OR REPLACE MINOR PARTS 

L4310 MULTI-PODUS OR EQUAL ORTHOTIC PREPARATORY MANAGEMENT SYSTEM FOR LOWER 

EXTREMITIES 

L4320 ADDITION TO AFO, MULTI-PODUS (OR EQUAL) ORTHOTIC PREPARATORY MANAGEMENT SYSTEM 

FOR LOWER EXTREMITIES, FLEXIBLE FOOT POSITIONER WITH SOFT INTERFACE FOR AFO, 

WITH VELCRO CLOSURE 

L4350 PNEUMATIC ANKLE CONTROL SPLINT (E.G., AIRCAST), PREFABRICATED, INCLUDES FITTING 


L4360 PNEUMATIC WALKING SPLINT (E.G., AIRCAST), PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L4370 PNEUMATIC FULL LEG SPLINT (E.G., AIRCAST), PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L4380 PNEUMATIC KNEE SPLINT (E.G., AIRCAST), PREFABRICATED, INCLUDES FITTING AND 

ADJUSTMENT 

L4390 REPLACE SOFT INTERFACE MATERIAL, MULTI-PODUS TYPE SPLINT 

L4392 REPLACEMENT, SOFT INTERFACE MATERIAL, STATIC AFO 

L4394 REPLACE SOFT INTERFACE MATERIAL, FOOT DROP SPLINT 

L4396 STATIC ANKLE FOOT ORTHOSIS, INCLUDING SOFT INTERFACE MATERIAL, FOR

POSITIONING, PRESSURE REDUCTION, MAY BE USED FOR MINIMAL AMBULATION, 


L4398 FOOT DROP SPLINT, RECUMBENT POSITIONING DEVICE, PREFABRICATED, INCLUDES FITTING 


L5000 PARTIAL FOOT, SHOE INSERT WITH LONGITUDINAL ARCH, TOE FILLER 

L5010 PARTIAL FOOT, MOLDED SOCKET, ANKLE HEIGHT, WITH TOE FILLER 

L5020 PARTIAL FOOT, MOLDED SOCKET, TIBIAL TUBERCLE HEIGHT, WITH TOE FILLER 

L5050 ANKLE, SYMES, MOLDED SOCKET, SACH FOOT 

L5060 ANKLE, SYMES, METAL FRAME, MOLDED LEATHER SOCKET, ARTICULATED ANKLE/FOOT 

L5100 BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT 

L5105 BELOW KNEE, PLASTIC SOCKET, JOINTS AND THIGH LACER, SACH FOOT 

L5150 KNEE DISARTICULATION (OR THROUGH KNEE), MOLDED SOCKET, EXTERNAL KNEE JOINTS, 

SHIN, SACH FOOT 

L5160 KNEE DISARTICULATION (OR THROUGH KNEE), MOLDED SOCKET, BENT KNEE CONFIGURATION, 

EXTERNAL KNEE JOINTS, SHIN, SACH FOOT 

L5200 ABOVE KNEE, MOLDED SOCKET, SINGLE AXIS CONSTANT FRICTION KNEE, SHIN, SACH FOOT 

L5210 ABOVE KNEE, SHORT PROSTHESIS, NO KNEE JOINT ('STUBBIES'), WITH FOOT BLOCKS, NO 

ANKLE JOINTS, EACH 

L5220 ABOVE KNEE, SHORT PROSTHESIS, NO KNEE JOINT ('STUBBIES'), WITH ARTICULATED 

ANKLE/FOOT, DYNAMICALLY ALIGNED, EACH 

L5230 ABOVE KNEE, FOR PROXIMAL FEMORAL FOCAL DEFICIENCY, CONSTANT FRICTION KNEE, 

SHIN, SACH FOOT 

L5250 HIP DISARTICULATION, CANADIAN TYPE; MOLDED SOCKET, HIP JOINT, SINGLE AXIS 

CONSTANT FRICTION KNEE, SHIN, SACH FOOT 

L5270 HIP DISARTICULATION, TILT TABLE TYPE; MOLDED SOCKET, LOCKING HIP JOINT, SINGLE 

AXIS CONSTANT FRICTION KNEE, SHIN, SACH FOOT 

L5280 HEMIPELVECTOMY, CANADIAN TYPE; MOLDED SOCKET, HIP JOINT, SINGLE AXIS CONSTANT 

FRICTION KNEE, SHIN, SACH FOOT 

L5300 BELOW KNEE, MOLDED SOCKET, SACH FOOT, ENDOSKELETAL SYSTEM, INCLUDING SOFT COVER 

AND FINISHING 

L5310 KNEE DISARTICULATION (OR THROUGH KNEE), MOLDED SOCKET, SACH FOOT ENDOSKELETAL 

SYSTEM, INCLUDING SOFT COVER AND FINISHING 

L5320 ABOVE KNEE, MOLDED SOCKET, OPEN END, SACH FOOT, ENDOSKELETAL SYSTEM, SINGLE 

AXIS KNEE, INCLUDING SOFT COVER AND FINISHING 

L5330 HIP DISARTICULATION, CANADIAN TYPE; MOLDED SOCKET, ENDOSKELETAL SYSTEM, HIP 

JOINT, SINGLE AXIS KNEE, SACH FOOT, INCLUDING SOFT COVER AND FINISHING 

L5340 HEMIPELVECTOMY, CANADIAN TYPE; MOLDED SOCKET, ENDOSKELETAL SYSTEM, HIP JOINT, 

SINGLE AXIS KNEE, SACH FOOT, INCLUDING SOFT COVER AND FINISHING 

L5400 IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID 

DRESSING, INCLUDING FITTING, ALIGNMENT, SUSPENSION, AND ONE CAST CHANGE, BELOW 

KNEE 


DRESSING, INCLUDING FITTING, ALIGNMENT AND SUSPENSION, BELOW KNEE, EACH 

ADDITIONAL CAST CHANGE AND REALIGNMENT 


DRESSING, INCLUDING FITTING, ALIGNMENT AND SUSPENSION AND ONE CAST CHANGE 'AK' 

OR KNEE DISARTICULATION 


DRESSING, INCL. FITTING, ALIGNMENT AND SUPENSION, 'AK' OR KNEE DISARTICULATION, 

EACH ADDITIONAL CAST CHANGE AND REALIGNMENT 

L5450 IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF NON-WEIGHT BEARING 

RIGID DRESSING, BELOW KNEE 

L5460 IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF NON-WEIGHT BEARING 

RIGID DRESSING, ABOVE KNEE 

L5500 INITIAL, BELOW KNEE 'PTB' TYPE SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO COVER, 

SACH FOOT, PLASTER SOCKET, DIRECT FORMED 

L5505 INITIAL, ABOVE KNEE - KNEE DISARTICULATION, ISCHIAL LEVEL SOCKET, NON-ALIGNABLE

SYSTEM, PYLON, NO COVER, SACH FOOT, PLASTER SOCKET, DIRECT FORMED 

L5510 PREPARATORY, BELOW KNEE 'PTB' TYPE SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO 

COVER, SACH FOOT, PLASTER SOCKET, MOLDED TO MODEL 


COVER, SACH FOOT, THERMOPLASTIC OR EQUAL, DIRECT FORMED 


COVER, SACH FOOT, THERMOPLASTIC OR EQUAL, MOLDED TO MODEL 

L5535 PREPARATORY, BELOW KNEE 'PTB' TYPE SOCKET, NON-ALIGNABLE SYSTEM, NO COVER, SACH 

FOOT, PREFABRICATED, ADJUSTABLE OPEN END SOCKET 


COVER, SACH FOOT, LAMINATED SOCKET, MOLDED TO MODEL 

L5560 PREPARATORY, ABOVE KNEE- KNEE DISARTICULATION, ISCHIAL LEVEL SOCKET, 

NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, PLASTER SOCKET, MOLDED TO 

MODEL 

L5570 PREPARATORY, ABOVE KNEE - KNEE DISARTICULATION, ISCHIAL LEVEL SOCKET, 

NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, THERMOPLASTIC OR EQUAL, 

DIRECT FORMED 

L5580 PREPARATORY, ABOVE KNEE - KNEE DISARTICULATION ISCHIAL LEVEL SOCKET, 

NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, THERMOPLASTIC OR EQUAL, 

MOLDED TO MODEL 

L5585 PREPARATORY, ABOVE KNEE - KNEE DISARTICULATION, ISCHIAL LEVEL SOCKET, 

NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, PREFABRICATED ADJUSTABLE OPEN 

END SOCKET 

L5590 PREPARATORY, ABOVE KNEE - KNEE DISARTICULATION ISCHIAL LEVEL SOCKET, 

NON-ALIGNABLE SYSTEM, PYLON NO COVER, SACH FOOT, LAMINATED SOCKET, MOLDED TO 

MODEL 

L5595 PREPARATORY, HIP DISARTICULATION-HEMIPELVECTOMY, PYLON, NO COVER, SACH FOOT, 

THERMOPLASTIC OR EQUAL, MOLDED TO PATIENT MODEL 

L5600 PREPARATORY, HIP DISARTICULATION-HEMIPELVECTOMY, PYLON, NO COVER, SACH FOOT, 

LAMINATED SOCKET, MOLDED TO PATIENT MODEL 

L5610 ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE, HYDRACADENCE 

SYSTEM 

L5611 ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE - KNEE 

DISARTICULATION, 4 BAR LINKAGE, WITH FRICTION SWING PHASE CONTROL 

L5613 ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE-KNEE 

DISARTICULATION, 4 BAR LINKAGE, WITH HYDRAULIC SWING PHASE CONTROL 

L5614 ADDITION TO LOWER EXTREMITY, EXOSKELETAL SYSTEM, ABOVE KNEE-KNEE 

DISARTICULATION, 4 BAR LINKAGE, WITH PNEUMATIC SWING PHASE CONTROL 

L5616 ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE, UNIVERSAL 

MULTIPLEX SYSTEM, FRICTION SWING PHASE CONTROL 

L5617 ADDITION TO LOWER EXTREMITY, QUICK CHANGE SELF-ALIGNING UNIT, ABOVE KNEE OR 

BELOW KNEE, EACH 

L5618 ADDITION TO LOWER EXTREMITY, TEST SOCKET, SYMES 

L5620 ADDITION TO LOWER EXTREMITY, TEST SOCKET, BELOW KNEE 

L5622 ADDITION TO LOWER EXTREMITY, TEST SOCKET, KNEE DISARTICULATION 

L5624 ADDITION TO LOWER EXTREMITY, TEST SOCKET, ABOVE KNEE 

L5626 ADDITION TO LOWER EXTREMITY, TEST SOCKET, HIP DISARTICULATION 

L5628 ADDITION TO LOWER EXTREMITY, TEST SOCKET, HEMIPELVECTOMY 

L5629 ADDITION TO LOWER EXTREMITY, BELOW KNEE, ACRYLIC SOCKET 

L5630 ADDITION TO LOWER EXTREMITY, SYMES TYPE, EXPANDABLE WALL SOCKET 

L5631 ADDITION TO LOWER EXTREMITY, ABOVE KNEE OR KNEE DISARTICULATION, ACRYLIC SOCKET 

L5632 ADDITION TO LOWER EXTREMITY, SYMES TYPE, 'PTB' BRIM DESIGN SOCKET 

L5634 ADDITION TO LOWER EXTREMITY, SYMES TYPE, POSTERIOR OPENING (CANADIAN) SOCKET 

L5636 ADDITION TO LOWER EXTREMITY, SYMES TYPE, MEDIAL OPENING SOCKET 

L5637 ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT 

L5638 ADDITION TO LOWER EXTREMITY, BELOW KNEE, LEATHER SOCKET 

L5639 ADDITION TO LOWER EXTREMITY, BELOW KNEE, WOOD SOCKET

L5640 ADDITION TO LOWER EXTREMITY, KNEE DISARTICULATION, LEATHER SOCKET 

L5642 ADDITION TO LOWER EXTREMITY, ABOVE KNEE, LEATHER SOCKET 

L5643 ADDITION TO LOWER EXTREMITY, HIP DISARTICULATION, FLEXIBLE INNER SOCKET, 

EXTERNAL FRAME 

L5644 ADDITION TO LOWER EXTREMITY, ABOVE KNEE, WOOD SOCKET 

L5645 ADDITION TO LOWER EXTREMITY, BELOW KNEE, FLEXIBLE INNER SOCKET, EXTERNAL FRAME 

L5646 ADDITION TO LOWER EXTREMITY, BELOW KNEE, AIR CUSHION SOCKET 

L5647 ADDITION TO LOWER EXTREMITY, BELOW KNEE SUCTION SOCKET 

L5648 ADDITION TO LOWER EXTREMITY, ABOVE KNEE, AIR CUSHION SOCKET 

L5649 ADDITION TO LOWER EXTREMITY, ISCHIAL CONTAINMENT/NARROW M-L SOCKET 

L5650 ADDITIONS TO LOWER EXTREMITY, TOTAL CONTACT, ABOVE KNEE OR KNEE DISARTICULATION 

SOCKET 

L5651 ADDITION TO LOWER EXTREMITY, ABOVE KNEE, FLEXIBLE INNER SOCKET, EXTERNAL FRAME 

L5652 ADDITION TO LOWER EXTREMITY, SUCTION SUSPENSION, ABOVE KNEE OR KNEE 

DISARTICULATION SOCKET 

L5653 ADDITION TO LOWER EXTREMITY, KNEE DISARTICULATION, EXPANDABLE WALL SOCKET 

L5654 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, SYMES, (KEMBLO, PELITE, ALIPLAST, 

PLASTAZOTE OR EQUAL) 

L5655 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, BELOW KNEE (KEMBLO, PELITE, 

ALIPLAST, PLASTAZOTE OR EQUAL) 

L5656 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, KNEE DISARTICULATION (KEMBLO, 

PELITE, ALIPLAST, PLASTAZOTE OR EQUAL) 

L5658 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, ABOVE KNEE (KEMBLO, PELITE, 

ALIPLAST, PLASTAZOTE OR EQUAL) 

L5660 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, SYMES, SILICONE GEL OR EQUAL 

L5661 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, MULTI-DUROMETER SYMES 

L5662 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, BELOW KNEE, SILICONE GEL OR EQUAL 

L5663 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, KNEE DISARTICULATION, SILICONE GEL 

OR EQUAL 

L5664 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, ABOVE KNEE, SILICONE GEL OR EQUAL 

L5665 ADDITION TO LOWER EXTREMITY, SOCKET INSERT, MULTI-DUROMETER, BELOW KNEE 

L5666 ADDITION TO LOWER EXTREMITY, BELOW KNEE, CUFF SUSPENSION 

L5667 ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, SOCKET INSERT, SUCTION 

SUSPENSION WITH LOCKING MECHANISM 

L5668 ADDITION TO LOWER EXTREMITY, BELOW KNEE, MOLDED DISTAL CUSHION 

L5669 ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, SOCKET INSERT, SUCTION 

SUSPENSION WITHOUT LOCKING MECHANISM 

L5670 ADDITION TO LOWER EXTREMITY, BELOW KNEE, MOLDED SUPRACONDYLAR SUSPENSION 

('PTS' OR SIMILAR) 

L5672 ADDITION TO LOWER EXTREMITY, BELOW KNEE, REMOVABLE MEDIAL BRIM SUSPENSION 

L5674 ADDITION TO LOWER EXTREMITY, BELOW KNEE, SUSPENSION SLEEVE, ANY MATERIAL, EACH 

L5675 ADDITION TO LOWER EXTREMITY, BELOW KNEE, SUSPENSION SLEEVE, HEAVY DUTY, ANY 

MATERIAL, EACH 

L5676 ADDITIONS TO LOWER EXTREMITY, BELOW KNEE, KNEE JOINTS, SINGLE AXIS, PAIR 

L5677 ADDITIONS TO LOWER EXTREMITY, BELOW KNEE, KNEE JOINTS, POLYCENTRIC, PAIR 

L5678 ADDITIONS TO LOWER EXTREMITY, BELOW KNEE, JOINT COVERS, PAIR 

L5680 ADDITION TO LOWER EXTREMITY, BELOW KNEE, THIGH LACER, NONMOLDED 

L5682 ADDITION TO LOWER EXTREMITY, BELOW KNEE, THIGH LACER, GLUTEAL/ISCHIAL, MOLDED 

L5684 ADDITION TO LOWER EXTREMITY, BELOW KNEE, FORK STRAP 

L5686 ADDITION TO LOWER EXTREMITY, BELOW KNEE, BACK CHECK (EXTENSION CONTROL) 

L5688 ADDITION TO LOWER EXTREMITY, BELOW KNEE, WAIST BELT, WEBBING 

L5690 ADDITION TO LOWER EXTREMITY, BELOW KNEE, WAIST BELT, PADDED AND LINED 

L5692 ADDITION TO LOWER EXTREMITY, ABOVE KNEE, PELVIC CONTROL BELT, LIGHT 

L5694 ADDITION TO LOWER EXTREMITY, ABOVE KNEE, PELVIC CONTROL BELT, PADDED AND LINED 

L5695 ADDITION TO LOWER EXTREMITY, ABOVE KNEE, PELVIC CONTROL, SLEEVE SUSPENSION, 

NEOPRENE OR EQUAL, EACH 

L5696 ADDITION TO LOWER EXTREMITY, ABOVE KNEE OR KNEE DISARTICULATION, PELVIC JOINT

L5697 ADDITION TO LOWER EXTREMITY, ABOVE KNEE OR KNEE DISARTICULATION, PELVIC BAND 

L5698 ADDITION TO LOWER EXTREMITY, ABOVE KNEE OR KNEE DISARTICULATION, SILESIAN 

BANDAGE 

L5699 ALL LOWER EXTREMITY PROSTHESES, SHOULDER HARNESS 

L5700 REPLACEMENT, SOCKET, BELOW KNEE, MOLDED TO PATIENT MODEL 

L5701 REPLACEMENT, SOCKET, ABOVE KNEE/KNEE DISARTICULATION, INCLUDING ATTACHMENT 

PLATE, MOLDED TO PATIENT MODEL 

L5702 REPLACEMENT, SOCKET, HIP DISARTICULATION, INCLUDING HIP JOINT, MOLDED TO 

PATIENT MODEL 

L5704 REPLACEMENT, CUSTOM SHAPED PROTECTIVE COVER, BELOW KNEE 

L5705 REPLACEMENT, CUSTOM SHAPED PROTECTIVE COVER, ABOVE KNEE 

L5706 REPLACEMENT, CUSTOM SHAPED PROTECTIVE COVER, KNEE DISARTICULATION 

L5707 REPLACEMENT, CUSTOM SHAPED PROTECTIVE COVER, HIP DISARTICULATION 

L5710 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, MANUAL LOCK 

L5711 ADDITIONS EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, MANUAL LOCK, ULTRA-LIGHT 

MATERIAL 

L5712 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FRICTION SWING AND STANCE 

PHASE CONTROL (SAFETY KNEE) 

L5714 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, VARIABLE FRICTION SWING 

PHASE CONTROL 

L5716 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, MECHANICAL STANCE PHASE 

LOCK 

L5718 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, FRICTION SWING AND 

STANCE PHASE CONTROL 

L5722 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, PNEUMATIC SWING, FRICTION 


L5724 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FLUID SWING PHASE CONTROL 

L5726 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, EXTERNAL JOINTS FLUID 

SWING PHASE CONTROL 

L5728 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FLUID SWING AND STANCE 

PHASE CONTROL 

L5780 ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, PNEUMATIC/HYDRA PNEUMATIC 


L5785 ADDITION, EXOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, 

CARBON FIBER OR EQUAL) 

L5790 ADDITION, EXOSKELETAL SYSTEM, ABOVE KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, 


L5795 ADDITION, EXOSKELETAL SYSTEM, HIP DISARTICULATION, ULTRA-LIGHT MATERIAL 

(TITANIUM, CARBON FIBER OR EQUAL) 

L5810 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, MANUAL LOCK 

L5811 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, MANUAL LOCK, ULTRA-LIGHT 

MATERIAL 

L5812 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FRICTION SWING AND STANCE 

PHASE CONTROL (SAFETY KNEE) 

L5814 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, HYDRAULIC SWING PHASE 

CONTROL, MECHANICAL STANCE PHASE LOCK 

L5816 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, MECHANICAL STANCE PHASE 

LOCK 

L5818 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, FRICTION SWING, AND 


L5822 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, PNEUMATIC SWING, FRICTION 


L5824 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FLUID SWING PHASE CONTROL 

L5826 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, HYDRAULIC SWING PHASE 

CONTROL, WITH MINIATURE HIGH ACTIVITY FRAME 

L5828 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FLUID SWING AND STANCE 

PHASE CONTROL

L5830 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, PNEUMATIC/ SWING PHASE 

CONTROL 

L5840 ADDITION, ENDOSKELETAL KNEE/SHIN SYSTEM, 4-BAR LINKAGE OR MULTIAXIAL, PNEUMATIC 


L5845 ADDITION, ENDOSKELETAL, KNEE-SHIN SYSTEM, STANCE FLEXION FEATURE, ADJUSTABLE 

L5846 ADDITION, ENDOSKELETAL, KNEE-SHIN SYSTEM, MICROPROCESSOR CONTROL FEATURE, SWING 

PHASE ONLY 

L5850 ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE OR HIP DISARTICULATION, KNEE 

EXTENSION ASSIST 

L5855 ADDITION, ENDOSKELETAL SYSTEM, HIP DISARTICULATION, MECHANICAL HIP EXTENSION 

ASSIST 

L5910 ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM 

L5920 ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE OR HIP DISARTICULATION, ALIGNABLE 

SYSTEM 

L5925 ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE, KNEE DISARTICULATION OR HIP 

DISARTICULATION, MANUAL LOCK 

L5930 ADDITION, ENDOSKELETAL SYSTEM, HIGH ACTIVITY KNEE CONTROL FRAME 

L5940 ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, 


L5950 ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, 


L5960 ADDITION, ENDOSKELETAL SYSTEM, HIP DISARTICULATION, ULTRA-LIGHT MATERIAL 

(TITANIUM, CARBON FIBER OR EQUAL) 

L5962 ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, FLEXIBLE PROTECTIVE OUTER SURFACE 

COVERING SYSTEM 

L5964 ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE, FLEXIBLE PROTECTIVE OUTER SURFACE 

COVERING SYSTEM 

L5966 ADDITION, ENDOSKELETAL SYSTEM, HIP DISARTICULATION, FLEXIBLE PROTECTIVE OUTER 

SURFACE COVERING SYSTEM 

L5968 ADDITION TO LOWER LIMB PROSTHESIS, MULTIAXIAL ANKLE WITH SWING PHASE ACTIVE 

DORSIFLEXION FEATURE 

L5970 ALL LOWER EXTREMITY PROSTHESES, FOOT, EXTERNAL KEEL, SACH FOOT 

L5972 ALL LOWER EXTREMITY PROSTHESES, FLEXIBLE KEEL FOOT (SAFE, STEN, BOCK DYNAMIC OR 

EQUAL) 

L5974 ALL LOWER EXTREMITY PROSTHESES, FOOT, SINGLE AXIS ANKLE/FOOT 

L5975 ALL LOWER EXTREMITY PROSTHESIS, COMBINATION SINGLE AXIS ANKLE AND FLEXIBLE KEEL 

FOOT 

L5976 ALL LOWER EXTREMITY PROSTHESES, ENERGY STORING FOOT (SEATTLE CARBON COPY II OR 

EQUAL) 

L5978 ALL LOWER EXTREMITY PROSTHESES, FOOT, MULTIAXIAL ANKLE/FOOT 

L5979 ALL LOWER EXTREMITY PROSTHESIS, MULTI-AXIAL ANKLE, DYNAMIC RESPONSE FOOT, ONE 

PIECE SYSTEM 

L5980 ALL LOWER EXTREMITY PROSTHESES, FLEX FOOT SYSTEM 

L5981 ALL LOWER EXTREMITY PROSTHESES, FLEX-WALK SYSTEM OR EQUAL 

L5982 ALL EXOSKELETAL LOWER EXTREMITY PROSTHESES, AXIAL ROTATION UNIT 

L5984 ALL ENDOSKELETAL LOWER EXTREMITY PROSTHESES, AXIAL ROTATION UNIT 

L5985 ALL ENDOSKELETAL LOWER EXTREMITY PROTHESES, DYNAMIC PROSTHETIC PYLON 

L5986 ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ROTATION UNIT ('MCP' OR EQUAL) 

L5987 ALL LOWER EXTREMITY PROSTHESIS, SHANK FOOT SYSTEM WITH VERTICAL LOADING PYLON 

L5988 ADDITION TO LOWER LIMB PROSTHESIS, VERTICAL SHOCK REDUCING PYLON FEATURE 

L5999 LOWER EXTREMITY PROSTHESIS, NOT OTHERWISE SPECIFIED 

L6000 PARTIAL HAND, ROBIN-AIDS, THUMB REMAINING (OR EQUAL) 

L6010 PARTIAL HAND, ROBIN-AIDS, LITTLE AND/OR RING FINGER REMAINING (OR EQUAL) 

L6020 PARTIAL HAND, ROBIN-AIDS, NO FINGER REMAINING (OR EQUAL) 

L6050 WRIST DISARTICULATION, MOLDED SOCKET, FLEXIBLE ELBOW HINGES, TRICEPS PAD 

L6055 WRIST DISARTICULATION, MOLDED SOCKET WITH EXPANDABLE INTERFACE, FLEXIBLE ELBOW 

HINGES, TRICEPS PAD

L6100 BELOW ELBOW, MOLDED SOCKET, FLEXIBLE ELBOW HINGE, TRICEPS PAD 

L6110 BELOW ELBOW, MOLDED SOCKET, (MUENSTER OR NORTHWESTERN SUSPENSION TYPES) 

L6120 BELOW ELBOW, MOLDED DOUBLE WALL SPLIT SOCKET, STEP-UP HINGES, HALF CUFF 

L6130 BELOW ELBOW, MOLDED DOUBLE WALL SPLIT SOCKET, STUMP ACTIVATED LOCKING HINGE, 

HALF CUFF 

L6200 ELBOW DISARTICULATION, MOLDED SOCKET, OUTSIDE LOCKING HINGE, FOREARM 

L6205 ELBOW DISARTICULATION, MOLDED SOCKET WITH EXPANDABLE INTERFACE, OUTSIDE LOCKING 

HINGES, FOREARM 

L6250 ABOVE ELBOW, MOLDED DOUBLE WALL SOCKET, INTERNAL LOCKING ELBOW, FOREARM 

L6300 SHOULDER DISARTICULATION, MOLDED SOCKET, SHOULDER BULKHEAD, HUMERAL SECTION, 

INTERNAL LOCKING ELBOW, FOREARM 

L6310 SHOULDER DISARTICULATION, PASSIVE RESTORATION (COMPLETE PROSTHESIS) 

L6320 SHOULDER DISARTICULATION, PASSIVE RESTORATION (SHOULDER CAP ONLY) 

L6350 INTERSCAPULAR THORACIC, MOLDED SOCKET, SHOULDER BULKHEAD, HUMERAL SECTION, 

INTERNAL LOCKING ELBOW, FOREARM 

L6360 INTERSCAPULAR THORACIC, PASSIVE RESTORATION (COMPLETE PROSTHESIS) 

L6370 INTERSCAPULAR THORACIC, PASSIVE RESTORATION (SHOULDER CAP ONLY) 


DRESSING, INCLUDING FITTING ALIGNMENT AND SUSPENSION OF COMPONENTS, AND ONE 

CAST CHANGE, WRIST DISARTICULATION OR BELOW ELBOW 

L6382 IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING 

INCLUDING FITTING ALIGNMENT AND SUSPENSION OF COMPONENTS, AND ONE CAST CHANGE, 

ELBOW DISARTICULATION OR ABOVE ELBOW 

L6384 IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING 

INCLUDING FITTING ALIGNMENT AND SUSPENSION OF COMPONENTS, AND ONE CAST CHANGE, 

SHOULDER DISARTICULATION OR INTERSCAPULAR THORACIC 

L6386 IMMEDIATE POST SURGICAL OR EARLY FITTING, EACH ADDITIONAL CAST CHANGE AND 

REALIGNMENT 

L6388 IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF RIGID DRESSING ONLY 

L6400 BELOW ELBOW, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT PROSTHETIC 

TISSUE SHAPING 

L6450 ELBOW DISARTICULATION, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT 

PROSTHETIC TISSUE SHAPING 

L6500 ABOVE ELBOW, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT PROSTHETIC 

TISSUE SHAPING 

L6550 SHOULDER DISARTICULATION, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT 


L6570 INTERSCAPULAR THORACIC, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT 


L6580 PREPARATORY, WRIST DISARTICULATION OR BELOW ELBOW, SINGLE WALL PLASTIC SOCKET, 

FRICTION WRIST, FLEXIBLE ELBOW HINGES, FIGURE OF EIGHT HARNESS, HUMERAL CUFF, 

BOWDEN CABLE CONTROL, USMC OR EQUAL PYLON, NO COVER, MOLDED TO PATIENT MODEL 

L6582 PREPARATORY, WRIST DISARTICULATION OR BELOW ELBOW, SINGLE WALL SOCKET, FRICTION 

WRIST, FLEXIBLE ELBOW HINGES, FIGURE OF EIGHT HARNESS, HUMERAL CUFF, BOWDEN 

CABLE CONTROL, USMC OR EQUAL PYLON, NO COVER, DIRECT FORMED 

L6584 PREPARATORY, ELBOW DISARTICULATION OR ABOVE ELBOW, SINGLE WALL PLASTIC SOCKET, 

FRICTION WRIST, LOCKING ELBOW, FIGURE OF EIGHT HARNESS, FAIR LEAD CABLE 

CONTROL, USMC OR EQUAL PYLON, NO COVER, MOLDED TO PATIENT MODEL 

L6586 PREPARATORY, ELBOW DISARTICULATION OR ABOVE ELBOW, SINGLE WALL SOCKET, FRICTION 

WRIST, LOCKING ELBOW, FIGURE OF EIGHT HARNESS, FAIR LEAD CABLE CONTROL, USMC OR 

EQUAL PYLON, NO COVER, DIRECT FORMED 

L6588 PREPARATORY, SHOULDER DISARTICULATION OR INTERSCAPULAR THORACIC, SINGLE WALL 

PLASTIC SOCKET, SHOULDER JOINT, LOCKING ELBOW, FRICTION WRIST, CHEST STRAP, 

FAIR LEAD CABLE CONTROL, USMC OR EQUAL PYLON, NO COVER, MOLDED TO PATIENT MODEL 

L6590 PREPARATORY, SHOULDER DISARTICULATION OR INTERSCAPULAR THORACIC, SINGLE WALL 

SOCKET, SHOULDER JOINT, LOCKING ELBOW, FRICTION WRIST, CHEST STRAP, FAIR LEAD 

CABLE CONTROL, USMC OR EQUAL PYLON, NO COVER, DIRECT FORMED

L6600 UPPER EXTREMITY ADDITIONS, POLYCENTRIC HINGE, PAIR 

L6605 UPPER EXTREMITY ADDITIONS, SINGLE PIVOT HINGE, PAIR 

L6610 UPPER EXTREMITY ADDITIONS, FLEXIBLE METAL HINGE, PAIR 

L6615 UPPER EXTREMITY ADDITION, DISCONNECT LOCKING WRIST UNIT 

L6616 UPPER EXTREMITY ADDITION, ADDITIONAL DISCONNECT INSERT FOR LOCKING WRIST UNIT, 

EACH 

L6620 UPPER EXTREMITY ADDITION, FLEXION-FRICTION WRIST UNIT 

L6623 UPPER EXTREMITY ADDITION, SPRING ASSISTED ROTATIONAL WRIST UNIT WITH LATCH 

RELEASE 

L6625 UPPER EXTREMITY ADDITION, ROTATION WRIST UNIT WITH CABLE LOCK 

L6628 UPPER EXTREMITY ADDITION, QUICK DISCONNECT HOOK ADAPTER, OTTO BOCK OR EQUAL 

L6629 UPPER EXTREMITY ADDITION, QUICK DISCONNECT LAMINATION COLLAR WITH COUPLING 

PIECE, OTTO BOCK OR EQUAL 

L6630 UPPER EXTREMITY ADDITION, STAINLESS STEEL, ANY WRIST 

L6632 UPPER EXTREMITY ADDITION, LATEX SUSPENSION SLEEVE, EACH 

L6635 UPPER EXTREMITY ADDITION, LIFT ASSIST FOR ELBOW 

L6637 UPPER EXTREMITY ADDITION, NUDGE CONTROL ELBOW LOCK 

L6640 UPPER EXTREMITY ADDITIONS, SHOULDER ABDUCTION JOINT, PAIR 

L6641 UPPER EXTREMITY ADDITION, EXCURSION AMPLIFIER, PULLEY TYPE 

L6642 UPPER EXTREMITY ADDITION, EXCURSION AMPLIFIER, LEVER TYPE 

L6645 UPPER EXTREMITY ADDITION, SHOULDER FLEXION-ABDUCTION JOINT, EACH 

L6650 UPPER EXTREMITY ADDITION, SHOULDER UNIVERSAL JOINT, EACH 

L6655 UPPER EXTREMITY ADDITION, STANDARD CONTROL CABLE, EXTRA 

L6660 UPPER EXTREMITY ADDITION, HEAVY DUTY CONTROL CABLE 

L6665 UPPER EXTREMITY ADDITION, TEFLON, OR EQUAL, CABLE LINING 

L6670 UPPER EXTREMITY ADDITION, HOOK TO HAND, CABLE ADAPTER 

L6672 UPPER EXTREMITY ADDITION, HARNESS, CHEST OR SHOULDER, SADDLE TYPE 

L6675 UPPER EXTREMITY ADDITION, HARNESS, FIGURE OF ('8') EIGHT TYPE, FOR SINGLE 

CONTROL 

L6676 UPPER EXTREMITY ADDITION, HARNESS, FIGURE OF ('8') EIGHT TYPE, FOR DUAL 

CONTROL 

L6680 UPPER EXTREMITY ADDITION, TEST SOCKET, WRIST DISARTICULATION OR BELOW ELBOW 

L6682 UPPER EXTREMITY ADDITION, TEST SOCKET, ELBOW DISARTICULATION OR ABOVE ELBOW 

L6684 UPPER EXTREMITY ADDITION, TEST SOCKET, SHOULDER DISARTICULATION OR 

INTERSCAPULAR THORACIC 

L6686 UPPER EXTREMITY ADDITION, SUCTION SOCKET 

L6687 UPPER EXTREMITY ADDITION, FRAME TYPE SOCKET, BELOW ELBOW OR WRIST 

DISARTICULATION 

L6688 UPPER EXTREMITY ADDITION, FRAME TYPE SOCKET, ABOVE ELBOW OR ELBOW 

DISARTICULATION 

L6689 UPPER EXTREMITY ADDITION, FRAME TYPE SOCKET, SHOULDER DISARTICULATION 

L6690 UPPER EXTREMITY ADDITION, FRAME TYPE SOCKET, INTERSCAPULAR-THORACIC 

L6691 UPPER EXTREMITY ADDITION, REMOVABLE INSERT, EACH 

L6692 UPPER EXTREMITY ADDITION, SILICONE GEL INSERT OR EQUAL, EACH 

L6693 UPPER EXTREMITY ADDITION, LOCKING ELBOW, FOREARM COUNTERBALANCE 

L6700 TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #3 


L6710 TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #5X 

L6715 TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #5XA 



L6730 TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #7LO 




L6750 TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #10P 

L6755 TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #10X

L6765 TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #12P 



L6780 TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #SS555 

L6790 TERMINAL DEVICE, HOOK-ACCU HOOK, OR EQUAL 

L6795 TERMINAL DEVICE, HOOK-2 LOAD, OR EQUAL 

L6800 TERMINAL DEVICE, HOOK-APRL VC, OR EQUAL 

L6805 TERMINAL DEVICE, MODIFIER WRIST FLEXION UNIT 

L6806 TERMINAL DEVICE, HOOK, TRS GRIP, GRIP III, VC, OR EQUAL 

L6807 TERMINAL DEVICE, HOOK, GRIP I, GRIP II, VC, OR EQUAL 

L6808 TERMINAL DEVICE, HOOK, TRS ADEPT, INFANT OR CHILD, VC, OR EQUAL 

L6809 TERMINAL DEVICE, HOOK, TRS SUPER SPORT, PASSIVE 

L6810 TERMINAL DEVICE, PINCHER TOOL, OTTO BOCK OR EQUAL 

L6825 TERMINAL DEVICE, HAND, DORRANCE, VO 

L6830 TERMINAL DEVICE, HAND, APRL, VC 

L6835 TERMINAL DEVICE, HAND, SIERRA, VO 

L6840 TERMINAL DEVICE, HAND, BECKER IMPERIAL 

L6845 TERMINAL DEVICE, HAND, BECKER LOCK GRIP 

L6850 TERMINAL DEVICE, HAND, BECKER PLYLITE 

L6855 TERMINAL DEVICE, HAND, ROBIN-AIDS, VO 

L6860 TERMINAL DEVICE, HAND, ROBIN-AIDS, VO SOFT 

L6865 TERMINAL DEVICE, HAND, PASSIVE HAND 

L6867 TERMINAL DEVICE, HAND, DETROIT INFANT HAND (MECHANICAL) 

L6868 TERMINAL DEVICE, HAND, PASSIVE INFANT HAND, (STEEPER, HOSMER OR EQUAL) 

L6870 TERMINAL DEVICE, HAND, CHILD MITT 

L6872 TERMINAL DEVICE, HAND, NYU CHILD HAND 

L6873 TERMINAL DEVICE, HAND, MECHANICAL INFANT HAND, STEEPER OR EQUAL 

L6875 TERMINAL DEVICE, HAND, BOCK, VC 

L6880 TERMINAL DEVICE, HAND, BOCK, VO 

L6890 TERMINAL DEVICE, GLOVE FOR ABOVE HANDS, PRODUCTION GLOVE 

L6895 TERMINAL DEVICE, GLOVE FOR ABOVE HANDS, CUSTOM GLOVE 

L6900 HAND RESTORATION (CASTS, SHADING AND MEASUREMENTS INCLUDED), PARTIAL HAND, WITH 

GLOVE, THUMB OR ONE FINGER REMAINING 


GLOVE, MULTIPLE FINGERS REMAINING 


GLOVE, NO FINGERS REMAINING 

L6915 HAND RESTORATION (SHADING, AND MEASUREMENTS INCLUDED), REPLACEMENT GLOVE FOR 

ABOVE 

L6920 WRIST DISARTICULATION, EXTERNAL POWER, SELF-SUSPENDED INNER SOCKET, REMOVABLE 

FOREARM SHELL, OTTO BOCK OR EQUAL, SWITCH, CABLES, TWO BATTERIES AND ONE 

CHARGER, SWITCH CONTROL OF TERMINAL DEVICE 

L6925 WRIST DISARTICULATION, EXTERNAL POWER, SELF-SUSPENDED INNER SOCKET, REMOVABLE 

FOREARM SHELL, OTTO BOCK OR EQUAL ELECTRODES, CABLES, TWO BATTERIES AND ONE 

CHARGER, MYOELECTRONIC CONTROL OF TERMINAL DEVICE 

L6930 BELOW ELBOW, EXTERNAL POWER, SELF-SUSPENDED INNER SOCKET, REMOVABLE FOREARM 

SHELL, OTTO BOCK OR EQUAL SWITCH, CABLES, TWO BATTERIES AND ONE CHARGER, SWITCH 

CONTROL OF TERMINAL DEVICE 

L6935 BELOW ELBOW, EXTERNAL POWER, SELF-SUSPENDED INNER SOCKET, REMOVABLE FOREARM 

SHELL, OTTO BOCK OR EQUAL ELECTRODES, CABLES, TWO BATTERIES AND ONE CHARGER, 

MYOELECTRONIC CONTROL OF TERMINAL DEVICE 

L6940 ELBOW DISARTICULATION, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE HUMERAL 

SHELL, OUTSIDE LOCKING HINGES, FOREARM, OTTO BOCK OR EQUAL SWITCH, CABLES, TWO 

BATTERIES AND ONE CHARGER, SWITCH CONTROL OF TERMINAL DEVICE 

L6945 ELBOW DISARTICULATION, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE HUMERAL 

SHELL, OUTSIDE LOCKING HINGES, FOREARM, OTTO BOCK OR EQUAL ELECTRODES, CABLES, 

TWO BATTERIES AND ONE CHARGER, MYOELECTRONIC CONTROL OF TERMINAL DEVICE

L6950 ABOVE ELBOW, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE HUMERAL SHELL, 

INTERNAL LOCKING ELBOW, FOREARM, OTTO BOCK OR EQUAL SWITCH, CABLES, TWO 

BATTERIES AND ONE CHARGER, SWITCH CONTROL OF TERMINAL DEVICE 

L6955 ABOVE ELBOW, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE HUMERAL SHELL, 

INTERNAL LOCKING ELBOW, FOREARM, OTTO BOCK OR EQUAL ELECTRODES, CABLES, TWO 

BATTERIES AND ONE CHARGER, MYOELECTRONIC CONTROL OF TERMINAL DEVICE 

L6960 SHOULDER DISARTICULATION, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE 

SHOULDER SHELL, SHOULDER BULKHEAD, HUMERAL SECTION, MECHANICAL ELBOW, FOREARM, 

OTTO BOCK OR EQUAL SWITCH, CABLES, TWO BATTERIES AND ONE CHARGER, SWITCH 


L6965 SHOULDER DISARTICULATION, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE 

SHOULDER SHELL, SHOULDER BULKHEAD, HUMERAL SECTION, MECHANICAL ELBOW, FOREARM, 

OTTO BOCK OR EQUAL ELECTRODES, CABLES, TWO BATTERIES AND ONE CHARGER, 

MYOELECTRONIC CONTROL OF TERMINAL DEVICE 

L6970 INTERSCAPULAR-THORACIC, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE SHOULDER 

SHELL, SHOULDER BULKHEAD, HUMERAL SECTION, MECHANICAL ELBOW, FOREARM, OTTO BOCK 

OR EQUAL SWITCH, CABLES, TWO BATTERIES AND ONE CHARGER, SWITCH CONTROL OF 

TERMINAL DEVICE 

L6975 INTERSCAPULAR-THORACIC, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE SHOULDER 

SHELL, SHOULDER BULKHEAD, HUMERAL SECTION, MECHANICAL ELBOW, FOREARM, OTTO BOCK 

OR EQUAL ELECTRODES, CABLES, TWO BATTERIES AND ONE CHARGER, MYOELECTRONIC 


L7010 ELECTRONIC HAND, OTTO BOCK, STEEPER OR EQUAL, SWITCH CONTROLLED 

L7015 ELECTRONIC HAND, SYSTEM TEKNIK, VARIETY VILLAGE OR EQUAL, SWITCH CONTROLLED 

L7020 ELECTRONIC GREIFER, OTTO BOCK OR EQUAL, SWITCH CONTROLLED 

L7025 ELECTRONIC HAND, OTTO BOCK OR EQUAL, MYOELECTRONICALLY CONTROLLED 

L7030 ELECTRONIC HAND, SYSTEM TEKNIK, VARIETY VILLAGE OR EQUAL, MYOELECTRONICALLY 

CONTROLLED 

L7035 ELECTRONIC GREIFER, OTTO BOCK OR EQUAL, MYOELECTRONICALLY CONTROLLED 

L7040 PREHENSILE ACTUATOR, HOSMER OR EQUAL, SWITCH CONTROLLED 

L7045 ELECTRONIC HOOK, CHILD, MICHIGAN OR EQUAL, SWITCH CONTROLLED 

L7170 ELECTRONIC ELBOW, HOSMER OR EQUAL, SWITCH CONTROLLED 

L7180 ELECTRONIC ELBOW, BOSTON, UTAH OR EQUAL, MYOELECTRONICALLY CONTROLLED 

L7185 ELECTRONIC ELBOW, ADOLESCENT, VARIETY VILLAGE OR EQUAL, SWITCH CONTROLLED 

L7186 ELECTRONIC ELBOW, CHILD, VARIETY VILLAGE OR EQUAL, SWITCH CONTROLLED 

L7190 ELECTRONIC ELBOW, ADOLESCENT, VARIETY VILLAGE OR EQUAL, MYOELECTRONICALLY 

CONTROLLED 

L7191 ELECTRONIC ELBOW, CHILD, VARIETY VILLAGE OR EQUAL, MYOELECTRONICALLY CONTROLLED 

L7260 ELECTRONIC WRIST ROTATOR, OTTO BOCK OR EQUAL 

L7261 ELECTRONIC WRIST ROTATOR, FOR UTAH ARM 

L7266 SERVO CONTROL, STEEPER OR EQUAL 

L7272 ANALOGUE CONTROL, UNB OR EQUAL 

L7274 PROPORTIONAL CONTROL, 6-12 VOLT, LIBERTY, UTAH OR EQUAL 

L7360 SIX VOLT BATTERY, OTTO BOCK OR EQUAL, EACH 

L7362 BATTERY CHARGER, SIX VOLT, OTTO BOCK OR EQUAL 

L7364 TWELVE VOLT BATTERY, UTAH OR EQUAL, EACH 

L7366 BATTERY CHARGER, TWELVE VOLT, UTAH OR EQUAL 

L7499 UPPER EXTREMITY PROSTHESIS, NOT OTHERWISE SPECIFIED 

L7500 REPAIR OF PROSTHETIC DEVICE, HOURLY RATE (EXCLUDES V5335 REPAIR OF ORAL OR 

LARYNGEAL PROSTHESIS OR ARTIFICIAL LARYNX) 

L7510 REPAIR OF PROSTHETIC DEVICE, REPAIR OR REPLACE MINOR PARTS (EXCLUDES V5335 

REPAIR OF ORAL OR LARYNGEAL PROSTHESIS OR ARTIFICIAL LARYNX) 

L7520 REPAIR PROSTHETIC DEVICE, LABOR COMPONENT, PER 15 MINUTES 

L7900 VACUUM ERECTION SYSTEM 

L8000 BREAST PROSTHESIS, MASTECTOMY BRA 

L8010 BREAST PROSTHESIS, MASTECTOMY SLEEVE 

L8015 EXTERNAL BREAST PROSTHESIS GARMENT, WITH MASTECTOMY FORM, POST MASTECTOMY

L8020 BREAST PROSTHESIS, MASTECTOMY FORM 

L8030 BREAST PROSTHESIS, SILICONE OR EQUAL 

L8035 CUSTOM BREAST PROSTHESIS, POST MASTECTOMY, MOLDED TO PATIENT MODEL 

L8039 BREAST PROSTHESIS, NOT OTHERWISE SPECIFIED 

L8040 NASAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN 

L8041 MIDFACIAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN 

L8042 ORBITAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN 

L8043 UPPER FACIAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN 

L8044 HEMI-FACIAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN 

L8045 AURICULAR PROSTHESIS, PROVIDED BY A NON-PHYSICIAN 

L8046 PARTIAL FACIAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN 

L8047 NASAL SEPTAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN 

L8048 UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT, PROVIDED BY A NON-PHYSICIAN 

L8049 REPAIR OR MODIFICATION OF MAXILLOFACIAL PROSTHESIS, LABOR COMPONENT, 15 MINUTE 

INCREMENTS, PROVIDED BY A NON-PHYSICIAN 

L8100 GRADIENT COMPRESSION STOCKING, BELOW KNEE, 18-30 MMHG, EACH 



L8130 GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 18-30 MMHG, EACH 



L8160 GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 18-30 MMHG, EACH 



L8190 GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 18-30 MMHG, EACH 



L8210 GRADIENT COMPRESSION STOCKING, CUSTOM MADE 

L8220 GRADIENT COMPRESSION STOCKING, LYMPHEDEMA 

L8230 GRADIENT COMPRESSION STOCKING, GARTER BELT 

L8239 GRADIENT COMPRESSION STOCKING, NOT OTHERWISE SPECIFIED 

L8300 TRUSS, SINGLE WITH STANDARD PAD 

L8310 TRUSS, DOUBLE WITH STANDARD PADS 

L8320 TRUSS, ADDITION TO STANDARD PAD, WATER PAD 

L8330 TRUSS, ADDITION TO STANDARD PAD, SCROTAL PAD 

L8400 PROSTHETIC SHEATH, BELOW KNEE, EACH 

L8410 PROSTHETIC SHEATH, ABOVE KNEE, EACH 

L8415 PROSTHETIC SHEATH, UPPER LIMB, EACH 

L8417 PROSTHETIC SHEATH/SOCK, INCLUDING A GEL CUSHION LAYER, BELOW KNEE OR ABOVE 

KNEE, EACH 

L8420 PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH 

L8430 PROSTHETIC SOCK, MULTIPLE PLY, ABOVE KNEE, EACH 

L8435 PROSTHETIC SOCK, MULTIPLE PLY, UPPER LIMB, EACH 

L8440 PROSTHETIC SHRINKER, BELOW KNEE, EACH 

L8460 PROSTHETIC SHRINKER, ABOVE KNEE, EACH 

L8465 PROSTHETIC SHRINKER, UPPER LIMB, EACH 

L8470 PROSTHETIC SOCK, SINGLE PLY, FITTING, BELOW KNEE, EACH 

L8480 PROSTHETIC SOCK, SINGLE PLY, FITTING, ABOVE KNEE, EACH 

L8485 PROSTHETIC SOCK, SINGLE PLY, FITTING, UPPER LIMB, EACH 

L8490 ADDITION TO PROSTHETIC SHEATH/SOCK, AIR SEAL SUCTION RETENTION SYSTEM 

L8499 UNLISTED PROCEDURE FOR MISCELLANEOUS PROSTHETIC SERVICES 

L8500 ARTIFICIAL LARYNX, ANY TYPE 

L8501 TRACHEOSTOMY SPEAKING VALVE 

L8600 IMPLANTABLE BREAST PROSTHESIS, SILICONE OR EQUAL 

L8603 INJECTABLE BULKING AGENT, COLLAGEN IMPLANT, URINARY TRACT, 2.5 ML SYRINGE, 

INCLUDES SHIPPING AND NECESSARY SUPPLIES 

L8605 TISSUE EXPANDER IMPLANT

L8606 INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, 

INCLUDES SHIPPING AND NECESSARY SUPPLIES 

L8610 OCULAR IMPLANT 

L8611 ORBITAL IMPLANT 

L8612 AQUEOUS SHUNT 

L8613 OSSICULA IMPLANT 

L8614 COCHLEAR DEVICE/SYSTEM 

L8615 TEMPOROMANDIBULAR JOINT IMPLANT 

L8616 MAXILLA IMPLANT 

L8617 MANDIBLE IMPLANT 

L8618 PALATE IMPLANT 

L8619 COCHLEAR IMPLANT EXTERNAL SPEECH PROCESSOR, REPLACEMENT 

L8620 RADIAL HEAD IMPLANT 

L8621 DISTAL HUMERUS IMPLANT 

L8622 PROXIMAL ULNA/RADIUS IMPLANT 

L8623 DISTAL ULNA IMPLANT 

L8624 DISTAL RADIUS IMPLANT 

L8625 TRAPEZIUM IMPLANT 

L8626 WRIST IMPLANT 

L8627 LUNATE IMPLANT 

L8628 CARPUS IMPLANT 

L8629 SCAPHOID IMPLANT 

L8630 METACARPOPHALANGEAL JOINT IMPLANT 

L8640 PATELLA IMPLANT 

L8641 METATARSAL JOINT IMPLANT 

L8642 HALLUX IMPLANT 

L8655 FLEXOR TENDON IN HAND OR FINGER, IMPLANT 

L8656 EXTENSOR TENDON IN HAND OR FINGER, IMPLANT 

L8657 TENDON OTHER THAN HAND OR FINGER, IMPLANT 

L8658 INTERPHALANGEAL JOINT IMPLANT 

L8670 VASCULAR GRAFT MATERIAL, SYNTHETIC, IMPLANT 

L8680 BILIARY STENT, ENDOPROSTHESIS (PERMANENT), IMPLANT 

L8690 TESTICLE IMPLANT 

L8699 PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED 

L9900 ORTHOTIC AND PROSTHETIC SUPPLY, ACCESSORY, AND/OR SERVICE COMPONENT OF ANOTHER 

HCPCS ”L” CODE 

M0005 OFFICE VISITS WITH TWO OR MORE MODALITIES TO THE SAME AREA, INITIAL 30 MINUTES, 

EACH VISIT. 

M0006 OFFICE VISITS WITH ONE OF THE ABOVE MENTIONED TREATMENT MODALITIES, EACH 

ADDITIONAL 15 MINUTES 

M0007 OFFICE VISITS INCLUDING COMBINATION OF ANY MODALITY(S) AND PROCEDURE(S), 

INITIAL 30 MINUTES, EACH VISIT. 

M0008 OFFICE VISIT INCLUDING COMBINATION OF ANY MODALITY(S) AND PROCEDURE(S), EACH 

ADDITIONAL 15 MINUTES 

M0064 BRIEF OFFICE VISIT FOR THE SOLE PURPOSE OF MONITORING OR CHANGING DRUG 

PRESCRIPTIONS USED IN THE TREATMENT OF MENTAL PSYCHONEUROTIC AND PERSONALITY 

DISORDERS 

M0075 CELLULAR THERAPY 

M0076 PROLOTHERAPY 

M0100 INTRAGASTRIC HYPOTHERMIA USING GASTRIC FREEZING (MNP) 

M0101 CUTTING OR REMOVAL OF CORNS, CALLUSES AND/OR TRIMMING OF NAILS, APPLICATION OF 

SKIN CREAMS AND OTHER HYGIENIC AND PREVENTIVE MAINTENANCE CARE (EXCLUDES 

DEBRIDEMENT OF NAIL(S) 

M0300 IV CHELATION THERAPY (CHEMICAL ENDARTERECTOMY) 

M0301 FABRIC WRAPPING OF ABDOMINAL ANEURYSM (MNP) 

M0302 ASSESSMENT OF CARDIAC OUTPUT BY ELECTRICAL BIOIMPEDANCE 

P2028 CEPHALIN FLOCULATION, BLOOD

P2029 CONGO RED, BLOOD 

P2031 HAIR ANALYSIS (EXCLUDING ARSENIC) 

P2033 THYMOL TURBIDITY, BLOOD 

P2038 MUCOPROTEIN, BLOOD (SEROMUCOID) (MEDICAL NECESSITY PROCEDURE) 

P3000 SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, BY 

TECHNICIAN UNDER PHYSICIAN SUPERVISION 

P3001 SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, 

REQUIRING INTERPRETATION BY PHYSICIAN 

P7001 CULTURE, BACTERIAL, URINE; QUANTITATIVE, SENSITIVITY STUDY 

P9010 BLOOD (WHOLE), FOR TRANSFUSION, PER UNIT 

P9011 BLOOD (SPLIT UNIT), SPECIFY AMOUNT 

P9012 CRYOPRECIPITATE, EACH UNIT 

P9013 FIBRINOGEN UNIT 

P9014 GLOBULIN, GAMMA, 1 ML. 

P9015 GLOBULIN, RH IMMUNE, 1 ML. 

P9016 RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT 

P9017 FRESH FROZEN PLASMA (SINGLE DONOR), EACH UNIT 

P9018 PLASMA PROTEIN FRACTION, EACH UNIT 

P9019 PLATELETS, EACH UNIT 

P9020 PLATELET RICH PLASMA, EACH UNIT 

P9021 RED BLOOD CELLS, EACH UNIT 

P9022 RED BLOOD CELLS, WASHED, EACH UNIT 

P9023 PLASMA, POOLED MULTIPLE DONOR, SOLVENT/DETERGENT TREATED, FROZEN, EACH UNIT 

P9031 PLATELETS, LEUKOCYTES REDUCED, EACH UNIT 

P9032 PLATELETS, IRRADIATED, EACH UNIT 

P9033 PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT 

P9034 PLATELETS, PHERESIS, EACH UNIT 

P9035 PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT 

P9036 PLATELETS, PHERESIS, IRRADIATED, EACH UNIT 

P9037 PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT 

P9038 RED BLOOD CELLS, IRRADIATED, EACH UNIT 

P9039 RED BLOOD CELLS, DEGLYCEROLIZED, EACH UNIT 

P9040 RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT 

P9041 INFUSION, ALBUMIN (HUMAN), 5%, 50 ML 

P9042 INFUSION, ALBUMIN (HUMAN), 25%, 10 ML 

P9043 INFUSION, PLASMA PROTEIN FRACTION (HUMAN), 5%, 50 ML 

P9044 PLASMA, CRYOPRECIPITATE REDUCED, EACH UNIT 

P9603 TRAVEL ALLOWANCE ONE WAY IN CONNECTION WITH MEDICALLY NECESSARY LABORATORY 

SPECIMEN COLLECTION DRAWN FROM HOME BOUND OR NURSING HOME BOUND PATIENT; 

PRORATED MILES ACTUALLY TRAVELLED. 

P9604 TRAVEL ALLOWANCE ONE WAY IN CONNECTION WITH MEDICALLY NECESSARY LABORATORY 

SPECIMEN COLLECTION DRAWN FROM HOME BOUND OR NURSING HOME BOUND PATIENT; 

PRORATED TRIP CHARGE. 

P9610 CATHETERIZATION FOR COLLECTION OF SPECIMEN (S), SINGLE HOME BOUND, NURSING 

HOME, OR SNF PATIENT 

P9612 CATHETERIZATION FOR COLLECTION OF SPECIMEN, SINGLE PATIENT, ALL PLACES OF 

SERVICE 

P9615 CATHETERIZATION FOR COLLECTION OF SPECIMEN (S) (MULTIPLE PATIENTS) 

Q0034 ADMINISTRATION OF INFLUENZA VACCINE TO MEDICARE BENEFICIARIES BY PARTICIPATING 

DEMONSTRATION SITES 

Q0035 CARDIOKYMOGRAPHY 

Q0068 EXTRACORPOREAL PLASMAPHERESIS: IMMUNOADSORPTION WITH STAPHYLOCOCCAL PROTEIN A 

COLUMNS 

Q0081 INFUSION THERAPY, USING OTHER THAN CHEMOTHERAPEUTIC DRUGS, PER VISIT 

Q0082 ACTIVITY THERAPY FURNISHED IN CONNECTION WITH PARTIAL HOSPITALIZATION (EG 

MUSIC, DANCE, ART OR PLAY THERAPIES THAT ARE NOT PRIMARILY RECREATIONAL), PER 

VISIT

Q0083 CHEMOTHERAPY ADMINISTRATION BY OTHER THAN INFUSION TECHNIQUE ONLY (EG 

SUBCUTANEOUS, INTRAMUSCULAR, PUSH), PER VISIT 

Q0084 CHEMOTHERAPY ADMINISTRATION BY INFUSION TECHNIQUE ONLY, PER VISIT 

Q0085 CHEMOTHERAPY ADMINISTRATION BY BOTH INFUSION TECHNIQUE AND OTHER TECHIQUE(S) 

(EG SUBCUTANEOUS, INTRAMUSCULAR, PUSH), PER VISIT 

Q0086 PHYSICAL THERAPY EVALUATION/TREATMENT, PER VISIT 

Q0091 SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVEYANCE OF CERVICAL 

OR VAGINAL SMEAR TO LABORATORY 

Q0092 SET-UP PORTABLE X-RAY EQUIPMENT 

Q0103 PHYSICAL THERAPY EVALUATION, INITIAL 

Q0104 PHYSICAL THERAPY RE-EVALUATION, PERIODIC 

Q0109 OCCUPATIONAL THERAPY EVALUATION, INITIAL 

Q0110 OCCUPATIONAL THERAPY RE-EVALUATION, PERIODIC 

Q0111 WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS 

Q0112 ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS 

Q0113 PINWORM EXAMINATIONS 

Q0114 FERN TEST 

Q0115 POST-COITAL DIRECT, QUALITATIVE EXAMINATIONS OF VAGINAL OR CERVICAL MUCOUS 

Q0132 DISPENSING FEE FOR COVERED DRUG ADMINISTERED THROUGH DME NEBULIZER 

Q0136 INJECTION, EPOETIN ALPHA, (FOR NON ESRD USE), PER 1000 UNITS 

Q0144 AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM 

Q0156 INFUSION, ALBUMIN (HUMAN), 5%, 500 ML 

Q0157 INFUSION, ALBUMIN (HUMAN), 25%, 50 ML 

Q0158 IMMUNIZATION, ACTIVE, HEPATITIS B AND HEMOPHILUS INFLUENZA TYPE B (HIB) VACCINE 

Q0159 INJECTION, ADENOSINE, 90MG (NOT TO BE USED TO REPORT ADENOSINE PHOSPHATE 


Q0160 FACTOR IX (ANTIHEMOPHILIC FACTOR, PURIFIED, NON-RECOMBINANT) PER I.U. 

Q0161 FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U. 

Q0162 CATHERIZATION FOR COLLECTION OF SPECIMEN(S), SINGLE PATIENT, ALL PLACES OF 

SERVICE 

Q0163 DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION 

ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC 

AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN 

Q0164 PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, 

FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME 

OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN 

Q0165 PROCHLORPERAZINE MALEATE, 10 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, 



Q0166 GRANISETRON HYDROCHLORIDE, 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, 



Q0167 DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A 

COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF 

CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN 

Q0168 DRONABINOL, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A 



Q0169 PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION 


AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN 

Q0170 PROMETHAZINE HYDROCHLORIDE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION 



Q0171 CHLORPROMAZINE HYDROCHLORIDE, 10 MG, ORAL, FDA APPROVED PRESCRIPTION 


AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN

Q0172 CHLORPROMAZINE HYDROCHLORIDE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION 



Q0173 TRIMETHOBENZAMIDE HYDROCHLORIDE, 250 MG, ORAL, FDA APPROVED PRESCRIPTION 



Q0174 THIETHYLPERAZINE MALEATE, 10 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, 



Q0175 PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A 



Q0176 PERPHENAZINE, 8MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A 



Q0177 HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR 

USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF 


Q0178 HYDROXYZINE PAMOATE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR 



Q0179 ONDANSETRON HYDROCHLORIDE 8 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, 



Q0180 DOLASETRON MESYLATE, 100 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR 



Q0181 UNSPECIFIED ORAL DOSAGE FORM, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS 

A COMPLETE THERAPEUTIC SUBSTITUTE FOR A IV ANTI-EMETIC AT THE TIME OF 


Q0182 ALPROSTADIL URETHRAL SUPPOSITORY, ADMINISTERED UNDER DIRECT PHYSICIAN 

SUPERVISION, EXCLUDES SELF-ADMINISTRATION 

Q0183 DERMAL TISSUE, OF HUMAN ORIGIN, WITH AND WITHOUT OTHER BIOENGINEERED OR 

PROCESSED ELEMENTS, BUT WITHOUT METABOLICALLY ACTIVE ELEMENTS, PER SQUARE 

CENTIMETER 

Q0184 DERMAL TISSUE, OF HUMAN ORIGIN, WITH OR WITHOUT OTHER BIOENGINEERED OR 

PROCESSED ELEMENTS, WITH METABOLICALLY ACTIVE ELEMENTS, PER SQUARE CENTIMETER 

Q0185 DERMAL AND EPIDERMAL, TISSUE OF HUMAN ORIGIN, WITH OR WITHOUT BIOENGINEERED OR 

PROCESSED ELEMENTS, WITH METABOLICALLY ACTIVE ELEMENTS, PER SQUARE CENTIMETER 

Q0186 PARAMEDIC INTERCEPT, RURAL AREA, TRANSPORT FURNISHED BY A VOLUNTEER AMBULANCE 

COMPANY WHICH IS PROHIBITED BY STATE LAW FROM BILLING THIRD PARTY PAYERS 

Q0187 FACTOR VIIA (COAGULATION FACTOR, RECOMBINANT) PER 1.2 MG 

Q0188 SUPPLY OF INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY 

Q1001 NEW TECHNOLOGY INTRAOCULAR LENS CATEGORY 1 AS DEFINED IN FEDERAL REGISTER 

NOTICE, VOL 65, DATED MAY 3, 2000 


NOTICE, VOL 65, DATED MAY 3, 2000 


NOTICE 


NOTICE 


NOTICE 

Q2001 ORAL, CABERGOLINE, 0.5 MG 

Q2002 INJECTION, ELLIOTTS B SOLUTION, PER ML 

Q2003 INJECTION, APROTININ, 10,000 KIU 

Q2004 IRRIGATION SOLUTION FOR TREATMENT OF BLADDER CALCULI, FOR EXAMPLE RENACIDIN,

PER 500 ML 

Q2005 INJECTION, CORTICORELIN OVINE TRIFLUTATE, PER DOSE 

Q2006 INJECTION, DIGOXIN IMMUNE FAB (OVINE), PER VIAL 

Q2007 INJECTION, ETHANOLAMINE OLEATE, 100 MG 

Q2008 INJECTION, FOMEPIZOLE, 1.5 MG 

Q2009 INJECTION, FOSPHENYTOIN, 50 MG 

Q2010 INJECTION, GLATIRAMER ACETATE, PER DOSE 

Q2011 INJECTION, HEMIN, PER 1 MG 

Q2012 INJECTION, PEGADEMASE BOVINE, 25 IU 

Q2013 INJECTION, PENTASTARCH, 10% SOLUTION, PER 100 ML 

Q2014 INJECTION, SERMORELIN ACETATE, 0.5 MG 

Q2015 INJECTION, SOMATREM, 5 MG 

Q2016 INJECTION, SOMATROPIN, 1 MG 

Q2017 INJECTION, TENIPOSIDE, 50 MG 

Q2018 INJECTION, UROFOLLITROPIN, 75 IU 

Q2019 INJECTION, BASILIXIMAB, 20 MG 

Q2020 INJECTION, HISTRELIN ACETATE, 10 MG 

Q2021 INJECTION, LEPIRUDIN, 50 MG 

Q2022 VON WILLEBRAND FACTOR COMPLEX, HUMAN, PER IU 

Q3001 RADIOELEMENTS FOR BRACHYTHERAPY, ANY TYPE, EACH 

Q3002 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, GALLIUM GA 67, PER MCI 

Q3003 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M 

BICISATE, PER UNIT DOSE 

Q3004 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, XENON XE 133, PER 10 

MCI 

Q3005 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M 

MERTIATIDE, PER MCI 

Q3006 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M 

GLUCEPATATE, PER 5 MCI 

Q3007 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, SODIUM PHOSPHATE P32, 

PER MCI 

Q3008 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM 111-IN 

PENTETREOTIDE, PER 3 MCI 

Q3009 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M 

OXIDRONATE, PER MCI 

Q3010 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M - 

LABELED RED BLOOD CELLS, PER MCI 

Q3011 SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, CHROMIC PHOSPHATE P32 

SUSPENSION, PER MCI 

Q3012 SUPPLY OF ORAL RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, CYANOCOBALAMIN 

COBALT CO57, PER 0.5 MCI 

Q9920 INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 20 OR LESS 

Q9921 INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 21 














Q9935 INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 35





Q9940 INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 40 OR ABOVE 

R0070 TRANSPORTATION OF PORTABLE X-RAY EQUIPMENT AND PERSONNEL TO HOME OR NURSING 

HOME, PER TRIP TO FACILITY OR LOCATION, ONE PATIENT SEEN 

R0075 TRANSPORTATION OF PORTABLE X-RAY EQUIPMENT AND PERSONNEL TO HOME OR NURSING 

HOME, PER TRIP TO FACILITY OR LOCATION, MORE THAN ONE PATIENT SEEN, PER PATIENT 

R0076 TRANSPORTATION OF PORTABLE EKG TO FACILITY OR LOCATION, PER PATIENT 

S0009 INJECTION, BUTORPHANOL TARTRATE, 1 MG 

S0010 INJECTION, SOMATREM, 5 MG 

S0011 INJECTION, SOMATROPIN, 5 MG 

S0012 BUTORPHANOL TARTRATE, NASAL SPRAY, 25 MG 

S0014 TACRINE HYDROCHLORIDE, 10 MG 

S0016 INJECTION, AMIKACIN SULFATE, 500 MG 

S0017 INJECTION, AMINOCAPROIC ACID, 5 GRAMS 

S0020 INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML 

S0021 INJECTION, CEFOPERAZONE SODIUM, 1 GRAM 

S0023 INJECTION, CIMETIDINE HYDROCHLORIDE, 300 MG 

S0024 INJECTION, CIPROFLOXACIN, 200 MG 

S0028 INJECTION, FAMOTIDINE, 20 MG 

S0029 INJECTION, FLUCONAZOLE, 400 MG 

S0030 INJECTION, METRONIDAZOLE, 500 MG 

S0032 INJECTION, NAFCILLIN SODIUM, 2 GRAMS 

S0034 INJECTION, OFLOXACIN, 400 MG 

S0039 INJECTION, SULFAMETHOXAZOLE AND TRIMETHOPRIM, 10 ML 

S0040 INJECTION, TICARCILLIN DISODIUM AND CLAVULANATE POTASSIUM, 3.1 GRAMS 

S0071 INJECTION, ACYCLOVIR SODIUM, 50 MG 

S0072 INJECTION, AMIKACIN SULFATE, 100 MG 

S0073 INJECTION, AZTREONAM, 500 MG 

S0074 INJECTION, CEFOTETAN DISODIUM, 500 MG 

S0077 INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG 

S0078 INJECTION, FOSPHENYTOIN SODIUM, 750 MG 

S0080 INJECTION, PENTAMIDINE ISETHIONATE, 300 MG 

S0081 INJECTION, PIPERACILLIN SODIUM, 500 MG 

S0085 INJECTION, GATIFLOXACIN, 200 MG 

S0086 INJECTION, VERTEPORFIN, 15 MG 

S0090 SILDENAFIL CITRATE, 25 MG 

S0096 INJECTION, ITRACONAZOLE, 200 MG 

S0097 INJECTION, IBUTILIDE FUMARATE, 1 MG 

S0098 INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE, 62.5 MG 

S0156 EXEMESTANE, 25 MG 

S0157 BECAPLERMIN GEL 0.01%, 0.5 GM 

S0220 MEDICAL CONFERENCE BY A PHYSICIAN WITH INTERDISCIPLINARY TEAM OF HEALTH 

PROFESSIONALS OR REPRESENTATIVES OF COMMUNITY AGENCIES TO COORDINATE ACTIVITIES 

OF PATIENT CARE (PATIENT IS PRESENT); APPROXIMATELY 30 MINUTES 

S0221 MEDICAL CONFERENCE BY A PHYSICIAN WITH INTERDISCIPLINARY TEAM OF HEALTH 

PROFESSIONALS OR REPRESENTATIVES OF COMMUNITY AGENCIES TO COORDINATE ACTIVITIES 

OF PATIENT CARE (PATIENT IS PRESENT); APPROXIMATELY 60 MINUTES 

S0601 SCREENING PROCTOSCOPY 

S0605 DIGITAL RECTAL EXAMINATION, ANNUAL 

S0610 ANNUAL GYNECOLOGICAL EXAMINATION, NEW PATIENT 

S0612 ANNUAL GYNECOLOGICAL EXAMINATION, ESTABLISHED PATIENT 

S0620 ROUTINE OPHTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; NEW PATIENT 

S0621 ROUTINE OPHTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; ESTABLISHED PATIENT 

S0630 REMOVAL OF SUTURES; BY A PHYSICIAN OTHER THAN THE PHYSICIAN WHO ORIGINALLY

CLOSED THE WOUND 

S0800 LASER IN SITU KERATOMILEUSIS (LASIK) 

S0810 PHOTOREFRACTIVE KERATECTOMY (PRK) 

S0820 COMPUTERIZED CORNEAL TOPOGRAPHY, UNILATERAL 

S0830 ULTRASOUND PACHYMETRY TO DETERMINE CORNEAL THICKNESS, WITH INTERPRETATION AND 

REPORT, UNILATERAL 

S1015 IV TUBING EXTENSION SET 

S1016 NON-PVC (POLYVINYL CHLORIDE) INTRAVENOUS ADMINISTRATION SET, FOR USE WITH DRUGS 

THAT ARE NOT STABLE IN PVC E.G. PACLITAXEL 

S2050 DONOR ENTERECTOMY, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT; FROM CADAVER 

DONOR 

S2052 TRANSPLANTATION OF SMALL INTESTINE ALLOGRAFT 

S2053 TRANSPLANTATION OF SMALL INTESTINE AND LIVER ALLOGRAFTS 

S2054 TRANSPLANTATION OF MULTIVISCERAL ORGANS 

S2055 HARVESTING OF DONOR MULTIVISCERAL ORGANS, WITH PREPARATION AND MAINTENANCE OF 

ALLOGRAFTS; FROM CADAVER DONOR 

S2060 LOBAR LUNG TRANSPLANTATION 

S2061 DONOR LOBECTOMY (LUNG) FOR TRANSPLANTATION, LIVING DONOR 

S2102 ISLET CELL TISSUE TRANSPLANT FROM PANCREAS 

S2103 ADRENAL TISSUE TRANSPLANT TO BRAIN 

S2109 AUTOLOGOUS CHONDROCYTE TRANSPLANTATION (PREPARATION OF AUTOLOGOUS CULTURED 

CHONDROCYTES) 

S2120 LOW DENSITY LIPOPROTEIN (LDL) APHERESIS USING HEPARIN-INDUCED EXTRACORPOREAL 

LDL PRECIPITATION 

S2140 CORD BLOOD HARVESTING FOR TRANSPLANTATION, ALLOGENEIC 

S2142 CORD BLOOD-DERIVED STEM-CELL TRANSPLANTATION, ALLOGENEIC 

S2180 DONOR LEUKOCYTE INFUSION (E.G. DLI, DONOR LYMPHOCYTE INFUSION, DONOR BUFFY COAT 

CELL TRANSFUSION, DONOR PERIPHERAL BLOOD MONOCYTE TRANSFUSION) 

S2190 SUBCUTANEOUS IMPLANTATION OF MEDICATION PELLET(S) 

S2202 ECHOSCLEROTHERAPY 

S2204 TRANSMYOCARDIAL LASER REVASCULARIZATION 

S2205 MINIMALLY INVASIVE DIRECT CORONARY ARTERY BYPASS SURGERY INVOLVING 

MINI-THORACOTOMY OR MINI-STERNOTOMY SURGERY, PERFORMED UNDER DIRECT VISION; 

USING ARTERIAL GRAFT(S), SINGLE CORONARY ARTERIAL GRAFT 



USING ARTERIAL GRAFT(S), TWO CORONARY ARTERIAL GRAFTS 



USING VENOUS GRAFT ONLY, SINGLE CORONARY VENOUS GRAFT 



USING SINGLE ARTERIAL AND VENOUS GRAFT(S), SINGLE VENOUS GRAFT 



USING TWO ARTERIAL GRAFTS AND SINGLE VENOUS GRAFT 

S2210 CRYOSURGICAL ABLATION (IN SITU DESTRUCTION) OF TUMOROUS TISSUE, ONE OR MORE 

LESIONS; LIVER 

S2220 THROMBECTOMY, CORONARY; BY MECHANICAL MEANS (E.G. USING RHEOLYTIC CATHETER) 

S2300 ARTHROSCOPY, SHOULDER, SURGICAL; WITH THERMALLY-INDUCED CAPSULORRHAPHY 

S2340 CHEMODENERVATION OF ABDUCTOR MUSCLE(S) OF VOCAL CORD 

S2350 DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S), 

INCLUDING OSTEOPHYTECTOMY; LUMBAR, SINGLE INTERSPACE 

S2351 DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S), 

INCLUDING OSTEOPHYTECTOMY; LUMBAR, EACH ADDITIONAL INTERSPACE (LIST SEPARATELY 

IN ADDITION TO CODE FOR PRIMARY PROCEDURE) 

S2370 INTRADISCAL ELECTROTHERMAL THERAPY, SINGLE INTERSPACE

S2371 EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY 

PROCEDURE) 

S3620 NEWBORN METABOLIC SCREENING PANEL, INCLUDES TEST KIT, POSTAGE AND THE FOLLOWING 

TESTS: HEMOGLOBIN, ELECTROPHORESIS; HYDROXYPROGESTERONE; 17-D; PHENALANINE 

(PKU); AND THYROXINE, TOTAL 

S3645 HIV-1 ANTIBODY TESTING OF ORAL MUCOSAL TRANSUDATE 

S3650 SALIVA TEST, HORMONE LEVEL; DURING MENOPAUSE 

S3652 SALIVA TEST, HORMONE LEVEL; TO ASSESS PRETERM LABOR RISK 

S3700 BLADDER TUMOR-ASSOCIATED ANTIGEN TEST 

S3708 GASTROINTESTINAL FAT ABSORPTION STUDY 

S3902 BALLISTOCARDIOGRAM 

S3904 MASTERS TWO STEP 

S3906 TRANSFUSION, DIRECT, BLOOD OR BLOOD COMPONENTS 

S5000 PRESCRIPTION DRUG, GENERIC 

S5001 PRESCRIPTION DRUG, BRAND NAME 

S5002 FAT EMULSION 10% IN 250 ML, WITH ADMINISTRATION SET 

S5003 FAT EMULSION 20% IN 250 ML, WITH ADMINISTRATION SET 

S5010 5% DEXTROSE AND 45% NORMAL SALINE, 1000 ML 

S5011 5% DEXTROSE IN LACTATED RINGER’S, 1000 ML 

S5012 5% DEXTROSE WITH POTASSIUM CHLORIDE, 1000 ML 

S5013 5% DEXTROSE/45% NORMAL SALINE WITH POTASSIUM CHLORIDE AND MAGNESIUM SULFATE, 

1000 ML 

S5014 5% DEXTROSE/45% NORMAL SALINE WITH POTASSIUM CHLORIDE AND MAGNESIUM SULFATE, 

1500 ML 

S5016 ANTIBIOTIC ADMINISTRATION SUPPLIES (WITH PUMP), PER DIEM 

S5017 ANTIBIOTIC ADMINISTRATION SUPPLIES (WITHOUT PUMP), PER DIEM 

S5018 PAIN THERAPY ADMINISTRATION SUPPLIES (PCA OR CONTINUOUS), PER DIEM 

S5019 CHEMOTHERAPY ADMINISTRATION SUPPLIES (WITH PUMP), PER DIEM 

S5020 CHEMOTHERAPY ADMINISTRATION SUPPLIES (WITHOUT PUMP), PER DIEM 

S5021 HYDRATION THERAPY ADMINISTRATION SUPPLIES, PER DIEM 

S5022 GROWTH HORMONE THERAPY (E.G., PROTROPIN, HUMATROPE) 

S5025 INFUSION PUMP RENTAL, PER DIEM 

S5503 MAINTENANCE OF IMPLANTED VASCULAR ACCESS DEVICE, INCLUDING SUPPLIES; PER DIEM 

S8001 RADIOFREQUENCY STIMULATION OF THE THALAMUS FOR TREMOR ACCOMPLISHED BY 

STEREOTACTIC METHOD, INCLUDING BURR HOLES, LOCALIZING AND RECORDING TECHNIQUES 

AND PLACEMENT OF THE ELECTRODE(S) 

S8035 MAGNETIC SOURCE IMAGING 

S8040 TOPOGRAPHIC BRAIN MAPPING 

S8048 ISOLATED LIMB PERFUSION 

S8049 INTRAOPERATIVE RADIATION THERAPY (SINGLE ADMINISTRATION) 

S8060 SUPPLY OF CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY (USE IN ADDITION TO 

ECHOCARDIOGRAPHY CODE) 

S8080 SCINTIMAMMOGRAPHY (RADIOIMMUNOSCINTIGRAPHY OF THE BREAST), UNILATERAL, 

INCLUDING SUPPLY OF RADIOPHARMACEUTICAL 

S8085 FLUORINE-18 FLUORODEOXYGLUCOSE (F-18 FDG) IMAGING USING DUAL-HEAD COINCIDENCE 

DETECTION SYSTEM (NON-DEDICATED PET SCAN) 

S8092 ELECTRON BEAM COMPUTED TOMOGRAPHY (ALSO KNOWN AS ULTRAFAST CT, CINE CT) 

S8095 WIG (FOR MEDICALLY-INDUCED HAIR LOSS) 

S8096 PORTABLE PEAK FLOW METER 

S8105 OXIMETER FOR MEASURING BLOOD OXYGEN LEVELS NONINVASIVELY 

S8110 PEAK EXPIRATORY FLOW RATE (PHYSICIAN SERVICES) 

S8200 CHEST COMPRESSION VEST 

S8205 CHEST COMPRESSION SYSTEM GENERATOR AND HOSES (FOR USE WITH CHEST COMPRESSION 

VEST - S8200) 

S8210 MUCUS TRAP 

S8260 ORAL ORTHOTIC FOR TREATMENT OF SLEEP APNEA, INCLUDES FITTING, FABRICATION, AND 

MATERIALS

S8300 SACRAL NERVE STIMULATION TEST LEAD KIT 

S8400 INCONTINENCE PANTS, EACH 

S8402 DIAPERS, EACH 

S8405 INCONTINENCE LINERS, EACH 

S8950 COMPLEX LYMPHEDEMA THERAPY, EACH 15 MINUTES 

S8999 RESUSCITATION BAG (FOR USE BY PATIENT ON ARTIFICIAL RESPIRATION DURING POWER 

FAILURE OR OTHER CATASTROPHIC EVENT) 

S9001 HOME UTERINE MONITOR WITH OR WITHOUT ASSOCIATED NURSING SERVICES 

S9007 ULTRAFILTRATION MONITOR 

S9015 AUTOMATED EEG MONITORING 

S9022 DIGITAL SUBTRACTION ANGIOGRAPHY (USE IN ADDITION TO CPT CODE FOR THE PROCEDURE 

FOR FURTHER IDENTIFICATION) 

S9023 XENON REGIONAL CEREBRAL BLOOD FLOW STUDIES 

S9024 PARANASAL SINUS ULTRASOUND 

S9025 OMNICARDIOGRAM/CARDIOINTEGRAM 

S9033 GAIT ANALYSIS 

S9035 MEDICAL EQUIPMENT OR SUPPLIES DISTRIBUTED BY HOME CARE PROVIDER WITHOUT 

PROFESSIONAL NURSING INTERVENTION, PER DIEM 

S9055 PROCUREN OR OTHER GROWTH FACTOR PREPARATION TO PROMOTE WOUND HEALING 

S9056 COMA STIMULATION PER DIEM 

S9061 MEDICAL SUPPLIES AND EQUIPMENT RENTAL DISTRIBUTED BY THE HOME CARE PROVIDER; 

AEROSOLIZED DRUG THERAPY; PER DIEM 

S9075 SMOKING CESSATION TREATMENT 

S9085 MENISCAL ALLOGRAFT TRANSPLANTATION 

S9088 SERVICES PROVIDED IN AN URGENT CARE CENTER 

S9090 VERTEBRAL AXIAL DECOMPRESSION, PER SESSION 

S9122 HOME HEALTH AIDE OR CERTIFIED NURSE ASSISTANT, PROVIDING CARE IN THE HOME; PER 

HOUR 

S9123 NURSING CARE, IN THE HOME; BY REGISTERED NURSE, PER HOUR 

S9124 NURSING CARE, IN THE HOME; BY LICENSED PRACTICAL NURSE, PER HOUR 

S9125 RESPITE CARE, IN THE HOME, PER DIEM 

S9126 HOSPICE CARE, IN THE HOME, PER DIEM 

S9127 SOCIAL WORK VISIT, IN THE HOME, PER DIEM 

S9128 SPEECH THERAPY, IN THE HOME, PER DIEM 

S9129 OCCUPATIONAL THERAPY, IN THE HOME, PER DIEM 

S9140 DIABETIC MANAGEMENT PROGRAM, FOLLOW-UP VISIT TO NON-MD PROVIDER 

S9141 DIABETIC MANAGEMENT PROGRAM, FOLLOW-UP VISIT TO MD PROVIDER 

S9200 NURSING SERVICES AND ALL NECESSARY SUPPLIES (INCLUDING PCA PUMP RENTAL) FOR 

HOME ADMINISTRATION OF PATIENT CONTROLLED ANALGESIA (PCA) PER DIEM (DRUGS NOT 

INCLUDED) 

S9210 NURSING SERVICES AND ALL NECESSARY EQUIPMENT AND SUPPLIES FOR CONTINUOUS, 

UNINTERRUPTED INFUSION OF EPOPROSTENOL (INCLUDES VENOUS ACCESS DEVICE, INFUSION 

PUMP, BACK UP PUMP, ICE PACKS FOR CASSETTES, BATTERIES, ALL RELATED SUPPLIES, 

AND ALL NURSING SERVICES INCLUDING FOLLOW-UP VISITS, TELEPHONE MONITORING, 24 

HOUR/7 DAY A WEEK AVAILABILITY, AND ALL EDUCATION TO PATIENT AND CARE GIVERS); 

PER DIEM 

S9220 NURSING SERVICES AND ALL NECESSARY EQUIPMENT AND SUPPLIES FOR HOME 

ADMINISTRATION OF CONTROLLED RATE INTRAVENOUS INFUSION (E.G. DOBUTAMINE) 

REQUIRING PROLONGED ATTENDANCE BY THE NURSE, PER DIEM (DRUGS NOT INCLUDED) 


ADMINISTRATION OF INTRAVENOUS TOCOLYTIC THERAPY, PER DIEM 


ADMINISTRATION OF HEPARIN, PER DIEM 

S9300 NURSING SERVICES AND ALL NECESSARY SUPPLIES FOR HOME ENTERAL FEEDING BY 

GRAVITY, PER DIEM (ENTERAL FORMULA NOT INCLUDED) 

S9308 NURSING SERVICES AND ALL NECESSARY SUPPLIES FOR HOME ENTERAL FEEDING BY PUMP, 

INCLUDING PUMP RENTAL, PER DIEM (ENTERAL FORMULA NOT INCLUDED)

S9310 NURSING SERVICES AND ALL NECESSARY SUPPLIES FOR HOME PARENTERAL NUTRITION 

WITHOUT LIPIDS, INCLUDING PUMP RENTAL, PER DIEM (PARENTERAL SOLUTIONS NOT 

INCLUDED) 

S9395 NURSING SERVICES AND ALL NECESSARY SUPPLIES AND ADDITIVES FOR HOME IV HYDRATION 

(VIA GRAVITY OR PUMP), PER DIEM (HYDRATION SOLUTION AND DRUGS NOT INCLUDED) 

S9420 NURSING SERVICES AND ALL NECESSARY SUPPLIES FOR INTERIM HOME MAINTENANCE OF 

IMPLANTED VASCULAR ACCESS PORT/CATHETER/RESERVOIR, PER DIEM (FOR INTERIM 

MAINTENANCE OF VASCULAR ACCESS NOT CURRENTLY IN USE) 

S9423 NURSING SERVICES, PATIENT ASSESSMENT AND EDUCATION, FOLLOW-UP VISITS, 

ELECTRONIC PROGRAMMER AND EQUIPMENT (USE OF COMPUTER), PROGRAMMING OF THE PUMP, 

ALL NECESSARY SUPPLIES, PRODUCTS OR SERVICES FOR INTRATHECAL DRUG INFUSION, PER 

DIEM 

S9425 NURSING SERVICES AND ALL NECESSARY SUPPLIES AND ADDITIVES FOR HOME IV 

CHEMOTHERAPY (VIA IV PUSH, GRAVITY DRIP, STATIONARY PUMP, AMBULATORY BELT 

PUMP), PER DIEM (HYDRATION SOLUTION AND DRUGS NOT INCLUDED) 

S9435 MEDICAL FOODS FOR INBORN ERRORS OF METABOLISM 

S9455 DIABETIC MANAGEMENT PROGRAM, GROUP SESSION 

S9460 DIABETIC MANAGEMENT PROGRAM, NURSE VISIT 

S9465 DIABETIC MANAGEMENT PROGRAM, DIETITIAN VISIT 

S9470 NUTRITIONAL COUNSELING, DIETITIAN VISIT 

S9472 CARDIAC REHABILITATION PROGRAM, NON-PHYSICIAN PROVIDER, PER DIEM 

S9473 PULMONARY REHABILITATION PROGRAM, NON-PHYSICIAN PROVIDER, PER DIEM 

S9474 ENTEROSTOMAL THERAPY BY A REGISTERED NURSE CERTIFIED IN ENTEROSTOMAL THERAPY, 

PER DIEM 

S9475 AMBULATORY SETTING SUBSTANCE ABUSE TREATMENT OR DETOXIFICATION SERVICES, PER 

DIEM 

S9480 INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM 

S9485 CRISIS INTERVENTION MENTAL HEALTH SERVICES, PER DIEM 

S9524 NURSING SERVICES RELATED TO HOME IV THERAPY, PER DIEM 

S9526 SKILLED NURSING VISITS FOR BLOOD PRODUCT ADMINISTRATION, INCLUDING PUMP AND ALL 

RELATED SUPPLIES; PER SERVICE 

S9527 INSERTION OF A PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC), INCLUDING 

NURSING SERVICES AND ALL SUPPLIES 

S9528 INSERTION OF MIDLINE CENTRAL VENOUS CATHETER, INCLUDING NURSING SERVICES AND 

ALL SUPPLIES 

S9533 PAIN MANAGEMENT, INTRAVENOUS, EPIDURAL OR SUBCUTANEOUS, INCLUDING SOLUTION, 

EQUIPMENT RENTAL, NURSING CARE, AND SUPPLIES; PER DIEM (DRUGS NOT INCLUDED) 

S9535 ADMINISTRATION OF HEMATOPOIETIC HORMONES (E.G. ERYTHROPOIETIN, G-CSF, GM-CSF) 

OR PLATELETS, INTRAVENOUSLY, IN THE HOME SETTING, INCLUDING ALL NURSING CARE, 

EQUIPMENT, AND SUPPLIES; PER DIEM 

S9539 ADMINISTRATION OF ANTIBIOTICS, INTRAVENOUSLY, IN THE HOME SETTING, INCLUDING 

ALL NURSING CARE, EQUIPMENT, AND SUPPLIES; PER DIEM 

S9543 ADMINISTRATION OF MEDICATION, INTRAMUSCULARLY, EPIDURALLY OR SUBCUTANEOUSLY, IN 

THE HOME SETTING, INCLUDING ALL NURSING CARE, EQUIPMENT, AND SUPPLIES; PER DIEM 

S9545 ADMINISTRATION OF IMMUNE GLOBULIN, INTRAVENOUSLY, IN THE HOME SETTING, 

INCLUDING ALL NURSING CARE, EQUIPMENT, AND SUPPLIES; PER DIEM 

S9550 HOME IV THERAPY, HYDRATION FLUIDS AND ELECTROLYTES, INCLUDING ALL NURSING CARE, 

EQUIPMENT, AND SUPPLIES; PER DIEM 

S9555 ADDITIONAL HOME INFUSION THERAPY, INCLUDING ALL NURSING CARE, EQUIPMENT, AND 

SUPPLIES; EACH THERAPY, PER DIEM (S9555 SHOULD BE USED IN ADDITION TO THE CODE 

FOR THE PRIMARY THERAPY) 

S9990 SERVICES PROVIDED AS PART OF A PHASE II CLINICAL TRIAL 

S9991 SERVICES PROVIDED AS PART OF A PHASE III CLINICAL TRIAL 

S9992 TRANSPORTATION COSTS TO AND FROM TRIAL LOCATION AND LOCAL TRANSPORTATION COSTS 

(E.G., FARES FOR TAXICAB OR BUS) FOR CLINICAL TRIAL PARTICIPANT AND ONE 

CAREGIVER/COMPANION 

S9994 LODGING COSTS (E.G., HOTEL CHARGES) FOR CLINICAL TRIAL PARTICIPANT AND ONE

CAREGIVER/COMPANION 

S9996 MEALS FOR CLINICAL TRIAL PARTICIPANT AND ONE CAREGIVER/COMPANION 

S9999 SALES TAX 

V2020 FRAMES, PURCHASES 

V2025 DELUXE FRAME 

V2100 SPHERE, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00, PER LENS 

V2101 SPHERE, SINGLE VISION, PLUS OR MINUS 4.12 TO PLUS OR MINUS 7.00D, PER LENS 

V2102 SPHERE, SINGLE VISION, PLUS OR MINUS 7.12 TO PLUS OR MINUS 20.00D, PER LENS 

V2103 SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, .12 TO 

2.00D CYLINDER, PER LENS 

V2104 SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, 2.12 TO 


V2105 SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, 4.25 TO 


V2106 SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, OVER 6.00D 

CYLINDER, PER LENS 

V2107 SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00 SPHERE, 

.12 TO 2.00D CYLINDER, PER LENS 

V2108 SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25D TO PLUS OR MINUS 7.00D 

SPHERE, 2.12 TO 4.00D CYLINDER, PER LENS 

V2109 SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D 


V2110 SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO 7.00D SPHERE, OVER 6.00D 



SPHERE, .25 TO 2.25D CYLINDER, PER LENS 


SPHERE, 2.25D TO 4.00D CYLINDER, PER LENS 



V2114 SPHEROCYLINDER, SINGLE VISION, SPHERE OVER PLUS OR MINUS 12.00D, PER LENS 

V2115 LENTICULAR, (MYODISC), PER LENS, SINGLE VISION 

V2116 LENTICULAR LENS, NONASPHERIC, PER LENS, SINGLE VISION 

V2117 LENTICULAR, ASPHERIC, PER LENS, SINGLE VISION 

V2118 ANISEIKONIC LENS, SINGLE VISION 

V2199 NOT OTHERWISE CLASSIFIED, SINGLE VISION LENS 

V2200 SPHERE, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D, PER LENS 

V2201 SPHERE, BIFOCAL, PLUS OR MINUS 4.12 TO PLUS OR MINUS 7.00D, PER LENS 

V2202 SPHERE, BIFOCAL, PLUS OR MINUS 7.12 TO PLUS OR MINUS 20.00D, PER LENS 

V2203 SPHEROCYLINDER, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, .12 TO 2.00D 


V2204 SPHEROCYLINDER, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, 2.12 TO 4.00D 


V2205 SPHEROCYLINDER, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, 4.25 TO 6.00D 


V2206 SPHEROCYLINDER, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, OVER 6.00D 


V2207 SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE,.12 

TO 2.00D CYLINDER, PER LENS 

V2208 SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, 2.12 


V2209 SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, 4.25 


V2210 SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, OVER 

6.00D CYLINDER,PER LENS 

V2211 SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, .25 

TO 2.25D CYLINDER, PER LENS

V2212 SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 

2.25 TO 4.00D CYLINDER, PER LENS 

V2213 SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 


V2214 SPHEROCYLINDER, BIFOCAL, SPHERE OVER PLUS OR MINUS 12.00D, PER LENS 

V2215 LENTICULAR (MYODISC), PER LENS, BIFOCAL 

V2216 LENTICULAR, NONASPHERIC, PER LENS, BIFOCAL 

V2217 LENTICULAR, ASPHERIC LENS, BIFOCAL 

V2218 ANISEIKONIC, PER LENS, BIFOCAL 

V2219 BIFOCAL SEG WIDTH OVER 28MM 

V2220 BIFOCAL ADD OVER 3.25D 

V2299 SPECIALTY BIFOCAL (BY REPORT) 

V2300 SPHERE, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D, PER LENS 

V2301 SPHERE, TRIFOCAL, PLUS OR MINUS 4.12 TO PLUS OR MINUS 7.00D, PER LENS 

V2302 SPHERE, TRIFOCAL, PLUS OR MINUS 7.12 TO PLUS OR MINUS 20.00, PER LENS 

V2303 SPHEROCYLINDER, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, .12-2.00D 


V2304 SPHEROCYLINDER, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, 2.25-4.00D 


V2305 SPHEROCYLINDER, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, 4.25 TO 6.00 


V2306 SPHEROCYLINDER, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, OVER 6.00D 


V2307 SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, .12 


V2308 SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, 





OVER 6.00D CYLINDER, PER LENS 


.25 TO 2.25D CYLINDER, PER LENS 





V2314 SPHEROCYLINDER, TRIFOCAL, SPHERE OVER PLUS OR MINUS 12 .00D, PER LENS 

V2315 LENTICULAR, (MYODISC), PER LENS, TRIFOCAL 

V2316 LENTICULAR NONASPHERIC, PER LENS, TRIFOCAL 

V2317 LENTICULAR, ASPHERIC LENS, TRIFOCAL 

V2318 ANISEIKONIC LENS, TRIFOCAL 

V2319 TRIFOCAL SEG WIDTH OVER 28 MM 

V2320 TRIFOCAL ADD OVER 3.25D 

V2399 SPECIALTY TRIFOCAL (BY REPORT) 

V2410 VARIABLE ASPHERICITY LENS, SINGLE VISION, FULL FIELD, GLASS OR PLASTIC, PER 

LENS 

V2430 VARIABLE ASPHERICITY LENS, BIFOCAL, FULL FIELD, GLASS OR PLASTIC, PER LENS 

V2499 VARIABLE SPHERICITY LENS, OTHER TYPE 

V2500 CONTACT LENS, PMMA, SPHERICAL, PER LENS 

V2501 CONTACT LENS, PMMA, TORIC OR PRISM BALLAST, PER LENS 

V2502 CONTACT LENS PMMA, BIFOCAL, PER LENS 

V2503 CONTACT LENS, PMMA, COLOR VISION DEFICIENCY, PER LENS 

V2510 CONTACT LENS, GAS PERMEABLE, SPHERICAL, PER LENS 

V2511 CONTACT LENS, GAS PERMEABLE, TORIC, PRISM BALLAST, PER LENS 

V2512 CONTACT LENS, GAS PERMEABLE, BIFOCAL, PER LENS 

V2513 CONTACT LENS, GAS PERMEABLE, EXTENDED WEAR, PER LENS

V2520 CONTACT LENS, HYDROPHILIC, SPHERICAL, PER LENS 

V2521 CONTACT LENS, HYDROPHILIC, TORIC, OR PRISM BALLAST, PER LENS 

V2522 CONTACT LENS, HYDROPHILLIC, BIFOCAL, PER LENS 

V2523 CONTACT LENS, HYDROPHILIC, EXTENDED WEAR, PER LENS 

V2530 CONTACT LENS, SCLERAL, GAS IMPERMEABLE, PER LENS (FOR CONTACT LENS 

MODIFICATION, SEE 92325) 

V2531 CONTACT LENS, SCLERAL, GAS PERMEABLE, PER LENS (FOR CONTACT LENS MODIFICATION, 

SEE 92325) 

V2599 CONTACT LENS, OTHER TYPE 

V2600 HAND HELD LOW VISION AIDS AND OTHER NONSPECTACLE MOUNTED AIDS 

V2610 SINGLE LENS SPECTACLE MOUNTED LOW VISION AIDS 

V2615 TELESCOPIC AND OTHER COMPOUND LENS SYSTEM, INCLUDING DISTANCE VISION 

TELESCOPIC, NEAR VISION TELESCOPES AND COMPOUND MICROSCOPIC LENS SYSTEM 

V2623 PROSTHETIC EYE, PLASTIC, CUSTOM 

V2624 POLISHING/RESURFACING OF OCULAR PROSTHESIS 

V2625 ENLARGEMENT OF OCULAR PROSTHESIS 

V2626 REDUCTION OF OCULAR PROSTHESIS 

V2627 SCLERAL COVER SHELL 

V2628 FABRICATION AND FITTING OF OCULAR CONFORMER 

V2629 PROSTHETIC EYE, OTHER TYPE 

V2630 ANTERIOR CHAMBER INTRAOCULAR LENS 

V2631 IRIS SUPPORTED INTRAOCULAR LENS 

V2632 POSTERIOR CHAMBER INTRAOCULAR LENS 

V2700 BALANCE LENS, PER LENS 

V2710 SLAB OFF PRISM, GLASS OR PLASTIC, PER LENS 

V2715 PRISM, PER LENS 

V2718 PRESS-ON LENS, FRESNELL PRISM, PER LENS 

V2730 SPECIAL BASE CURVE, GLASS OR PLASTIC, PER LENS 

V2740 TINT, PLASTIC, ROSE 1 OR 2 PER LENS 

V2741 TINT, PLASTIC, OTHER THAN ROSE 1-2, PER LENS 

V2742 TINT, GLASS ROSE 1 OR 2, PER LENS 

V2743 TINT, GLASS OTHER THAN ROSE 1 OR 2, PER LENS 

V2744 TINT, PHOTOCHROMATIC, PER LENS 

V2750 ANTI-REFLECTIVE COATING, PER LENS 

V2755 U-V LENS, PER LENS 

V2760 SCRATCH RESISTANT COATING, PER LENS 

V2770 OCCLUDER LENS, PER LENS 

V2780 OVERSIZE LENS, PER LENS 

V2781 PROGRESSIVE LENS, PER LENS 

V2785 PROCESSING, PRESERVING AND TRANSPORTING CORNEAL TISSUE 

V2790 AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE 

V2799 VISION SERVICE, MISCELLANEOUS 

V5008 HEARING SCREENING 

V5010 ASSESSMENT FOR HEARING AID 

V5011 FITTING/ORIENTATION/CHECKING OF HEARING AID 

V5014 REPAIR/MODIFICATION OF A HEARING AID 

V5020 CONFORMITY EVALUATION 

V5030 HEARING AID, MONAURAL, BODY WORN, AIR CONDUCTION 

V5040 HEARING AID, MONAURAL, BODY WORN, BONE CONDUCTION 

V5050 HEARING AID, MONAURAL, IN THE EAR 

V5060 HEARING AID, MONAURAL, BEHIND THE EAR 

V5070 GLASSES, AIR CONDUCTION 

V5080 GLASSES, BONE CONDUCTION 

V5090 DISPENSING FEE, UNSPECIFIED HEARING AID 

V5100 HEARING AID, BILATERAL, BODY WORN 

V5110 DISPENSING FEE, BILATERAL 

V5120 BINAURAL, BODY

V5130 BINAURAL, IN THE EAR 

V5140 BINAURAL, BEHIND THE EAR 

V5150 BINAURAL, GLASSES 

V5160 DISPENSING FEE, BINAURAL 

V5170 HEARING AID, CROS, IN THE EAR 

V5180 HEARING AID, CROS, BEHIND THE EAR 

V5190 HEARING AID, CROS, GLASSES 

V5200 DISPENSING FEE, CROS 

V5210 HEARING AID, BICROS, IN THE EAR 

V5220 HEARING AID, BICROS, BEHIND THE EAR 

V5230 HEARING AID, BICROS, GLASSES 

V5240 DISPENSING FEE, BICROS 

V5299 HEARING SERVICE, MISCELLANEOUS 

V5336 REPAIR/MODIFICATION OF AUGMENTATIVE COMMUNICATIVE SYSTEM OR DEVICE (EXCLUDES 

ADAPTIVE HEARING AID) 

V5362 SPEECH SCREENING 

V5363 LANGUAGE SCREENING 

V5364 DYSPHAGIA SCREENING

Medicare Data Utilities Appendices

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