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	6	0	2
3	Primary or Other Diagnosis = Cancer, selected benign neoplasms	0	7	0	7
4	Primary Diagnosis = Diabetes	0	7	0	4
5	Other Diagnosis = Diabetes	1	0	0	0
6	Primary or Other Diagnosis = Dysphagia AND Primary or Other Diagnosis = Neuro 3 - Stroke	3	16	1	9
7	Primary or Other Diagnosis = Dysphagia AND M1030 (Therapy at home) = 3 (Enteral)	1	10	1	10
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	6	0	6
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	1	0
11	Primary or Other Diagnosis = Heart Disease OR Hypertension	1	0	0	0
12	Primary Diagnosis = Neuro 1 - Brain disorders and paralysis	3	11	6	11
13	Primary or Other Diagnosis = Neuro 1—Brain disorders and paralysis. AND M1840 (Toilet transfer) = 2 or more	0	2	0	2
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	7	1	6
15	Primary or Other Diagnosis = Neuro 3 - Stroke	3	9	2	7
16	Primary or Other Diagnosis = Neuro 3 - Stroke AND M1810 or M1820 (Dressing upper or lower body) = 1, 2, or 3	0	5	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 transferring) = 2 or more OR M1850 (Transferring) = 2 or more OR M1860 (Ambulation) = 4 or more	3	10	7	10
19	Primary or Other Diagnosis = Ortho 1 - Leg Disorders or Gait Abnormality AND M1324 (most problematic pressure ulcer stage) = 1, 2, 3 or 4	8	1	8	1
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	0
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	0
24	Primary or Other Diagnosis = Pulmonary disorders AND M1860 (Ambulation) = 1 or more	0	0	0	0
25	Primary Diagnosis = Skin 1 - Traumatic wounds, burns and post-operative complications	3	19	8	19
26	Other Diagnosis = Skin 1 - Traumatic wounds, burns and post-operative complications	6	16	8	13
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)	4	0	0	0
28	Primary or Other Diagnosis = Skin 2 - Ulcers and other skin conditions 	2	17	9	17
29	Primary or Other Diagnosis = Tracheostomy Care	3	17	3	17
30	Primary or Other Diagnosis = Urostomy/Cystostomy Care 	0	19	0	12
31	M1030 (Therapy at home) = 1 (IV/Infusion) or 2 (Parenteral)	0	17	6	17
32	M1030 (Therapy at home) = 3 (Enteral)	0	15	0	5
33	M1200 (Vision) = 1 or more	0	0	0	0
34	M1242 (Pain) = 3 or 4	2	0	1	0
35	M1308 = Two or more pressure ulcers at stage 3 or 4	5	5	5	14
36	M1324 (Most problematic pressure ulcer stage) = 1 or 2	4	19	7	17
37	M1324 (Most problematic pressure ulcer stage) = 3 or 4	8	33	11	27
38	M1334 (Stasis ulcer status) = 2	4	13	8	13
39	M1334 (Stasis ulcer status) = 3	7	17	10	17
40	M1342 (Surgical wound status) = 2	2	8	5	13
41	M1342 (Surgical wound status) = 3	1	7	5	8
42	M1400 (Dyspnea) = 2, 3, or 4	0	1	0	1
43	M1620 (Bowel Incontinence) = 2 to 5	0	4	0	4
44	M1630 (Ostomy) = 1 or 2	4	12	2	7
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	2	0	1	0
47	M1830 (Bathing) = 2 or more	6	2	5	0
48	M1840 (Toilet transferring) = 2 or more	1	4	1	1
49	M1850 (Transferring) = 2 or more	3	2	1	0
50	M1860 (Ambulation) = 1, 2, or 3	7	0	4	0
51	M1860 (Ambulation) = 4 or more	7	9	6	7
