ICD-10-CM/PCS MS-DRG v38.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v38.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 34 of 74 |
| A000 B303 C579 C8444 D3131 E093513 E13638 F423 H02202 H30121 H59031 I5089 I70722 K006 K9089 L97103 M10361 M247 M60159 M80052S M84633D M90569 N8341 O2942 O3623X4 O6000 P258 Q72819 S00221S S02622K S066X0D S12651B S21101S S25319D S31612D S32472S S36513D S42031B S42424B S46019S S52033M S52264P S52521A S55802S S60041A S61341A S62304D S62643B S63497A S66411A S72019D S72102S S72309C S72435C S76309S S82033M S82235R S82492B S83222D S89132P S92016A S92401P S95999S T17998A T23042A T25392D T38803S T438X5D T492X6D T595X4A T7462XA T8332XD Z22322 Z95820 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S25319D | 23 | 949-950 | S2753XD | 23 | 949-950 | S3096XD | 23 | 949-950 | ||
| S25319S | 05 | 299-301 | S2753XS | 04 | 205-206 | S3096XS | 09 | 604-605 | ||
| S25321A | 15 | 791 | S2759XA | 04 | 205-206 | S3097XA | 09 | 604-605 | ||
| S25321A | 15 | 793 | S2759XA | 24 | 955-965 | S3097XA | 24 | 955-965 | ||
| S25321A | 21 | 913-914 | S2759XD | 23 | 949-950 | S3097XD | 23 | 949-950 | ||
| S25321A | 24 | 955-965 | S2759XS | 04 | 205-206 | S3097XS | 09 | 604-605 | ||
| S25321D | 23 | 949-950 | S2760XA | 04 | 205-206 | S3098XA | 09 | 604-605 | ||
| S25321S | 05 | 299-301 | S2760XA | 24 | 955-965 | S3098XA | 24 | 955-965 | ||
| S25322A | 15 | 791 | S2760XD | 23 | 949-950 | S3098XD | 23 | 949-950 | ||
| S25322A | 15 | 793 | S2760XS | 04 | 205-206 | S3098XS | 09 | 604-605 | ||
| S25322A | 21 | 913-914 | S2763XA | 04 | 205-206 | S31000A | 09 | 604-605 | ||
| S25322A | 24 | 955-965 | S2763XA | 24 | 955-965 | S31000A | 24 | 955-965 | ||
| S25322D | 23 | 949-950 | S2763XD | 23 | 949-950 | S31000D | 23 | 949-950 | ||
| S25322S | 05 | 299-301 | S2763XS | 04 | 205-206 | S31000S | 09 | 604-605 | ||
| S25329A | 15 | 791 | S2769XA | 04 | 205-206 | S31001A | 11 | 698-700 | ||
| S25329A | 15 | 793 | S2769XA | 24 | 955-965 | S31001A | 24 | 955-965 | ||
| S25329A | 21 | 913-914 | S2769XD | 23 | 949-950 | S31001D | 23 | 949-950 | ||
| S25329A | 24 | 955-965 | S2769XS | 04 | 205-206 | S31001S | 09 | 604-605 | ||
| S25329D | 23 | 949-950 | S27802A | 04 | 183-185 | S31010A | 09 | 604-605 | ||
| S25329S | 05 | 299-301 | S27802A | 24 | 955-965 | S31010A | 24 | 955-965 | ||
| S25391A | 15 | 791 | S27802D | 23 | 949-950 | S31010D | 23 | 949-950 | ||
| S25391A | 15 | 793 | S27802S | 04 | 205-206 | S31010S | 09 | 604-605 | ||
| S25391A | 21 | 913-914 | S27803A | 04 | 183-185 | S31011A | 11 | 698-700 | ||
| S25391A | 24 | 955-965 | S27803A | 24 | 955-965 | S31011A | 24 | 955-965 | ||
| S25391D | 23 | 949-950 | S27803D | 23 | 949-950 | S31011D | 23 | 949-950 | ||
| S25391S | 05 | 299-301 | S27803S | 04 | 205-206 | S31011S | 09 | 604-605 | ||
| S25392A | 15 | 791 | S27808A | 04 | 183-185 | S31020A | 09 | 604-605 | ||
| S25392A | 15 | 793 | S27808A | 24 | 955-965 | S31020A | 24 | 955-965 | ||
| S25392A | 21 | 913-914 | S27808D | 23 | 949-950 | S31020D | 23 | 949-950 | ||
| S25392A | 24 | 955-965 | S27808S | 04 | 205-206 | S31020S | 09 | 604-605 | ||
| S25392D | 23 | 949-950 | S27809A | 04 | 183-185 | S31021A | 11 | 698-700 | ||
| S25392S | 05 | 299-301 | S27809A | 24 | 955-965 | S31021A | 24 | 955-965 | ||
| S25399A | 15 | 791 | S27809D | 23 | 949-950 | S31021D | 23 | 949-950 | ||
| S25399A | 15 | 793 | S27809S | 04 | 205-206 | S31021S | 09 | 604-605 | ||
| S25399A | 21 | 913-914 | S27812A | 06 | 368-370 | S31030A | 09 | 604-605 | ||
| S25399A | 24 | 955-965 | S27812A | 24 | 955-965 | S31030A | 24 | 955-965 | ||
| S25399D | 23 | 949-950 | S27812D | 23 | 949-950 | S31030D | 23 | 949-950 | ||
| S25399S | 05 | 299-301 | S27812S | 04 | 205-206 | S31030S | 09 | 604-605 | ||
| S25401A | 15 | 791 | S27813A | 06 | 368-370 | S31031A | 11 | 698-700 | ||
| S25401A | 15 | 793 | S27813A | 24 | 955-965 | S31031A | 24 | 955-965 | ||
| S25401A | 21 | 913-914 | S27813D | 23 | 949-950 | S31031D | 23 | 949-950 | ||
| S25401A | 24 | 955-965 | S27813S | 04 | 205-206 | S31031S | 09 | 604-605 | ||
| S25401D | 23 | 949-950 | S27818A | 06 | 368-370 | S31040A | 09 | 604-605 | ||
| S25401S | 05 | 299-301 | S27818A | 24 | 955-965 | S31040A | 24 | 955-965 | ||
| S25402A | 15 | 791 | S27818D | 23 | 949-950 | S31040D | 23 | 949-950 | ||
| S25402A | 15 | 793 | S27818S | 04 | 205-206 | S31040S | 09 | 604-605 | ||
| S25402A | 21 | 913-914 | S27819A | 06 | 368-370 | S31041A | 11 | 698-700 | ||
| S25402A | 24 | 955-965 | S27819A | 24 | 955-965 | S31041A | 24 | 955-965 | ||
| S25402D | 23 | 949-950 | S27819D | 23 | 949-950 | S31041D | 23 | 949-950 | ||
| S25402S | 05 | 299-301 | S27819S | 04 | 205-206 | S31041S | 09 | 604-605 | ||
| S25409A | 15 | 791 | S27892A | 04 | 205-206 | S31050A | 09 | 604-605 | ||
| S25409A | 15 | 793 | S27892A | 24 | 955-965 | S31050A | 24 | 955-965 | ||
| S25409A | 21 | 913-914 | S27892D | 23 | 949-950 | S31050D | 23 | 949-950 | ||
| S25409A | 24 | 955-965 | S27892S | 04 | 205-206 | S31050S | 09 | 604-605 | ||
| S25409D | 23 | 949-950 | S27893A | 04 | 205-206 | S31051A | 11 | 698-700 | ||
| S25409S | 05 | 299-301 | S27893A | 24 | 955-965 | S31051A | 24 | 955-965 | ||
| S25411A | 15 | 791 | S27893D | 23 | 949-950 | S31051D | 23 | 949-950 | ||
| S25411A | 15 | 793 | S27893S | 04 | 205-206 | S31051S | 09 | 604-605 | ||
| S25411A | 21 | 913-914 | S27898A | 04 | 205-206 | S31100A | 09 | 604-605 | ||
| S25411A | 24 | 955-965 | S27898A | 24 | 955-965 | S31100A | 24 | 955-965 | ||
| S25411D | 23 | 949-950 | S27898D | 23 | 949-950 | S31100D | 23 | 949-950 | ||
| S25411S | 05 | 299-301 | S27898S | 04 | 205-206 | S31100S | 09 | 604-605 | ||
| S25412A | 15 | 791 | S27899A | 04 | 205-206 | S31101A | 09 | 604-605 | ||
| S25412A | 15 | 793 | S27899A | 24 | 955-965 | S31101A | 24 | 955-965 | ||
| S25412A | 21 | 913-914 | S27899D | 23 | 949-950 | S31101D | 23 | 949-950 | ||
| S25412A | 24 | 955-965 | S27899S | 04 | 205-206 | S31101S | 09 | 604-605 | ||
| S25412D | 23 | 949-950 | S279XXA | 21 | 913-914 | S31102A | 09 | 604-605 | ||
| S25412S | 05 | 299-301 | S279XXA | 24 | 955-965 | S31102A | 24 | 955-965 | ||
| S25419A | 15 | 791 | S279XXD | 23 | 949-950 | S31102D | 23 | 949-950 | ||
| S25419A | 15 | 793 | S279XXS | 04 | 205-206 | S31102S | 09 | 604-605 | ||
| S25419A | 21 | 913-914 | S280XXA | 21 | 913-914 | S31103A | 09 | 604-605 | ||
| S25419A | 24 | 955-965 | S280XXA | 24 | 955-965 | S31103A | 24 | 955-965 | ||
| S25419D | 23 | 949-950 | S280XXD | 23 | 949-950 | S31103D | 23 | 949-950 | ||
| S25419S | 05 | 299-301 | S280XXS | 09 | 604-605 | S31103S | 09 | 604-605 | ||
| S25421A | 15 | 791 | S281XXA | 09 | 604-605 | S31104A | 09 | 604-605 | ||
| S25421A | 15 | 793 | S281XXA | 24 | 955-965 | S31104A | 24 | 955-965 | ||
| S25421A | 21 | 913-914 | S281XXD | 23 | 949-950 | S31104D | 23 | 949-950 | ||
| S25421A | 24 | 955-965 | S281XXS | 09 | 604-605 | S31104S | 09 | 604-605 | ||
| S25421D | 23 | 949-950 | S28211A | 09 | 604-605 | S31105A | 09 | 604-605 | ||
| S25421S | 05 | 299-301 | S28211A | 24 | 955-965 | S31105A | 24 | 955-965 | ||
| S25422A | 15 | 791 | S28211D | 23 | 949-950 | S31105D | 23 | 949-950 | ||
| S25422A | 15 | 793 | S28211S | 09 | 604-605 | S31105S | 09 | 604-605 | ||
| S25422A | 21 | 913-914 | S28212A | 09 | 604-605 | S31109A | 09 | 604-605 | ||
| S25422A | 24 | 955-965 | S28212A | 24 | 955-965 | S31109A | 24 | 955-965 | ||
| S25422D | 23 | 949-950 | S28212D | 23 | 949-950 | S31109D | 23 | 949-950 | ||
| S25422S | 05 | 299-301 | S28212S | 09 | 604-605 | S31109S | 09 | 604-605 | ||
| S25429A | 15 | 791 | S28219A | 09 | 604-605 | S31110A | 09 | 604-605 | ||
| S25429A | 15 | 793 | S28219A | 24 | 955-965 | S31110A | 24 | 955-965 | ||
| S25429A | 21 | 913-914 | S28219D | 23 | 949-950 | S31110D | 23 | 949-950 | ||
| S25429A | 24 | 955-965 | S28219S | 09 | 604-605 | S31110S | 09 | 604-605 | ||
| S25429D | 23 | 949-950 | S28221A | 09 | 604-605 | S31111A | 09 | 604-605 | ||
| S25429S | 05 | 299-301 | S28221A | 24 | 955-965 | S31111A | 24 | 955-965 | ||
| S25491A | 15 | 791 | S28221D | 23 | 949-950 | S31111D | 23 | 949-950 | ||
| S25491A | 15 | 793 | S28221S | 09 | 604-605 | S31111S | 09 | 604-605 | ||
| S25491A | 21 | 913-914 | S28222A | 09 | 604-605 | S31112A | 09 | 604-605 | ||
| S25491A | 24 | 955-965 | S28222A | 24 | 955-965 | S31112A | 24 | 955-965 | ||
| S25491D | 23 | 949-950 | S28222D | 23 | 949-950 | S31112D | 23 | 949-950 | ||
| S25491S | 05 | 299-301 | S28222S | 09 | 604-605 | S31112S | 09 | 604-605 | ||
| S25492A | 15 | 791 | S28229A | 09 | 604-605 | S31113A | 09 | 604-605 | ||
| S25492A | 15 | 793 | S28229A | 24 | 955-965 | S31113A | 24 | 955-965 | ||
| S25492A | 21 | 913-914 | S28229D | 23 | 949-950 | S31113D | 23 | 949-950 | ||
| S25492A | 24 | 955-965 | S28229S | 09 | 604-605 | S31113S | 09 | 604-605 | ||
| S25492D | 23 | 949-950 | S29001A | 21 | 913-914 | S31114A | 09 | 604-605 | ||
| S25492S | 05 | 299-301 | S29001A | 24 | 955-965 | S31114A | 24 | 955-965 | ||
| S25499A | 15 | 791 | S29001D | 23 | 949-950 | S31114D | 23 | 949-950 | ||
| S25499A | 15 | 793 | S29001S | 21 | 913-914 | S31114S | 09 | 604-605 | ||
| S25499A | 21 | 913-914 | S29002A | 21 | 913-914 | S31115A | 09 | 604-605 | ||
| S25499A | 24 | 955-965 | S29002A | 24 | 955-965 | S31115A | 24 | 955-965 | ||
| S25499D | 23 | 949-950 | S29002D | 23 | 949-950 | S31115D | 23 | 949-950 | ||
| S25499S | 05 | 299-301 | S29002S | 21 | 913-914 | S31115S | 09 | 604-605 | ||
| S25501A | 21 | 913-914 | S29009A | 21 | 913-914 | S31119A | 09 | 604-605 | ||
| S25501A | 24 | 955-965 | S29009A | 24 | 955-965 | S31119A | 24 | 955-965 | ||
| S25501D | 23 | 949-950 | S29009D | 23 | 949-950 | S31119D | 23 | 949-950 | ||
| S25501S | 05 | 299-301 | S29009S | 21 | 913-914 | S31119S | 09 | 604-605 | ||
| S25502A | 21 | 913-914 | S29011A | 08 | 562-563 | S31120A | 21 | 913-914 | ||
| S25502A | 24 | 955-965 | S29011A | 24 | 955-965 | S31120A | 24 | 955-965 | ||
| S25502D | 23 | 949-950 | S29011D | 23 | 949-950 | S31120D | 23 | 949-950 | ||
| S25502S | 05 | 299-301 | S29011S | 08 | 562-563 | S31120S | 09 | 604-605 | ||
| S25509A | 21 | 913-914 | S29012A | 08 | 562-563 | S31121A | 21 | 913-914 | ||
| S25509A | 24 | 955-965 | S29012A | 24 | 955-965 | S31121A | 24 | 955-965 | ||
| S25509D | 23 | 949-950 | S29012D | 23 | 949-950 | S31121D | 23 | 949-950 | ||
| S25509S | 05 | 299-301 | S29012S | 08 | 562-563 | S31121S | 09 | 604-605 | ||
| S25511A | 21 | 913-914 | S29019A | 08 | 562-563 | S31122A | 21 | 913-914 | ||
| S25511A | 24 | 955-965 | S29019A | 24 | 955-965 | S31122A | 24 | 955-965 | ||
| S25511D | 23 | 949-950 | S29019D | 23 | 949-950 | S31122D | 23 | 949-950 | ||
| S25511S | 05 | 299-301 | S29019S | 08 | 562-563 | S31122S | 09 | 604-605 | ||
| S25512A | 21 | 913-914 | S29021A | 09 | 604-605 | S31123A | 21 | 913-914 | ||
| S25512A | 24 | 955-965 | S29021A | 24 | 955-965 | S31123A | 24 | 955-965 | ||
| S25512D | 23 | 949-950 | S29021D | 23 | 949-950 | S31123D | 23 | 949-950 | ||
| S25512S | 05 | 299-301 | S29021S | 09 | 604-605 | S31123S | 09 | 604-605 | ||
| S25519A | 21 | 913-914 | S29022A | 09 | 604-605 | S31124A | 21 | 913-914 | ||
| S25519A | 24 | 955-965 | S29022A | 24 | 955-965 | S31124A | 24 | 955-965 | ||
| S25519D | 23 | 949-950 | S29022D | 23 | 949-950 | S31124D | 23 | 949-950 | ||
| S25519S | 05 | 299-301 | S29022S | 09 | 604-605 | S31124S | 09 | 604-605 | ||
| S25591A | 21 | 913-914 | S29029A | 09 | 604-605 | S31125A | 21 | 913-914 | ||
| S25591A | 24 | 955-965 | S29029A | 24 | 955-965 | S31125A | 24 | 955-965 | ||
| S25591D | 23 | 949-950 | S29029D | 23 | 949-950 | S31125D | 23 | 949-950 | ||
| S25591S | 05 | 299-301 | S29029S | 09 | 604-605 | S31125S | 09 | 604-605 | ||
| S25592A | 21 | 913-914 | S29091A | 21 | 913-914 | S31129A | 21 | 913-914 | ||
| S25592A | 24 | 955-965 | S29091A | 24 | 955-965 | S31129A | 24 | 955-965 | ||
| S25592D | 23 | 949-950 | S29091D | 23 | 949-950 | S31129D | 23 | 949-950 | ||
| S25592S | 05 | 299-301 | S29091S | 21 | 913-914 | S31129S | 09 | 604-605 | ||
| S25599A | 21 | 913-914 | S29092A | 21 | 913-914 | S31130A | 09 | 604-605 | ||
| S25599A | 24 | 955-965 | S29092A | 24 | 955-965 | S31130A | 24 | 955-965 | ||
| S25599D | 23 | 949-950 | S29092D | 23 | 949-950 | S31130D | 23 | 949-950 | ||
| S25599S | 05 | 299-301 | S29092S | 21 | 913-914 | S31130S | 09 | 604-605 | ||
| S25801A | 21 | 913-914 | S29099A | 21 | 913-914 | S31131A | 09 | 604-605 | ||
| S25801A | 24 | 955-965 | S29099A | 24 | 955-965 | S31131A | 24 | 955-965 | ||
| S25801D | 23 | 949-950 | S29099D | 23 | 949-950 | S31131D | 23 | 949-950 | ||
| S25801S | 05 | 299-301 | S29099S | 21 | 913-914 | S31131S | 09 | 604-605 | ||
| S25802A | 21 | 913-914 | S298XXA | 21 | 913-914 | S31132A | 09 | 604-605 | ||
| S25802A | 24 | 955-965 | S298XXA | 24 | 955-965 | S31132A | 24 | 955-965 | ||
| S25802D | 23 | 949-950 | S298XXD | 23 | 949-950 | S31132D | 23 | 949-950 | ||
| S25802S | 05 | 299-301 | S298XXS | 21 | 913-914 | S31132S | 09 | 604-605 | ||
| S25809A | 21 | 913-914 | S299XXA | 21 | 913-914 | S31133A | 09 | 604-605 | ||
| S25809A | 24 | 955-965 | S299XXA | 24 | 955-965 | S31133A | 24 | 955-965 | ||
| S25809D | 23 | 949-950 | S299XXD | 23 | 949-950 | S31133D | 23 | 949-950 | ||
| S25809S | 05 | 299-301 | S299XXS | 21 | 913-914 | S31133S | 09 | 604-605 | ||
| S25811A | 21 | 913-914 | S300XXA | 09 | 604-605 | S31134A | 09 | 604-605 | ||
| S25811A | 24 | 955-965 | S300XXA | 24 | 955-965 | S31134A | 24 | 955-965 | ||
| S25811D | 23 | 949-950 | S300XXD | 23 | 949-950 | S31134D | 23 | 949-950 | ||
| S25811S | 05 | 299-301 | S300XXS | 09 | 604-605 | S31134S | 09 | 604-605 | ||
| S25812A | 21 | 913-914 | S301XXA | 09 | 604-605 | S31135A | 09 | 604-605 | ||
| S25812A | 24 | 955-965 | S301XXA | 24 | 955-965 | S31135A | 24 | 955-965 | ||
| S25812D | 23 | 949-950 | S301XXD | 23 | 949-950 | S31135D | 23 | 949-950 | ||
| S25812S | 05 | 299-301 | S301XXS | 09 | 604-605 | S31135S | 09 | 604-605 | ||
| S25819A | 21 | 913-914 | S30201A | 12 | 729-730 | S31139A | 09 | 604-605 | ||
| S25819A | 24 | 955-965 | S30201A | 24 | 955-965 | S31139A | 24 | 955-965 | ||
| S25819D | 23 | 949-950 | S30201D | 23 | 949-950 | S31139D | 23 | 949-950 | ||
| S25819S | 05 | 299-301 | S30201S | 09 | 604-605 | S31139S | 09 | 604-605 | ||
| S25891A | 21 | 913-914 | S30202A | 13 | 742-743 | S31140A | 21 | 913-914 | ||
| S25891A | 24 | 955-965 | S30202A | 13 | 760-761 | S31140A | 24 | 955-965 | ||
| S25891D | 23 | 949-950 | S30202A | 24 | 955-965 | S31140D | 23 | 949-950 | ||
| S25891S | 05 | 299-301 | S30202D | 23 | 949-950 | S31140S | 09 | 604-605 | ||
| S25892A | 21 | 913-914 | S30202S | 09 | 604-605 | S31141A | 21 | 913-914 | ||
| S25892A | 24 | 955-965 | S3021XA | 12 | 729-730 | S31141A | 24 | 955-965 | ||
| S25892D | 23 | 949-950 | S3021XA | 24 | 955-965 | S31141D | 23 | 949-950 | ||
| S25892S | 05 | 299-301 | S3021XD | 23 | 949-950 | S31141S | 09 | 604-605 | ||
| S25899A | 21 | 913-914 | S3021XS | 09 | 604-605 | S31142A | 21 | 913-914 | ||
| S25899A | 24 | 955-965 | S3022XA | 12 | 729-730 | S31142A | 24 | 955-965 | ||
| S25899D | 23 | 949-950 | S3022XA | 24 | 955-965 | S31142D | 23 | 949-950 | ||
| S25899S | 05 | 299-301 | S3022XD | 23 | 949-950 | S31142S | 09 | 604-605 | ||
| S2590XA | 21 | 913-914 | S3022XS | 09 | 604-605 | S31143A | 21 | 913-914 | ||
| S2590XA | 24 | 955-965 | S3023XA | 13 | 742-743 | S31143A | 24 | 955-965 | ||
| S2590XD | 23 | 949-950 | S3023XA | 13 | 760-761 | S31143D | 23 | 949-950 | ||
| S2590XS | 05 | 299-301 | S3023XA | 24 | 955-965 | S31143S | 09 | 604-605 | ||
| S2591XA | 21 | 913-914 | S3023XD | 23 | 949-950 | S31144A | 21 | 913-914 | ||
| S2591XA | 24 | 955-965 | S3023XS | 09 | 604-605 | S31144A | 24 | 955-965 | ||
| S2591XD | 23 | 949-950 | S303XXA | 09 | 604-605 | S31144D | 23 | 949-950 | ||
| S2591XS | 05 | 299-301 | S303XXA | 24 | 955-965 | S31144S | 09 | 604-605 | ||
| S2599XA | 21 | 913-914 | S303XXD | 23 | 949-950 | S31145A | 21 | 913-914 | ||
| S2599XA | 24 | 955-965 | S303XXS | 09 | 604-605 | S31145A | 24 | 955-965 | ||
| S2599XD | 23 | 949-950 | S30810A | 09 | 604-605 | S31145D | 23 | 949-950 | ||
| S2599XS | 05 | 299-301 | S30810A | 24 | 955-965 | S31145S | 09 | 604-605 | ||
| S2600XA | 05 | 314-316 | S30810D | 23 | 949-950 | S31149A | 21 | 913-914 | ||
| S2600XA | 24 | 955-965 | S30810S | 09 | 604-605 | S31149A | 24 | 955-965 | ||
| S2600XD | 23 | 949-950 | S30811A | 09 | 604-605 | S31149D | 23 | 949-950 | ||
| S2600XS | 04 | 205-206 | S30811A | 24 | 955-965 | S31149S | 09 | 604-605 | ||
| S2601XA | 05 | 314-316 | S30811D | 23 | 949-950 | S31150A | 09 | 604-605 | ||
| S2601XA | 24 | 955-965 | S30811S | 09 | 604-605 | S31150A | 24 | 955-965 | ||
| S2601XD | 23 | 949-950 | S30812A | 09 | 604-605 | S31150D | 23 | 949-950 | ||
| S2601XS | 04 | 205-206 | S30812A | 24 | 955-965 | S31150S | 09 | 604-605 | ||
| S26020A | 05 | 314-316 | S30812D | 23 | 949-950 | S31151A | 09 | 604-605 | ||
| S26020A | 24 | 955-965 | S30812S | 09 | 604-605 | S31151A | 24 | 955-965 | ||
| S26020D | 23 | 949-950 | S30813A | 09 | 604-605 | S31151D | 23 | 949-950 | ||
| S26020S | 04 | 205-206 | S30813A | 24 | 955-965 | S31151S | 09 | 604-605 | ||
| S26021A | 05 | 314-316 | S30813D | 23 | 949-950 | S31152A | 09 | 604-605 | ||
| S26021A | 24 | 955-965 | S30813S | 09 | 604-605 | S31152A | 24 | 955-965 | ||
| S26021D | 23 | 949-950 | S30814A | 09 | 604-605 | S31152D | 23 | 949-950 | ||
| S26021S | 04 | 205-206 | S30814A | 24 | 955-965 | S31152S | 09 | 604-605 | ||
| S26022A | 05 | 314-316 | S30814D | 23 | 949-950 | S31153A | 09 | 604-605 | ||
| S26022A | 24 | 955-965 | S30814S | 09 | 604-605 | S31153A | 24 | 955-965 | ||
| S26022D | 23 | 949-950 | S30815A | 09 | 604-605 | S31153D | 23 | 949-950 | ||
| S26022S | 04 | 205-206 | S30815A | 24 | 955-965 | S31153S | 09 | 604-605 | ||
| S2609XA | 05 | 314-316 | S30815D | 23 | 949-950 | S31154A | 09 | 604-605 | ||
| S2609XA | 24 | 955-965 | S30815S | 09 | 604-605 | S31154A | 24 | 955-965 | ||
| S2609XD | 23 | 949-950 | S30816A | 09 | 604-605 | S31154D | 23 | 949-950 | ||
| S2609XS | 04 | 205-206 | S30816A | 24 | 955-965 | S31154S | 09 | 604-605 | ||
| S2610XA | 05 | 314-316 | S30816D | 23 | 949-950 | S31155A | 09 | 604-605 | ||
| S2610XA | 24 | 955-965 | S30816S | 09 | 604-605 | S31155A | 24 | 955-965 | ||
| S2610XD | 23 | 949-950 | S30817A | 09 | 604-605 | S31155D | 23 | 949-950 | ||
| S2610XS | 04 | 205-206 | S30817A | 24 | 955-965 | S31155S | 09 | 604-605 | ||
| S2611XA | 05 | 314-316 | S30817D | 23 | 949-950 | S31159A | 09 | 604-605 | ||
| S2611XA | 24 | 955-965 | S30817S | 09 | 604-605 | S31159A | 24 | 955-965 | ||
| S2611XD | 23 | 949-950 | S30820A | 09 | 606-607 | S31159D | 23 | 949-950 | ||
| S2611XS | 04 | 205-206 | S30820A | 24 | 955-965 | S31159S | 09 | 604-605 | ||
| S2612XA | 05 | 314-316 | S30820D | 23 | 949-950 | S3120XA | 12 | 729-730 | ||
| S2612XA | 24 | 955-965 | S30820S | 09 | 604-605 | S3120XA | 24 | 955-965 | ||
| S2612XD | 23 | 949-950 | S30821A | 09 | 606-607 | S3120XD | 23 | 949-950 | ||
| S2612XS | 04 | 205-206 | S30821A | 24 | 955-965 | S3120XS | 09 | 604-605 | ||
| S2619XA | 05 | 314-316 | S30821D | 23 | 949-950 | S3121XA | 12 | 729-730 | ||
| S2619XA | 24 | 955-965 | S30821S | 09 | 604-605 | S3121XA | 24 | 955-965 | ||
| S2619XD | 23 | 949-950 | S30822A | 09 | 606-607 | S3121XD | 23 | 949-950 | ||
| S2619XS | 04 | 205-206 | S30822A | 24 | 955-965 | S3121XS | 09 | 604-605 | ||
| S2690XA | 05 | 314-316 | S30822D | 23 | 949-950 | S3122XA | 12 | 729-730 | ||
| S2690XA | 24 | 955-965 | S30822S | 09 | 604-605 | S3122XA | 24 | 955-965 | ||
| S2690XD | 23 | 949-950 | S30823A | 09 | 606-607 | S3122XD | 23 | 949-950 | ||
| S2690XS | 04 | 205-206 | S30823A | 24 | 955-965 | S3122XS | 09 | 604-605 | ||
| S2691XA | 05 | 314-316 | S30823D | 23 | 949-950 | S3123XA | 12 | 729-730 | ||
| S2691XA | 24 | 955-965 | S30823S | 09 | 604-605 | S3123XA | 24 | 955-965 | ||
| S2691XD | 23 | 949-950 | S30824A | 09 | 606-607 | S3123XD | 23 | 949-950 | ||
| S2691XS | 04 | 205-206 | S30824A | 24 | 955-965 | S3123XS | 09 | 604-605 | ||
| S2692XA | 05 | 314-316 | S30824D | 23 | 949-950 | S3124XA | 12 | 729-730 | ||
| S2692XA | 24 | 955-965 | S30824S | 09 | 604-605 | S3124XA | 24 | 955-965 | ||
| S2692XD | 23 | 949-950 | S30825A | 09 | 606-607 | S3124XD | 23 | 949-950 | ||
| S2692XS | 04 | 205-206 | S30825A | 24 | 955-965 | S3124XS | 09 | 604-605 | ||
| S2699XA | 05 | 314-316 | S30825D | 23 | 949-950 | S3125XA | 12 | 729-730 | ||
| S2699XA | 24 | 955-965 | S30825S | 09 | 604-605 | S3125XA | 24 | 955-965 | ||
| S2699XD | 23 | 949-950 | S30826A | 09 | 606-607 | S3125XD | 23 | 949-950 | ||
| S2699XS | 04 | 205-206 | S30826A | 24 | 955-965 | S3125XS | 09 | 604-605 | ||
| S270XXA | 04 | 199-201 | S30826D | 23 | 949-950 | S3130XA | 12 | 729-730 | ||
| S270XXA | 15 | 791 | S30826S | 09 | 604-605 | S3130XA | 24 | 955-965 | ||
| S270XXA | 15 | 793 | S30827A | 09 | 606-607 | S3130XD | 23 | 949-950 | ||
| S270XXA | 24 | 955-965 | S30827A | 24 | 955-965 | S3130XS | 09 | 604-605 | ||
| S270XXD | 23 | 949-950 | S30827D | 23 | 949-950 | S3131XA | 12 | 729-730 | ||
| S270XXS | 04 | 205-206 | S30827S | 09 | 604-605 | S3131XA | 24 | 955-965 | ||
| S271XXA | 04 | 199-201 | S30840A | 09 | 604-605 | S3131XD | 23 | 949-950 | ||
| S271XXA | 15 | 791 | S30840A | 24 | 955-965 | S3131XS | 09 | 604-605 | ||
| S271XXA | 15 | 793 | S30840D | 23 | 949-950 | S3132XA | 12 | 729-730 | ||
| S271XXA | 24 | 955-965 | S30840S | 09 | 604-605 | S3132XA | 24 | 955-965 | ||
| S271XXD | 23 | 949-950 | S30841A | 09 | 604-605 | S3132XD | 23 | 949-950 | ||
| S271XXS | 04 | 205-206 | S30841A | 24 | 955-965 | S3132XS | 09 | 604-605 | ||
| S272XXA | 04 | 199-201 | S30841D | 23 | 949-950 | S3133XA | 12 | 729-730 | ||
| S272XXA | 15 | 791 | S30841S | 09 | 604-605 | S3133XA | 24 | 955-965 | ||
| S272XXA | 15 | 793 | S30842A | 09 | 604-605 | S3133XD | 23 | 949-950 | ||
| S272XXA | 24 | 955-965 | S30842A | 24 | 955-965 | S3133XS | 09 | 604-605 | ||
| S272XXD | 23 | 949-950 | S30842D | 23 | 949-950 | S3134XA | 12 | 729-730 | ||
| S272XXS | 04 | 205-206 | S30842S | 09 | 604-605 | S3134XA | 24 | 955-965 | ||
| S27301A | 04 | 205-206 | S30843A | 09 | 604-605 | S3134XD | 23 | 949-950 | ||
| S27301A | 24 | 955-965 | S30843A | 24 | 955-965 | S3134XS | 09 | 604-605 | ||
| S27301D | 23 | 949-950 | S30843D | 23 | 949-950 | S3135XA | 12 | 729-730 | ||
| S27301S | 04 | 205-206 | S30843S | 09 | 604-605 | S3135XA | 24 | 955-965 | ||
| S27302A | 04 | 205-206 | S30844A | 09 | 604-605 | S3135XD | 23 | 949-950 | ||
| S27302A | 24 | 955-965 | S30844A | 24 | 955-965 | S3135XS | 09 | 604-605 | ||
| S27302D | 23 | 949-950 | S30844D | 23 | 949-950 | S3140XA | 13 | 742-743 | ||
| S27302S | 04 | 205-206 | S30844S | 09 | 604-605 | S3140XA | 13 | 760-761 | ||
| S27309A | 04 | 205-206 | S30845A | 09 | 604-605 | S3140XA | 24 | 955-965 | ||
| S27309A | 24 | 955-965 | S30845A | 24 | 955-965 | S3140XD | 23 | 949-950 | ||
| S27309D | 23 | 949-950 | S30845D | 23 | 949-950 | S3140XS | 09 | 604-605 | ||
| S27309S | 04 | 205-206 | S30845S | 09 | 604-605 | S3141XA | 13 | 742-743 | ||
| S27311A | 04 | 205-206 | S30846A | 09 | 604-605 | S3141XA | 13 | 760-761 | ||
| S27311A | 24 | 955-965 | S30846A | 24 | 955-965 | S3141XA | 24 | 955-965 | ||
| S27311D | 23 | 949-950 | S30846D | 23 | 949-950 | S3141XD | 23 | 949-950 | ||
| S27311S | 04 | 205-206 | S30846S | 09 | 604-605 | S3141XS | 09 | 604-605 | ||
| S27312A | 04 | 205-206 | S30850A | 09 | 604-605 | S3142XA | 13 | 742-743 | ||
| S27312A | 24 | 955-965 | S30850A | 24 | 955-965 | S3142XA | 13 | 760-761 | ||
| S27312D | 23 | 949-950 | S30850D | 23 | 949-950 | S3142XA | 24 | 955-965 | ||
| S27312S | 04 | 205-206 | S30850S | 09 | 604-605 | S3142XD | 23 | 949-950 | ||
| S27319A | 04 | 205-206 | S30851A | 09 | 604-605 | S3142XS | 09 | 604-605 | ||
| S27319A | 24 | 955-965 | S30851A | 24 | 955-965 | S3143XA | 13 | 742-743 | ||
| S27319D | 23 | 949-950 | S30851D | 23 | 949-950 | S3143XA | 13 | 760-761 | ||
| S27319S | 04 | 205-206 | S30851S | 09 | 604-605 | S3143XA | 24 | 955-965 | ||
| S27321A | 04 | 205-206 | S30852A | 09 | 604-605 | S3143XD | 23 | 949-950 | ||
| S27321A | 24 | 955-965 | S30852A | 24 | 955-965 | S3143XS | 09 | 604-605 | ||
| S27321D | 23 | 949-950 | S30852D | 23 | 949-950 | S3144XA | 13 | 742-743 | ||
| S27321S | 04 | 205-206 | S30852S | 09 | 604-605 | S3144XA | 13 | 760-761 | ||
| S27322A | 04 | 205-206 | S30853A | 09 | 604-605 | S3144XA | 24 | 955-965 | ||
| S27322A | 24 | 955-965 | S30853A | 24 | 955-965 | S3144XD | 23 | 949-950 | ||
| S27322D | 23 | 949-950 | S30853D | 23 | 949-950 | S3144XS | 09 | 604-605 | ||
| S27322S | 04 | 205-206 | S30853S | 09 | 604-605 | S3145XA | 13 | 742-743 | ||
| S27329A | 04 | 205-206 | S30854A | 09 | 604-605 | S3145XA | 13 | 760-761 | ||
| S27329A | 24 | 955-965 | S30854A | 24 | 955-965 | S3145XA | 24 | 955-965 | ||
| S27329D | 23 | 949-950 | S30854D | 23 | 949-950 | S3145XD | 23 | 949-950 | ||
| S27329S | 04 | 205-206 | S30854S | 09 | 604-605 | S3145XS | 09 | 604-605 | ||
| S27331A | 04 | 183-185 | S30855A | 09 | 604-605 | S31501A | 12 | 729-730 | ||
| S27331A | 24 | 955-965 | S30855A | 24 | 955-965 | S31501A | 24 | 955-965 | ||
| S27331D | 23 | 949-950 | S30855D | 23 | 949-950 | S31501D | 23 | 949-950 | ||
| S27331S | 04 | 205-206 | S30855S | 09 | 604-605 | S31501S | 12 | 729-730 | ||
| S27332A | 04 | 183-185 | S30856A | 09 | 604-605 | S31502A | 13 | 742-743 | ||
| S27332A | 24 | 955-965 | S30856A | 24 | 955-965 | S31502A | 13 | 760-761 | ||
| S27332D | 23 | 949-950 | S30856D | 23 | 949-950 | S31502A | 24 | 955-965 | ||
| S27332S | 04 | 205-206 | S30856S | 09 | 604-605 | S31502D | 23 | 949-950 | ||
| S27339A | 04 | 183-185 | S30857A | 09 | 604-605 | S31502S | 13 | 742-743 | ||
| S27339A | 24 | 955-965 | S30857A | 24 | 955-965 | S31502S | 13 | 760-761 | ||
| S27339D | 23 | 949-950 | S30857D | 23 | 949-950 | S31511A | 12 | 729-730 | ||
| S27339S | 04 | 205-206 | S30857S | 09 | 604-605 | S31511A | 24 | 955-965 | ||
| S27391A | 04 | 205-206 | S30860A | 09 | 606-607 | S31511D | 23 | 949-950 | ||
| S27391A | 24 | 955-965 | S30860A | 24 | 955-965 | S31511S | 12 | 729-730 | ||
| S27391D | 23 | 949-950 | S30860D | 23 | 949-950 | S31512A | 13 | 742-743 | ||
| S27391S | 04 | 205-206 | S30860S | 09 | 604-605 | S31512A | 13 | 760-761 | ||
| S27392A | 04 | 205-206 | S30861A | 09 | 606-607 | S31512A | 24 | 955-965 | ||
| S27392A | 24 | 955-965 | S30861A | 24 | 955-965 | S31512D | 23 | 949-950 | ||
| S27392D | 23 | 949-950 | S30861D | 23 | 949-950 | S31512S | 13 | 742-743 | ||
| S27392S | 04 | 205-206 | S30861S | 09 | 604-605 | S31512S | 13 | 760-761 | ||
| S27399A | 04 | 205-206 | S30862A | 09 | 606-607 | S31521A | 12 | 729-730 | ||
| S27399A | 24 | 955-965 | S30862A | 24 | 955-965 | S31521A | 24 | 955-965 | ||
| S27399D | 23 | 949-950 | S30862D | 23 | 949-950 | S31521D | 23 | 949-950 | ||
| S27399S | 04 | 205-206 | S30862S | 09 | 604-605 | S31521S | 12 | 729-730 | ||
| S27401A | 04 | 183-185 | S30863A | 09 | 606-607 | S31522A | 13 | 742-743 | ||
| S27401A | 24 | 955-965 | S30863A | 24 | 955-965 | S31522A | 13 | 760-761 | ||
| S27401D | 23 | 949-950 | S30863D | 23 | 949-950 | S31522A | 24 | 955-965 | ||
| S27401S | 04 | 205-206 | S30863S | 09 | 604-605 | S31522D | 23 | 949-950 | ||
| S27402A | 04 | 183-185 | S30864A | 09 | 606-607 | S31522S | 13 | 742-743 | ||
| S27402A | 24 | 955-965 | S30864A | 24 | 955-965 | S31522S | 13 | 760-761 | ||
| S27402D | 23 | 949-950 | S30864D | 23 | 949-950 | S31531A | 12 | 729-730 | ||
| S27402S | 04 | 205-206 | S30864S | 09 | 604-605 | S31531A | 24 | 955-965 | ||
| S27409A | 04 | 183-185 | S30865A | 09 | 606-607 | S31531D | 23 | 949-950 | ||
| S27409A | 24 | 955-965 | S30865A | 24 | 955-965 | S31531S | 12 | 729-730 | ||
| S27409D | 23 | 949-950 | S30865D | 23 | 949-950 | S31532A | 13 | 742-743 | ||
| S27409S | 04 | 205-206 | S30865S | 09 | 604-605 | S31532A | 13 | 760-761 | ||
| S27411A | 04 | 183-185 | S30866A | 09 | 606-607 | S31532A | 24 | 955-965 | ||
| S27411A | 24 | 955-965 | S30866A | 24 | 955-965 | S31532D | 23 | 949-950 | ||
| S27411D | 23 | 949-950 | S30866D | 23 | 949-950 | S31532S | 13 | 742-743 | ||
| S27411S | 04 | 205-206 | S30866S | 09 | 604-605 | S31532S | 13 | 760-761 | ||
| S27412A | 04 | 183-185 | S30867A | 09 | 606-607 | S31541A | 12 | 729-730 | ||
| S27412A | 24 | 955-965 | S30867A | 24 | 955-965 | S31541A | 24 | 955-965 | ||
| S27412D | 23 | 949-950 | S30867D | 23 | 949-950 | S31541D | 23 | 949-950 | ||
| S27412S | 04 | 205-206 | S30867S | 09 | 604-605 | S31541S | 12 | 729-730 | ||
| S27419A | 04 | 183-185 | S30870A | 09 | 604-605 | S31542A | 13 | 742-743 | ||
| S27419A | 24 | 955-965 | S30870A | 24 | 955-965 | S31542A | 13 | 760-761 | ||
| S27419D | 23 | 949-950 | S30870D | 23 | 949-950 | S31542A | 24 | 955-965 | ||
| S27419S | 04 | 205-206 | S30870S | 09 | 604-605 | S31542D | 23 | 949-950 | ||
| S27421A | 04 | 183-185 | S30871A | 09 | 604-605 | S31542S | 13 | 742-743 | ||
| S27421A | 24 | 955-965 | S30871A | 24 | 955-965 | S31542S | 13 | 760-761 | ||
| S27421D | 23 | 949-950 | S30871D | 23 | 949-950 | S31551A | 12 | 729-730 | ||
| S27421S | 04 | 205-206 | S30871S | 09 | 604-605 | S31551A | 24 | 955-965 | ||
| S27422A | 04 | 183-185 | S30872A | 09 | 604-605 | S31551D | 23 | 949-950 | ||
| S27422A | 24 | 955-965 | S30872A | 24 | 955-965 | S31551S | 12 | 729-730 | ||
| S27422D | 23 | 949-950 | S30872D | 23 | 949-950 | S31552A | 13 | 742-743 | ||
| S27422S | 04 | 205-206 | S30872S | 09 | 604-605 | S31552A | 13 | 760-761 | ||
| S27429A | 04 | 183-185 | S30873A | 09 | 604-605 | S31552A | 24 | 955-965 | ||
| S27429A | 24 | 955-965 | S30873A | 24 | 955-965 | S31552D | 23 | 949-950 | ||
| S27429D | 23 | 949-950 | S30873D | 23 | 949-950 | S31552S | 13 | 742-743 | ||
| S27429S | 04 | 205-206 | S30873S | 09 | 604-605 | S31552S | 13 | 760-761 | ||
| S27431A | 04 | 183-185 | S30874A | 09 | 604-605 | S31600A | 06 | 393-395 | ||
| S27431A | 24 | 955-965 | S30874A | 24 | 955-965 | S31600A | 24 | 955-965 | ||
| S27431D | 23 | 949-950 | S30874D | 23 | 949-950 | S31600D | 23 | 949-950 | ||
| S27431S | 04 | 205-206 | S30874S | 09 | 604-605 | S31600S | 09 | 604-605 | ||
| S27432A | 04 | 183-185 | S30875A | 09 | 604-605 | S31601A | 06 | 393-395 | ||
| S27432A | 24 | 955-965 | S30875A | 24 | 955-965 | S31601A | 24 | 955-965 | ||
| S27432D | 23 | 949-950 | S30875D | 23 | 949-950 | S31601D | 23 | 949-950 | ||
| S27432S | 04 | 205-206 | S30875S | 09 | 604-605 | S31601S | 09 | 604-605 | ||
| S27439A | 04 | 183-185 | S30876A | 09 | 604-605 | S31602A | 06 | 393-395 | ||
| S27439A | 24 | 955-965 | S30876A | 24 | 955-965 | S31602A | 24 | 955-965 | ||
| S27439D | 23 | 949-950 | S30876D | 23 | 949-950 | S31602D | 23 | 949-950 | ||
| S27439S | 04 | 205-206 | S30876S | 09 | 604-605 | S31602S | 09 | 604-605 | ||
| S27491A | 04 | 183-185 | S30877A | 09 | 604-605 | S31603A | 06 | 393-395 | ||
| S27491A | 24 | 955-965 | S30877A | 24 | 955-965 | S31603A | 24 | 955-965 | ||
| S27491D | 23 | 949-950 | S30877D | 23 | 949-950 | S31603D | 23 | 949-950 | ||
| S27491S | 04 | 205-206 | S30877S | 09 | 604-605 | S31603S | 09 | 604-605 | ||
| S27492A | 04 | 183-185 | S3091XA | 09 | 604-605 | S31604A | 06 | 393-395 | ||
| S27492A | 24 | 955-965 | S3091XA | 24 | 955-965 | S31604A | 24 | 955-965 | ||
| S27492D | 23 | 949-950 | S3091XD | 23 | 949-950 | S31604D | 23 | 949-950 | ||
| S27492S | 04 | 205-206 | S3091XS | 09 | 604-605 | S31604S | 09 | 604-605 | ||
| S27499A | 04 | 183-185 | S3092XA | 09 | 604-605 | S31605A | 06 | 393-395 | ||
| S27499A | 24 | 955-965 | S3092XA | 24 | 955-965 | S31605A | 24 | 955-965 | ||
| S27499D | 23 | 949-950 | S3092XD | 23 | 949-950 | S31605D | 23 | 949-950 | ||
| S27499S | 04 | 205-206 | S3092XS | 09 | 604-605 | S31605S | 09 | 604-605 | ||
| S2750XA | 04 | 205-206 | S3093XA | 09 | 604-605 | S31609A | 06 | 393-395 | ||
| S2750XA | 24 | 955-965 | S3093XA | 24 | 955-965 | S31609A | 24 | 955-965 | ||
| S2750XD | 23 | 949-950 | S3093XD | 23 | 949-950 | S31609D | 23 | 949-950 | ||
| S2750XS | 04 | 205-206 | S3093XS | 09 | 604-605 | S31609S | 09 | 604-605 | ||
| S2751XA | 04 | 205-206 | S3094XA | 09 | 604-605 | S31610A | 06 | 393-395 | ||
| S2751XA | 24 | 955-965 | S3094XA | 24 | 955-965 | S31610A | 24 | 955-965 | ||
| S2751XD | 23 | 949-950 | S3094XD | 23 | 949-950 | S31610D | 23 | 949-950 | ||
| S2751XS | 04 | 205-206 | S3094XS | 09 | 604-605 | S31610S | 09 | 604-605 | ||
| S2752XA | 04 | 205-206 | S3095XA | 09 | 604-605 | S31611A | 06 | 393-395 | ||
| S2752XA | 24 | 955-965 | S3095XA | 24 | 955-965 | S31611A | 24 | 955-965 | ||
| S2752XD | 23 | 949-950 | S3095XD | 23 | 949-950 | S31611D | 23 | 949-950 | ||
| S2752XS | 04 | 205-206 | S3095XS | 09 | 604-605 | S31611S | 09 | 604-605 | ||
| S2753XA | 04 | 205-206 | S3096XA | 09 | 604-605 | S31612A | 06 | 393-395 | ||
| S2753XA | 24 | 955-965 | S3096XA | 24 | 955-965 | S31612A | 24 | 955-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 14 Apr 2020 14:43:32 CMS, code-revision=250, description-revision=1275 |