ICD-9-CM Changes Effective 10/1/2004-9/30/2005

Source: Federal Register Thursday, August 11, 2004 

[[Page 49611]]


Table 6A - New Diagnosis Codes
Diagnosis
Code Description CC MDC DRG
66.40 West Nile Fever, unspecified N 18 421,422
66.41 West Nile Fever with encephalitis N 18 421,422
66.42 West Nile Fever with other neurologic manifestation N 18 421,422
66.49 West Nile Fever with other complications N 18 421,422
70.70 Unspecified viral hepatitis C without hepatic coma Y
 7 205,206
70.71 Unspecified viral hepatitis C with hepatic coma Y 7 205,206
252.00 Hyperparathyroidism, unspecified N 10 300,301
252.01 Primary hyperparathyroidism N 10 300,301
252.02 Secondary hyperparathyroidism, non-renal N 10 300,301
252.08 Other hyperparathyroidism N 10 300,301
273.40 Alpha-I-antitrypsin deficiency N 10 299
277.85 Disorders of fatty acid oxidation N 10 299
277.86 Peroxisomal disorders N 10 299
277.87 Disorders of mitochondrial metabolism N 10 299
347.00 Narcolepsy, without cataplexy N 1 34,35
347.01 Narcolepsy, with cataplexy N 1 34,35
347.10 Narcolepsy in conditions classified elsewhere, without cataplexy N 1 34,35
347.11 Narcolepsy in conditions classified elsewhere, with cataplexy N 1 34,35
380.03 Chondritis of pinna N 8 256
453.40 Venous embolism and thrombosis of unspecified deep vessels of lower extremity Y 5 130, 131
453.41 Venous embolism and thrombosis of deep vessels of proximal lower extremity Y 5 130, 131
453.42 Venous embolism and thrombosis of deep vessels of distal lower extremity Y 5 130, 131
477.20 Allergic rhinitis, due to animal (cat) (dog) hair and dander N 3 68,69,70
491.22 Obstructive chronic bronchitis with acute bronchitis Y
 4 88
521.06 Dental caries pit and fissure N PRE3 482,185, 186, 187
521.07 Dental caries of smooth surface N PRE 3 482,185, 186, 187
521.08 Dental caries of root surface N PRE 3 482,185, 186, 187
521.10 Excessive attrition, unspecified N PRE 3 482,185, 186, 187
521.11 Excessive attrition, limited to enamel N PRE 3 482,185, 186, 187
521.12 Excessive attrition, extending into dentine N PRE 3 482,185, 186, 187
521.13 Excessive attrition, extending into pulp N PRE 3 482,185, 186, 187
521.14 Excessive attrition, localized N PRE 3 482,185, 186, 187
521.15 Excessive attrition, generalized N PRE 3 482,185, 186, 187
521.20 Abrasion, unspecified N PRE 3 482,185, 186, 187
521.21 Abrasion, limited to enamel N PRE 3 482,185,186, 187
521.22 Abrasion, extending into dentine N PRE 3 482,185,186, 187
521.23 Abrasion, extending into pulp N PRE 3 482,185, 186, 187
521.24 Abrasion, localized N PRE 3 482,185, 186, 187
521.25 Abrasion, generalized N PRE 3 482,185, 186, 187
521.30 Erosion, unspecified N PRE 3 482,185, 186, 187
521.31 Erosion, limited to enamel N PRE 3 482,185, 186, 187
521.32 Erosion, extending into dentine N PRE 3 482,185, 186, 187
521.33 Erosion, extending into pulp N PRE 3 482,185, 186, 187
521.34 Erosion, localized N PRE 3 482,185, 186, 187
521.35 Erosion, generalized N PRE 3 482,185, 186, 187
521.40 Pathological resorption, unspecified N PRE 3 482,185, 186, 187
521.41 Pathological resorption, internal N PRE 3 482,185, 186, 187
521.42 Pathological resorption, external N PRE 3 482,185, 186, 187
521.49 Other pathological resorption N PRE 3 482,185, 186, 187
523.20 Gingival recession, unspecified N PRE 3 482,185, 186, 187
523.21 Gingival recession, minimal N PRE 3 482,185, 186, 187
523.22 Gingival recession, moderate N PRE 3 482,185, 186, 187
523.23 Gingival recession, severe N PRE 3 482,185, 186, 187
523.24 Gingival recession, localized N PRE 3 482,185, 186, 187
523.25 Gingival recession, generalized N PRE 3 482,185, 186, 187
524.07 Excessive tuberosity of jaw N PRE 3 482,185, 186, 187
524.20 Unspecified anomaly of dental arch relationship N PRE 3 482,185, 186, 187
524.21 Angle's class I N PRE 3 482,185, 186, 187
524.22 Angle's class II N PRE 3 482,185, 186, 187
524.23 Angle's class III N PRE 3 482,185, 186, 187
524.24 Open anterior occlusal relationship N PRE 3 482,185, 186, 187
524.25 Open posterior occlusal relationship N PRE 3 482,185, 186, 187
524.26 Excessive horizontal overlap N PRE 3 482,185, 186, 187
524.27 Reverse articulation N PRE 3 482,185, 186, 187
524.28 Anomalies of interarch distance N PRE 3 482,185, 186, 187
524.29 Other anomalies of dental arch relationship N PRE 3 482,185, 186, 187
524.30 Unspecified anomaly of tooth position N PRE 3 482,185, 186, 187
524.31 Crowding of teeth N PRE 3 482,185, 186, 187
524.32 Excessive spacing of teeth N PRE 3 482,185, 186, 187
524.33 Horizontal displacement of teeth N PRE 3 482,185, 186, 187
524.34 Vertical displacement of teeth N PRE 3 482,185, 186, 187
524.35 Rotation of teeth N PRE 3 482,185, 186, 187
524.36 Insufficient interocclusal distance of teeth (ridge) N PRE 3 482,185, 186, 187
524.37 Excessive interocclusal distance of teeth N PRE 3 482,185, 186, 187
524.39 Other anomalies of tooth position N PRE 3 482,185, 186, 187
524.50 Dentofacial functional abnormality, unspecified N PRE 3 482,185, 186, 187
524.51 Abnormal jaw closure N PRE 3 482,185, 186, 187
524.52 Limited mandibular range of motion N PRE 3 482,185, 186, 187
524.53 Deviation in opening and closing of the mandible N PRE 3 482,185, 186, 187
524.54 Insufficient anterior guidance N PRE 3 482,185, 186, 187
524.55 Centric occlusion maximum intercuspation discrepancy N PRE 3 482,185, 186, 187
524.56 Non-working side interference N PRE 3 482,185, 186, 187
524.57 Lack of posterior occlusal support N PRE 3 482,185, 186, 187
524.59 Other dentofacial functional abnormalities N PRE 3 482,185, 186, 187
524.64 Temporomandibular joint sounds on opening and/or closing the jaw N PRE 3 482,185, 186, 187
524.75 Vertical displacement of alveolus and teeth N PRE 3 482,185, 186, 187
524.76 Occlusal plane deviation N PRE 3 482,185, 186, 187
524.81 Anterior soft tissue impingement N PRE 3 482,185, 186, 187
524.82 Posterior soft tissue impingement N PRE 3 482,185, 186, 187
524.89 Other specified dentofacial anomalies N PRE 3 482,185, 186, 187
525.20 Unspecified atrophy of edentulous alveolar ridge N PRE 3 482,185, 186, 187
525.21 Minimal atrophy of the mandible N PRE 3 482,185, 186, 187
525.22 Moderate atrophy of the mandible N PRE 3 482,185, 186, 187
525.23 Severe atrophy of the mandible N PRE 3 482,185, 186, 187
525.24 Minimal atrophy of the maxilla N PRE 3 482,185, 186, 187
525.25 Moderate atrophy of the maxilla N PRE 3 482,185, 186, 187
525.26 Severe atrophy of the maxilla N PRE 3 482,185, 186, 187
528.71 Minimal keratinized residual ridge mucosa N PRE 3 482,185, 186, 187
528.72 Excessive keratinized residual ridge mucosa N PRE 3 482,185, 186, 187
528.79 Other disturbances of oral epithelium, including tongue N PRE 3 482,185, 186, 187
530.86 Infection of esophagostomy y 6 188, 189, 190
530.87 Mechanical complication of esophagostomy y 6 188, 189, 190
588.81 Secondary hyperparathyroidism (of renal origin) N 11 331,332,333
588.89 Other specified disorders resulting from impaired renal function N 11 331,332,333
618.00 Unspecified prolapse of vaginal walls N 13 358,359,369
618.01 Cystocele, midline N 13 358,359,369
618.02 Cystocele, lateral N 13 358,359,369
618.03 Urethrocele N 13 358,359,369
618.04 Rectocele N 13 358,359,369
618.05 Perineocele N 13 358,359,369
618.09 Other prolapse of vaginal walls without mention of uterine prolapse N 13 358,359,369
618.81 Incompetence or weakening of pubocervical tissue N 13 358,359,369
618.82 Incompetence or weakening of rectovagina1 tissue N 13 358,359,369
618.83 Pelvic muscle wasting N "13 358,359,369
618.89 Other specified genital prolapse N 13 358,359,369
621.30 Endometrial hyperplasia, unspecified N 13 358,359,369
621.31 Simple endometrial hyperplasia without atypia N 13 358,359,369
621.32 Complex endometrial hyperplasia without atypia N 13 358,359,369
621.33 Endometrial hyperplasia with atypia N 13 358,359,369
622.10 Dysplasia of cervix, unspecified N 13 358,359,369
622.11 Mild dysplasia of cervix N 13 358,359,369
622.12 Moderate dysplasia of cervix N 13 358,359,369
629.20 Female genital mutilation status, unspecified N 13 358,359,369
629.21 Female genital mutilation Type I status N 13 358,359,369
629.22 Female genital mutilation Type II status N 13 358,359,369
629.23 Female genital mutilation Type III status N 13 358,359,369
692.84 Contact dermatitis and other eczema due to animal (cat) (dog) dander N 9 283,284
705.21 Primary focal hyperhidrosis N 9 283,284
705.22 Secondary focal hyperhidrosis N 9 283,284



5 1211
707.00 Decubitus ulcer, unspecified site Y
 9 263,264,271



5 1211
707.01 Decubitus ulcer, elbow Y
 9 263,264,271



5 1211
707.02 Decubitus ulcer, upper back Y
 9 263,264,271



5 1211
707.03 Decubitus ulcer, lower back Y
 9 263,264,271



5 1211
707.04 Decubitus ulcer, hip Y
 9 263,264,271



5 1211
707.05 Decubitus ulcer, buttock Y
 9 263,264,271



5 1211
707.06 Decubitus ulcer, ankle Y
 9 263,264,271



5 1211
707.07 Decubitus ulcer, heel Y
 9 263,264,271



5 1211
707.09 Decubitus ulcer, other site Y
 9 263,264,271
758.31 Cri-du-chat syndrome N 19 429
758.32 V elo-cardio- facial syndrome N 19 429
758.33 Other microdeletions N 19 429
758.39 Other autosomal deletions N 19 429
780.58 Sleep related movement disorder N 19 432
788.38 Overflow incontinence N 11 325,326,327
790.95 Elevated C-reactive protein (CRP) N 23 463,464
795.03 (LGSIL)Papanicolaou smear of cervix with low grade squamous intraepithelial lesion N 13 358,359,369
795.04 (HGSIL)Papanicolaou smear of cervix with high grade squamous intraepitheliallesion N 13 358,359,369
795.05 Cervical high risk human papilIomavirus (HPV) DNA test positive N 13 358,359,369
795.08 Nonspecific abnormal papanicolaou smear of cervix, unsatisfactory smear N 13 358,359,369
796.60 Nonspecific abnormal findings on neonatal screening N 23 463,464
V01.71 Contact or exposure to varicella N 23 467
V01.79 Contact or exposure to other viral diseases N 23 467
V01.83 Contact or exposure to escherichia coli (E. coli) N 23 467
V01.84 Contact or exposure to meningococcus N 23 467
V46.11 Dependence on respirator, status Y 23 467
V46.12 Encounter for respirator dependence during power failure Y
 23 467
V49.83 A waiting organ transplant status Y 23 467
V58.44 Aftercare following organ transplant N 23 465-466
V58.66 Long-term (current) use of aspirin N 23 465-466
V58.67 Long-term (current) use of insulin N 23 465-466
V69.4 Lack of adequate sleep N 23 467
V72.31 Routine gynecological examination N 23 467
V72.32 Encounter for Papanicolaou cervical smear to confirm findings of recent normal smear following initial abnormal smear N 23 467
V72.40 Pregnancy examination or test, pregnancy unconfirmed N 23 467
V72.41 Pregnancy examination or test, negative result N 23 467
V84.01 Genetic susceptibility to malignant neoplasm of breast N 23 467
V84.02 Genetic susceptibility to malignant neoplasm of ovary N 23 467
V84.03 Genetic susceptibility to malignant neoplasm of prostate N 23 467
V84.04 Genetic susceptibility to malignant neoplasm of endometrium N 23 467
V84.09 Genetic susceptibility to other malignant neoplasm N 23 467
V84.8 Genetic susceptibility to other disease N 23 467
TABLE 6B--NEW PROCEDURE CODES
Procedure
Code Description OR MDC DRG
0.16 Pressurized treatment of venous bypass graft N

[conduit] with pharmaceutical substance
0.17 Infusion of vasopressor agent N
0.21 Intravascular imaging of extracranial N

cerebral vessels
0.22 Intravascular imaging of intrathoracic N

vessels
0.23 Intravascular imaging of peripheral vessels N
0.24 Intravascular imaging of coronary vessels N
0.25 Intravascular imaging of renal vessels N
0.28 Intravascular imaging, other specified N

vessel(s)
0.29 Intravascular imaging, unspecified vessel(s) N
0.31 Computer assisted surgery with CT/CT A N
0.32 Computer assisted surgery with MR/MRA N
0.33 Computer assisted surgery with fluoroscopy N
0.34 Imageless computer assisted surgery N
0.35 Computer assisted surgery with multiple datasets N
0.39 Other computer assisted surgery N
0.61 Percutaneous angioplasty or atherectomy of Y 1 533,534

pre cerebral (extracranial) vessel(s)
5 478,479



21 442,443



24 486
0.62 Percutaneous angioplasty or atherectomy of Y 1 533,534

intracranial vessel(s)
5 478,479



21 442,443



24 486
0.63 Percutaneous insertion of carotid artery stent( s ) N
0.64 Percutaneous insertion of other precerebral(extracranial) artery stent(s) N
0.65 Percutaneous insertion of intracranial vascular stent(s) N
0.91 Transplant from live related donor N
0.92 Transplant from live non-related donor N
0.93 Transplant from cadaver N
27.64 Insertion of palatal implant N
37.68 Insertion of percutaneous external heart assist device Y 5 104, 105
37.90 Insertion of left atrial appendage device N 5 518
44.38 Laparoscopic gastroenterostomy Y 5 120



6 154, 155, 156



7 201



10 288



17 406,407, 539,




540
44.67 Laparoscopic procedures for creation of Y 6 154, 155, 156

esophagogastric sphincteric competence
21 442,443



24 486
44.68 Laparoscopic gastroplasty Y 6 154, 155, 156



10 288



21 442,443



24 486
44.95 Laparoscopic gastric restrictive procedure Y 10 288
44.96 Laparoscopic revision of gastric restrictive procedure Y 10 288
44.97 Laparoscopic removal of gastric restrictive device(s) Y 10 288
44.98 (Laparoscopic) adjustment of size of adjustable gastric restrictive device Y 10 288
81.65 Vertebroplasty Y 8 233,234



21 442,443



24 486
81.66 Kyphoplasty Y 8 233,234



21 442,443



24 486
84.53 Implantation of internal limb lengthening device with kinetic distraction N
84.54 Implantation of other internal limb lengthening device N
84.55 Insertion of bone void filler N
84.59 Insertion of other spinal devices Y 1 531,532



8 499,500



21 442,443



24 486
84.60 Insertion of spinal disc prosthesis, not Y 1 531,532

otherwise specified
8 499,500



21 442,443



24 486
84.61 Insertion of partial spinal disc prosthesis, Y 1 531,532

cervical
8 499,500



21 442,443



24 486
84.62 Insertion of total spinal disc prosthesis, Y 1 531,532

cervical
8 499,500



21 442,443



24 486
84.63 Insertion of spinal disc prosthesis, thoracic Y 1 531,532



8 499,500



21 442,443



24 486
84.64 Insertion of partial spinal disc prosthesis, Y 1 531,532

lumbosacral
8 499,500



21 442,443



24 486
84.65 Insertion of total spinal disc prosthesis, Y 1 531,532

lumbosacral
8 499,500



21 442,443



24 486
84.66 Revision or replacement of artificial spinal Y 1 531,532

disc prosthesis, cervical
8 499,500



21 442,443



24 486
84.67 Revision or replacement of artificial spinal Y 1 531,532

disc prosthesis, thoracic
8 499,500



21 442,443



24 486
84.68 Revision or replacement of artificial spinal Y 1 531,532

disc prosthesis, lumbosacral
8 499,500



21 442,443



24 486
84.69 Revision or replacement of artificial spinal Y 1 531,532

disc prosthesis, not otherwise specified
8 499,500



21 442,443



24 486
86.94 Insertion or replacement of single array neurostimulator pulse generator Y
7,8
86.95 Insertion or replacement of dual array neurostimulator pulse generator Y 1 7,8
86.96 Insertion or replacement of other neurostimulator pulse generator Y 1 7,8
89.49 Automatic implantable cardioverter/defibrillator (AI CD) check N
99.78 Aquapheresis N
TABLE 6C - INVALID DIAGNOSIS CODES
Diagnosis
Code Description CC MDC DRG
66.40 West Nile Fever N 18 421,422
252.00 Hyperparathyroidism N 10 300,301
347.00 Cataplexy and narcolepsy N 1 34,35
521.10 Excessive attrition N PRE 482



3 185, 186, 187
521.20 Abrasion N PRE 482



3 185, 186, 187
521.30 Erosion N PRE 482



3 185, 186, 187
521.40 Pathological resorption N PRE 482



3 185, 186, 187
523.20 Gingival recession N PRE 482



3 185, 186, 187
524.20 Anomalies of dental arch relationship N PRE 482



3 185, 186, 187
524.30 Anomalies of tooth position N PRE 482



3 185, 186, 187
524.50 Dentofacial functional abnormalities N PRE 482



3 185, 186, 187
524.80 Other specified dentofacial anomalies N PRE 482



3 185, 186, 187
525.20 Atrophy of edentulous alveolar ridge N PRE 482



3 185, 186, 187
528.70 Other disturbances of oral epithelium, including tongue N PRE 482



3 185, 186, 187
588.80 Other specified disorders resulting from impaired renal N 11 331,332,333

function
618.00 Prolapse of vaginal walls without mention of uterine N 13 358,359,369

prolapse
618.80 Other specified genital prolapse N 13 358,359,369
621.30 Endometrial cystic hyperplasia N 13 358,359,369
622.10 Dysplasia of cevix (uteri) N 13 358,359,369
707.00 Decubitus ulcer Y 5 1211



9 263,264,271
758.30 Autosomal deletion syndromes N 19 429
V01.7 Other viral diseases N 23 467
V46.1 Respirator Y 23 467
V72.3 Gynecological examination N 23 467
V72.4 Pregnancy examination or test, pregnancy unconfirmed N 23 467

TABLE 6D - INVALID PROCEDURE CODES

There are no invalid procedure codes for FY 2005.
TABLE 6E--REVISED DIAGNOSIS CODE TITLES
Diagnosis Code Description CC MDC DRG
41.82 Bacteroides fragilis N 18 423
70.41 Acute hepatitis C with hepatic coma Y 7 205,206



15 387 389
70.51 Acute hepatitis C without mention Y 7 205,206

of hepatic coma
15 387 389
250.00 Diabetes mellitus without mention N PRE 512,513

of complication, type II or
10 294,295

unspecified type, not stated as

uncontrolled
250.01 Diabetes mellitus without mention Y PRE 512,513

of complication, type I [juvenile
10 294,295

type], not stated as uncontrolled
250.02 Diabetes mellitus without mention Y PRE 512,513

of complication, type II or
10 294,295

unspecified type, uncontrolled
250.03 Diabetes mellitus without mention Y PRE 512,513

of complication, type I [juvenile
10 294,295

type], uncontrolled
250.10 Diabetes with ketoacidosis, type II N PRE 512,513

or unspecified type, not stated as
10 294,295

uncontrolled
250.11 Diabetes with ketoacidosis, type I Y PRE 512,513

[juvenile type], not stated as
10 294,295

uncontrolled
250.12 Diabetes with ketoacidosis, type II Y PRE 512,513

or unspecified type, uncontrolled
10 294,295
250.13 Diabetes with ketoacidosis, type I Y PRE 512,513

[juvenile type], uncontrolled
10 294,295
250.20 Diabetes with hyperosmolarity, type N PRE 512,513

II or unspecified type, not stated as
10 294,295

uncontrolled
250.21 Diabetes with hyperosmolarity, type Y PRE 512,513

I [juvenile type], not stated as
10 294,295
Diagnosis Code Description CC MDC DRG

uncontrolled
250.22 Diabetes with hyperosmolarity, type Y PRE 512,513

II or unspecified type, uncontrolled
10 294,295
250.23 Diabetes with hyperosmolarity, type Y PRE 512,513

I [juvenile type], uncontrolled
10 294,295
250.30 Diabetes with other coma, type II or N PRE 512,513

unspecified type, not stated as
10 294,295

uncontrolled
250.31 Diabetes with other coma, type I Y PRE 512,513

[juvenile type], not stated as
10 294,295

uncontrolled
250.32 Diabetes with other coma, type II or Y PRE 512,513

unspecified type, uncontrolled
10 294,295
250.33 Diabetes with other coma, type I Y PRE 512,513

[juvenile type], uncontrolled
10 294,295
250.40 Diabetes with renal manifestations, N PRE 512,513

type II or unspecified type, not
11 331,332,333

stated as uncontrolled
250.41 Diabetes with renal manifestations, Y PRE 512,513

type I [juvenile type], not stated as
11 331,332,333

uncontrolled
250.42 Diabetes with renal manifestations, Y PRE 512,513

type II or unspecified type,
11 331,332,333

uncontrolled
250.43 Diabetes with renal manifestations, Y PRE 512,513

type I [juvenile type], uncontrolled
11 331,332,333
250.50 Diabetes with ophthalmic N PRE 512,513

manifestations, type II or
2 46,47,48

unspecified type, not stated as

uncontrolled
250.51 Diabetes with ophthalmic Y PRE 512,513

manifestations, type I [juvenile
2 46,47,48

type], not stated as uncontrolled
250.52 Diabetes with ophthalmic Y PRE 512,513

manifestations, type II or
2 46,47,48

unspecified type, uncontrolled
250.53 Diabetes with ophthalmic Y PRE 512,513

manifestations, type I [juvenile
2 46,47,48

type], uncontrolled
250.60 Diabetes with neurological N PRE 512,513

manifestations, type II or
1 18, 19

unspecified type, not stated as

uncontrolled
250.61 Diabetes with neurological Y PRE 512,513

manifestations, type I [juvenile
1 18, 19

type], not stated as uncontrolled
250.62 Diabetes with neurological Y PRE 512,513

manifestations, type II or
1 18, 19

unspecified type, uncontrolled
250.63 Diabetes with neurological Y PRE 1 512,513

manifestations, type I [juvenile

18, 19

type], uncontrolled
250.70 Diabetes with peripheral circulatory N PRE 512,513

disorders, type II or unspecified
5 130, 131

type, not stated as uncontrolled
250.71 Diabetes with peripheral circulatory Y PRE 512,513

disorders, type I [juvenile type], not
5 130, 131

stated as uncontrolled
250.72 Diabetes with peripheral circulatory Y PRE 512,513

disorders, type II or unspecified
5 130, 131

type, uncontrolled
250.73 Diabetes with peripheral circulatory Y PRE 512,513

disorders, type I [juvenile type],
5 130, 131

uncontrolled
250.80 Diabetes with other specified N PRE 512,513

manifestations, type II or
10 294,295

unspecified type, not stated as

uncontrolled
250.81 Diabetes with other specified Y PRE 512,513

manifestations, type I [juvenile
10 294,295

type], not stated as uncontrolled
250.82 Diabetes with other specified Y PRE 512,513

manifestations, type II or
10 294,295

unspecified type, uncontrolled
250.83 Diabetes with other specified Y PRE 512,513

manifestations, type I [juvenile
10 294,295

type], uncontrolled
250.90 Diabetes with unspecified N PRE 512,513

complication, type II or unspecified
10 294,295

type, not stated as uncontrolled
250.91 Diabetes with unspecified Y PRE 512,513

complication, type I [juvenile type],
10 294,295

not stated as uncontrolled
250.92 Diabetes with unspecified Y PRE 512,513

complication, type II or unspecified
10 294,295

type, uncontrolled
250.93 Diabetes with unspecified Y PRE 512,513

complication, type I [juvenile type],
10 294,295

uncontrolled
286.50 Hemorrhagic disorder due to Y 16 397

intrinsic circulating anticoagulants
290.40 Vascular dementia, uncomplicated N 19 429
290.41 Vascular dementia, with delirium N 19 429
290.42 Vascular dementia, with delusions N 19 429
290.43 Vascular dementia, with depressed N 19 429

mood
291.10 Alcohol-induced persisting amnestic Y 20 521,522,523

disorder
291.20 Alcohol-induced persisting Y 20 521,522,523

dementia
291.30 Alcohol-induced psychotic disorder Y 20 521,522,523

with hallucinations
291.50 Alcohol-induced psychotic disorder N 20 521,522,523

with delusions
291.89 Other specified alcohol-induced Y 20 521,522,523

mental disorders
291.90 Unspecified alcohol-induced mental Y 20 521,522,523

disorders
292.00 Drug withdrawal Y 15 3871 3891



20 521,522,523
292.11 Drug-induced psychotic disorder Y 20 521,522,523

with delusions
292.12 Drug-induced psychotic disorder Y 20 521,522,523

with hallucinations
292.82 Drug-induced persisting dementia Y 20 521,522,523
292.83 Drug-induced persisting amnestic Y 20 521,522,523

disorder
292.84 Drug-induced mood disorder Y 20 521,522,523
293.00 Delirium due to conditions N 19 425

classified elsewhere
293.81 Psychotic disorder with delusions in Y 19 429

conditions classified elsewhere
293.82 Psychotic disorder with Y 19 429

hallucinations in conditions

classified elsewhere
293.83 Mood disorder in conditions Y 19 429

classified elsewhere
293.84 Anxiety disorder in conditions Y 19 429

classified elsewhere
293.89 Other specified transient mental N 19 429

disorders due to conditions

classified elsewhere, other
293.90 Unspecified transient mental N 19 425

disorder in conditions classified

elsewhere
294.00 Amnestic disorder in conditions N 19 429

classified elsewhere
294.80 Other persistent mental disorders N 19 429

due to conditions classified

elsewhere
294.90 Unspecified persistent mental N 19 429

disorders due to conditions
25 4892

classified elsewhere
295.40 Schizophreniform disorder, Y 19 430

unspecified
295.41 Schizophreniform disorder, Y 19 430

sub chronic
295.42 Schizophreniform disorder, chronic Y 19 430
295.43 Schizophreniform disorder, Y 19 430

subchronic with acute exacerbation
295.44 Schizophreniform disorder, chronic Y 19 430

with acute exacerbation
295.45 Schizophreniform disorder, in N 19 430

remission
295.60 Schizophrenic disorders, residual Y 19 430

type, unspecified
295.61 Schizophrenic disorders, residual Y 19 430

type, sub chronic
295.62 Schizophrenic disorders, residual Y 19 430

type, chronic
295.63 Schizophrenic disorders, residual Y 19 430

type, subchronic with acute

exacerbation
295.64 Schizophrenic disorders, residual Y 19 430

type, chronic with acute

exacerbation
295.65 Schizophrenic disorders, residual N 19 430

type, in remission
295.70 Schizoaffective disorder, Y 19 430

unspecified
295.71 Schizoaffective disorder, subchronic Y 19 430
295.72 Schizoaffective disorder, chronic Y 19 430
295.73 Schizoaffective disorder, sub chronic Y 19 430

with acute exacerbation
295.74 Schizoaffective disorder, chronic Y 19 430

with acute exacerbation
295.75 Schizoaffective disorder, in N 19 430

remission
296.00 Bipolar I disorder, single manic N 19 430

episode, unspecified
296.01 Bipolar I disorder, single manic N 19 430

episode, mild
296.02 Bipolar I disorder, single manic N 19 430

episode, moderate
296.03 Bipolar I disorder, single manic N 19 430

episode, severe, without mention of

psychotic behavior
296.04 Bipolar I disorder, single manic Y 19 430

episode, severe, specified as with

psychotic behavior
296.05 Bipolar I disorder, single manic N 19 430

episode, in partial or unspecified

remission
296.06 Bipolar I disorder, single manic N 19 430

episode, in full remission
296.40 Bipolar I disorder, most recent N 19 430

episode (or current) manic,

unspecified
296.41 Bipolar I disorder, most recent N 19 430

episode (or current) manic, mild
296.42 Bipolar I disorder, most recent N 19 430

episode (or current) manic,

moderate
296.43 Bipolar I disorder, most recent N 19 430

episode (or current) manic, severe,

without mention of psychotic

behavior
296.44 Bipolar I disorder, most recent Y 19 430

episode (or current) manic, severe,

specified as with psychotic behavior
296.45 Bipolar I disorder, most recent N 19 430

episode (or current) manic, in partial

or unspecified remission
296.46 Bipolar I disorder, most recent N 19 430

episode (or current) manic, in full

remission
296.50 Bipolar I disorder, most recent N 19 430

episode (or current) depressed,

unspecified
296.51 Bipolar I disorder, most recent N 19 430

episode (or current) depressed, mild
296.52 Bipolar I disorder, most recent N 19 430

episode (or current) depressed,

moderate
296.53 Bipolar I disorder, most recent N 19 430

episode (or current) depressed,

severe, without mention of

psychotic behavior
296.54 Bipolar I disorder, most recent Y 19 430

episode (or current) depressed,

severe, specified as with psychotic

behavior
296.55 Bipolar I disorder, most recent N 19 430

episode (or current) depressed, in

partial or unspecified remission
296.56 Bipolar I disorder, most recent N 19 430

episode (or current) depressed, in

full remission
296.60 Bipolar I disorder, most recent N 19 430

episode (or current) mixed,

unspecified
296.61 Bipolar I disorder, most recent N 19 430

episode (or current) mixed, mild
296.62 Bipolar I disorder, most recent N 19 430

episode (or current) mixed,

moderate
296.63 Bipolar I disorder, most recent N 19 430

episode (or current) mixed, severe,

without mention of psychotic

behavior
296.64 Bipolar I disorder, most recent Y 19 430

episode (or current) mixed, severe,

specified as with psychotic behavior
296.65 Bipolar I disorder, most recent N 19 430

episode (or current) mixed, in partial

or unspecified remission
296.66 Bipolar I disorder, most recent N 19 430

episode (or current) mixed, in full

remission
296.70 Bipolar I disorder, most recent N 19 430

episode (or current) unspecified
296.80 Bipolar disorder, unspecified N 19 430
296.89 Other and unspecified bipolar N 19 430

disorders, other
296.90 Unspecified episodic mood disorder N 19 430
296.99 Other specified episodic mood N 19 430

disorder
297.10 Delusional disorder N 19 430
297.30 Shared psychotic disorder N 19 430
299.00 Autistic disorder, current or active Y 19 429

state
299.01 Autistic disorder, residual state N 19 429
299.10 Childhood disintegrative disorder, Y 19 429

current or active state
299.11 Childhood disintegrative disorder, N 19 429

residual state
299.80 Other specified pervasive Y 19 430

developmental disorders, current or

active state
299.81 Other specified pervasive N 19 430

developmental disorders, residual

state
299.90 Unspecified pervasive Y 19 430

developmental disorder, current or

active state
299.91 Unspecified pervasive N 19 430

developmental disorder, residual

state
300.01 Panic disorder without agoraphobia N 19 425
300.12 Dissociative amnesia N 19 425
300.13 Dissociative fugue N 19 425
300.14 Dissociative identity disorder N 19 428
300.16 Factitious disorder with N 19 425

predominantly psychological signs

and symptoms
300.21 Agoraphobia with panic disorder N 19 427
300.29 Other isolated or specific phobias N 19 427
300.40 Dysthymic disorder N 19 426
300.60 Depersonalization disorder N 19 427
300.89 Other somatoform disorders N 19 427
300.90 Unspecified nonpsychotic mental N 19 425

disorder
301.22 Schizotypal personality disorder N 19 428
301.40 Obsessive-compulsive personality N 19 428

disorder
301.81 Narcissistic personality disorder N 19 428
301.82 Avoidant personality disorder N 19 428
301.83 Borderline personality disorder N 19 428
302.00 Ego-dystonic sexual orientation N 19 432
302.30 Transvestic fetishism N 19 432
302.60 Gender identity disorder in children N 19 432
302.71 Hypoactive sexual desire disorder N 19 432
302.73 Female orgasmic disorder N 19 432
302.74 Male orgasmic disorder N 19 432
302.75 Premature ejaculation N 19 432
302.76 Dyspareunia, psychogenic N 19 432
302.85 Gender identity disorder in N 19 432

adolescents or adults
304.10 Sedative, hypnotic or anxiolytic Y 20 521,522,523

dependence, unspecified
304.11 Sedative, hypnotic or anxiolytic Y 20 521,522,523

dependence, continuous
304.12 Sedative, hypnotic or anxiolytic Y 20 521,522,523

dependence, episodic
304.13 Sedative, hypnotic or anxiolytic N 20 521,522,523

dependence, in remission
305.40 Sedative, hypnotic or anxiolytic Y 20 521,522,523

abuse, unspecified
305.41 Sedative, hypnotic or anxiolytic Y 20 521,522,523

abuse, continuous
305.42 Sedative, hypnotic or anxiolytic Y 20 521,522,523

abuse, episodic
305.43 Sedative, hypnotic or anxiolytic N 20 521,522,523

abuse, in remission
307.00 Stuttering N 19 432
307.21 Transient tic disorder N 1 34,35
307.22 Chronic motor or vocal tic disorder N 1 34,35
307.23 Tourette's disorder N 1 34, 35
307.30 Stereotypic movement disorder N 19 432
307.45 Circadian rhythm sleep disorder N 19 432
307.46 Sleep arousal disorder N 19 432
307.51 Bulimia nervosa N 19 432
307.53 Rumination disorder N 19 427
307.89 Other, pain disorder related to N 19 427

psychological factors
309.00 Adjustment disorder with depressed N 19 426

mood
309.24 Adjustment disorder with anxiety N 19 427
309.28 Adjustment disorder with mixed N 19 427

anxiety and depressed mood
309.30 Adjustment disorder with N 19 427

disturbance of conduct
309.40 Adjustment disorder with mixed N 19 427

disburbance of emotions and

conduct
309.81 Posttraumatic stress disorder N 19 427
310.10 Personality change due to conditions N 19 429

classified elsewhere
313.23 Selective mutism N 19 431
313.81 Oppositional defiant disorder N 19 431
313.90 Unspecified emotional disturbance N 19 431

of childhood or adolescence
315.10 Mathematics disorder N 19 431
315.31 Expressive language disorder N 19 431
315.32 Mixed receptive-expressive N 19 431

language disorder
315.40 Developmental coordination N 19 431

disorder
521.70 Intrinsic posteruptive color changes N PRE 482



3 185, 186, 187
760.70 Noxious influences affecting fetus N 15 390

or newborn via placenta or breast

milk, unspecified noxious substance
760.71 Noxious influences affecting fetus N 15 390

or newborn via placenta or breast

milk, alcohol
760.72 Noxious influences affecting fetus N 15 390

or newborn via placenta or breast

milk, narcotics
760.73 Noxious influences affecting fetus N 15 390

or newborn via placenta or breast

milk, hallucinogenic agents
760.74 Noxious influences affecting fetus N 15 390

or newborn via placenta or breast

milk, anti-infectives
760.75 Noxious influences affecting fetus N 15 390

or newborn via placenta or breast

milk, cocaine
760.76 Noxious influences affecting fetus N 15 390

or newborn via placenta or breast

milk, diethylstilbestrol [DES]
760.79 Noxious influences affecting fetus N 15 390

or newborn via placenta or breast

milk, other
780.80 Generalized hyperhidrosis N 9 283-284



25 490
795.00 Abnormal glandular Papanicolaou N 13 358,359,369

smear of cervix
795.01 Papanicolaou smear of cervix with N 13 358,359,369

atypical squamous cells of

undetermined significance (ASC-US)
795.02 Papanicolaou smear of cervix with N 13 358,359,369

atypical squamous cells cannot

exclude high grade squamous

intraepitheliallesion (ASC-H)
795.09 Other abnormal Papanicolaou smear N 13 358,359,369

of cervix and cervical HPV
V07.4 Hormone replacement therapy N 23 467

(postmenopausal)

TABLE 6F--REVISED PROCEDURE CODE TITLES
Procedure Code Description OR MDC DRG
0.55 Insertion of drug-eluting peripheral vessel N

stent( s )
1.22 Removal of intracranial neurostimulator Y 1 1,2,3

lead(s)
17 406,407,539,540



17
2.93 Implantation or replacement of intracranial Y I 1,2,3

neurostimulator lead( s)
17 406,407,539,540




442,443



21 486



24
3.93 Implantation or replacement of spinal Y 1 531,532

neurostimulator lead( s)
8 499,500



11 315



12 344,345



13 365



17 406, 407,




539,540



21 442,443



24 486
3.94 Removal of spinal neurostimulator lead(s) Y 1 531,532



8 499,500



II 315



12 344,345



13 365



21 442,443



24 486
4.92 Implantation or replacement of peripheral Y 1 7,8

neurostimulator lead(s)
3 63



8 233,234



11 315



12 344,345



13 365



21 442,443



24 486
4.93 Removal of peripheral neurostimulator Y 1 7,8

lead(s)
3 63



8 233,234



12 344,345



13 365



21 442,443



24 486
36.11 (Aorto )coronary bypass of one coronary Y 5 106, 107, 109

artery
36.12 (Aorto)coronary bypass of two coronary Y 5 106, 107, 109

arteries
36.13 (Aorto )coronary bypass of three coronary Y 5 106, 107, 109

arteries
36.14 (Aorto )coronary bypass of four or more Y 5 106, 107, 109

coronary arteries
37.62 Insertion of non-implantable heart assist Y 5 525

system
37.63 Repair of heart assist system Y 5 525
37.65 Implant of external heart assist system Y 5 525
37.66 Insertion of implantable heart assist system Y 5 103
39.50 Angioplasty or atherectomy of other non- Y 1 533,534

coronary vessel(s)
4 76, 77



5 478,479



6 170,171



7 201



8 233,234



9 269,270



10 292,293



11 315



21 442,443



24 486
39.90 Insertion of non-drug-eluting peripheral N

vessel stents(s)
86.05 Incision with removal of foreign body or N

device from skin and subcutaneous tissue