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 55 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S76309S | 21 | 913-914 | S79121D | 08 | 559-561 | S81802S | 09 | 604-605 | ||
| S76311A | 08 | 537-538 | S79121G | 08 | 559-561 | S81809A | 09 | 604-605 | ||
| S76311A | 24 | 955-965 | S79121K | 08 | 564-566 | S81809A | 24 | 955-965 | ||
| S76311D | 23 | 949-950 | S79121P | 08 | 564-566 | S81809D | 23 | 949-950 | ||
| S76311S | 08 | 562-563 | S79121S | 08 | 559-561 | S81809S | 09 | 604-605 | ||
| S76312A | 08 | 537-538 | S79122A | 08 | 533-534 | S81811A | 09 | 604-605 | ||
| S76312A | 24 | 955-965 | S79122A | 24 | 955-965 | S81811A | 24 | 955-965 | ||
| S76312D | 23 | 949-950 | S79122D | 08 | 559-561 | S81811D | 23 | 949-950 | ||
| S76312S | 08 | 562-563 | S79122G | 08 | 559-561 | S81811S | 09 | 604-605 | ||
| S76319A | 08 | 537-538 | S79122K | 08 | 564-566 | S81812A | 09 | 604-605 | ||
| S76319A | 24 | 955-965 | S79122P | 08 | 564-566 | S81812A | 24 | 955-965 | ||
| S76319D | 23 | 949-950 | S79122S | 08 | 559-561 | S81812D | 23 | 949-950 | ||
| S76319S | 08 | 562-563 | S79129A | 08 | 533-534 | S81812S | 09 | 604-605 | ||
| S76321A | 08 | 564-566 | S79129A | 24 | 955-965 | S81819A | 09 | 604-605 | ||
| S76321A | 24 | 955-965 | S79129D | 08 | 559-561 | S81819A | 24 | 955-965 | ||
| S76321D | 23 | 949-950 | S79129G | 08 | 559-561 | S81819D | 23 | 949-950 | ||
| S76321S | 09 | 604-605 | S79129K | 08 | 564-566 | S81819S | 09 | 604-605 | ||
| S76322A | 08 | 564-566 | S79129P | 08 | 564-566 | S81821A | 21 | 913-914 | ||
| S76322A | 24 | 955-965 | S79129S | 08 | 559-561 | S81821A | 24 | 955-965 | ||
| S76322D | 23 | 949-950 | S79131A | 08 | 533-534 | S81821D | 23 | 949-950 | ||
| S76322S | 09 | 604-605 | S79131A | 24 | 955-965 | S81821S | 09 | 604-605 | ||
| S76329A | 08 | 564-566 | S79131D | 08 | 559-561 | S81822A | 21 | 913-914 | ||
| S76329A | 24 | 955-965 | S79131G | 08 | 559-561 | S81822A | 24 | 955-965 | ||
| S76329D | 23 | 949-950 | S79131K | 08 | 564-566 | S81822D | 23 | 949-950 | ||
| S76329S | 09 | 604-605 | S79131P | 08 | 564-566 | S81822S | 09 | 604-605 | ||
| S76391A | 21 | 913-914 | S79131S | 08 | 559-561 | S81829A | 21 | 913-914 | ||
| S76391A | 24 | 955-965 | S79132A | 08 | 533-534 | S81829A | 24 | 955-965 | ||
| S76391D | 23 | 949-950 | S79132A | 24 | 955-965 | S81829D | 23 | 949-950 | ||
| S76391S | 21 | 913-914 | S79132D | 08 | 559-561 | S81829S | 09 | 604-605 | ||
| S76392A | 21 | 913-914 | S79132G | 08 | 559-561 | S81831A | 09 | 604-605 | ||
| S76392A | 24 | 955-965 | S79132K | 08 | 564-566 | S81831A | 24 | 955-965 | ||
| S76392D | 23 | 949-950 | S79132P | 08 | 564-566 | S81831D | 23 | 949-950 | ||
| S76392S | 21 | 913-914 | S79132S | 08 | 559-561 | S81831S | 09 | 604-605 | ||
| S76399A | 21 | 913-914 | S79139A | 08 | 533-534 | S81832A | 09 | 604-605 | ||
| S76399A | 24 | 955-965 | S79139A | 24 | 955-965 | S81832A | 24 | 955-965 | ||
| S76399D | 23 | 949-950 | S79139D | 08 | 559-561 | S81832D | 23 | 949-950 | ||
| S76399S | 21 | 913-914 | S79139G | 08 | 559-561 | S81832S | 09 | 604-605 | ||
| S76801A | 21 | 913-914 | S79139K | 08 | 564-566 | S81839A | 09 | 604-605 | ||
| S76801A | 24 | 955-965 | S79139P | 08 | 564-566 | S81839A | 24 | 955-965 | ||
| S76801D | 23 | 949-950 | S79139S | 08 | 559-561 | S81839D | 23 | 949-950 | ||
| S76801S | 21 | 913-914 | S79141A | 08 | 533-534 | S81839S | 09 | 604-605 | ||
| S76802A | 21 | 913-914 | S79141A | 24 | 955-965 | S81841A | 21 | 913-914 | ||
| S76802A | 24 | 955-965 | S79141D | 08 | 559-561 | S81841A | 24 | 955-965 | ||
| S76802D | 23 | 949-950 | S79141G | 08 | 559-561 | S81841D | 23 | 949-950 | ||
| S76802S | 21 | 913-914 | S79141K | 08 | 564-566 | S81841S | 09 | 604-605 | ||
| S76809A | 21 | 913-914 | S79141P | 08 | 564-566 | S81842A | 21 | 913-914 | ||
| S76809A | 24 | 955-965 | S79141S | 08 | 559-561 | S81842A | 24 | 955-965 | ||
| S76809D | 23 | 949-950 | S79142A | 08 | 533-534 | S81842D | 23 | 949-950 | ||
| S76809S | 21 | 913-914 | S79142A | 24 | 955-965 | S81842S | 09 | 604-605 | ||
| S76811A | 08 | 537-538 | S79142D | 08 | 559-561 | S81849A | 21 | 913-914 | ||
| S76811A | 24 | 955-965 | S79142G | 08 | 559-561 | S81849A | 24 | 955-965 | ||
| S76811D | 23 | 949-950 | S79142K | 08 | 564-566 | S81849D | 23 | 949-950 | ||
| S76811S | 08 | 562-563 | S79142P | 08 | 564-566 | S81849S | 09 | 604-605 | ||
| S76812A | 08 | 537-538 | S79142S | 08 | 559-561 | S81851A | 09 | 604-605 | ||
| S76812A | 24 | 955-965 | S79149A | 08 | 533-534 | S81851A | 24 | 955-965 | ||
| S76812D | 23 | 949-950 | S79149A | 24 | 955-965 | S81851D | 23 | 949-950 | ||
| S76812S | 08 | 562-563 | S79149D | 08 | 559-561 | S81851S | 09 | 604-605 | ||
| S76819A | 08 | 537-538 | S79149G | 08 | 559-561 | S81852A | 09 | 604-605 | ||
| S76819A | 24 | 955-965 | S79149K | 08 | 564-566 | S81852A | 24 | 955-965 | ||
| S76819D | 23 | 949-950 | S79149P | 08 | 564-566 | S81852D | 23 | 949-950 | ||
| S76819S | 08 | 562-563 | S79149S | 08 | 559-561 | S81852S | 09 | 604-605 | ||
| S76821A | 08 | 564-566 | S79191A | 08 | 533-534 | S81859A | 09 | 604-605 | ||
| S76821A | 24 | 955-965 | S79191A | 24 | 955-965 | S81859A | 24 | 955-965 | ||
| S76821D | 23 | 949-950 | S79191D | 08 | 559-561 | S81859D | 23 | 949-950 | ||
| S76821S | 09 | 604-605 | S79191G | 08 | 559-561 | S81859S | 09 | 604-605 | ||
| S76822A | 08 | 564-566 | S79191K | 08 | 564-566 | S82001A | 08 | 562-563 | ||
| S76822A | 24 | 955-965 | S79191P | 08 | 564-566 | S82001A | 24 | 955-965 | ||
| S76822D | 23 | 949-950 | S79191S | 08 | 559-561 | S82001B | 08 | 562-563 | ||
| S76822S | 09 | 604-605 | S79192A | 08 | 533-534 | S82001B | 24 | 955-965 | ||
| S76829A | 08 | 564-566 | S79192A | 24 | 955-965 | S82001C | 08 | 562-563 | ||
| S76829A | 24 | 955-965 | S79192D | 08 | 559-561 | S82001C | 24 | 955-965 | ||
| S76829D | 23 | 949-950 | S79192G | 08 | 559-561 | S82001D | 08 | 559-561 | ||
| S76829S | 09 | 604-605 | S79192K | 08 | 564-566 | S82001E | 08 | 559-561 | ||
| S76891A | 21 | 913-914 | S79192P | 08 | 564-566 | S82001F | 08 | 559-561 | ||
| S76891A | 24 | 955-965 | S79192S | 08 | 559-561 | S82001G | 08 | 559-561 | ||
| S76891D | 23 | 949-950 | S79199A | 08 | 533-534 | S82001H | 08 | 559-561 | ||
| S76891S | 21 | 913-914 | S79199A | 24 | 955-965 | S82001J | 08 | 559-561 | ||
| S76892A | 21 | 913-914 | S79199D | 08 | 559-561 | S82001K | 08 | 564-566 | ||
| S76892A | 24 | 955-965 | S79199G | 08 | 559-561 | S82001M | 08 | 564-566 | ||
| S76892D | 23 | 949-950 | S79199K | 08 | 564-566 | S82001N | 08 | 564-566 | ||
| S76892S | 21 | 913-914 | S79199P | 08 | 564-566 | S82001P | 08 | 564-566 | ||
| S76899A | 21 | 913-914 | S79199S | 08 | 559-561 | S82001Q | 08 | 564-566 | ||
| S76899A | 24 | 955-965 | S79811A | 21 | 913-914 | S82001R | 08 | 564-566 | ||
| S76899D | 23 | 949-950 | S79811A | 24 | 955-965 | S82001S | 08 | 559-561 | ||
| S76899S | 21 | 913-914 | S79811D | 23 | 949-950 | S82002A | 08 | 562-563 | ||
| S76901A | 21 | 913-914 | S79811S | 21 | 913-914 | S82002A | 24 | 955-965 | ||
| S76901A | 24 | 955-965 | S79812A | 21 | 913-914 | S82002B | 08 | 562-563 | ||
| S76901D | 23 | 949-950 | S79812A | 24 | 955-965 | S82002B | 24 | 955-965 | ||
| S76901S | 21 | 913-914 | S79812D | 23 | 949-950 | S82002C | 08 | 562-563 | ||
| S76902A | 21 | 913-914 | S79812S | 21 | 913-914 | S82002C | 24 | 955-965 | ||
| S76902A | 24 | 955-965 | S79819A | 21 | 913-914 | S82002D | 08 | 559-561 | ||
| S76902D | 23 | 949-950 | S79819A | 24 | 955-965 | S82002E | 08 | 559-561 | ||
| S76902S | 21 | 913-914 | S79819D | 23 | 949-950 | S82002F | 08 | 559-561 | ||
| S76909A | 21 | 913-914 | S79819S | 21 | 913-914 | S82002G | 08 | 559-561 | ||
| S76909A | 24 | 955-965 | S79821A | 21 | 913-914 | S82002H | 08 | 559-561 | ||
| S76909D | 23 | 949-950 | S79821A | 24 | 955-965 | S82002J | 08 | 559-561 | ||
| S76909S | 21 | 913-914 | S79821D | 23 | 949-950 | S82002K | 08 | 564-566 | ||
| S76911A | 08 | 537-538 | S79821S | 21 | 913-914 | S82002M | 08 | 564-566 | ||
| S76911A | 24 | 955-965 | S79822A | 21 | 913-914 | S82002N | 08 | 564-566 | ||
| S76911D | 23 | 949-950 | S79822A | 24 | 955-965 | S82002P | 08 | 564-566 | ||
| S76911S | 08 | 562-563 | S79822D | 23 | 949-950 | S82002Q | 08 | 564-566 | ||
| S76912A | 08 | 537-538 | S79822S | 21 | 913-914 | S82002R | 08 | 564-566 | ||
| S76912A | 24 | 955-965 | S79829A | 21 | 913-914 | S82002S | 08 | 559-561 | ||
| S76912D | 23 | 949-950 | S79829A | 24 | 955-965 | S82009A | 08 | 562-563 | ||
| S76912S | 08 | 562-563 | S79829D | 23 | 949-950 | S82009A | 24 | 955-965 | ||
| S76919A | 08 | 537-538 | S79829S | 21 | 913-914 | S82009B | 08 | 562-563 | ||
| S76919A | 24 | 955-965 | S79911A | 21 | 913-914 | S82009B | 24 | 955-965 | ||
| S76919D | 23 | 949-950 | S79911A | 24 | 955-965 | S82009C | 08 | 562-563 | ||
| S76919S | 08 | 562-563 | S79911D | 23 | 949-950 | S82009C | 24 | 955-965 | ||
| S76921A | 08 | 564-566 | S79911S | 21 | 913-914 | S82009D | 08 | 559-561 | ||
| S76921A | 24 | 955-965 | S79912A | 21 | 913-914 | S82009E | 08 | 559-561 | ||
| S76921D | 23 | 949-950 | S79912A | 24 | 955-965 | S82009F | 08 | 559-561 | ||
| S76921S | 09 | 604-605 | S79912D | 23 | 949-950 | S82009G | 08 | 559-561 | ||
| S76922A | 08 | 564-566 | S79912S | 21 | 913-914 | S82009H | 08 | 559-561 | ||
| S76922A | 24 | 955-965 | S79919A | 21 | 913-914 | S82009J | 08 | 559-561 | ||
| S76922D | 23 | 949-950 | S79919A | 24 | 955-965 | S82009K | 08 | 564-566 | ||
| S76922S | 09 | 604-605 | S79919D | 23 | 949-950 | S82009M | 08 | 564-566 | ||
| S76929A | 08 | 564-566 | S79919S | 21 | 913-914 | S82009N | 08 | 564-566 | ||
| S76929A | 24 | 955-965 | S79921A | 21 | 913-914 | S82009P | 08 | 564-566 | ||
| S76929D | 23 | 949-950 | S79921A | 24 | 955-965 | S82009Q | 08 | 564-566 | ||
| S76929S | 09 | 604-605 | S79921D | 23 | 949-950 | S82009R | 08 | 564-566 | ||
| S76991A | 21 | 913-914 | S79921S | 21 | 913-914 | S82009S | 08 | 559-561 | ||
| S76991A | 24 | 955-965 | S79922A | 21 | 913-914 | S82011A | 08 | 562-563 | ||
| S76991D | 23 | 949-950 | S79922A | 24 | 955-965 | S82011A | 24 | 955-965 | ||
| S76991S | 21 | 913-914 | S79922D | 23 | 949-950 | S82011B | 08 | 562-563 | ||
| S76992A | 21 | 913-914 | S79922S | 21 | 913-914 | S82011B | 24 | 955-965 | ||
| S76992A | 24 | 955-965 | S79929A | 21 | 913-914 | S82011C | 08 | 562-563 | ||
| S76992D | 23 | 949-950 | S79929A | 24 | 955-965 | S82011C | 24 | 955-965 | ||
| S76992S | 21 | 913-914 | S79929D | 23 | 949-950 | S82011D | 08 | 559-561 | ||
| S76999A | 21 | 913-914 | S79929S | 21 | 913-914 | S82011E | 08 | 559-561 | ||
| S76999A | 24 | 955-965 | S8000XA | 09 | 604-605 | S82011F | 08 | 559-561 | ||
| S76999D | 23 | 949-950 | S8000XA | 24 | 955-965 | S82011G | 08 | 559-561 | ||
| S76999S | 21 | 913-914 | S8000XD | 23 | 949-950 | S82011H | 08 | 559-561 | ||
| S7700XA | 21 | 913-914 | S8000XS | 09 | 604-605 | S82011J | 08 | 559-561 | ||
| S7700XA | 24 | 955-965 | S8001XA | 09 | 604-605 | S82011K | 08 | 564-566 | ||
| S7700XD | 23 | 949-950 | S8001XA | 24 | 955-965 | S82011M | 08 | 564-566 | ||
| S7700XS | 09 | 604-605 | S8001XD | 23 | 949-950 | S82011N | 08 | 564-566 | ||
| S7701XA | 21 | 913-914 | S8001XS | 09 | 604-605 | S82011P | 08 | 564-566 | ||
| S7701XA | 24 | 955-965 | S8002XA | 09 | 604-605 | S82011Q | 08 | 564-566 | ||
| S7701XD | 23 | 949-950 | S8002XA | 24 | 955-965 | S82011R | 08 | 564-566 | ||
| S7701XS | 09 | 604-605 | S8002XD | 23 | 949-950 | S82011S | 08 | 559-561 | ||
| S7702XA | 21 | 913-914 | S8002XS | 09 | 604-605 | S82012A | 08 | 562-563 | ||
| S7702XA | 24 | 955-965 | S8010XA | 09 | 604-605 | S82012A | 24 | 955-965 | ||
| S7702XD | 23 | 949-950 | S8010XA | 24 | 955-965 | S82012B | 08 | 562-563 | ||
| S7702XS | 09 | 604-605 | S8010XD | 23 | 949-950 | S82012B | 24 | 955-965 | ||
| S7710XA | 21 | 913-914 | S8010XS | 09 | 604-605 | S82012C | 08 | 562-563 | ||
| S7710XA | 24 | 955-965 | S8011XA | 09 | 604-605 | S82012C | 24 | 955-965 | ||
| S7710XD | 23 | 949-950 | S8011XA | 24 | 955-965 | S82012D | 08 | 559-561 | ||
| S7710XS | 09 | 604-605 | S8011XD | 23 | 949-950 | S82012E | 08 | 559-561 | ||
| S7711XA | 21 | 913-914 | S8011XS | 09 | 604-605 | S82012F | 08 | 559-561 | ||
| S7711XA | 24 | 955-965 | S8012XA | 09 | 604-605 | S82012G | 08 | 559-561 | ||
| S7711XD | 23 | 949-950 | S8012XA | 24 | 955-965 | S82012H | 08 | 559-561 | ||
| S7711XS | 09 | 604-605 | S8012XD | 23 | 949-950 | S82012J | 08 | 559-561 | ||
| S7712XA | 21 | 913-914 | S8012XS | 09 | 604-605 | S82012K | 08 | 564-566 | ||
| S7712XA | 24 | 955-965 | S80211A | 09 | 604-605 | S82012M | 08 | 564-566 | ||
| S7712XD | 23 | 949-950 | S80211A | 24 | 955-965 | S82012N | 08 | 564-566 | ||
| S7712XS | 09 | 604-605 | S80211D | 23 | 949-950 | S82012P | 08 | 564-566 | ||
| S7720XA | 21 | 913-914 | S80211S | 09 | 604-605 | S82012Q | 08 | 564-566 | ||
| S7720XA | 24 | 955-965 | S80212A | 09 | 604-605 | S82012R | 08 | 564-566 | ||
| S7720XD | 23 | 949-950 | S80212A | 24 | 955-965 | S82012S | 08 | 559-561 | ||
| S7720XS | 09 | 604-605 | S80212D | 23 | 949-950 | S82013A | 08 | 562-563 | ||
| S7721XA | 21 | 913-914 | S80212S | 09 | 604-605 | S82013A | 24 | 955-965 | ||
| S7721XA | 24 | 955-965 | S80219A | 09 | 604-605 | S82013B | 08 | 562-563 | ||
| S7721XD | 23 | 949-950 | S80219A | 24 | 955-965 | S82013B | 24 | 955-965 | ||
| S7721XS | 09 | 604-605 | S80219D | 23 | 949-950 | S82013C | 08 | 562-563 | ||
| S7722XA | 21 | 913-914 | S80219S | 09 | 604-605 | S82013C | 24 | 955-965 | ||
| S7722XA | 24 | 955-965 | S80221A | 09 | 606-607 | S82013D | 08 | 559-561 | ||
| S7722XD | 23 | 949-950 | S80221A | 24 | 955-965 | S82013E | 08 | 559-561 | ||
| S7722XS | 09 | 604-605 | S80221D | 23 | 949-950 | S82013F | 08 | 559-561 | ||
| S78011A | 21 | 913-914 | S80221S | 09 | 604-605 | S82013G | 08 | 559-561 | ||
| S78011A | 24 | 955-965 | S80222A | 09 | 606-607 | S82013H | 08 | 559-561 | ||
| S78011D | 23 | 949-950 | S80222A | 24 | 955-965 | S82013J | 08 | 559-561 | ||
| S78011S | 08 | 559-561 | S80222D | 23 | 949-950 | S82013K | 08 | 564-566 | ||
| S78012A | 21 | 913-914 | S80222S | 09 | 604-605 | S82013M | 08 | 564-566 | ||
| S78012A | 24 | 955-965 | S80229A | 09 | 606-607 | S82013N | 08 | 564-566 | ||
| S78012D | 23 | 949-950 | S80229A | 24 | 955-965 | S82013P | 08 | 564-566 | ||
| S78012S | 08 | 559-561 | S80229D | 23 | 949-950 | S82013Q | 08 | 564-566 | ||
| S78019A | 21 | 913-914 | S80229S | 09 | 604-605 | S82013R | 08 | 564-566 | ||
| S78019A | 24 | 955-965 | S80241A | 09 | 604-605 | S82013S | 08 | 559-561 | ||
| S78019D | 23 | 949-950 | S80241A | 24 | 955-965 | S82014A | 08 | 562-563 | ||
| S78019S | 08 | 559-561 | S80241D | 23 | 949-950 | S82014A | 24 | 955-965 | ||
| S78021A | 21 | 913-914 | S80241S | 09 | 604-605 | S82014B | 08 | 562-563 | ||
| S78021A | 24 | 955-965 | S80242A | 09 | 604-605 | S82014B | 24 | 955-965 | ||
| S78021D | 23 | 949-950 | S80242A | 24 | 955-965 | S82014C | 08 | 562-563 | ||
| S78021S | 08 | 559-561 | S80242D | 23 | 949-950 | S82014C | 24 | 955-965 | ||
| S78022A | 21 | 913-914 | S80242S | 09 | 604-605 | S82014D | 08 | 559-561 | ||
| S78022A | 24 | 955-965 | S80249A | 09 | 604-605 | S82014E | 08 | 559-561 | ||
| S78022D | 23 | 949-950 | S80249A | 24 | 955-965 | S82014F | 08 | 559-561 | ||
| S78022S | 08 | 559-561 | S80249D | 23 | 949-950 | S82014G | 08 | 559-561 | ||
| S78029A | 21 | 913-914 | S80249S | 09 | 604-605 | S82014H | 08 | 559-561 | ||
| S78029A | 24 | 955-965 | S80251A | 09 | 604-605 | S82014J | 08 | 559-561 | ||
| S78029D | 23 | 949-950 | S80251A | 24 | 955-965 | S82014K | 08 | 564-566 | ||
| S78029S | 08 | 559-561 | S80251D | 23 | 949-950 | S82014M | 08 | 564-566 | ||
| S78111A | 21 | 913-914 | S80251S | 09 | 604-605 | S82014N | 08 | 564-566 | ||
| S78111A | 24 | 955-965 | S80252A | 09 | 604-605 | S82014P | 08 | 564-566 | ||
| S78111D | 23 | 949-950 | S80252A | 24 | 955-965 | S82014Q | 08 | 564-566 | ||
| S78111S | 08 | 559-561 | S80252D | 23 | 949-950 | S82014R | 08 | 564-566 | ||
| S78112A | 21 | 913-914 | S80252S | 09 | 604-605 | S82014S | 08 | 559-561 | ||
| S78112A | 24 | 955-965 | S80259A | 09 | 604-605 | S82015A | 08 | 562-563 | ||
| S78112D | 23 | 949-950 | S80259A | 24 | 955-965 | S82015A | 24 | 955-965 | ||
| S78112S | 08 | 559-561 | S80259D | 23 | 949-950 | S82015B | 08 | 562-563 | ||
| S78119A | 21 | 913-914 | S80259S | 09 | 604-605 | S82015B | 24 | 955-965 | ||
| S78119A | 24 | 955-965 | S80261A | 09 | 606-607 | S82015C | 08 | 562-563 | ||
| S78119D | 23 | 949-950 | S80261A | 24 | 955-965 | S82015C | 24 | 955-965 | ||
| S78119S | 08 | 559-561 | S80261D | 23 | 949-950 | S82015D | 08 | 559-561 | ||
| S78121A | 21 | 913-914 | S80261S | 09 | 604-605 | S82015E | 08 | 559-561 | ||
| S78121A | 24 | 955-965 | S80262A | 09 | 606-607 | S82015F | 08 | 559-561 | ||
| S78121D | 23 | 949-950 | S80262A | 24 | 955-965 | S82015G | 08 | 559-561 | ||
| S78121S | 08 | 559-561 | S80262D | 23 | 949-950 | S82015H | 08 | 559-561 | ||
| S78122A | 21 | 913-914 | S80262S | 09 | 604-605 | S82015J | 08 | 559-561 | ||
| S78122A | 24 | 955-965 | S80269A | 09 | 606-607 | S82015K | 08 | 564-566 | ||
| S78122D | 23 | 949-950 | S80269A | 24 | 955-965 | S82015M | 08 | 564-566 | ||
| S78122S | 08 | 559-561 | S80269D | 23 | 949-950 | S82015N | 08 | 564-566 | ||
| S78129A | 21 | 913-914 | S80269S | 09 | 604-605 | S82015P | 08 | 564-566 | ||
| S78129A | 24 | 955-965 | S80271A | 09 | 604-605 | S82015Q | 08 | 564-566 | ||
| S78129D | 23 | 949-950 | S80271A | 24 | 955-965 | S82015R | 08 | 564-566 | ||
| S78129S | 08 | 559-561 | S80271D | 23 | 949-950 | S82015S | 08 | 559-561 | ||
| S78911A | 21 | 913-914 | S80271S | 09 | 604-605 | S82016A | 08 | 562-563 | ||
| S78911A | 24 | 955-965 | S80272A | 09 | 604-605 | S82016A | 24 | 955-965 | ||
| S78911D | 23 | 949-950 | S80272A | 24 | 955-965 | S82016B | 08 | 562-563 | ||
| S78911S | 08 | 559-561 | S80272D | 23 | 949-950 | S82016B | 24 | 955-965 | ||
| S78912A | 21 | 913-914 | S80272S | 09 | 604-605 | S82016C | 08 | 562-563 | ||
| S78912A | 24 | 955-965 | S80279A | 09 | 604-605 | S82016C | 24 | 955-965 | ||
| S78912D | 23 | 949-950 | S80279A | 24 | 955-965 | S82016D | 08 | 559-561 | ||
| S78912S | 08 | 559-561 | S80279D | 23 | 949-950 | S82016E | 08 | 559-561 | ||
| S78919A | 21 | 913-914 | S80279S | 09 | 604-605 | S82016F | 08 | 559-561 | ||
| S78919A | 24 | 955-965 | S80811A | 09 | 604-605 | S82016G | 08 | 559-561 | ||
| S78919D | 23 | 949-950 | S80811A | 24 | 955-965 | S82016H | 08 | 559-561 | ||
| S78919S | 08 | 559-561 | S80811D | 23 | 949-950 | S82016J | 08 | 559-561 | ||
| S78921A | 21 | 913-914 | S80811S | 09 | 604-605 | S82016K | 08 | 564-566 | ||
| S78921A | 24 | 955-965 | S80812A | 09 | 604-605 | S82016M | 08 | 564-566 | ||
| S78921D | 23 | 949-950 | S80812A | 24 | 955-965 | S82016N | 08 | 564-566 | ||
| S78921S | 08 | 559-561 | S80812D | 23 | 949-950 | S82016P | 08 | 564-566 | ||
| S78922A | 21 | 913-914 | S80812S | 09 | 604-605 | S82016Q | 08 | 564-566 | ||
| S78922A | 24 | 955-965 | S80819A | 09 | 604-605 | S82016R | 08 | 564-566 | ||
| S78922D | 23 | 949-950 | S80819A | 24 | 955-965 | S82016S | 08 | 559-561 | ||
| S78922S | 08 | 559-561 | S80819D | 23 | 949-950 | S82021A | 08 | 562-563 | ||
| S78929A | 21 | 913-914 | S80819S | 09 | 604-605 | S82021A | 24 | 955-965 | ||
| S78929A | 24 | 955-965 | S80821A | 09 | 606-607 | S82021B | 08 | 562-563 | ||
| S78929D | 23 | 949-950 | S80821A | 24 | 955-965 | S82021B | 24 | 955-965 | ||
| S78929S | 08 | 559-561 | S80821D | 23 | 949-950 | S82021C | 08 | 562-563 | ||
| S79001A | 08 | 521-522 | S80821S | 09 | 604-605 | S82021C | 24 | 955-965 | ||
| S79001A | 08 | 535-536 | S80822A | 09 | 606-607 | S82021D | 08 | 559-561 | ||
| S79001A | 15 | 791 | S80822A | 24 | 955-965 | S82021E | 08 | 559-561 | ||
| S79001A | 15 | 793 | S80822D | 23 | 949-950 | S82021F | 08 | 559-561 | ||
| S79001A | 24 | 955-965 | S80822S | 09 | 604-605 | S82021G | 08 | 559-561 | ||
| S79001D | 08 | 559-561 | S80829A | 09 | 606-607 | S82021H | 08 | 559-561 | ||
| S79001G | 08 | 521-522 | S80829A | 24 | 955-965 | S82021J | 08 | 559-561 | ||
| S79001G | 08 | 559-561 | S80829D | 23 | 949-950 | S82021K | 08 | 564-566 | ||
| S79001K | 08 | 521-522 | S80829S | 09 | 604-605 | S82021M | 08 | 564-566 | ||
| S79001K | 08 | 564-566 | S80841A | 09 | 604-605 | S82021N | 08 | 564-566 | ||
| S79001P | 08 | 521-522 | S80841A | 24 | 955-965 | S82021P | 08 | 564-566 | ||
| S79001P | 08 | 564-566 | S80841D | 23 | 949-950 | S82021Q | 08 | 564-566 | ||
| S79001S | 08 | 559-561 | S80841S | 09 | 604-605 | S82021R | 08 | 564-566 | ||
| S79002A | 08 | 521-522 | S80842A | 09 | 604-605 | S82021S | 08 | 559-561 | ||
| S79002A | 08 | 535-536 | S80842A | 24 | 955-965 | S82022A | 08 | 562-563 | ||
| S79002A | 15 | 791 | S80842D | 23 | 949-950 | S82022A | 24 | 955-965 | ||
| S79002A | 15 | 793 | S80842S | 09 | 604-605 | S82022B | 08 | 562-563 | ||
| S79002A | 24 | 955-965 | S80849A | 09 | 604-605 | S82022B | 24 | 955-965 | ||
| S79002D | 08 | 559-561 | S80849A | 24 | 955-965 | S82022C | 08 | 562-563 | ||
| S79002G | 08 | 521-522 | S80849D | 23 | 949-950 | S82022C | 24 | 955-965 | ||
| S79002G | 08 | 559-561 | S80849S | 09 | 604-605 | S82022D | 08 | 559-561 | ||
| S79002K | 08 | 521-522 | S80851A | 09 | 604-605 | S82022E | 08 | 559-561 | ||
| S79002K | 08 | 564-566 | S80851A | 24 | 955-965 | S82022F | 08 | 559-561 | ||
| S79002P | 08 | 521-522 | S80851D | 23 | 949-950 | S82022G | 08 | 559-561 | ||
| S79002P | 08 | 564-566 | S80851S | 09 | 604-605 | S82022H | 08 | 559-561 | ||
| S79002S | 08 | 559-561 | S80852A | 09 | 604-605 | S82022J | 08 | 559-561 | ||
| S79009A | 08 | 521-522 | S80852A | 24 | 955-965 | S82022K | 08 | 564-566 | ||
| S79009A | 08 | 535-536 | S80852D | 23 | 949-950 | S82022M | 08 | 564-566 | ||
| S79009A | 15 | 791 | S80852S | 09 | 604-605 | S82022N | 08 | 564-566 | ||
| S79009A | 15 | 793 | S80859A | 09 | 604-605 | S82022P | 08 | 564-566 | ||
| S79009A | 24 | 955-965 | S80859A | 24 | 955-965 | S82022Q | 08 | 564-566 | ||
| S79009D | 08 | 559-561 | S80859D | 23 | 949-950 | S82022R | 08 | 564-566 | ||
| S79009G | 08 | 521-522 | S80859S | 09 | 604-605 | S82022S | 08 | 559-561 | ||
| S79009G | 08 | 559-561 | S80861A | 09 | 606-607 | S82023A | 08 | 562-563 | ||
| S79009K | 08 | 521-522 | S80861A | 24 | 955-965 | S82023A | 24 | 955-965 | ||
| S79009K | 08 | 564-566 | S80861D | 23 | 949-950 | S82023B | 08 | 562-563 | ||
| S79009P | 08 | 521-522 | S80861S | 09 | 604-605 | S82023B | 24 | 955-965 | ||
| S79009P | 08 | 564-566 | S80862A | 09 | 606-607 | S82023C | 08 | 562-563 | ||
| S79009S | 08 | 559-561 | S80862A | 24 | 955-965 | S82023C | 24 | 955-965 | ||
| S79011A | 08 | 521-522 | S80862D | 23 | 949-950 | S82023D | 08 | 559-561 | ||
| S79011A | 08 | 535-536 | S80862S | 09 | 604-605 | S82023E | 08 | 559-561 | ||
| S79011A | 15 | 791 | S80869A | 09 | 606-607 | S82023F | 08 | 559-561 | ||
| S79011A | 15 | 793 | S80869A | 24 | 955-965 | S82023G | 08 | 559-561 | ||
| S79011A | 24 | 955-965 | S80869D | 23 | 949-950 | S82023H | 08 | 559-561 | ||
| S79011D | 08 | 559-561 | S80869S | 09 | 604-605 | S82023J | 08 | 559-561 | ||
| S79011G | 08 | 521-522 | S80871A | 09 | 604-605 | S82023K | 08 | 564-566 | ||
| S79011G | 08 | 559-561 | S80871A | 24 | 955-965 | S82023M | 08 | 564-566 | ||
| S79011K | 08 | 521-522 | S80871D | 23 | 949-950 | S82023N | 08 | 564-566 | ||
| S79011K | 08 | 564-566 | S80871S | 09 | 604-605 | S82023P | 08 | 564-566 | ||
| S79011P | 08 | 521-522 | S80872A | 09 | 604-605 | S82023Q | 08 | 564-566 | ||
| S79011P | 08 | 564-566 | S80872A | 24 | 955-965 | S82023R | 08 | 564-566 | ||
| S79011S | 08 | 559-561 | S80872D | 23 | 949-950 | S82023S | 08 | 559-561 | ||
| S79012A | 08 | 521-522 | S80872S | 09 | 604-605 | S82024A | 08 | 562-563 | ||
| S79012A | 08 | 535-536 | S80879A | 09 | 604-605 | S82024A | 24 | 955-965 | ||
| S79012A | 15 | 791 | S80879A | 24 | 955-965 | S82024B | 08 | 562-563 | ||
| S79012A | 15 | 793 | S80879D | 23 | 949-950 | S82024B | 24 | 955-965 | ||
| S79012A | 24 | 955-965 | S80879S | 09 | 604-605 | S82024C | 08 | 562-563 | ||
| S79012D | 08 | 559-561 | S80911A | 09 | 604-605 | S82024C | 24 | 955-965 | ||
| S79012G | 08 | 521-522 | S80911A | 24 | 955-965 | S82024D | 08 | 559-561 | ||
| S79012G | 08 | 559-561 | S80911D | 23 | 949-950 | S82024E | 08 | 559-561 | ||
| S79012K | 08 | 521-522 | S80911S | 09 | 604-605 | S82024F | 08 | 559-561 | ||
| S79012K | 08 | 564-566 | S80912A | 09 | 604-605 | S82024G | 08 | 559-561 | ||
| S79012P | 08 | 521-522 | S80912A | 24 | 955-965 | S82024H | 08 | 559-561 | ||
| S79012P | 08 | 564-566 | S80912D | 23 | 949-950 | S82024J | 08 | 559-561 | ||
| S79012S | 08 | 559-561 | S80912S | 09 | 604-605 | S82024K | 08 | 564-566 | ||
| S79019A | 08 | 521-522 | S80919A | 09 | 604-605 | S82024M | 08 | 564-566 | ||
| S79019A | 08 | 535-536 | S80919A | 24 | 955-965 | S82024N | 08 | 564-566 | ||
| S79019A | 15 | 791 | S80919D | 23 | 949-950 | S82024P | 08 | 564-566 | ||
| S79019A | 15 | 793 | S80919S | 09 | 604-605 | S82024Q | 08 | 564-566 | ||
| S79019A | 24 | 955-965 | S80921A | 09 | 604-605 | S82024R | 08 | 564-566 | ||
| S79019D | 08 | 559-561 | S80921A | 24 | 955-965 | S82024S | 08 | 559-561 | ||
| S79019G | 08 | 521-522 | S80921D | 23 | 949-950 | S82025A | 08 | 562-563 | ||
| S79019G | 08 | 559-561 | S80921S | 09 | 604-605 | S82025A | 24 | 955-965 | ||
| S79019K | 08 | 521-522 | S80922A | 09 | 604-605 | S82025B | 08 | 562-563 | ||
| S79019K | 08 | 564-566 | S80922A | 24 | 955-965 | S82025B | 24 | 955-965 | ||
| S79019P | 08 | 521-522 | S80922D | 23 | 949-950 | S82025C | 08 | 562-563 | ||
| S79019P | 08 | 564-566 | S80922S | 09 | 604-605 | S82025C | 24 | 955-965 | ||
| S79019S | 08 | 559-561 | S80929A | 09 | 604-605 | S82025D | 08 | 559-561 | ||
| S79091A | 08 | 521-522 | S80929A | 24 | 955-965 | S82025E | 08 | 559-561 | ||
| S79091A | 08 | 535-536 | S80929D | 23 | 949-950 | S82025F | 08 | 559-561 | ||
| S79091A | 15 | 791 | S80929S | 09 | 604-605 | S82025G | 08 | 559-561 | ||
| S79091A | 15 | 793 | S81001A | 09 | 604-605 | S82025H | 08 | 559-561 | ||
| S79091A | 24 | 955-965 | S81001A | 24 | 955-965 | S82025J | 08 | 559-561 | ||
| S79091D | 08 | 559-561 | S81001D | 23 | 949-950 | S82025K | 08 | 564-566 | ||
| S79091G | 08 | 521-522 | S81001S | 09 | 604-605 | S82025M | 08 | 564-566 | ||
| S79091G | 08 | 559-561 | S81002A | 09 | 604-605 | S82025N | 08 | 564-566 | ||
| S79091K | 08 | 521-522 | S81002A | 24 | 955-965 | S82025P | 08 | 564-566 | ||
| S79091K | 08 | 564-566 | S81002D | 23 | 949-950 | S82025Q | 08 | 564-566 | ||
| S79091P | 08 | 521-522 | S81002S | 09 | 604-605 | S82025R | 08 | 564-566 | ||
| S79091P | 08 | 564-566 | S81009A | 09 | 604-605 | S82025S | 08 | 559-561 | ||
| S79091S | 08 | 559-561 | S81009A | 24 | 955-965 | S82026A | 08 | 562-563 | ||
| S79092A | 08 | 521-522 | S81009D | 23 | 949-950 | S82026A | 24 | 955-965 | ||
| S79092A | 08 | 535-536 | S81009S | 09 | 604-605 | S82026B | 08 | 562-563 | ||
| S79092A | 15 | 791 | S81011A | 09 | 604-605 | S82026B | 24 | 955-965 | ||
| S79092A | 15 | 793 | S81011A | 24 | 955-965 | S82026C | 08 | 562-563 | ||
| S79092A | 24 | 955-965 | S81011D | 23 | 949-950 | S82026C | 24 | 955-965 | ||
| S79092D | 08 | 559-561 | S81011S | 09 | 604-605 | S82026D | 08 | 559-561 | ||
| S79092G | 08 | 521-522 | S81012A | 09 | 604-605 | S82026E | 08 | 559-561 | ||
| S79092G | 08 | 559-561 | S81012A | 24 | 955-965 | S82026F | 08 | 559-561 | ||
| S79092K | 08 | 521-522 | S81012D | 23 | 949-950 | S82026G | 08 | 559-561 | ||
| S79092K | 08 | 564-566 | S81012S | 09 | 604-605 | S82026H | 08 | 559-561 | ||
| S79092P | 08 | 521-522 | S81019A | 09 | 604-605 | S82026J | 08 | 559-561 | ||
| S79092P | 08 | 564-566 | S81019A | 24 | 955-965 | S82026K | 08 | 564-566 | ||
| S79092S | 08 | 559-561 | S81019D | 23 | 949-950 | S82026M | 08 | 564-566 | ||
| S79099A | 08 | 521-522 | S81019S | 09 | 604-605 | S82026N | 08 | 564-566 | ||
| S79099A | 08 | 535-536 | S81021A | 21 | 913-914 | S82026P | 08 | 564-566 | ||
| S79099A | 15 | 791 | S81021A | 24 | 955-965 | S82026Q | 08 | 564-566 | ||
| S79099A | 15 | 793 | S81021D | 23 | 949-950 | S82026R | 08 | 564-566 | ||
| S79099A | 24 | 955-965 | S81021S | 09 | 604-605 | S82026S | 08 | 559-561 | ||
| S79099D | 08 | 559-561 | S81022A | 21 | 913-914 | S82031A | 08 | 562-563 | ||
| S79099G | 08 | 521-522 | S81022A | 24 | 955-965 | S82031A | 24 | 955-965 | ||
| S79099G | 08 | 559-561 | S81022D | 23 | 949-950 | S82031B | 08 | 562-563 | ||
| S79099K | 08 | 521-522 | S81022S | 09 | 604-605 | S82031B | 24 | 955-965 | ||
| S79099K | 08 | 564-566 | S81029A | 21 | 913-914 | S82031C | 08 | 562-563 | ||
| S79099P | 08 | 521-522 | S81029A | 24 | 955-965 | S82031C | 24 | 955-965 | ||
| S79099P | 08 | 564-566 | S81029D | 23 | 949-950 | S82031D | 08 | 559-561 | ||
| S79099S | 08 | 559-561 | S81029S | 09 | 604-605 | S82031E | 08 | 559-561 | ||
| S79101A | 08 | 533-534 | S81031A | 09 | 604-605 | S82031F | 08 | 559-561 | ||
| S79101A | 24 | 955-965 | S81031A | 24 | 955-965 | S82031G | 08 | 559-561 | ||
| S79101D | 08 | 559-561 | S81031D | 23 | 949-950 | S82031H | 08 | 559-561 | ||
| S79101G | 08 | 559-561 | S81031S | 09 | 604-605 | S82031J | 08 | 559-561 | ||
| S79101K | 08 | 564-566 | S81032A | 09 | 604-605 | S82031K | 08 | 564-566 | ||
| S79101P | 08 | 564-566 | S81032A | 24 | 955-965 | S82031M | 08 | 564-566 | ||
| S79101S | 08 | 559-561 | S81032D | 23 | 949-950 | S82031N | 08 | 564-566 | ||
| S79102A | 08 | 533-534 | S81032S | 09 | 604-605 | S82031P | 08 | 564-566 | ||
| S79102A | 24 | 955-965 | S81039A | 09 | 604-605 | S82031Q | 08 | 564-566 | ||
| S79102D | 08 | 559-561 | S81039A | 24 | 955-965 | S82031R | 08 | 564-566 | ||
| S79102G | 08 | 559-561 | S81039D | 23 | 949-950 | S82031S | 08 | 559-561 | ||
| S79102K | 08 | 564-566 | S81039S | 09 | 604-605 | S82032A | 08 | 562-563 | ||
| S79102P | 08 | 564-566 | S81041A | 21 | 913-914 | S82032A | 24 | 955-965 | ||
| S79102S | 08 | 559-561 | S81041A | 24 | 955-965 | S82032B | 08 | 562-563 | ||
| S79109A | 08 | 533-534 | S81041D | 23 | 949-950 | S82032B | 24 | 955-965 | ||
| S79109A | 24 | 955-965 | S81041S | 09 | 604-605 | S82032C | 08 | 562-563 | ||
| S79109D | 08 | 559-561 | S81042A | 21 | 913-914 | S82032C | 24 | 955-965 | ||
| S79109G | 08 | 559-561 | S81042A | 24 | 955-965 | S82032D | 08 | 559-561 | ||
| S79109K | 08 | 564-566 | S81042D | 23 | 949-950 | S82032E | 08 | 559-561 | ||
| S79109P | 08 | 564-566 | S81042S | 09 | 604-605 | S82032F | 08 | 559-561 | ||
| S79109S | 08 | 559-561 | S81049A | 21 | 913-914 | S82032G | 08 | 559-561 | ||
| S79111A | 08 | 533-534 | S81049A | 24 | 955-965 | S82032H | 08 | 559-561 | ||
| S79111A | 24 | 955-965 | S81049D | 23 | 949-950 | S82032J | 08 | 559-561 | ||
| S79111D | 08 | 559-561 | S81049S | 09 | 604-605 | S82032K | 08 | 564-566 | ||
| S79111G | 08 | 559-561 | S81051A | 09 | 604-605 | S82032M | 08 | 564-566 | ||
| S79111K | 08 | 564-566 | S81051A | 24 | 955-965 | S82032N | 08 | 564-566 | ||
| S79111P | 08 | 564-566 | S81051D | 23 | 949-950 | S82032P | 08 | 564-566 | ||
| S79111S | 08 | 559-561 | S81051S | 09 | 604-605 | S82032Q | 08 | 564-566 | ||
| S79112A | 08 | 533-534 | S81052A | 09 | 604-605 | S82032R | 08 | 564-566 | ||
| S79112A | 24 | 955-965 | S81052A | 24 | 955-965 | S82032S | 08 | 559-561 | ||
| S79112D | 08 | 559-561 | S81052D | 23 | 949-950 | S82033A | 08 | 562-563 | ||
| S79112G | 08 | 559-561 | S81052S | 09 | 604-605 | S82033A | 24 | 955-965 | ||
| S79112K | 08 | 564-566 | S81059A | 09 | 604-605 | S82033B | 08 | 562-563 | ||
| S79112P | 08 | 564-566 | S81059A | 24 | 955-965 | S82033B | 24 | 955-965 | ||
| S79112S | 08 | 559-561 | S81059D | 23 | 949-950 | S82033C | 08 | 562-563 | ||
| S79119A | 08 | 533-534 | S81059S | 09 | 604-605 | S82033C | 24 | 955-965 | ||
| S79119A | 24 | 955-965 | S81801A | 09 | 604-605 | S82033D | 08 | 559-561 | ||
| S79119D | 08 | 559-561 | S81801A | 24 | 955-965 | S82033E | 08 | 559-561 | ||
| S79119G | 08 | 559-561 | S81801D | 23 | 949-950 | S82033F | 08 | 559-561 | ||
| S79119K | 08 | 564-566 | S81801S | 09 | 604-605 | S82033G | 08 | 559-561 | ||
| S79119P | 08 | 564-566 | S81802A | 09 | 604-605 | S82033H | 08 | 559-561 | ||
| S79119S | 08 | 559-561 | S81802A | 24 | 955-965 | S82033J | 08 | 559-561 | ||
| S79121A | 08 | 533-534 | S81802D | 23 | 949-950 | S82033K | 08 | 564-566 | ||
| S79121A | 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 |