ID	Description	Equation1	Equation2	Equation3	Equation4
1	Primary or Other Diagnosis = Blindness/Low Vision	0	0	0	0
2	Primary or Other Diagnosis = Blood disorders	0	2	0	0
3	Primary or Other Diagnosis = Cancer, selected benign neoplasms	0	5	0	5
4	Primary Diagnosis = Diabetes	0	4	0	2
5	Other Diagnosis = Diabetes	1	0	0	0
6	Primary or Other Diagnosis = Dysphagia AND Primary or Other Diagnosis = Neuro 3 – Stroke	2	18	2	12
7	Primary or Other Diagnosis = Dysphagia AND M1030 (Therapy at home) = 3 (Enteral)	2	6	0	6
8	Primary or Other Diagnosis = Gastrointestinal disorders	0	0	0	0
9	Primary or Other Diagnosis = Gastrointestinal disorders AND M1630 (ostomy)= 1 or 2	0	7	0	0
10	Primary or Other Diagnosis = Gastrointestinal disorders AND Primary or Other Diagnosis = Neuro 1 - Brain disorders and paralysis, OR Neuro 2 - Peripheral neurological disorders, OR Neuro 3 - Stroke, OR Neuro 4 - Multiple Sclerosis	0	0	0	0
11	Primary or Other Diagnosis = Heart Disease OR Hypertension	1	2	0	2
12	Primary Diagnosis = Neuro 1 - Brain disorders and paralysis	2	12	7	12
13	Primary or Other Diagnosis = Neuro 1 - Brain disorders and paralysis AND M1840 (Toilet transfer) = 2 or more	0	3	0	3
14	Primary or Other Diagnosis = Neuro 1 - Brain disorders and paralysis OR Neuro 2 - Peripheral neurological disorders AND M1810 or M1820 (Dressing upper or lower body)= 1, 2, or 3	2	3	1	3
15	Primary or Other Diagnosis = Neuro 3 - Stroke	3	12	2	5
16	Primary or Other Diagnosis = Neuro 3 - Stroke AND M1810 or M1820 (Dressing upper or lower body)= 1, 2, or 3	0	0	0	0
17	Primary or Other Diagnosis = Neuro 3 - Stroke AND M1860 (Ambulation) = 4 or more	0	0	0	0
18	Primary or Other Diagnosis = Neuro 4 - Multiple Sclerosis AND AT LEAST ONE OF THE FOLLOWING: M1830 (Bathing) = 2 or more OR M1840 (Toilet transfer) = 2 or more OR M1850 (Transferring) = 2 or more OR M1860 (Ambulation) = 4  or more	3	7	6	11
19	Primary or Other Diagnosis = Ortho 1 - Leg Disorders or Gait Disorders AND M1324 (most problematic pressure ulcer stage)= 1, 2, 3 or 4	8	1	7	0
20	Primary or Other Diagnosis = Ortho 1 - Leg OR Ortho 2 - Other orthopedic disorders AND M1030 (Therapy at home) = 1 (IV/Infusion) or 2 (Parenteral)	3	0	3	4
21	Primary or Other Diagnosis = Psych 1 – Affective and other psychoses, depression	0	0	0	0
22	Primary or Other Diagnosis = Psych 2 - Degenerative and other organic psychiatric disorders	0	0	0	0
23	Primary or Other Diagnosis = Pulmonary disorders	0	0	0	1
24	Primary or Other Diagnosis = Pulmonary disorders AND M1860 (Ambulation) = 1 or more	0	1	0	0
25	Primary Diagnosis = Skin 1 - Traumatic wounds, burns and post-operative complications	4	20	7	18
26	Other Diagnosis = Skin 1 - Traumatic wounds, burns and post-operative complications	7	15	8	15
27	Primary or Other Diagnosis = Skin 1 -Traumatic wounds, burns, and post-operative complications OR Skin 2 – Ulcers and other skin conditions AND M1030 (Therapy at home) = 1 (IV/Infusion) or 2 (Parenteral)	3	0	0	0
28	Primary or Other Diagnosis = Skin 2 - Ulcers and other skin conditions	2	17	8	17
29	Primary or Other Diagnosis = Tracheostomy	4	17	4	17
30	Primary or Other Diagnosis = Urostomy/Cystostomy	0	18	0	13
31	M1030 (Therapy at home) = 1 (IV/Infusion) or 2 (Parenteral)	0	17	6	17
32	M1030 (Therapy at home) = 3 (Enteral)	0	16	0	9
33	M1200 (Vision) = 1 or more	0	0	0	0
34	M1242 (Pain)= 3 or 4	3	0	2	0
35	M1311 = Two or more pressure ulcers at stage 3 or 4	5	10	5	10
36	M1324 (Most problematic pressure ulcer stage)= 1 or 2	4	19	7	16
37	M1324 (Most problematic pressure ulcer stage)= 3 or 4	9	32	11	26
38	M1334 (Stasis ulcer status)= 2	4	15	8	15
39	M1334 (Stasis ulcer status)= 3	7	17	10	17
40	M1342 (Surgical wound status)= 2	2	7	5	11
41	M1342 (Surgical wound status)= 3	0	6	4	9
42	M1400 (Dyspnea) = 2, 3, or 4	0	0	0	0
43	M1620 (Bowel Incontinence) = 2 to 5	0	4	0	3
44	M1630 (Ostomy)= 1 or 2	4	12	2	8
45	M2030 (Injectable Drug Use) = 0, 1, 2, or 3	0	0	0	0
46	M1810 or M1820 (Dressing upper or lower body)= 1, 2, or 3	1	0	1	0
47	M1830 (Bathing) = 2 or more	6	5	5	2
48	M1840 (Toilet transferring) = 2 or more	1	2	0	0
49	M1850 (Transferring) = 2 or more	3	1	2	0
50	M1860 (Ambulation) = 1, 2 or 3	7	0	4	0
51	M1860 (Ambulation) = 4 or more	8	9	6	8
