Medicare Data Utilities Appendices

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1171 KERATOMILEUSIS 1172 KERATOPHAKIA 1173 KERATOPROSTHESIS 1174 THERMOKERATOPLASTY 1175 RADIAL KERATOTOMY 1176 EPIKERATOPHAKIA 1179 CORNEA RECONSTRUCT NEC 119 OTHER CORNEAL OPERATIONS* 1191 CORNEAL TATTOOING 1192 REMOVE CORNEAL IMPLANT 1199 CORNEAL OPERATION NEC 12 ANTERIOR SEGMENT OPS* 120 REMOV INTRAOC FB ANT SEG* 1200 REMOV ANT SEGMNT FB NOS 1201 MAGNET REMOV ANT SEG FB 1202 NONMAG REMOV ANT SEG FB 121 IRIDOTOMY/SIMPLE IRIDECT* 1211 IRIDOTOMY W TRANSFIXION 1212 IRIDOTOMY NEC 1213 PROLAPSED IRIS EXCISION 1214 IRIDECTOMY NEC 122 ANTERIOR SEGMENT DX PROC* 1221 DX ASPIRAT-ANT CHAMBER 1222 IRIS BIOPSY 1229 ANT SEGMENT DX PROC NEC 123 IRIDOPLASTY/COREOPLASTY* 1231 GONIOSYNECHIAE LYSIS 1232 ANT SYNECHIA LYSIS NEC 1233 POST SYNECHIAE LYSIS 1234 CORNEOVITREAL ADHESIOLYS 1235 COREOPLASTY 1239 IRIDOPLASTY NEC 124 DESTR IRIS/CIL BODY LES* 1240 REMOV ANT SEGMNT LES NOS 1241 NONEXC DESTRUC IRIS LES 1242 EXCISION OF IRIS LESION 1243 NONEXC DESTR CIL BOD LES 1244 EXCISE CILIARY BODY LES 125 INTRAOCUL CIRC FACILITAT* 1251 GONIOPUNCTURE 1252 GONIOTOMY 1253 GONIOTOMY W GONIOPUNCTUR 1254 TRABECULOTOMY AB EXTERNO 1255 CYCLODIALYSIS 1259 FACILIT INTRAOC CIRC NEC 126 SCLERAL FISTULIZATION* 1261 TREPHIN SCLERA W IRIDECT 1262 THERMCAUT SCLER W IRIDEC 1263 IRIDENCLEISIS/IRIDOTASIS 1264 TRABECULECTOM AB EXTERNO 1265 SCLER FISTULIZ W IRIDECT 1266 POSTOP REVIS SCL FISTUL 1269 SCLER FISTULIZING OP NEC 127 HI INTR-OC PRESS RELIEF* 1271 CYCLODIATHERMY 1272 CYCLOCRYOTHERAPY 1273 CYCLOPHOTOCOAGULATION
1274 CIL BODY DIMINUTION NOS 1279 GLAUCOMA PROCEDURE NEC 128 OPERATIONS ON SCLERA* 1281 SUTURE SCLERAL LACER 1282 SCLERAL FISTULA REPAIR 1283 REVIS ANT SEG OP WND NEC 1284 DESTRUCT SCLERAL LESION 1285 REPAIR STAPHYLOM W GRAFT 1286 REP SCLER STAPHYLOMA NEC 1287 GRAFT REINFORCE SCLERA 1288 SCLERA REINFORCEMENT NEC 1289 SCLERAL OPERATION NEC 129 OTH ANTERIOR SEGMENT OPS* 1291 THERAPEUT EVAC ANT CHAMB 1292 ANTERIOR CHAMBER INJECT 1293 REMOV EPITHEL DOWNGROWTH 1297 IRIS OPERATION NEC 1298 CILIARY BODY OP NEC 1299 ANTERIOR CHAMBER OP NEC 13 OPERATIONS ON LENS* 130 REMOVE FB FROM LENS* 1300 REMOVE FB LENS NOS 1301 MAGNET REMOVE FB LENS 1302 NONMAGNET REMOVE FB LENS 131 INTRACAPSUL LENS EXTRAC* 1311 TEMP-INF INTRCAP LENS EX 1319 INTRACAPSUL LENS EXT NEC 132 LINEAR EXTRACAP LENS EXT 133 SIMPL ASPIR LENS EXTRACT 134 FRAG-ASP XTRACAP LENS EX* 1341 CATARAC PHACOEMULS/ASPIR 1342 POST CATARAC FRAG/ASPIR 1343 CATARACT FRAG/ASPIR NEC 135 EXTRACAPS LENS EXTR NEC* 1351 TEMP-INF XTRACAP LENS EX 1359 EXTRACAP LENS EXTRAC NEC 136 OTH CATARACT EXTRACTION* 1364 AFTER-CATAR DISCISSION 1365 AFTER-CATARACT EXCISION 1366 AFTER CATAR FRAGMNTATION 1369 CATARACT EXTRACTION NEC 137 INSERT PROSTHETIC LENS* 1370 INSERT PSEUDOPHAKOS NOS 1371 INSERT LENS AT CATAR EXT 1372 SECONDARY INSERT LENS 138 IMPLANTED LENS REMOVAL 139 OTHER OPERATIONS ON LENS 14 POSTERIOR SEGMENT OPS* 140 REMOVE POST SEGMENT FB* 1400 REMOV POST SEGMNT FB NOS 1401 MAGNET REMOV POST SEG FB 1402 NONMAG REMOV POST SEG FB 141 POSTERIOR SEG DIAGNOS OP* 1411 DIAGNOST VITREOUS ASPIR 1419 DX PROC POST SEG NEC 142 RETINA-CHOR LES DESTRUCT* 1421 CHORIORET LES DIATHERMY
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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
Page 43 and 44:
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
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04181 MYCOPLASMA 04182 BACILLUS FRA
Page 53 and 54:
05579 MEASLES COMPLICATION NEC 0558
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0771 EPIDEM KERATOCONJUNCTIV 0772 P
Page 57 and 58:
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
Page 95 and 96:
30721 TRANSIENT TIC, CHILDHOOD 3072
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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
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5539 HERNIA NOS 555 REGIONAL ENTERI
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572 SEQUELA OF CHR LIVER DIS* 5720
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5838 NEPHRITIS NOS W OTH LES* 58381
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5997 HEMATURIA 5998 URINARY TRACT D
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6168 FEMALE GEN INFLAM NEC 6169 FEM
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6281 INFERTIL-PITUITARY ORIG 6282 I
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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
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64821 ANEMIA-DELIVERED 64822 ANEMIA
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65270 PROLAPSED ARM-UNSPEC 65271 PR
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65501 FETAL CNS MALFORM-DELIV 65503
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65901 FAIL MECH INDUCT-DELIVER 6590
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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
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67494 PUERP COMPL NOS-POSTPART 675
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6825 CELLULITIS OF BUTTOCK 6826 CEL
Page 179 and 180:
7038 DISEASES OF NAIL NEC 7039 DISE
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71145 BACT ARTHRITIS-PELVIS 71146 B
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71298 CRY ARTHROP NOS-OTH SITE 7129
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71635 CLIMACT ARTHRITIS-PELVIS 7163
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71830 RECUR DISLOCAT-UNSPEC 71831 R
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71951 JT STIFFNESS NEC-SHLDER 71952
Page 191 and 192:
724 BACK DISORDER NEC & NOS* 7240 S
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72886 NECROTIZING FASCIITIS 72889 M
Page 195 and 196:
7330 OSTEOPOROSIS* 73300 OSTEOPOROS
Page 197 and 198:
7379 CURVATURE OF SPINE NOS 738 OTH
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74405 ANOMALIES OF INNER EAR 74409
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74904 BILAT CLEFT PALATE-INC 7491 C
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75433 CONG HIP SUBLUX, BILAT 75435
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75681 ABSENCE OF MUSCLE/TENDON 7568
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7641 LT-FOR-DATES W FETAL MAL* 7641
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7732 NB HEMOLYT DIS-ISOIM NEC 7733
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7826 PALLOR & FLUSHING* 78261 PALLO
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78900 ABDMNAL PAIN UNSPCF SITE 7890
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7951 ABN PAP SMEAR-OTH SITE 7952 AB
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80090 OP SKL VLT FX/BR INJ NEC 8009
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80230 MANDIBLE FX NOS-OPEN 80231 FX
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80405 CL SKUL/OTH FX-DEEP COMA 8040
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8060 CLOS CERV FX W CORD INJ* 80600
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81011 FX CLAVIC, STERN END-OPN 8101
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8141 FRACTURE CARPAL BONE-OPN* 8141
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82391 FX FIBULA NOS-OPEN 82392 FX T
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836 DISLOCATION OF KNEE* 8360 TEAR
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84213 SPRAIN INTERPHALANGEAL 84219
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85155 OPN CEREBE CONT-DEEP COM 8515
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8540 BRAIN INJURY NEC* 85400 BRAIN
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86412 LIVER LACERAT, MINOR-OPN 8641
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87333 OPEN WND NAS SINUS-COMPL 8733
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8821 OPN WOUND HAND-COMPLICAT 8822
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90242 INJURY RENAL VEIN 90249 INJUR
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9117 FOREIGN BODY TRUNK-INFEC 9118
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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
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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
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
Page 299 and 300: 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: 098 NASO-LACRIMAL FISTULIZAT* 0981
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
Page 323 and 324: 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
Page 329 and 330: 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
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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
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9927 IONTOPHORESIS 9928 IMMUNOTHERA
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Appendix R Diagnostic Related Group
Page 383 and 384:
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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Medicare Data Utilities Appendices

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