Medicare Data Utilities Appendices

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7190 EFFUSION OF JOINT* 71900 JOINT EFFUSION-UNSPEC 71901 JOINT EFFUSION-SHLDER 71902 JOINT EFFUSION-UP/ARM 71903 JOINT EFFUSION-FOREARM 71904 JOINT EFFUSION-HAND 71905 JOINT EFFUSION-PELVIS 71906 JOINT EFFUSION-L/LEG 71907 JOINT EFFUSION-ANKLE 71908 JOINT EFFUSION-JT NEC 71909 JOINT EFFUSION-MULT JTS 7191 HEMARTHROSIS* 71910 HEMARTHROSIS-UNSPEC 71911 HEMARTHROSIS-SHLDER 71912 HEMARTHROSIS-UP/ARM 71913 HEMARTHROSIS-FOREARM 71914 HEMARTHROSIS-HAND 71915 HEMARTHROSIS-PELVIS 71916 HEMARTHROSIS-L/LEG 71917 HEMARTHROSIS-ANKLE 71918 HEMARTHROSIS-JT NEC 71919 HEMARTHROSIS-MULT JTS 7192 VILLONODULAR SYNOVITIS* 71920 VILLONOD SYNOVIT-UNSPEC 71921 VILLONOD SYNOVIT-SHLDER 71922 VILLONOD SYNOVIT-UP/ARM 71923 VILLONOD SYNOVIT-FOREARM 71924 VILLONOD SYNOVIT-HAND 71925 VILLONOD SYNOVIT-PELVIS 71926 VILLONOD SYNOVIT-L/LEG 71927 VILLONOD SYNOVIT-ANKLE 71928 VILLONOD SYNOVIT-JT NEC 71929 VILLONOD SYNOVIT-MULT JT 7193 PALINDROMIC RHEUMATISM* 71930 PALINDROM RHEUM-UNSPEC 71931 PALINDROM RHEUM-SHLDER 71932 PALINDROM RHEUM-UP/ARM 71933 PALINDROM RHEUM-FOREARM 71934 PALINDROM RHEUM-HAND 71935 PALINDROM RHEUM-PELVIS 71936 PALINDROM RHEUM-L/LEG 71937 PALINDROM RHEUM-ANKLE 71938 PALINDROM RHEUM-JT NEC 71939 PALINDROM RHEUM-MULT JTS 7194 PAIN IN JOINT* 71940 JOINT PAIN-UNSPEC 71941 JOINT PAIN-SHLDER 71942 JOINT PAIN-UP/ARM 71943 JOINT PAIN-FOREARM 71944 JOINT PAIN-HAND 71945 JOINT PAIN-PELVIS 71946 JOINT PAIN-L/LEG 71947 JOINT PAIN-ANKLE 71948 JOINT PAIN-JT NEC 71949 JOINT PAIN-MULT JTS 7195 STIFFNESS OF JOINT NEC* 71950 JT STIFFNESS NEC-UNSPEC
71951 JT STIFFNESS NEC-SHLDER 71952 JT STIFFNESS NEC-UP/ARM 71953 JT STIFFNES NEC-FOREARM 71954 JT STIFFNESS NEC-HAND 71955 JT STIFFNESS NEC-PELVIS 71956 JT STIFFNESS NEC-L/LEG 71957 JT STIFFNESS NEC-ANKLE 71958 JT STIFFNESS NEC-OTH JT 71959 JT STIFFNESS NEC-MULT JT 7196 JOINT SYMPTOMS NEC* 71960 JOINT SYMPT NEC-UNSP JT 71961 JOINT SYMPTOM NEC-SHLDER 71962 JOINT SYMPTOM NEC-UP/ARM 71963 JOINT SYMPT NEC-FOREARM 71964 JOINT SYMPTOM NEC-HAND 71965 JOINT SYMPTOM NEC-PELVIS 71966 JOINT SYMPTOM NEC-L/LEG 71967 JOINT SYMPTOM NEC-ANKLE 71968 JOINT SYMPTOM NEC-OTH JT 71969 JOINT SYMPT NEC-MULT JTS 7197 DIFFICULTY IN WALKING* 71970 DIFFICULT WALK-UNSPEC 71975 DIFFICULT WALK-PELVIS 71976 DIFFICULT WALK-LO/LEG 71977 DIFFICULT WALK-FOOT 71978 DIFFICULT WALK NEC 71979 DIFFICULT WALK-MULT 7198 JOINT DISORDERS NEC* 71980 JOINT DIS NEC-UNSPEC 71981 JOINT DIS NEC-SHLDER 71982 JOINT DIS NEC-UP/ARM 71983 JOINT DIS NEC-FOREARM 71984 JOINT DIS NEC-HAND 71985 JOINT DIS NEC-PELVIS 71986 JOINT DIS NEC-L/LEG 71987 JOINT DIS NEC-ANKLE 71988 JOINT DIS NEC-OTH JT 71989 JOINT DIS NEC-MULT JTS 7199 JOINT DISORDER NOS* 71990 JOINT DIS NOS-UNSPEC JT 71991 JOINT DIS NOS-SHLDER 71992 JOINT DIS NOS-UP/ARM 71993 JOINT DIS NOS-FOREARM 71994 JOINT DIS NOS-HAND 71995 JOINT DIS NOS-PELVIS 71996 JOINT DIS NOS-L/LEG 71997 JOINT DIS NOS-ANKLE 71998 JOINT DIS NOS-OTH JT 71999 JOINT DIS NOS-MULT JTS 720 INFLAM SPONDYLOPATHIES* 7200 ANKYLOSING SPONDYLITIS 7201 SPINAL ENTHESOPATHY 7202 SACROILIITIS NEC 7208 OTH INFLAM SPONDYLOPATHY* 72081 SPONDYLOPATHY IN OTH DIS 72089 INFLAM SPONDYLOPATHY NEC 7209 INFLAM SPONDYLOPATHY NOS
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Medicare Data Utilities Appendices
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Appendix C BETOS Table The Berenson
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Appendix D Carrier Claim Payment De
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Appendix G CMS Provider Specialty T
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8O = Clinical social worker (1991)
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75 = Other medical care (GPPP) (not
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Appendix I Line Place of Service Ta
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0406 = (C) MAMMOGRAPHY WITH NO HCPC
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46XB = (C) MULTIPLE COIN VALU CODES
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5500 = (U) FULL DAYS/SNF-HOSP FULL
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6911 = (C) REV CODE 274 ON OUTPAT A
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94X5 = (C) BLOOD/MSP CODE/COMPUTED
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Appendix L State Table The followin
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Appendix M Identification of variab
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48 Thyroid disorders 49 Diabetes me
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159 Urinary tract infections 160 Ca
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Appendix O Agency for Healthcare Re
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102 Ureteral catheterization 103 Ne
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216 Respiratory intubation and mech
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0064 AMEBIC LUNG ABSCESS 0065 AMEBI
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01136 TB OF BRONCHUS-OTH TEST 0114
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01326 TUBRCLOMA BRAIN-OTH TEST 0133
Page 45 and 46:
01576 TB OF BONE NEC-OTH TEST 0158
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01726 TB PERIPH LYMPH-OTH TEST 0173
Page 49 and 50:
026 RAT-BITE FEVER* 0260 SPIRILLARY
Page 51 and 52:
04181 MYCOPLASMA 04182 BACILLUS FRA
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05579 MEASLES COMPLICATION NEC 0558
Page 55 and 56:
0771 EPIDEM KERATOCONJUNCTIV 0772 P
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0907 LATE CONGEN SYPH NOS 0909 CONG
Page 59 and 60:
09889 GONOCOCCAL INF SITE NEC 099 O
Page 61 and 62:
1160 BLASTOMYCOSIS 1161 PARACOCCIDI
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1330 SCABIES 1338 ACARIASIS NEC 133
Page 65 and 66:
151 MALIGNANT NEO STOMACH* 1510 MAL
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1712 MAL NEO SOFT TISSUE ARM 1713 M
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1902 MAL NEO LACRIMAL GLAND 1903 MA
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20083 MIXED LYMPHOSARC ABDOM 20084
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20225 SEZARY'S DISEASE INGUIN 20226
Page 75 and 76:
20610 CHR MONO LEUK W/O RMSION 2061
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218 UTERINE LEIOMYOMA* 2180 SUBMUCO
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234 CA IN SITU NEC/NOS* 2340 CA IN
Page 81 and 82:
2469 DISORDER OF THYROID NOS 250 DI
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2592 CARCINOID SYNDROME 2593 ECTOPI
Page 85 and 86:
2766 FLUID OVERLOAD 2767 HYPERPOTAS
Page 87 and 88:
2882 GENETIC ANOMALY LEUKOCYT 2883
Page 89 and 90:
29552 LATENT SCHIZOPHREN-CHR 29553
Page 91 and 92:
2990 INFANTILE AUTISM* 29900 INFANT
Page 93 and 94:
30403 OPIOID DEPENDENCE-REMISS 3041
Page 95 and 96:
30721 TRANSIENT TIC, CHILDHOOD 3072
Page 97 and 98:
3150 SPECIFIC READING DIS* 31500 RE
Page 99 and 100:
33510 SPINAL MUSCL ATROPHY NOS 3351
Page 101 and 102:
34600 CLSC MIGRNE WO NTRC MGRN 3460
Page 103 and 104:
3594 TOXIC MYOPATHY 3595 MYOPATHY I
Page 105 and 106:
3625 DEGENERATION OF MACULA* 36250
Page 107 and 108:
36459 IRIS ATROPHY NEC 3646 ANTERIO
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36731 ANISOMETROPIA 36732 ANISEIKON
Page 111 and 112:
37005 MYCOTIC CORNEAL ULCER 37006 P
Page 113 and 114:
37230 CONJUNCTIVITIS NOS 37231 ROSA
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3752 EPIPHORA* 37520 EPIPHORA NOS 3
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37775 CORTICAL BLINDNESS 3779 OPTIC
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37953 VISUAL DEPRIVATN NYSTAGM 3795
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38421 CENT PERF TYMPANIC MEMB 38422
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38900 CONDUCT HEARING LOSS NOS 3890
Page 125 and 126:
41020 AMI INFEROLATERAL,UNSPEC 4102
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426 CONDUCTION DISORDERS* 4260 ATRI
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438 LATE EFF CEREBROVASC DIS* 4380
Page 131 and 132:
4518 THROMBOPHLEBITIS NEC* 45181 IL
Page 133 and 134:
4741 T & A HYPERTROPHY* 47410 HYPER
Page 135 and 136:
4951 BAGASSOSIS 4952 BIRD-FANCIERS'
Page 137 and 138: 5226 CHR APICAL PERIODONTITIS 5227
Page 139 and 140: 53089 OTHER DSRDERS ESOPHAGUS 5309
Page 141 and 142: 535 GASTRITIS AND DUODENITIS* 5350
Page 143 and 144: 5539 HERNIA NOS 555 REGIONAL ENTERI
Page 145 and 146: 572 SEQUELA OF CHR LIVER DIS* 5720
Page 147 and 148: 5838 NEPHRITIS NOS W OTH LES* 58381
Page 149 and 150: 5997 HEMATURIA 5998 URINARY TRACT D
Page 151 and 152: 6168 FEMALE GEN INFLAM NEC 6169 FEM
Page 153 and 154: 6281 INFERTIL-PITUITARY ORIG 6282 I
Page 155 and 156: 63622 ILLEG AB W PEL DAMG-COMP 6363
Page 157 and 158: 64120 PREM SEPAR PLACEN-UNSPEC 6412
Page 159 and 160: 64613 EDEMA IN PREG-ANTEPARTUM 6461
Page 161 and 162: 64821 ANEMIA-DELIVERED 64822 ANEMIA
Page 163 and 164: 65270 PROLAPSED ARM-UNSPEC 65271 PR
Page 165 and 166: 65501 FETAL CNS MALFORM-DELIV 65503
Page 167 and 168: 65901 FAIL MECH INDUCT-DELIVER 6590
Page 169 and 170: 66221 PROLONG 2ND STAGE-DELIV 66223
Page 171 and 172: 66584 OB TRAUMA NEC-POSTPARTUM 6659
Page 173 and 174: 670 MAJOR PUERPERAL INFECT* 67000 M
Page 175 and 176: 67494 PUERP COMPL NOS-POSTPART 675
Page 177 and 178: 6825 CELLULITIS OF BUTTOCK 6826 CEL
Page 179 and 180: 7038 DISEASES OF NAIL NEC 7039 DISE
Page 181 and 182: 71145 BACT ARTHRITIS-PELVIS 71146 B
Page 183 and 184: 71298 CRY ARTHROP NOS-OTH SITE 7129
Page 185 and 186: 71635 CLIMACT ARTHRITIS-PELVIS 7163
Page 187: 71830 RECUR DISLOCAT-UNSPEC 71831 R
Page 191 and 192: 724 BACK DISORDER NEC & NOS* 7240 S
Page 193 and 194: 72886 NECROTIZING FASCIITIS 72889 M
Page 195 and 196: 7330 OSTEOPOROSIS* 73300 OSTEOPOROS
Page 197 and 198: 7379 CURVATURE OF SPINE NOS 738 OTH
Page 199 and 200: 74405 ANOMALIES OF INNER EAR 74409
Page 201 and 202: 74904 BILAT CLEFT PALATE-INC 7491 C
Page 203 and 204: 75433 CONG HIP SUBLUX, BILAT 75435
Page 205 and 206: 75681 ABSENCE OF MUSCLE/TENDON 7568
Page 207 and 208: 7641 LT-FOR-DATES W FETAL MAL* 7641
Page 209 and 210: 7732 NB HEMOLYT DIS-ISOIM NEC 7733
Page 211 and 212: 7826 PALLOR & FLUSHING* 78261 PALLO
Page 213 and 214: 78900 ABDMNAL PAIN UNSPCF SITE 7890
Page 215 and 216: 7951 ABN PAP SMEAR-OTH SITE 7952 AB
Page 217 and 218: 80090 OP SKL VLT FX/BR INJ NEC 8009
Page 219 and 220: 80230 MANDIBLE FX NOS-OPEN 80231 FX
Page 221 and 222: 80405 CL SKUL/OTH FX-DEEP COMA 8040
Page 223 and 224: 8060 CLOS CERV FX W CORD INJ* 80600
Page 225 and 226: 81011 FX CLAVIC, STERN END-OPN 8101
Page 227 and 228: 8141 FRACTURE CARPAL BONE-OPN* 8141
Page 229 and 230: 82391 FX FIBULA NOS-OPEN 82392 FX T
Page 231 and 232: 836 DISLOCATION OF KNEE* 8360 TEAR
Page 233 and 234: 84213 SPRAIN INTERPHALANGEAL 84219
Page 235 and 236: 85155 OPN CEREBE CONT-DEEP COM 8515
Page 237 and 238: 8540 BRAIN INJURY NEC* 85400 BRAIN
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86412 LIVER LACERAT, MINOR-OPN 8641
Page 241 and 242:
87333 OPEN WND NAS SINUS-COMPL 8733
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8821 OPN WOUND HAND-COMPLICAT 8822
Page 245 and 246:
90242 INJURY RENAL VEIN 90249 INJUR
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9117 FOREIGN BODY TRUNK-INFEC 9118
Page 249 and 250:
92320 CONTUSION OF HAND(S) 92321 CO
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94111 1ST DEG BURN EAR 94112 1ST DE
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94311 1ST DEG BURN FOREARM 94312 1S
Page 255 and 256:
9451 1ST DEGREE BURN LEG* 94510 1ST
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94888 80-89% BDY BRN/80-89% 3D 9489
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9590 FACE AND NECK INJURY NOS* 9590
Page 261 and 262:
9697 POISON-PSYCHOSTIMULANTS 9698 P
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9840 TX EFF INORG LEAD COMPND 9841
Page 265 and 266:
99580 ADULT MALTREATMENT NOS 99581
Page 267 and 268:
9994 ANAPHYLACTIC SHOCK-SERUM 9995
Page 269 and 270:
E8147 MV COLL W PEDEST-PEDEST E8148
Page 271 and 272:
E8250 MV N-TRAFF ACC NEC-DRIV E8251
Page 273 and 274:
E8378 WATERCRAFT EXPL-PERS NEC E837
Page 275 and 276:
E8551 ACC POISN-CNS DEPRES NEC E855
Page 277 and 278:
E8714 POSTENDOSCOPY FORGN BODY E871
Page 279 and 280:
E893 CLOTHING FIRE ACCIDENT* E8930
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E9203 KNIFE/SWORD/DAGGER ACC E9204
Page 283 and 284:
E935 ADV EFF ANALGESICS* E9350 ADV
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E9473 ADV EFF ALCOHOL DETER E9474 A
Page 287 and 288:
E9682 ASSAULT-STRIKING W OBJ E9683
Page 289 and 290:
V0261 HEPATITIS B CARRIER V0262 HEP
Page 291 and 292:
V1062 HX OF MYELOID LEUKEMIA V1063
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V169 FAMILY HX-MALIGNANCY NOS V17 F
Page 295 and 296:
V291 NB OBSRV SUSPCT NEURLGCL V292
Page 297 and 298:
V440 TRACHEOSTOMY STATUS V441 GASTR
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V533 ADJUST CARDIAC PACEMAKER* V533
Page 301 and 302:
V6289 PSYCHOLOGICAL STRESS NEC V629
Page 303 and 304:
V738 SCREEN VRAL CHLM DIS NEC* V738
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Appendix Q International Classifica
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0405 GASSERIAN GANGLIONECTOMY 0406
Page 309 and 310:
0752 PINEAL GLAND INCISION 0753 PAR
Page 311 and 312:
098 NASO-LACRIMAL FISTULIZAT* 0981
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1274 CIL BODY DIMINUTION NOS 1279 G
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161 REMOVE PENETRAT FB EYE 162 ORBI
Page 317 and 318:
2098 IMP/REP MCHAN COCHL PROS 2099
Page 319 and 320:
2499 DENTAL OPERATION NEC 25 OPERAT
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2991 PHARYNGEAL DILATION 2992 DIVIS
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3423 CHEST WALL BIOPSY 3424 PLEURAL
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3631 OPEN CHEST TRANS REVASC 3632 O
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385 VARICOSE LIGAT & STRIP* 3850 VA
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406 THORACIC DUCT OPERATIONS* 4061
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4400 VAGOTOMY NOS 4401 TRUNCAL VAGO
Page 333 and 334:
4624 DELAY OPENING ILEOSTOMY 463 OT
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4939 OTHER DESTRUC ANUS LES 494 HEM
Page 337 and 338:
5196 PERC EXTRAC COM DUC CALC 5198
Page 339 and 340:
5495 PERITONEAL INCISION 5496 INJEC
Page 341 and 342:
5749 TU DESTRUC BLADD LES NEC 575 B
Page 343 and 344:
6091 PERCUT PROSTATIC ASPIRAT 6092
Page 345 and 346:
6525 OTH LAP LOC EXC DEST OVA 6529
Page 347 and 348:
686 RADICAL ABD HYSTERECTOMY 687 RA
Page 349 and 350:
7254 TOT BREECH EXTRAC NEC 726 FORC
Page 351 and 352:
7699 FACIAL BONE/JNT OP NEC 77 INCI
Page 353 and 354:
7802 BONE GRAFT TO HUMERUS 7803 BON
Page 355 and 356:
7909 CLOSED FX REDUCTION NEC 791 CL
Page 357 and 358:
8019 OTHER ARTHROTOMY NEC 802 ARTHR
Page 359 and 360:
8151 TOTAL HIP REPLACEMENT 8152 PAR
Page 361 and 362:
8339 EXC LES SOFT TISSUE NEC 834 OT
Page 363 and 364:
8541 UNILAT SIMPLE MASTECTOMY 8542
Page 365 and 366:
8729 SPINAL X-RAY NEC 873 THORAX SO
Page 367 and 368:
8862 CONTR PHLEBOGRAM-PULMON 8863 T
Page 369 and 370:
901 MICRO EXAM-ENDOCRINE* 9011 BACT
Page 371 and 372:
9151 BACT SMEAR-MUSCULOSKEL 9152 CU
Page 373 and 374:
934 SKELETAL & OTH TRACTION* 9341 S
Page 375 and 376:
9507 DARK ADAPTATION STUDY 9509 EYE
Page 377 and 378:
9723 REPLACE TRACH TUBE 9724 REPLAC
Page 379 and 380:
9927 IONTOPHORESIS 9928 IMMUNOTHERA
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Appendix R Diagnostic Related Group
Page 383 and 384:
104 MDC 05P CARDIAC VALVE & OTH MAJ
Page 385 and 386:
218 MDC 08P LOWER EXTREM & HUMER PR
Page 387 and 388:
332 MDC 11M OTHER KIDNEY & URINARY
Page 389 and 390:
446 MDC 21M TRAUMATIC INJURY AGE 0-
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Appendix S Alpha-Numeric HCPCS Code
Page 393 and 394:
A0425 GROUND MILEAGE, PER STATUTE M
Page 395 and 396:
A4356 EXTERNAL URETHRAL CLAMP OR CO
Page 397 and 398:
A4636 REPLACEMENT, HANDGRIP, CANE,
Page 399 and 400:
A6021 COLLAGEN DRESSING, PAD SIZE 1
Page 401 and 402:
EACH DRESSING A6259 TRANSPARENT FIL
Page 403 and 404:
HOMEMIX B4178 PARENTERAL NUTRITION
Page 405 and 406:
C1047 CATHETER, DIAGNOSTIC, NAVI-ST
Page 407 and 408:
C1134 PACEMAKER, DUAL CHAMBER, SIGM
Page 409 and 410:
SOMNOPLASTY COAGULATING ELECTRODE C
Page 411 and 412:
C1812 ANCHOR, OBL 2.0MM MINI TAC AC
Page 413 and 414:
C2104 CATHETER, ELECTROPHYSIOLOGY,
Page 415 and 416:
C4607 LEAD, PACEMAKER, FINELINE II
Page 417 and 418:
C5601 VASCULAR CLOSURE DEVICE, VASC
Page 419 and 420:
C8513 LEAD, NEUROSTIMULATION, PISCE
Page 421 and 422:
E0147 HEAVY DUTY, MULTIPLE BREAKING
Page 423 and 424:
E0424 STATIONARY COMPRESSED GASEOUS
Page 425 and 426:
E0757 IMPLANTABLE NEUROSTIMULATOR R
Page 427 and 428:
AWAY DETACHABLE FOOTRESTS E1100 SEM
Page 429 and 430:
E1635 COMPACT (PORTABLE) TRAVEL HEM
Page 431 and 432:
PATIENT'S CARE, INTEGRATION OF NEW
Page 433 and 434:
G0115 NETT PULM-REHAB; PSYCHOLOGICA
Page 435 and 436:
INVOLVED IN THE PATIENT’S CARE, I
Page 437 and 438:
J0200 INJECTION, ALATROFLOXACIN MES
Page 439 and 440:
J1364 INJECTION, ERYTHROMYCIN LACTO
Page 441 and 442:
J2512 INJECTION, PENTAGASTRIN, PER
Page 443 and 444:
J7320 HYLAN G-F 20, 16 MG, FOR INTR
Page 445 and 446:
J9000 DOXORUBICIN HCL, 10 MG J9001
Page 447 and 448:
K0034 HEEL LOOP,EACH K0035 HEEL LOO
Page 449 and 450:
K0171 ADMINISTRATION SET, SMALL VOL
Page 451 and 452:
K0462 TEMPORARY REPLACEMENT FOR PAT
Page 453 and 454:
L0340 TLSO, ANTERIOR-POSTERIOR-LATE
Page 455 and 456:
CUSTOM FABRICATED L1686 HIP ORTHOSI
Page 457 and 458:
CUSTOM-FABRICATED L2112 ANKLE FOOT
Page 459 and 460:
L2780 ADDITION TO LOWER EXTREMITY O
Page 461 and 462:
L3640 TRANSFER OF AN ORTHOSIS FROM
Page 463 and 464:
RECLINING, PREFABRICATED, INCLUDES
Page 465 and 466:
SYSTEM, PYLON, NO COVER, SACH FOOT,
Page 467 and 468:
L5697 ADDITION TO LOWER EXTREMITY,
Page 469 and 470:
L6100 BELOW ELBOW, MOLDED SOCKET, F
Page 471 and 472:
L6765 TERMINAL DEVICE, HOOK, DORRAN
Page 473 and 474:
L8020 BREAST PROSTHESIS, MASTECTOMY
Page 475 and 476:
P2029 CONGO RED, BLOOD P2031 HAIR A
Page 477 and 478:
Q0172 CHLORPROMAZINE HYDROCHLORIDE,
Page 479 and 480:
Q9936 INJECTION OF EPO, PER 1000 UN
Page 481 and 482:
S2371 EACH ADDITIONAL INTERSPACE (L
Page 483 and 484:
S9310 NURSING SERVICES AND ALL NECE
Page 485 and 486:
V2212 SPHEROCYLINDER, BIFOCAL, PLUS
Page 487:
V5130 BINAURAL, IN THE EAR V5140 BI
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Medicare Data Utilities Appendices

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