Version 1
An episode of care, also known as an episode, groups all relevant services provided to a patient for a particular condition within a confined time range. An episode of care serves as a unit of accounting as well as a unit of accountability for providers who take on financial risk for the episode. Defining an episode in such a manner helps to identify sources of variation and to standardize care.
An episode of care for Shoulder Replacement, sometimes abbreviated SHLDRP, is a procedural episode. The Shoulder Replacement episode includes services related to the procedure such as a facility stay, anesthesia services, as well as services within the 30-day pre- and 90-day post-operative care time window, such as diagnostic services, (imaging, labs etc.), office visits, physical therapy and ancillary services.
Episode Components
| Triggers | A Shoulder Replacement episode trigger includes an inpatient facility claim with a procedure trigger code in the principal position and a qualifying diagnosis code in the principal position (Table 1). This episode is also triggered by an outpatient facility or professional claim with a procedure trigger code (in any position) and a qualifying diagnosis code (in any position) on the same claim line. |
| Typical Diagnosis | Typical diagnosis codes (ICD 10 DX codes) indicate typical care. Claims with typical diagnosis codes usually associated with an episode help steer services into this episode. However, a relevant procedure code is required on the same claim/claim line for the indicated diagnosis code to be incorporated into the episode. (Table 2) |
| Actionable adverse events (AAE) | Actionable adverse events (AAE) are events that are recognized by diagnosis codes (ICD 10 DX codes) and their timing to indicate potential complications of care. They require a relevant procedure code (ICD 10 PX codes; CPT/HCPCS codes) on the same claim/claim line to assign the claim to the episode. Additional rules are used to identify AAEs in addition to the presence of AAE diagnosis codes. For example, relevant acute inpatient readmission claims are flagged as actionable adverse events regardless of the presence of AAE codes. (Table 3) |
| Relevant Procedure Codes | All relevant services within the timeframe of an episode are included within an episode. These include office visits, emergency room visits, inpatient professional or facility services, labs, radiology or ancillary services. Relevant diagnosis and procedure codes help identify which services are included. Some procedure codes are sufficient to stand alone, while others require typical or actionable adverse event (AAE) diagnosis codes on the same claim/claim line to steer services into the episode. (Tables 4 and 5) |
| Relevant Pharmacy | All relevant pharmacy services are included within an episode. These are identified by National Drug Codes (NDC) on a pharmacy claim and are grouped using the RxNorm grouping classification for ease of assigning them into episodes. (Table 6) |
| SubTypes | Episode subtypes are used to adjust the target price and/or to subset episode type for reporting purposes. They are specific to the episode and identified from the trigger claim or from claims during the look-back period. Examples of Subtype Groups: Total Shoulder ReplacementPartial Shoulder Replacement |
Code Tables
Table 1: Trigger Codes
| Trigger Type | Code Value |
| CPT / HCPCS Triggers | 23470, 23472, 23473, 23474 |
| ICD-10-CM (DX) Qualifying Diagnosis | M02011, M02012, M02019, M02111, M02112, M02119, M02211, M02212, M02219, M02311, M02312, M02319, M02811, M02812, M02819, M05011, M05012, M05019, M05211, M05212, M05219, M05311, M05312, M05319, M05411, M05412, M05419, M05511, M05512, M05519, M05611, M05612, M05619, M05711, M05712, M05811, M05812, M05819, M06011, M06012, M06019, M06211, M06212, M06219, M06311, M06312, M06319, M06811, M06812, M06819, M07611, M07612, M07619, M08011, M08012, M08019, M08211, M08212, M08219, M08411, M08412, M08419, M08811, M08812, M08819, M08911, M08912, M08919, M10011, M10012, M10019, M10111, M10112, M10119, M10211, M10212, M10219, M10411, M10412, M10419, M11011, M11012, M11019, M11111, M11112, M11119, M11211, M11212, M11219, M11811, M11812, M11819, M12011, M12012, M12019, M12111, M12112, M12119, M12211, M12212, M12219, M12311, M12312, M12319, M12411, M12412, M12419, M12811, M12812, M12819, M13111, M13112, M13119, M13811, M13812, M13819, M14611, M14612, M14619, M14811, M14812, M14819, M19011, M19012, M19019, M19211, M19212, M19219, M1A0110, M1A0111, M1A0120, M1A0121, M1A0190, M1A0191, M1A2110, M1A2111, M1A2120, M1A2121, M1A2190, M1A2191, M1A3110, M1A3111, M1A3120, M1A3121, M1A3191, M1A4110, M1A4111, M1A4120, M1A4121, M1A4190, M1A4191, M21211, M21212, M21219, M24011, M24012, M24019, M24111, M24112, M24119, M24311, M24312, M24319, M24411, M24412, M24419, M24511, M24512, M24519, M24611, M24612, M24619, M24811, M24812, M24819, M25011, M25012, M25019, M25111, M25112, M25119, M25211, M25212, M25219, M25311, M25312, M25319, M25411, M25412, M25419, M25511, M25512, M25519, M25611, M25612, M25619, M25711, M25712, M25719, M25811, M25812, M25819, M62511, M62512, M62519, M63811, M63812, M63819, M66111, M66112, M66119, M67411, M67412, M67419, M71111, M71112, M71119, M71311, M71312, M71319, M7500, M7501, M7502, M75100, M75101, M75102, M75110, M75111, M75112, M75120, M75121, M75122, M7520, M7521, M7522, M7530, M7531, M7532, M7540, M7541, M7542, M7550, M7551, M7552, M7580, M7581, M7582, M7590, M7591, M7592, M80011A, M80011K, M80011P, M80012A, M80012K, M80012P, M80019A, M80019K, M80019P, M80021A, M80021K, M80021P, M80022A, M80022K, M80022P, M80029A, M80029K, M80029P, M8080XA, M8080XK, M8080XP, M80811A, M80811K, M80811P, M80812A, M80812K, M80812P, M80819A, M80819K, M80819P, M80821A, M80821K, M80821P, M80822A, M80822K, M80822P, M80829A, M80829K, M80829P, M84311A, M84311K, M84311P, M84312A, M84312K, M84312P, M84319A, M84319K, M84319P, M84321A, M84321K, M84321P, M84322A, M84322K, M84322P, M84329A, M84329K, M84329P, M84411A, M84411K, M84411P, M84412A, M84412K, M84412P, M84419A, M84419K, M84419P, M84421A, M84421K, M84421P, M84422A, M84422K, M84422P, M84429A, M84429K, M84429P, M84511A, M84511K, M84511P, M84512A, M84512K, M84512P, M84519A, M84519K, M84519P, M84521A, M84521K, M84521P, M84522A, M84522K, M84522P, M84529A, M84529K, M84529P, M84611A, M84611K, M84611P, M84612A, M84612K, M84612P, M84619A, M84619K, M84619P, M84811, M84812, M84819, M85011, M85012, M85019, M85111, M85112, M85119, M85311, M85312, M85319, M85411, M85412, M85419, M85511, M85512, M85519, M85611, M85612, M85619, M85811, M85812, M85819, M87011, M87012, M87019, M87111, M87112, M87119, M87211, M87212, M87219, M87311, M87312, M87319, M87811, M87812, M87819, M88811, M88812, M88819, M89011, M89012, M89019, M89211, M89212, M89219, M89311, M89312, M89319, M89511, M89512, M89519, M89711, M89712, M89719, M898X1, M90511, M90512, M90519, M90611, M90612, M90619, M90811, M90812, M90819, M93211, M93212, M93219, M93811, M93812, M93819, M93911, M93912, M93919, M94211, M94212, M94219, M948X1, S42101K, S42101P, S42102K, S42102P, S42109K, S42109P, S42111K, S42111P, S42112K, S42112P, S42113K, S42113P, S42114K, S42114P, S42115K, S42115P, S42116K, S42116P, S42121K, S42121P, S42122K, S42122P, S42123K, S42123P, S42124K, S42124P, S42125K, S42125P, S42126K, S42126P, S42131K, S42131P, S42132K, S42132P, S42133K, S42133P, S42134K, S42134P, S42135K, S42135P, S42136K, S42136P, S42141K, S42141P, S42142K, S42142P, S42143K, S42143P, S42144K, S42144P, S42145K, S42145P, S42146K, S42146P, S42151K, S42151P, S42152K, S42152P, S42153K, S42153P, S42154K, S42154P, S42155K, S42155P, S42156K, S42156P, S42191K, S42191P, S42192K, S42192P, S42199K, S42199P, S42201K, S42201P, S42202K, S42202P, S42209K, S42209P, S42211K, S42211P, S42212K, S42212P, S42213K, S42213P, S42214K, S42214P, S42215K, S42215P, S42216K, S42216P, S42221K, S42221P, S42222K, S42222P, S42223K, S42223P, S42224K, S42224P, S42225K, S42225P, S42226K, S42226P, S42231K, S42231P, S42232K, S42232P, S42239K, S42239P, S42241K, S42241P, S42242K, S42242P, S42249K, S42249P, S42251K, S42251P, S42252K, S42252P, S42253K, S42253P, S42254K, S42254P, S42255K, S42255P, S42256K, S42256P, S42261K, S42261P, S42262K, S42262P, S42263K, S42263P, S42264K, S42264P, S42265K, S42265P, S42266K, S42266P, S42271K, S42271P, S42272K, S42272P, S42279K, S42279P, S42291K, S42291P, S42292K, S42292P, S42293K, S42293P, S42294K, S42294P, S42295K, S42295P, S42296K, S42296P, S4290XK, S4290XP, S4291XK, S4291XP, S4292XK, S4292XP, S43421A, S43422A, S43429A, S49011K, S49011P, S49012K, S49012P, S49019K, S49019P, S49021K, S49021P, S49022K, S49022P, S49029K, S49029P, S49031K, S49031P, S49032K, S49032P, S49039K, S49039P, S49041K, S49041P, S49042K, S49042P, S49049K, S49049P, S49091K, S49091P, S49092K, S49092P, S49099K, S49099P, Z96611, Z96612, Z96619 |
| ICD-10-PCS (PX) Triggers | 0RRG07Z, 0RRG0JZ, 0RRG0KZ, 0RRH07Z, 0RRH0JZ, 0RRH0KZ, 0RRJ00Z, 0RRJ07Z, 0RRJ0J6, 0RRJ0J7, 0RRJ0JZ, 0RRJ0KZ, 0RRK00Z, 0RRK07Z, 0RRK0J6, 0RRK0J7, 0RRK0JZ, 0RRK0KZ, 0RWG0JZ, 0RWG3JZ, 0RWG4JZ, 0RWH0JZ, 0RWH3JZ, 0RWH4JZ, 0RWJ0JZ, 0RWJ3JZ, 0RWJ4JZ, 0RWK0JZ, 0RWK3JZ, 0RWK4JZ |
Table 2: ICD-10 Typical Diagnosis
| Group ID | Group Name | Code Value |
| DXX0009 | Open wounds of extremities | S41009D, S41109D |
| DXX0012 | Other injuries and conditions due to external | S46001D, S46002D, S46009D, S46091D, S46092D, S46099D, S46101D, S46102D, S46109D, S46191D, S46192D, S46199D, S46201D, S46202D, S46209D, S46291D, S46292D, S46299D, S46301D, S46302D, S46309D, S46391D, S46392D, S46399D, S46801D, S46802D, S46809D, S46891D, S46892D, S46899D, S46901D, S46902D, S46909D, S46991D, S46992D, S46999D, S4980XD, S4981XD, S4982XD, S4990XD, S4991XD, S4992XD |
| DXX0020 | Superficial injury; contusion | S40011D, S40012D, S40019D, S40211D, S40212D, S40219D, S40811D, S40812D, S40819D |
| DXX01149 | NS – polyneuropathy – collagen vascular disease | M0550, M05511, M05512, M05519, M0559 |
| DXX01185 | NS – chronic pain – post op | G8928 |
| DXX05183 | CV – vasc cath adjust remove | Z452 |
| DXX05345 | Orthostatic Hypotension / Dizziness | R42 |
| DXX081043 | Aseptic Necrosis | M8700, M87011, M87012, M87019, M87021, M87022, M87029, M8708, M8709, M8710, M87111, M87112, M87119, M87121, M87122, M87129, M87188, M8719, M8720, M87211, M87212, M87219, M87221, M87222, M87229, M8728, M8729, M8730, M87311, M87312, M87319, M87321, M87322, M87329, M8738, M8739, M8780, M87811, M87812, M87819, M87821, M87822, M87829, M8788, M8789, M879, M9050, M90511, M90512, M90519, M90521, M90522, M90529, M9058, M9059 |
| DXX081047 | Gout and other crystal arthropathies | M1000, M10011, M10012, M10019, M1009, M1010, M10111, M10112, M10119, M1019, M1020, M10211, M10212, M10219, M1029, M1040, M10411, M10412, M10419, M1049, M109, M1100, M11011, M11012, M11019, M1109, M1110, M11111, M11112, M11119, M1119, M1120, M11211, M11212, M11219, M1129, M1180, M11811, M11812, M11819, M1189, M119, M1A00X0, M1A00X1, M1A0110, M1A0111, M1A0120, M1A0121, M1A0190, M1A0191, M1A09X0, M1A09X1, M1A20X0, M1A20X1, M1A2110, M1A2111, M1A2120, M1A2121, M1A2190, M1A2191, M1A29X0, M1A29X1, M1A30X0, M1A30X1, M1A3110, M1A3111, M1A3120, M1A3121, M1A3190, M1A3191, M1A39X0, M1A39X1, M1A40X0, M1A40X1, M1A4110, M1A4111, M1A4120, M1A4121, M1A4190, M1A4191, M1A49X0, M1A49X1, M1A9XX0, M1A9XX1 |
| DXX081050 | Inflammatory Arthropathies | M02111, M02112, M02119, M0219, M02311, M02312, M02319, M0239 |
| DXX081056 | Malunion | M8000XP, M80011P, M80012P, M80019P, M80021P, M80022P, M80029P, M8080XP, M80811P, M80812P, M80819P, M80821P, M80822P, M80829P, M8430XP, M84311P, M84312P, M84319P, M84321P, M84322P, M84329P, M8438XP, M8440XP, M84411P, M84412P, M84419P, M84421P, M84422P, M84429P, M8448XP, M8450XP, M84511P, M84512P, M84519P, M84521P, M84522P, M84529P, M8458XP, M8460XP, M84611P, M84612P, M84619P, M84621P, M84622P, M84629P, M8468XP, S42001P, S42002P, S42009P, S42031P, S42032P, S42033P, S42034P, S42035P, S42036P, S42101P, S42102P, S42109P, S42111P, S42112P, S42113P, S42114P, S42115P, S42116P, S42121P, S42122P, S42123P, S42124P, S42125P, S42126P, S42131P, S42132P, S42133P, S42134P, S42135P, S42136P, S42141P, S42142P, S42143P, S42144P, S42145P, S42146P, S42151P, S42152P, S42153P, S42154P, S42155P, S42156P, S42191P, S42192P, S42199P, S42201P, S42202P, S42209P, S42211P, S42212P, S42213P, S42214P, S42215P, S42216P, S42221P, S42222P, S42223P, S42224P, S42225P, S42226P, S42231P, S42232P, S42239P, S42241P, S42242P, S42249P, S42251P, S42252P, S42253P, S42254P, S42255P, S42256P, S42261P, S42262P, S42263P, S42264P, S42265P, S42266P, S42271P, S42272P, S42279P, S42291P, S42292P, S42293P, S42294P, S42295P, S42296P, S4290XP, S4291XP, S4292XP, S49011P, S49012P, S49019P, S49021P, S49022P, S49029P, S49031P, S49032P, S49039P, S49041P, S49042P, S49049P, S49091P, S49092P, S49099P |
| DXX081057 | Nonunion | M8000XK, M80011K, M80012K, M80019K, M80021K, M80022K, M80029K, M8080XK, M80811K, M80812K, M80819K, M80821K, M80822K, M80829K, M8430XK, M84311K, M84312K, M84319K, M84321K, M84322K, M84329K, M8438XK, M8440XK, M84411K, M84412K, M84419K, M84421K, M84422K, M84429K, M8448XK, M8450XK, M84511K, M84512K, M84519K, M84521K, M84522K, M84529K, M8458XK, M8460XK, M84611K, M84612K, M84619K, M84621K, M84622K, M84629K, M8468XK, S42001K, S42002K, S42009K, S42031K, S42032K, S42033K, S42034K, S42035K, S42036K, S42101K, S42102K, S42109K, S42111K, S42112K, S42113K, S42114K, S42115K, S42116K, S42121K, S42122K, S42123K, S42124K, S42125K, S42126K, S42131K, S42132K, S42133K, S42134K, S42135K, S42136K, S42141K, S42142K, S42143K, S42144K, S42145K, S42146K, S42151K, S42152K, S42153K, S42154K, S42155K, S42156K, S42191K, S42192K, S42199K, S42201K, S42202K, S42209K, S42211K, S42212K, S42213K, S42214K, S42215K, S42216K, S42221K, S42222K, S42223K, S42224K, S42225K, S42226K, S42231K, S42232K, S42239K, S42241K, S42242K, S42249K, S42251K, S42252K, S42253K, S42254K, S42255K, S42256K, S42261K, S42262K, S42263K, S42264K, S42265K, S42266K, S42271K, S42272K, S42279K, S42291K, S42292K, S42293K, S42294K, S42295K, S42296K, S4290XK, S4291XK, S4292XK, S49011K, S49012K, S49019K, S49021K, S49022K, S49029K, S49031K, S49032K, S49039K, S49041K, S49042K, S49049K, S49091K, S49092K, S49099K |
| DXX081060 | Osteoarthritis, other joints | M150, M153, M154, M158, M159, M1991, M1992, M1993 |
| DXX081061 | Osteoporosis, osteitis deformans | M8000XA, M80011A, M80012A, M80019A, M8080XA, M80811A, M80812A, M80819A, M810, M816, M818, M8430XA, M84311A, M84312A, M84319A, M84321A, M84322A, M84329A, M8438XA, M8440XA, M84411A, M84412A, M84419A, M8448XA, M8450XA, M84511A, M84512A, M84519A, M8460XA, M84611A, M84612A, M84619A, M8468XA, M8500, M85011, M85012, M85019, M85021, M85022, M85029, M8508, M8509, M8530, M85311, M85312, M85319, M85321, M85322, M85329, M8538, M8539, M8540, M85411, M85412, M85419, M85421, M85422, M85429, M8548, M8550, M85511, M85512, M85519, M85521, M85522, M85529, M8558, M8559, M8560, M85611, M85612, M85619, M85621, M85622, M85629, M8568, M8569, M88811, M88812, M88819, M88821, M88822, M88829, M8888, M8889, M889, M89411, M89412, M89419, M89421, M89422, M89429, M8949, M8970, M89711, M89712, M89719, M89721, M89722, M89729, M8978, M8979, M9060, M90611, M90612, M90619, M90621, M90622, M90629, M9068, M9069, M90821, M90822, M90829, M928, M929, M9320, M93211, M93212, M93219, M9328, M9329, M9390, M93911, M93912, M93919, M93921, M93922, M93929, M9398, M9399, M940, Q773, Q776, Q780, Q781, Q782, Q783, Q785, Q786, Q788, Q789 |
| DXX081062 | Other arthropathies | A5216, E08610, E08618, M0200, M02011, M02012, M02019, M0209, M0220, M02211, M02212, M02219, M0229, M029, M064, M0760, M07611, M07612, M07619, M0769, M1200, M12011, M12012, M12019, M1208, M1209, M1210, M12111, M12112, M12119, M1219, M1229, M1239, M1249, M1250, M12511, M12512, M12519, M1258, M1259, M1280, M12811, M12812, M12819, M1288, M1289, M129, M130, M1310, M13111, M13112, M13119, M1380, M13811, M13812, M13819, M1388, M1389, M1460, M14611, M14612, M14619, M1469, M1480, M14811, M14812, M14819, M1489, M2400, M2410, M2430, M2460, M2480, M249, M2550, M2560, M2580, M259, M361, M362, M363, M364, M931, M9380, M93811, M93812, M93819, M93821, M93822, M93829, M9388, M9389, R29898 |
| DXX081064 | Other deformities, limb, other sites | M2120, M21211, M21212, M21219, M2170, M21721, M21722, M21729, M2180, M21821, M21822, M21829, M2190, M21921, M21922, M21929, M2450, M89121, M89122, M89123, M89124, M89129, M8918, M958, M959, M9987, M999, Q688, Q798, Q799 |
| DXX081066 | Rheumatoid Arthritis | M0500, M05011, M05012, M05019, M0509, M0520, M05211, M05212, M05219, M0529, M0530, M05311, M05312, M05319, M0539, M0560, M05611, M05612, M05619, M0569, M0570, M05711, M05712, M05719, M0579, M0580, M05811, M05812, M05819, M0589, M059, M0600, M06011, M06012, M06019, M0609, M061, M0680, M06811, M06812, M06819, M0689, M069, M0800, M08011, M08012, M08019, M0809, M0820, M08211, M08212, M08219, M0829, M083, M0840, M08411, M08412, M08419, M0880, M08811, M08812, M08819, M0888, M0889, M0890, M08911, M08912, M08919, M0899 |
| DXX081071 | Infective Arthritis | M01X11, M01X12, M01X19, M01X9, M02811, M02812, M02819, M0289 |
| DXX081073 | Osteoarthritis, Shoulder | M19011, M19012, M19019, M19111, M19112, M19119, M19211, M19212, M19219 |
| DXX081074 | Rotator Cuff Strain, Tear and tendonitis | M66211, M66212, M66219, M66811, M66812, M66819, M7500, M7501, M7502, M75100, M75101, M75102, M75110, M75111, M75112, M75120, M75121, M75122, M7520, M7521, M7522, M7550, M7551, M7552, S43421A, S43422A, S43429A |
| DXX081075 | Other Shoulder Derangements | M12211, M12212, M12219, M12311, M12312, M12319, M12411, M12412, M12419, M24011, M24012, M24019, M24111, M24112, M24119, M24311, M24312, M24319, M24411, M24412, M24419, M24511, M24512, M24519, M24611, M24612, M24619, M24811, M24812, M24819, M25011, M25012, M25019, M25111, M25112, M25119, M25211, M25212, M25219, M25311, M25312, M25319, M25411, M25412, M25419, M25511, M25512, M25519, M25611, M25612, M25619, M25711, M25712, M25719, M25811, M25812, M25819, M7530, M7531, M7532, M7540, M7541, M7542, M7580, M7581, M7582, M7590, M7591, M7592 |
| DXX081082 | Compl of joint prosthesis, orthopedic proced | T84612D, T84613D |
| DXX081084 | Hemarthrosis: Bleeding into Joints | M2500, M2508 |
| DXX081090 | Osteopathy from polio | M89611, M89612, M89619 |
| DXX081098 | Other aftercare | Z4731 |
| DXX081100 | Osteoarthritis | M1990 |
| DXX081102 | Fistula, Effusion in Joint | M2510, M2540 |
| DXX081103 | Other osteopathic disorders | M9080, M90811, M90812, M90819, M9088, M9089, M9989 |
| DXX081113 | Rheumatoid Arthritis and Inflammatory Connective Tissue Disease | M0540, M05411, M05412, M05419, M0549, M0620, M06211, M06212, M06219, M0629, M0630, M06311, M06312, M06319, M0639, M352 |
| DXX081114 | Wasting of Muscles and Neuro Muscular Dystrophy | M8900, M89011, M89012, M89019, M89021, M89022, M89029, M8908, M8909 |
| DXX081115 | Periprosthetic fracture | M9731XS, M9732XS, M9741XD, M9742XD, T84048S, T84049S |
| DXX08217 | MS – spine – fx – pathologic | M8468XD |
| DXX08286 | MS – shldr jt replacement | Z96611, Z96612, Z96619 |
| DXX08295 | MS – uppr arm – fx – humerus – pathologic | M80021A, M80022A, M80029A, M80821A, M80822A, M80829A, M84421A, M84422A, M84429A, M84521A, M84522A, M84529A, M84621A, M84622A, M84629A |
| DXX0833 | Neoplsm – benign neoplsm – humerus / radius / scapula / ulna | D1600, D1601, D1602 |
| DXX0835 | Neoplsm – benign neoplsm – upper extremity | D2110, D2111, D2112 |
| DXX0839 | Neoplsm – benign neoplsm – bone / cartilage – nos | D169 |
| DXX08522 | MS – uppr extrm – nos – ostchndrpthy | M9200, M9201, M9202, M9230, M9231, M9232 |
| DXX08524 | MS – uppr extrm – other deformity | Q749 |
| DXX08530 | MS – uppr extrm – nos – sprn/strn | S46011A, S46012A |
| DXX0860 | MS – face – acqrd defrmty | M8938, M898X8 |
| DXX08833 | MS – extrmty – pain | M79601, M79602, M79603, M79609, M79621, M79622, M79629 |
| DXX08843 | MS – extrmty – other deformity | Q748 |
| DXX08845 | MS – extrmty – nonallo | M9907 |
| DXX08869 | MS – bone – nos – osteoporosis | Z13820 |
| DXX08870 | MS – bone – nos – fx – pathologic | M8000XD, M8000XG, M8080XD, M8080XG, M8430XD, M8430XG, M8438XD, M8438XG, M8440XD, M8440XG, M8448XD, M8448XG, M8450XD, M8450XG, M8460XD, M8460XG, M8468XG |
| DXX08874 | MS – bone – nos – fx – aftercare | S42001D, S42001G, S42002D, S42002G, S42009D, S42009G, S42031D, S42031G, S42032D, S42032G, S42033D, S42033G, S42034D, S42034G, S42035D, S42035G, S42036D, S42036G |
| DXX08877 | MS – bone – nos – chondrodystrophy | Q770, Q774, Q775, Q777, Q778, Q779, Q784 |
| DXX08880 | MS – bone – nos – nec / nos | M8480, M84811, M84812, M84819, M84821, M84822, M84829, M8488, M849, M8510, M85111, M85112, M85119, M85121, M85122, M85129, M8518, M8519, M8580, M85811, M85812, M85819, M85821, M85822, M85829, M8588, M8589, M859, M8920, M89211, M89212, M89219, M89221, M89222, M89229, M8928, M8929, M8930, M89311, M89312, M89319, M89321, M89322, M89329, M8939, M8950, M89511, M89512, M89519, M89521, M89522, M89529, M8958, M8959, M898X0, M898X1, M898X2, M898X9, M899, M941, M9420, M94211, M94212, M94219, M9428, M9429, M948X0, M948X1, M948X2, M948X8, M948X9, M949 |
| DXX08881 | MS – bone – nos – service – other | Z472 |
| DXX08891 | MS – joint nos – other arthropathy | M1220, M1228, M1230, M1238, M1240, M1248, M2518 |
| DXX08894 | MS – joint nos – jnt derangmnt – loose body | M2408 |
| DXX08897 | MS – joint nos – jnt derangmnt – other | M2520, M2528, M2530 |
| DXX08900 | MS – joint – nos – effusion | M2548 |
| DXX08909 | MS – joint nos – discloc – recurrent | M2440 |
| DXX08920 | MS – joint – nos – replacement – aftercare | Z471 |
| DXX08928 | MS – soft tissue – nos- hematoma | M7981 |
| DXX08931 | MS – soft tissue – nos- nec / nos | M7989 |
| DXX08934 | MS – synvm / tndn / brsa – nos – synvtis/tensyn | M6580, M659 |
| DXX08935 | MS – synvm / tndn / brsa – nos – bursitis | M7110, M71111, M71112, M71119, M7118, M7119, M7150, M7158 |
| DXX08936 | MS – synvm / tndn / brsa – nos – ganglion / cyst | M6740, M67411, M67412, M67419, M6748, M6749, M7130, M71311, M71312, M71319, M7138, M7139 |
| DXX08937 | MS – synvm / tndn / brsa – nos – rupture – synovium | M6610, M66111, M66112, M66119, M6618 |
| DXX08938 | MS – synvm / tndn / brsa – nos – rupture – tendon | M6620, M669 |
| DXX08939 | MS – synvm / tndn / brsa – nos – nec / nos | M6520, M65221, M65222, M65229, M6528, M6529, M7140, M7148, M7149 |
| DXX08941 | MS – muscle nos- myosits | M6010, M60111, M60112, M60119, M60121, M60122, M60129, M6018, M6019 |
| DXX08942 | MS – muscle nos- FB granuloma | M6020, M60211, M60212, M60219, M60221, M60222, M60229, M6028 |
| DXX08943 | MS – muscle nos- muscle rupture | M6210, M62111, M62112, M62119, M62121, M62122, M62129, M6218 |
| DXX08944 | MS – muscle nos- muscle diastasis | M6200, M62011, M62012, M62019, M62021, M62022, M62029, M6208 |
| DXX08946 | MS – muscle – nos – other ds | M6284 |
| DXX08947 | MS – muscle – nos – muscle atrophy | M6250, M62511, M62512, M62519, M62521, M62522, M62529, M6258, M6259 |
| DXX08948 | MS – muscle – nos – spasm of muscle | M6240, M62411, M62412, M62419, M62421, M62422, M62429, M6248, M6249, M62838 |
| DXX08949 | MS – muscle – nos – muscle weakness | M6281 |
| DXX08953 | MS – mscl / lgmnt / fscia – nos – nec / nos | M354, M6220, M62211, M62212, M62219, M62221, M62222, M62229, M6228, M6289, M629, M6380, M63811, M63812, M63819, M63821, M63822, M63829, M6388, M6389, M728 |
| DXX08960 | MS – nos – aftercare | Z4789 |
| DXX10101 | diabetes mellitus with neurologic manifestations | E09610, E10610, E11610, E13610 |
| DXX10111 | Diabetes, other manifestation | E09618, E10618, E11618, E13618 |
| DXX1770 | Complications from chemotherapy | T80810D |
| DXX1963 | Anxiety Disorders | F064 |
| DXX2008 | Tobacco Use | T65214D, T65221D, T65224D, T65291D, T65294D |
| DXX2104 | NS – acute pain – post op | G8918 |
| DXX2167 | Accidental Poisoning by Alcohol | T510X1D, T510X4D |
| DXX2339 | Prvn – admin exam / visit | Z0271 |
| DXX2340 | Prvn – pre-op exam | Z0130, Z0131, Z01810, Z01811, Z01812, Z01818, Z0183 |
| DXX2342 | Prvn – encounter for lab test | Z0184 |
| DXX2345 | Othr – fitting – other device | Z448, Z449, Z451, Z4589, Z459, Z469 |
| DXX2354 | Othr – aftercare | S40021D, S40022D, S40029D, S40241D, S40242D, S40249D, S40251D, S40252D, S40259D, S40841D, S40842D, S40849D, S40851D, S40852D, S40859D, S40911D, S40912D, S40919D, S40921D, S40922D, S40929D, S41001D, S41002D, S41011D, S41012D, S41019D, S41021D, S41022D, S41029D, S41031D, S41032D, S41039D, S41041D, S41042D, S41049D, S41101D, S41102D, S41111D, S41112D, S41119D, S41121D, S41122D, S41129D, S41131D, S41132D, S41139D, S41141D, S41142D, S41149D, S41151D, S41152D, S41159D, S43001D, S43002D, S43003D, S43004D, S43005D, S43006D, S43011D, S43012D, S43013D, S43014D, S43015D, S43016D, S43021D, S43022D, S43023D, S43024D, S43025D, S43026D, S43031D, S43032D, S43033D, S43034D, S43035D, S43036D, S43081D, S43082D, S43083D, S43084D, S43085D, S43086D, S43101D, S43102D, S43109D, S43111D, S43112D, S43119D, S43121D, S43122D, S43129D, S43131D, S43132D, S43139D, S43141D, S43142D, S43149D, S43151D, S43152D, S43159D, S43301D, S43302D, S43303D, S43304D, S43305D, S43306D, S43311D, S43312D, S43313D, S43314D, S43315D, S43316D, S43391D, S43392D, S43393D, S43394D, S43395D, S43396D, S43401D, S43402D, S43409D, S43411D, S43412D, S43419D, S43421D, S43422D, S43429D, S43431D, S43432D, S43439D, S43491D, S43492D, S43499D, S4350XD, S4351XD, S4352XD, S4380XD, S4381XD, S4382XD, S4390XD, S4391XD, S4392XD, S4410XD, S4411XD, S4412XD, S4430XD, S4431XD, S4432XD, S4440XD, S4441XD, S4442XD, S4450XD, S4451XD, S4452XD, S45001D, S45002D, S45009D, S45011D, S45012D, S45019D, S45091D, S45092D, S45099D, S45101D, S45102D, S45109D, S45111D, S45112D, S45119D, S45191D, S45192D, S45199D, S45201D, S45202D, S45209D, S45211D, S45212D, S45219D, S45291D, S45292D, S45299D, S45301D, S45302D, S45309D, S45311D, S45312D, S45319D, S45391D, S45392D, S45399D, S45801D, S45802D, S45809D, S45811D, S45812D, S45819D, S45891D, S45892D, S45899D, S45901D, S45902D, S45909D, S45911D, S45912D, S45919D, S45991D, S45992D, S45999D, S46011D, S46012D, S46019D, S46021D, S46022D, S46029D, S46111D, S46112D, S46119D, S46121D, S46122D, S46129D, S46211D, S46212D, S46219D, S46221D, S46222D, S46229D, S46311D, S46312D, S46319D, S46321D, S46322D, S46329D, S46811D, S46812D, S46819D, S46821D, S46822D, S46829D, S46911D, S46912D, S46919D, S46921D, S46922D, S46929D, S471XXD, S472XXD, S479XXD, S48111D, S48112D, S48119D, S48121D, S48122D, S48129D, S48911D, S48912D, S48919D, S48921D, S63131D, T698XXD, T7411XD, T7412XD, T7491XD, T7492XD, T7611XD, T7612XD, T7800XD, T7801XD, T7802XD, T7803XD, T7804XD, T7805XD, T7806XD, T7807XD, T7808XD, T7809XD, T781XXD |
| DXX2358 | Othr – post op care | Z4803 |
| DXX2359 | Othr – other aftercare | Z4800, Z4801, Z4802, Z481 |
| DXX2360 | Complication of Implanted device, graft | T8581XS, T8582XS, T8583XS, T8584XS, T8585XS, T8586XS, T8589XS |
| DXX2361 | complications of surgical procedures | R5082 |
| DXX2370 | Fever & Chills | R5081, R509, R6883 |
| DXX2379 | Observation/Examination | Z0000, Z0189 |
| DXX2381 | Aftercare | Z09, Z4689, Z4889, Z5189 |
| DXX2382 | Preventive Screening | Z13828, Z1389 |
| DXX2395 | Foreign body left during procedure | T8161XD |
Table 3: ICD-10 Actionable Adverse Events
| Group ID | Group Name | Code Value |
| DXX0012 | Other injuries and conditions due to external | T783XXD |
| DXX0019 | Skin and subcutaneous tissue infections | L0889 |
| DXX01384 | Hemorrhagic Stroke | I6000, I6001, I6002, I6010, I6011, I6012, I602, I6020, I6021, I6022, I6030, I6031, I6032, I604, I6050, I6051, I6052, I606, I607, I608, I609, I610, I611, I612, I613, I614, I615, I616, I618, I619, I6200, I6201, I6202, I6203, I621, I629 |
| DXX01385 | Thromboembolic Stroke | I6300, I63011, I63012, I63013, I63019, I6302, I63031, I63032, I63033, I63039, I6309, I6310, I63111, I63112, I63113, I63119, I6312, I63131, I63132, I63133, I63139, I6319, I6320, I63211, I63212, I63213, I63219, I6322, I63231, I63232, I63233, I63239, I6329, I6330, I63311, I63312, I63313, I63319, I63321, I63322, I63323, I63329, I63331, I63332, I63333, I63339, I63341, I63342, I63343, I63349, I6339, I6340, I63411, I63412, I63413, I63419, I63421, I63422, I63423, I63429, I63431, I63432, I63433, I63439, I63441, I63442, I63443, I63449, I6349, I6350, I63511, I63512, I63513, I63519, I63521, I63522, I63523, I63529, I63531, I63532, I63533, I63539, I63541, I63542, I63543, I63549, I6359, I636, I638, I639 |
| DXX01391 | Meningitis / Encephalitis | G038 |
| DXX01392 | Delirium, Encephalopathy | F05, G92, G9340, G9341, G9349, I6783 |
| DXX01403 | Complication of nervous system device | T85695D, T85810D, T85820D, T85830D, T85850D |
| DXX04126 | other lung complications | J90, J940, J941, J942, J949, J954, J955, J95811, J95859, J9588, R091 |
| DXX04127 | empyema, lung abscess | J869 |
| DXX04130 | Aspiration Pneumonia | J690, J698 |
| DXX04142 | Respiratory Failure | J80, J9584, J9600, J9601, J9602, J9620, J9621, J9622, J9690, J9691, J9692, R092 |
| DXX04154 | Respiratory Insufficiency | R0681, R0901, R0902, Y654, Z9981 |
| DXX04164 | Chronic Fungal and Other Pneumonias | A70, B390, B391, B392, B440, B7781 |
| DXX04170 | Ventilator Associated Pnuemonia | J95851 |
| DXX04172 | Gram Negative Pneumonia | J155, J156 |
| DXX04173 | MRSA Pneumonia | J15212 |
| DXX04174 | Other Staph Pneumonia | J1520, J15211, J1529 |
| DXX04176 | Resp Failure following trauma / surgery | J952, J953, J95821, J95822 |
| DXX04177 | Ventilator Dependence | Z9911, Z9912 |
| DXX04187 | Other lung problems | J182, J918, J9811, J9819 |
| DXX04188 | Other Bacterial Pneumonia | J158, J159, J17, J188, J189 |
| DXX04190 | Influenza with Pneumonia | J1000, J1001, J1008, J1100, J1108 |
| DXX05264 | arterial thromboembolism | I7411, I742, I743, I744, I745, I748, I749, I75011, I75012, I75013, I75019, I75021, I75022, I75023, I75029, I7581, I7589 |
| DXX05272 | dic, coagulation, hemorrhagic disorders | D65, D688, D689, D7582 |
| DXX05274 | Transfusion, Infusion related complications | D6951, E8771, R5084, T8029XA, T8029XD, T8030XA, T8030XD, T80310A, T80310D, T80311A, T80311D, T80319A, T80319D, T8039XA, T8039XD, T8040XA, T8040XD, T80410A, T80410D, T80411A, T80411D, T80419A, T80419D, T8049XA, T8049XD, T8051XA, T8051XD, T8059XA, T8059XD, T8061XA, T8061XD, T8069XA, T8069XD, T80818A, T80818D, T8089XA, T8089XD, T8090XA, T8090XD, T80910A, T80910D, T80911A, T80911D, T80919A, T80919D, T8092XA, T8092XD, T80A0XA, T80A0XD, T80A10A, T80A10D, T80A11A, T80A11D, T80A19A, T80A19D, T80A9XA, T80A9XD, Y620, Y621, Y623, Y630, Y631, Y640, Y650, Y651 |
| DXX05275 | Phlebitis, Deep vein thrombosis (DVT) | I8000, I8001, I8002, I8003, I8010, I8011, I8012, I8013, I80201, I80202, I80203, I80209, I80211, I80212, I80213, I80219, I80221, I80222, I80223, I80229, I80231, I80232, I80233, I80239, I80291, I80292, I80293, I80299, I803, I809, I821, I82401, I82402, I82403, I82409, I82411, I82412, I82413, I82419, I82421, I82422, I82423, I82429, I82431, I82432, I82433, I82439, I82441, I82442, I82443, I82449, I82491, I82492, I82493, I82499, I824Y1, I824Y2, I824Y3, I824Y9, I824Z1, I824Z2, I824Z3, I824Z9, I82890, I8290, I87001, I87002, I87003, I87009, I87011, I87012, I87013, I87019, I87021, I87022, I87023, I87029, I87031, I87032, I87033, I87039, I87091, I87092, I87093, I87099, T79A0XA, T79A0XD |
| DXX05281 | STEMI | I2101, I2102, I2109, I2111, I2119, I2121, I2129, I213 |
| DXX05289 | Subendocardial infarct | I214 |
| DXX05291 | Recent AMI | I220, I221, I222, I228, I229 |
| DXX05297 | Hypotension / Syncope | I952, I9581, I959, R55 |
| DXX05298 | Fluid Electrolyte Acid Base Problems | E8330, E8339, E8340, E8341, E8342, E8349, E870, E871, E872, E873, E874, E875, E876, E8770, E8779, E878 |
| DXX05299 | Shock / Cardiac Arrest | I462, I468, I469, I4901, I4902, R570, R571, R578, R579, T782XXA, T882XXA, T882XXD, T886XXA, T886XXD |
| DXX05303 | Acute CHF / pulm edema | I5021, I5023, I5031, I5033, I5041, I5043, J810, J811, R0601 |
| DXX05308 | Pulmonary Embolism | I2690, I2692, I2699 |
| DXX05311 | Other Phlebitis, Lymphangitis, varices | I808, I82601, I82602, I82603, I82609, I82611, I82612, I82613, I82619, I82621, I82622, I82623, I82629, I82A11, I82A12, I82A13, I82A19, I891 |
| DXX05320 | Atrial Flutter / Fibrillation | I480, I481, I482, I483, I484, I4891, I4892 |
| DXX05336 | Supraventricular Tachyarrhythmias | I471, I492 |
| DXX05339 | Ventricular Arrhythmias | I470, I472 |
| DXX05340 | Other cardiac arrhythmias | I479, I499, R000, R002 |
| DXX05342 | Acute cor pulmonale | I2601, I2602, I2609 |
| DXX05367 | Hypertensive Urgency | I160, I161, I169 |
| DXX05373 | Shock during or post-procedure | I97711, I97791, I9788, T8110XA, T8110XD, T8111XA, T8111XD, T8112XA, T8112XD, T8119XA, T8119XD |
| DXX05375 | Dehydration | E860, E861, E869 |
| DXX06306 | GI Bleed | K2901, K2931, K2961, K2971, K2981, K2991, K625, K920, K921, K922 |
| DXX06307 | Intestinal Obstruction | K315, K560, K5669, K567 |
| DXX06317 | Acute esophagitis, acute gastritis, duodenitis | K2900, K2970, K2980, K2990 |
| DXX06369 | Esophageal Reflux and Other Esophagitis | K209 |
| DXX07110 | Hepatorenal Syndrome | K767 |
| DXX081068 | Acute Osteomyelitis | M8600, M86011, M86012, M86019, M8608, M8609, M8610, M86111, M86112, M86119, M8618, M8619, M8620, M86211, M86212, M86219, M8628, M8629 |
| DXX081069 | Chronic and Unspecified Osteomyelitis | M8630, M86311, M86312, M86319, M8638, M8639, M8640, M86411, M86412, M86419, M8648, M8649, M8650, M86511, M86512, M86519, M8658, M8659, M8660, M86611, M86612, M86619, M8668, M8669, M868X0, M868X1, M868X8, M868X9, M869 |
| DXX081072 | Pyogenic Arthritis | M00011, M00012, M00019, M0009, M00111, M00112, M00119, M0019, M00211, M00212, M00219, M0029, M00811, M00812, M00819, M0089 |
| DXX081082 | Compl of joint prosthesis, orthopedic proced | M960, M96621, M96622, M96629, M9669, T84018A, T84018D, T84019A, T84019D, T84028A, T84028D, T84029A, T84029D, T84038A, T84038D, T84039A, T84039D, T84058A, T84058D, T84059A, T84059D, T84068A, T84068D, T84069A, T84069D, T84098A, T84098D, T84099A, T84099D, T84110A, T84110D, T84111A, T84111D, T84119A, T84119D, T84120A, T84120D, T84121A, T84121D, T84129A, T84129D, T84190A, T84190D, T84191D, T84199A, T84199D, T84218A, T84228A, T84298A, T84298D, T84310A, T84310D, T84318A, T84318D, T84320A, T84320D, T84328A, T84328D, T84390A, T84390D, T84398A, T84398D, T84410A, T84410D, T84418A, T84418D, T84420A, T84420D, T84428A, T84428D, T84490A, T84490D, T84498A, T84498D, T8450XA, T8450XD, T8459XA, T8459XD, T8460XA, T8460XD, T84610A, T84610D, T84611A, T84611D, T84619A, T84619D, T8469XA, T8469XD, T847XXA, T847XXD, T8481XA, T8481XD, T8482XA, T8482XD, T8483XA, T8483XD, T8484XA, T8484XD, T8485XA, T8485XD, T8486XA, T8486XD, T8489XA, T8489XD, T849XXA, T849XXD |
| DXX081083 | Injury to nerves, shoulder region | S448X1A, S448X1D, S448X2A, S448X2D, S448X9A, S448X9D, S4490XA, S4490XD, S4491XA, S4491XD, S4492XA, S4492XD |
| DXX081115 | Periprosthetic fracture | M9731XA, M9731XD, M9732XA, M9732XD, M978XXA, M978XXD, M979XXA, M979XXD, T84048D, T84049A, T84049D |
| DXX09187 | Wound Infections | A4852, K6811, T814XXA, T814XXD, T8183XA, T8183XD |
| DXX09190 | Wound Dehiscence | T8130XA, T8130XD, T8131XA, T8131XD, T8132XA, T8132XD |
| DXX09191 | Decubitus Ulcer | L89000, L89001, L89002, L89009, L89010, L89011, L89012, L89019, L89020, L89021, L89022, L89029, L89100, L89101, L89102, L89109, L89110, L89111, L89112, L89119, L89120, L89121, L89122, L89129, L89130, L89131, L89132, L89139, L89140, L89141, L89142, L89149, L89150, L89151, L89152, L89159, L89300, L89301, L89302, L89309, L89310, L89311, L89312, L89319, L89320, L89321, L89322, L89329, L8940, L8941, L8942, L8945, L89600, L89601, L89602, L89609, L89610, L89611, L89612, L89619, L89620, L89621, L89622, L89629, L89810, L89811, L89812, L89819, L89890, L89891, L89892, L89899, L8990, L8991, L8992, L8995 |
| DXX09192 | Dermatitis, Urticaria | T7841XA |
| DXX09193 | Cellulitis, Skin Infection | L02419, L02818, L0291, L03119, L03129, L03818, L03898, L0390, L0391 |
| DXX09194 | Chronic Skin Ulcer | L97201, L97202, L97203, L97204, L97209, L97211, L97212, L97213, L97214, L97219, L97221, L97222, L97223, L97224, L97229, L97401, L97402, L97403, L97404, L97409, L97411, L97412, L97413, L97414, L97419, L97421, L97422, L97423, L97424, L97429 |
| DXX09202 | Pyoderma | L080, L0881, L88 |
| DXX10102 | diabetes mellitus with ophthalmic manifestations | E11311 |
| DXX1030 | Diabetes, poor control | E0811, E08641, E08649, E0865, E0911, E09641, E0965, E1011, E10641, E1065, E11641, E1165, E1311, E13641, E160, E161, E162 |
| DXX11137 | rhabdomyolysis | M6282 |
| DXX11143 | Urinary Tract Infection | N10, N110, N111, N136, N151, N2884, N2885, N2886, N3000, N3001, N3030, N3031, N3080, N3081, N3090, N3091, N340, N341, N342, N35111, N35112, N35113, N35114, N35119, N3512, N390, R309 |
| DXX11147 | Complication of genitourinary device | T83510A, T83510D, T83511A, T83511D, T83512A, T83512D, T83518A, T83518D |
| DXX11152 | Urinary Frequency & other symptoms | R300, R34 |
| DXX11153 | Urinary Incontinence | R32 |
| DXX11167 | Acute Kidney Failure | N170, N171, N178, N179, N19, N990 |
| DXX16296 | Hemorrhage | R58, R710 |
| DXX1849 | Other bacterial infections | R899 |
| DXX1850 | MRSA, Drug Resistant Infections | Z1610, Z1611, Z1612, Z1619, Z1620, Z1621, Z1622, Z1623, Z1624, Z1629, Z1630, Z1631, Z1632, Z1633, Z16341, Z16342, Z1635, Z1639 |
| DXX1851 | Sepsis | A392, A394, A400, A401, A403, A408, A409, A4101, A4102, A411, A412, A413, A414, A4150, A4151, A4152, A4153, A4159, A4181, A4189, A419 |
| DXX1852 | Severe Sepsis | A483, R6511, R6520, R6521 |
| DXX1853 | Bacteremia, SIRS, no organ dysfunction | R6510, R7881 |
| DXX19103 | Altered mental status | R400, R401, R440, R442, R443 |
| DXX2040 | Poisoning by Opiates | T400X1D, T400X4D, T401X1D, T401X4D, T402X1A, T402X1D, T402X4A, T402X4D, T403X1D, T403X4D, T404X1A, T404X1D, T404X4A, T404X4D, T40601A, T40601D, T40604A, T40604D, T40691A, T40691D, T40694A, T40694D |
| DXX2161 | Complications from Central Line | T80211A, T80211D, T80212A, T80212D, T80218A, T80218D, T80219A, T80219D, T8022XA, T8022XD |
| DXX2164 | Accidental Falls | V00811A, V00811D, V00812A, V00812D, V00818A, V00818D, V00831A, V00831D, W050XXA, W050XXD, W051XXA, W051XXD, W052XXA, W052XXD, W06XXXA, W06XXXD, W07XXXA, W07XXXD, W08XXXA, W08XXXD, W102XXA, W102XXD, W108XXA, W108XXD, W109XXA, W109XXD, W1811XA, W1811XD, W1812XA, W1812XD |
| DXX2169 | Poisoning by Psychostimulants | T405X1D, T405X4D, T408X1D, T408X4D, T40901D, T40904D, T40991D |
| DXX2171 | Adverse effects of drugs | G4440, G4441, K1232, R502, T360X5A, T360X5D, T360X5D, T361X5A, T361X5D, T361X5D, T362X5A, T362X5D, T362X5D, T363X5A, T363X5D, T363X5D, T364X5A, T364X5D, T364X5D, T365X5A, T365X5D, T365X5D, T366X5A, T366X5D, T366X5D, T367X5A, T367X5D, T367X5D, T368X5A, T368X5D, T368X5D, T3695XA, T3695XD, T3695XD, T370X5A, T370X5D, T370X5D, T371X5A, T371X5D, T371X5D, T372X5A, T372X5D, T372X5D, T373X5A, T373X5D, T373X5D, T374X5A, T374X5D, T374X5D, T375X5A, T375X5D, T375X5D, T378X5A, T378X5D, T378X5D, T3795XA, T3795XD, T3795XD, T380X5A, T380X5D, T380X5D, T381X5A, T381X5D, T381X5D, T382X5A, T382X5D, T382X5D, T383X5A, T383X5D, T383X5D, T384X5A, T384X5D, T384X5D, T385X5A, T385X5D, T385X5D, T386X5A, T386X5D, T386X5D, T387X5A, T387X5D, T387X5D, T38805A, T38805D, T38805D, T38815A, T38815D, T38815D, T38895A, T38895D, T38895D, T38905A, T38905D, T38905D, T38995A, T38995D, T38995D, T39015A, T39015D, T39015D, T39095A, T39095D, T39095D, T391X5A, T391X5D, T391X5D, T392X5A, T392X5D, T392X5D, T39315A, T39315D, T39315D, T39395A, T39395D, T39395D, T394X5A, T394X5D, T394X5D, T398X5A, T398X5D, T398X5D, T3995XA, T3995XD, T3995XD, T400X5D, T402X5A, T402X5D, T402X5D, T403X5D, T404X5A, T404X5D, T404X5D, T405X5D, T40605A, T40605D, T40605D, T40695A, T40695D, T40695D, T407X5A, T407X5D, T407X5D, T40905A, T40905D, T40905D, T40995A, T40995D, T40995D, T410X5D, T411X5D, T41205D, T41295D, T413X5D, T4145XD, T415X5A, T415X5D, T415X5D, T420X5A, T420X5D, T420X5D, T421X5A, T421X5D, T421X5D, T422X5A, T422X5D, T422X5D, T423X5A, T423X5D, T423X5D, T424X5A, T424X5D, T424X5D, T425X5A, T425X5D, T425X5D, T426X5A, T426X5D, T426X5D, T4275XA, T4275XD, T4275XD, T428X5A, T428X5D, T428X5D, T43015A, T43015D, T43015D, T43025A, T43025D, T43025D, T431X5A, T431X5D, T431X5D, T43205A, T43205D, T43205D, T43215A, T43215D, T43215D, T43225A, T43225D, T43225D, T43295A, T43295D, T43295D, T433X5A, T433X5D, T434X5A, T434X5D, T43505A, T43505D, T43595A, T43595D, T43605A, T43605D, T43615A, T43615D, T43625A, T43625D, T43635A, T43635D, T43695A, T43695D, T438X5A, T438X5D, T4395XA, T4395XD, T440X5A, T440X5D, T440X5D, T441X5A, T441X5D, T441X5D, T442X5A, T442X5D, T442X5D, T443X5A, T443X5D, T443X5D, T444X5A, T444X5D, T444X5D, T445X5A, T445X5D, T445X5D, T446X5A, T446X5D, T446X5D, T447X5A, T447X5D, T447X5D, T448X5A, T448X5D, T448X5D, T44905A, T44905D, T44905D, T44995A, T44995D, T44995D, T450X5A, T450X5D, T450X5D, T451X5A, T451X5D, T451X5D, T452X5A, T452X5D, T452X5D, T453X5A, T453X5D, T453X5D, T454X5A, T454X5D, T454X5D, T45515A, T45515D, T45515D, T45525A, T45525D, T45525D, T45605A, T45605D, T45605D, T45615A, T45615D, T45615D, T45625A, T45625D, T45625D, T45695A, T45695D, T45695D, T457X5A, T457X5D, T457X5D, T458X5A, T458X5D, T458X5D, T4595XA, T4595XD, T4595XD, T460X5A, T460X5D, T460X5D, T461X5A, T461X5D, T461X5D, T462X5A, T462X5D, T462X5D, T463X5A, T463X5D, T463X5D, T464X5A, T464X5D, T464X5D, T465X5A, T465X5D, T465X5D, T466X5A, T466X5D, T466X5D, T467X5A, T467X5D, T467X5D, T468X5A, T468X5D, T468X5D, T46905A, T46905D, T46905D, T46995A, T46995D, T46995D, T470X5A, T470X5D, T470X5D, T471X5A, T471X5D, T471X5D, T472X5A, T472X5D, T472X5D, T473X5A, T473X5D, T473X5D, T474X5A, T474X5D, T474X5D, T475X5A, T475X5D, T475X5D, T476X5A, T476X5D, T476X5D, T477X5A, T477X5D, T477X5D, T478X5A, T478X5D, T478X5D, T4795XA, T4795XD, T4795XD, T480X5A, T480X5D, T480X5D, T481X5A, T481X5D, T481X5D, T48205A, T48205D, T48205D, T48295A, T48295D, T48295D, T483X5A, T483X5D, T483X5D, T484X5A, T484X5D, T484X5D, T485X5A, T485X5D, T485X5D, T486X5A, T486X5D, T486X5D, T48905A, T48905D, T48905D, T48995A, T48995D, T48995D, T490X5A, T490X5D, T490X5D, T491X5A, T491X5D, T491X5D, T492X5A, T492X5D, T492X5D, T493X5A, T493X5D, T493X5D, T494X5A, T494X5D, T494X5D, T495X5A, T495X5D, T495X5D, T496X5A, T496X5D, T496X5D, T497X5A, T497X5D, T497X5D, T498X5A, T498X5D, T498X5D, T4995XA, T4995XD, T4995XD, T500X5A, T500X5D, T500X5D, T501X5A, T501X5D, T501X5D, T502X5A, T502X5D, T502X5D, T503X5A, T503X5D, T503X5D, T504X5A, T504X5D, T504X5D, T505X5A, T505X5D, T505X5D, T506X5A, T506X5D, T506X5D, T507X5A, T507X5D, T507X5D, T508X5A, T508X5D, T508X5D, T50905A, T50905D, T50905D, T50995A, T50995D, T50995D, T50A15A, T50A25A, T50A95A, T50B15A, T50B15D, T50B95A, T50B95D, T50Z15A, T50Z15D, T50Z15D, T50Z95A, T50Z95D |
| DXX2172 | Overdose, Poisonings | T360X1A, T360X1D, T360X4A, T360X4D, T361X1A, T361X1D, T361X4A, T361X4D, T362X1A, T362X1D, T362X4A, T362X4D, T363X1A, T363X1D, T363X4A, T363X4D, T364X1A, T364X1D, T364X4A, T364X4D, T365X1A, T365X1D, T365X4A, T365X4D, T366X1A, T366X1D, T366X4A, T366X4D, T367X1A, T367X1D, T367X4A, T367X4D, T368X1A, T368X1D, T368X4A, T368X4D, T3691XA, T3691XD, T3694XA, T3694XD, T370X1A, T370X1D, T370X4A, T370X4D, T371X1A, T371X1D, T371X4A, T371X4D, T372X1D, T372X4D, T373X1D, T373X4D, T374X1D, T374X4D, T375X1D, T375X4D, T378X1D, T378X4D, T3791XD, T3794XD, T380X1A, T380X1D, T380X4A, T380X4D, T381X1D, T381X4D, T382X1D, T382X4D, T383X1A, T383X1D, T383X4A, T383X4D, T384X1D, T384X4D, T385X1D, T385X4D, T386X1D, T386X4D, T387X1D, T387X4D, T38801D, T38804D, T38811D, T38814D, T38891D, T38894D, T38901D, T38904D, T38991D, T38994D, T39011A, T39011D, T39014A, T39014D, T39091A, T39091D, T39094A, T39094D, T391X1A, T391X1D, T391X4A, T391X4D, T392X1A, T392X1D, T392X4A, T392X4D, T39311A, T39311D, T39314A, T39314D, T39391A, T39391D, T39394A, T39394D, T394X1A, T394X1D, T394X4A, T394X4D, T398X1A, T398X1D, T398X4A, T398X4D, T3991XA, T3991XD, T3994XA, T3994XD, T40994D, T410X1A, T410X1D, T410X4A, T410X4D, T411X1A, T411X1D, T411X4A, T411X4D, T41201A, T41201D, T41204A, T41204D, T41291A, T41291D, T41294A, T41294D, T413X1A, T413X1D, T413X4A, T413X4D, T4141XA, T4141XD, T4144XA, T4144XD, T415X1A, T415X1D, T415X4A, T415X4D, T420X1D, T420X4D, T421X1A, T421X1D, T421X4A, T421X4D, T422X1D, T422X4D, T423X1A, T423X1D, T423X4A, T423X4D, T424X1A, T424X1D, T424X4A, T424X4D, T425X1D, T425X4D, T426X1A, T426X1D, T426X4A, T426X4D, T4271XA, T4271XD, T4274XA, T4274XD, T428X1A, T428X1D, T428X4A, T428X4D, T43011D, T43014D, T43021D, T43024D, T431X1D, T431X4D, T43201D, T43204D, T43211D, T43214D, T43221D, T43224D, T43291D, T43294D, T440X1D, T440X4D, T441X1D, T441X4D, T442X1D, T442X4D, T443X1D, T443X4D, T444X1D, T444X4D, T445X1D, T445X4D, T446X1D, T446X4D, T447X1D, T447X4D, T448X1D, T448X4D, T44901D, T44904D, T44991D, T44994D, T450X1A, T450X1D, T450X4A, T450X4D, T451X1D, T451X4D, T452X1D, T452X4D, T453X1D, T453X4D, T454X1D, T454X4D, T45511A, T45511D, T45514A, T45514D, T45521A, T45521D, T45524A, T45524D, T45601A, T45601D, T45604A, T45604D, T45611A, T45611D, T45614A, T45614D, T45621A, T45621D, T45624A, T45624D, T45691A, T45691D, T45694A, T45694D, T457X1A, T457X1D, T457X4A, T457X4D, T458X1A, T458X1D, T458X4A, T458X4D, T4591XA, T4591XD, T4594XA, T4594XD, T460X1D, T460X4D, T461X1D, T461X4D, T462X1D, T462X4D, T463X1D, T463X4D, T464X1D, T464X4D, T465X1A, T465X1D, T465X4A, T465X4D, T466X1A, T466X1D, T466X4A, T466X4D, T467X1A, T467X1D, T467X4A, T467X4D, T468X1D, T468X4D, T46901D, T46904D, T46991D, T46994D, T470X1A, T470X1D, T470X4A, T470X4D, T471X1A, T471X1D, T471X4A, T471X4D, T472X1A, T472X1D, T472X4A, T472X4D, T473X1A, T473X1D, T473X4A, T473X4D, T474X1A, T474X1D, T474X4A, T474X4D, T475X1A, T475X1D, T475X4A, T475X4D, T476X1A, T476X1D, T476X4A, T476X4D, T477X1A, T477X1D, T477X4A, T477X4D, T478X1A, T478X1D, T478X4A, T478X4D, T4791XA, T4791XD, T4794XA, T4794XD, T480X1D, T480X4D, T481X1A, T481X1D, T481X4A, T481X4D, T48201A, T48201D, T48204A, T48204D, T48291A, T48291D, T48294A, T48294D, T483X1D, T483X4D, T484X1D, T484X4D, T485X1D, T485X4D, T486X1D, T486X4D, T48901A, T48901D, T48904A, T48904D, T48991A, T48991D, T48994A, T48994D, T490X1A, T490X1D, T490X4A, T490X4D, T491X1A, T491X1D, T491X4A, T491X4D, T492X1D, T492X4D, T493X1D, T493X4D, T494X1D, T494X4D, T495X1D, T495X4D, T496X1D, T496X4D, T497X1D, T497X4D, T498X1D, T498X4D, T4991XD, T4994XD, T500X1D, T500X4D, T501X1D, T501X4D, T502X1D, T502X4D, T503X1A, T503X1D, T503X4A, T503X4D, T504X1A, T504X1D, T504X4A, T504X4D, T505X1D, T505X4D, T506X1D, T506X4D, T507X1A, T507X1D, T507X4A, T507X4D, T508X1A, T508X1D, T508X4A, T508X4D, T50901A, T50901D, T50904A, T50904D, T50991A, T50991D, T50994A, T50994D, T50Z11D, T50Z14D |
| DXX2175 | Complications of anesthesia | T410X5A, T411X5A, T41205A, T41295A, T413X5A, T4145XA, T883XXA, T883XXD, T884XXA, T884XXD, T8851XD, T8852XA, T8852XD, T8853XA, T8853XD, T8859XA, T8859XD, Y653, Y700, Y701, Y702, Y703, Y708 |
| DXX2176 | Poisoning by Cannabis | T407X1D, T407X4D |
| DXX2360 | Complication of Implanted device, graft | T85612D, T85613D, T85614D, T85618D, T85622D, T85623D, T85624D, T85628D, T85633D, T85638D, T85692D, T85693A, T85693D, T85695A, T85698A, T85698D, T8572XA, T8579XA, T8579XD, T85818A, T85818D, T8581XA, T8581XD, T85828A, T85828D, T8582XA, T8582XD, T85838A, T85838D, T8583XA, T8583XD, T85848A, T85848D, T8584XA, T8584XD, T85858A, T85858D, T8585XA, T8585XD, T85868A, T85868D, T8586XA, T8586XD, T85898A, T85898D, T8589XA, T8589XD, T859XXD |
| DXX2361 | complications of surgical procedures | I97131, I97191, I9752, I9762, I97620, I97621, J9562, J9572, J95831, J95861, J95863, K9162, K9172, K91841, K91871, K91873, L7602, L7612, L7622, L7632, L7634, M96810, M96811, M96820, M96821, M96830, M96831, M96840, M96841, M96842, M96843, N9962, N9972, N99821, N99841, N99843, T81710D, T81711D, T81718A, T81718D, T81719A, T81719D, T8172XA, T8172XD, T8182XA, T8189XA, T8189XD, T819XXA, T819XXD, T888XXA, T888XXD, Y624, Y626, Y628, Y629, Y652, Y6551, Y6552, Y6553, Y710, Y711, Y712, Y713, Y718, Y720, Y721, Y722, Y723, Y740, Y741, Y742, Y743, Y748, Y790, Y791, Y792, Y793, Y798, Y800, Y801, Y802, Y803, Y808, Y810, Y811, Y812, Y813, Y818, Y828, Y829, Y848 |
| DXX2362 | complications of medical care | I973, J95850, L7681, L7682, M9689, T782XXD, T7840XD, T7841XD, T7841XD, T7849XD, T788XXD, T801XXA, T801XXD, T8052XD, T8181XA, T8181XD, T880XXA, T887XXA, T887XXD, T889XXA, T889XXD, Y633, Y635, Y636, Y638, Y639, Y641, Y648, Y649, Y658, Y66, Y69, Y844, Y846, Y847 |
| DXX2395 | Foreign body left during procedure | T81500A, T81500D, T81501A, T81501D, T81503A, T81504A, T81506A, T81507A, T81508A, T81508D, T81509A, T81509D, T81510A, T81510D, T81511A, T81511D, T81513A, T81514A, T81515A, T81516A, T81517A, T81518A, T81518D, T81519A, T81519D, T81520A, T81520D, T81521A, T81521D, T81523A, T81524A, T81525A, T81526A, T81527A, T81528A, T81528D, T81529A, T81529D, T81530A, T81530D, T81531A, T81531D, T81533A, T81534A, T81535A, T81536A, T81537A, T81538A, T81538D, T81539A, T81539D, T81590A, T81590D, T81591A, T81591D, T81593A, T81594A, T81595A, T81596A, T81597A, T81598A, T81598D, T81599A, T81599D, T8160XA, T8160XD, T8161XA, T8169XA, T8169XD |
| DXX9910 | HAC 02: Air Embolism | T800XXA, T800XXD |
| DXX9912 | HAC 04: Stage III and IV Pressure Ulcers | L89003, L89004, L89013, L89014, L89023, L89024, L89103, L89104, L89113, L89114, L89123, L89124, L89133, L89134, L89143, L89144, L89153, L89154, L89303, L89304, L89313, L89314, L89323, L89324, L89603, L89604, L89613, L89614, L89623, L89624, L89813, L89814, L89893, L89894, L8993, L8994 |
| DXX9914 | HAC 09: Manifestations of Poor Glycemic Control | E0800, E0801, E0810, E0900, E0901, E0910, E1010, E1100, E1101, E1300, E1301, E1310, E15 |
Table 4: ICD-10 Relevant Procedure Codes
| Group ID | Group Name | Code Value |
| PXX0108 | Other non-OR or closed therapeutic nervous system procedures – 008 | 3C1ZX8Z, 3E0T33Z, 3E0T3BZ, 3E0T3CZ |
| PXX01198 | Magnetic resonance imaging – 198 | B33HY0Z, B33HYZZ, B33HZZZ, B33JY0Z, B33JYZZ, B33JZZZ, B33KY0Z, B33KYZZ, B33KZZZ, B53MY0Z, B53MYZZ, B53MZZZ, B53NY0Z, B53NYZZ, B53NZZZ, B53PY0Z, B53PYZZ, B53PZZZ, B53VY0Z, B53VYZZ, B53VZZZ, BH3FY0Z, BH3FYZZ, BH3FZZZ, BL30Y0Z, BL30YZZ, BL30ZZZ, BL32Y0Z, BL32YZZ, BL32ZZZ, BN39YZZ, BN39ZZZ, BP38Y0Z, BP38YZZ, BP38ZZZ, BP39Y0Z, BP39YZZ, BP39ZZZ, BP3EY0Z, BP3EYZZ, BP3EZZZ, BP3FY0Z, BP3FYZZ, BP3FZZZ |
| PXX01199 | Electroencephalogram (EEG) – 199 | 4A1134Z, 4A11X4Z |
| PXX02220 | Ophthalmologic and otologic diagnosis and treatment – 220 | F0DZ8UZ |
| PXX03215 | Other physical therapy and rehabilitation – 215 | 7W00X0Z, 7W00X1Z, 7W00X2Z, 7W00X3Z, 7W07X0Z, 7W07X1Z, 7W07X2Z, 7W07X3Z, 7W07X4Z, 7W07X5Z, 7W07X6Z, 7W07X7Z, 7W07X8Z, 7W07X9Z, F07K6ZZ, F07Z5CZ, F07Z5EZ, F07Z5FZ, F07Z5UZ, F07Z5YZ, F07Z5ZZ, F08Z0EZ, F08Z0FZ, F08Z0UZ, F08Z0YZ, F08Z0ZZ, F08Z1EZ, F08Z1FZ, F08Z1UZ, F08Z1YZ, F08Z1ZZ, F08Z2EZ, F08Z2FZ, F08Z2UZ, F08Z2YZ, F08Z2ZZ, F08Z3CZ, F08Z3DZ, F08Z3EZ, F08Z3FZ, F08Z3UZ, F08Z3YZ, F08Z3ZZ, F08Z4DZ, F08Z4EZ, F08Z4FZ, F08Z4UZ, F08Z4YZ, F08Z4ZZ, F08Z6ZZ, F08Z7BZ, F08Z7CZ, F08Z7DZ, F08Z7EZ, F08Z7FZ, F08Z7GZ, F08Z7UZ, F08Z7YZ, F08Z7ZZ, F0FZ0EZ, F0FZ0FZ, F0FZ0UZ, F0FZ0ZZ, F0FZ1EZ, F0FZ1FZ, F0FZ1UZ, F0FZ1ZZ, F0FZ2EZ, F0FZ2FZ, F0FZ2UZ, F0FZ2ZZ, F0FZ3EZ, F0FZ3FZ, F0FZ3UZ, F0FZ3ZZ, F0FZ4EZ, F0FZ4FZ, F0FZ4UZ, F0FZ4ZZ, F0FZ5EZ, F0FZ5FZ, F0FZ5UZ, F0FZ5ZZ, F0FZ6EZ, F0FZ6FZ, F0FZ6UZ, F0FZ6ZZ, F0FZ7EZ, F0FZ7FZ, F0FZ7UZ, F0FZ7ZZ, F0FZ8EZ, F0FZ8FZ, F0FZ8UZ, F0FZ8ZZ, F0FZ9EZ, F0FZ9FZ, F0FZ9UZ, F0FZ9ZZ, F0FZBEZ, F0FZBFZ, F0FZBUZ, F0FZBZZ, F0FZHEZ, F0FZHFZ, F0FZHUZ, F0FZHZZ, F0FZJKZ, F0FZJLZ, F0FZJMZ, F0FZJPZ, F0FZJZZ |
| PXX03231 | Other therapeutic procedures – 231 | 039300Z, 03930ZZ, 039330Z, 03933ZZ, 039340Z, 03934ZZ, 039400Z, 03940ZZ, 039430Z, 03943ZZ, 039440Z, 03944ZZ, 039500Z, 03950ZZ, 039530Z, 03953ZZ, 039540Z, 03954ZZ, 039600Z, 03960ZZ, 039630Z, 03963ZZ, 039640Z, 03964ZZ, 039700Z, 03970ZZ, 039730Z, 03973ZZ, 039740Z, 03974ZZ, 039800Z, 03980ZZ, 039830Z, 03983ZZ, 039840Z, 03984ZZ, 059330Z, 05933ZZ, 059340Z, 05934ZZ, 059430Z, 05943ZZ, 059440Z, 05944ZZ, 059530Z, 05953ZZ, 059540Z, 05954ZZ, 059630Z, 05963ZZ, 059640Z, 05964ZZ, 059730Z, 05973ZZ, 059740Z, 05974ZZ, 059830Z, 05983ZZ, 059840Z, 05984ZZ, 059930Z, 05993ZZ, 059940Z, 05994ZZ, 059A30Z, 059A3ZZ, 059A40Z, 059A4ZZ, 0PP5X4Z, 0PP6X4Z, 0PP7X4Z, 0PP8X4Z, 0PP9X4Z, 0PPBX4Z, 0PPCX4Z, 0PPDX4Z, 0PPFX4Z, 0PPGX4Z, 0PW5X4Z, 0PW5X7Z, 0PW5XJZ, 0PW5XKZ, 0PW6X4Z, 0PW6X7Z, 0PW6XJZ, 0PW6XKZ, 0PW7X4Z, 0PW7X7Z, 0PW7XJZ, 0PW7XKZ, 0PW8X4Z, 0PW8X7Z, 0PW8XJZ, 0PW8XKZ, 0PW9X4Z, 0PW9X7Z, 0PW9XJZ, 0PW9XKZ, 0PWBX4Z, 0PWBX7Z, 0PWBXJZ, 0PWBXKZ, 0PWCX4Z, 0PWCX5Z, 0PWCX7Z, 0PWCXJZ, 0PWCXKZ, 0PWDX4Z, 0PWDX5Z, 0PWDX7Z, 0PWDXJZ, 0PWDXKZ, 0RPGX0Z, 0RPGX3Z, 0RPGX4Z, 0RPHX0Z, 0RPHX3Z, 0RPHX4Z, 0RPJX0Z, 0RPJX3Z, 0RPJX4Z, 0RPKX0Z, 0RPKX3Z, 0RPKX4Z, 0RWGX0Z, 0RWGX3Z, 0RWGX4Z, 0RWGX7Z, 0RWGX8Z, 0RWGXJZ, 0RWGXKZ, 0RWHX0Z, 0RWHX3Z, 0RWHX4Z, 0RWHX7Z, 0RWHX8Z, 0RWHXJZ, 0RWHXKZ, 0RWJX0Z, 0RWJX3Z, 0RWJX4Z, 0RWJX7Z, 0RWJX8Z, 0RWJXJZ, 0RWJXKZ, 0RWKX0Z, 0RWKX3Z, 0RWKX4Z, 0RWKX7Z, 0RWKX8Z, 0RWKXJZ, 0RWKXKZ, 0X26X0Z, 0X26XYZ, 0X27X0Z, 0X27XYZ, 0XP6X0Z, 0XP6X1Z, 0XP6X3Z, 0XP6XJZ, 0XP6XYZ, 0XP7X0Z, 0XP7X1Z, 0XP7X3Z, 0XP7XJZ, 0XP7XYZ, 0XQ6XZZ, 0XQ7XZZ, 0XW6X0Z, 0XW6X3Z, 0XW6X7Z, 0XW6XJZ, 0XW6XKZ, 0XW6XYZ, 0XW7X0Z, 0XW7X3Z, 0XW7X7Z, 0XW7XJZ, 0XW7XKZ, 0XW7XYZ, 2W08X0Z, 2W08X4Z, 2W08X5Z, 2W08X6Z, 2W08X7Z, 2W08XYZ, 2W09X0Z, 2W09X4Z, 2W09X5Z, 2W09X6Z, 2W09X7Z, 2W09XYZ, 2W0AX0Z, 2W0AX4Z, 2W0AX5Z, 2W0AX6Z, 2W0AX7Z, 2W0AXYZ, 2W0BX0Z, 2W0BX4Z, 2W0BX5Z, 2W0BX6Z, 2W0BX7Z, 2W0BXYZ, 2W58X0Z, 2W58X4Z, 2W58X5Z, 2W58X6Z, 2W58X7Z, 2W58XYZ, 2W59X0Z, 2W59X4Z, 2W59X5Z, 2W59X6Z, 2W59X7Z, 2W59XYZ, 2W5AX0Z, 2W5AX4Z, 2W5AX5Z, 2W5AX6Z, 2W5AX7Z, 2W5AXYZ, 2W5BX0Z, 2W5BX4Z, 2W5BX5Z, 2W5BX6Z, 2W5BX7Z, 2W5BXYZ, 3E01328, 3E0133Z, 3E013GC, 3E02328, 3E0233Z, 3E023GC, 3E023NZ, 3E03028, 3E0303Z, 3E030KZ, 3E030NZ, 3E030PZ, 3E03328, 3E0333Z, 3E0337Z, 3E033FZ, 3E04028, 3E0403Z, 3E0407Z, 3E040FZ, 3E040NZ, 3E04328, 3E0433Z, 3E043NZ, 3E05028, 3E0503Z, 3E0504Z, 3E05328, 3E0533Z, 3E053KZ, 3E06028, 3E0603Z, 3E0607Z, 3E06328, 3E0633Z, 3E063FZ |
| PXX03235 | Robotic Assisted Procedure | 8E0X0CZ, 8E0X3CZ, 8E0X4CZ, 8E0XXCZ |
| PXX04183 | Routine chest X-ray – 183 | BW03ZZZ |
| PXX05226 | Other diagnostic radiology and related techniques – 226 | 4A0ZXKZ, B301ZZZ, B302ZZZ, B30HZZZ, B30JZZZ, B30KZZZ, B30NZZZ, B311ZZZ, B312ZZZ, B31HZZZ, B31JZZZ, B31KZZZ, B31NZZZ, B516ZZA, B517ZZA, B51MZZA, B51MZZZ, B51NZZA, B51NZZZ, B51PZZA, B51PZZZ, B51VZZA, B51VZZZ, B7050ZZ, B7051ZZ, B705YZZ, B7060ZZ, B7061ZZ, B706YZZ, B7070ZZ, B7071ZZ, B707YZZ, BP06ZZZ, BP07ZZZ, BP080ZZ, BP081ZZ, BP08YZZ, BP08ZZZ, BP090ZZ, BP091ZZ, BP09YZZ, BP09ZZZ, BP0AZZZ, BP0BZZZ, BP0EZZZ, BP0FZZZ, BP16ZZZ, BP17ZZZ, BP180ZZ, BP181ZZ, BP18YZZ, BP18ZZZ, BP190ZZ, BP191ZZ, BP19YZZ, BP19ZZZ, BP1AZZZ, BP1BZZZ, BP1EZZZ, BP1FZZZ, BP48ZZ1, BP49ZZ1, BW0BZZZ, BW0JZZZ |
| PXX05227 | Other diagnostic procedures (interview, evaluation, consultation) – 227 | 03JYXZZ, 05JYXZZ, 0JJVXZZ, 0KJXXZZ, 0LJXXZZ, 0MJXXZZ, 0PJYXZZ, 0RJGXZZ, 0RJHXZZ, 0RJJXZZ, 0RJKXZZ, 0XJ2XZZ, 0XJ3XZZ, 0XJ4XZZ, 0XJ5XZZ, 0XJ6XZZ, 0XJ7XZZ, 0XJ8XZZ, 0XJ9XZZ, 4A0002Z, 4A000BZ, 4A00X2Z, 4A01029, 4A0102B, 4A01329, 4A0132B, 4A01X29, 4A01X2B, 4A0971Z, 4A0975Z, 4A097CZ, 4A097DZ, 4A097LZ, 4A097MZ, 4A0981Z, 4A098CZ, 4A098DZ, 4A098LZ, 4A098MZ, 4A09X1Z, 4A09X5Z, 4A09XCZ, 4A09XDZ, 4A09XLZ, 4A09XMZ, 4A0B78Z, 4A0B7GZ, 4A0B88Z, 4A0B8GZ, 4A0Z76Z, 4A0Z7KZ, 4A0ZX6Z, 4A1971Z, 4A1975Z, 4A197CZ, 4A197DZ, 4A197LZ, 4A19X1Z, 4A19X5Z, 4A19XCZ, 4A19XDZ, 4A19XLZ, 4A1B78Z, 4A1B7GZ, 4A1B88Z, 4A1B8GZ, 4A1Z7KZ, 4A1ZXKZ, 4B0FXVZ |
| PXX06223 | Enteral and parenteral nutrition – 223 | 3E0306Z, 3E0336Z, 3E0406Z, 3E0436Z, 3E0506Z, 3E0536Z, 3E0606Z, 3E0636Z |
| PXX08142 | Partial excision bone – 142 | 0PBC0ZZ, 0PBD0ZZ, 0PBF0ZZ, 0PBG0ZZ |
| PXX08148 | Other fracture and dislocation procedure – 148 | 0PHC04Z, 0PHC06Z, 0PHC34Z, 0PHC36Z, 0PHC44Z, 0PHC46Z, 0PHD04Z, 0PHD06Z, 0PHD34Z, 0PHD36Z, 0PHD44Z, 0PHD46Z, 0PHF04Z, 0PHF06Z, 0PHF34Z, 0PHF36Z, 0PHF44Z, 0PHF46Z, 0PHG04Z, 0PHG06Z, 0PHG34Z, 0PHG36Z, 0PHG44Z, 0PHG46Z, 0PPC04Z, 0PPC05Z, 0PPC07Z, 0PPC0JZ, 0PPC0KZ, 0PPC34Z, 0PPC35Z, 0PPC37Z, 0PPC3JZ, 0PPC3KZ, 0PPC44Z, 0PPC45Z, 0PPC47Z, 0PPC4JZ, 0PPC4KZ, 0PPD04Z, 0PPD05Z, 0PPD07Z, 0PPD0JZ, 0PPD0KZ, 0PPD34Z, 0PPD35Z, 0PPD37Z, 0PPD3JZ, 0PPD3KZ, 0PPD44Z, 0PPD45Z, 0PPD47Z, 0PPD4JZ, 0PPD4KZ, 0PPF04Z, 0PPF05Z, 0PPF07Z, 0PPF0JZ, 0PPF0KZ, 0PPF34Z, 0PPF35Z, 0PPF37Z, 0PPF3JZ, 0PPF3KZ, 0PPF44Z, 0PPF45Z, 0PPF47Z, 0PPF4JZ, 0PPF4KZ, 0PPG04Z, 0PPG05Z, 0PPG07Z, 0PPG0JZ, 0PPG0KZ, 0PPG34Z, 0PPG35Z, 0PPG37Z, 0PPG3JZ, 0PPG3KZ, 0PPG44Z, 0PPG45Z, 0PPG47Z, 0PPG4JZ, 0PPG4KZ, 0PQ50ZZ, 0PQ53ZZ, 0PQ54ZZ, 0PQ60ZZ, 0PQ63ZZ, 0PQ64ZZ, 0PQ70ZZ, 0PQ73ZZ, 0PQ74ZZ, 0PQ80ZZ, 0PQ83ZZ, 0PQ84ZZ, 0PQ90ZZ, 0PQ93ZZ, 0PQ94ZZ, 0PQB0ZZ, 0PQB3ZZ, 0PQB4ZZ, 0PQC0ZZ, 0PQC3ZZ, 0PQC4ZZ, 0PQCXZZ, 0PQD0ZZ, 0PQD3ZZ, 0PQD4ZZ, 0PQDXZZ, 0PQF0ZZ, 0PQF3ZZ, 0PQF4ZZ, 0PQFXZZ, 0PQG0ZZ, 0PQG3ZZ, 0PQG4ZZ, 0PQGXZZ, 0PSC04Z, 0PSC05Z, 0PSC06Z, 0PSC0BZ, 0PSC0CZ, 0PSC0DZ, 0PSC0ZZ, 0PSC34Z, 0PSC35Z, 0PSC36Z, 0PSC3BZ, 0PSC3CZ, 0PSC3DZ, 0PSC3ZZ, 0PSC44Z, 0PSC45Z, 0PSC46Z, 0PSC4BZ, 0PSC4CZ, 0PSC4DZ, 0PSC4ZZ, 0PSCXZZ, 0PSD04Z, 0PSD05Z, 0PSD06Z, 0PSD0BZ, 0PSD0CZ, 0PSD0DZ, 0PSD0ZZ, 0PSD34Z, 0PSD35Z, 0PSD36Z, 0PSD3BZ, 0PSD3CZ, 0PSD3DZ, 0PSD3ZZ, 0PSD44Z, 0PSD45Z, 0PSD46Z, 0PSD4BZ, 0PSD4CZ, 0PSD4DZ, 0PSD4ZZ, 0PSDXZZ, 0PSF04Z, 0PSF05Z, 0PSF06Z, 0PSF0BZ, 0PSF0CZ, 0PSF0DZ, 0PSF0ZZ, 0PSF34Z, 0PSF35Z, 0PSF36Z, 0PSF3BZ, 0PSF3CZ, 0PSF3DZ, 0PSF3ZZ, 0PSF44Z, 0PSF45Z, 0PSF46Z, 0PSF4BZ, 0PSF4CZ, 0PSF4DZ, 0PSF4ZZ, 0PSFXZZ, 0PSG04Z, 0PSG05Z, 0PSG06Z, 0PSG0BZ, 0PSG0CZ, 0PSG0DZ, 0PSG0ZZ, 0PSG34Z, 0PSG35Z, 0PSG36Z, 0PSG3BZ, 0PSG3CZ, 0PSG3DZ, 0PSG3ZZ, 0PSG44Z, 0PSG45Z, 0PSG46Z, 0PSG4BZ, 0PSG4CZ, 0PSG4DZ, 0PSG4ZZ, 0PSGXZZ, 0RSE04Z, 0RSE0ZZ, 0RSE34Z, 0RSE3ZZ, 0RSE44Z, 0RSE4ZZ, 0RSEX4Z, 0RSEXZZ, 0RSF04Z, 0RSF0ZZ, 0RSF34Z, 0RSF3ZZ, 0RSF44Z, 0RSF4ZZ, 0RSFX4Z, 0RSFXZZ, 0RSG04Z, 0RSG0ZZ, 0RSG34Z, 0RSG3ZZ, 0RSG44Z, 0RSG4ZZ, 0RSGX4Z, 0RSGXZZ, 0RSH04Z, 0RSH0ZZ, 0RSH34Z, 0RSH3ZZ, 0RSH44Z, 0RSH4ZZ, 0RSHX4Z, 0RSHXZZ, 0RSJ04Z, 0RSJ0ZZ, 0RSJ34Z, 0RSJ3ZZ, 0RSJ44Z, 0RSJ4ZZ, 0RSJX4Z, 0RSJXZZ, 0RSK04Z, 0RSK0ZZ, 0RSK34Z, 0RSK3ZZ, 0RSK44Z, 0RSK4ZZ, 0RSKX4Z, 0RSKXZZ |
| PXX08149 | Arthroscopy – 149 | 0RJG4ZZ, 0RJH4ZZ, 0RJJ4ZZ, 0RJK4ZZ |
| PXX08156 | Injections and aspirations of muscles, tendons, bursa, joints and soft tis – 156 | 0K953ZZ, 0K963ZZ, 0K973ZZ, 0K983ZZ, 0M9130Z, 0M913ZZ, 0M9140Z, 0M914ZZ, 0M9230Z, 0M923ZZ, 0M9240Z, 0M924ZZ, 0M9930Z, 0M993ZZ, 0M9940Z, 0M994ZZ, 0M9B30Z, 0M9B3ZZ, 0M9B40Z, 0M9B4ZZ, 3E0137Z, 3E013BZ, 3E013HZ, 3E013KZ, 3E013TZ, 3E0236Z, 3E0237Z, 3E023BZ, 3E023HZ, 3E023KZ, 3E023TZ, 3E0U36Z, 3E0U37Z, 3E0U3BZ, 3E0U3HZ, 3E0U3KZ, 3E0U3SF, 3E0U3TZ |
| PXX08159 | Other diagnostic procedures on musculoskeletal system – 159 | 0JJV0ZZ, 0JJV3ZZ, 0K950ZX, 0K953ZX, 0K954ZX, 0K960ZX, 0K963ZX, 0K964ZX, 0K970ZX, 0K973ZX, 0K974ZX, 0K980ZX, 0K983ZX, 0K984ZX, 0KB50ZX, 0KB53ZX, 0KB54ZX, 0KB60ZX, 0KB63ZX, 0KB64ZX, 0KB70ZX, 0KB73ZX, 0KB74ZX, 0KB80ZX, 0KB83ZX, 0KB84ZX, 0KJX0ZZ, 0KJX3ZZ, 0KJX4ZZ, 0L910ZX, 0L913ZX, 0L914ZX, 0L920ZX, 0L923ZX, 0L924ZX, 0L930ZX, 0L933ZX, 0L934ZX, 0L940ZX, 0L943ZX, 0L944ZX, 0LB10ZX, 0LB13ZX, 0LB14ZX, 0LB20ZX, 0LB23ZX, 0LB24ZX, 0LB30ZX, 0LB33ZX, 0LB34ZX, 0LB40ZX, 0LB43ZX, 0LB44ZX, 0LJX0ZZ, 0LJX3ZZ, 0LJX4ZZ, 0M910ZX, 0M913ZX, 0M914ZX, 0M920ZX, 0M923ZX, 0M924ZX, 0M990ZX, 0M993ZX, 0M994ZX, 0M9B0ZX, 0M9B3ZX, 0M9B4ZX, 0MB10ZX, 0MB13ZX, 0MB14ZX, 0MB20ZX, 0MB23ZX, 0MB24ZX, 0MB90ZX, 0MB93ZX, 0MB94ZX, 0MBB0ZX, 0MBB3ZX, 0MBB4ZX, 0PB50ZX, 0PB53ZX, 0PB54ZX, 0PB60ZX, 0PB63ZX, 0PB64ZX, 0PB90ZX, 0PB93ZX, 0PB94ZX, 0PBB0ZX, 0PBB3ZX, 0PBB4ZX, 0PBC0ZX, 0PBC3ZX, 0PBC4ZX, 0PBD0ZX, 0PBD3ZX, 0PBD4ZX, 0PBF0ZX, 0PBF3ZX, 0PBF4ZX, 0PBG0ZX, 0PBG3ZX, 0PBG4ZX, 0PJY0ZZ, 0PJY3ZZ, 0PJY4ZZ, 0RBG0ZX, 0RBG3ZX, 0RBG4ZX, 0RBH0ZX, 0RBH3ZX, 0RBH4ZX, 0RBJ0ZX, 0RBJ3ZX, 0RBJ4ZX, 0RBK0ZX, 0RBK3ZX, 0RBK4ZX |
| PXX08160 | Other therapeutic procedures on muscles and tendons – 160 | 0J5D0ZZ, 0J5D3ZZ, 0J5F0ZZ, 0J5F3ZZ, 0J9D0ZZ, 0J9F0ZZ, 0JBD0ZZ, 0JBD3ZZ, 0JBF0ZZ, 0JBF3ZZ, 0JDD0ZZ, 0JDF0ZZ, 0JQD0ZZ, 0JQD3ZZ, 0JQF0ZZ, 0JQF3ZZ, 0LM10ZZ, 0LM14ZZ, 0LM20ZZ, 0LM24ZZ, 0LM30ZZ, 0LM34ZZ, 0LM40ZZ, 0LM44ZZ, 0LQ10ZZ, 0LQ13ZZ, 0LQ14ZZ, 0LQ20ZZ, 0LQ23ZZ, 0LQ24ZZ, 0LQ30ZZ, 0LQ33ZZ, 0LQ34ZZ, 0LQ40ZZ, 0LQ43ZZ, 0LQ44ZZ, 0M9100Z, 0M910ZZ, 0M9200Z, 0M920ZZ, 0MC10ZZ, 0MC13ZZ, 0MC14ZZ, 0MC20ZZ, 0MC23ZZ, 0MC24ZZ, 0MJX0ZZ |
| PXX08161 | Other OR therapeutic procedures on bone – 161 | 0P8C0ZZ, 0P8C3ZZ, 0P8C4ZZ, 0P8D0ZZ, 0P8D3ZZ, 0P8D4ZZ, 0P8F0ZZ, 0P8F3ZZ, 0P8F4ZZ, 0P8G0ZZ, 0P8G3ZZ, 0P8G4ZZ, 0PHY0MZ, 0PHY3MZ, 0PHY4MZ |
| PXX08162 | Other OR therapeutic procedures on joints – 162 | 0MJX3ZZ, 0MJX4ZZ, 0R9E00Z, 0R9E0ZZ, 0R9F00Z, 0R9F0ZZ, 0R9G00Z, 0R9G0ZZ, 0R9H00Z, 0R9H0ZZ, 0R9J00Z, 0R9J0ZZ, 0R9K00Z, 0R9K0ZZ, 0RCE0ZZ, 0RCE3ZZ, 0RCE4ZZ, 0RCF0ZZ, 0RCF3ZZ, 0RCF4ZZ, 0RCG0ZZ, 0RCG3ZZ, 0RCG4ZZ, 0RCH0ZZ, 0RCH3ZZ, 0RCH4ZZ, 0RCJ0ZZ, 0RCJ3ZZ, 0RCJ4ZZ, 0RCK0ZZ, 0RCK3ZZ, 0RCK4ZZ, 0RHE04Z, 0RHE34Z, 0RHE44Z, 0RHF04Z, 0RHF34Z, 0RHF44Z, 0RHG04Z, 0RHG34Z, 0RHG44Z, 0RHH04Z, 0RHH34Z, 0RHH44Z, 0RHJ04Z, 0RHJ34Z, 0RHJ44Z, 0RHK04Z, 0RHK34Z, 0RHK44Z, 0RJE0ZZ, 0RJE3ZZ, 0RJF0ZZ, 0RJF3ZZ, 0RJG0ZZ, 0RJG3ZZ, 0RJH0ZZ, 0RJH3ZZ, 0RJJ0ZZ, 0RJJ3ZZ, 0RJK0ZZ, 0RJK3ZZ, 0RPE00Z, 0RPE03Z, 0RPE04Z, 0RPE07Z, 0RPE0JZ, 0RPE0KZ, 0RPE30Z, 0RPE33Z, 0RPE34Z, 0RPE37Z, 0RPE3JZ, 0RPE3KZ, 0RPE40Z, 0RPE43Z, 0RPE44Z, 0RPE47Z, 0RPE4JZ, 0RPE4KZ, 0RPF00Z, 0RPF03Z, 0RPF04Z, 0RPF07Z, 0RPF0JZ, 0RPF0KZ, 0RPF30Z, 0RPF33Z, 0RPF34Z, 0RPF37Z, 0RPF3JZ, 0RPF3KZ, 0RPF40Z, 0RPF43Z, 0RPF44Z, 0RPF47Z, 0RPF4JZ, 0RPF4KZ, 0RPG00Z, 0RPG03Z, 0RPG04Z, 0RPG07Z, 0RPG0JZ, 0RPG0KZ, 0RPG30Z, 0RPG33Z, 0RPG34Z, 0RPG37Z, 0RPG3JZ, 0RPG3KZ, 0RPG40Z, 0RPG43Z, 0RPG44Z, 0RPG47Z, 0RPG4JZ, 0RPG4KZ, 0RPH00Z, 0RPH03Z, 0RPH04Z, 0RPH07Z, 0RPH0JZ, 0RPH0KZ, 0RPH30Z, 0RPH33Z, 0RPH34Z, 0RPH37Z, 0RPH3JZ, 0RPH3KZ, 0RPH40Z, 0RPH43Z, 0RPH44Z, 0RPH47Z, 0RPH4JZ, 0RPH4KZ, 0RPJ00Z, 0RPJ03Z, 0RPJ04Z, 0RPJ07Z, 0RPJ0JZ, 0RPJ0KZ, 0RPJ30Z, 0RPJ33Z, 0RPJ34Z, 0RPJ37Z, 0RPJ3JZ, 0RPJ3KZ, 0RPJ40Z, 0RPJ43Z, 0RPJ44Z, 0RPJ47Z, 0RPJ4JZ, 0RPJ4KZ, 0RPK00Z, 0RPK03Z, 0RPK04Z, 0RPK07Z, 0RPK0JZ, 0RPK0KZ, 0RPK30Z, 0RPK33Z, 0RPK34Z, 0RPK37Z, 0RPK3JZ, 0RPK3KZ, 0RPK40Z, 0RPK43Z, 0RPK44Z, 0RPK47Z, 0RPK4JZ, 0RPK4KZ, 0RWE00Z, 0RWE03Z, 0RWE04Z, 0RWE07Z, 0RWE08Z, 0RWE0JZ, 0RWE0KZ, 0RWE30Z, 0RWE33Z, 0RWE34Z, 0RWE37Z, 0RWE38Z, 0RWE3JZ, 0RWE3KZ, 0RWE40Z, 0RWE43Z, 0RWE44Z, 0RWE47Z, 0RWE48Z, 0RWE4JZ, 0RWE4KZ, 0RWF00Z, 0RWF03Z, 0RWF04Z, 0RWF07Z, 0RWF08Z, 0RWF0JZ, 0RWF0KZ, 0RWF30Z, 0RWF33Z, 0RWF34Z, 0RWF37Z, 0RWF38Z, 0RWF3JZ, 0RWF3KZ, 0RWF40Z, 0RWF43Z, 0RWF44Z, 0RWF47Z, 0RWF48Z, 0RWF4JZ, 0RWF4KZ, 0RWG00Z, 0RWG03Z, 0RWG04Z, 0RWG07Z, 0RWG08Z, 0RWG0KZ, 0RWG30Z, 0RWG33Z, 0RWG34Z, 0RWG37Z, 0RWG38Z, 0RWG3KZ, 0RWG40Z, 0RWG43Z, 0RWG44Z, 0RWG47Z, 0RWG48Z, 0RWG4KZ, 0RWH00Z, 0RWH03Z, 0RWH04Z, 0RWH07Z, 0RWH08Z, 0RWH0KZ, 0RWH30Z, 0RWH33Z, 0RWH34Z, 0RWH37Z, 0RWH38Z, 0RWH3KZ, 0RWH40Z, 0RWH43Z, 0RWH44Z, 0RWH47Z, 0RWH48Z, 0RWH4KZ, 0RWJ00Z, 0RWJ03Z, 0RWJ04Z, 0RWJ07Z, 0RWJ08Z, 0RWJ0KZ, 0RWJ30Z, 0RWJ33Z, 0RWJ34Z, 0RWJ37Z, 0RWJ38Z, 0RWJ3KZ, 0RWJ40Z, 0RWJ43Z, 0RWJ44Z, 0RWJ47Z, 0RWJ48Z, 0RWJ4KZ, 0RWK00Z, 0RWK03Z, 0RWK04Z, 0RWK07Z, 0RWK08Z, 0RWK0KZ, 0RWK30Z, 0RWK33Z, 0RWK34Z, 0RWK37Z, 0RWK38Z, 0RWK3KZ, 0RWK40Z, 0RWK43Z, 0RWK44Z, 0RWK47Z, 0RWK48Z, 0RWK4KZ |
| PXX08163 | Other non-OR therapeutic procedures on musculoskeletal system – 163 | 0PHC08Z, 0PHC38Z, 0PHC48Z, 0PHD08Z, 0PHD38Z, 0PHD48Z, 0PHF08Z, 0PHF38Z, 0PHF48Z, 0PHG08Z, 0PHG38Z, 0PHG48Z, 0PPCX5Z, 0PPDX5Z, 0PPFX5Z, 0PPGX5Z, 0RPE08Z, 0RPE38Z, 0RPE48Z, 0RPF08Z, 0RPF38Z, 0RPF48Z, 0RPG08Z, 0RPG38Z, 0RPG48Z, 0RPH08Z, 0RPH38Z, 0RPH48Z, 0RPJ08Z, 0RPJ38Z, 0RPJ48Z, 0RPK08Z, 0RPK38Z, 0RPK48Z, 2W08X1Z, 2W08X3Z, 2W09X1Z, 2W09X3Z, 2W0AX1Z, 2W0AX3Z, 2W0BX1Z, 2W0BX3Z, 2W58X1Z, 2W58X2Z, 2W58X3Z, 2W59X1Z, 2W59X2Z, 2W59X3Z, 2W5AX1Z, 2W5AX2Z, 2W5AX3Z, 2W5BX1Z, 2W5BX2Z, 2W5BX3Z |
| PXX08164 | Other OR therapeutic procedures on musculoskeletal system – 164 | 0HQBXZZ, 0HQCXZZ |
| PXX08212 | Diagnostic physical therapy – 212 | 4A0F33Z, 4A0FX3Z, F00ZNNZ, F00ZNPZ, F00ZNTZ, F00ZNYZ, F0110EZ, F0110FZ, F0110UZ, F0110YZ, F0110ZZ, F0111ZZ, F0113ZZ, F0114ZZ, F0115YZ, F0115ZZ, F0116YZ, F0116ZZ, F011GZZ, F0130EZ, F0130FZ, F0130UZ, F0130YZ, F0130ZZ, F0131ZZ, F0133ZZ, F0134ZZ, F0135YZ, F0135ZZ, F0136YZ, F0136ZZ, F013GZZ, F01F0EZ, F01F0FZ, F01F0UZ, F01F0YZ, F01F0ZZ, F01F1ZZ, F01F5YZ, F01F5ZZ, F01F6YZ, F01F6ZZ, F01H0EZ, F01H0FZ, F01H0UZ, F01H0YZ, F01H0ZZ, F01H1ZZ, F01H5YZ, F01H5ZZ, F01H6YZ, F01H6ZZ, F01K0EZ, F01K0FZ, F01K0UZ, F01K0YZ, F01K0ZZ, F01K1ZZ, F01K5YZ, F01K5ZZ, F01K6YZ, F01K6ZZ, F01M0EZ, F01M0FZ, F01M0UZ, F01M0YZ, F01M0ZZ, F01M1ZZ, F01M5YZ, F01M5ZZ, F01M6YZ, F01M6ZZ, F01ZBEZ, F01ZBFZ, F01ZBUZ, F01ZBZZ, F01ZCEZ, F01ZCFZ, F01ZCUZ, F01ZCZZ, F01ZDEZ, F01ZDFZ, F01ZDUZ, F01ZDYZ, F01ZDZZ, F021DYZ, F021DZZ, F023DYZ, F023DZZ, F025GCZ, F025GGZ, F025GYZ, F025GZZ, F0277EZ, F0277GZ, F0277UZ, F0277YZ, F0277ZZ, F02Z0EZ, F02Z0FZ, F02Z0UZ, F02Z0ZZ, F02Z1EZ, F02Z1FZ, F02Z1UZ, F02Z1ZZ, F02Z2YZ, F02Z2ZZ, F02Z3EZ, F02Z3FZ, F02Z3UZ, F02Z3ZZ, F02Z4EZ, F02Z4FZ, F02Z4UZ, F02Z4ZZ, F02Z8YZ, F02Z8ZZ, F02ZBEZ, F02ZBFZ, F02ZBUZ, F02ZBYZ, F02ZBZZ, F02ZCEZ, F02ZCFZ, F02ZCUZ, F02ZCYZ, F02ZCZZ, F02ZFYZ, F02ZFZZ, F02ZHEZ, F02ZHFZ, F02ZHGZ, F02ZHUZ, F02ZHYZ, F02ZHZZ |
| PXX08213 | Physical therapy exercises, manipulation, and other procedures – 213 | 0JNDXZZ, 0JNFXZZ, 0KN5XZZ, 0KN6XZZ, 0KN7XZZ, 0KN8XZZ, 0LN1XZZ, 0LN2XZZ, 0LN3XZZ, 0LN4XZZ, 0RNJXZZ, 0RNKXZZ, 8E0KX1Z, 8E0ZXY4, 9WB7XBZ, 9WB7XCZ, 9WB7XDZ, 9WB7XFZ, 9WB7XGZ, 9WB7XHZ, 9WB7XJZ, 9WB7XKZ, 9WB7XLZ, F0710EZ, F0710FZ, F0710UZ, F0710YZ, F0710ZZ, F0711EZ, F0711FZ, F0711UZ, F0711YZ, F0711ZZ, F0712EZ, F0712FZ, F0712UZ, F0712YZ, F0712ZZ, F0713EZ, F0713FZ, F0713UZ, F0713YZ, F0713ZZ, F0716BZ, F0716CZ, F0716DZ, F0716EZ, F0716FZ, F0716GZ, F0716HZ, F0716UZ, F0716YZ, F0716ZZ, F0717ZZ, F0730EZ, F0730FZ, F0730UZ, F0730YZ, F0730ZZ, F0731EZ, F0731FZ, F0731UZ, F0731YZ, F0731ZZ, F0732EZ, F0732FZ, F0732UZ, F0732YZ, F0732ZZ, F0733EZ, F0733FZ, F0733UZ, F0733YZ, F0733ZZ, F0736BZ, F0736CZ, F0736DZ, F0736EZ, F0736FZ, F0736GZ, F0736HZ, F0736UZ, F0736YZ, F0736ZZ, F0737ZZ, F0756BZ, F0756CZ, F0756DZ, F0756EZ, F0756FZ, F0756GZ, F0756HZ, F0756UZ, F0756YZ, F0756ZZ, F0776BZ, F0776CZ, F0776DZ, F0776EZ, F0776FZ, F0776GZ, F0776HZ, F0776UZ, F0776YZ, F0776ZZ, F0796BZ, F0796DZ, F0796EZ, F0796FZ, F0796GZ, F0796HZ, F0796UZ, F0796YZ, F0796ZZ, F07C6BZ, F07C6CZ, F07C6DZ, F07C6EZ, F07C6FZ, F07C6GZ, F07C6HZ, F07C6UZ, F07C6YZ, F07C6ZZ, F07F0EZ, F07F0FZ, F07F0UZ, F07F0YZ, F07F0ZZ, F07F1EZ, F07F1FZ, F07F1UZ, F07F1YZ, F07F1ZZ, F07F2EZ, F07F2FZ, F07F2UZ, F07F2YZ, F07F2ZZ, F07F3EZ, F07F3FZ, F07F3UZ, F07F3YZ, F07F3ZZ, F07F6BZ, F07F6CZ, F07F6DZ, F07F6EZ, F07F6FZ, F07F6GZ, F07F6HZ, F07F6UZ, F07F6YZ, F07F6ZZ, F07F7ZZ, F07H0EZ, F07H0FZ, F07H0UZ, F07H0YZ, F07H0ZZ, F07H1EZ, F07H1FZ, F07H1UZ, F07H1YZ, F07H1ZZ, F07H2EZ, F07H2FZ, F07H2UZ, F07H2YZ, F07H2ZZ, F07H3EZ, F07H3FZ, F07H3UZ, F07H3YZ, F07H3ZZ, F07H6BZ, F07H6CZ, F07H6DZ, F07H6EZ, F07H6FZ, F07H6GZ, F07H6HZ, F07H6UZ, F07H6YZ, F07H7ZZ, F07K0EZ, F07K0FZ, F07K0UZ, F07K0YZ, F07K0ZZ, F07K1EZ, F07K1FZ, F07K1UZ, F07K1YZ, F07K1ZZ, F07K2EZ, F07K2FZ, F07K2UZ, F07K2YZ, F07K2ZZ, F07K3EZ, F07K3FZ, F07K3UZ, F07K3YZ, F07K3ZZ, F07K6BZ, F07K6CZ, F07K6DZ, F07K6EZ, F07K6FZ, F07K6GZ, F07K6HZ, F07K6UZ, F07K6YZ, F07K7ZZ, F07M0EZ, F07M0FZ, F07M0UZ, F07M0YZ, F07M0ZZ, F07M1EZ, F07M1FZ, F07M1UZ, F07M1YZ, F07M1ZZ, F07M2EZ, F07M2FZ, F07M2UZ, F07M2YZ, F07M2ZZ, F07M3EZ, F07M3FZ, F07M3UZ, F07M3YZ, F07M3ZZ, F07M6BZ, F07M6CZ, F07M6DZ, F07M6EZ, F07M6FZ, F07M6GZ, F07M6HZ, F07M6UZ, F07M6YZ, F07M7ZZ, F07N1EZ, F07N1FZ, F07N1UZ, F07N1YZ, F07N1ZZ, F07N6BZ, F07N6CZ, F07N6DZ, F07N6EZ, F07N6FZ, F07N6GZ, F07N6HZ, F07N6UZ, F07N6YZ, F07N6ZZ, F07Z8CZ, F07Z8DZ, F07Z8EZ, F07Z8FZ, F07Z8UZ, F07Z8YZ, F07Z8ZZ, F07Z9CZ, F07Z9DZ, F07Z9EZ, F07Z9FZ, F07Z9GZ, F07Z9UZ, F07Z9YZ, F07Z9ZZ, F08F5BZ, F08F5CZ, F08F5DZ, F08F5EZ, F08F5FZ, F08F5UZ, F08F5YZ, F08F5ZZ, F08K5BZ, F08K5CZ, F08K5DZ, F08K5EZ, F08K5FZ, F08K5UZ, F08K5YZ, F08K5ZZ, F0DZ6EZ, F0DZ6FZ, F0DZ6UZ, F0DZ6ZZ, F0DZ7EZ, F0DZ7FZ, F0DZ7UZ, F0DZ7ZZ, F0FZDEZ, F0FZDFZ, F0FZDUZ, F0FZDZZ, F0FZFEZ, F0FZFFZ, F0FZFUZ, F0FZFZZ, F0FZGEZ, F0FZGFZ, F0FZGUZ, F0FZGZZ |
| PXX08214 | Traction, splints, and other wound care – 214 | 2W18X6Z, 2W18X7Z, 2W19X6Z, 2W19X7Z, 2W1AX6Z, 2W1AX7Z, 2W1BX6Z, 2W1BX7Z, 2W28X4Z, 2W29X4Z, 2W2AX4Z, 2W2BX4Z, 2W38X1Z, 2W38X2Z, 2W38X3Z, 2W38XYZ, 2W39X1Z, 2W39X2Z, 2W39X3Z, 2W39XYZ, 2W3AX1Z, 2W3AX2Z, 2W3AX3Z, 2W3AXYZ, 2W3BX1Z, 2W3BX2Z, 2W3BX3Z, 2W3BXYZ, 2W48X5Z, 2W49X5Z, 2W4AX5Z, 2W4BX5Z, 2W68XZZ, 2W69XZZ, 2W6AXZZ, 2W6BXZZ |
| PXX08217 | Biologic Infusions | 3E0U0GB, 3E0U3GB, 3E0V0GB, 3E0V3GB |
| PXX08227 | Stabilization of Shoulder Joint | 0RHG08Z, 0RHG38Z, 0RHG48Z, 0RHH08Z, 0RHH38Z, 0RHH48Z, 0RHJ08Z, 0RHJ38Z, 0RHJ48Z, 0RHK08Z, 0RHK38Z, 0RHK48Z |
| PXX08233 | Total Shoulder Replacement | 0RRJ00Z, 0RRJ07Z, 0RRJ0JZ, 0RRJ0KZ, 0RRK00Z, 0RRK07Z, 0RRK0JZ, 0RRK0KZ |
| PXX08234 | Partial Shoulder Replacement | 0RRE07Z, 0RRE0JZ, 0RRE0KZ, 0RRF07Z, 0RRF0JZ, 0RRF0KZ, 0RRG07Z, 0RRG0JZ, 0RRG0KZ, 0RRH07Z, 0RRH0JZ, 0RRH0KZ, 0RRJ0J6, 0RRJ0J7, 0RRK0J6, 0RRK0J7 |
| PXX08238 | Revision of Shoulder Joint | 0RWG0JZ, 0RWG3JZ, 0RWG4JZ, 0RWH0JZ, 0RWH3JZ, 0RWH4JZ, 0RWJ0JZ, 0RWJ3JZ, 0RWJ4JZ, 0RWK0JZ, 0RWK3JZ, 0RWK4JZ |
| PXX09168 | Incision and drainage, skin and subcutaneous tissue – 168 | 0H9BX0Z, 0H9BXZZ, 0H9CX0Z, 0H9CXZZ, 0J9D00Z, 0J9F00Z, 0X9200Z, 0X920ZZ, 0X9230Z, 0X923ZZ, 0X9240Z, 0X924ZZ, 0X9300Z, 0X930ZZ, 0X9330Z, 0X933ZZ, 0X9340Z, 0X934ZZ, 0X9400Z, 0X940ZZ, 0X9430Z, 0X943ZZ, 0X9440Z, 0X944ZZ, 0X9500Z, 0X950ZZ, 0X9530Z, 0X953ZZ, 0X9540Z, 0X954ZZ, 0X9600Z, 0X960ZZ, 0X9630Z, 0X963ZZ, 0X9640Z, 0X964ZZ, 0X9700Z, 0X970ZZ, 0X9730Z, 0X973ZZ, 0X9740Z, 0X974ZZ, 0X9800Z, 0X980ZZ, 0X9830Z, 0X983ZZ, 0X9840Z, 0X984ZZ, 0X9900Z, 0X990ZZ, 0X9930Z, 0X993ZZ, 0X9940Z, 0X994ZZ |
| PXX09169 | Debridement of wound, infection or burn – 169 | 0HB6XZZ, 0HBBXZZ, 0HBCXZZ, 3E1038Z |
| PXX11180 | Other CT scan – 180 | BG22ZZZ, BP200ZZ, BP201ZZ, BP20YZZ, BP210ZZ, BP211ZZ, BP21YZZ, BP220ZZ, BP221ZZ, BP22YZZ, BP22ZZZ, BP230ZZ, BP231ZZ, BP23YZZ, BP23ZZZ, BP240ZZ, BP241ZZ, BP24YZZ, BP24ZZZ, BP250ZZ, BP251ZZ, BP25YZZ, BP25ZZZ, BP260ZZ, BP261ZZ, BP26YZZ, BP26ZZZ, BP270ZZ, BP271ZZ, BP27YZZ, BP27ZZZ, BP280ZZ, BP281ZZ, BP28YZZ, BP28ZZZ, BP290ZZ, BP291ZZ, BP29YZZ, BP29ZZZ, BP2A0ZZ, BP2A1ZZ, BP2AYZZ, BP2AZZZ, BP2B0ZZ, BP2B1ZZ, BP2BYZZ, BP2BZZZ, BP2E0ZZ, BP2E1ZZ, BP2EYZZ, BP2EZZZ, BP2F0ZZ, BP2F1ZZ, BP2FYZZ, BP2FZZZ, BP2T0ZZ, BP2T1ZZ, BP2TYZZ, BP2TZZZ, BP2U0ZZ, BP2U1ZZ, BP2UYZZ, BP2UZZZ, BP2V0ZZ, BP2V1ZZ, BP2VYZZ, BP2VZZZ |
| PXX16222 | Blood transfusion – 222 | 30230H0, 30230H1, 30230J0, 30230J1, 30230K0, 30230K1, 30230L0, 30230L1, 30230M0, 30230M1, 30230N0, 30230N1, 30230P0, 30230P1, 30230Q0, 30230Q1, 30230R0, 30230R1, 30230S0, 30230T0, 30230T1, 30230V0, 30230V1, 30230W0, 30230W1, 30233H0, 30233H1, 30233J0, 30233J1, 30233K0, 30233K1, 30233L0, 30233L1, 30233M0, 30233M1, 30233N0, 30233N1, 30233P0, 30233P1, 30233Q0, 30233Q1, 30233R0, 30233R1, 30233S0, 30233T0, 30233T1, 30233V0, 30233V1, 30233W0, 30233W1, 30240H0, 30240H1, 30240J0, 30240J1, 30240K0, 30240K1, 30240L0, 30240L1, 30240M0, 30240M1, 30240N0, 30240N1, 30240P0, 30240P1, 30240Q0, 30240Q1, 30240R0, 30240R1, 30240S0, 30240T0, 30240T1, 30240V0, 30240V1, 30240W0, 30240W1, 30243H0, 30243H1, 30243J0, 30243J1, 30243K0, 30243K1, 30243L0, 30243L1, 30243M0, 30243M1, 30243N0, 30243N1, 30243P0, 30243P1, 30243Q0, 30243Q1, 30243R0, 30243R1, 30243S0, 30243T0, 30243T1, 30243V0, 30243V1, 30243W0, 30243W1, 30250H0, 30250H1, 30250J0, 30250J1, 30250K0, 30250K1, 30250L0, 30250L1, 30250M0, 30250M1, 30250N0, 30250N1, 30250P0, 30250P1, 30250Q0, 30250Q1, 30250R0, 30250R1, 30250S0, 30250T0, 30250T1, 30250V0, 30250V1, 30250W0, 30250W1, 30253H0, 30253H1, 30253J0, 30253J1, 30253K0, 30253K1, 30253L0, 30253L1, 30253M0, 30253M1, 30253N0, 30253N1, 30253P0, 30253P1, 30253Q0, 30253Q1, 30253R0, 30253R1, 30253S0, 30253T0, 30253T1, 30253V0, 30253V1, 30253W0, 30253W1, 30260H0, 30260H1, 30260J0, 30260J1, 30260K0, 30260K1, 30260L0, 30260L1, 30260M0, 30260M1, 30260N0, 30260N1, 30260P0, 30260P1, 30260Q0, 30260Q1, 30260R0, 30260R1, 30260S0, 30260T0, 30260T1, 30260V0, 30260V1, 30260W0, 30260W1, 30263H0, 30263H1, 30263J0, 30263J1, 30263K0, 30263K1, 30263L0, 30263L1, 30263M0, 30263M1, 30263N0, 30263N1, 30263P0, 30263P1, 30263Q0, 30263Q1, 30263R0, 30263R1, 30263S0, 30263T0, 30263T1, 30263V0, 30263V1, 30263W0, 30263W1, 3E030GC, 3E033GC, 3E040GC, 3E043GC, 3E050GC, 3E053GC, 3E060GC, 3E063GC |
| PXX17225 | CHEMOTHERAPY | 3E00X0M, 3E0130M, 3E0230M, 3E0300M, 3E0330M, 3E0400M, 3E0430M, 3E0500M, 3E0530M, 3E0600M, 3E0630M |
| XX0000 | Ungrouped Codes | 0KD50ZZ, 0KD60ZZ, 0KD70ZZ, 0KD80ZZ, 0KHX0YZ, 0KHX3YZ, 0KHX4YZ, 0KPX0YZ, 0KPX3YZ, 0KPX4YZ, 0KR507Z, 0KR50JZ, 0KR50KZ, 0KR547Z, 0KR54JZ, 0KR54KZ, 0KR607Z, 0KR60JZ, 0KR60KZ, 0KR647Z, 0KR64JZ, 0KR64KZ, 0KR707Z, 0KR70JZ, 0KR70KZ, 0KR747Z, 0KR74JZ, 0KR74KZ, 0KR807Z, 0KR80JZ, 0KR80KZ, 0KR847Z, 0KR84JZ, 0KR84KZ, 0KWX0YZ, 0KWX3YZ, 0KWX4YZ, 0LD10ZZ, 0LD20ZZ, 0LD30ZZ, 0LD40ZZ, 0LHX0YZ, 0LHX3YZ, 0LHX4YZ, 0LPX0YZ, 0LPX3YZ, 0LPX4YZ, 0LWX0YZ, 0LWX3YZ, 0LWX4YZ, 0MHX0YZ, 0MHX3YZ, 0MHX4YZ, 0MPX0YZ, 0MPX3YZ, 0MPX4YZ, 0MR107Z, 0MR10JZ, 0MR10KZ, 0MR147Z, 0MR14JZ, 0MR14KZ, 0MR207Z, 0MR20JZ, 0MR20KZ, 0MR247Z, 0MR24JZ, 0MR24KZ, 0MR907Z, 0MR90JZ, 0MR90KZ, 0MR947Z, 0MR94JZ, 0MR94KZ, 0MRB07Z, 0MRB0JZ, 0MRB0KZ, 0MRB47Z, 0MRB4JZ, 0MRB4KZ, 0MWX0YZ, 0MWX3YZ, 0MWX4YZ, 0PD50ZZ, 0PD60ZZ, 0PD70ZZ, 0PD80ZZ, 0PD90ZZ, 0PDB0ZZ, 0PDC0ZZ, 0PDD0ZZ, 0PDF0ZZ, 0PDG0ZZ |
Table 5: Relevant Procedure Codes CPT/HCPCS
| Group ID | Group Name | Code Value |
| CT0006 | X-Ray Shoulder Scapula Clavicle | 73000, 73010, 73020, 73030, 73050 |
| CT0016 | Drug Deiivery implantation | 11981, 11983 |
| CT0025 | Preventive Medicine, Care Coordination | 98960, 98961, 98962, 98966, 98967, 98968, 99078, 99361, 99362, 99366, 99367, 99368, 99371, 99372, 99373, 99396, 99441, 99442, 99443, 99446, 99447, 99448, 99449, 99499, G0175, G0406, G0407, G0408, G0425, G0426, G0427, S0220, S0221, S0315, S0316, S0317, S0320 |
| CT0026 | Anesthesia and pain management | J1960, J2270, J3010, J3070, S0012, S0092, S0093 |
| CT0078 | Prosthetic Implant | L8699 |
| CT0080 | Imaging Abdomen | 76999 |
| CT0082 | Medicines for pain | 96372, J0592, J1230 |
| CT0083 | Blood Type, Coomb’s test | 86077, 86880, 86900, 86901 |
| CT0089 | Metabolic Renal Hepatic Chemistry Panel | 80047, 80048, 80049, 80050, 80051, 80053, 80069, 80074, 80076, 82040, 82247, 82248, 82310, 82330, 82374, 82435, 82565, 82575, 82947, 84132, 84155, 84295, 84450, 84460, 84520, 84550 |
| CT0090 | Physical Therapy / Rehab | 97001, 97002, 97003, 97004, 97005, 97006, 97010, 97012, 97014, 97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036, 97039, 97110, 97112, 97113, 97116, 97124, 97139, 97140, 97150, 97530, 97545, 97546, 97750, 97755, 97762, 97799, G0129, S9129, S9131 |
| CT0091 | Physician Services – Outpatient | 99050, 99051, 99053, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99271, 99272, 99273, 99274, 99275, 99354, 99355, T1015 |
| CT0092 | Physician Services – Inpatient | 99221, 99222, 99223, 99238, 99239, 99252, 99253, 99254, 99255 |
| CT0094 | Screen for amino acid disorders | 84030 |
| CT0098 | Occult blood | 82270 |
| CT0114 | Procedure – spinal canal – catheter | C1755, E0785 |
| CT0119 | Procedure – block – nerve | 64413, 64415, 64416, 64417, 64418, 64420, 64421, 64450, 64470, 64472, 64479, 64480, 64520 |
| CT0120 | Procedure – destruction – nerve | 95873, 95874 |
| CT0124 | Procedure – other or rx – peripheral neurostimulator procedures | 64550, 64555, 64560, 64565, 64575, 64577, 64580, 64585 |
| CT0125 | Procedure – neuro – other or rx | 62360, 62361, 62362, 62365, 62367, 62368 |
| CT0126 | Procedure – neuro – other non – or rx | 62273 |
| CT0131 | Procedure – anesthesia | 01991, 01992 |
| CT01394 | Medications (Injections, infusions and other forms) | C9743, J0695, J0714, J0875, J7121 |
| CT01395 | DME and supplies | A4466, A9273, E1036, E2622, E2623, E2624, E2625, K0740, K0743, K0744, K0745, K0746, L3672, L3673 |
| CT0162 | Tests – neuro – ncv / emg | 95860, 95861, 95863, 95864, 95869, 95870, 95872, 95875, 95900, 95903, 95904 |
| CT0165 | Tests – neuro – other | 96000 |
| CT02387 | Pathology | 81490 |
| CT0351 | Therapy – habilitation | T2012 |
| CT04281 | Blood Gases, Pulse Oximetry | 94760, 94761, 94762 |
| CT0439 | Other care – respiratory – equipment / supplies – peak flow meter | S8096 |
| CT0440 | Other care – respiratory – equipment / supplies – spirometer | A9284 |
| CT0443 | Other care – respiratory – other | 94002, 94003, 94004, 94644, 94645, S8999 |
| CT0453 | Tests – pulmonary – peak flow | S8110 |
| CT05141 | Procedure – graft | L8670 |
| CT05171 | Procedure – central venous catheter – insertion | 36555, 36556, 36557, 36558, 36560, 36561, 36563, 36565, 36566, 36568, 36569, 36570, 36571, S5522, S5523 |
| CT05175 | Procedure – central venous catheter – removal | 36589, 36590 |
| CT05176 | Procedure – peripheral venous catheter | 36000 |
| CT05179 | Procedure – catheter – arterial – arterial line for monitoring | 36620, 36625 |
| CT05184 | Procedure – vascular access – port / pump – insertion | E0782, E0783, E0786 |
| CT05210 | Other care – other – pvd – compressor | E0675 |
| CT05233 | Tests – cardiac – ecg – ecg – 12 lead | R0076 |
| CT05257 | Tests – vascular – arterial – extremity | 93930, 93931 |
| CT05258 | Tests – vascular – venous | 93965, 93970, 93971 |
| CT05307 | Electrocardiogram – EKG monitoring | 93000, 93005, 93010, G0403, G0404, G0405 |
| CT05308 | Cardiac Stress Test | 78452, 93015, 93016, 93017, 93018 |
| CT05385 | Other diagnostic cardiovascular procedures | 93050 |
| CT0692 | Therapy – neurostimulator – nausea / vomiting | E0765 |
| CT0694 | Rx – gi – antiemetics | S9351, S9370 |
| CT0697 | Rx – gi – ppis | C9113 |
| CT08106 | Imaging – x-ray – other – joint survey | 77077, R0070 |
| CT08110 | Imaging – other imaging – bone density | 77083 |
| CT08113 | DME – heat/cold application | E0200, E0205, E0210, E0215, E0217, E0218, E0221, E0225, E0231, E0232, E0235, E0236, E0239 |
| CT08114 | DME – traction | E0830, E0880 |
| CT08115 | DME – trapeze / other orthopedic device | E0910, E0911, E0912, E0920, E0930, E0940, E0941, E0945, E0946, E0948 |
| CT08117 | Prosthetics – upper extremity | L6300, L6310, L6320, L6350, L6360, L6370, L6384, L6386, L6388, L6550, L6570, L6600, L6605, L6610, L6611, L6640, L6641, L6642, L6645, L6646, L6647, L6648, L6650, L6655, L6660, L6665, L6672, L6675, L6676, L6677, L6684, L6686, L6689, L6690, L6691, L6692, L6704, L6706, L6707, L6711, L6712, L6885 |
| CT0812 | Procedure – rotator cuff repair – open / arthroscopic | 23412 |
| CT08120 | Prosthetics – external power | L6960, L6965, L7009, L7040, L7266, L7272, L7402, L7405, L7499 |
| CT08122 | Orthotics – upper extremity | L3650, L3671, L3677, L3964, L3965, L3966, L3968, L3970, L3972, L3974, L3980 |
| CT08125 | Orthotics – other | L0982, L0984 |
| CT0813 | Procedure – arthroscopy – shoulder | 29822, 29823 |
| CT08143 | Partial Shoulder Replacement | 23470 |
| CT08144 | Total Shoulder Replacement | 23472 |
| CT08145 | Revision of Shoulder Replacement | 23473, 23474 |
| CT0828 | Procedure – arthroscopy – other joints | 29999 |
| CT08307 | Joint X-Rays | 73060 |
| CT0831 | Procedure – removal of pins or fixation | 20670, 20680, 20694 |
| CT0832 | Procedure – bone graft | 20900, 20902, 20910, 20920, 20922, 20926 |
| CT0833 | Procedure – casting / splinting – application | 29049, 29055, 29058, 29240, 29730, 29799 |
| CT0834 | Procedure – casting / splinting – supplies | A4565, A4570, A4580, A4590, Q4003, Q4004, Q4050, Q4051 |
| CT0835 | Procedure – injection – tendons / joints / etc. | 20500, 20550, 20551, 20552, 20553, 20612 |
| CT0836 | Procedure – arthrocentesis | 20610 |
| CT0837 | Procedure – partial excision bone | 23120, 27640, 27641 |
| CT0839 | Procedure – other fracture / dislocation – rx | 23575, 23665, 23670, 23675, 23680 |
| CT0840 | Procedure – other dx on musculoskeletal system | 20200, 20205, 20206, 20220, 23066, 23107 |
| CT0841 | Procedure – other rx on muscles and tendons | 23020, 23030, 23395, 23397, 23405, 23406, 23430, 24301, 24305, 24310, 24320 |
| CT0842 | Procedure – other or rx on bone | 20615, 20690, 20692, 20693, 20975, 23035, 24935 |
| CT0843 | Procedure – other or rx on joints | 23031, 23330, 23331, 23332, 23700, 23929 |
| CT0844 | Procedure – other or rx on musculoskeletal system | 23071, 23073, 23075, 23076, 23077, 23078, 23920, 23921 |
| CT0845 | Procedure – other non – or rx on musculoskeletal system | 20974, 20979, 20982 |
| CT0849 | Procedure – anesthesia | 01610, 01620, 01622, 01630, 01632, 01634, 01636, 01638, 01650, 01652, 01654, 01656, 01670, 01680, 01682, 01712, 01714 |
| CT0851 | Therapy – chiropractic / osteopathic manipulation | 98925, 98926, 98927, 98928, 98929 |
| CT0852 | Therapy – rehabilitation – related supplies / equipment – motion device | E1820, E1821, E1840, E1841 |
| CT0853 | Therapy – osteogenesis stimulator | E0747, E0748, E0749, E0760 |
| CT0855 | Therapy – neurostimulator – muscle training | E0764, E0770 |
| CT0857 | Rx – muscle relaxants – muscle relax, skeletal central | S9363 |
| CT0864 | Imaging – ct – upper extremity | 73200, 73201, 73202 |
| CT0871 | Imaging – mri – upper extremity | 73218, 73219, 73220, 73221, 73222, 73223 |
| CT0875 | Imaging – mra – upper extremity | 73225 |
| CT0893 | Imaging – x-ray – shoulder – arthrogram | 23350, 73040 |
| CT0920 | Procedure – injection of skin lesion | 11900, 11901 |
| CT0922 | Procedure – i&d – skin – drainage of abscess | 10060, 10061, 20000 |
| CT0923 | Procedure – i&d – skin – drainage of hematoma | 10140 |
| CT0924 | Procedure – i&d – skin – drainage – post – op infection | 10180 |
| CT0925 | Procedure – debridement – wound / infection / burn – debridement | 11000, 11001, 11041, 11042, 11043, 11044 |
| CT0929 | Procedure – excision – skin – shave skin lesion | 1121F, 1125F, 1126F, 1127F, 1128F, 1150F, 1151F, 1152F, 1153F, 1159F, 1160F |
| CT0942 | Procedure – suture – skin – repair of superficial wound | G0168 |
| CT0943 | Procedure – suture – skin – delayed wound closure | 12020, 12021, 13160 |
| CT0950 | Procedure – graft – skin – graft material | Q4100, Q4101, Q4102, Q4103, Q4104, Q4105, Q4106, Q4107, Q4108, Q4110, Q4111 |
| CT0958 | Procedure – other non – or rx – chemodenervation of eccrine glands | 64650, 64653 |
| CT0959 | Procedure – other non – or rx – other non – or skin procedures | 11950, 11951, 11952, 15850, 15851, 15852, 97602, S0630 |
| CT0965 | Other care – wound care | 97597, 97598, 97605, 97606, E0181, E0182, E0184, E0185, E0186, E0187, E0188, E0189, E0190, E0191, E0193, E0194, E0196, E0197, E0198, E0199, E0769, G0281, G0282, S9097 |
| CT0966 | Other care – wound care – hyperbaric oxygen | A4575 |
| CT0968 | Other care – wound care – growth factor | S9055 |
| CT0970 | Other care – chronic edema – appliance – limb compression | A4600 |
| CT0972 | Other care – chronic edema – appliance – segmental | E0668, E0672 |
| CT0974 | Other care – chronic edema – compressor – non – segmental | E0650 |
| CT0975 | Other care – chronic edema – compressor – segmental | E0651, E0652 |
| CT0976 | Other care – chronic edema – compressor | E0676 |
| CT0977 | Other care – chronic edema – sleeve | S8420, S8421, S8422, S8423, S8424 |
| CT0978 | Other care – chronic edema – glove | S8425, S8426, S8427 |
| CT0979 | Other care – chronic edema – gauntlet | S8428 |
| CT0980 | Other care – chronic edema – exterior wrap | S8429 |
| CT0993 | DME – wound therapy | E2402 |
| CT1021 | Rx – vitamins – multivit prep | A9152, A9153 |
| CT10295 | Thyroid Function Tests | 84443 |
| CT10296 | Low dose steroids | S9490 |
| CT1036 | Other care – nutrition – assessment | 97802, 97803, G0270, G0271 |
| CT1044 | Other care – nutrition – parenteral – pump | E0791 |
| CT1045 | Other care – nutrition – parenteral – all – inclusive | S9364, S9365, S9366, S9367, S9368 |
| CT1046 | Other care – nutrition – education | S9452 |
| CT1047 | Other care – nutrition – medical food | S9433, S9434, S9435 |
| CT1048 | Other care – nutrition – counseling – dietician | S9470 |
| CT1117 | Procedure – indwelling catheter | 51701, 51702, 51703 |
| CT1146 | Therapy – supplies | A4657, A4660, A4927, A4928, A4930, A4931, A4932 |
| CT1166 | Lab – urinalysis | 81007, 81015, 81020, 81050, 81099 |
| CT14389 | Other Laboratory | 0030T, 0194T |
| CT1615 | Therapy – transfusion – administration | 36430 |
| CT1616 | Therapy – transfusion – blood | P9010, P9011, P9016, P9021, P9022, P9038, P9039, P9040, P9051, P9054, P9056, P9057, P9058, S9538 |
| CT1617 | Therapy – transfusion – plasma | P9017, P9023, P9043, P9044, P9048, P9059, P9060 |
| CT1619 | Therapy – transfusion – platelets | P9019 |
| CT1620 | Therapy – phlebotomy | 99195 |
| CT1626 | Rx – blood derivatives | P9041, P9045, P9046, P9047 |
| CT16296 | Lipid Level Monitoring | 80061, 82465, 83695, 83698, 83700, 83701, 83704, 83718, 83719, 83721, 84478 |
| CT16297 | Blood Count | 82728, 83540, 83550, 85004, 85007, 85008, 85009, 85013, 85014, 85018, 85025, 85027, 85032, 85041, 85044, 85045, 85046, 85048, 85049, 85060, G0306, G0307 |
| CT16299 | Bleeding Status | 85002, 85345, 85347, 85348, 85610, 85611, 85670, 85675, 85705, 85730, 85732, 99363, 99364, G0248, G0250, S9401 |
| CT1630 | Rx – coagulation system – anticoagulants | S9336, S9372 |
| CT1631 | Rx – coagulation system – antiheparin agnt | A4802 |
| CT16316 | Blood transfusion | P9070, P9071, P9072 |
| CT1632 | Rx – coagulation system – hemostatics | P9012 |
| CT1635 | Rx – serums, toxoids, vaccines – serums | 90399 |
| CT1638 | Rx – administration – injection | 90772, 90773, 90774, 90775, 96373, 96374, 96375, 96376, 99506 |
| CT1639 | Rx – administration – infusion | 90765, 90766, 90767, 90768, 90779, 96361, 96365, 96366, 96367, 96368, 96369, 96370, 96371, 96379, 96521, 96522, 96523, 99601, 99602, A4220, A4221, A4222, A4223, A4305, A4306, C8957, E0776, E0779, E0780, E0781, K0552, K0601, K0602, K0603, K0604, K0605, S1015, S1016, S5035, S5036, S5497, S5498, S5501, S5502, S5517, S5518, S5520, S5521, S9379, S9542, S9810 |
| CT1646 | Lab – hematology – coagulation | 85170, 85175, 85210, 85220, 85230, 85240, 85244, 85245, 85246, 85247, 85250, 85260, 85270, 85280, 85290, 85291, 85292, 85293, 85300, 85301, 85302, 85303, 85305, 85306, 85307, 85335, 85337, 85360, 85362, 85366, 85370, 85378, 85379, 85380, 85384, 85385, 85390, 85396, 85397, 85400, 85410, 85415, 85420, 85421, 85612, 85613, 85635, G0249 |
| CT1647 | Lab – hematology – blood count | 85055 |
| CT1649 | Lab – other hematology | 85097, 85130, 85460, 85461, 85475, 85520, 85525, 85530, 85536, 85540, 85547, 85549, 85555, 85557, 85576, 85597, 85810, 85999, 88738, 88740, 88741 |
| CT1651 | Lab – immunology | 86000, 86001, 86003, 86005, 86021, 86022, 86023, 86038, 86039, 86060, 86063, 86078, 86079, 86146, 86147, 86148, 86155, 86156, 86157, 86160, 86161, 86162, 86171, 86185, 86200, 86215, 86225, 86226, 86235, 86243, 86255, 86256, 86277, 86280, 86294, 86300, 86301, 86304, 86305, 86308, 86309, 86310, 86316, 86320, 86325, 86327, 86329, 86331, 86332, 86334, 86335, 86336, 86337, 86340, 86343, 86344, 86352, 86353, 86355, 86356, 86357, 86359, 86360, 86361, 86367, 86378, 86382, 86384, 86403, 86406, 86430, 86431, 86480, 86485, 86486, 86490, 86510, 86580, 86586, 86590, 86592, 86593 |
| CT1652 | Lab – transfusion medicine | 86850, 86860, 86870, 86885, 86886, 86890, 86891, 86903, 86904, 86905, 86906, 86910, 86911, 86920, 86921, 86922, 86923, 86927, 86930, 86931, 86932, 86940, 86941, 86945, 86950, 86960, 86965, 86970, 86971, 86972, 86975, 86976, 86977, 86978, 86985, 86999 |
| CT17101 | IMMUNOTHERAPY | S9338 |
| CT1805 | Rx – antibiotics / antivirals / antifungals – infusion | S9345, S9494, S9497, S9500, S9501, S9502, S9503, S9504 |
| CT1807 | Rx – antibiotics – cephalosporins | J0690, J0692, J0694, J0696, J0697, J0698, J0710, J0713, J0715, J1890 |
| CT1816 | Rx – antibiotics – anti-infectives, misc | S9061 |
| CT1820 | Other care – other – infection control | S8301 |
| CT1825 | Lab – microbiology – c & s | 87040, 87045, 87046, 87070, 87071, 87073, 87075, 87076, 87077, 87081, 87084, 87086, 87088, 87101, 87102, 87103, 87106, 87107, 87109, 87116, 87118, 87140, 87143, 87147, 87149, 87150, 87152, 87153, 87158, 87181, 87184, 87185, 87186, 87187, 87188, 87190, 87197 |
| CT1826 | Lab – microbiology – microscopic exam | 87205, 87206, 87207, 87209, 87210, 87220 |
| CT1828 | Lab – microbiology | P7001 |
| CT18300 | Microscopic examination (bacterial smear, culture, toxicology) | 0041T |
| CT18302 | CHLAMYDIA SCREENING | 87110 |
| CT1905 | Therapy – behavior – partial hospitalization | S0201 |
| CT19303 | Psychiatry Evaluations | T1023 |
| CT19378 | Laboratory – Chemistry and Hematology | 83987 |
| CT20376 | Other Laboratory | G9143 |
| CT2101 | Lab – therapeutic drug assay | 80150, 80154, 80170, 80176, 80200, 80202 |
| CT2304 | Therapy – pt – exercises / activities | 93668, 97533, 97537, S8990 |
| CT2305 | Therapy – pt – modalities | S8948 |
| CT2308 | Therapy – biofeedback | 90901, E0746 |
| CT2330 | Other care – bladder / bowel care – other supplies – skin barrier | A5120, A5121, A5122, A5126, A5131, A5200 |
| CT23309 | Markers for Inflammation | 85651, 85652, 86140, 86141 |
| CT2331 | Other care – observation | G0379 |
| CT23398 | Ancillary Services | 0115T, 0116T, 0117T, 99415, 99416, G9475, G9476, G9477, G9478, G9479 |
| CT2341 | Other care – other – exercise classes | S9451 |
| CT2352 | DME – mobility aids | E0950, E0955, E0957, E0958, E0959, E0960, E0966, E0968, E0969, E0971, E0973, E0974, E0980, E0981, E0982, E0983, E0984, E0985, E0986, E0992, E0994, E0995, E1002, E1003, E1004, E1005, E1006, E1007, E1008, E1011, E1014, E1015, E1016, E1017, E1018, E1020, E1028, E1029, E1030, E1031, E1035, E1037, E1038, E1039, E1070, E1085, E1086, E1089, E1090, E1093, E1130, E1140, E1161, E1180, E1200, E1220, E1221, E1223, E1225, E1226, E1227, E1228, E1229, E1230, E1231, E1232, E1233, E1234, E1235, E1236, E1237, E1238, E1239, E1250, E1260, E1285, E1290, E1296, E1297, E1298, E2201, E2202, E2203, E2204, E2206, E2207, E2208, E2210, E2211, E2212, E2213, E2214, E2215, E2216, E2217, E2218, E2219, E2220, E2221, E2222, E2224, E2225, E2226, E2227, E2228, E2230, E2231, E2291, E2292, E2293, E2294, E2295, E2300, E2301, E2310, E2311, E2313, E2324, E2325, E2326, E2327, E2328, E2329, E2330, E2331, E2340, E2341, E2342, E2343, E2360, E2361, E2362, E2363, E2364, E2365, E2366, E2367, E2368, E2369, E2370, E2371, E2372, E2375, E2376, E2377, E2381, E2382, E2383, E2384, E2385, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2394, E2395, E2396, E2397, E2601, E2602, E2603, E2604, E2605, E2606, E2607, E2608, E2609, E2610, E2611, E2612, E2613, E2614, E2615, E2616, E2617, E2619, E2620, E2621, E8000, E8001, E8002, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0009, K0010, K0011, K0012, K0014, K0015, K0017, K0018, K0019, K0020, K0037, K0040, K0041, K0042, K0044, K0045, K0050, K0052, K0053, K0056, K0065, K0069, K0070, K0071, K0072, K0073, K0077, K0098, K0105, K0108, K0669, K0733, K0800, K0801, K0802, K0806, K0807, K0808, K0812, K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0830, K0831, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, K0864, K0868, K0869, K0870, K0871, K0877, K0878, K0879, K0880, K0884, K0885, K0886, K0890, K0891, K0898, K0899, L0978 |
| CT2353 | DME – patient lifts | E0621, E0625, E0627, E0628, E0629, E0630, E0635, E0636, E0637, E0638, E0639, E0640, E0641, E0642 |
| CT9902 | E & M – consultation | Q3014, T1014 |
| CT9903 | E & M – hospital | 99217, 99218, 99219, 99220, 99231, 99232, 99233, 99234, 99235, 99236, 99291, 99292, 99481, 99482, G0378, G0390, S0310 |
| CT9904 | E & M – emergency care | 99058, 99281, 99282, 99283, 99284, 99285, G0380, G0381, G0382, G0383, G0384, S9083, S9088 |
| CT9905 | E & M – home visit | 99224, 99225, 99226, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, S0273 |
| CT9906 | E & M – nursing home | 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337 |
| CT9907 | E & M – prevention | 99420, S0302 |
| CT9908 | E & M – other | 96040, 99026, 99027, 99056, 99060, 99150, 99170, 99288, 99290, 99360, 99450, 99455, 99456, 99485, 99486, 99488, S0260 |
| CT9910 | Procedure – anesthesia | 01996, 01999, 99135, 99140 |
| CT99102 | Other care – other | S1001, S1002, S9988, S9989, S9990, S9991, S9999, T2025, T2035, T2038, T2040, T2041 |
| CT99103 | Imaging – ct – follow – up | 76380 |
| CT99104 | Imaging – ct – other | 76497 |
| CT99105 | Imaging – ct – guidance | 77011, 77012, 77013, 77014 |
| CT99107 | Imaging – mri – other | 75559, 75563, 76498, S8035, S8042 |
| CT99108 | Imaging – mri – guidance | 77021, 77022 |
| CT99109 | Imaging – mri – contrast agent | Q9954 |
| CT9911 | Procedure – sedation | 99143, 99144, 99145, 99148, 99149 |
| CT99113 | Imaging – us – guide – biopsy | 76942 |
| CT99114 | Imaging – us – guide – other | 76998 |
| CT99115 | Imaging – us – other | 76970, 76977 |
| CT99133 | Imaging – other imaging – fluoroscopy | 76496 |
| CT99134 | Imaging – other imaging – fluoroscopy – guidance | 77002 |
| CT99136 | Imaging – other imaging | 76120, 76125, 76140, 76150, 76350, 76376, 76377, 76390, 76499, Q0092, R0075 |
| CT99139 | Imaging – supplies – contrast agent – low osmolar | Q9965, Q9966, Q9967 |
| CT99140 | Imaging – supplies – contrast agent – high osmolar | Q9958, Q9959, Q9960, Q9961, Q9962, Q9963, Q9964 |
| CT99142 | Lab – pathology consultation | 80500, 80502 |
| CT99143 | Lab – chemistry | 82000, 82003, 82013, 82016, 82017, 82024, 82030, 82045, 82085, 82088, 82101, 82103, 82104, 82105, 82106, 82107, 82108, 82120, 82127, 82128, 82131, 82135, 82136, 82139, 82140, 82143, 82145, 82150, 82154, 82157, 82160, 82163, 82164, 82172, 82175, 82180, 82190, 82205, 82232, 82239, 82240, 82252, 82261, 82271, 82272, 82273, 82274, 82286, 82300, 82306, 82307, 82308, 82331, 82340, 82355, 82360, 82365, 82370, 82373, 82375, 82376, 82378, 82379, 82380, 82382, 82383, 82384, 82387, 82390, 82397, 82415, 82436, 82438, 82441, 82480, 82482, 82485, 82486, 82487, 82488, 82489, 82491, 82492, 82495, 82507, 82520, 82523, 82525, 82528, 82530, 82533, 82540, 82541, 82542, 82543, 82544, 82550, 82552, 82553, 82554, 82570, 82585, 82595, 82600, 82607, 82608, 82610, 82615, 82626, 82627, 82633, 82634, 82638, 82646, 82649, 82651, 82652, 82654, 82656, 82657, 82658, 82664, 82666, 82668, 82670, 82671, 82672, 82677, 82679, 82690, 82693, 82696, 82705, 82710, 82715, 82725, 82726, 82731, 82735, 82742, 82746, 82747, 82757, 82759, 82760, 82775, 82776, 82784, 82785, 82787, 82926, 82928, 82938, 82941, 82943, 82945, 82946, 82950, 82951, 82952, 82953, 82955, 82960, 82962, 82963, 82965, 82975, 82977, 82978, 82979, 82980, 82985, 83001, 83002, 83003, 83008, 83009, 83010, 83012, 83013, 83014, 83015, 83018, 83020, 83021, 83026, 83030, 83033, 83045, 83050, 83051, 83055, 83060, 83065, 83068, 83069, 83070, 83071, 83080, 83088, 83090, 83150, 83491, 83497, 83498, 83499, 83500, 83505, 83516, 83518, 83519, 83520, 83525, 83527, 83528, 83570, 83582, 83586, 83593, 83605, 83615, 83625, 83630, 83631, 83632, 83633, 83634, 83670, 83690, 83727, 83735, 83775, 83785, 83788, 83789, 83805, 83825, 83835, 83840, 83857, 83858, 83864, 83866, 83872, 83873, 83874, 83876, 83880, 83883, 83885, 83887, 83890, 83891, 83892, 83893, 83894, 83896, 83897, 83898, 83900, 83901, 83902, 83903, 83904, 83905, 83906, 83907, 83908, 83909, 83912, 83913, 83914, 83915, 83916, 83918, 83919, 83921, 83925, 83930, 83935, 83937, 83945, 83950, 83951, 83986, 83992, 83993, 84022, 84035, 84060, 84061, 84066, 84075, 84078, 84080, 84081, 84085, 84087, 84100, 84105, 84106, 84110, 84119, 84120, 84126, 84127, 84133, 84134, 84135, 84138, 84140, 84143, 84144, 84145, 84146, 84150, 84152, 84153, 84154, 84156, 84157, 84160, 84163, 84165, 84166, 84181, 84182, 84202, 84203, 84206, 84207, 84210, 84220, 84228, 84233, 84234, 84235, 84238, 84244, 84252, 84255, 84260, 84270, 84275, 84285, 84300, 84302, 84305, 84307, 84311, 84315, 84375, 84376, 84377, 84378, 84379, 84392, 84402, 84403, 84425, 84430, 84431, 84446, 84449, 84466, 84484, 84485, 84488, 84490, 84510, 84512, 84525, 84540, 84545, 84560, 84577, 84578, 84580, 84583, 84585, 84586, 84588, 84590, 84591, 84597, 84600, 84620, 84630, 84681, 84702, 84703, 84704, 84830, 84999, 95250 |
| CT99148 | Lab – surgical pathology | 88300, 88304, 88305, 88311, 88312, 88313, 88314, 88318, 88319, 88321, 88323, 88325, 88329, 88331, 88332, 88333, 88334, 88342, 88346, 88347, 88348, 88349, 88355, 88356, 88360, 88361, 88362, 88365, 88367, 88368, 88371, 88372, 88380, 88381, 88384, 88385, 88386, 88387, 88388, 88399 |
| CT9915 | Procedure – microsurgery | 69990 |
| CT99169 | Lab – specimen collection – blood – venous – venipuncture | 36410, 36415, S9529 |
| CT9917 | Procedure – related supplies – access catheter | A4300, A4301 |
| CT99171 | Lab – specimen collection – blood – venous – venous port | 36540, 36591, 36592 |
| CT99172 | Lab – specimen collection – blood – arterial – arterial puncture | 36600 |
| CT99176 | Lab – stat request | S3600, S3601 |
| CT9918 | Procedure – related supplies – ablation – catheter | Q4116 |
| CT99182 | Transportation – paramedic | S0207, S0208 |
| CT99183 | Transportation – other transportation | A0021, A0080, A0090, A0100, A0110, A0120, A0130, A0140, A0160, A0170, A0180, A0190, A0200, A0210, A0225, A0380, A0382, A0384, A0390, A0392, A0394, A0396, A0398, A0420, A0422, A0424, A0425, A0426, A0427, A0428, A0429, A0430, A0431, A0432, A0433, A0434, A0435, A0436, A0888, A0998, A0999, P9603, P9604, S0209, S0215, S9975, S9992, T2001, T2002, T2003, T2004, T2005, T2007, T2049 |
| CT99184 | DME – other | A9281, A9283, A9300, A9900, A9901, A9999, S8185, S8270, S9381, T1999, T2029, T2039, T5999 |
| CT99185 | DME – bath / toilet aids | E0160, E0161, E0162, E0163, E0165, E0167, E0168, E0170, E0171, E0172, E0175, E0240, E0241, E0242, E0243, E0244, E0245, E0246, E0247, E0248, E0249 |
| CT99186 | DME – beds / accessories | E0250, E0251, E0255, E0256, E0260, E0261, E0265, E0266, E0270, E0271, E0272, E0273, E0274, E0275, E0276, E0277, E0280, E0290, E0291, E0292, E0293, E0294, E0295, E0296, E0297, E0300, E0301, E0302, E0303, E0304, E0305, E0310, E0315, E0316, E0325, E0326, E0328, E0329, E0350, E0352, E0370, E0371, E0372, E0373 |
| CT99187 | DME – safety equipment | E0700, E0705 |
| CT99191 | Supplies | A4206, A4207, A4208, A4209, A4210, A4211, A4212, A4213, A4215, A4216, A4217, A4218, A4244, A4245, A4246, A4247, A4248, A4265, A4270, A4450, A4452, A4455, A4456, A4458, A4461, A4463, A4465, A4470, A4480, A4550, A4561, A4562, A4601, A4649, A4651, A4652, A6000, A6010, A6011, A6021, A6022, A6023, A6024, A6025, A6154, A6196, A6197, A6198, A6199, A6203, A6204, A6205, A6206, A6207, A6208, A6209, A6210, A6211, A6212, A6213, A6214, A6215, A6216, A6217, A6218, A6219, A6220, A6221, A6222, A6223, A6224, A6228, A6229, A6230, A6231, A6232, A6233, A6234, A6235, A6236, A6237, A6238, A6239, A6240, A6241, A6242, A6243, A6244, A6245, A6246, A6247, A6248, A6250, A6251, A6252, A6253, A6254, A6255, A6256, A6257, A6258, A6259, A6260, A6261, A6262, A6266, A6402, A6403, A6404, A6407, A6413, A6441, A6442, A6443, A6444, A6445, A6446, A6447, A6448, A6449, A6450, A6451, A6452, A6453, A6454, A6455, A6456, A6457, A6550, A7000, A7001, A7002, A9155, C1751, C1769, C1883, C1894, C9898, J1642, S8430, S8431, T2028 |
| CT99192 | Prosthetics – implant | L8680, L8681, L8682, L8683, L8684, L8685, L8686, L8687, L8688, L8689, L8695, L9900 |
| CT99195 | Prosthetics – other | K0462, L8415, L8435, L8465, L8499 |
| CT99196 | Prosthetics – repair | L7500, L7510, L7520, L7600 |
| CT99197 | Other – non – covered | A9270, G0293, G0294, S9986 |
| CT9923 | Procedure – related supplies – graft / repair | Q4112, Q4113, Q4114, Q4115 |
| CT9927 | Procedure – related supplies – other | A4648, C1713, C1727, C1765, C1879, C9250, C9359, C9360, C9361, C9363, C9364, Q9968 |
| CT9928 | Therapy – acupuncture | 97810, 97811, 97813, 97814 |
| CT9930 | Therapy – habilitation | T2013, T2014, T2015, T2016, T2017, T2018, T2019, T2020, T2021 |
| CT99309 | Physician Services | 99251 |
| CT99311 | Urine Protein | 81000, 81001, 81002, 81003, 81005, 82042, 82043, 82044 |
| CT99312 | HbA1C | 83036, 83037 |
| CT99314 | Robotic Surgery | S2900 |
| CT99316 | Physician Services – Inpatient | 99356, 99357 |
| CT9935 | Therapy – hyperbaric oxygen | 99183, C1300 |
| CT9936 | Therapy – neurostimulator – tens – device | E0720, E0730, E0731 |
| CT99392 | Other diagnostic procedures (interview, evaluation, consultation) | 0074T, 0089T, 0185T, 0188T, 0189T, G0438, G0439 |
| CT9940 | Therapy – other | 36299, 99024, 99185, 99186, E0761, E0762, M0076 |
| CT99400 | Advance care planning | 1123F, 1124F, 1157F, 1158F |
| CT99401 | Bundled Payment / Medical Home | G9187, S0280, S0281 |
| CT99402 | Care Plan Oversight | 94005, 99339, 99340, 99374, 99375, 99377, 99378, 99379, 99380 |
| CT99403 | Case Management Services | 5050F, G0162, G0463, G9012, S0250, T1001, T1016, T1017, T2022, T2023, T2024 |
| CT99404 | Case Management Services – Behavioral | 96116, G0503, G0507, H0023, H1011 |
| CT99408 | Chronic Care Management | 99487, 99489 |
| CT99409 | Home Health / Hospice | G0179, G0180, G0181, G0182 |
| CT99411 | Medication Therapy Management Services | 99605, 99606, 99607 |
| CT99412 | Online Management | 98969, 99444 |
| CT99413 | Personal Care Services | T1019, T1020 |
| CT99414 | Physical therapy / Rehab | 97164, 97168, 97172 |
| CT99415 | Physician Services – Outpatient | 99358, 99359 |
| CT99416 | Procedures and Reporting | 99090, 99091 |
| CT99417 | Risk Assessment | G9316 |
| CT99419 | Wellness Assessment | S5190 |
| CT99420 | LEAD SCREENING | 83655 |
| CT9946 | Rx – analg/antipy/nsaids – nsaids | J1885 |
| CT9947 | Rx – analg/antipy/nsaids – narcotics | J0364, J0595, J0745, J1170, J1810, J2175, J2180, J2271, J2275, J2300, J2410, S0109 |
| CT9950 | Rx – electrolytic, caloric, water – potassium supp | S5012 |
| CT9951 | Rx – electrolytic, caloric, water – multi-mineral prep | S5014 |
| CT9955 | Rx – electrolytic, caloric, water – caloric rx dextrose / rel | S5010, S5011, S5013 |
| CT9956 | Rx – electrolytic, caloric, water – hydration – unspecfied | 90760, 90761, Q0081, S9373, S9374, S9375, S9376, S9377 |
| CT9957 | Rx – miscellaneous rx | A9150, C9399, Q4074 |
| CT9961 | Rx – diagnostic rx – roentgenography | Q9957 |
| CT9963 | Rx – pharmacy fee | S9430 |
| CT9964 | Other care – home care – specialized visit | 99509, 99600 |
| CT9965 | Other care – home care – physician supervision | G0372, S0270, S0272 |
| CT9966 | Other care – home care – nursing care | G0128, T1000, T1002, T1003, T1004 |
| CT9967 | Other care – home care – nursing care – rn | G0154, S9123, T1030 |
| CT9968 | Other care – home care – nursing care – lpn | S9124, T1031 |
| CT9969 | Other care – home care – nursing care – np | S0274 |
| CT9970 | Other care – home care – rehabilitation – physical therapy | G0151 |
| CT9971 | Other care – home care – rehabilitation – occupational therapy | G0152 |
| CT9973 | Other care – home care – social worker | G0155, S9127 |
| CT9974 | Other care – home care – home health aide | G0156, S9122, T1021 |
| CT9975 | Other care – home care – other care – day care | S5100, S5101, S5102, S5105 |
| CT9976 | Other care – home care – other care – chore care | S5120, S5121 |
| CT9977 | Other care – home care – other care – attendant care | S5125, S5126 |
| CT9979 | Other care – home care – other care – companion care | S5135, S5136 |
| CT9980 | Other care – home care – other care – respite care | S5150, S5151, S9125, T1005 |
| CT9981 | Other care – home care – other care | S5165, S5175, S5185, S5199, T1022 |
| CT9982 | Other care – home care – training | S5108, S5109, S5110, S5111, S5115, S5116 |
| CT9984 | Other care – home care – meals | S5170 |
| CT9985 | Other care – pain management – pca / related | S9325, S9326, S9327, S9328 |
| CT9986 | Other care – hospice | G0337, Q5001, Q5002, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5009, S9126 |
| CT9987 | Other care – long term care – residential care | T2010, T2011, T2032, T2033 |
| CT9988 | Other care – long term care – assisted living | T2030, T2031 |
| CT9990 | Other care – other – ancillary services | 97804, 99070, 99071, 99075, 99082, 99199 |
| CT9996 | Other care – other – lodging | S9976, S9994 |
| CT9997 | Other care – other – meals | S9977, S9996 |
| CT9998 | Other care – other – medical records | S9981, S9982 |
| XX0000 | Ungrouped Codes | 0054T, 0055T, 0056T, 1100F, 1101F, 23333, 23334, 23335, 33952, 33954, 33958, 33962, 33966, 7010F, 76881, 76882, 90769, 90770, 90771, 90776, 96360, 97161, 97162, 97163, 97165, 97166, 97167, 97169, 97170, 97171, 97610, 97763, 99152, 99153, 99155, 99156, 99157, C9443, C9444, C9446, G0299, G0300, G0472, G0473, G6045, G6046, G8152, G8153, G8154, G8155, G8156, G8157, G8193, G8196, G8204, G8209, G8214, G8217, G8219, G8220, G8221, G8696, G8697, G8698, G8702, G8703, G8704, G8705, G8706, G8707, G8916, G8917, G8918, G8961, G8962, G8967, G8968, G8969, G8970, G8971, G8972, G9199, G9200, G9201, G9298, G9299, G9307, G9308, G9309, G9310, G9311, G9312, G9362, G9363, G9497, G9500, G9501, G9539, G9540, G9541, G9542, G9543, G9544, G9558, G9559, G9560, G9637, G9638, G9642, G9643, G9644, G9645, G9654, G9656, G9657, G9954, G9968, G9969, G9970, J2274, J2704, L3660, L3670, L3675, L3678, Q9974, S0144 |
Table 6: Relevant Typical Drug Groups
| Group ID | Group Name |
| RX001 | contrast media |
| RX002 | diagnostic agents |
| RX0111 | parasympathomimetics |
| RX017 | hypnotics and sedatives |
| RX0320 | cough and cold preparations |
| RX0321 | decongestants and other nasal preparations for topical use |
| RX0324 | throat preparations |
| RX0425 | antihistamines for systemic use |
| RX0426 | Bronchodilators: adrenergics for systemic use |
| RX0427 | drugs for obstructive airway diseases – inhalants |
| RX0429 | other systemic drugs for obstructive airway diseases |
| RX0530 | agents acting on the renin-angiotensin system |
| RX0535 | beta blocking agents |
| RX0536 | calcium channel blockers |
| RX0538 | diuretics |
| RX0539 | i.v. solutions & additives |
| RX0540 | Nitrates and other antianginals |
| RX0541 | other antihypertensives |
| RX0546 | Antiplatelet agents, thrombin inhibitors |
| RX0547 | Heparin group |
| RX0645 | antacids |
| RX0646 | antidiarrheals intestinal adsorbents |
| RX0647 | antiemetics and antinauseants |
| RX0648 | digestives incl. enzymes |
| RX0649 | drugs for constipation |
| RX0651 | drugs for peptic ulcer and gerd |
| RX0652 | intestinal antiinfectives |
| RX0855 | Glucosamine |
| RX0856 | antigout preparations |
| RX0857 | antiinflammatory and antirheumatic products |
| RX0860 | muscle relaxants |
| RX0861 | opioids |
| RX0862 | other analgesics and antipyretics |
| RX0863 | other drugs for disorders of the musculo-skeletal system |
| RX0864 | topical products for joint and muscular pain |
| RX0968 | antibiotics and chemotherapeutics for dermatological use |
| RX0969 | antifungals for dermatological use |
| RX0970 | antipruritics incl. antihistamines anesthetics etc. |
| RX0971 | antiseptics and disinfectants |
| RX0973 | corticosteroids dermatological preparations |
| RX0974 | ectoparasiticides incl. scabicides insecticides and repellents |
| RX0976 | irrigating solutions |
| RX0977 | medicated dressings |
| RX0978 | other dermatological preparations |
| RX0979 | preparations for treatment of wounds and ulcers |
| RX0980 | Moisturizers and skin protective agents |
| RX1086 | corticosteroids for systemic use |
| RX16106 | iron preparations |
| RX16109 | vitamin b12 and folic acid |
| RX18117 | antibacterials for systemic use |
| RX18119 | antiinfectives |
| RX19125 | anxiolytics |
| RX23131 | mineral supplements |
| RX23133 | other nutrients |
| RX23135 | vitamins |
| RX99136 | anesthetics general |
| RX99137 | anesthetics local |
| RX99138 | medical gas |