ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual |
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| Appendix C: Principal diagnoses which convert CC/MCC to non-CC |
| Page 560 of 1270 |
| PDX Collection 4879 (continued) | |
| I2102 | ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery |
| I2109 | ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall |
| I2111 | ST elevation (STEMI) myocardial infarction involving right coronary artery |
| I2119 | ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall |
| I2121 | ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery |
| I2129 | ST elevation (STEMI) myocardial infarction involving other sites |
| I213 | ST elevation (STEMI) myocardial infarction of unspecified site |
| I214 | Non-ST elevation (NSTEMI) myocardial infarction |
| I219 | Acute myocardial infarction, unspecified |
| I21A1 | Myocardial infarction type 2 |
| I21A9 | Other myocardial infarction type |
| I220 | Subsequent ST elevation (STEMI) myocardial infarction of anterior wall |
| I221 | Subsequent ST elevation (STEMI) myocardial infarction of inferior wall |
| I222 | Subsequent non-ST elevation (NSTEMI) myocardial infarction |
| I228 | Subsequent ST elevation (STEMI) myocardial infarction of other sites |
| I229 | Subsequent ST elevation (STEMI) myocardial infarction of unspecified site |
| I240 | Acute coronary thrombosis not resulting in myocardial infarction |
| I241 | Dressler's syndrome |
| I248 | Other forms of acute ischemic heart disease |
| I249 | Acute ischemic heart disease, unspecified |
| I255 | Ischemic cardiomyopathy |
| I256 | Silent myocardial ischemia |
| I25702 | Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris |
| I25712 | Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris |
| I25722 | Atherosclerosis of autologous artery coronary artery bypass graft(s) with refractory angina pectoris |
| I25732 | Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with refractory angina pectoris |
| I25752 | Atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris |
| I25762 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris |
| I25792 | Atherosclerosis of other coronary artery bypass graft(s) with refractory angina pectoris |
| I2589 | Other forms of chronic ischemic heart disease |
| I259 | Chronic ischemic heart disease, unspecified |
| I878 | Other specified disorders of veins |
| I879 | Disorder of vein, unspecified |
| I998 | Other disorder of circulatory system |
| I999 | Unspecified disorder of circulatory system |
| PDX Collection 4880 | |
| F0670 | Mild neurocognitive disorder due to known physiological condition without behavioral disturbance |
| F0671 | Mild neurocognitive disorder due to known physiological condition with behavioral disturbance |
| F1090 | Alcohol use, unspecified, uncomplicated |
| F1091 | Alcohol use, unspecified, in remission |
| F11222 | Opioid dependence with intoxication with perceptual disturbance |
| F1191 | Opioid use, unspecified, in remission |
| F1291 | Cannabis use, unspecified, in remission |
| F1391 | Sedative, hypnotic or anxiolytic use, unspecified, in remission |
| F1491 | Cocaine use, unspecified, in remission |
| F1591 | Other stimulant use, unspecified, in remission |
| F1691 | Hallucinogen use, unspecified, in remission |
| F1891 | Inhalant use, unspecified, in remission |
| F1991 | Other psychoactive substance use, unspecified, in remission |
| PDX Collection 4881 | |
| F070 | Personality change due to known physiological condition |
| F0781 | Postconcussional syndrome |
| F079 | Unspecified personality and behavioral disorder due to known physiological condition |
| F09 | Unspecified mental disorder due to known physiological condition |
| F200 | Paranoid schizophrenia |
| F201 | Disorganized schizophrenia |
| F202 | Catatonic schizophrenia |
| F203 | Undifferentiated schizophrenia |
| F205 | Residual schizophrenia |
| F2081 | Schizophreniform disorder |
| F2089 | Other schizophrenia |
| F209 | Schizophrenia, unspecified |
| F21 | Schizotypal disorder |
| F22 | Delusional disorders |
| F23 | Brief psychotic disorder |
| F24 | Shared psychotic disorder |
| F250 | Schizoaffective disorder, bipolar type |
| F251 | Schizoaffective disorder, depressive type |
| F258 | Other schizoaffective disorders |
| F259 | Schizoaffective disorder, unspecified |
| F28 | Other psychotic disorder not due to a substance or known physiological condition |
| F29 | Unspecified psychosis not due to a substance or known physiological condition |
| F3010 | Manic episode without psychotic symptoms, unspecified |
| F3011 | Manic episode without psychotic symptoms, mild |
| F3012 | Manic episode without psychotic symptoms, moderate |
| F3013 | Manic episode, severe, without psychotic symptoms |
| F302 | Manic episode, severe with psychotic symptoms |
| F303 | Manic episode in partial remission |
| F304 | Manic episode in full remission |
| F308 | Other manic episodes |
| F309 | Manic episode, unspecified |
| F310 | Bipolar disorder, current episode hypomanic |
| F3110 | Bipolar disorder, current episode manic without psychotic features, unspecified |
| F3111 | Bipolar disorder, current episode manic without psychotic features, mild |
| F3112 | Bipolar disorder, current episode manic without psychotic features, moderate |
| F3113 | Bipolar disorder, current episode manic without psychotic features, severe |
| F312 | Bipolar disorder, current episode manic severe with psychotic features |
| F3130 | Bipolar disorder, current episode depressed, mild or moderate severity, unspecified |
| F3131 | Bipolar disorder, current episode depressed, mild |
| F3132 | Bipolar disorder, current episode depressed, moderate |
| F314 | Bipolar disorder, current episode depressed, severe, without psychotic features |
| F315 | Bipolar disorder, current episode depressed, severe, with psychotic features |
| F3160 | Bipolar disorder, current episode mixed, unspecified |
| F3161 | Bipolar disorder, current episode mixed, mild |
| F3162 | Bipolar disorder, current episode mixed, moderate |
| F3163 | Bipolar disorder, current episode mixed, severe, without psychotic features |
| F3164 | Bipolar disorder, current episode mixed, severe, with psychotic features |
| F3170 | Bipolar disorder, currently in remission, most recent episode unspecified |
| F3171 | Bipolar disorder, in partial remission, most recent episode hypomanic |
| F3172 | Bipolar disorder, in full remission, most recent episode hypomanic |
| F3173 | Bipolar disorder, in partial remission, most recent episode manic |
| F3174 | Bipolar disorder, in full remission, most recent episode manic |
| F3175 | Bipolar disorder, in partial remission, most recent episode depressed |
| F3176 | Bipolar disorder, in full remission, most recent episode depressed |
| F3177 | Bipolar disorder, in partial remission, most recent episode mixed |
| F3178 | Bipolar disorder, in full remission, most recent episode mixed |
| F3181 | Bipolar II disorder |
| F3189 | Other bipolar disorder |
| F319 | Bipolar disorder, unspecified |
| F320 | Major depressive disorder, single episode, mild |
| F321 | Major depressive disorder, single episode, moderate |
| F322 | Major depressive disorder, single episode, severe without psychotic features |
| F323 | Major depressive disorder, single episode, severe with psychotic features |
| F324 | Major depressive disorder, single episode, in partial remission |
| F325 | Major depressive disorder, single episode, in full remission |
| F3281 | Premenstrual dysphoric disorder |
| F3289 | Other specified depressive episodes |
| F329 | Major depressive disorder, single episode, unspecified |
| F32A | Depression, unspecified |
| F330 | Major depressive disorder, recurrent, mild |
| F331 | Major depressive disorder, recurrent, moderate |
| F332 | Major depressive disorder, recurrent severe without psychotic features |
| F333 | Major depressive disorder, recurrent, severe with psychotic symptoms |
| F3340 | Major depressive disorder, recurrent, in remission, unspecified |
| F3341 | Major depressive disorder, recurrent, in partial remission |
| F3342 | Major depressive disorder, recurrent, in full remission |
| F338 | Other recurrent depressive disorders |
| F339 | Major depressive disorder, recurrent, unspecified |
| F340 | Cyclothymic disorder |
| F341 | Dysthymic disorder |
| F3481 | Disruptive mood dysregulation disorder |
| F3489 | Other specified persistent mood disorders |
| F349 | Persistent mood [affective] disorder, unspecified |
| F39 | Unspecified mood [affective] disorder |
| F4000 | Agoraphobia, unspecified |
| F4001 | Agoraphobia with panic disorder |
| F4002 | Agoraphobia without panic disorder |
| F4010 | Social phobia, unspecified |
| F4011 | Social phobia, generalized |
| F40210 | Arachnophobia |
| F40218 | Other animal type phobia |
| F40220 | Fear of thunderstorms |
| F40228 | Other natural environment type phobia |
| F40230 | Fear of blood |
| F40231 | Fear of injections and transfusions |
| F40232 | Fear of other medical care |
| F40233 | Fear of injury |
| F40240 | Claustrophobia |
| F40241 | Acrophobia |
| F40242 | Fear of bridges |
| F40243 | Fear of flying |
| F40248 | Other situational type phobia |
| F40290 | Androphobia |
| F40291 | Gynephobia |
| F40298 | Other specified phobia |
| F408 | Other phobic anxiety disorders |
| F409 | Phobic anxiety disorder, unspecified |
| F410 | Panic disorder [episodic paroxysmal anxiety] |
| F411 | Generalized anxiety disorder |
| F413 | Other mixed anxiety disorders |
| F418 | Other specified anxiety disorders |
| F419 | Anxiety disorder, unspecified |
| F422 | Mixed obsessional thoughts and acts |
| F423 | Hoarding disorder |
| F424 | Excoriation (skin-picking) disorder |
| F428 | Other obsessive-compulsive disorder |
| F429 | Obsessive-compulsive disorder, unspecified |
| F430 | Acute stress reaction |
| F4310 | Post-traumatic stress disorder, unspecified |
| F4311 | Post-traumatic stress disorder, acute |
| F4312 | Post-traumatic stress disorder, chronic |
| F4320 | Adjustment disorder, unspecified |
| F4321 | Adjustment disorder with depressed mood |
| F4322 | Adjustment disorder with anxiety |
| F4323 | Adjustment disorder with mixed anxiety and depressed mood |
| F4324 | Adjustment disorder with disturbance of conduct |
| F4325 | Adjustment disorder with mixed disturbance of emotions and conduct |
| F4329 | Adjustment disorder with other symptoms |
| F4381 | Prolonged grief disorder |
| F4389 | Other reactions to severe stress |
| F439 | Reaction to severe stress, unspecified |
| F440 | Dissociative amnesia |
| F441 | Dissociative fugue |
| F442 | Dissociative stupor |
| F444 | Conversion disorder with motor symptom or deficit |
| F445 | Conversion disorder with seizures or convulsions |
| F446 | Conversion disorder with sensory symptom or deficit |
| F447 | Conversion disorder with mixed symptom presentation |
| F4481 | Dissociative identity disorder |
| F4489 | Other dissociative and conversion disorders |
| F449 | Dissociative and conversion disorder, unspecified |
| F450 | Somatization disorder |
| F451 | Undifferentiated somatoform disorder |
| F4520 | Hypochondriacal disorder, unspecified |
| F4521 | Hypochondriasis |
| F4522 | Body dysmorphic disorder |
| F4529 | Other hypochondriacal disorders |
| F4541 | Pain disorder exclusively related to psychological factors |
| F4542 | Pain disorder with related psychological factors |
| F458 | Other somatoform disorders |
| F459 | Somatoform disorder, unspecified |
| F481 | Depersonalization-derealization syndrome |
| F488 | Other specified nonpsychotic mental disorders |
| F489 | Nonpsychotic mental disorder, unspecified |
| F5000 | Anorexia nervosa, unspecified |
| F5001 | Anorexia nervosa, restricting type |
| F5002 | Anorexia nervosa, binge eating/purging type |
| F502 | Bulimia nervosa |
| F5081 | Binge eating disorder |
| F5082 | Avoidant/restrictive food intake disorder |
| F5089 | Other specified eating disorder |
| F509 | Eating disorder, unspecified |
| F5101 | Primary insomnia |
| F5102 | Adjustment insomnia |
| F5103 | Paradoxical insomnia |
| F5112 | Insufficient sleep syndrome |
| F5119 | Other hypersomnia not due to a substance or known physiological condition |
| F513 | Sleepwalking [somnambulism] |
| F514 | Sleep terrors [night terrors] |
| F515 | Nightmare disorder |
| F518 | Other sleep disorders not due to a substance or known physiological condition |
| F519 | Sleep disorder not due to a substance or known physiological condition, unspecified |
| F525 | Vaginismus not due to a substance or known physiological condition |
| F54 | Psychological and behavioral factors associated with disorders or diseases classified elsewhere |
| F59 | Unspecified behavioral syndromes associated with physiological disturbances and physical factors |
| F600 | Paranoid personality disorder |
| F601 | Schizoid personality disorder |
| F602 | Antisocial personality disorder |
| F603 | Borderline personality disorder |
| F604 | Histrionic personality disorder |
| F605 | Obsessive-compulsive personality disorder |
| F606 | Avoidant personality disorder |
| F607 | Dependent personality disorder |
| F6081 | Narcissistic personality disorder |
| F6089 | Other specific personality disorders |
| F609 | Personality disorder, unspecified |
| F630 | Pathological gambling |
| F631 | Pyromania |
| F632 | Kleptomania |
| F6381 | Intermittent explosive disorder |
| F6389 | Other impulse disorders |
| F639 | Impulse disorder, unspecified |
| F6810 | Factitious disorder imposed on self, unspecified |
| F6811 | Factitious disorder imposed on self, with predominantly psychological signs and symptoms |
| F6812 | Factitious disorder imposed on self, with predominantly physical signs and symptoms |
| F6813 | Factitious disorder imposed on self, with combined psychological and physical signs and symptoms |
| F688 | Other specified disorders of adult personality and behavior |
| F68A | Factitious disorder imposed on another |
| F69 | Unspecified disorder of adult personality and behavior |
| F70 | Mild intellectual disabilities |
| F71 | Moderate intellectual disabilities |
| F72 | Severe intellectual disabilities |
| F73 | Profound intellectual disabilities |
| F79 | Unspecified intellectual disabilities |
| F800 | Phonological disorder |
| F801 | Expressive language disorder |
| F802 | Mixed receptive-expressive language disorder |
| F804 | Speech and language development delay due to hearing loss |
| F8082 | Social pragmatic communication disorder |
| F8089 | Other developmental disorders of speech and language |
| F809 | Developmental disorder of speech and language, unspecified |
| F810 | Specific reading disorder |
| F812 | Mathematics disorder |
| F8181 | Disorder of written expression |
| F8189 | Other developmental disorders of scholastic skills |
| F819 | Developmental disorder of scholastic skills, unspecified |
| F82 | Specific developmental disorder of motor function |
| F840 | Autistic disorder |
| F843 | Other childhood disintegrative disorder |
| F845 | Asperger's syndrome |
| F848 | Other pervasive developmental disorders |
| F849 | Pervasive developmental disorder, unspecified |
| F88 | Other disorders of psychological development |
| F89 | Unspecified disorder of psychological development |
| F900 | Attention-deficit hyperactivity disorder, predominantly inattentive type |
| F901 | Attention-deficit hyperactivity disorder, predominantly hyperactive type |
| F902 | Attention-deficit hyperactivity disorder, combined type |
| F908 | Attention-deficit hyperactivity disorder, other type |
| F909 | Attention-deficit hyperactivity disorder, unspecified type |
| F910 | Conduct disorder confined to family context |
| F911 | Conduct disorder, childhood-onset type |
| F912 | Conduct disorder, adolescent-onset type |
| F913 | Oppositional defiant disorder |
| F918 | Other conduct disorders |
| F919 | Conduct disorder, unspecified |
| F930 | Separation anxiety disorder of childhood |
| F938 | Other childhood emotional disorders |
| F939 | Childhood emotional disorder, unspecified |
| F940 | Selective mutism |
| F941 | Reactive attachment disorder of childhood |
| F942 | Disinhibited attachment disorder of childhood |
| F948 | Other childhood disorders of social functioning |
| F949 | Childhood disorder of social functioning, unspecified |
| F950 | Transient tic disorder |
| F951 | Chronic motor or vocal tic disorder |
| F952 | Tourette's disorder |
| F958 | Other tic disorders |
| F959 | Tic disorder, unspecified |
| F980 | Enuresis not due to a substance or known physiological condition |
| F981 | Encopresis not due to a substance or known physiological condition |
| F9821 | Rumination disorder of infancy |
| F9829 | Other feeding disorders of infancy and early childhood |
| F983 | Pica of infancy and childhood |
| F984 | Stereotyped movement disorders |
| F985 | Adult onset fluency disorder |
| F988 | Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence |
| F989 | Unspecified behavioral and emotional disorders with onset usually occurring in childhood and adolescence |
| F99 | Mental disorder, not otherwise specified |
| G44201 | Tension-type headache, unspecified, intractable |
| G44209 | Tension-type headache, unspecified, not intractable |
| G44211 | Episodic tension-type headache, intractable |
| G44219 | Episodic tension-type headache, not intractable |
| G44221 | Chronic tension-type headache, intractable |
| G44229 | Chronic tension-type headache, not intractable |
| H9325 | Central auditory processing disorder |
| R451 | Restlessness and agitation |
| R452 | Unhappiness |
| R455 | Hostility |
| R456 | Violent behavior |
| R457 | State of emotional shock and stress, unspecified |
| R4581 | Low self-esteem |
| R4582 | Worries |
| R4586 | Emotional lability |
| R4587 | Impulsiveness |
| PDX Collection 4882 | |
| A179 | Tuberculosis of nervous system, unspecified |
| A1810 | Tuberculosis of genitourinary system, unspecified |
| A1811 | Tuberculosis of kidney and ureter |
| A1813 | Tuberculosis of other urinary organs |
| A1882 | Tuberculosis of other endocrine glands |
| A1884 | Tuberculosis of heart |
| A1889 | Tuberculosis of other sites |
| A5421 | Gonococcal infection of kidney and ureter |
| A5429 | Other gonococcal genitourinary infections |
| A5482 | Gonococcal brain abscess |
| A5484 | Gonococcal pneumonia |
| A5489 | Other gonococcal infections |
| A549 | Gonococcal infection, unspecified |
| A5900 | Urogenital trichomoniasis, unspecified |
| A598 | Trichomoniasis of other sites |
| A599 | Trichomoniasis, unspecified |
| B3741 | Candidal cystitis and urethritis |
| B3742 | Candidal balanitis |
| B3749 | Other urogenital candidiasis |
| E0821 | Diabetes mellitus due to underlying condition with diabetic nephropathy |
| E0822 | Diabetes mellitus due to underlying condition with diabetic chronic kidney disease |
| E0829 | Diabetes mellitus due to underlying condition with other diabetic kidney complication |
| E0921 | Drug or chemical induced diabetes mellitus with diabetic nephropathy |
| E0922 | Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease |
| E0929 | Drug or chemical induced diabetes mellitus with other diabetic kidney complication |
| M1030 | Gout due to renal impairment, unspecified site |
| M10311 | Gout due to renal impairment, right shoulder |
| M10312 | Gout due to renal impairment, left shoulder |
| M10319 | Gout due to renal impairment, unspecified shoulder |
| M10321 | Gout due to renal impairment, right elbow |
| M10322 | Gout due to renal impairment, left elbow |
| M10329 | Gout due to renal impairment, unspecified elbow |
| M10331 | Gout due to renal impairment, right wrist |
| M10332 | Gout due to renal impairment, left wrist |
| M10339 | Gout due to renal impairment, unspecified wrist |
| M10341 | Gout due to renal impairment, right hand |
| M10342 | Gout due to renal impairment, left hand |
| M10349 | Gout due to renal impairment, unspecified hand |
| M10351 | Gout due to renal impairment, right hip |
| M10352 | Gout due to renal impairment, left hip |
| M10359 | Gout due to renal impairment, unspecified hip |
| M10361 | Gout due to renal impairment, right knee |
| M10362 | Gout due to renal impairment, left knee |
| M10369 | Gout due to renal impairment, unspecified knee |
| M10371 | Gout due to renal impairment, right ankle and foot |
| M10372 | Gout due to renal impairment, left ankle and foot |
| M10379 | Gout due to renal impairment, unspecified ankle and foot |
| M1038 | Gout due to renal impairment, vertebrae |
| M1039 | Gout due to renal impairment, multiple sites |
| N000 | Acute nephritic syndrome with minor glomerular abnormality |
| N001 | Acute nephritic syndrome with focal and segmental glomerular lesions |
| N002 | Acute nephritic syndrome with diffuse membranous glomerulonephritis |
| N003 | Acute nephritic syndrome with diffuse mesangial proliferative glomerulonephritis |
| N004 | Acute nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis |
| N005 | Acute nephritic syndrome with diffuse mesangiocapillary glomerulonephritis |
| N006 | Acute nephritic syndrome with dense deposit disease |
| N007 | Acute nephritic syndrome with diffuse crescentic glomerulonephritis |
| N008 | Acute nephritic syndrome with other morphologic changes |
| N009 | Acute nephritic syndrome with unspecified morphologic changes |
| N010 | Rapidly progressive nephritic syndrome with minor glomerular abnormality |
| N011 | Rapidly progressive nephritic syndrome with focal and segmental glomerular lesions |
| N012 | Rapidly progressive nephritic syndrome with diffuse membranous glomerulonephritis |
| N013 | Rapidly progressive nephritic syndrome with diffuse mesangial proliferative glomerulonephritis |
| N014 | Rapidly progressive nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis |
| N015 | Rapidly progressive nephritic syndrome with diffuse mesangiocapillary glomerulonephritis |
| N016 | Rapidly progressive nephritic syndrome with dense deposit disease |
| N017 | Rapidly progressive nephritic syndrome with diffuse crescentic glomerulonephritis |
| N018 | Rapidly progressive nephritic syndrome with other morphologic changes |
| N019 | Rapidly progressive nephritic syndrome with unspecified morphologic changes |
| N020 | Recurrent and persistent hematuria with minor glomerular abnormality |
| N021 | Recurrent and persistent hematuria with focal and segmental glomerular lesions |
| N022 | Recurrent and persistent hematuria with diffuse membranous glomerulonephritis |
| N023 | Recurrent and persistent hematuria with diffuse mesangial proliferative glomerulonephritis |
| N024 | Recurrent and persistent hematuria with diffuse endocapillary proliferative glomerulonephritis |
| N025 | Recurrent and persistent hematuria with diffuse mesangiocapillary glomerulonephritis |
| N026 | Recurrent and persistent hematuria with dense deposit disease |
| N027 | Recurrent and persistent hematuria with diffuse crescentic glomerulonephritis |
| N028 | Recurrent and persistent hematuria with other morphologic changes |
| N029 | Recurrent and persistent hematuria with unspecified morphologic changes |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 17:08:13 CMS, code-revision=333, description-revision=1331 |