ICD-10-CM/PCS MS-DRG v44.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v44.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 12 of 75 |
| A000 B309 C673 C8441 D220 E0901 E133541 F16280 G809 H18043 H44659 H9554 I673 J1282 K51211 L282 L98A229 M13179 M2650 M62229 M80851P M84673P M929 N99524 O3100X3 O360995 O43892 P0489 Q6680 R928 S0242XD S06369A S12230G S20302D S23163D S31041S S32409G S35404S S40822A S42322P S43491D S50911D S52231N S52363P S53106A S59029A S61151D S62173S S62523D S63255S S65999S S70311S S72059B S72142K S72366J S73122A S81021D S82146S S82431R S82872Q S86219S S91103S S92226D S93325A S99142B T2220XS T24119A T362X2D T420X1A T465X3S T523X1A T63463S T81501D T8482XS Z5301 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| H9554 | 21 | 919-921 | I4891 | 05 | 308-310 | I63231 | 01 | 023-024 | ||
| H95811 | 21 | 919-921 | I4891 | 15 | 791 | I63231 | 01 | 061-063 | ||
| H95812 | 21 | 919-921 | I4891 | 15 | 793 | I63231 | 01 | 064-066 | ||
| H95813 | 21 | 919-921 | I4892 | 05 | 308-310 | I63231 | 15 | 791 | ||
| H95819 | 21 | 919-921 | I4892 | 15 | 791 | I63231 | 15 | 793 | ||
| H9588 | 21 | 919-921 | I4892 | 15 | 793 | I63232 | 01 | 023-024 | ||
| H9589 | 21 | 919-921 | I4901 | 05 | 308-310 | I63232 | 01 | 061-063 | ||
| I00 | 08 | 545-547 | I4901 | 15 | 791 | I63232 | 01 | 064-066 | ||
| I010 | 05 | 314-316 | I4901 | 15 | 793 | I63232 | 15 | 791 | ||
| I011 | 05 | 306-307 | I4902 | 05 | 308-310 | I63232 | 15 | 793 | ||
| I012 | 05 | 314-316 | I4902 | 15 | 791 | I63233 | 01 | 023-024 | ||
| I018 | 05 | 314-316 | I4902 | 15 | 793 | I63233 | 01 | 061-063 | ||
| I019 | 05 | 314-316 | I491 | 05 | 308-310 | I63233 | 01 | 064-066 | ||
| I020 | 05 | 314-316 | I492 | 05 | 308-310 | I63233 | 15 | 791 | ||
| I029 | 05 | 314-316 | I493 | 05 | 308-310 | I63233 | 15 | 793 | ||
| I050 | 05 | 306-307 | I4940 | 05 | 308-310 | I63239 | 01 | 023-024 | ||
| I051 | 05 | 306-307 | I4949 | 05 | 308-310 | I63239 | 01 | 061-063 | ||
| I052 | 05 | 306-307 | I495 | 05 | 308-310 | I63239 | 01 | 064-066 | ||
| I058 | 05 | 306-307 | I4981 | 05 | 308-310 | I63239 | 15 | 791 | ||
| I059 | 05 | 306-307 | I4982 | 05 | 308-310 | I63239 | 15 | 793 | ||
| I060 | 05 | 306-307 | I4989 | 05 | 308-310 | I6329 | 01 | 023-024 | ||
| I061 | 05 | 306-307 | I499 | 05 | 308-310 | I6329 | 01 | 061-063 | ||
| I062 | 05 | 306-307 | I501 | 05 | 291-293 | I6329 | 01 | 064-066 | ||
| I068 | 05 | 306-307 | I501 | 15 | 791 | I6329 | 15 | 791 | ||
| I069 | 05 | 306-307 | I501 | 15 | 793 | I6329 | 15 | 793 | ||
| I070 | 05 | 306-307 | I5020 | 05 | 291-293 | I6330 | 01 | 023-024 | ||
| I071 | 05 | 306-307 | I5020 | 15 | 791 | I6330 | 01 | 061-063 | ||
| I072 | 05 | 306-307 | I5020 | 15 | 793 | I6330 | 01 | 064-066 | ||
| I078 | 05 | 306-307 | I5021 | 05 | 291-293 | I6330 | 15 | 791 | ||
| I079 | 05 | 306-307 | I5021 | 15 | 791 | I6330 | 15 | 793 | ||
| I080 | 05 | 306-307 | I5021 | 15 | 793 | I63311 | 01 | 023-024 | ||
| I081 | 05 | 306-307 | I5022 | 05 | 291-293 | I63311 | 01 | 061-063 | ||
| I082 | 05 | 306-307 | I5022 | 15 | 791 | I63311 | 01 | 064-066 | ||
| I083 | 05 | 306-307 | I5022 | 15 | 793 | I63311 | 15 | 791 | ||
| I088 | 05 | 306-307 | I5023 | 05 | 291-293 | I63311 | 15 | 793 | ||
| I089 | 05 | 306-307 | I5023 | 15 | 791 | I63312 | 01 | 023-024 | ||
| I090 | 05 | 314-316 | I5023 | 15 | 793 | I63312 | 01 | 061-063 | ||
| I091 | 05 | 306-307 | I5030 | 05 | 291-293 | I63312 | 01 | 064-066 | ||
| I092 | 05 | 314-316 | I5030 | 15 | 791 | I63312 | 15 | 791 | ||
| I0981 | 05 | 291-293 | I5030 | 15 | 793 | I63312 | 15 | 793 | ||
| I0981 | 15 | 791 | I5031 | 05 | 291-293 | I63313 | 01 | 023-024 | ||
| I0981 | 15 | 793 | I5031 | 15 | 791 | I63313 | 01 | 061-063 | ||
| I0989 | 05 | 306-307 | I5031 | 15 | 793 | I63313 | 01 | 064-066 | ||
| I099 | 05 | 314-316 | I5032 | 05 | 291-293 | I63313 | 15 | 791 | ||
| I10 | 05 | 304-305 | I5032 | 15 | 791 | I63313 | 15 | 793 | ||
| I110 | 05 | 291-293 | I5032 | 15 | 793 | I63319 | 01 | 023-024 | ||
| I110 | 15 | 791 | I5033 | 05 | 291-293 | I63319 | 01 | 061-063 | ||
| I110 | 15 | 793 | I5033 | 15 | 791 | I63319 | 01 | 064-066 | ||
| I119 | 05 | 304-305 | I5033 | 15 | 793 | I63319 | 15 | 791 | ||
| I120 | Pre | 008 | I5040 | 05 | 291-293 | I63319 | 15 | 793 | ||
| I120 | Pre | 019 | I5040 | 15 | 791 | I63321 | 01 | 023-024 | ||
| I120 | 11 | 673-675 | I5040 | 15 | 793 | I63321 | 01 | 061-063 | ||
| I120 | 11 | 682-684 | I5041 | 05 | 291-293 | I63321 | 01 | 064-066 | ||
| I129 | 11 | 682-684 | I5041 | 15 | 791 | I63321 | 15 | 791 | ||
| I130 | 05 | 291-293 | I5041 | 15 | 793 | I63321 | 15 | 793 | ||
| I130 | 15 | 791 | I5042 | 05 | 291-293 | I63322 | 01 | 023-024 | ||
| I130 | 15 | 793 | I5042 | 15 | 791 | I63322 | 01 | 061-063 | ||
| I1310 | 11 | 682-684 | I5042 | 15 | 793 | I63322 | 01 | 064-066 | ||
| I1311 | Pre | 008 | I5043 | 05 | 291-293 | I63322 | 15 | 791 | ||
| I1311 | Pre | 019 | I5043 | 15 | 791 | I63322 | 15 | 793 | ||
| I1311 | 11 | 673-675 | I5043 | 15 | 793 | I63323 | 01 | 023-024 | ||
| I1311 | 11 | 682-684 | I50810 | 05 | 291-293 | I63323 | 01 | 061-063 | ||
| I132 | Pre | 008 | I50810 | 15 | 791 | I63323 | 01 | 064-066 | ||
| I132 | Pre | 019 | I50810 | 15 | 793 | I63323 | 15 | 791 | ||
| I132 | 05 | 291-293 | I50811 | 05 | 291-293 | I63323 | 15 | 793 | ||
| I132 | 15 | 791 | I50811 | 15 | 791 | I63329 | 01 | 023-024 | ||
| I132 | 15 | 793 | I50811 | 15 | 793 | I63329 | 01 | 061-063 | ||
| I150 | 05 | 304-305 | I50812 | 05 | 291-293 | I63329 | 01 | 064-066 | ||
| I151 | 05 | 304-305 | I50812 | 15 | 791 | I63329 | 15 | 791 | ||
| I152 | 05 | 304-305 | I50812 | 15 | 793 | I63329 | 15 | 793 | ||
| I158 | 05 | 304-305 | I50813 | 05 | 291-293 | I63331 | 01 | 023-024 | ||
| I159 | 05 | 304-305 | I50813 | 15 | 791 | I63331 | 01 | 061-063 | ||
| I160 | 05 | 304-305 | I50813 | 15 | 793 | I63331 | 01 | 064-066 | ||
| I161 | 05 | 304-305 | I50814 | 05 | 291-293 | I63331 | 15 | 791 | ||
| I169 | 05 | 304-305 | I50814 | 15 | 791 | I63331 | 15 | 793 | ||
| I1A0 | 05 | 304-305 | I50814 | 15 | 793 | I63332 | 01 | 023-024 | ||
| I200 | 05 | 311 | I5082 | 05 | 291-293 | I63332 | 01 | 061-063 | ||
| I201 | 05 | 311 | I5082 | 15 | 791 | I63332 | 01 | 064-066 | ||
| I202 | 05 | 311 | I5082 | 15 | 793 | I63332 | 15 | 791 | ||
| I2081 | 05 | 311 | I5083 | 05 | 291-293 | I63332 | 15 | 793 | ||
| I2089 | 05 | 311 | I5083 | 15 | 791 | I63333 | 01 | 023-024 | ||
| I209 | 05 | 311 | I5083 | 15 | 793 | I63333 | 01 | 061-063 | ||
| I2101 | 05 | 280-285 | I5084 | 05 | 291-293 | I63333 | 01 | 064-066 | ||
| I2102 | 05 | 280-285 | I5084 | 15 | 791 | I63333 | 15 | 791 | ||
| I2109 | 05 | 280-285 | I5084 | 15 | 793 | I63333 | 15 | 793 | ||
| I2111 | 05 | 280-285 | I5089 | 05 | 291-293 | I63339 | 01 | 023-024 | ||
| I2119 | 05 | 280-285 | I5089 | 15 | 791 | I63339 | 01 | 061-063 | ||
| I2121 | 05 | 280-285 | I5089 | 15 | 793 | I63339 | 01 | 064-066 | ||
| I2129 | 05 | 280-285 | I509 | 05 | 291-293 | I63339 | 15 | 791 | ||
| I213 | 05 | 280-285 | I509 | 15 | 791 | I63339 | 15 | 793 | ||
| I214 | 05 | 280-285 | I509 | 15 | 793 | I63341 | 01 | 023-024 | ||
| I219 | 05 | 280-285 | I510 | 05 | 314-316 | I63341 | 01 | 061-063 | ||
| I21A1 | 05 | 280-285 | I511 | 05 | 306-307 | I63341 | 01 | 064-066 | ||
| I21A9 | 05 | 280-285 | I512 | 05 | 306-307 | I63341 | 15 | 791 | ||
| I21B | 05 | 280-285 | I513 | 05 | 302-303 | I63341 | 15 | 793 | ||
| I220 | 05 | 280-285 | I514 | 05 | 314-316 | I63342 | 01 | 023-024 | ||
| I221 | 05 | 280-285 | I515 | 05 | 314-316 | I63342 | 01 | 061-063 | ||
| I222 | 05 | 280-285 | I517 | 05 | 302-303 | I63342 | 01 | 064-066 | ||
| I228 | 05 | 280-285 | I5181 | 05 | 314-316 | I63342 | 15 | 791 | ||
| I229 | 05 | 280-285 | I5189 | 05 | 302-303 | I63342 | 15 | 793 | ||
| I230 | 05 | 314-316 | I519 | 05 | 302-303 | I63343 | 01 | 023-024 | ||
| I231 | 05 | 314-316 | I52 | 05 | 302-303 | I63343 | 01 | 061-063 | ||
| I232 | 05 | 314-316 | I5A | 05 | 314-316 | I63343 | 01 | 064-066 | ||
| I233 | 05 | 314-316 | I6000 | 01 | 020-022 | I63343 | 15 | 791 | ||
| I234 | 05 | 306-307 | I6000 | 01 | 023-024 | I63343 | 15 | 793 | ||
| I235 | 05 | 306-307 | I6000 | 01 | 064-066 | I63349 | 01 | 023-024 | ||
| I236 | 05 | 314-316 | I6000 | 15 | 791 | I63349 | 01 | 061-063 | ||
| I237 | 05 | 314-316 | I6000 | 15 | 793 | I63349 | 01 | 064-066 | ||
| I238 | 05 | 314-316 | I6001 | 01 | 020-022 | I63349 | 15 | 791 | ||
| I240 | 05 | 311 | I6001 | 01 | 023-024 | I63349 | 15 | 793 | ||
| I241 | 05 | 314-316 | I6001 | 01 | 064-066 | I6339 | 01 | 023-024 | ||
| I2481 | 05 | 311 | I6001 | 15 | 791 | I6339 | 01 | 061-063 | ||
| I2489 | 05 | 311 | I6001 | 15 | 793 | I6339 | 01 | 064-066 | ||
| I249 | 05 | 311 | I6002 | 01 | 020-022 | I6339 | 15 | 791 | ||
| I2510 | 05 | 302-303 | I6002 | 01 | 023-024 | I6339 | 15 | 793 | ||
| I25110 | 05 | 302-303 | I6002 | 01 | 064-066 | I6340 | 01 | 023-024 | ||
| I25111 | 05 | 302-303 | I6002 | 15 | 791 | I6340 | 01 | 061-063 | ||
| I25112 | 05 | 302-303 | I6002 | 15 | 793 | I6340 | 01 | 064-066 | ||
| I25118 | 05 | 302-303 | I6010 | 01 | 020-022 | I6340 | 15 | 791 | ||
| I25119 | 05 | 302-303 | I6010 | 01 | 023-024 | I6340 | 15 | 793 | ||
| I252 | 05 | 302-303 | I6010 | 01 | 064-066 | I63411 | 01 | 023-024 | ||
| I253 | 05 | 314-316 | I6010 | 15 | 791 | I63411 | 01 | 061-063 | ||
| I253 | 15 | 791 | I6010 | 15 | 793 | I63411 | 01 | 064-066 | ||
| I253 | 15 | 793 | I6011 | 01 | 020-022 | I63411 | 15 | 791 | ||
| I2541 | 05 | 314-316 | I6011 | 01 | 023-024 | I63411 | 15 | 793 | ||
| I2542 | 05 | 314-316 | I6011 | 01 | 064-066 | I63412 | 01 | 023-024 | ||
| I255 | 05 | 302-303 | I6011 | 15 | 791 | I63412 | 01 | 061-063 | ||
| I256 | 05 | 302-303 | I6011 | 15 | 793 | I63412 | 01 | 064-066 | ||
| I25700 | 05 | 302-303 | I6012 | 01 | 020-022 | I63412 | 15 | 791 | ||
| I25701 | 05 | 302-303 | I6012 | 01 | 023-024 | I63412 | 15 | 793 | ||
| I25702 | 05 | 302-303 | I6012 | 01 | 064-066 | I63413 | 01 | 023-024 | ||
| I25708 | 05 | 302-303 | I6012 | 15 | 791 | I63413 | 01 | 061-063 | ||
| I25709 | 05 | 302-303 | I6012 | 15 | 793 | I63413 | 01 | 064-066 | ||
| I25710 | 05 | 302-303 | I602 | 01 | 020-022 | I63413 | 15 | 791 | ||
| I25711 | 05 | 302-303 | I602 | 01 | 023-024 | I63413 | 15 | 793 | ||
| I25712 | 05 | 302-303 | I602 | 01 | 064-066 | I63419 | 01 | 023-024 | ||
| I25718 | 05 | 302-303 | I602 | 15 | 791 | I63419 | 01 | 061-063 | ||
| I25719 | 05 | 302-303 | I602 | 15 | 793 | I63419 | 01 | 064-066 | ||
| I25720 | 05 | 302-303 | I6030 | 01 | 020-022 | I63419 | 15 | 791 | ||
| I25721 | 05 | 302-303 | I6030 | 01 | 023-024 | I63419 | 15 | 793 | ||
| I25722 | 05 | 302-303 | I6030 | 01 | 064-066 | I63421 | 01 | 023-024 | ||
| I25728 | 05 | 302-303 | I6030 | 15 | 791 | I63421 | 01 | 061-063 | ||
| I25729 | 05 | 302-303 | I6030 | 15 | 793 | I63421 | 01 | 064-066 | ||
| I25730 | 05 | 302-303 | I6031 | 01 | 020-022 | I63421 | 15 | 791 | ||
| I25731 | 05 | 302-303 | I6031 | 01 | 023-024 | I63421 | 15 | 793 | ||
| I25732 | 05 | 302-303 | I6031 | 01 | 064-066 | I63422 | 01 | 023-024 | ||
| I25738 | 05 | 302-303 | I6031 | 15 | 791 | I63422 | 01 | 061-063 | ||
| I25739 | 05 | 302-303 | I6031 | 15 | 793 | I63422 | 01 | 064-066 | ||
| I25750 | 05 | 302-303 | I6032 | 01 | 020-022 | I63422 | 15 | 791 | ||
| I25751 | 05 | 302-303 | I6032 | 01 | 023-024 | I63422 | 15 | 793 | ||
| I25752 | 05 | 302-303 | I6032 | 01 | 064-066 | I63423 | 01 | 023-024 | ||
| I25758 | 05 | 302-303 | I6032 | 15 | 791 | I63423 | 01 | 061-063 | ||
| I25759 | 05 | 302-303 | I6032 | 15 | 793 | I63423 | 01 | 064-066 | ||
| I25760 | 05 | 302-303 | I604 | 01 | 020-022 | I63423 | 15 | 791 | ||
| I25761 | 05 | 302-303 | I604 | 01 | 023-024 | I63423 | 15 | 793 | ||
| I25762 | 05 | 302-303 | I604 | 01 | 064-066 | I63429 | 01 | 023-024 | ||
| I25768 | 05 | 302-303 | I604 | 15 | 791 | I63429 | 01 | 061-063 | ||
| I25769 | 05 | 302-303 | I604 | 15 | 793 | I63429 | 01 | 064-066 | ||
| I25790 | 05 | 302-303 | I6050 | 01 | 020-022 | I63429 | 15 | 791 | ||
| I25791 | 05 | 302-303 | I6050 | 01 | 023-024 | I63429 | 15 | 793 | ||
| I25792 | 05 | 302-303 | I6050 | 01 | 064-066 | I63431 | 01 | 023-024 | ||
| I25798 | 05 | 302-303 | I6050 | 15 | 791 | I63431 | 01 | 061-063 | ||
| I25799 | 05 | 302-303 | I6050 | 15 | 793 | I63431 | 01 | 064-066 | ||
| I25810 | 05 | 302-303 | I6051 | 01 | 020-022 | I63431 | 15 | 791 | ||
| I25811 | 05 | 302-303 | I6051 | 01 | 023-024 | I63431 | 15 | 793 | ||
| I25812 | 05 | 302-303 | I6051 | 01 | 064-066 | I63432 | 01 | 023-024 | ||
| I2582 | 05 | 302-303 | I6051 | 15 | 791 | I63432 | 01 | 061-063 | ||
| I2583 | 05 | 302-303 | I6051 | 15 | 793 | I63432 | 01 | 064-066 | ||
| I2584 | 05 | 302-303 | I6052 | 01 | 020-022 | I63432 | 15 | 791 | ||
| I2585 | 05 | 302-303 | I6052 | 01 | 023-024 | I63432 | 15 | 793 | ||
| I2589 | 05 | 302-303 | I6052 | 01 | 064-066 | I63433 | 01 | 023-024 | ||
| I259 | 05 | 302-303 | I6052 | 15 | 791 | I63433 | 01 | 061-063 | ||
| I2601 | 04 | 173 | I6052 | 15 | 793 | I63433 | 01 | 064-066 | ||
| I2601 | 04 | 175-176 | I606 | 01 | 020-022 | I63433 | 15 | 791 | ||
| I2601 | 15 | 791 | I606 | 01 | 023-024 | I63433 | 15 | 793 | ||
| I2601 | 15 | 793 | I606 | 01 | 064-066 | I63439 | 01 | 023-024 | ||
| I2602 | 04 | 173 | I606 | 15 | 791 | I63439 | 01 | 061-063 | ||
| I2602 | 04 | 175-176 | I606 | 15 | 793 | I63439 | 01 | 064-066 | ||
| I2602 | 15 | 791 | I607 | 01 | 020-022 | I63439 | 15 | 791 | ||
| I2602 | 15 | 793 | I607 | 01 | 023-024 | I63439 | 15 | 793 | ||
| I2603 | 04 | 173 | I607 | 01 | 064-066 | I63441 | 01 | 023-024 | ||
| I2603 | 04 | 175-176 | I607 | 15 | 791 | I63441 | 01 | 061-063 | ||
| I2603 | 15 | 791 | I607 | 15 | 793 | I63441 | 01 | 064-066 | ||
| I2603 | 15 | 793 | I608 | 01 | 020-022 | I63441 | 15 | 791 | ||
| I2604 | 04 | 173 | I608 | 01 | 023-024 | I63441 | 15 | 793 | ||
| I2604 | 04 | 175-176 | I608 | 01 | 064-066 | I63442 | 01 | 023-024 | ||
| I2604 | 15 | 791 | I608 | 15 | 791 | I63442 | 01 | 061-063 | ||
| I2604 | 15 | 793 | I608 | 15 | 793 | I63442 | 01 | 064-066 | ||
| I2609 | 04 | 173 | I609 | 01 | 020-022 | I63442 | 15 | 791 | ||
| I2609 | 04 | 175-176 | I609 | 01 | 023-024 | I63442 | 15 | 793 | ||
| I2609 | 15 | 791 | I609 | 01 | 064-066 | I63443 | 01 | 023-024 | ||
| I2609 | 15 | 793 | I609 | 15 | 791 | I63443 | 01 | 061-063 | ||
| I2690 | 04 | 173 | I609 | 15 | 793 | I63443 | 01 | 064-066 | ||
| I2690 | 04 | 175-176 | I610 | 01 | 020-022 | I63443 | 15 | 791 | ||
| I2690 | 15 | 791 | I610 | 01 | 023-024 | I63443 | 15 | 793 | ||
| I2690 | 15 | 793 | I610 | 01 | 064-066 | I63449 | 01 | 023-024 | ||
| I2692 | 04 | 173 | I610 | 15 | 791 | I63449 | 01 | 061-063 | ||
| I2692 | 04 | 175-176 | I610 | 15 | 793 | I63449 | 01 | 064-066 | ||
| I2692 | 15 | 791 | I611 | 01 | 020-022 | I63449 | 15 | 791 | ||
| I2692 | 15 | 793 | I611 | 01 | 023-024 | I63449 | 15 | 793 | ||
| I2693 | 04 | 173 | I611 | 01 | 064-066 | I6349 | 01 | 023-024 | ||
| I2693 | 04 | 175-176 | I611 | 15 | 791 | I6349 | 01 | 061-063 | ||
| I2693 | 15 | 791 | I611 | 15 | 793 | I6349 | 01 | 064-066 | ||
| I2693 | 15 | 793 | I612 | 01 | 020-022 | I6349 | 15 | 791 | ||
| I2694 | 04 | 173 | I612 | 01 | 023-024 | I6349 | 15 | 793 | ||
| I2694 | 04 | 175-176 | I612 | 01 | 064-066 | I6350 | 01 | 023-024 | ||
| I2694 | 15 | 791 | I612 | 15 | 791 | I6350 | 01 | 061-063 | ||
| I2694 | 15 | 793 | I612 | 15 | 793 | I6350 | 01 | 064-066 | ||
| I2695 | 04 | 173 | I613 | 01 | 020-022 | I6350 | 15 | 791 | ||
| I2695 | 04 | 175-176 | I613 | 01 | 023-024 | I6350 | 15 | 793 | ||
| I2695 | 15 | 791 | I613 | 01 | 064-066 | I63511 | 01 | 023-024 | ||
| I2695 | 15 | 793 | I613 | 15 | 791 | I63511 | 01 | 061-063 | ||
| I2696 | 04 | 173 | I613 | 15 | 793 | I63511 | 01 | 064-066 | ||
| I2696 | 04 | 175-176 | I614 | 01 | 020-022 | I63511 | 15 | 791 | ||
| I2696 | 15 | 791 | I614 | 01 | 023-024 | I63511 | 15 | 793 | ||
| I2696 | 15 | 793 | I614 | 01 | 064-066 | I63512 | 01 | 023-024 | ||
| I2699 | 04 | 173 | I614 | 15 | 791 | I63512 | 01 | 061-063 | ||
| I2699 | 04 | 175-176 | I614 | 15 | 793 | I63512 | 01 | 064-066 | ||
| I2699 | 15 | 791 | I615 | 01 | 020-022 | I63512 | 15 | 791 | ||
| I2699 | 15 | 793 | I615 | 01 | 023-024 | I63512 | 15 | 793 | ||
| I270 | 05 | 314-316 | I615 | 01 | 064-066 | I63513 | 01 | 023-024 | ||
| I271 | 05 | 314-316 | I615 | 15 | 791 | I63513 | 01 | 061-063 | ||
| I2720 | 05 | 314-316 | I615 | 15 | 793 | I63513 | 01 | 064-066 | ||
| I2721 | 05 | 314-316 | I616 | 01 | 020-022 | I63513 | 15 | 791 | ||
| I2722 | 05 | 314-316 | I616 | 01 | 023-024 | I63513 | 15 | 793 | ||
| I2723 | 05 | 314-316 | I616 | 01 | 064-066 | I63519 | 01 | 023-024 | ||
| I2724 | 05 | 314-316 | I616 | 15 | 791 | I63519 | 01 | 061-063 | ||
| I2729 | 05 | 314-316 | I616 | 15 | 793 | I63519 | 01 | 064-066 | ||
| I2781 | 05 | 314-316 | I618 | 01 | 020-022 | I63519 | 15 | 791 | ||
| I2782 | 04 | 173 | I618 | 01 | 023-024 | I63519 | 15 | 793 | ||
| I2782 | 04 | 175-176 | I618 | 01 | 064-066 | I63521 | 01 | 023-024 | ||
| I2782 | 15 | 791 | I618 | 15 | 791 | I63521 | 01 | 061-063 | ||
| I2782 | 15 | 793 | I618 | 15 | 793 | I63521 | 01 | 064-066 | ||
| I2783 | 05 | 314-316 | I619 | 01 | 020-022 | I63521 | 15 | 791 | ||
| I27840 | 07 | 441-443 | I619 | 01 | 023-024 | I63521 | 15 | 793 | ||
| I27841 | 16 | 808-810 | I619 | 01 | 064-066 | I63522 | 01 | 023-024 | ||
| I27848 | 05 | 314-316 | I619 | 15 | 791 | I63522 | 01 | 061-063 | ||
| I27849 | 05 | 314-316 | I619 | 15 | 793 | I63522 | 01 | 064-066 | ||
| I2789 | 05 | 314-316 | I6200 | 01 | 020-022 | I63522 | 15 | 791 | ||
| I279 | 05 | 314-316 | I6200 | 01 | 064-066 | I63522 | 15 | 793 | ||
| I280 | 05 | 314-316 | I6200 | 15 | 791 | I63523 | 01 | 023-024 | ||
| I281 | 05 | 314-316 | I6200 | 15 | 793 | I63523 | 01 | 061-063 | ||
| I288 | 05 | 314-316 | I6201 | 01 | 020-022 | I63523 | 01 | 064-066 | ||
| I289 | 05 | 314-316 | I6201 | 01 | 064-066 | I63523 | 15 | 791 | ||
| I300 | 05 | 314-316 | I6201 | 15 | 791 | I63523 | 15 | 793 | ||
| I301 | 05 | 314-316 | I6201 | 15 | 793 | I63529 | 01 | 023-024 | ||
| I308 | 05 | 314-316 | I6202 | 01 | 020-022 | I63529 | 01 | 061-063 | ||
| I309 | 05 | 314-316 | I6202 | 01 | 064-066 | I63529 | 01 | 064-066 | ||
| I310 | 05 | 314-316 | I6202 | 15 | 791 | I63529 | 15 | 791 | ||
| I311 | 05 | 314-316 | I6202 | 15 | 793 | I63529 | 15 | 793 | ||
| I312 | 05 | 314-316 | I6203 | 01 | 020-022 | I63531 | 01 | 023-024 | ||
| I312 | 15 | 791 | I6203 | 01 | 064-066 | I63531 | 01 | 061-063 | ||
| I312 | 15 | 793 | I6203 | 15 | 791 | I63531 | 01 | 064-066 | ||
| I3131 | 05 | 314-316 | I6203 | 15 | 793 | I63531 | 15 | 791 | ||
| I3139 | 05 | 314-316 | I621 | 01 | 020-022 | I63531 | 15 | 793 | ||
| I314 | 05 | 314-316 | I621 | 01 | 064-066 | I63532 | 01 | 023-024 | ||
| I318 | 05 | 314-316 | I621 | 15 | 791 | I63532 | 01 | 061-063 | ||
| I319 | 05 | 314-316 | I621 | 15 | 793 | I63532 | 01 | 064-066 | ||
| I32 | 05 | 314-316 | I629 | 01 | 020-022 | I63532 | 15 | 791 | ||
| I32 | 15 | 791 | I629 | 01 | 023-024 | I63532 | 15 | 793 | ||
| I32 | 15 | 793 | I629 | 01 | 064-066 | I63533 | 01 | 023-024 | ||
| I330 | 05 | 288-290 | I629 | 15 | 791 | I63533 | 01 | 061-063 | ||
| I330 | 15 | 791 | I629 | 15 | 793 | I63533 | 01 | 064-066 | ||
| I330 | 15 | 793 | I6300 | 01 | 023-024 | I63533 | 15 | 791 | ||
| I330 | 25 | 974-976 | I6300 | 01 | 061-063 | I63533 | 15 | 793 | ||
| I339 | 05 | 288-290 | I6300 | 01 | 064-066 | I63539 | 01 | 023-024 | ||
| I339 | 15 | 791 | I6300 | 15 | 791 | I63539 | 01 | 061-063 | ||
| I339 | 15 | 793 | I6300 | 15 | 793 | I63539 | 01 | 064-066 | ||
| I339 | 25 | 974-976 | I63011 | 01 | 023-024 | I63539 | 15 | 791 | ||
| I340 | 05 | 306-307 | I63011 | 01 | 061-063 | I63539 | 15 | 793 | ||
| I341 | 05 | 306-307 | I63011 | 01 | 064-066 | I63541 | 01 | 023-024 | ||
| I342 | 05 | 306-307 | I63011 | 15 | 791 | I63541 | 01 | 061-063 | ||
| I3481 | 05 | 306-307 | I63011 | 15 | 793 | I63541 | 01 | 064-066 | ||
| I3489 | 05 | 306-307 | I63012 | 01 | 023-024 | I63541 | 15 | 791 | ||
| I349 | 05 | 306-307 | I63012 | 01 | 061-063 | I63541 | 15 | 793 | ||
| I350 | 05 | 306-307 | I63012 | 01 | 064-066 | I63542 | 01 | 023-024 | ||
| I351 | 05 | 306-307 | I63012 | 15 | 791 | I63542 | 01 | 061-063 | ||
| I352 | 05 | 306-307 | I63012 | 15 | 793 | I63542 | 01 | 064-066 | ||
| I358 | 05 | 306-307 | I63013 | 01 | 023-024 | I63542 | 15 | 791 | ||
| I359 | 05 | 306-307 | I63013 | 01 | 061-063 | I63542 | 15 | 793 | ||
| I360 | 05 | 306-307 | I63013 | 01 | 064-066 | I63543 | 01 | 023-024 | ||
| I361 | 05 | 306-307 | I63013 | 15 | 791 | I63543 | 01 | 061-063 | ||
| I362 | 05 | 306-307 | I63013 | 15 | 793 | I63543 | 01 | 064-066 | ||
| I368 | 05 | 306-307 | I63019 | 01 | 023-024 | I63543 | 15 | 791 | ||
| I369 | 05 | 306-307 | I63019 | 01 | 061-063 | I63543 | 15 | 793 | ||
| I370 | 05 | 306-307 | I63019 | 01 | 064-066 | I63549 | 01 | 023-024 | ||
| I371 | 05 | 306-307 | I63019 | 15 | 791 | I63549 | 01 | 061-063 | ||
| I372 | 05 | 306-307 | I63019 | 15 | 793 | I63549 | 01 | 064-066 | ||
| I378 | 05 | 306-307 | I6302 | 01 | 023-024 | I63549 | 15 | 791 | ||
| I379 | 05 | 306-307 | I6302 | 01 | 061-063 | I63549 | 15 | 793 | ||
| I38 | 05 | 306-307 | I6302 | 01 | 064-066 | I6359 | 01 | 023-024 | ||
| I38 | 15 | 791 | I6302 | 15 | 791 | I6359 | 01 | 061-063 | ||
| I38 | 15 | 793 | I6302 | 15 | 793 | I6359 | 01 | 064-066 | ||
| I39 | 05 | 306-307 | I63031 | 01 | 023-024 | I6359 | 15 | 791 | ||
| I39 | 15 | 791 | I63031 | 01 | 061-063 | I6359 | 15 | 793 | ||
| I39 | 15 | 793 | I63031 | 01 | 064-066 | I636 | 01 | 023-024 | ||
| I400 | 05 | 314-316 | I63031 | 15 | 791 | I636 | 01 | 061-063 | ||
| I400 | 15 | 791 | I63031 | 15 | 793 | I636 | 01 | 064-066 | ||
| I400 | 15 | 793 | I63032 | 01 | 023-024 | I636 | 15 | 791 | ||
| I400 | 25 | 974-976 | I63032 | 01 | 061-063 | I636 | 15 | 793 | ||
| I401 | 05 | 314-316 | I63032 | 01 | 064-066 | I6381 | 01 | 023-024 | ||
| I401 | 25 | 974-976 | I63032 | 15 | 791 | I6381 | 01 | 061-063 | ||
| I408 | 05 | 314-316 | I63032 | 15 | 793 | I6381 | 01 | 064-066 | ||
| I408 | 25 | 974-976 | I63033 | 01 | 023-024 | I6381 | 15 | 791 | ||
| I409 | 05 | 314-316 | I63033 | 01 | 061-063 | I6381 | 15 | 793 | ||
| I409 | 25 | 974-976 | I63033 | 01 | 064-066 | I6389 | 01 | 023-024 | ||
| I41 | 05 | 314-316 | I63033 | 15 | 791 | I6389 | 01 | 061-063 | ||
| I41 | 15 | 791 | I63033 | 15 | 793 | I6389 | 01 | 064-066 | ||
| I41 | 15 | 793 | I63039 | 01 | 023-024 | I6389 | 15 | 791 | ||
| I4200 | 05 | 314-316 | I63039 | 01 | 061-063 | I6389 | 15 | 793 | ||
| I4201 | 05 | 314-316 | I63039 | 01 | 064-066 | I639 | 01 | 023-024 | ||
| I4209 | 05 | 314-316 | I63039 | 15 | 791 | I639 | 01 | 061-063 | ||
| I421 | 05 | 314-316 | I63039 | 15 | 793 | I639 | 01 | 064-066 | ||
| I422 | 05 | 314-316 | I6309 | 01 | 023-024 | I639 | 15 | 791 | ||
| I423 | 05 | 314-316 | I6309 | 01 | 061-063 | I639 | 15 | 793 | ||
| I424 | 05 | 314-316 | I6309 | 01 | 064-066 | I6501 | 01 | 061-063 | ||
| I425 | 05 | 314-316 | I6309 | 15 | 791 | I6501 | 01 | 067-068 | ||
| I426 | 05 | 314-316 | I6309 | 15 | 793 | I6502 | 01 | 061-063 | ||
| I427 | 05 | 314-316 | I6310 | 01 | 023-024 | I6502 | 01 | 067-068 | ||
| I4281 | 05 | 314-316 | I6310 | 01 | 061-063 | I6503 | 01 | 061-063 | ||
| I4289 | 05 | 314-316 | I6310 | 01 | 064-066 | I6503 | 01 | 067-068 | ||
| I429 | 05 | 314-316 | I6310 | 15 | 791 | I6509 | 01 | 061-063 | ||
| I43 | 05 | 314-316 | I6310 | 15 | 793 | I6509 | 01 | 067-068 | ||
| I43 | 15 | 791 | I63111 | 01 | 023-024 | I651 | 01 | 061-063 | ||
| I43 | 15 | 793 | I63111 | 01 | 061-063 | I651 | 01 | 067-068 | ||
| I440 | 05 | 308-310 | I63111 | 01 | 064-066 | I6521 | 01 | 061-063 | ||
| I441 | 05 | 308-310 | I63111 | 15 | 791 | I6521 | 01 | 067-068 | ||
| I442 | 05 | 308-310 | I63111 | 15 | 793 | I6522 | 01 | 061-063 | ||
| I442 | 15 | 791 | I63112 | 01 | 023-024 | I6522 | 01 | 067-068 | ||
| I442 | 15 | 793 | I63112 | 01 | 061-063 | I6523 | 01 | 061-063 | ||
| I4430 | 05 | 308-310 | I63112 | 01 | 064-066 | I6523 | 01 | 067-068 | ||
| I4439 | 05 | 308-310 | I63112 | 15 | 791 | I6529 | 01 | 061-063 | ||
| I444 | 05 | 308-310 | I63112 | 15 | 793 | I6529 | 01 | 067-068 | ||
| I445 | 05 | 308-310 | I63113 | 01 | 023-024 | I658 | 01 | 061-063 | ||
| I4460 | 05 | 308-310 | I63113 | 01 | 061-063 | I658 | 01 | 067-068 | ||
| I4469 | 05 | 308-310 | I63113 | 01 | 064-066 | I659 | 01 | 061-063 | ||
| I447 | 05 | 308-310 | I63113 | 15 | 791 | I659 | 01 | 067-068 | ||
| I450 | 05 | 308-310 | I63113 | 15 | 793 | I6601 | 01 | 061-063 | ||
| I4510 | 05 | 308-310 | I63119 | 01 | 023-024 | I6601 | 01 | 067-068 | ||
| I4519 | 05 | 308-310 | I63119 | 01 | 061-063 | I6601 | 15 | 791 | ||
| I452 | 05 | 308-310 | I63119 | 01 | 064-066 | I6601 | 15 | 793 | ||
| I452 | 15 | 791 | I63119 | 15 | 791 | I6602 | 01 | 061-063 | ||
| I452 | 15 | 793 | I63119 | 15 | 793 | I6602 | 01 | 067-068 | ||
| I453 | 05 | 308-310 | I6312 | 01 | 023-024 | I6602 | 15 | 791 | ||
| I453 | 15 | 791 | I6312 | 01 | 061-063 | I6602 | 15 | 793 | ||
| I453 | 15 | 793 | I6312 | 01 | 064-066 | I6603 | 01 | 061-063 | ||
| I454 | 05 | 308-310 | I6312 | 15 | 791 | I6603 | 01 | 067-068 | ||
| I455 | 05 | 308-310 | I6312 | 15 | 793 | I6603 | 15 | 791 | ||
| I456 | 05 | 308-310 | I63131 | 01 | 023-024 | I6603 | 15 | 793 | ||
| I456 | 15 | 791 | I63131 | 01 | 061-063 | I6609 | 01 | 061-063 | ||
| I456 | 15 | 793 | I63131 | 01 | 064-066 | I6609 | 01 | 067-068 | ||
| I4581 | 05 | 308-310 | I63131 | 15 | 791 | I6609 | 15 | 791 | ||
| I4589 | 05 | 308-310 | I63131 | 15 | 793 | I6609 | 15 | 793 | ||
| I4589 | 15 | 791 | I63132 | 01 | 023-024 | I6611 | 01 | 061-063 | ||
| I4589 | 15 | 793 | I63132 | 01 | 061-063 | I6611 | 01 | 067-068 | ||
| I459 | 05 | 308-310 | I63132 | 01 | 064-066 | I6611 | 15 | 791 | ||
| I462 | 05 | 296-298 | I63132 | 15 | 791 | I6611 | 15 | 793 | ||
| I462 | 15 | 791 | I63132 | 15 | 793 | I6612 | 01 | 061-063 | ||
| I462 | 15 | 793 | I63133 | 01 | 023-024 | I6612 | 01 | 067-068 | ||
| I468 | 05 | 296-298 | I63133 | 01 | 061-063 | I6612 | 15 | 791 | ||
| I468 | 15 | 791 | I63133 | 01 | 064-066 | I6612 | 15 | 793 | ||
| I468 | 15 | 793 | I63133 | 15 | 791 | I6613 | 01 | 061-063 | ||
| I469 | 05 | 296-298 | I63133 | 15 | 793 | I6613 | 01 | 067-068 | ||
| I469 | 15 | 791 | I63139 | 01 | 023-024 | I6613 | 15 | 791 | ||
| I469 | 15 | 793 | I63139 | 01 | 061-063 | I6613 | 15 | 793 | ||
| I470 | 05 | 308-310 | I63139 | 01 | 064-066 | I6619 | 01 | 061-063 | ||
| I470 | 15 | 791 | I63139 | 15 | 791 | I6619 | 01 | 067-068 | ||
| I470 | 15 | 793 | I63139 | 15 | 793 | I6619 | 15 | 791 | ||
| I4710 | 05 | 308-310 | I6319 | 01 | 023-024 | I6619 | 15 | 793 | ||
| I4711 | 05 | 308-310 | I6319 | 01 | 061-063 | I6621 | 01 | 061-063 | ||
| I4719 | 05 | 308-310 | I6319 | 01 | 064-066 | I6621 | 01 | 067-068 | ||
| I4720 | 05 | 308-310 | I6319 | 15 | 791 | I6621 | 15 | 791 | ||
| I4720 | 15 | 791 | I6319 | 15 | 793 | I6621 | 15 | 793 | ||
| I4720 | 15 | 793 | I6320 | 01 | 023-024 | I6622 | 01 | 061-063 | ||
| I4721 | 05 | 308-310 | I6320 | 01 | 061-063 | I6622 | 01 | 067-068 | ||
| I4721 | 15 | 791 | I6320 | 01 | 064-066 | I6622 | 15 | 791 | ||
| I4721 | 15 | 793 | I6320 | 15 | 791 | I6622 | 15 | 793 | ||
| I4722 | 05 | 308-310 | I6320 | 15 | 793 | I6623 | 01 | 061-063 | ||
| I4722 | 15 | 791 | I63211 | 01 | 023-024 | I6623 | 01 | 067-068 | ||
| I4722 | 15 | 793 | I63211 | 01 | 061-063 | I6623 | 15 | 791 | ||
| I4729 | 05 | 308-310 | I63211 | 01 | 064-066 | I6623 | 15 | 793 | ||
| I4729 | 15 | 791 | I63211 | 15 | 791 | I6629 | 01 | 061-063 | ||
| I4729 | 15 | 793 | I63211 | 15 | 793 | I6629 | 01 | 067-068 | ||
| I479 | 05 | 308-310 | I63212 | 01 | 023-024 | I6629 | 15 | 791 | ||
| I480 | 05 | 308-310 | I63212 | 01 | 061-063 | I6629 | 15 | 793 | ||
| I480 | 15 | 791 | I63212 | 01 | 064-066 | I663 | 01 | 061-063 | ||
| I480 | 15 | 793 | I63212 | 15 | 791 | I663 | 01 | 067-068 | ||
| I4811 | 05 | 308-310 | I63212 | 15 | 793 | I663 | 15 | 791 | ||
| I4819 | 05 | 308-310 | I63213 | 01 | 023-024 | I663 | 15 | 793 | ||
| I4819 | 15 | 791 | I63213 | 01 | 061-063 | I668 | 01 | 061-063 | ||
| I4819 | 15 | 793 | I63213 | 01 | 064-066 | I668 | 01 | 067-068 | ||
| I4820 | 05 | 308-310 | I63213 | 15 | 791 | I668 | 15 | 791 | ||
| I4821 | 05 | 308-310 | I63213 | 15 | 793 | I668 | 15 | 793 | ||
| I4821 | 15 | 791 | I63219 | 01 | 023-024 | I669 | 01 | 061-063 | ||
| I4821 | 15 | 793 | I63219 | 01 | 061-063 | I669 | 01 | 067-068 | ||
| I483 | 05 | 308-310 | I63219 | 01 | 064-066 | I669 | 15 | 791 | ||
| I483 | 15 | 791 | I63219 | 15 | 791 | I669 | 15 | 793 | ||
| I483 | 15 | 793 | I63219 | 15 | 793 | I670 | 05 | 299-301 | ||
| I484 | 05 | 308-310 | I6322 | 01 | 023-024 | I671 | 01 | 091-093 | ||
| I484 | 15 | 791 | I6322 | 01 | 061-063 | I672 | 01 | 070-072 | ||
| I484 | 15 | 793 | I6322 | 01 | 064-066 | |||||
| I6322 | 15 | 791 | ||||||||
| I6322 | 15 | 793 |
| | |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 25 Mar 2026 13:16:25 CMS, code-revision=381, description-revision=1473 |