Medicare Data Utilities Appendices

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8502 CONCUSSION-MODERATE COMA 8503 CONCUSSION-PROLONG COMA 8504 CONCUSSION-DEEP COMA 8505 CONCUSSION W COMA NOS 8509 CONCUSSION NOS 851 CEREBRAL LACER/CONTUSION* 8510 CORTEX CONTUSION* 85100 CEREBRAL CORTX CONTUSION 85101 CORTEX CONTUSION-NO COMA 85102 CORTEX CONTUS-BRIEF COMA 85103 CORTEX CONTUS-MOD COMA 85104 CORTX CONTUS-PROLNG COMA 85105 CORTEX CONTUS-DEEP COMA 85106 CORTEX CONTUS-COMA NOS 85109 CORTEX CONTUS-CONCUS NOS 8511 CORTEX CONTUSION/OPN WND* 85110 CORTEX CONTUSION/OPN WND 85111 OPN CORTX CONTUS-NO COMA 85112 OPN CORT CONTUS-BRF COMA 85113 OPN CORT CONTUS-MOD COMA 85114 OPN CORT CONTU-PROL COMA 85115 OPN CORT CONTU-DEEP COMA 85116 OPN CORT CONTUS-COMA NOS 85119 OPN CORTX CONTUS-CONCUSS 8512 CEREBRAL CORTEX LACERAT* 85120 CEREBRAL CORTEX LACERAT 85121 CORTEX LACERAT W/O COMA 85122 CORTEX LACERA-BRIEF COMA 85123 CORTEX LACERAT-MOD COMA 85124 CORTEX LACERAT-PROL COMA 85125 CORTEX LACERAT-DEEP COMA 85126 CORTEX LACERAT-COMA NOS 85129 CORTEX LACERAT-CONCUSS 8513 CORTEX LACER W OPN WOUND* 85130 CORTEX LACER W OPN WOUND 85131 OPN CORTEX LACER-NO COMA 85132 OPN CORTX LAC-BRIEF COMA 85133 OPN CORTX LACER-MOD COMA 85134 OPN CORTX LAC-PROLN COMA 85135 OPN CORTEX LAC-DEEP COMA 85136 OPN CORTX LACER-COMA NOS 85139 OPN CORTX LACER-CONCUSS 8514 CEREBEL/BRAIN STM CONTUS* 85140 CEREBEL/BRAIN STM CONTUS 85141 CEREBELL CONTUS W/O COMA 85142 CEREBELL CONTUS-BRF COMA 85143 CEREBELL CONTUS-MOD COMA 85144 CEREBEL CONTUS-PROL COMA 85145 CEREBEL CONTUS-DEEP COMA 85146 CEREBELL CONTUS-COMA NOS 85149 CEREBELL CONTUS-CONCUSS 8515 CEREBEL CONTUS W OPN WND* 85150 CEREBEL CONTUS W OPN WND 85151 OPN CEREBE CONT W/O COMA 85152 OPN CEREBE CONT-BRF COMA 85153 OPN CEREBE CONT-MOD COMA 85154 OPN CEREBE CONT-PROL COM
85155 OPN CEREBE CONT-DEEP COM 85156 OPN CEREBE CONT-COMA NOS 85159 OPN CEREBEL CONT-CONCUSS 8516 CEREBEL/BRAIN STEM LACER* 85160 CEREBEL/BRAIN STEM LACER 85161 CEREBEL LACERAT W/O COMA 85162 CEREBEL LACER-BRIEF COMA 85163 CEREBEL LACERAT-MOD COMA 85164 CEREBEL LACER-PROLN COMA 85165 CEREBELL LACER-DEEP COMA 85166 CEREBEL LACERAT-COMA NOS 85169 CEREBEL LACER-CONCUSSION 8517 CEREBEL LACER W OPEN WND* 85170 CEREBEL LACER W OPEN WND 85171 OPN CEREBEL LAC W/O COMA 85172 OPN CEREBEL LAC-BRF COMA 85173 OPN CEREBEL LAC-MOD COMA 85174 OPN CEREBE LAC-PROL COMA 85175 OPN CEREBE LAC-DEEP COMA 85176 OPN CEREBEL LAC-COMA NOS 85179 OPN CEREBELL LAC-CONCUSS 8518 CEREBRAL LACERATION NEC* 85180 BRAIN LACERATION NEC 85181 BRAIN LACER NEC W/O COMA 85182 BRAIN LAC NEC-BRIEF COMA 85183 BRAIN LACER NEC-MOD COMA 85184 BRAIN LAC NEC-PROLN COMA 85185 BRAIN LAC NEC-DEEP COMA 85186 BRAIN LACER NEC-COMA NOS 85189 BRAIN LACER NEC-CONCUSS 8519 BRAIN LAC NEC W OPEN WND* 85190 BRAIN LAC NEC W OPEN WND 85191 OPN BRAIN LACER W/O COMA 85192 OPN BRAIN LAC-BRIEF COMA 85193 OPN BRAIN LACER-MOD COMA 85194 OPN BRAIN LAC-PROLN COMA 85195 OPEN BRAIN LAC-DEEP COMA 85196 OPN BRAIN LACER-COMA NOS 85199 OPEN BRAIN LACER-CONCUSS 852 MENINGEAL HEM FOLLOW INJ* 8520 TRAUM SUBARACHNOID HEM* 85200 TRAUM SUBARACHNOID HEM 85201 SUBARACHNOID HEM-NO COMA 85202 SUBARACH HEM-BRIEF COMA 85203 SUBARACH HEM-MOD COMA 85204 SUBARACH HEM-PROLNG COMA 85205 SUBARACH HEM-DEEP COMA 85206 SUBARACH HEM-COMA NOS 85209 SUBARACH HEM-CONCUSSION 8521 SUBARACH HEM W OPN WOUND* 85210 SUBARACH HEM W OPN WOUND 85211 OPN SUBARACH HEM-NO COMA 85212 OP SUBARACH HEM-BRF COMA 85213 OP SUBARACH HEM-MOD COMA 85214 OP SUBARACH HEM-PROL COM 85215 OP SUBARACH HEM-DEEP COM 85216 OP SUBARACH HEM-COMA NOS
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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
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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
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04181 MYCOPLASMA 04182 BACILLUS FRA
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05579 MEASLES COMPLICATION NEC 0558
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0771 EPIDEM KERATOCONJUNCTIV 0772 P
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0907 LATE CONGEN SYPH NOS 0909 CONG
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09889 GONOCOCCAL INF SITE NEC 099 O
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1160 BLASTOMYCOSIS 1161 PARACOCCIDI
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1330 SCABIES 1338 ACARIASIS NEC 133
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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
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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
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2469 DISORDER OF THYROID NOS 250 DI
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2592 CARCINOID SYNDROME 2593 ECTOPI
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2766 FLUID OVERLOAD 2767 HYPERPOTAS
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2882 GENETIC ANOMALY LEUKOCYT 2883
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29552 LATENT SCHIZOPHREN-CHR 29553
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2990 INFANTILE AUTISM* 29900 INFANT
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30403 OPIOID DEPENDENCE-REMISS 3041
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30721 TRANSIENT TIC, CHILDHOOD 3072
Page 97 and 98:
3150 SPECIFIC READING DIS* 31500 RE
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33510 SPINAL MUSCL ATROPHY NOS 3351
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34600 CLSC MIGRNE WO NTRC MGRN 3460
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3594 TOXIC MYOPATHY 3595 MYOPATHY I
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3625 DEGENERATION OF MACULA* 36250
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36459 IRIS ATROPHY NEC 3646 ANTERIO
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36731 ANISOMETROPIA 36732 ANISEIKON
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37005 MYCOTIC CORNEAL ULCER 37006 P
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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
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41020 AMI INFEROLATERAL,UNSPEC 4102
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426 CONDUCTION DISORDERS* 4260 ATRI
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438 LATE EFF CEREBROVASC DIS* 4380
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4518 THROMBOPHLEBITIS NEC* 45181 IL
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4741 T & A HYPERTROPHY* 47410 HYPER
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4951 BAGASSOSIS 4952 BIRD-FANCIERS'
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5226 CHR APICAL PERIODONTITIS 5227
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53089 OTHER DSRDERS ESOPHAGUS 5309
Page 141 and 142:
535 GASTRITIS AND DUODENITIS* 5350
Page 143 and 144:
5539 HERNIA NOS 555 REGIONAL ENTERI
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572 SEQUELA OF CHR LIVER DIS* 5720
Page 147 and 148:
5838 NEPHRITIS NOS W OTH LES* 58381
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5997 HEMATURIA 5998 URINARY TRACT D
Page 151 and 152:
6168 FEMALE GEN INFLAM NEC 6169 FEM
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6281 INFERTIL-PITUITARY ORIG 6282 I
Page 155 and 156:
63622 ILLEG AB W PEL DAMG-COMP 6363
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64120 PREM SEPAR PLACEN-UNSPEC 6412
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64613 EDEMA IN PREG-ANTEPARTUM 6461
Page 161 and 162:
64821 ANEMIA-DELIVERED 64822 ANEMIA
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65270 PROLAPSED ARM-UNSPEC 65271 PR
Page 165 and 166:
65501 FETAL CNS MALFORM-DELIV 65503
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65901 FAIL MECH INDUCT-DELIVER 6590
Page 169 and 170:
66221 PROLONG 2ND STAGE-DELIV 66223
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66584 OB TRAUMA NEC-POSTPARTUM 6659
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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 and 188: 71830 RECUR DISLOCAT-UNSPEC 71831 R
Page 189 and 190: 71951 JT STIFFNESS NEC-SHLDER 71952
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: 84213 SPRAIN INTERPHALANGEAL 84219
Page 237 and 238: 8540 BRAIN INJURY NEC* 85400 BRAIN
Page 239 and 240: 86412 LIVER LACERAT, MINOR-OPN 8641
Page 241 and 242: 87333 OPEN WND NAS SINUS-COMPL 8733
Page 243 and 244: 8821 OPN WOUND HAND-COMPLICAT 8822
Page 245 and 246: 90242 INJURY RENAL VEIN 90249 INJUR
Page 247 and 248: 9117 FOREIGN BODY TRUNK-INFEC 9118
Page 249 and 250: 92320 CONTUSION OF HAND(S) 92321 CO
Page 251 and 252: 94111 1ST DEG BURN EAR 94112 1ST DE
Page 253 and 254: 94311 1ST DEG BURN FOREARM 94312 1S
Page 255 and 256: 9451 1ST DEGREE BURN LEG* 94510 1ST
Page 257 and 258: 94888 80-89% BDY BRN/80-89% 3D 9489
Page 259 and 260: 9590 FACE AND NECK INJURY NOS* 9590
Page 261 and 262: 9697 POISON-PSYCHOSTIMULANTS 9698 P
Page 263 and 264: 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
Page 281 and 282: 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
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V0261 HEPATITIS B CARRIER V0262 HEP
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V1062 HX OF MYELOID LEUKEMIA V1063
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V169 FAMILY HX-MALIGNANCY NOS V17 F
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V291 NB OBSRV SUSPCT NEURLGCL V292
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V440 TRACHEOSTOMY STATUS V441 GASTR
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V533 ADJUST CARDIAC PACEMAKER* V533
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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
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0752 PINEAL GLAND INCISION 0753 PAR
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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
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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
Page 335 and 336:
4939 OTHER DESTRUC ANUS LES 494 HEM
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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
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8339 EXC LES SOFT TISSUE NEC 834 OT
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8541 UNILAT SIMPLE MASTECTOMY 8542
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8729 SPINAL X-RAY NEC 873 THORAX SO
Page 367 and 368:
8862 CONTR PHLEBOGRAM-PULMON 8863 T
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901 MICRO EXAM-ENDOCRINE* 9011 BACT
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9151 BACT SMEAR-MUSCULOSKEL 9152 CU
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934 SKELETAL & OTH TRACTION* 9341 S
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9507 DARK ADAPTATION STUDY 9509 EYE
Page 377 and 378:
9723 REPLACE TRACH TUBE 9724 REPLAC
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9927 IONTOPHORESIS 9928 IMMUNOTHERA
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Appendix R Diagnostic Related Group
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104 MDC 05P CARDIAC VALVE & OTH MAJ
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218 MDC 08P LOWER EXTREM & HUMER PR
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332 MDC 11M OTHER KIDNEY & URINARY
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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,
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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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