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 Trauma and Stressors Disorders, sometimes abbreviated PTSD, is a chronic condition episode. There is a 30-day lookback period to capture services rendered prior to the trigger claim, such as diagnostic services, office visits, and ancillary services. The Trauma and Stressors Disorders episode does not have an end date regarding the look-forward period, but can be broken into distinct reporting periods for implementations (e.g., 12 months).
Episode Components
| Triggers | A Trauma and Stressors Disorders episode can be triggered by an inpatient facility claim with a trigger principal diagnosis code for the condition (See Table 1) or an outpatient facility or professional claim with a trigger diagnosis code (in any position) and an E&M procedure code (in any position) on the same claim line. For professional claim triggers a second trigger signal or confirming claim is required that meets the same criteria as any of the initial trigger claims above. The confirming claim must be at least 30 days after the initial trigger claim. |
| 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, for chronic episodes, relevant acute inpatient admissions 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 diagnoses 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: Acute Reaction to StressAdjustment DisordersReactive States |
Code Tables
Table 1: Trigger Codes
| Trigger Type | Code Value |
| ICD-10-CM (DX) Triggers | F430, F4310, F4311, F4312, F4320, F4321, F4322, F4323, F4324, F4325, F4329, F438, F439, R457 |
Table 2: ICD-10 Typical Diagnosis
| Group ID | Group Name | Code Value |
| DXX0004 | Candida Infection | B370, B372, B373, B3783, B379 |
| DXX0012 | Other injuries and conditions due to external | T161XXA, T161XXD, T162XXA, T162XXD, T169XXA, T169XXD, T783XXA, T783XXD |
| DXX01109 | NS – headache – tension | G44209 |
| DXX01111 | NS – headache – symptom | G441, R51 |
| DXX01155 | NS – tremor – benign essential | G250, G251, G252 |
| DXX01186 | NS – chronic pain – other | G8929, G894 |
| DXX01196 | NS – abnormal stimulus response | R94130 |
| DXX01400 | Persistent Cognitive and Gait Abnormalities | R260, R261, R2681, R2689, R269, R270, R278, R279, R411, R412, R413 |
| DXX01401 | Dyskinesia | G2581, G2583 |
| DXX01402 | Narcolepsy | G47411, G47419 |
| DXX03220 | Inj – nose – foreign body | T170XXA, T171XXA |
| DXX03241 | Inj – mouth – foreign body | T180XXA |
| DXX06203 | GI – anorexia | R630 |
| DXX06277 | Irritable Bowel and other functional GI disor | K580, K581, K582, K588, K589, K5900, K5903, K5904, K591, K634, K6389, K9289 |
| DXX09106 | Inj – face / neck / scalp – foreign body | S0035XA, S00451A, S00452A, S00459A, S00552A |
| DXX09116 | Inj – trunk – nos – foreign body | S30852A, S30853A, S30854A, S30857A |
| DXX09192 | Dermatitis, Urticaria | L270, L271, L298, L299, L300, L308, L309, L501, L508, L509, T7841XA |
| DXX0939 | BH – other ds | F424 |
| DXX0988 | Skin – other | L110, L850, L851, R21 |
| DXX1007 | Overweight | E663 |
| DXX10108 | Sleep Apnea | G4730 |
| DXX10110 | Severe Protein Calorie Malnutrition | E45 |
| DXX10119 | Mild-mod malnutrition | E440, E441, E46, E640 |
| DXX10121 | Vitamin, Mineral & Other Nutrl Deficiency | D81818, D81819, E508, E509, E5111, E5112, E512, E518, E519, E52, E530, E531, E538, E539, E54, E559, E560, E561, E568, E569, E58, E59, E60, E610, E611, E612, E613, E614, E615, E616, E617, E618, E619, E630, E631, E638, E639, E641, E642, E648, E649 |
| DXX1019 | Morbid Obesity | E6601, Z6841, Z6842 |
| DXX1069 | Abnormal Weight Gain | R635 |
| DXX1096 | Prvn – screening – other | Z1321, Z13228, Z1329 |
| DXX11124 | Inj – gu tract – foreign body | T198XXA, T199XXA |
| DXX11143 | Urinary Tract Infection | N390, R309 |
| DXX11152 | Urinary Frequency & other symptoms | R300, R350 |
| DXX11153 | Urinary Incontinence | N3941, N3946, N39491, N39492, N39498, R32 |
| DXX11154 | Urinary Retention | R330, R338, R339, R3914 |
| DXX1263 | Inj – penis – foreign body | T194XXA |
| DXX1265 | Male infertility, impotence | N5201, N5202, N5203, N521, N522, N529 |
| DXX1388 | Inj – uterus – foreign body | T192XXA |
| DXX19103 | Altered mental status | G454, R400, R401, R404, R410, R4182 |
| DXX19104 | Other somatoform disorders | F458, F459 |
| DXX19106 | Personality & Conduct Disorders | F69 |
| DXX1920 | BH – personality disorder | R4681 |
| DXX1923 | BH – other ds | F489, F5000, F5001, F5002, F59, F99, R452, R455, R456, Z046, Z8659, Z91419, Z9149 |
| DXX1924 | BH – emotional ds of childhood | F938 |
| DXX1928 | BH – symptoms | R450, R453, R454, R4586, R4587, R4589 |
| DXX1930 | NS – hypersomnia | F5104, F5105, F5111, F5112, F5113, F5119, G4710, G4711, G4712, G4713, G4714, G4719 |
| DXX1931 | NS – insomnia | F5101, F5102, F5103, F5109, F519, G4700, G4701, G4709 |
| DXX1932 | NS – other sleep ds | G4720, G478, G479 |
| DXX1935 | Sxs – symptoms -other – other | R4583 |
| DXX1947 | Acute Reaction to Stress | F430 |
| DXX1949 | Suicidal ideation | R45851 |
| DXX1953 | Drug induced Mental Disorder | F17203, F17208, F17209, F17213, F17218, F17219, F17223, F17228, F17229, F17293, F17298, F17299 |
| DXX1979 | Other psychotic disorders | F23 |
| DXX1983 | Adjustment disorders | F4320, F4321, F4322, F4323, F4324, F4325, F4329, F438, F439, F948 |
| DXX1984 | Acute stress Disorders | R457 |
| DXX1985 | Reactive states | F4489 |
| DXX1986 | PTSD | F4310, F4311, F4312 |
| DXX1992 | Other Cognitive / Execution Deficits | R41840, R41841 |
| DXX1995 | Miscellaneous disorders | R4689 |
| DXX2004 | BH – other ds | Z91410, Z91411, Z91412 |
| DXX2005 | Inj – nos – effects | T7401XA, T7402XA, T7601XA, T7602XA |
| DXX2008 | Tobacco Use | F17200, F17201, F17210, F17211, F17220, F17221, F17290, F17291, Z87891 |
| DXX2113 | Inj – foot – effects | T69021A, T69022A, T69029A |
| DXX2116 | Inj – nos – effects | T670XXA, T671XXA, T672XXA, T673XXA, T674XXA, T675XXA, T676XXA, T677XXA, T69011A, T69012A, T69019A, T698XXA, T699XXA |
| DXX2119 | Inj – nos – other | T754XXA |
| DXX2171 | Adverse effects of drugs | T7840XA, T7849XA |
| DXX2328 | Sxs – malaise / fatigue | R531, R5381, R5383 |
| DXX2329 | Sxs – chronic fatigue syndrome | R5382 |
| DXX2332 | Sxs – symptoms -other | R419, R448, R449, R4584, R460, R461, R462, R463, R464, R465, R466, R467, R6889, R69 |
| DXX2334 | Sxs – symptoms -other – other | R6882 |
| DXX2336 | Prvn – observation | Z0471, Z0472 |
| DXX2338 | Prvn – routine exam – other | Z0070, Z0071 |
| DXX2339 | Prvn – admin exam / visit | Z020, Z021, Z022, Z023, Z024, Z025, Z026, Z0281, Z0282, Z0283, Z0289, Z029, Z760 |
| DXX2344 | Prvn – counseling | R4183, Z322, Z323, Z550, Z551, Z552, Z553, Z554, Z558, Z559, Z560, Z562, Z563, Z564, Z565, Z566, Z5681, Z5682, Z5689, Z569, Z570, Z571, Z572, Z5731, Z5739, Z574, Z575, Z576, Z577, Z579, Z590, Z591, Z592, Z594, Z595, Z596, Z597, Z598, Z599, Z600, Z602, Z608, Z609, Z620, Z621, Z6222, Z6229, Z623, Z626, Z62810, Z62811, Z62812, Z62819, Z62820, Z62821, Z62822, Z62890, Z62891, Z62898, Z629, Z630, Z631, Z6331, Z6332, Z634, Z635, Z636, Z6371, Z6372, Z6379, Z638, Z639, Z644, Z650, Z651, Z652, Z653, Z654, Z659, Z69010, Z69011, Z69020, Z69021, Z6911, Z6912, Z6981, Z6982, Z700, Z701, Z702, Z703, Z708, Z709, Z712, Z713, Z7141, Z7142, Z7151, Z7152, Z716, Z7181, Z7189, Z719, Z736, Z741, Z742, Z743, Z748, Z749, Z755, Z7689 |
| DXX2352 | Othr – other | Z72820, Z73810, Z73811, Z73812, Z73819, Z7389 |
| DXX2354 | Othr – aftercare | S0035XD, S00451D, S00452D, S00459D, S00552D, S1015XD, S30852D, S30853D, S30854D, S30857D, T170XXD, T171XXD, T180XXD, T185XXD, T191XXD, T192XXD, T193XXD, T194XXD, T198XXD, T199XXD, T670XXD, T671XXD, T672XXD, T673XXD, T674XXD, T675XXD, T676XXD, T677XXD, T69011D, T69012D, T69019D, T69021D, T69022D, T69029D, T698XXD, T699XXD, T730XXD, T731XXD, T732XXD, T733XXD, T738XXD, T739XXD, T7401XD, T7402XD, T7411XD, T7412XD, T7421XD, T7422XD, T7431XD, T7432XD, T744XXD, T7491XD, T7492XD, T754XXD, T7601XD, T7602XD, T7611XD, T7612XD, T7621XD, T7622XD, T7631XD, T7632XD, T7691XD, T7692XD |
| DXX2356 | Othr – long-term use other medication | Z793, Z7984, Z79891, Z79899 |
| DXX2362 | Allergies | T7840XD, T7841XD, T7849XD |
| DXX2369 | Abnormal weight loss | R634 |
| DXX2377 | Personal history of blood, endocrine, nutritional disorders | Z8639 |
| DXX2378 | Pain, unspecified | R52 |
| DXX2379 | Observation/Examination | Z008, Z0189, Z0389, Z048, Z049 |
| DXX2381 | Aftercare | Z09, Z5189 |
| DXX2382 | Preventive Screening | Z1389 |
| DXX2383 | Medical Noncompliance | Z531 |
| DXX2384 | Other personal risk factors | Z578, Z658 |
Table 3: ICD-10 Actionable Adverse Events
| Group ID | Group Name | Code Value |
| DXX0007 | Head injury | S060X0A, S060X0D, S060X1A, S060X1D, S060X9A, S060X9D, S06890A, S06890D |
| DXX0014 | Pediculosis | B850, B852 |
| DXX0016 | Poisoning by nonmedicinal substances | T535X4A, T560X1A, T560X4A, T573X1A, T573X4A, T590X1A, T590X4A, T591X4A, T593X4A, T594X1A, T594X4A |
| DXX0017 | Scabies | B86 |
| DXX0019 | Skin and subcutaneous tissue infections | L0100, L0101, L0102, L0103, L0109, L011, L03021, L03022, L03029, L03031, L03032, L03041, L03042, L03049 |
| DXX0020 | Superficial injury; contusion | S0000XA, S0000XD, S0001XA, S0001XD, S0003XA, S0003XD, S0004XA, S0004XD, S0010XA, S0010XD, S0011XA, S0011XD, S0012XA, S0012XD, S0030XA, S0030XD, S0031XA, S0031XD, S0033XA, S0033XD, S0034XA, S0034XD, S00401A, S00401D, S00402A, S00402D, S00409A, S00409D, S00411A, S00411D, S00412A, S00412D, S00419A, S00419D, S00431A, S00431D, S00432A, S00432D, S00439A, S00439D, S00441A, S00441D, S00442A, S00442D, S00449A, S00449D, S00501A, S00501D, S00502A, S00502D, S00511A, S00511D, S00512A, S00512D, S00531A, S00531D, S00532A, S00532D, S00541A, S00541D, S00542A, S00542D, S0080XA, S0080XD, S0081XA, S0081XD, S0083XA, S0083XD, S0084XA, S0084XD, S0090XA, S0090XD, S0091XA, S0091XD, S0093XA, S0093XD, S0094XA, S0094XD, S0510XA, S0510XD, S0511XA, S0511XD, S0512XA, S0512XD, S0590XA, S0590XD, S100XXA, S100XXD, S1010XA, S1010XD, S1011XA, S1011XD, S1014XA, S1014XD, S1080XA, S1080XD, S1081XA, S1081XD, S1083XA, S1083XD, S1084XA, S1084XD, S1090XA, S1090XD, S1091XA, S1091XD, S1093XA, S1093XD, S1094XA, S1094XD, S20111A, S20111D, S20112A, S20112D, S20119A, S20119D, S20211A, S20211D, S20212A, S20212D, S20219A, S20219D, S20311A, S20311D, S20312A, S20312D, S20319A, S20319D, S20411A, S20411D, S20412A, S20412D, S20419A, S20419D, S2091XA, S2091XD, S300XXA, S300XXD, S301XXA, S301XXD, S30810A, S30810D, S30811A, S30811D, S30812A, S30812D, S30813A, S30813D, S30814A, S30814D, S30815A, S30815D, S30816A, S30816D, S30817A, S30817D, S40011A, S40011D, S40012A, S40012D, S40019A, S40019D, S40211A, S40211D, S40212A, S40212D, S40219A, S40219D, S40811A, S40811D, S40812A, S40812D, S40819A, S40819D, S5000XA, S5000XD, S5001XA, S5001XD, S5002XA, S5002XD, S5010XA, S5010XD, S5011XA, S5011XD, S5012XA, S5012XD, S50311A, S50311D, S50312A, S50312D, S50319A, S50319D, S50811A, S50811D, S50812A, S50812D, S50819A, S50819D, S6000XA, S6000XD, S60011A, S60011D, S60012A, S60012D, S60019A, S60019D, S60021A, S60021D, S60022A, S60022D, S60029A, S60029D, S60031A, S60031D, S60032A, S60032D, S60039A, S60039D, S60041A, S60041D, S60042A, S60042D, S60049A, S60049D, S60051A, S60051D, S60052A, S60052D, S60059A, S60059D, S6010XA, S6010XD, S60111A, S60111D, S60112A, S60112D, S60119A, S60119D, S60121A, S60121D, S60122A, S60122D, S60129A, S60129D, S60131A, S60131D, S60132A, S60132D, S60139A, S60139D, S60141A, S60141D, S60142A, S60142D, S60149A, S60149D, S60151A, S60151D, S60152A, S60152D, S60159A, S60159D, S60211A, S60211D, S60212A, S60212D, S60219A, S60219D, S60221A, S60221D, S60222A, S60222D, S60229A, S60229D, S60311A, S60311D, S60312A, S60312D, S60319A, S60319D, S60410A, S60410D, S60411A, S60411D, S60412A, S60412D, S60413A, S60413D, S60414A, S60414D, S60415A, S60415D, S60416A, S60416D, S60417A, S60417D, S60418A, S60418D, S60419A, S60419D, S60511A, S60511D, S60512A, S60512D, S60519A, S60519D, S60811A, S60811D, S60812A, S60812D, S60819A, S60819D, S7000XA, S7000XD, S7001XA, S7001XD, S7002XA, S7002XD, S7010XA, S7010XD, S7011XA, S7011XD, S7012XA, S7012XD, S70211A, S70211D, S70212A, S70212D, S70219A, S70219D, S70311A, S70311D, S70312A, S70312D, S70319A, S70319D, S8000XA, S8000XD, S8001XA, S8001XD, S8002XA, S8002XD, S8010XA, S8010XD, S8011XA, S8011XD, S8012XA, S8012XD, S80211A, S80211D, S80212A, S80212D, S80219A, S80219D, S80811A, S80811D, S80812A, S80812D, S80819A, S80819D, S9000XA, S9000XD, S9001XA, S9001XD, S9002XA, S9002XD, S90111A, S90111D, S90112A, S90112D, S90119A, S90119D, S90121A, S90121D, S90122A, S90122D, S90129A, S90129D, S90211A, S90211D, S90212A, S90212D, S90219A, S90219D, S90221A, S90221D, S90222A, S90222D, S90229A, S90229D, S9030XA, S9030XD, S9031XA, S9031XD, S9032XA, S9032XD, S90411A, S90411D, S90412A, S90412D, S90413A, S90413D, S90414A, S90414D, S90415A, S90415D, S90416A, S90416D, S90511A, S90511D, S90512A, S90512D, S90519A, S90519D, S90811A, S90811D, S90812A, S90812D, S90819A, S90819D |
| DXX01390 | Coma, persistent vegetative state | E035, R4020, R402110, R402111, R402112, R402113, R402114, R402120, R402121, R402122, R402123, R402124, R402210, R402211, R402212, R402213, R402214, R402220, R402221, R402222, R402223, R402224, R402310, R402311, R402312, R402313, R402314, R402320, R402321, R402322, R402323, R402324, R402340, R402341, R402342, R402343, R402344 |
| DXX01391 | Meningitis / Encephalitis | G0481, G0490, G0491, G374 |
| DXX01392 | Delirium, Encephalopathy | F05, G92, G9340, G9349 |
| DXX03237 | Inj – mouth / pharynx – open wound | S1121XA, S1122XA |
| DXX03240 | Inj – mouth / pharynx – foreign body | T17200A, T17210A, T17218A, T17220A, T17228A, T17290A |
| DXX03243 | Inj – larynx / trachea – foreign body | T17300A, T17310A, T17318A, T17320A, T17328A, T17390A |
| DXX04119 | Inj – trachea – foreign body | T17400A, T17410A, T17418A, T17420A, T17428A, T17490A |
| DXX04120 | Inj – bronchus – foreign body | T17500A, T17510A, T17518A, T17520A, T17528A, T17590A |
| DXX04121 | Inj – lung – foreign body | T17800A, T17808A, T17810A, T17818A, T17820A, T17828A, T17890A, T17898A, T17900A, T17908A, T17910A, T17918A, T17920A, T17928A, T17990A, T17998A |
| DXX04130 | Aspiration Pneumonia | J690 |
| DXX05274 | Transfusion, Infusion related complications | T8029XA, T8029XD, T8030XA, T8030XD, T80310A, T80310D, T80311A, T80311D, T80319A, T80319D, T8039XA, T8039XD, T8040XA, T8040XD, T80410A, T80410D, T80411A, T80411D, T80419A, T80419D, T8049XA, T8049XD, T8061XA, T8061XD, T80818A, T80818D, T8089XA, T8089XD, T8090XA, T8090XD, T80910A, T80910D, T80911A, T80911D, T80919A, T80919D, T8092XA, T8092XD, T80A0XA, T80A0XD, T80A10A, T80A10D, T80A11A, T80A11D, T80A19A, T80A19D, T80A9XA, T80A9XD |
| 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, I82811, I82812, I82813, I82819, I82890, I8290, I87001, I87002, I87003, I87009, I87011, I87012, I87013, I87019, I87021, I87022, I87023, I87029, I87031, I87032, I87033, I87039, I87091, I87092, I87093, I87099, T79A0XA, T79A0XD |
| DXX05291 | Recent AMI | I220, I221, I222, I228, I229 |
| DXX05297 | Hypotension / Syncope | R55 |
| DXX05298 | Fluid Electrolyte Acid Base Problems | E870, E871, E872, E875, E876, E8770, E8779, E878 |
| DXX05299 | Shock / Cardiac Arrest | I462, I468, I469, I4901, I4902, R570, T882XXA, T882XXD, T886XXA, T886XXD |
| DXX05309 | IVC & other intra-abd venous thrombosis | I82220, I823 |
| DXX05311 | Other Phlebitis, Lymphangitis, varices | I808, I82210, I82290, I82601, I82602, I82603, I82609, I82611, I82612, I82613, I82619, I82621, I82622, I82623, I82629, I82A11, I82A12, I82A13, I82A19, I82B11, I82B12, I82B13, I82B19, I82C11, I82C12, I82C13, I82C19, I891 |
| DXX05375 | Dehydration | E860, E861, E869 |
| DXX06306 | GI Bleed | K2901, K2961, K2971, K2981, K2991, K920, K922 |
| DXX06312 | Injury to GI Tract | S31621A |
| DXX06331 | Other Esophageal conditions | T18100A, T18110A, T18118A, T18120A, T18128A |
| DXX07114 | Hepatotoxicity | K710, K7110, K712, K716, K717, K718, K719 |
| DXX07117 | Hepatic Encephalopathy | K7111 |
| DXX0717 | Acute Pancreatitis, pseudo cyst | K852, K8520, K8521, K8522, K853, K8530, K8531, K8532 |
| DXX09187 | Wound Infections | T814XXA, T814XXD, T8183XA, T8183XD |
| 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, L89200, L89201, L89202, L89209, L89210, L89211, L89212, L89219, L89220, L89221, L89222, L89229, L89300, L89301, L89302, L89309, L89310, L89311, L89312, L89319, L89320, L89321, L89322, L89329, L8940, L8941, L8942, L8945, L89500, L89501, L89502, L89509, L89510, L89511, L89512, L89519, L89520, L89521, L89522, L89529, L89600, L89601, L89602, L89609, L89610, L89611, L89612, L89619, L89620, L89621, L89622, L89629, L89810, L89811, L89812, L89819, L89890, L89891, L89892, L89899, L8990, L8991, L8992, L8995 |
| DXX09195 | Toxic Erythema | L1230, L1231, L1235, L511, L512, L513, L530, L531, L532 |
| DXX09205 | Injuries | S022XXA, S022XXD |
| DXX1030 | Diabetes, poor control | E160, E161, E162 |
| DXX11147 | Complication of genitourinary device | T83018A, T83018D, T83028A, T83028D, T83098A, T83098D |
| DXX11166 | Gonococcal Infection of Genitourinary Tract | A5402, A5409, A541 |
| DXX1262 | Inj – scrotum / testes – open wound | S3131XA, S3132XA |
| DXX1385 | Inj – vulva – open wound | S3141XA, S3142XA |
| DXX1850 | MRSA, Drug Resistant Infections | A4902, B9562 |
| DXX1858 | Syphilis | A5141, A5149, A515, A539 |
| DXX1859 | Other Gonococcal Infections | A5430, A5431, A5432, A5433, A5439, A545, A5482, A5484, A549 |
| DXX1860 | Other Sexually Transmitted Diseases | A55, A5601, A5602, A5609, A57, A58, A5900, A5901, A5902, A5903, A5909, A598, A599, A638, A64 |
| DXX1861 | Herpes Virus Infection | A6000, A6002, A6003, A601, A609 |
| DXX1863 | Chlamydial infections | A5600, A5619, A562, A563, A564, A568, A749 |
| DXX19103 | Altered mental status | F060, F062, R440, R442, R443 |
| DXX1948 | Suicide or Self-inflicted Injury | T1491, T360X2A, T360X2D, T360X2D, T361X2A, T361X2D, T361X2D, T362X2A, T362X2D, T362X2D, T363X2A, T363X2D, T363X2D, T364X2A, T364X2D, T364X2D, T365X2A, T365X2D, T365X2D, T366X2A, T366X2D, T366X2D, T367X2A, T367X2D, T367X2D, T368X2A, T368X2D, T368X2D, T3692XA, T3692XD, T3692XD, T370X2A, T370X2D, T370X2D, T371X2A, T371X2D, T371X2D, T372X2A, T372X2D, T372X2D, T373X2A, T373X2D, T373X2D, T374X2A, T374X2D, T374X2D, T375X2A, T375X2D, T375X2D, T378X2A, T378X2D, T378X2D, T3792XA, T3792XD, T3792XD, T380X2A, T380X2D, T380X2D, T381X2A, T381X2D, T381X2D, T382X2A, T382X2D, T382X2D, T383X2A, T383X2D, T383X2D, T384X2A, T384X2D, T384X2D, T385X2A, T385X2D, T385X2D, T386X2A, T386X2D, T386X2D, T387X2A, T387X2D, T387X2D, T38802A, T38802D, T38802D, T38812A, T38812D, T38812D, T38892A, T38892D, T38892D, T38902A, T38902D, T38902D, T38992A, T38992D, T38992D, T39012A, T39012D, T39012D, T39092A, T39092D, T39092D, T391X2A, T391X2D, T391X2D, T392X2A, T392X2D, T392X2D, T39312A, T39312D, T39312D, T39392A, T39392D, T39392D, T394X2A, T394X2D, T394X2D, T398X2A, T398X2D, T398X2D, T3992XA, T3992XD, T3992XD, T400X2D, T405X2A, T405X2D, T40602D, T40692D, T407X2D, T408X2D, T40902D, T40992D, T410X2A, T410X2D, T410X2D, T411X2A, T411X2D, T411X2D, T41202A, T41202D, T41202D, T41292A, T41292D, T41292D, T413X2A, T413X2D, T413X2D, T4142XA, T4142XD, T4142XD, T415X2A, T415X2D, T415X2D, T420X2A, T420X2D, T420X2D, T421X2A, T421X2D, T421X2D, T422X2A, T422X2D, T422X2D, T423X2A, T423X2D, T423X2D, T424X2A, T424X2D, T424X2D, T425X2A, T425X2D, T425X2D, T426X2A, T426X2D, T426X2D, T4272XA, T4272XD, T4272XD, T428X2A, T428X2D, T428X2D, T43012A, T43012D, T43012D, T43022A, T43022D, T43022D, T431X2A, T431X2D, T431X2D, T43202A, T43202D, T43202D, T43212A, T43212D, T43212D, T43222A, T43222D, T43222D, T43292A, T43292D, T43292D, T433X2A, T433X2D, T433X2D, T434X2A, T434X2D, T434X2D, T43502A, T43502D, T43502D, T43592A, T43592D, T43592D, T43602D, T43612A, T43612D, T43612D, T43622A, T43622D, T43622D, T43632A, T43632D, T43632D, T43692A, T43692D, T43692D, T438X2A, T438X2D, T438X2D, T4392XA, T4392XD, T4392XD, T440X2A, T440X2D, T440X2D, T441X2A, T441X2D, T441X2D, T442X2A, T442X2D, T442X2D, T443X2A, T443X2D, T443X2D, T444X2A, T444X2D, T444X2D, T445X2A, T445X2D, T445X2D, T446X2A, T446X2D, T446X2D, T447X2A, T447X2D, T447X2D, T448X2A, T448X2D, T448X2D, T44902A, T44902D, T44902D, T44992A, T44992D, T44992D, T450X2A, T450X2D, T450X2D, T451X2A, T451X2D, T451X2D, T452X2A, T452X2D, T452X2D, T453X2A, T453X2D, T453X2D, T454X2A, T454X2D, T454X2D, T45512A, T45512D, T45512D, T45522A, T45522D, T45522D, T45602A, T45602D, T45602D, T45612A, T45612D, T45612D, T45622A, T45622D, T45622D, T45692A, T45692D, T45692D, T457X2A, T457X2D, T457X2D, T458X2A, T458X2D, T458X2D, T4592XA, T4592XD, T4592XD, T460X2A, T460X2D, T460X2D, T461X2A, T461X2D, T461X2D, T462X2A, T462X2D, T462X2D, T463X2A, T463X2D, T463X2D, T464X2A, T464X2D, T464X2D, T465X2A, T465X2D, T465X2D, T466X2A, T466X2D, T466X2D, T467X2A, T467X2D, T467X2D, T468X2A, T468X2D, T468X2D, T46902A, T46902D, T46902D, T46992A, T46992D, T46992D, T470X2A, T470X2D, T470X2D, T471X2A, T471X2D, T471X2D, T472X2A, T472X2D, T472X2D, T473X2A, T473X2D, T473X2D, T474X2A, T474X2D, T474X2D, T475X2A, T475X2D, T475X2D, T476X2A, T476X2D, T476X2D, T477X2A, T477X2D, T477X2D, T478X2A, T478X2D, T478X2D, T4792XA, T4792XD, T4792XD, T480X2A, T480X2D, T480X2D, T481X2A, T481X2D, T481X2D, T48202A, T48202D, T48202D, T48292A, T48292D, T48292D, T483X2A, T483X2D, T483X2D, T484X2A, T484X2D, T484X2D, T485X2A, T485X2D, T485X2D, T486X2A, T486X2D, T486X2D, T48902A, T48902D, T48902D, T48992A, T48992D, T48992D, T490X2A, T490X2D, T490X2D, T491X2A, T491X2D, T491X2D, T492X2A, T492X2D, T492X2D, T493X2A, T493X2D, T493X2D, T494X2A, T494X2D, T494X2D, T495X2A, T495X2D, T495X2D, T496X2A, T496X2D, T496X2D, T497X2A, T497X2D, T497X2D, T498X2A, T498X2D, T498X2D, T4992XA, T4992XD, T4992XD, T500X2A, T500X2D, T500X2D, T501X2A, T501X2D, T501X2D, T502X2A, T502X2D, T502X2D, T503X2A, T503X2D, T503X2D, T504X2A, T504X2D, T504X2D, T505X2A, T505X2D, T505X2D, T506X2A, T506X2D, T506X2D, T507X2A, T507X2D, T507X2D, T508X2A, T508X2D, T508X2D, T50902D, T50992A, T50992D, T50A12A, T50A12D, T50A22A, T50A22D, T50A92A, T50A92D, T50B12A, T50B12D, T50B12D, T50B92A, T50B92D, T50B92D, T50Z12A, T50Z12D, T50Z12D, T50Z92A, T50Z92D, T510X2D, T510X3D, T511X2A, T511X2D, T511X2D, T512X2A, T512X2D, T512X2D, T513X2A, T513X2D, T513X2D, T518X2A, T518X2D, T518X2D, T5192XA, T5192XD, T5192XD, T520X2A, T520X2D, T520X2D, T521X2A, T521X2D, T521X2D, T522X2A, T522X2D, T522X2D, T523X2A, T523X2D, T523X2D, T524X2A, T524X2D, T524X2D, T528X2A, T528X2D, T528X2D, T5292XA, T5292XD, T5292XD, T530X2A, T530X2D, T530X2D, T531X2A, T531X2D, T531X2D, T532X2A, T532X2D, T532X2D, T533X2A, T533X2D, T533X2D, T534X2A, T534X2D, T534X2D, T535X2A, T535X2D, T535X2D, T536X2A, T536X2D, T536X2D, T537X2A, T537X2D, T537X2D, T5392XA, T5392XD, T5392XD, T540X2A, T540X2D, T540X2D, T541X2A, T541X2D, T541X2D, T542X2A, T542X2D, T543X2A, T543X2D, T5492XA, T5492XD, T550X2A, T550X2D, T550X2D, T551X2A, T551X2D, T551X2D, T560X2A, T560X2D, T560X2D, T561X2A, T561X2D, T561X2D, T562X2A, T562X2D, T562X2D, T563X2A, T563X2D, T563X2D, T564X2A, T564X2D, T564X2D, T565X2A, T565X2D, T565X2D, T566X2A, T566X2D, T566X2D, T567X2A, T567X2D, T567X2D, T56812A, T56812D, T56812D, T56892A, T56892D, T56892D, T5692XA, T5692XD, T5692XD, T570X2A, T570X2D, T570X2D, T571X2A, T571X2D, T571X2D, T572X2A, T572X2D, T572X2D, T573X2A, T573X2D, T573X2D, T578X2A, T578X2D, T5792XA, T5792XD, T5802XA, T5802XD, T5802XD, T5812XA, T5812XD, T5812XD, T582X2A, T582X2D, T582X2D, T588X2A, T588X2D, T588X2D, T5892XA, T5892XD, T5892XD, T590X2A, T590X2D, T590X2D, T591X2A, T591X2D, T591X2D, T592X2A, T592X2D, T592X2D, T593X2A, T593X2D, T593X2D, T594X2A, T594X2D, T594X2D, T595X2A, T595X2D, T595X2D, T596X2A, T596X2D, T596X2D, T597X2A, T597X2D, T597X2D, T59812A, T59812D, T59812D, T59892A, T59892D, T59892D, T5992XA, T5992XD, T5992XD, T600X2A, T600X2D, T600X2D, T601X2A, T601X2D, T601X2D, T602X2A, T602X2D, T602X2D, T603X2A, T603X2D, T603X2D, T604X2A, T604X2D, T604X2D, T608X2A, T608X2D, T608X2D, T6092XA, T6092XD, T6092XD, T6102XA, T6102XD, T6102XD, T6112XA, T6112XD, T6112XD, T61772A, T61772D, T61772D, T61782A, T61782D, T61782D, T618X2A, T618X2D, T618X2D, T6192XA, T6192XD, T6192XD, T620X2A, T620X2D, T620X2D, T621X2A, T621X2D, T621X2D, T622X2A, T622X2D, T622X2D, T628X2A, T628X2D, T6292XA, T6292XD, T6292XD, T63002A, T63002D, T63002D, T63012A, T63012D, T63012D, T63022A, T63022D, T63022D, T63032A, T63032D, T63032D, T63042A, T63042D, T63042D, T63062A, T63062D, T63062D, T63072A, T63072D, T63072D, T63082A, T63082D, T63082D, T63092A, T63092D, T63092D, T63112A, T63112D, T63112D, T63122A, T63122D, T63122D, T63192A, T63192D, T63192D, T632X2A, T632X2D, T632X2D, T63302A, T63302D, T63302D, T63312A, T63312D, T63312D, T63322A, T63322D, T63322D, T63332A, T63332D, T63332D, T63392A, T63392D, T63392D, T63412A, T63412D, T63412D, T63422A, T63422D, T63422D, T63432A, T63432D, T63432D, T63442A, T63442D, T63442D, T63452A, T63452D, T63452D, T63462A, T63462D, T63462D, T63482A, T63482D, T63482D, T63512A, T63512D, T63512D, T63592A, T63592D, T63592D, T63612A, T63612D, T63612D, T63622A, T63622D, T63622D, T63632A, T63632D, T63632D, T63692A, T63692D, T63692D, T63712A, T63712D, T63712D, T63792A, T63792D, T63792D, T63812A, T63812D, T63812D, T63822A, T63822D, T63822D, T63832A, T63832D, T63832D, T63892A, T63892D, T63892D, T6392XA, T6392XD, T6392XD, T6402XA, T6402XD, T6402XD, T6482XA, T6482XD, T6482XD, T650X2A, T650X2D, T650X2D, T651X2A, T651X2D, T651X2D, T653X2A, T653X2D, T653X2D, T654X2A, T654X2D, T654X2D, T655X2A, T655X2D, T655X2D, T656X2A, T656X2D, T656X2D, T65812A, T65812D, T65812D, T65822A, T65822D, T65822D, T65832A, T65832D, T65832D, T65892A, T65892D, T6592XA, T6592XD, T71112A, T71112D, T71112D, T71122A, T71122D, T71122D, T71132A, T71132D, T71132D, T71152A, T71152D, T71152D, T71162A, T71162D, T71162D, T71192A, T71192D, T71192D, T71222A, T71222D, T71222D, T71232A, T71232D, T71232D, X710XXA, X710XXD, X710XXD, X711XXA, X711XXD, X711XXD, X712XXA, X712XXD, X712XXD, X713XXA, X713XXD, X713XXD, X718XXA, X718XXD, X718XXD, X719XXA, X719XXD, X719XXD, X72XXXA, X72XXXD, X72XXXD, X730XXA, X730XXD, X730XXD, X731XXA, X731XXD, X731XXD, X732XXA, X732XXD, X732XXD, X738XXA, X738XXD, X738XXD, X739XXA, X739XXD, X739XXD, X7401XA, X7401XD, X7401XD, X7402XA, X7402XD, X7402XD, X7409XA, X7409XD, X7409XD, X748XXA, X748XXD, X748XXD, X749XXA, X749XXD, X749XXD, X75XXXA, X75XXXD, X75XXXD, X76XXXA, X76XXXD, X76XXXD, X770XXA, X770XXD, X770XXD, X771XXA, X771XXD, X771XXD, X772XXA, X772XXD, X772XXD, X773XXA, X773XXD, X773XXD, X778XXA, X778XXD, X778XXD, X779XXA, X779XXD, X779XXD, X780XXA, X780XXD, X780XXD, X781XXA, X781XXD, X781XXD, X782XXA, X782XXD, X782XXD, X788XXA, X788XXD, X788XXD, X789XXA, X789XXD, X789XXD, X79XXXA, X79XXXD, X79XXXD, X80XXXA, X80XXXD, X80XXXD, X810XXA, X810XXD, X810XXD, X811XXA, X811XXD, X811XXD, X818XXA, X818XXD, X818XXD, X820XXA, X820XXD, X820XXD, X821XXA, X821XXD, X821XXD, X822XXA, X822XXD, X822XXD, X828XXA, X828XXD, X828XXD, X830XXA, X830XXD, X830XXD, X831XXA, X831XXD, X831XXD, X832XXA, X832XXD, X832XXD, X838XXA, X838XXD, X838XXD |
| DXX1950 | Homicidal ideation | R45850 |
| DXX2008 | Tobacco Use | T65211A, T65212A, T65212D, T65214A, T65214D, T65221A, T65221D, T65222A, T65222D, T65224A, T65224D, T65291A, T65291D, T65292A, T65292D, T65294A, T65294D |
| DXX2010 | Alcohol induced disorders | G621, T510X3A |
| DXX2021 | Sedative, hypnotic or anxiolytic intoxication | F13921 |
| DXX2025 | Opioid intoxication | F11921 |
| DXX2029 | Stimulant intoxication | F14921, F15921 |
| DXX2033 | Inhalant intoxication | F18921 |
| DXX2035 | Other psychoactive substance intoxication | F19921 |
| DXX2037 | Hallucinogen intoxication | F16921 |
| DXX2040 | Poisoning by Opiates | T40601A, T40601D, T40604D, T40691A, T40691D, T40694D |
| DXX2116 | Inj – nos – effects | T751XXA |
| DXX2117 | Inj – nos – poisoning | T535X1A, T561X1A, T561X4A, T562X1A, T562X4A, T563X1A, T563X4A, T564X1A, T564X4A, T565X1A, T565X4A, T566X1A, T566X4A, T567X1A, T567X4A, T56811A, T56814A, T56891A, T56894A, T5691XA, T5694XA, T570X1A, T570X4A, T572X1A, T572X4A, T591X1A, T593X1A, T65811A, T65814A, T65894A |
| DXX2119 | Inj – nos – other | T71111A, T71114A, T71121A, T71124A, T71131A, T71134A, T71141A, T71143A, T71144A, T71151A, T71154A, T71161A, T71164A |
| DXX2127 | Othr – other | T650X1A, T650X4A, T651X1A, T651X4A, T653X1A, T653X4A, T654X1A, T654X4A, T655X1A, T655X4A, T656X1A, T656X4A, T65831A, T65834A, T65891A, T6591XA, T6594XA |
| 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 |
| DXX2165 | Toxic Myopathy, Neuropathy | G720, G721, G722 |
| DXX2166 | Toxic Effects of Substances | T511X1A, T511X1D, T511X4A, T511X4D, T512X1A, T512X1D, T512X4A, T512X4D, T513X1A, T513X1D, T513X4A, T513X4D, T518X1A, T518X1D, T518X4A, T518X4D, T5194XD, T520X1A, T520X1D, T520X4A, T520X4D, T521X1A, T521X1D, T521X4A, T521X4D, T522X1A, T522X1D, T522X4A, T522X4D, T523X1A, T523X1D, T523X4A, T523X4D, T524X1A, T524X1D, T524X4A, T524X4D, T528X1A, T528X1D, T528X4A, T528X4D, T5291XA, T5291XD, T5294XA, T5294XD, T530X1D, T530X4A, T530X4D, T531X1D, T531X4A, T531X4D, T532X1D, T532X4A, T532X4D, T533X1D, T533X4A, T533X4D, T534X1D, T534X4A, T534X4D, T535X1D, T535X4D, T536X1D, T536X3D, T536X4A, T536X4D, T537X1D, T537X3D, T537X4A, T537X4D, T5391XD, T5393XD, T5394XA, T5394XD, T540X1A, T540X1D, T540X4A, T540X4D, T541X1A, T541X1D, T541X4A, T541X4D, T542X1A, T542X1D, T542X3D, T542X4A, T542X4D, T543X1A, T543X1D, T543X3D, T543X4A, T543X4D, T5491XA, T5491XD, T5494XA, T5494XD, T550X1A, T550X1D, T550X4A, T550X4D, T551X1A, T551X1D, T551X4A, T551X4D, T560X1D, T560X4D, T561X1D, T561X4D, T562X1D, T562X4D, T563X1D, T563X4D, T564X1D, T564X4D, T565X1D, T565X4D, T566X1D, T566X4D, T567X1D, T567X4D, T56811D, T56814D, T56891D, T56894D, T5691XD, T5694XD, T570X1D, T570X4D, T571X1A, T571X1D, T571X4A, T571X4D, T572X1D, T572X4D, T573X1D, T573X4D, T578X1A, T578X1D, T578X4A, T578X4D, T5791XA, T5791XD, T5794XA, T5794XD, T5801XA, T5801XD, T5803XD, T5804XA, T5804XD, T5811XA, T5811XD, T5814XA, T5814XD, T582X1A, T582X1D, T582X3D, T582X4A, T582X4D, T588X1A, T588X1D, T588X4A, T588X4D, T5891XA, T5891XD, T5894XA, T5894XD, T590X1D, T590X4D, T591X1D, T591X4D, T592X1D, T592X4D, T593X1D, T593X4D, T594X1D, T594X4D, T595X1D, T595X3D, T595X4D, T596X1A, T596X1D, T596X4D, T597X1D, T597X4D, T59811D, T59814D, T59891D, T59894D, T5991XD, T5994XD, T600X1A, T600X1D, T600X3D, T600X4A, T600X4D, T601X1A, T601X1D, T601X4A, T601X4D, T602X1A, T602X1D, T602X4A, T602X4D, T603X1A, T603X1D, T603X4A, T603X4D, T604X1A, T604X1D, T604X4A, T604X4D, T608X1A, T608X1D, T608X4A, T608X4D, T6091XA, T6091XD, T6094XA, T6094XD, T650X1D, T650X4D, T651X1D, T651X4D, T65211D, T653X1D, T653X3D, T653X4D, T654X1D, T654X4D, T655X1D, T655X3D, T655X4D, T656X1D, T656X4D, T65811D, T65814D, T65831D, T65834D, T65891D, T65894D, T6591XD, T6594XD |
| DXX2167 | Accidental Poisoning by Alcohol | T5191XA |
| DXX2169 | Poisoning by Psychostimulants | T43601A |
| DXX2171 | Adverse effects of drugs | T39015A, T39015D, T39095A, T39095D, T392X5A, T392X5D, T39315A, T39315D, T39395A, T39395D, T394X5A, T394X5D, T398X5A, T398X5D, T398X5D, T3995XA, T3995XD, T3995XD, T400X5A, T400X5D, T402X5A, T402X5D, T402X5D, T403X5A, T403X5D, T404X5A, T404X5D, T404X5D, T405X5A, T405X5D, T405X5D, T40605A, T40605D, T40605D, T40695A, T40695D, T40695D, T407X5A, T407X5D, T407X5D, T40905A, T40905D, T40905D, T40995A, T40995D, T40995D, T410X5D, T411X5D, T41205D, T41295D, T413X5D, T4145XD, T415X5A, T415X5D, T423X5A, T423X5D, T423X5D, T424X5A, T424X5D, T424X5D, T426X5A, T426X5D, T426X5D, T4275XA, T4275XD, T4275XD, T43015A, T43015D, T43015D, T43025A, T43025D, T43025D, T431X5A, T431X5D, T431X5D, T43205A, T43205D, T43205D, T43215A, T43215D, T43215D, T43225A, T43225D, T43225D, T43295A, T43295D, T43295D, T433X5A, T433X5D, T433X5D, T434X5A, T434X5D, T434X5D, T43505A, T43505D, T43505D, T43595A, T43595D, T43595D, T43605A, T43605D, T43605D, T43615A, T43615D, T43625A, T43625D, T43625D, T43635A, T43635D, T43635D, T43695A, T43695D, T43695D, T438X5A, T438X5D, T438X5D, T4395XA, T4395XD, T4395XD, T452X5A, T452X5D, T454X5A, T454X5D, T470X5A, T470X5D, T471X5A, T471X5D, T472X5A, T472X5D, T473X5A, T473X5D, T474X5A, T474X5D, T476X5A, T476X5D, T476X5D, T477X5A, T477X5D, T483X5A, T483X5D, T484X5A, T484X5D, T485X5A, T485X5D, T486X5A, T486X5D, T490X5A, T490X5D, T491X5A, T491X5D, T492X5A, T492X5D, T493X5A, T493X5D, T494X5A, T494X5D, T506X5A, T506X5D, T506X5D, T507X5A, T507X5D, T507X5D |
| DXX2172 | Overdose, Poisonings | T39391A, T39391D, T39394A, T39394D, T394X1A, T394X1D, T394X4A, T394X4D, T398X1A, T398X1D, T398X4A, T398X4D, T3991XA, T3991XD, T3994XA, T3994XD, 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, T423X1A, T423X1D, T423X4A, T423X4D, T424X1A, T424X1D, T424X4A, T424X4D, T426X1A, T426X1D, T426X4A, T426X4D, T4271XA, T4271XD, T4274XA, T4274XD, T43011A, T43011D, T43014A, T43014D, T43021A, T43021D, T43024A, T43024D, T431X1A, T431X1D, T431X4A, T431X4D, T43201A, T43201D, T43204A, T43204D, T43211A, T43211D, T43214A, T43214D, T43221A, T43221D, T43224A, T43224D, T43291A, T43291D, T43294A, T43294D, T433X1A, T433X1D, T433X4A, T433X4D, T434X1A, T434X1D, T434X4A, T434X4D, T43501A, T43501D, T43504A, T43504D, T43591A, T43591D, T43594A, T43594D, T43621A, T43621D, T43624A, T43624D, T43631A, T43631D, T43634A, T43634D, T43691A, T43691D, T43694A, T43694D, T438X1A, T438X1D, T438X4A, T438X4D, T4391XA, T4391XD, T4394XA, T4394XD, T506X1A, T506X1D, T506X4A, T506X4D, T507X1A, T507X1D, T507X4A, T507X4D, T50904A, T50904D, T530X1A, T531X1A, T532X1A, T533X1A, T534X1A, T536X1A, T537X1A, T5391XA, T592X1A, T592X4A, T595X1A, T595X4A, T596X4A, T597X1A, T597X4A, T59811A, T59814A, T59891A, T59894A, T5991XA, T5994XA |
| DXX2173 | Poisoning by Assault | T536X3A, T537X3A, T5393XA, T542X3A, T543X3A, T5803XA, T582X3A, T595X3A, T600X3A, T653X3A, T655X3A |
| DXX2175 | Complications of anesthesia | T410X5A, T411X5A, T41205A, T41295A, T413X5A, T4145XA, T883XXA, T883XXD, T884XXA, T884XXD, T8851XA, T8851XD, T8852XA, T8852XD, T8853XA, T8853XD, T8859XA, T8859XD |
| DXX2354 | Othr – aftercare | S1121XD, S1122XD, S3131XD, S3132XD, S3141XD, S3142XD, S31521D, S31621D, T17200D, T17210D, T17218D, T17220D, T17228D, T17290D, T17300D, T17310D, T17318D, T17320D, T17328D, T17390D, T17400D, T17410D, T17418D, T17420D, T17428D, T17490D, T17500D, T17510D, T17518D, T17520D, T17528D, T17590D, T17800D, T17808D, T17810D, T17818D, T17820D, T17828D, T17890D, T17898D, T17900D, T17908D, T17910D, T17918D, T17920D, T17928D, T17990D, T17998D, T18100D, T18110D, T18118D, T18120D, T18128D, T71111D, T71114D, T71121D, T71124D, T71131D, T71134D, T71141D, T71143D, T71144D, T71151D, T71154D, T71161D, T71164D, T751XXD |
| DXX2360 | Complication of Implanted device, graft | T8572XA, T8572XD |
| DXX2361 | complications of surgical procedures | T888XXA, T888XXD |
| DXX2362 | complications of medical care | I973, L7681, L7682, M9689, R680, T782XXD, T801XXA, T801XXD, T8181XA, T8181XD, T880XXA, T880XXD, T881XXA, T881XXD, T887XXA, T887XXD, T889XXA, T889XXD, Y633, Y634, Y658, Y66, Y69, Y847 |
| DXX2428 | Inj – external genitalia – open wound | S31521A |
| 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, L89203, L89204, L89213, L89214, L89223, L89224, L89303, L89304, L89313, L89314, L89323, L89324, L8943, L8944, L89503, L89504, L89513, L89514, L89523, L89524, L89603, L89604, L89613, L89614, L89623, L89624, L89813, L89814, L89893, L89894, L8993, L8994 |
| XX0000 | Ungrouped Codes | T1491XA, T1491XD, T1491XS |
Table 4: ICD-10 Relevant Procedure Codes
| Group ID | Group Name | Code Value |
| PXX01177 | Computerized axial tomography (CT) scan head – 177 | B92FZZZ, B92JZZZ |
| PXX01199 | Electroencephalogram (EEG) – 199 | 4A0004Z, 4A0034Z, 4A00X4Z, 4A0104Z, 4A0134Z, 4A01X4Z, 4A1004Z, 4A1034Z, 4A10X4Z, 4A1104Z, 4A1134Z, 4A11X4Z |
| PXX03231 | Other therapeutic procedures – 231 | 059030Z, 05903ZZ, 059040Z, 05904ZZ, 059130Z, 05913ZZ, 059140Z, 05914ZZ, 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, 059B30Z, 059B3ZZ, 059B40Z, 059B4ZZ, 059C30Z, 059C3ZZ, 059C40Z, 059C4ZZ, 059D30Z, 059D3ZZ, 059D40Z, 059D4ZZ, 059F30Z, 059F3ZZ, 059F40Z, 059F4ZZ, 059G30Z, 059G3ZZ, 059G40Z, 059G4ZZ, 059H30Z, 059H3ZZ, 059H40Z, 059H4ZZ, 059L30Z, 059L3ZZ, 059L40Z, 059L4ZZ, 059M30Z, 059M3ZZ, 059M40Z, 059M4ZZ, 059N30Z, 059N3ZZ, 059N40Z, 059N4ZZ, 059P30Z, 059P3ZZ, 059P40Z, 059P4ZZ, 059Q30Z, 059Q3ZZ, 059Q40Z, 059Q4ZZ, 059R30Z, 059R3ZZ, 059R40Z, 059R4ZZ, 059S30Z, 059S3ZZ, 059S40Z, 059S4ZZ, 059T30Z, 059T3ZZ, 059T40Z, 059T4ZZ, 059V30Z, 059V3ZZ, 059V40Z, 059V4ZZ, 059Y30Z, 059Y3ZZ, 059Y40Z, 059Y4ZZ, 069030Z, 06903ZZ, 069040Z, 06904ZZ, 069130Z, 06913ZZ, 069140Z, 06914ZZ, 069230Z, 06923ZZ, 069240Z, 06924ZZ, 069430Z, 06943ZZ, 069440Z, 06944ZZ, 069530Z, 06953ZZ, 069540Z, 06954ZZ, 069630Z, 06963ZZ, 069640Z, 06964ZZ, 069730Z, 06973ZZ, 069740Z, 06974ZZ, 069830Z, 06983ZZ, 069840Z, 06984ZZ, 069930Z, 06993ZZ, 069940Z, 06994ZZ, 069B30Z, 069B3ZZ, 069B40Z, 069B4ZZ, 069C30Z, 069C3ZZ, 069C40Z, 069C4ZZ, 069D30Z, 069D3ZZ, 069D40Z, 069D4ZZ, 069F30Z, 069F3ZZ, 069F40Z, 069F4ZZ, 069G30Z, 069G3ZZ, 069G40Z, 069G4ZZ, 069H30Z, 069H3ZZ, 069H40Z, 069H4ZZ, 069J30Z, 069J3ZZ, 069J40Z, 069J4ZZ, 069M30Z, 069M3ZZ, 069M40Z, 069M4ZZ, 069N30Z, 069N3ZZ, 069N40Z, 069N4ZZ, 069P30Z, 069P3ZZ, 069P40Z, 069P4ZZ, 069Q30Z, 069Q3ZZ, 069Q40Z, 069Q4ZZ, 069R30Z, 069R3ZZ, 069R40Z, 069R4ZZ, 069S30Z, 069S3ZZ, 069S40Z, 069S4ZZ, 069T30Z, 069T3ZZ, 069T40Z, 069T4ZZ, 069V30Z, 069V3ZZ, 069V40Z, 069V4ZZ, 069Y30Z, 069Y3ZZ, 069Y40Z, 069Y4ZZ, 3E013GC, 3E0303Z, 3E0307Z, 3E030FZ, 3E030HZ, 3E030KZ, 3E030RZ, 3E030WK, 3E0333Z, 3E0337Z, 3E033FZ, 3E033HZ, 3E033KZ, 3E033RZ, 3E033WK, 3E0403Z, 3E0407Z, 3E040FZ, 3E040HZ, 3E040KZ, 3E040RZ, 3E040WK, 3E0433Z, 3E0437Z, 3E043FZ, 3E043HZ, 3E043KZ, 3E043RZ, 3E043WK, 3E0503Z, 3E0507Z, 3E050FZ, 3E050HZ, 3E050KZ, 3E050RZ, 3E050TZ, 3E050WK, 3E0533Z, 3E0537Z, 3E053FZ, 3E053HZ, 3E053KZ, 3E053RZ, 3E053TZ, 3E053WK, 3E0603Z, 3E0607Z, 3E060FZ, 3E060HZ, 3E060RZ, 3E060TZ, 3E060WK, 3E0633Z, 3E0637Z, 3E063FZ, 3E063HZ, 3E063RZ, 3E063TZ, 3E063WK, 3E09329, 3E0933Z, 3E0934Z, 3E093BZ, 3E093GC, 3E093HZ, 3E093KZ, 3E093TZ, 3E09729, 3E0973Z, 3E0974Z, 3E097BZ, 3E097GC, 3E097HZ, 3E097KZ, 3E097TZ, 3E09X29, 3E09X3Z, 3E09X4Z, 3E09XBZ, 3E09XHZ, 3E09XKZ, 3E09XTZ, 3E0D329, 3E0D33Z, 3E0D34Z, 3E0D36Z, 3E0D37Z, 3E0D3BZ, 3E0D3GC, 3E0D3HZ, 3E0D3KZ, 3E0D3RZ, 3E0D3TZ, 3E0D729, 3E0D73Z, 3E0D74Z, 3E0D76Z, 3E0D77Z, 3E0D7BZ, 3E0D7GC, 3E0D7HZ, 3E0D7KZ, 3E0D7RZ, 3E0D7TZ, 3E0DX29, 3E0DX3Z, 3E0DX4Z, 3E0DX6Z, 3E0DX7Z, 3E0DXBZ, 3E0DXHZ, 3E0DXKZ, 3E0DXRZ, 3E0DXTZ, 3E0F3SF, 3E0F7SF, 3E0F8SF, 3E0G3BZ, 3E0G3HZ, 3E0G3KZ, 3E0G3SF, 3E0G3TZ, 3E0G7BZ, 3E0G7HZ, 3E0G7KZ, 3E0G7SF, 3E0G7TZ, 3E0G8BZ, 3E0G8HZ, 3E0G8KZ, 3E0G8SF, 3E0G8TZ, 3E0H3BZ, 3E0H3GC, 3E0H3HZ, 3E0H3KZ, 3E0H3SF, 3E0H3TZ, 3E0H7BZ, 3E0H7HZ, 3E0H7KZ, 3E0H7SF, 3E0H7TZ, 3E0H8BZ, 3E0H8HZ, 3E0H8KZ, 3E0H8SF, 3E0H8TZ, 3E0J3SF, 3E0J7SF, 3E0J8SF, 3E0K3BZ, 3E0K3HZ, 3E0K3KZ, 3E0K3SF, 3E0K3TZ, 3E0K7BZ, 3E0K7GC, 3E0K7HZ, 3E0K7KZ, 3E0K7SF, 3E0K7TZ, 3E0K8BZ, 3E0K8GC, 3E0K8HZ, 3E0K8KZ, 3E0K8SF, 3E0K8TZ, 3E0N73Z, 3E0N76Z, 3E0N77Z, 3E0N7BZ, 3E0N7GC, 3E0N7HZ, 3E0N7KZ, 3E0N7SF, 3E0N7TZ, 3E0N83Z, 3E0N86Z, 3E0N87Z, 3E0N8BZ, 3E0N8GC, 3E0N8HZ, 3E0N8KZ, 3E0N8SF, 3E0N8TZ, 3E0P3GC, 3E0P3SF, 3E0P7SF, 3E0P8SF, 3E0W33Z, 3E0W36Z, 3E0W37Z, 3E0W3BZ, 3E0W3GC, 3E0W3HZ, 3E0W3KZ, 3E0W3TZ, XW03331, XW03372, XW04331, XW04372 |
| PXX05202 | Electrocardiogram – 202 | 4A0204Z, 4A02X4A, 4A02X4Z |
| PXX11180 | Other CT scan – 180 | B22100Z, B2210ZZ, B22110Z, B2211ZZ, B221Y0Z, B221YZZ, B221ZZZ, B22300Z, B2230ZZ, B22310Z, B2231ZZ, B223Y0Z, B223YZZ, B223ZZZ, B3200ZZ, B3201ZZ, B320YZZ, B320ZZZ, B3250ZZ, B3251ZZ, B325YZZ, B325ZZZ, B3280ZZ, B3281ZZ, B328YZZ, B328ZZZ, B32G0ZZ, B32G1ZZ, B32GYZZ, B32GZZZ, B4200ZZ, B4201ZZ, B420YZZ, B420ZZZ, B4210ZZ, B4211ZZ, B421YZZ, B421ZZZ, B4240ZZ, B4241ZZ, B424YZZ, B424ZZZ, B4280ZZ, B4281ZZ, B428YZZ, B428ZZZ, B42C0ZZ, B42C1ZZ, B42CYZZ, B42CZZZ, B42F0ZZ, B42F1ZZ, B42FYZZ, B42FZZZ, B42G0ZZ, B42G1ZZ, B42GYZZ, B42GZZZ, B42H0ZZ, B42H1ZZ, B42HYZZ, B42HZZZ, B42M0ZZ, B42M1ZZ, B42MYZZ, B42MZZZ, B52200Z, B5220ZZ, B52210Z, B5221ZZ, B522Y0Z, B522YZZ, B522ZZZ, B52800Z, B5280ZZ, B52810Z, B5281ZZ, B528Y0Z, B528YZZ, B528ZZZ, B52900Z, B5290ZZ, B52910Z, B5291ZZ, B529Y0Z, B529YZZ, B529ZZZ, B52J00Z, B52J0ZZ, B52J10Z, B52J1ZZ, B52JY0Z, B52JYZZ, B52JZZZ, B52K00Z, B52K0ZZ, B52K10Z, B52K1ZZ, B52KY0Z, B52KYZZ, B52KZZZ, B52L00Z, B52L0ZZ, B52L10Z, B52L1ZZ, B52LY0Z, B52LYZZ, B52LZZZ, B52Q00Z, B52Q0ZZ, B52Q10Z, B52Q1ZZ, B52QY0Z, B52QYZZ, B52QZZZ, B52R00Z, B52R0ZZ, B52R10Z, B52R1ZZ, B52RY0Z, B52RYZZ, B52RZZZ, B52S00Z, B52S0ZZ, B52S10Z, B52S1ZZ, B52SY0Z, B52SYZZ, B52SZZZ, B52T00Z, B52T0ZZ, B52T10Z, B52T1ZZ, B52TY0Z, B52TYZZ, B52TZZZ, B82500Z, B8250ZZ, B82510Z, B8251ZZ, B825Y0Z, B825YZZ, B825ZZZ, B82600Z, B8260ZZ, B82610Z, B8261ZZ, B826Y0Z, B826YZZ, B826ZZZ, B82700Z, B8270ZZ, B82710Z, B8271ZZ, B827Y0Z, B827YZZ, B827ZZZ, B92F00Z, B92F0ZZ, B92F10Z, B92F1ZZ, B92FY0Z, B92FYZZ, B92J00Z, B92J0ZZ, B92J10Z, B92J1ZZ, B92JY0Z, B92JYZZ, BB2700Z, BB270ZZ, BB2710Z, BB271ZZ, BB27Y0Z, BB27YZZ, BB27ZZZ, BB2800Z, BB280ZZ, BB2810Z, BB281ZZ, BB28Y0Z, BB28YZZ, BB28ZZZ, BB2900Z, BB290ZZ, BB2910Z, BB291ZZ, BB29Y0Z, BB29YZZ, BB29ZZZ, BB2F00Z, BB2F0ZZ, BB2F10Z, BB2F1ZZ, BB2FY0Z, BB2FYZZ, BB2FZZZ, BG2200Z, BG220ZZ, BG2210Z, BG221ZZ, BG22Y0Z, BG22YZZ, BG22ZZZ, BG2300Z, BG230ZZ, BG2310Z, BG231ZZ, BG23Y0Z, BG23YZZ, BG23ZZZ, BG2400Z, BG240ZZ, BG2410Z, BG241ZZ, BG24Y0Z, BG24YZZ, BG24ZZZ, BP200ZZ, BP201ZZ, BP20YZZ, BP210ZZ, BP211ZZ, BP21YZZ, BP220ZZ, BP221ZZ, BP22YZZ, BP22ZZZ, BP230ZZ, BP231ZZ, BP23YZZ, BP23ZZZ, BP240ZZ, BP241ZZ, BP24YZZ, BP24ZZZ, BP250ZZ, BP251ZZ, BP25YZZ, BP25ZZZ, BP280ZZ, BP281ZZ, BP28YZZ, BP28ZZZ, BP290ZZ, BP291ZZ, BP29YZZ, BP29ZZZ, BP2A0ZZ, BP2A1ZZ, BP2AYZZ, BP2AZZZ, BP2B0ZZ, BP2B1ZZ, BP2BYZZ, BP2BZZZ, BP2E0ZZ, BP2E1ZZ, BP2EYZZ, BP2EZZZ, BP2F0ZZ, BP2F1ZZ, BP2FYZZ, BP2FZZZ, BP2G0ZZ, BP2G1ZZ, BP2GYZZ, BP2GZZZ, BP2H0ZZ, BP2H1ZZ, BP2HYZZ, BP2HZZZ, BP2J0ZZ, BP2J1ZZ, BP2JYZZ, BP2JZZZ, BP2K0ZZ, BP2K1ZZ, BP2KYZZ, BP2KZZZ, BP2N0ZZ, BP2N1ZZ, BP2NYZZ, BP2NZZZ, BP2P0ZZ, BP2P1ZZ, BP2PYZZ, BP2PZZZ, BP2T0ZZ, BP2T1ZZ, BP2TYZZ, BP2TZZZ, BP2U0ZZ, BP2U1ZZ, BP2UYZZ, BP2UZZZ, BP2V0ZZ, BP2V1ZZ, BP2VYZZ, BP2VZZZ, BP2X0ZZ, BP2X1ZZ, BP2XYZZ, BP2XZZZ, BP2Y0ZZ, BP2Y1ZZ, BP2YYZZ, BP2YZZZ, BQ200ZZ, BQ201ZZ, BQ20YZZ, BQ20ZZZ, BQ210ZZ, BQ211ZZ, BQ21YZZ, BQ21ZZZ, BQ230ZZ, BQ231ZZ, BQ23YZZ, BQ23ZZZ, BQ240ZZ, BQ241ZZ, BQ24YZZ, BQ24ZZZ, BQ270ZZ, BQ271ZZ, BQ27YZZ, BQ27ZZZ, BQ280ZZ, BQ281ZZ, BQ28YZZ, BQ28ZZZ, BQ2B0ZZ, BQ2B1ZZ, BQ2BYZZ, BQ2C0ZZ, BQ2C1ZZ, BQ2CYZZ, BQ2D0ZZ, BQ2D1ZZ, BQ2DYZZ, BQ2DZZZ, BQ2F0ZZ, BQ2F1ZZ, BQ2FYZZ, BQ2FZZZ, BQ2L0ZZ, BQ2L1ZZ, BQ2LYZZ, BQ2LZZZ, BQ2M0ZZ, BQ2M1ZZ, BQ2MYZZ, BQ2MZZZ, BQ2P0ZZ, BQ2P1ZZ, BQ2PYZZ, BQ2PZZZ, BQ2Q0ZZ, BQ2Q1ZZ, BQ2QYZZ, BQ2QZZZ, BQ2R0ZZ, BQ2R1ZZ, BQ2RYZZ, BQ2RZZZ, BQ2S0ZZ, BQ2S1ZZ, BQ2SYZZ, BQ2SZZZ, BQ2V0ZZ, BQ2V1ZZ, BQ2VYZZ, BQ2VZZZ, BQ2W0ZZ, BQ2W1ZZ, BQ2WYZZ, BQ2WZZZ, BQ2X0ZZ, BQ2X1ZZ, BQ2XYZZ, BQ2XZZZ, BQ2Y0ZZ, BQ2Y1ZZ, BQ2YYZZ, BQ2YZZZ, BR200ZZ, BR201ZZ, BR20YZZ, BR20ZZZ, BR270ZZ, BR271ZZ, BR27YZZ, BR27ZZZ, BR290ZZ, BR291ZZ, BR29YZZ, BR29ZZZ, BR2C0ZZ, BR2C1ZZ, BR2CYZZ, BR2CZZZ, BR2D0ZZ, BR2D1ZZ, BR2DYZZ, BR2DZZZ, BR2F0ZZ, BR2F1ZZ, BR2FYZZ, BR2FZZZ, BT2000Z, BT200ZZ, BT2010Z, BT201ZZ, BT20Y0Z, BT20YZZ, BT20ZZZ, BV2300Z, BV230ZZ, BV2310Z, BV231ZZ, BV23Y0Z, BV23YZZ, BV23ZZZ, BW2100Z, BW210ZZ, BW2110Z, BW211ZZ, BW21Y0Z, BW21YZZ, BW21ZZZ, BW2500Z, BW250ZZ, BW2510Z, BW251ZZ, BW25Y0Z, BW25YZZ, BW25ZZZ, BW2F00Z, BW2F0ZZ, BW2F10Z, BW2F1ZZ, BW2FY0Z, BW2FYZZ, BW2FZZZ |
| PXX19218 | Psychological and psychiatric evaluation and therapy – 218 | 8E0ZXY5, GZ10ZZZ, GZ11ZZZ, GZ12ZZZ, GZ13ZZZ, GZ14ZZZ, GZ2ZZZZ, GZ3ZZZZ, GZ50ZZZ, GZ51ZZZ, GZ52ZZZ, GZ53ZZZ, GZ54ZZZ, GZ55ZZZ, GZ56ZZZ, GZ58ZZZ, GZ60ZZZ, GZ61ZZZ, GZ63ZZZ, GZ72ZZZ, GZB0ZZZ, GZB1ZZZ, GZB2ZZZ, GZB3ZZZ, GZB4ZZZ, GZC9ZZZ, GZFZZZZ, GZHZZZZ, GZJZZZZ, HZ30ZZZ, HZ31ZZZ, HZ32ZZZ, HZ33ZZZ, HZ34ZZZ, HZ35ZZZ, HZ36ZZZ, HZ37ZZZ, HZ38ZZZ, HZ39ZZZ, HZ3BZZZ, HZ3CZZZ, HZ40ZZZ, HZ41ZZZ, HZ42ZZZ, HZ43ZZZ, HZ44ZZZ, HZ45ZZZ, HZ46ZZZ, HZ47ZZZ, HZ48ZZZ, HZ49ZZZ, HZ4BZZZ, HZ4CZZZ |
Table 5: Relevant Procedure Codes CPT/HCPCS
| Group ID | Group Name | Code Value |
| CT0025 | Preventive Medicine, Care Coordination | 2000F, 2001F, 2028F, 4000F, 4001F, 4004F, 93790, 98960, 98961, 98962, 98966, 98967, 98968, 99078, 99361, 99362, 99366, 99367, 99368, 99371, 99372, 99373, 99382, 99383, 99384, 99385, 99386, 99387, 99392, 99393, 99394, 99395, 99396, 99397, 99398, 99399, 99400, 99401, 99402, 99403, 99404, 99411, 99412, 99429, 99441, 99442, 99443, 99446, 99447, 99448, 99449, 99499, G0108, G0109, G0175, G0245, G0246, G0247, G0402, G0406, G0407, G0408, G0425, G0426, G0427, G8402, G8453, G8686, G8688, G8690, G8692, G9458, H0034, H0039, H0040, S0220, S0221, S0315, S0316, S0317, S0320, S0390, S9140, S9141, S9145 |
| CT0026 | Medication Assisted Management (MAT) | 4063F, 4064F, 80159, 80342, 80343, 80344, C9497, J0400, J0401, J0780, J1630, J1631, J2310, J2358, J2426, J2680, J2794, J3230, J3486, S0136, S0166 |
| CT0028 | Depression Screening | 1040F, 1220F, 2060F, 3085F, 3351F, 3352F, 3353F, 3354F, 3725F, 96127, G0444, G8431, G8432, G8433, G8510, G8511, G8930, G8932, G8940, G8959, G8960, G9212, G9213, G9232 |
| CT0043 | Counseling Services | 90832, 90834, 90837, 90849, 90853, G0396, G0397, H0005 |
| CT0079 | Toxicology Screening | G0480, G0481, G0482, G0483 |
| CT0080 | Imaging Abdomen | 74000, 74020, 74176, 74177, 74178 |
| CT0082 | Opioid Administration / Dispensing (OTP) | 96372, H0020, H0033, J2315 |
| CT0085 | Developmental Milestones | 96110 |
| CT0089 | Metabolic Renal Hepatic Chemistry Panel | 80010, 80047, 80048, 80049, 80050, 80051, 80052, 80053, 80069, 80074, 80076, 82040, 82247, 82248, 82310, 82330, 82374, 82435, 82565, 82947, 84132, 84155, 84295, 84450, 84460, 84520, 84550 |
| CT0090 | Physical Therapy / Rehab | 97001, 97002, 97003, 97110, 97530, 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, 99381, 99391, T1015 |
| CT0092 | Physician Services – Inpatient | 99221, 99222, 99223, 99238, 99239, 99252, 99253, 99254, 99255 |
| CT0098 | Occult blood screening | 82270 |
| CT0136 | Rx – central nervous system – antidepressants | S0106 |
| CT0137 | Rx – central nervous system – tranq/antipsychotics | J1790, J2950, J3310, J3400, Q0171, Q0172, Q0175, Q0176 |
| CT01392 | Other diagnostic nervous system procedures | 0434T, 0435T, 0436T |
| CT01393 | Other OR therapeutic nervous system procedures | 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T |
| CT01395 | DME and supplies | E1012 |
| CT0140 | Rx – central nervous system – barbiturates | J0300, J2515, J2560 |
| CT0141 | Rx – central nervous system – benzodiazepines | J1990, J2060, J2250, J3360 |
| CT0142 | Rx – central nervous system – anxiolytic/sedative/hypnot nec | J3410, Q0177, Q0178 |
| CT0144 | Imaging – ct – head / brain | 70450, 70460, 70470 |
| CT0149 | Imaging – mri – brain | 70551, 70552, 70553, 70554, 70555, 70557, 70558, 70559 |
| CT0155 | Imaging – x-ray – skull | 70240, 70250, 70260 |
| CT0160 | Tests – neuro – eeg | 95812, 95813, 95816, 95819, 95822, 95824, 95827, 95830, 95950, 95951, 95953, 95954, 95955, 95956, 95957, 95958, 95961, 95962 |
| CT0163 | Tests – neuro – evoked potentials | 95925, 95926, 95927, 95928, 95929, 95930, 95933, 95934, 95936, 95937 |
| CT0164 | Tests – neuro – cognitive testing | 96020, 96101, 96102, 96103, 96111 |
| CT0165 | Tests – neuro – other | 95999, 96004 |
| CT03395 | Other therapeutic ear procedures | 69209 |
| CT0349 | Therapy – speech therapy | 92506 |
| CT04280 | Lung Function Tests | 94010, 94060, 94150, 94375, 94620 |
| CT04281 | Blood Gases, Pulse Oximetry | 94760, 94761 |
| CT04282 | Chest X-Ray | 71010, 71020 |
| CT05307 | Electrocardiogram – EKG monitoring | 93000, 93005, 93010, 93040, 93041, 93042, 93224 |
| CT0659 | Procedure – other lower gi procedures – other non – or rx | 99175 |
| CT0694 | Rx – gi – antiemetics | J2405, J2550, J2765 |
| CT0697 | Rx – gi – ppis | C9113 |
| CT0859 | Rx – muscle relaxants – muscle relax, neuromusc block | J0330 |
| CT1017 | Rx – vitamins – vitamin b / b complex | J3420 |
| CT1026 | Other care – diabetes care – glucose monitoring – lancet | A4259 |
| CT10295 | Thyroid Function Tests | 84432, 84436, 84437, 84439, 84442, 84443, 84445, 84479, 84480, 84481, 84482 |
| CT10296 | Low dose steroids | J7506 |
| CT1031 | Other care – diabetes care – shoes | A5500 |
| CT1036 | Other care – nutrition – assessment | 97802, 97803, G0270, G0271 |
| CT1166 | Lab – urinalysis | 81015 |
| CT1221 | Imaging – us – scrotum | 76870 |
| CT1620 | Therapy – phlebotomy | 99195 |
| 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 |
| CT16298 | Finger stick | 82948 |
| CT16299 | Bleeding Status | 85610 |
| CT1638 | Rx – administration – injection | 96373, 96374, 96375, 96376, 99506 |
| CT1639 | Rx – administration – infusion | 96361, 96365, 96366, 96367, 99601, 99602 |
| CT1647 | Lab – hematology – blood count | 85055 |
| CT1648 | Lab – hematology – blood count – eosinophil count | S3630 |
| CT1649 | Lab – other hematology | 85660 |
| CT1651 | Lab – immunology | 86038, 86039, 86480, 86580, 86592, 86593 |
| CT1807 | Rx – antibiotics – cephalosporins | J0690, J0696 |
| CT1821 | Lab – infectious agent antigen | 87340, 87350, 87430 |
| CT1822 | Lab – infectious agent antibody | 86695, 86696, 86701, 86703, 86704, 86705, 86706, 86707, 86708, 86709, 86780, 86787, 86803 |
| CT1823 | Lab – infectious agent dna | 87480, 87510, 87517, 87522, 87536, 87590, 87591, 87621, 87660, 87798, 87800, 87804, 87880, 87901, 87902 |
| CT1824 | Lab – microbiology – other | 87177 |
| CT1825 | Lab – microbiology – c & s | 87147, 87184, 87186 |
| CT1826 | Lab – microbiology – microscopic exam | 87205, 87210 |
| CT1828 | Lab – microbiology | P7001 |
| CT18300 | Microscopic examination (bacterial smear, culture, toxicology) | 87389 |
| CT18302 | CHLAMYDIA SCREENING | 87490, 87491 |
| CT1901 | Therapy – behavior – evaluation and therapy | 90875, 90876, 90880, 96150, 96151, 96152, 96153, 96154, 96155 |
| CT1902 | Therapy – behavior – electroconvulsive therapy | 90870 |
| CT1903 | Therapy – behavior – medication management | M0064 |
| CT1904 | Therapy – behavior – residential | H0017, H0018, H0019 |
| CT1905 | Therapy – behavior – partial hospitalization | H0035, S0201, S9480 |
| CT1907 | Tests – neuro – sleep studies | G0398, G0399, G0400 |
| CT19303 | Psychiatry Evaluations | 90785, 90791, 90792, 90801, 90802, 96118, 96119, 96120, 96125, T1023 |
| CT19304 | Psychiatry Services | 90804, 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90814, 90815, 90816, 90817, 90818, 90819, 90821, 90822, 90823, 90824, 90826, 90827, 90828, 90829, 90833, 90836, 90838, 90839, 90840, 90845, 90846, 90847, 90857, 90862, 90863, 90865, 90882, 90885, 90887, 90889, 90899, 97532, 97535, G0410, G0411, G8126, G8127, G8129, H0004, H0031, H0032, H0036, H0037, H0046, H2010, H2011, H2012, H2013, H2015, H2016, H2017, H2018, H2021, H2022, H2027, H2030, H2031, S3005, S9454, S9482, S9484, S9485, T2034 |
| CT19380 | Residential Services | T2048 |
| CT19381 | Smoking / Tobacco Cessation | 99406, 99407 |
| CT19382 | High Risk Behavior Screening | 4293F |
| CT19383 | Sexual Behavior Counseling | G0445 |
| CT19384 | Peer Services | H0038 |
| CT2004 | Lab – chemistry | 82055 |
| CT2006 | Alcohol / Drug Use Management | H0002, H0015, H0045, H0048 |
| CT2009 | Alcohol / Drug Use Screening | 3016F, 4158F, 4290F, 4320F, 80100, 80101, 80102, 80103, 80300, 80301, 80302, 80303, 80304, 80320, 80321, 80322, 80375, 80376, 80377, 82009, 82010, 82075, 99408, 99409, G0430, G0431, G0442, G0443, G9621, G9622, H0001, H0003, H0006, H0007, H0008, H0009, H0014, H0021, H0022, H0029, H0047, H0049, H0050, H2035, T1006, T1007, T1012 |
| CT20376 | Other Laboratory | G0477, G0478, G0479 |
| CT2101 | Lab – therapeutic drug assay | 80152, 80154, 80156, 80157, 80158, 80160, 80164, 80166, 80168, 80173, 80174, 80178, 80182, 80184, 80185, 80186, 80196, 80198, 80201, 80299 |
| CT2302 | Therapy – behavior – other | G0177, H0024, H0025, H0030, H2000, H2019, H2020, H2033 |
| CT2308 | Therapy – biofeedback | 90901 |
| CT2309 | Therapy – activity therapy | G0176, H2032 |
| CT2315 | Therapy – vaccination – hepatitis b | 90746 |
| CT23309 | Markers for Inflammation | 85651, 85652, 86140, 86141 |
| CT2331 | Other care – observation | G0379 |
| CT23311 | Current Tobacco / Cigarette Smoker | G8455 |
| CT23398 | Ancillary Services | 99415, 99416, G9473, G9474, G9475, G9476, G9477, G9478, G9479 |
| CT2352 | DME – mobility aids | E0100, E0114, E0143 |
| CT9902 | E & M – consultation | Q3014, T1014 |
| CT9903 | E & M – hospital | 99217, 99218, 99219, 99220, 99231, 99232, 99233, 99234, 99235, 99236, G0378, 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 |
| CT9907 | E & M – prevention | 99420, S0302 |
| CT9908 | E & M – other | 99026, 99027, 99056, 99060, 99150, 99288, 99360, 99450, 99455, 99456, 99485, 99488, S0260, S0265 |
| CT99102 | Other care – other | H0043, H0044, H2023, H2024, H2025, H2026, S9900 |
| CT9911 | Procedure – sedation | 99143, 99144, 99145, 99148, 99149 |
| CT99110 | Imaging – us – head / neck | 76536 |
| CT99111 | Imaging – us – retroperitoneum | 76770, 76775 |
| CT99112 | Imaging – us – pelvic | 76856, 76857 |
| CT99141 | Imaging – supplies – ultrasound related | A4559 |
| CT99143 | Lab – chemistry | 82000, 82003, 82140, 82145, 82150, 82172, 82205, 82272, 82274, 82306, 82307, 82520, 82528, 82530, 82533, 82540, 82542, 82550, 82553, 82570, 82600, 82607, 82627, 82646, 82649, 82651, 82652, 82654, 82670, 82677, 82746, 82784, 82785, 82946, 82950, 82951, 82952, 82962, 82977, 83015, 83018, 83605, 83615, 83690, 83735, 83789, 83805, 83840, 83858, 83874, 83880, 83925, 83992, 84075, 84100, 84144, 84146, 84156, 84165, 84270, 84311, 84402, 84403, 84425, 84430, 84466, 84600 |
| CT99169 | Lab – specimen collection – blood – venous – venipuncture | 36410, 36415, S9529 |
| CT99173 | Lab – specimen collection – specimen handling | 99000 |
| CT99176 | Lab – stat request | S3600, S3601 |
| CT99182 | Transportation – paramedic | S0207, S0208 |
| CT99183 | Transportation – other transportation | A0021, A0080, A0090, A0100, A0110, A0120, A0130, A0140, A0160, A0170, A0180, A0190, A0200, A0210, 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, S9992, T2001, T2002, T2003, T2004, T2005, T2007, T2049 |
| 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, A4280, A4450, A4452, A4455, A4456, A4458, A4461, A4463, A4465, 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, A6410, A6411, A6412, A6413, A6441, A6442, A6443, A6444, A6445, A6446, A6447, A6448, A6449, A6450, A6451, A6452, A6453, A6454, A6455, A6456, A6457, A6550, A7000, A7001, A7002, A9155, J1642, S8430, S8431, T2028 |
| CT99197 | Other – non – covered | A9270 |
| CT99198 | PQRI | G8128, G8420 |
| CT9929 | Therapy – rehabilitation | H2001 |
| CT99309 | Physician Services | 99251 |
| CT9931 | Therapy – rehabilitation – other | H2014 |
| CT99311 | Urine Protein | 81000, 81001, 81002, 81003, 82042, 82043 |
| CT99312 | HbA1C | 83036, 83037 |
| CT99316 | Physician Services – Inpatient | 99356, 99357 |
| CT99392 | Other diagnostic procedures (interview, evaluation, consultation) | 0074T, 0188T, 0189T, 0203T, 0204T, G0436, G0437, G0438, G0439, G0447, G0454, G9156, Q5010 |
| CT99400 | Advance care planning | 1123F, 1124F, 1157F, 1158F, 4553F, 99497, 99498, S0255, S0257, S0311 |
| 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 | 0518F, 0545F, 5050F, G0162, G0463, G9012, S0250, T1001, T1016, T1017, T2022, T2023, T2024 |
| CT99404 | Case Management Services – Behavioral | 96116, G0503, G0507, H0023, H1011 |
| CT99405 | Case Management Services – Educational | T1018 |
| CT99408 | Chronic Care Management | 99487, 99489, 99490, G0506 |
| CT99409 | Home Health / Hospice | G0179, G0180, G0181, G0182 |
| CT9941 | Rx – allergy – antihistamines / comb | J1200 |
| CT99410 | Coordinated Care Fees/Services | G9001, G9002, G9003, G9004, G9005, G9006, G9007, G9008, G9009, G9010, G9011 |
| CT99411 | Medication Therapy Management Services | 99605, 99606, 99607 |
| CT99412 | Online Management | 98969, 99444 |
| CT99413 | Personal Care Services | T1019, T1020 |
| CT99415 | Physician Services – Outpatient | 99358, 99359 |
| CT99416 | Procedures and Reporting | 99080, 99090, 99091 |
| CT99417 | Risk Assessment | G9316 |
| CT99418 | Transitional Care Management | 99495, 99496 |
| CT99419 | Wellness Assessment | S5190 |
| CT99420 | LEAD SCREENING | 83655 |
| CT9945 | Rx – autonomic rx – nicotine preps | S4990, S4991, S4995 |
| CT9951 | Rx – electrolytic, caloric, water – multi-mineral prep | J7120 |
| CT9952 | Rx – electrolytic, caloric, water – sodium chlor preps | J7030, J7040, J7050 |
| CT9956 | Rx – electrolytic, caloric, water – hydration – unspecified | 90760, 90761 |
| CT9959 | Rx – miscellaneous rx – heavy metal antagonists | J0470, J0600, J0895, J1190, J3520 |
| CT9964 | Other care – home care – specialized visit | 99507, 99509, 99510, 99511 |
| CT9965 | Other care – home care – physician supervision | G0372, S0270, S0272 |
| CT9966 | Other care – home care – nursing care | 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 |
| CT9974 | Other care – home care – home health aide | 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 |
| CT9978 | Other care – home care – other care – homemaker | S5130, S5131 |
| 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 |
| CT9984 | Other care – home care – meals | S5170 |
| CT9986 | Other care – hospice | G0337 |
| 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 |
| CT9997 | Other care – other – meals | T1010 |
| XX0000 | Ungrouped Codes | 0359T, 0360T, 0361T, 0362T, 0363T, 0364T, 0365T, 0366T, 0367T, 0368T, 0369T, 0370T, 0371T, 0372T, 0373T, 0374T, 1000F, 3008F, 33952, 33954, 33958, 33962, 33966, 33984, 4019F, 80104, 80323, 80324, 80325, 80326, 80327, 80328, 80329, 80330, 80331, 80332, 80333, 80334, 80335, 80336, 80337, 80338, 80339, 80340, 80341, 80345, 80346, 80347, 80348, 80349, 80350, 80351, 80352, 80353, 80354, 80355, 80356, 80357, 80358, 80359, 80360, 80361, 80362, 80363, 80364, 80365, 80366, 80367, 80368, 80369, 80370, 96360, 99052, 99054, 99151, C9443, C9444, C9446, C9801, C9802, G0299, G0300, G0344, G0434, G0449, G0459, G0466, G0467, G0468, G0469, G0470, G0472, G0473, G6030, G6031, G6032, G6034, G6036, G6037, G6040, G6041, G6042, G6043, G6044, G6050, G6051, G6052, G6053, G6054, G6055, G6056, G6057, G6058, G8130, G8131, G8155, G8156, G8157, G8214, G8217, G8219, G8220, G8221, G8466, G8467, G8553, G8790, G8791, G8792, G8793, G8794, G8795, G8931, G8933, G8947, G9165, G9166, G9167, G9168, G9169, G9170, G9193, G9194, G9195, G9199, G9200, G9201, G9369, G9370, G9393, G9394, G9395, G9396, G9509, G9510, G9511, G9518, G9572, G9573, G9574, G9635, G9642, G9669, G9670, G9673, G9675, G9676, G9677, Q0162, S9901 |
Table 6: Relevant Typical Drug Groups
| Group ID | Group Name |
| RX0110 | psychostimulants agents used for adhd and nootropics |
| RX013 | anti-dementia drugs |
| RX014 | anti-parkinson drugs |
| RX015 | antiepileptics |
| RX016 | antimigraine preparations |
| RX017 | hypnotics and sedatives |
| RX018 | other nervous system drugs |
| RX0425 | antihistamines for systemic use |
| RX0645 | antacids |
| RX0646 | antidiarrheals intestinal adsorbents |
| RX0647 | antiemetics and antinauseants |
| RX0648 | digestives incl. enzymes |
| RX0649 | drugs for constipation |
| RX0650 | drugs for functional gastrointestinal disorders |
| RX0651 | drugs for peptic ulcer and gerd |
| RX0652 | intestinal antiinfectives |
| RX0860 | muscle relaxants |
| RX0861 | opioids |
| RX0862 | other analgesics and antipyretics |
| RX1082 | antiobesity preparations excl. diet products |
| RX16109 | vitamin b12 and folic acid |
| RX18122 | antivirals for systemic use |
| RX19123 | antidepressants |
| RX19124 | antipsychotics |
| RX19125 | anxiolytics |
| RX19126 | drugs used in addictive disorders |
| RX19128 | Drugs for Rx of Mania |
| RX21127 | Drugs for poisoning & Antidotes |
| RX23136 | Smoking Cessation Agents |