Medicare Data Utilities Appendices

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869 INTERNAL INJURY NOS* 8690 INTERNAL INJ NOS-CLOSED 8691 INTERNAL INJURY NOS-OPEN 870 OCULAR ADNEXA OPEN WOUND* 8700 LAC EYELID SKN/PERIOCULR 8701 FULL-THICKNES LAC EYELID 8702 LAC EYELID INV LACRM PAS 8703 PENETR WND ORBIT W/O FB 8704 PENETRAT WND ORBIT W FB 8708 OPN WND OCULAR ADNEX NEC 8709 OPN WND OCULAR ADNEX NOS 871 EYEBALL OPEN WOUND* 8710 OCULAR LAC W/O PROLAPSE 8711 OCULAR LACERA W PROLAPSE 8712 RUPTURE EYE W TISSU LOSS 8713 AVULSION OF EYE 8714 LACERATION OF EYE NOS 8715 PENETRAT MAGNET FB EYE 8716 PENETRAT FB NEC EYE 8717 OCULAR PENETRATION NOS 8719 OPN WOUND OF EYEBALL NOS 872 OPEN WOUND OF EAR* 8720 OPEN WOUND EXTERNAL EAR* 87200 OPN WOUND EXTERN EAR NOS 87201 OPEN WOUND OF AURICLE 87202 OPN WOUND AUDITORY CANAL 8721 OPEN WOUND EXT EAR-COMPL* 87210 OPN WND EX EAR NOS-COMPL 87211 OPEN WOUND AURICLE-COMPL 87212 OPEN WND AUD CANAL-COMPL 8726 OPEN WOUND OF EAR NEC* 87261 OPEN WOUND OF EAR DRUM 87262 OPEN WOUND OF OSSICLES 87263 OPEN WND EUSTACHIAN TUBE 87264 OPEN WOUND OF COCHLEA 87269 OPEN WOUND OF EAR NEC 8727 OPEN WOUND EAR NEC-COMPL* 87271 OPEN WND EAR DRUM-COMPL 87272 OPEN WND OSSICLES-COMPL 87273 OPN WND EUSTACH TB-COMPL 87274 OPEN WOUND COCHLEA-COMPL 87279 OPEN WOUND EAR NEC-COMPL 8728 OPEN WOUND OF EAR NOS 8729 OPEN WOUND EAR NOS-COMPL 873 OTHER OPEN WOUND OF HEAD* 8730 OPEN WOUND OF SCALP 8731 OPEN WOUND SCALP-COMPL 8732 OPEN WOUND OF NOSE* 87320 OPEN WOUND OF NOSE NOS 87321 OPEN WOUND NASAL SEPTUM 87322 OPEN WOUND NASAL CAVITY 87323 OPEN WOUND NASAL SINUS 87329 MULT OPEN WOUND NOSE 8733 OPEN WOUND NOSE-COMPL* 87330 OPEN WND NOSE NOS-COMPL 87331 OPN WND NAS SEPTUM-COMPL 87332 OPEN WND NASAL CAV-COMPL
87333 OPEN WND NAS SINUS-COMPL 87339 MULT OPEN WND NOSE-COMPL 8734 OPEN WOUND OF FACE* 87340 OPEN WOUND OF FACE NOS 87341 OPEN WOUND OF CHEEK 87342 OPEN WOUND OF FOREHEAD 87343 OPEN WOUND OF LIP 87344 OPEN WOUND OF JAW 87349 OPEN WOUND OF FACE NEC 8735 OPEN WOUND FACE-COMPL* 87350 OPEN WND FACE NOS-COMPL 87351 OPEN WOUND CHEEK-COMPL 87352 OPEN WND FOREHEAD-COMPL 87353 OPEN WOUND LIP-COMPLICAT 87354 OPEN WOUND JAW-COMPLICAT 87359 OPEN WND FACE NEC-COMPL 8736 OPN WOUND INTERNAL MOUTH* 87360 OPEN WOUND OF MOUTH NOS 87361 OPEN WOUND BUCCAL MUCOSA 87362 OPEN WOUND OF GUM 87363 BROKEN TOOTH 87364 OPN WND TONGUE/MOUTH FLR 87365 OPEN WOUND OF PALATE 87369 OPEN WOUND MOUTH NEC 8737 OPEN WND INT MOUTH-COMPL* 87370 OPEN WND MOUTH NOS-COMPL 87371 OPN WND BUC MUCOSA-COMPL 87372 OPEN WOUND GUM-COMPL 87373 BROKEN TOOTH-COMPLICATED 87374 OPEN WOUND TONGUE-COMPL 87375 OPEN WOUND PALATE-COMPL 87379 OPEN WND MOUTH NOS-COMPL 8738 OPEN WOUND OF HEAD NEC 8739 OPEN WND HEAD NEC-COMPL 874 OPEN WOUND OF NECK* 8740 OPN WOUND LARYNX/TRACHEA* 87400 OPN WND LARYNX W TRACHEA 87401 OPEN WOUND OF LARYNX 87402 OPEN WOUND OF TRACHEA 8741 OPN WND LARYN/TRACH-COMP* 87410 OPN WND LARY W TRAC-COMP 87411 OPEN WOUND LARYNX-COMPL 87412 OPEN WOUND TRACHEA-COMPL 8742 OPEN WOUND THYROID GLAND 8743 OPEN WOUND THYROID-COMPL 8744 OPEN WOUND OF PHARYNX 8745 OPEN WOUND PHARYNX-COMPL 8748 OPEN WOUND OF NECK NEC 8749 OPN WOUND NECK NEC-COMPL 875 OPEN WOUND OF CHEST* 8750 OPEN WOUND OF CHEST 8751 OPEN WOUND CHEST-COMPL 876 OPEN WOUND OF BACK* 8760 OPEN WOUND OF BACK 8761 OPEN WOUND BACK-COMPL 877 OPEN WOUND OF BUTTOCK* 8770 OPEN WOUND OF BUTTOCK
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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
Page 113 and 114:
37230 CONJUNCTIVITIS NOS 37231 ROSA
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3752 EPIPHORA* 37520 EPIPHORA NOS 3
Page 117 and 118:
37775 CORTICAL BLINDNESS 3779 OPTIC
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37953 VISUAL DEPRIVATN NYSTAGM 3795
Page 121 and 122:
38421 CENT PERF TYMPANIC MEMB 38422
Page 123 and 124:
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
Page 131 and 132:
4518 THROMBOPHLEBITIS NEC* 45181 IL
Page 133 and 134:
4741 T & A HYPERTROPHY* 47410 HYPER
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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
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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 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 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
Page 239: 86412 LIVER LACERAT, MINOR-OPN 8641
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
Page 285 and 286: 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
Page 293 and 294:
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
Page 305 and 306:
Appendix Q International Classifica
Page 307 and 308:
0405 GASSERIAN GANGLIONECTOMY 0406
Page 309 and 310:
0752 PINEAL GLAND INCISION 0753 PAR
Page 311 and 312:
098 NASO-LACRIMAL FISTULIZAT* 0981
Page 313 and 314:
1274 CIL BODY DIMINUTION NOS 1279 G
Page 315 and 316:
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
Page 321 and 322:
2991 PHARYNGEAL DILATION 2992 DIVIS
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3423 CHEST WALL BIOPSY 3424 PLEURAL
Page 325 and 326:
3631 OPEN CHEST TRANS REVASC 3632 O
Page 327 and 328:
385 VARICOSE LIGAT & STRIP* 3850 VA
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406 THORACIC DUCT OPERATIONS* 4061
Page 331 and 332:
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
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
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901 MICRO EXAM-ENDOCRINE* 9011 BACT
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9151 BACT SMEAR-MUSCULOSKEL 9152 CU
Page 373 and 374:
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
Page 379 and 380:
9927 IONTOPHORESIS 9928 IMMUNOTHERA
Page 381 and 382:
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
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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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