2024 CMS HCC Changes Desk Reference

G129 Spinal muscular atrophy, unspecified 72 190 Yes Yes G110 Congenital nonprogressive ataxia 72 200 Yes Yes G1110 Early-onset cerebellar ataxia, unspecified 72 200 Yes Yes G1111 Friedreich ataxia 72 200 Yes Yes G1119 Other early-onset cerebellar ataxia 72 200 Yes Yes G112 Late-onset cerebellar ataxia 72 200 Yes Yes G113 Cerebellar ataxia with defective DNA repair 72 200 Yes Yes G114 Hereditary spastic paraplegia 72 200 Yes Yes G118 Other hereditary ataxias 72 200 Yes Yes G119 Hereditary ataxia, unspecified 72 200 Yes Yes S140XXS Concussion and edema of cervical spinal cord, sequela 72 Yes No S14101S Unspecified injury at C1 level of cervical spinal cord, sequela 72 Yes No S14102S Unspecified injury at C2 level of cervical spinal cord, sequela 72 Yes No S14103S Unspecified injury at C3 level of cervical spinal cord, sequela 72 Yes No S14104S Unspecified injury at C4 level of cervical spinal cord, sequela 72 Yes No S14105S Unspecified injury at C5 level of cervical spinal cord, sequela 72 Yes No S14106S Unspecified injury at C6 level of cervical spinal cord, sequela 72 Yes No S14107S Unspecified injury at C7 level of cervical spinal cord, sequela 72 Yes No S14108S Unspecified injury at C8 level of cervical spinal cord, sequela 72 Yes No S14109S Unspecified injury at unspecified level of cervical spinal cord, sequela 72 Yes No S14121S Central cord syndrome at C1 level of cervical spinal cord, sequela 72 Yes No S14122S Central cord syndrome at C2 level of cervical spinal cord, sequela 72 Yes No S14123S Central cord syndrome at C3 level of cervical spinal cord, sequela 72 Yes No S14124S Central cord syndrome at C4 level of cervical spinal cord, sequela 72 Yes No S14125S Central cord syndrome at C5 level of cervical spinal cord, sequela 72 Yes No S14126S Central cord syndrome at C6 level of cervical spinal cord, sequela 72 Yes No S14127S Central cord syndrome at C7 level of cervical spinal cord, sequela 72 Yes No S14128S Central cord syndrome at C8 level of cervical spinal cord, sequela 72 Yes No S14129S Central cord syndrome at unspecified level of cervical spinal cord, sequela 72 Yes No S14131S Anterior cord syndrome at C1 level of cervical spinal cord, sequela 72 Yes No S14132S Anterior cord syndrome at C2 level of cervical spinal cord, sequela 72 Yes No S14133S Anterior cord syndrome at C3 level of cervical spinal cord, sequela 72 Yes No S14134S Anterior cord syndrome at C4 level of cervical spinal cord, sequela 72 Yes No S14135S Anterior cord syndrome at C5 level of cervical spinal cord, sequela 72 Yes No S14136S Anterior cord syndrome at C6 level of cervical spinal cord, sequela 72 Yes No S14137S Anterior cord syndrome at C7 level of cervical spinal cord, sequela 72 Yes No S14138S Anterior cord syndrome at C8 level of cervical spinal cord, sequela 72 Yes No S14139S Anterior cord syndrome at unspecified level of cervical spinal cord, sequela 72 Yes No S14141S Brown-Sequard syndrome at C1 level of cervical spinal cord, sequela 72 Yes No S14142S Brown-Sequard syndrome at C2 level of cervical spinal cord, sequela 72 Yes No S14143S Brown-Sequard syndrome at C3 level of cervical spinal cord, sequela 72 Yes No S14144S Brown-Sequard syndrome at C4 level of cervical spinal cord, sequela 72 Yes No S14145S Brown-Sequard syndrome at C5 level of cervical spinal cord, sequela 72 Yes No S14146S Brown-Sequard syndrome at C6 level of cervical spinal cord, sequela 72 Yes No S14147S Brown-Sequard syndrome at C7 level of cervical spinal cord, sequela 72 Yes No S14148S Brown-Sequard syndrome at C8 level of cervical spinal cord, sequela 72 Yes No S14149S Brown-Sequard syndrome at unspecified level of cervical spinal cord, sequela 72 Yes No S14151S Other incomplete lesion at C1 level of cervical spinal cord, sequela 72 Yes No S14152S Other incomplete lesion at C2 level of cervical spinal cord, sequela 72 Yes No S14153S Other incomplete lesion at C3 level of cervical spinal cord, sequela 72 Yes No S14154S Other incomplete lesion at C4 level of cervical spinal cord, sequela 72 Yes No S14155S Other incomplete lesion at C5 level of cervical spinal cord, sequela 72 Yes No S14156S Other incomplete lesion at C6 level of cervical spinal cord, sequela 72 Yes No S14157S Other incomplete lesion at C7 level of cervical spinal cord, sequela 72 Yes No S14158S Other incomplete lesion at C8 level of cervical spinal cord, sequela 72 Yes No S14159S Other incomplete lesion at unspecified level of cervical spinal cord, sequela 72 Yes No S240XXS Concussion and edema of thoracic spinal cord, sequela 72 Yes No S24101S Unspecified injury at T1 level of thoracic spinal cord, sequela 72 Yes No S24102S Unspecified injury at T2-T6 level of thoracic spinal cord, sequela 72 Yes No S24103S Unspecified injury at T7-T10 level of thoracic spinal cord, sequela 72 Yes No S24104S Unspecified injury at T11-T12 level of thoracic spinal cord, sequela 72 Yes No S24109S Unspecified injury at unspecified level of thoracic spinal cord, sequela 72 Yes No S24131S Anterior cord syndrome at T1 level of thoracic spinal cord, sequela 72 Yes No S24132S Anterior cord syndrome at T2-T6 level of thoracic spinal cord, sequela 72 Yes No S24133S Anterior cord syndrome at T7-T10 level of thoracic spinal cord, sequela 72 Yes No S24134S Anterior cord syndrome at T11-T12 level of thoracic spinal cord, sequela 72 Yes No S24139S Anterior cord syndrome at unspecified level of thoracic spinal cord, sequela 72 Yes No S24141S Brown-Sequard syndrome at T1 level of thoracic spinal cord, sequela 72 Yes No S24142S Brown-Sequard syndrome at T2-T6 level of thoracic spinal cord, sequela 72 Yes No S24143S Brown-Sequard syndrome at T7-T10 level of thoracic spinal cord, sequela 72 Yes No S24144S Brown-Sequard syndrome at T11-T12 level of thoracic spinal cord, sequela 72 Yes No S24149S Brown-Sequard syndrome at unspecified level of thoracic spinal cord, sequela 72 Yes No S24151S Other incomplete lesion at T1 level of thoracic spinal cord, sequela 72 Yes No S24152S Other incomplete lesion at T2-T6 level of thoracic spinal cord, sequela 72 Yes No S24153S Other incomplete lesion at T7-T10 level of thoracic spinal cord, sequela 72 Yes No S24154S Other incomplete lesion at T11-T12 level of thoracic spinal cord, sequela 72 Yes No

S24159S Other incomplete lesion at unspecified level of thoracic spinal cord, sequela 72 Yes No S3401XS Concussion and edema of lumbar spinal cord, sequela 72 Yes No S3402XS Concussion and edema of sacral spinal cord, sequela 72 Yes No S34101S Unspecified injury to L1 level of lumbar spinal cord, sequela 72 Yes No S34102S Unspecified injury to L2 level of lumbar spinal cord, sequela 72 Yes No S34103S Unspecified injury to L3 level of lumbar spinal cord, sequela 72 Yes No S34104S Unspecified injury to L4 level of lumbar spinal cord, sequela 72 Yes No S34105S Unspecified injury to L5 level of lumbar spinal cord, sequela 72 Yes No S34109S Unspecified injury to unspecified level of lumbar spinal cord, sequela 72 Yes No S34111S Complete lesion of L1 level of lumbar spinal cord, sequela 72 Yes No S34112S Complete lesion of L2 level of lumbar spinal cord, sequela 72 Yes No S34113S Complete lesion of L3 level of lumbar spinal cord, sequela 72 Yes No S34114S Complete lesion of L4 level of lumbar spinal cord, sequela 72 Yes No S34115S Complete lesion of L5 level of lumbar spinal cord, sequela 72 Yes No S34119S Complete lesion of unspecified level of lumbar spinal cord, sequela 72 Yes No S34121S Incomplete lesion of L1 level of lumbar spinal cord, sequela 72 Yes No S34122S Incomplete lesion of L2 level of lumbar spinal cord, sequela 72 Yes No S34123S Incomplete lesion of L3 level of lumbar spinal cord, sequela 72 Yes No S34124S Incomplete lesion of L4 level of lumbar spinal cord, sequela 72 Yes No S34125S Incomplete lesion of L5 level of lumbar spinal cord, sequela 72 Yes No S34129S Incomplete lesion of unspecified level of lumbar spinal cord, sequela 72 Yes No S34131S Complete lesion of sacral spinal cord, sequela 72 Yes No S34132S Incomplete lesion of sacral spinal cord, sequela 72 Yes No S34139S Unspecified injury to sacral spinal cord, sequela 72 Yes No G14 Postpolio syndrome 182 No Yes P115 Birth injury to spine and spinal cord 182 No Yes

Neurological Disease Group V24 V28 Neurological Disease Group: 8 HCCs • HCC 73 (Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease) • HCC 74 (Cerebral Palsy) • HCC 75 (Myasthenia Gravis/Myoneural Disorders and Guillain-Barre Syndrome/Inflammatory and Toxic Neuropathy) • HCC 76 (Muscular Dystrophy) • HCC 77 (Multiple Sclerosis) • HCC 78 (Parkinson's and Huntington's Diseases) • HCC 79 (Seizure Disorders and Convulsions) • HCC 80 (Coma, Brain Compression/Anoxic Damage) Neurological Disease Group: 12 HCCs • HCC 190 (Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease, Spinal Muscular Atrophy) • HCC 191 (Quadriplegic Cerebral Palsy) • HCC 192 (Cerebral Palsy, Except Quadriplegic) • HCC 193 (Chronic Inflammatory Demyelinating Polyneuritis and Multifocal Motor Neuropathy) • HCC 195 (Myasthenia Gravis with (Acute) Exacerbation) • HCC 196 (Myasthenia Gravis without (Acute) Exacerbation and Other Myoneural Disorders) • HCC 197 (Muscular Dystrophy) • HCC 198 (Multiple Sclerosis) • HCC 199 (Parkinson and Other Degenerative Disease of Basal Ganglia) • HCC 200 (Friedreich and Other Hereditary Ataxias; Huntington Disease) • HCC 201 (Seizure Disorders and Convulsions) • HCC 202 (Coma, Brain Compression/Anoxic Damage)

ICD 10 Desccriptor V24 V28 V24 V28 G1220 Motor neuron disease, unspecified 73 190 Yes Yes G1221 Amyotrophic lateral sclerosis 73 190 Yes Yes G1222 Progressive bulbar palsy 73 190 Yes Yes G1223 Primary lateral sclerosis 73 190 Yes Yes G1224 Familial motor neuron disease 73 190 Yes Yes G1225 Progressive spinal muscle atrophy 73 190 Yes Yes G1229 Other motor neuron disease 73 190 Yes Yes G128 Other spinal muscular atrophies and related syndromes 72 190 Yes Yes G129 Spinal muscular atrophy, unspecified 72 190 Yes Yes G800 Spastic quadriplegic cerebral palsy 74 191 Yes Yes G801 Spastic diplegic cerebral palsy 74 192 Yes Yes G802 Spastic hemiplegic cerebral palsy 74 192 Yes Yes G803 Athetoid cerebral palsy 74 192 Yes Yes G804 Ataxic cerebral palsy 74 192 Yes Yes G808 Other cerebral palsy 74 192 Yes Yes G809 Cerebral palsy, unspecified 74 192 Yes Yes P570 Kernicterus due to isoimmunization 192 No Yes P578 Other specified kernicterus 192 No Yes P579 Kernicterus, unspecified 192 No Yes G6181 Chronic inflammatory demyelinating polyneuritis 75 193 Yes Yes G6182 Multifocal motor neuropathy 75 193 Yes Yes G7001 Myasthenia gravis with (acute) exacerbation 75 195 Yes Yes G7000 Myasthenia gravis without (acute) exacerbation 75 196 Yes Yes G701 Toxic myoneural disorders 75 196 Yes Yes G702 Congenital and developmental myasthenia 75 196 Yes Yes G7080 Lambert-Eaton syndrome, unspecified 75 196 Yes Yes G7081 Lambert-Eaton syndrome in disease classified elsewhere 75 196 Yes Yes G7089 Other specified myoneural disorders 75 196 Yes Yes G709 Myoneural disorder, unspecified 75 196 Yes Yes G731 Lambert-Eaton syndrome in neoplastic disease 75 196 Yes Yes G733 Myasthenic syndromes in other diseases classified elsewhere 75 196 Yes Yes G7100 Muscular dystrophy, unspecified 76 197 Yes Yes G7101 Duchenne or Becker muscular dystrophy 76 197 Yes Yes G7102 Facioscapulohumeral muscular dystrophy 76 197 Yes Yes G71031 Autosomal dominant limb girdle muscular dystrophy 76 197 Yes Yes G71032 Autosomal recessive limb girdle muscular dystrophy due to calpain-3 dysfunction 76 197 Yes Yes G71033 Limb girdle muscular dystrophy due to dysferlin dysfunction 76 197 Yes Yes G710340 Limb girdle muscular dystrophy due to sarcoglycan dysfunction, unspecified 76 197 Yes Yes G710341 Limb girdle muscular dystrophy due to alpha sarcoglycan dysfunction 76 197 Yes Yes G710342 Limb girdle muscular dystrophy due to beta sarcoglycan dysfunction 76 197 Yes Yes G710349 Limb girdle muscular dystrophy due to other sarcoglycan dysfunction 76 197 Yes Yes G71035 Limb girdle muscular dystrophy due to anoctamin-5 dysfunction 76 197 Yes Yes G71038 Other limb girdle muscular dystrophy 76 197 Yes Yes G71039 Limb girdle muscular dystrophy, unspecified 76 197 Yes Yes G7109 Other specified muscular dystrophies 76 197 Yes Yes G7111 Myotonic muscular dystrophy 76 197 Yes Yes G7120 Congenital myopathy, unspecified 76 197 Yes Yes G7121 Nemaline myopathy 76 197 Yes Yes G71220 X-linked myotubular myopathy 76 197 Yes Yes G71228 Other centronuclear myopathy 76 197 Yes Yes G7129 Other congenital myopathy 76 197 Yes Yes G35 Multiple sclerosis 77 198 Yes Yes G360 Neuromyelitis optica [Devic] 77 198 Yes Yes G361 Acute and subacute hemorrhagic leukoencephalitis [Hurst] 77 198 Yes Yes G368 Other specified acute disseminated demyelination 77 198 Yes Yes G369 Acute disseminated demyelination, unspecified 77 198 Yes Yes G370 Diffuse sclerosis of central nervous system 77 198 Yes Yes G371 Central demyelination of corpus callosum 77 198 Yes Yes G372 Central pontine myelinolysis 77 198 Yes Yes G375 Concentric sclerosis [Balo] of central nervous system 77 198 Yes Yes G378 Other specified demyelinating diseases of central nervous system 77 198 Yes Yes G379 Demyelinating disease of central nervous system, unspecified 77 198 Yes Yes G20 Parkinson's disease 78 199 Yes Yes G213 Postencephalitic parkinsonism 78 199 Yes Yes G214 Vascular parkinsonism 78 199 Yes Yes G218 Other secondary parkinsonism 78 199 Yes Yes G219 Secondary parkinsonism, unspecified 78 199 Yes Yes G230 Hallervorden-Spatz disease 78 199 Yes Yes G231 Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski] 78 199 Yes Yes G232 Striatonigral degeneration 78 199 Yes Yes G238 Other specified degenerative diseases of basal ganglia 78 199 Yes Yes G239 Degenerative disease of basal ganglia, unspecified 78 199 Yes Yes G903 Multi-system degeneration of the autonomic nervous system 78 199 Yes Yes G10 Huntington's disease 78 200 Yes Yes G110 Congenital nonprogressive ataxia 72 200 Yes Yes

G1110 Early-onset cerebellar ataxia, unspecified 72 200 Yes Yes G1111 Friedreich ataxia 72 200 Yes Yes G1119 Other early-onset cerebellar ataxia 72 200 Yes Yes G112 Late-onset cerebellar ataxia 72 200 Yes Yes G113 Cerebellar ataxia with defective DNA repair 72 200 Yes Yes G114 Hereditary spastic paraplegia 72 200 Yes Yes G118 Other hereditary ataxias 72 200 Yes Yes G119 Hereditary ataxia, unspecified 72 200 Yes Yes G40001 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus 79 201 Yes Yes G40009 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus 79 201 Yes Yes G40011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus 79 201 Yes Yes G40019 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus 79 201 Yes Yes G40101 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus 79 201 Yes Yes G40109 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus 79 201 Yes Yes G40111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus 79 201 Yes Yes G40119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus 79 201 Yes Yes G40201 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus 79 201 Yes Yes G40209 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus 79 201 Yes Yes G40211 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus 79 201 Yes Yes G40219 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus 79 201 Yes Yes G40301 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus 79 201 Yes Yes G40309 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus 79 201 Yes Yes G40311 Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus 79 201 Yes Yes G40319 Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus 79 201 Yes Yes G40401 Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus 79 201 Yes Yes G40409 Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus 79 201 Yes Yes G40411 Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus 79 201 Yes Yes G40419 Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus 79 201 Yes Yes G4042 Cyclin-Dependent Kinase-Like 5 Deficiency Disorder 79 201 Yes Yes G40501 Epileptic seizures related to external causes, not intractable, with status epilepticus 79 201 Yes Yes G40509 Epileptic seizures related to external causes, not intractable, without status epilepticus 79 201 Yes Yes G40801 Other epilepsy, not intractable, with status epilepticus 79 201 Yes Yes G40802 Other epilepsy, not intractable, without status epilepticus 79 201 Yes Yes G40803 Other epilepsy, intractable, with status epilepticus 79 201 Yes Yes G40804 Other epilepsy, intractable, without status epilepticus 79 201 Yes Yes G40811 Lennox-Gastaut syndrome, not intractable, with status epilepticus 79 201 Yes Yes G40812 Lennox-Gastaut syndrome, not intractable, without status epilepticus 79 201 Yes Yes G40813 Lennox-Gastaut syndrome, intractable, with status epilepticus 79 201 Yes Yes G40814 Lennox-Gastaut syndrome, intractable, without status epilepticus 79 201 Yes Yes G40821 Epileptic spasms, not intractable, with status epilepticus 79 201 Yes Yes G40822 Epileptic spasms, not intractable, without status epilepticus 79 201 Yes Yes G40823 Epileptic spasms, intractable, with status epilepticus 79 201 Yes Yes G40824 Epileptic spasms, intractable, without status epilepticus 79 201 Yes Yes G40833 Dravet syndrome, intractable, with status epilepticus 79 201 Yes Yes G40834 Dravet syndrome, intractable, without status epilepticus 79 201 Yes Yes G4089 Other seizures 79 201 Yes Yes G40901 Epilepsy, unspecified, not intractable, with status epilepticus 79 201 Yes Yes G40909 Epilepsy, unspecified, not intractable, without status epilepticus 79 201 Yes Yes G40911 Epilepsy, unspecified, intractable, with status epilepticus 79 201 Yes Yes G40919 Epilepsy, unspecified, intractable, without status epilepticus 79 201 Yes Yes G40A01 Absence epileptic syndrome, not intractable, with status epilepticus 79 201 Yes Yes G40A09 Absence epileptic syndrome, not intractable, without status epilepticus 79 201 Yes Yes G40A11 Absence epileptic syndrome, intractable, with status epilepticus 79 201 Yes Yes G40A19 Absence epileptic syndrome, intractable, without status epilepticus 79 201 Yes Yes G40B01 Juvenile myoclonic epilepsy, not intractable, with status epilepticus 79 201 Yes Yes G40B09 Juvenile myoclonic epilepsy, not intractable, without status epilepticus 79 201 Yes Yes G40B11 Juvenile myoclonic epilepsy, intractable, with status epilepticus 79 201 Yes Yes G40B19 Juvenile myoclonic epilepsy, intractable, without status epilepticus 79 201 Yes Yes R5600 Simple febrile convulsions 79 201 Yes Yes R5601 Complex febrile convulsions 79 201 Yes Yes R561 Post traumatic seizures 79 201 Yes Yes R569 Unspecified convulsions 79 201 Yes Yes P90 Convulsions of newborn 201 No Yes G931 Anoxic brain damage, not elsewhere classified 80 202 Yes Yes

G935 Compression of brain 80 202 Yes Yes G936 Cerebral edema 80 202 Yes Yes R4020 Unspecified coma 80 202 Yes Yes R402110 Coma scale, eyes open, never, unspecified time 80 202 Yes Yes R402111 Coma scale, eyes open, never, in the field [EMT or ambulance] 80 202 Yes Yes R402112 Coma scale, eyes open, never, at arrival to emergency department 80 202 Yes Yes R402113 Coma scale, eyes open, never, at hospital admission 80 202 Yes Yes R402114 Coma scale, eyes open, never, 24 hours or more after hospital admission 80 202 Yes Yes R402120 Coma scale, eyes open, to pain, unspecified time 80 202 Yes Yes R402121 Coma scale, eyes open, to pain, in the field [EMT or ambulance] 80 202 Yes Yes R402122 Coma scale, eyes open, to pain, at arrival to emergency department 80 202 Yes Yes R402123 Coma scale, eyes open, to pain, at hospital admission 80 202 Yes Yes R402124 Coma scale, eyes open, to pain, 24 hours or more after hospital admission 80 202 Yes Yes R402210 Coma scale, best verbal response, none, unspecified time 80 202 Yes Yes R402211 Coma scale, best verbal response, none, in the field [EMT or ambulance] 80 202 Yes Yes R402212 Coma scale, best verbal response, none, at arrival to emergency department 80 202 Yes Yes R402213 Coma scale, best verbal response, none, at hospital admission 80 202 Yes Yes R402214 Coma scale, best verbal response, none, 24 hours or more after hospital admission 80 202 Yes Yes R402220 Coma scale, best verbal response, incomprehensible words, unspecified time 80 202 Yes Yes R402221 Coma scale, best verbal response, incomprehensible words, in the field [EMT or ambulance] 80 202 Yes Yes R402222 Coma scale, best verbal response, incomprehensible words, at arrival to emergency department 80 202 Yes Yes R402223 Coma scale, best verbal response, incomprehensible words, at hospital admission 80 202 Yes Yes R402224 Coma scale, best verbal response, incomprehensible words, 24 hours or more after hospital admission 80 202 Yes Yes R402310 Coma scale, best motor response, none, unspecified time 80 202 Yes Yes R402311 Coma scale, best motor response, none, in the field [EMT or ambulance] 80 202 Yes Yes R402312 Coma scale, best motor response, none, at arrival to emergency department 80 202 Yes Yes R402313 Coma scale, best motor response, none, at hospital admission 80 202 Yes Yes R402314 Coma scale, best motor response, none, 24 hours or more after hospital admission 80 202 Yes Yes R402320 Coma scale, best motor response, extension, unspecified time 80 202 Yes Yes R402321 Coma scale, best motor response, extension, in the field [EMT or ambulance] 80 202 Yes Yes R402322 Coma scale, best motor response, extension, at arrival to emergency department 80 202 Yes Yes R402323 Coma scale, best motor response, extension, at hospital admission 80 202 Yes Yes R402324 Coma scale, best motor response, extension, 24 hours or more after hospital admission 80 202 Yes Yes R402430 Glasgow coma scale score 3-8, unspecified time 80 202 Yes Yes R402431 Glasgow coma scale score 3-8, in the field [EMT or ambulance] 80 202 Yes Yes R402432 Glasgow coma scale score 3-8, at arrival to emergency department 80 202 Yes Yes R402433 Glasgow coma scale score 3-8, at hospital admission 80 202 Yes Yes R402434 Glasgow coma scale score 3-8, 24 hours or more after hospital admission 80 202 Yes Yes R402440 Other coma, without documented Glasgow coma scale score, or with partial score reported, unspecified time 80 202 Yes Yes R402441 Other coma, without documented Glasgow coma scale score, or with partial score reported, in the field [EMT or ambulance] 80 202 Yes Yes R402442 Other coma, without documented Glasgow coma scale score, or with partial score reported, at arrival to emergency department 80 202 Yes Yes R402443 Other coma, without documented Glasgow coma scale score, or with partial score reported, at hospital admission 80 202 Yes Yes R402444 Other coma, without documented Glasgow coma scale score, or with partial score reported, 24 hours or more after hospital admission 80 202 Yes Yes R403 Persistent vegetative state 80 202 Yes Yes E035 Myxedema coma 23 202 Yes Yes P910 Neonatal cerebral ischemia 202 No Yes P911 Acquired periventricular cysts of newborn 202 No Yes P912 Neonatal cerebral leukomalacia 202 No Yes P913 Neonatal cerebral irritability 202 No Yes P914 Neonatal cerebral depression 202 No Yes P915 Neonatal coma 202 No Yes P9160 Hypoxic ischemic encephalopathy [HIE], unspecified 202 No Yes P9161 Mild hypoxic ischemic encephalopathy [HIE] 202 No Yes P9162 Moderate hypoxic ischemic encephalopathy [HIE] 202 No Yes P9163 Severe hypoxic ischemic encephalopathy [HIE] 202 No Yes P91811 Neonatal encephalopathy in diseases classified elsewhere 202 No Yes P91819 Neonatal encephalopathy, unspecified 202 No Yes P9188 Other specified disturbances of cerebral status of newborn 202 No Yes P919 Disturbance of cerebral status of newborn, unspecified 202 No Yes D8682 Multiple cranial nerve palsies in sarcoidosis 75 Yes No G130 Paraneoplastic neuromyopathy and neuropathy 75 Yes No G131 Other systemic atrophy primarily affecting central nervous system in neoplastic disease 75 Yes No G610 Guillain-Barre syndrome 75 Yes No G611 Serum neuropathy 75 Yes No G6189 Other inflammatory polyneuropathies 75 Yes No G619 Inflammatory polyneuropathy, unspecified 75 Yes No G620 Drug-induced polyneuropathy 75 Yes No G621 Alcoholic polyneuropathy 75 Yes No G622 Polyneuropathy due to other toxic agents 75 Yes No G6281 Critical illness polyneuropathy 75 Yes No G6282 Radiation-induced polyneuropathy 75 Yes No G63 Polyneuropathy in diseases classified elsewhere 75 Yes No G650 Sequelae of Guillain-Barre syndrome 75 Yes No G651 Sequelae of other inflammatory polyneuropathy 75 Yes No G652 Sequelae of toxic polyneuropathy 75 Yes No

M0550 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified site 75 Yes -- M05511 Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder 75 Yes -- M05512 Rheumatoid polyneuropathy with rheumatoid arthritis of left shoulder 75 Yes -- M05519 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified shoulder 75 Yes -- M05521 Rheumatoid polyneuropathy with rheumatoid arthritis of right elbow 75 Yes -- M05522 Rheumatoid polyneuropathy with rheumatoid arthritis of left elbow 75 Yes -- M05529 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified elbow 75 Yes -- M05531 Rheumatoid polyneuropathy with rheumatoid arthritis of right wrist 75 Yes -- M05532 Rheumatoid polyneuropathy with rheumatoid arthritis of left wrist 75 Yes -- M05539 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified wrist 75 Yes -- M05541 Rheumatoid polyneuropathy with rheumatoid arthritis of right hand 75 Yes -- M05542 Rheumatoid polyneuropathy with rheumatoid arthritis of left hand 75 Yes -- M05549 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hand 75 Yes -- M05551 Rheumatoid polyneuropathy with rheumatoid arthritis of right hip 75 Yes -- M05552 Rheumatoid polyneuropathy with rheumatoid arthritis of left hip 75 Yes -- M05559 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hip 75 Yes -- M05561 Rheumatoid polyneuropathy with rheumatoid arthritis of right knee 75 Yes -- M05562 Rheumatoid polyneuropathy with rheumatoid arthritis of left knee 75 Yes -- M05569 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified knee 75 Yes -- M05571 Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot 75 Yes -- M05572 Rheumatoid polyneuropathy with rheumatoid arthritis of left ankle and foot 75 Yes -- M05579 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified ankle and foot 75 Yes -- M0559 Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites 75 Yes -- M3483 Systemic sclerosis with polyneuropathy 75 Yes -- G2111 Neuroleptic induced parkinsonism 78 Yes No G2119 Other drug induced secondary parkinsonism 78 Yes No G212 Secondary parkinsonism due to other external agents 78 Yes No R402340 Coma scale, best motor response, flexion withdrawal, unspecified time 80 Yes No R402341 Coma scale, best motor response, flexion withdrawal, in the field [EMT or ambulance] 80 Yes No R402342 Coma scale, best motor response, flexion withdrawal, at arrival to emergency department 80 Yes No R402343 Coma scale, best motor response, flexion withdrawal, at hospital admission 80 Yes No R402344 Coma scale, best motor response, flexion withdrawal, 24 hours or more after hospital admission 80 Yes No

Arrest Disease Group V24 V28 Arrest Disease Group: 3 HCCs Arrest Disease Group: 3 HCCs • HCC 82 (Respirator Dependence/Tracheostomy • HCC 211 (Respirator Dependence/Tracheostomy Status) Status/Complications) • HCC 83 (Respiratory Arrest) • HCC 212 (Respiratory Arrest) • HCC 84 (Cardio-Respiratory Failure and Shock) • HCC 213 (Cardio-Respiratory Failure and Shock)

J9500 Unspecified tracheostomy complication 82 211 Yes Yes J9501 Hemorrhage from tracheostomy stoma 82 211 Yes Yes J9502 Infection of tracheostomy stoma 82 211 Yes Yes J9503 Malfunction of tracheostomy stoma 82 211 Yes Yes J9504 Tracheo-esophageal fistula following tracheostomy 82 211 Yes Yes J9509 Other tracheostomy complication 82 211 Yes Yes J95850 Mechanical complication of respirator 82 211 Yes Yes J95859 Other complication of respirator [ventilator] 82 211 Yes Yes Z430 Encounter for attention to tracheostomy 82 211 Yes Yes Z930 Tracheostomy status 82 211 Yes Yes Z9911 Dependence on respirator [ventilator] status 82 211 Yes Yes Z9912 Encounter for respirator [ventilator] dependence during power failure 82 211 Yes Yes J95851 Ventilator associated pneumonia 114 211 Yes Yes R092 Respiratory arrest 83 212 Yes Yes P2881 Respiratory arrest of newborn 212 No Yes I462 Cardiac arrest due to underlying cardiac condition 84 213 Yes Yes I468 Cardiac arrest due to other underlying condition 84 213 Yes Yes I469 Cardiac arrest, cause unspecified 84 213 Yes Yes I4901 Ventricular fibrillation 84 213 Yes Yes I4902 Ventricular flutter 84 213 Yes Yes J80 Acute respiratory distress syndrome 84 213 Yes Yes J810 Acute pulmonary edema 84 213 Yes Yes J9600 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia 84 213 Yes Yes J9601 Acute respiratory failure with hypoxia 84 213 Yes Yes J9602 Acute respiratory failure with hypercapnia 84 213 Yes Yes J9610 Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia 84 213 Yes Yes J9611 Chronic respiratory failure with hypoxia 84 213 Yes Yes J9612 Chronic respiratory failure with hypercapnia 84 213 Yes Yes J9620 Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia 84 213 Yes Yes J9621 Acute and chronic respiratory failure with hypoxia 84 213 Yes Yes J9622 Acute and chronic respiratory failure with hypercapnia 84 213 Yes Yes J9690 Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia 84 213 Yes Yes J9691 Respiratory failure, unspecified with hypoxia 84 213 Yes Yes J9692 Respiratory failure, unspecified with hypercapnia 84 213 Yes Yes R570 Cardiogenic shock 84 213 Yes Yes R579 Shock, unspecified 84 213 Yes Yes P220 Respiratory distress syndrome of newborn 213 No Yes P260 Tracheobronchial hemorrhage originating in the perinatal period 213 No Yes P261 Massive pulmonary hemorrhage originating in the perinatal period 213 No Yes P268 Other pulmonary hemorrhages originating in the perinatal period 213 No Yes P269 Unspecified pulmonary hemorrhage originating in the perinatal period 213 No Yes P270 Wilson-Mikity syndrome 213 No Yes P271 Bronchopulmonary dysplasia originating in the perinatal period 213 No Yes P278 Other chronic respiratory diseases originating in the perinatal period 213 No Yes P279 Unspecified chronic respiratory disease originating in the perinatal period 213 No Yes P280 Primary atelectasis of newborn 213 No Yes P2810 Unspecified atelectasis of newborn 213 No Yes P2811 Resorption atelectasis without respiratory distress syndrome 213 No Yes P2819 Other atelectasis of newborn 213 No Yes P285 Respiratory failure of newborn 213 No Yes P2981 Cardiac arrest of newborn 213 No Yes J951 Acute pulmonary insufficiency following thoracic surgery 84 Yes No J952 Acute pulmonary insufficiency following nonthoracic surgery 84 Yes No J953 Chronic pulmonary insufficiency following surgery 84 Yes No J95821 Acute postprocedural respiratory failure 84 Yes No J95822 Acute and chronic postprocedural respiratory failure 84 Yes No T8111XA Postprocedural cardiogenic shock, initial encounter 84 Yes No

Heart Disease Group V24 V28 Heart Disease Group: 5 HCCs • HCC 85 (Congestive Heart Failure) • HCC 86 (Acute Myocardial Infarction) • HCC 87 (Unstable Angina and Other Acute Ischemic Heart Disease) • HCC 88 (Angina Pectoris) • HCC 96 (Specified Heart Arrhythmias) Heart Disease Group: 10 HCCs • HCC 221 (Heart Transplant Status/Complications) • HCC 222 (End Stage Heart Failure) • HCC 223 (Heart Assist Device/Artificial Heart) 26 • HCC 224 (Acute on Chronic Heart Failure) • HCC 225 (Acute Heart Failure (Excludes Acute on Chronic)) • HCC 226 (Heart Failure, Except End Stage and Acute) • HCC 227 (Cardiomyopathy/Myocarditis) • HCC 228 (Acute Myocardial Infarction) • HCC 229 (Unstable Angina and Other Acute Ischemic Heart Disease) • HCC 238 (Specified Heart Arrhythmias) HCC 223 Heart Assist Device/Artificial Heart contains six ICD-10 codes for presence or complications of heart assist device and artificial heart. To capture only beneficiaries with heart failure (versus an acute condition), HCC 223 is further restricted to beneficiaries who also have an ICD-10 code mapping to heart failure HCCs 224, 225, or 226. Beneficiaries without a heart failure code will not be assigned to HCC 223. Beneficiaries with codes for heart transplant status/complications or for end stage heart failure will be assigned to HCC 221 Heart Transplant Status/Complications or HCC 222 End Stage Heart Failure, respectively. Coefficients (relative risk factors) for HCC 223 and HCC 222 are constrained equal.

ICD 10 Desccriptor V24 V28 V24 V28 T8620 Unspecified complication of heart transplant 186 221 Yes Yes T8621 Heart transplant rejection 186 221 Yes Yes T8622 Heart transplant failure 186 221 Yes Yes T8623 Heart transplant infection 186 221 Yes Yes T86290 Cardiac allograft vasculopathy 186 221 Yes Yes T86298 Other complications of heart transplant 186 221 Yes Yes T8630 Unspecified complication of heart-lung transplant 186 221 Yes Yes T8631 Heart-lung transplant rejection 186 221 Yes Yes T8632 Heart-lung transplant failure 186 221 Yes Yes T8633 Heart-lung transplant infection 186 221 Yes Yes T8639 Other complications of heart-lung transplant 186 221 Yes Yes Z4821 Encounter for aftercare following heart transplant 186 221 Yes Yes Z48280 Encounter for aftercare following heart-lung transplant 186 221 Yes Yes Z941 Heart transplant status 186 221 Yes Yes Z943 Heart and lungs transplant status 186 221 Yes Yes I5084 End stage heart failure 85 222 Yes Yes T82512A Breakdown (mechanical) of artificial heart, initial encounter 223 No Yes T82522A Displacement of artificial heart, initial encounter 223 No Yes T82532A Leakage of artificial heart, initial encounter 223 No Yes T82592A Other mechanical complication of artificial heart, initial encounter 223 No Yes Z95811 Presence of heart assist device 186 223 Yes Yes Z95812 Presence of fully implantable artificial heart 186 223 Yes Yes I5023 Acute on chronic systolic (congestive) heart failure 85 224 Yes Yes I5033 Acute on chronic diastolic (congestive) heart failure 85 224 Yes Yes I5043 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure 85 224 Yes Yes I5021 Acute systolic (congestive) heart failure 85 225 Yes Yes I5031 Acute diastolic (congestive) heart failure 85 225 Yes Yes I5041 Acute combined systolic (congestive) and diastolic (congestive) heart failure 85 225 Yes Yes I50811 Acute right heart failure 85 225 Yes Yes I50813 Acute on chronic right heart failure 85 225 Yes Yes P290 Neonatal cardiac failure 225 No Yes I0981 Rheumatic heart failure 85 226 Yes Yes I110 Hypertensive heart disease with heart failure 85 226 Yes Yes I130 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chroni 85 226 Yes Yes I132 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease 85 226 Yes Yes I270 Primary pulmonary hypertension 85 226 Yes Yes I271 Kyphoscoliotic heart disease 85 226 Yes Yes I2720 Pulmonary hypertension, unspecified 85 226 Yes Yes I2721 Secondary pulmonary arterial hypertension 85 226 Yes Yes I2722 Pulmonary hypertension due to left heart disease 85 226 Yes Yes I2723 Pulmonary hypertension due to lung diseases and hypoxia 85 226 Yes Yes I2724 Chronic thromboembolic pulmonary hypertension 85 226 Yes Yes I2729 Other secondary pulmonary hypertension 85 226 Yes Yes I2781 Cor pulmonale (chronic) 85 226 Yes Yes I2783 Eisenmenger's syndrome 85 226 Yes Yes I2789 Other specified pulmonary heart diseases 85 226 Yes Yes I279 Pulmonary heart disease, unspecified 85 226 Yes Yes I280 Arteriovenous fistula of pulmonary vessels 85 226 Yes Yes I281 Aneurysm of pulmonary artery 85 226 Yes Yes I288 Other diseases of pulmonary vessels 85 226 Yes Yes I289 Disease of pulmonary vessels, unspecified 85 226 Yes Yes I501 Left ventricular failure, unspecified 85 226 Yes Yes I5020 Unspecified systolic (congestive) heart failure 85 226 Yes Yes I5022 Chronic systolic (congestive) heart failure 85 226 Yes Yes I5030 Unspecified diastolic (congestive) heart failure 85 226 Yes Yes I5032 Chronic diastolic (congestive) heart failure 85 226 Yes Yes I5040 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 85 226 Yes Yes I5042 Chronic combined systolic (congestive) and diastolic (congestive) heart failure 85 226 Yes Yes I50810 Right heart failure, unspecified 85 226 Yes Yes I50812 Chronic right heart failure 85 226 Yes Yes I50814 Right heart failure due to left heart failure 85 226 Yes Yes I5082 Biventricular heart failure 85 226 Yes Yes I5083 High output heart failure 85 226 Yes Yes I5089 Other heart failure 85 226 Yes Yes I509 Heart failure, unspecified 85 226 Yes Yes A3681 Diphtheritic cardiomyopathy 85 227 Yes Yes B3324 Viral cardiomyopathy 85 227 Yes Yes I420 Dilated cardiomyopathy 85 227 Yes Yes I421 Obstructive hypertrophic cardiomyopathy 85 227 Yes Yes I422 Other hypertrophic cardiomyopathy 85 227 Yes Yes I423 Endomyocardial (eosinophilic) disease 85 227 Yes Yes I424 Endocardial fibroelastosis 85 227 Yes Yes I425 Other restrictive cardiomyopathy 85 227 Yes Yes I426 Alcoholic cardiomyopathy 85 227 Yes Yes I428 Other cardiomyopathies 85 227 Yes Yes

I429 Cardiomyopathy, unspecified 85 227 Yes Yes I43 Cardiomyopathy in diseases classified elsewhere 85 227 Yes Yes I514 Myocarditis, unspecified 85 227 Yes Yes I515 Myocardial degeneration 85 227 Yes Yes I2101 ST elevation (STEMI) myocardial infarction involving left main coronary artery 86 228 Yes Yes I2102 ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery 86 228 Yes Yes I2109 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall 86 228 Yes Yes I2111 ST elevation (STEMI) myocardial infarction involving right coronary artery 86 228 Yes Yes I2119 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall 86 228 Yes Yes I2121 ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery 86 228 Yes Yes I2129 ST elevation (STEMI) myocardial infarction involving other sites 86 228 Yes Yes I213 ST elevation (STEMI) myocardial infarction of unspecified site 86 228 Yes Yes I214 Non-ST elevation (NSTEMI) myocardial infarction 86 228 Yes Yes I219 Acute myocardial infarction, unspecified 86 228 Yes Yes I21A1 Myocardial infarction type 2 86 228 Yes Yes I21A9 Other myocardial infarction type 86 228 Yes Yes I220 Subsequent ST elevation (STEMI) myocardial infarction of anterior wall 86 228 Yes Yes I221 Subsequent ST elevation (STEMI) myocardial infarction of inferior wall 86 228 Yes Yes I222 Subsequent non-ST elevation (NSTEMI) myocardial infarction 86 228 Yes Yes I228 Subsequent ST elevation (STEMI) myocardial infarction of other sites 86 228 Yes Yes I229 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site 86 228 Yes Yes I234 Rupture of chordae tendineae as current complication following acute myocardial infarction 86 229 Yes Yes I235 Rupture of papillary muscle as current complication following acute myocardial infarction 86 229 Yes Yes I511 Rupture of chordae tendineae, not elsewhere classified 86 229 Yes Yes I512 Rupture of papillary muscle, not elsewhere classified 86 229 Yes Yes I200 Unstable angina 87 229 Yes Yes I230 Hemopericardium as current complication following acute myocardial infarction 87 229 Yes Yes I231 Atrial septal defect as current complication following acute myocardial infarction 87 229 Yes Yes I232 Ventricular septal defect as current complication following acute myocardial infarction 87 229 Yes Yes I233 Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction 87 229 Yes Yes I236 Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction 87 229 Yes Yes I237 Postinfarction angina 87 229 Yes Yes I238 Other current complications following acute myocardial infarction 87 229 Yes Yes I240 Acute coronary thrombosis not resulting in myocardial infarction 87 229 Yes Yes I241 Dressler's syndrome 87 229 Yes Yes I248 Other forms of acute ischemic heart disease 87 229 Yes Yes I249 Acute ischemic heart disease, unspecified 87 229 Yes Yes I25110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris 87 229 Yes Yes I25700 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris 87 229 Yes Yes I25710 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris 87 229 Yes Yes I25720 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris 87 229 Yes Yes I25730 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris 87 229 Yes Yes I25750 Atherosclerosis of native coronary artery of transplanted heart with unstable angina 87 229 Yes Yes I25760 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina 87 229 Yes Yes I25790 Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris 87 229 Yes Yes I442 Atrioventricular block, complete 96 238 Yes Yes I470 Re-entry ventricular arrhythmia 96 238 Yes Yes I472 Ventricular tachycardia 96 238 Yes Yes I4720 Ventricular tachycardia, unspecified 96 238 Yes Yes I4721 Torsades de pointes 96 238 Yes Yes I4729 Other ventricular tachycardia 96 238 Yes Yes I479 Paroxysmal tachycardia, unspecified 96 238 Yes Yes I480 Paroxysmal atrial fibrillation 96 238 Yes Yes I4811 Longstanding persistent atrial fibrillation 96 238 Yes Yes I4819 Other persistent atrial fibrillation 96 238 Yes Yes I4820 Chronic atrial fibrillation, unspecified 96 238 Yes Yes I4821 Permanent atrial fibrillation 96 238 Yes Yes I483 Typical atrial flutter 96 238 Yes Yes I484 Atypical atrial flutter 96 238 Yes Yes I4891 Unspecified atrial fibrillation 96 238 Yes Yes I4892 Unspecified atrial flutter 96 238 Yes Yes I492 Junctional premature depolarization 96 238 Yes Yes I495 Sick sinus syndrome 96 238 Yes Yes I2601 Septic pulmonary embolism with acute cor pulmonale 85 267 Yes Yes I2602 Saddle embolus of pulmonary artery with acute cor pulmonale 85 267 Yes Yes I2609 Other pulmonary embolism with acute cor pulmonale 85 267 Yes Yes I427 Cardiomyopathy due to drug and external agent 85 Yes No I201 Angina pectoris with documented spasm 88 Yes No I202 Refractory angina pectoris 88 Yes No I208 Other forms of angina pectoris 88 Yes No I209 Angina pectoris, unspecified 88 Yes No I25111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm 88 Yes No I25112 Atherosclerosic heart disease of native coronary artery with refractory angina pectoris 88 Yes No I25118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris 88 Yes No I25119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris 88 Yes No I25701 Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm 88 Yes No

I25702 Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris 88 Yes No I25708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris 88 Yes No I25709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris 88 Yes No I25711 Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm 88 Yes No I25712 Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris 88 Yes No I25718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris 88 Yes No I25719 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris 88 Yes No I25721 Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm 88 Yes No I25722 Atherosclerosis of autologous artery coronary artery bypass graft(s) with refractory angina pectoris 88 Yes No I25728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris 88 Yes No I25729 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris 88 Yes No I25731 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm 88 Yes No I25732 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with refractory angina pectoris 88 Yes No I25738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris 88 Yes No I25739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris 88 Yes No I25751 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm 88 Yes No I25752 Atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris 88 Yes No I25758 Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris 88 Yes No I25759 Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris 88 Yes No I25761 Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm 88 Yes No I25762 Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris 88 Yes No I25768 Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris 88 Yes No I25769 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris 88 Yes No I25791 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm 88 Yes No I25792 Atherosclerosis of other coronary artery bypass graft(s) with refractory angina pectoris 88 Yes No I25798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris 88 Yes No I25799 Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris 88 Yes No I471 Supraventricular tachycardia 96 Yes No

Cerebrovascular Disease Group V24 V28 Cerebrovascular Disease Group: 4 HCCs Cerebrovascular Disease Group: 4 HCCs • HCC 99 (Intracranial Hemorrhage) • HCC 248 (Intracranial Hemorrhage) • HCC 100 (Ischemic or Unspecified Stroke) • HCC 249 (Ischemic or Unspecified Stroke) • HCC 103 (Hemiplegia/Hemiparesis) • HCC 253 (Hemiplegia/Hemiparesis) • HCC 104 (Monoplegia, Other Paralytic Syndromes) • HCC 254 (Monoplegia, Other Paralytic Syndromes)

I6000 Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation 99 248 Yes Yes I6001 Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation 99 248 Yes Yes I6002 Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation 99 248 Yes Yes I6010 Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery 99 248 Yes Yes I6011 Nontraumatic subarachnoid hemorrhage from right middle cerebral artery 99 248 Yes Yes I6012 Nontraumatic subarachnoid hemorrhage from left middle cerebral artery 99 248 Yes Yes I602 Nontraumatic subarachnoid hemorrhage from anterior communicating artery 99 248 Yes Yes I6030 Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery 99 248 Yes Yes I6031 Nontraumatic subarachnoid hemorrhage from right posterior communicating artery 99 248 Yes Yes I6032 Nontraumatic subarachnoid hemorrhage from left posterior communicating artery 99 248 Yes Yes I604 Nontraumatic subarachnoid hemorrhage from basilar artery 99 248 Yes Yes I6050 Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery 99 248 Yes Yes I6051 Nontraumatic subarachnoid hemorrhage from right vertebral artery 99 248 Yes Yes I6052 Nontraumatic subarachnoid hemorrhage from left vertebral artery 99 248 Yes Yes I606 Nontraumatic subarachnoid hemorrhage from other intracranial arteries 99 248 Yes Yes I607 Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery 99 248 Yes Yes I608 Other nontraumatic subarachnoid hemorrhage 99 248 Yes Yes I609 Nontraumatic subarachnoid hemorrhage, unspecified 99 248 Yes Yes I610 Nontraumatic intracerebral hemorrhage in hemisphere, subcortical 99 248 Yes Yes I611 Nontraumatic intracerebral hemorrhage in hemisphere, cortical 99 248 Yes Yes I612 Nontraumatic intracerebral hemorrhage in hemisphere, unspecified 99 248 Yes Yes I613 Nontraumatic intracerebral hemorrhage in brain stem 99 248 Yes Yes I614 Nontraumatic intracerebral hemorrhage in cerebellum 99 248 Yes Yes I615 Nontraumatic intracerebral hemorrhage, intraventricular 99 248 Yes Yes I616 Nontraumatic intracerebral hemorrhage, multiple localized 99 248 Yes Yes I618 Other nontraumatic intracerebral hemorrhage 99 248 Yes Yes I619 Nontraumatic intracerebral hemorrhage, unspecified 99 248 Yes Yes I6200 Nontraumatic subdural hemorrhage, unspecified 99 248 Yes Yes I6201 Nontraumatic acute subdural hemorrhage 99 248 Yes Yes I6202 Nontraumatic subacute subdural hemorrhage 99 248 Yes Yes I6203 Nontraumatic chronic subdural hemorrhage 99 248 Yes Yes I621 Nontraumatic extradural hemorrhage 99 248 Yes Yes I629 Nontraumatic intracranial hemorrhage, unspecified 99 248 Yes Yes P100 Subdural hemorrhage due to birth injury 248 No Yes P101 Cerebral hemorrhage due to birth injury 248 No Yes P102 Intraventricular hemorrhage due to birth injury 248 No Yes P103 Subarachnoid hemorrhage due to birth injury 248 No Yes P104 Tentorial tear due to birth injury 248 No Yes P108 Other intracranial lacerations and hemorrhages due to birth injury 248 No Yes P109 Unspecified intracranial laceration and hemorrhage due to birth injury 248 No Yes P110 Cerebral edema due to birth injury 248 No Yes P111 Other specified brain damage due to birth injury 248 No Yes P112 Unspecified brain damage due to birth injury 248 No Yes P520 Intraventricular (nontraumatic) hemorrhage, grade 1, of newborn 248 No Yes P521 Intraventricular (nontraumatic) hemorrhage, grade 2, of newborn 248 No Yes P5221 Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn 248 No Yes P5222 Intraventricular (nontraumatic) hemorrhage, grade 4, of newborn 248 No Yes P523 Unspecified intraventricular (nontraumatic) hemorrhage of newborn 248 No Yes P524 Intracerebral (nontraumatic) hemorrhage of newborn 248 No Yes P525 Subarachnoid (nontraumatic) hemorrhage of newborn 248 No Yes P526 Cerebellar (nontraumatic) and posterior fossa hemorrhage of newborn 248 No Yes P528 Other intracranial (nontraumatic) hemorrhages of newborn 248 No Yes P529 Intracranial (nontraumatic) hemorrhage of newborn, unspecified 248 No Yes I6300 Cerebral infarction due to thrombosis of unspecified precerebral artery 100 249 Yes Yes I63011 Cerebral infarction due to thrombosis of right vertebral artery 100 249 Yes Yes I63012 Cerebral infarction due to thrombosis of left vertebral artery 100 249 Yes Yes I63013 Cerebral infarction due to thrombosis of bilateral vertebral arteries 100 249 Yes Yes I63019 Cerebral infarction due to thrombosis of unspecified vertebral artery 100 249 Yes Yes I6302 Cerebral infarction due to thrombosis of basilar artery 100 249 Yes Yes I63031 Cerebral infarction due to thrombosis of right carotid artery 100 249 Yes Yes I63032 Cerebral infarction due to thrombosis of left carotid artery 100 249 Yes Yes

I63033 Cerebral infarction due to thrombosis of bilateral carotid arteries 100 249 Yes Yes I63039 Cerebral infarction due to thrombosis of unspecified carotid artery 100 249 Yes Yes I6309 Cerebral infarction due to thrombosis of other precerebral artery 100 249 Yes Yes I6310 Cerebral infarction due to embolism of unspecified precerebral artery 100 249 Yes Yes I63111 Cerebral infarction due to embolism of right vertebral artery 100 249 Yes Yes I63112 Cerebral infarction due to embolism of left vertebral artery 100 249 Yes Yes I63113 Cerebral infarction due to embolism of bilateral vertebral arteries 100 249 Yes Yes I63119 Cerebral infarction due to embolism of unspecified vertebral artery 100 249 Yes Yes I6312 Cerebral infarction due to embolism of basilar artery 100 249 Yes Yes I63131 Cerebral infarction due to embolism of right carotid artery 100 249 Yes Yes I63132 Cerebral infarction due to embolism of left carotid artery 100 249 Yes Yes I63133 Cerebral infarction due to embolism of bilateral carotid arteries 100 249 Yes Yes I63139 Cerebral infarction due to embolism of unspecified carotid artery 100 249 Yes Yes I6319 Cerebral infarction due to embolism of other precerebral artery 100 249 Yes Yes I6320 Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries 100 249 Yes Yes I63211 Cerebral infarction due to unspecified occlusion or stenosis of right vertebral artery 100 249 Yes Yes I63212 Cerebral infarction due to unspecified occlusion or stenosis of left vertebral artery 100 249 Yes Yes I63213 Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries 100 249 Yes Yes I63219 Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery 100 249 Yes Yes I6322 Cerebral infarction due to unspecified occlusion or stenosis of basilar artery 100 249 Yes Yes I63231 Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries 100 249 Yes Yes I63232 Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries 100 249 Yes Yes I63233 Cerebral infarction due to unspecified occlusion or stenosis of bilateral carotid arteries 100 249 Yes Yes I63239 Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery 100 249 Yes Yes I6329 Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries 100 249 Yes Yes I6330 Cerebral infarction due to thrombosis of unspecified cerebral artery 100 249 Yes Yes I63311 Cerebral infarction due to thrombosis of right middle cerebral artery 100 249 Yes Yes I63312 Cerebral infarction due to thrombosis of left middle cerebral artery 100 249 Yes Yes I63313 Cerebral infarction due to thrombosis of bilateral middle cerebral arteries 100 249 Yes Yes I63319 Cerebral infarction due to thrombosis of unspecified middle cerebral artery 100 249 Yes Yes I63321 Cerebral infarction due to thrombosis of right anterior cerebral artery 100 249 Yes Yes I63322 Cerebral infarction due to thrombosis of left anterior cerebral artery 100 249 Yes Yes I63323 Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries 100 249 Yes Yes I63329 Cerebral infarction due to thrombosis of unspecified anterior cerebral artery 100 249 Yes Yes I63331 Cerebral infarction due to thrombosis of right posterior cerebral artery 100 249 Yes Yes I63332 Cerebral infarction due to thrombosis of left posterior cerebral artery 100 249 Yes Yes I63333 Cerebral infarction due to thrombosis of bilateral posterior cerebral arteries 100 249 Yes Yes I63339 Cerebral infarction due to thrombosis of unspecified posterior cerebral artery 100 249 Yes Yes I63341 Cerebral infarction due to thrombosis of right cerebellar artery 100 249 Yes Yes I63342 Cerebral infarction due to thrombosis of left cerebellar artery 100 249 Yes Yes I63343 Cerebral infarction due to thrombosis of bilateral cerebellar arteries 100 249 Yes Yes I63349 Cerebral infarction due to thrombosis of unspecified cerebellar artery 100 249 Yes Yes I6339 Cerebral infarction due to thrombosis of other cerebral artery 100 249 Yes Yes I6340 Cerebral infarction due to embolism of unspecified cerebral artery 100 249 Yes Yes I63411 Cerebral infarction due to embolism of right middle cerebral artery 100 249 Yes Yes I63412 Cerebral infarction due to embolism of left middle cerebral artery 100 249 Yes Yes I63413 Cerebral infarction due to embolism of bilateral middle cerebral arteries 100 249 Yes Yes I63419 Cerebral infarction due to embolism of unspecified middle cerebral artery 100 249 Yes Yes I63421 Cerebral infarction due to embolism of right anterior cerebral artery 100 249 Yes Yes I63422 Cerebral infarction due to embolism of left anterior cerebral artery 100 249 Yes Yes I63423 Cerebral infarction due to embolism of bilateral anterior cerebral arteries 100 249 Yes Yes I63429 Cerebral infarction due to embolism of unspecified anterior cerebral artery 100 249 Yes Yes I63431 Cerebral infarction due to embolism of right posterior cerebral artery 100 249 Yes Yes I63432 Cerebral infarction due to embolism of left posterior cerebral artery 100 249 Yes Yes I63433 Cerebral infarction due to embolism of bilateral posterior cerebral arteries 100 249 Yes Yes I63439 Cerebral infarction due to embolism of unspecified posterior cerebral artery 100 249 Yes Yes I63441 Cerebral infarction due to embolism of right cerebellar artery 100 249 Yes Yes I63442 Cerebral infarction due to embolism of left cerebellar artery 100 249 Yes Yes I63443 Cerebral infarction due to embolism of bilateral cerebellar arteries 100 249 Yes Yes I63449 Cerebral infarction due to embolism of unspecified cerebellar artery 100 249 Yes Yes I6349 Cerebral infarction due to embolism of other cerebral artery 100 249 Yes Yes

I6350 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery 100 249 Yes Yes I63511 Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery 100 249 Yes Yes I63512 Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery 100 249 Yes Yes I63513 Cerebral infarction due to unspecified occlusion or stenosis of bilateral middle cerebral arteries 100 249 Yes Yes I63519 Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral arte 100 249 Yes Yes I63521 Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery 100 249 Yes Yes I63522 Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery 100 249 Yes Yes I63523 Cerebral infarction due to unspecified occlusion or stenosis of bilateral anterior cerebral arterie 100 249 Yes Yes I63529 Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral art 100 249 Yes Yes I63531 Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery 100 249 Yes Yes I63532 Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery 100 249 Yes Yes I63533 Cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior cerebral arter 100 249 Yes Yes I63539 Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral ar 100 249 Yes Yes I63541 Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery 100 249 Yes Yes I63542 Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery 100 249 Yes Yes I63543 Cerebral infarction due to unspecified occlusion or stenosis of bilateral cerebellar arteries 100 249 Yes Yes I63549 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery 100 249 Yes Yes I6359 Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery 100 249 Yes Yes I636 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic 100 249 Yes Yes I6381 Other cerebral infarction due to occlusion or stenosis of small artery 100 249 Yes Yes I6389 Other cerebral infarction 100 249 Yes Yes I639 Cerebral infarction, unspecified 100 249 Yes Yes P91821 Neonatal cerebral infarction, right side of brain 100 249 Yes Yes P91822 Neonatal cerebral infarction, left side of brain 100 249 Yes Yes P91823 Neonatal cerebral infarction, bilateral 100 249 Yes Yes P91829 Neonatal cerebral infarction, unspecified side 100 249 Yes Yes G8100 Flaccid hemiplegia affecting unspecified side 103 253 Yes Yes G8101 Flaccid hemiplegia affecting right dominant side 103 253 Yes Yes G8102 Flaccid hemiplegia affecting left dominant side 103 253 Yes Yes G8103 Flaccid hemiplegia affecting right nondominant side 103 253 Yes Yes G8104 Flaccid hemiplegia affecting left nondominant side 103 253 Yes Yes G8110 Spastic hemiplegia affecting unspecified side 103 253 Yes Yes G8111 Spastic hemiplegia affecting right dominant side 103 253 Yes Yes G8112 Spastic hemiplegia affecting left dominant side 103 253 Yes Yes G8113 Spastic hemiplegia affecting right nondominant side 103 253 Yes Yes G8114 Spastic hemiplegia affecting left nondominant side 103 253 Yes Yes G8190 Hemiplegia, unspecified affecting unspecified side 103 253 Yes Yes G8191 Hemiplegia, unspecified affecting right dominant side 103 253 Yes Yes G8192 Hemiplegia, unspecified affecting left dominant side 103 253 Yes Yes G8193 Hemiplegia, unspecified affecting right nondominant side 103 253 Yes Yes G8194 Hemiplegia, unspecified affecting left nondominant side 103 253 Yes Yes I69051 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right 103 253 Yes Yes I69052 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left d 103 253 Yes Yes I69053 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right 103 253 Yes Yes I69054 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left n 103 253 Yes Yes I69059 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting unspe 103 253 Yes Yes I69151 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right d 103 253 Yes Yes I69152 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left do 103 253 Yes Yes I69153 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right n 103 253 Yes Yes I69154 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left no 103 253 Yes Yes I69159 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting unspe 103 253 Yes Yes I69251 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting ri 103 253 Yes Yes I69252 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting le 103 253 Yes Yes I69253 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting ri 103 253 Yes Yes I69254 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting le 103 253 Yes Yes I69259 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting u 103 253 Yes Yes I69351 Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side 103 253 Yes Yes I69352 Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side 103 253 Yes Yes I69353 Hemiplegia and hemiparesis following cerebral infarction affecting right non-dominant side 103 253 Yes Yes I69354 Hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side 103 253 Yes Yes I69359 Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side 103 253 Yes Yes

I69851 Hemiplegia and hemiparesis following other cerebrovascular disease affecting right dominant s 103 253 Yes Yes I69852 Hemiplegia and hemiparesis following other cerebrovascular disease affecting left dominant si 103 253 Yes Yes I69853 Hemiplegia and hemiparesis following other cerebrovascular disease affecting right non-domin 103 253 Yes Yes I69854 Hemiplegia and hemiparesis following other cerebrovascular disease affecting left non-domina 103 253 Yes Yes I69859 Hemiplegia and hemiparesis following other cerebrovascular disease affecting unspecified side 103 253 Yes Yes I69951 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right dom 103 253 Yes Yes I69952 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left domin 103 253 Yes Yes I69953 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right non- 103 253 Yes Yes I69954 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left non-d 103 253 Yes Yes I69959 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting unspecifie 103 253 Yes Yes G830 Diplegia of upper limbs 104 254 Yes Yes G8310 Monoplegia of lower limb affecting unspecified side 104 254 Yes Yes G8311 Monoplegia of lower limb affecting right dominant side 104 254 Yes Yes G8312 Monoplegia of lower limb affecting left dominant side 104 254 Yes Yes G8313 Monoplegia of lower limb affecting right nondominant side 104 254 Yes Yes G8314 Monoplegia of lower limb affecting left nondominant side 104 254 Yes Yes G8320 Monoplegia of upper limb affecting unspecified side 104 254 Yes Yes G8321 Monoplegia of upper limb affecting right dominant side 104 254 Yes Yes G8322 Monoplegia of upper limb affecting left dominant side 104 254 Yes Yes G8323 Monoplegia of upper limb affecting right nondominant side 104 254 Yes Yes G8324 Monoplegia of upper limb affecting left nondominant side 104 254 Yes Yes G8330 Monoplegia, unspecified affecting unspecified side 104 254 Yes Yes G8331 Monoplegia, unspecified affecting right dominant side 104 254 Yes Yes G8332 Monoplegia, unspecified affecting left dominant side 104 254 Yes Yes G8333 Monoplegia, unspecified affecting right nondominant side 104 254 Yes Yes G8334 Monoplegia, unspecified affecting left nondominant side 104 254 Yes Yes G835 Locked-in state 104 254 Yes Yes G8381 Brown-Sequard syndrome 104 254 Yes Yes G8382 Anterior cord syndrome 104 254 Yes Yes G8383 Posterior cord syndrome 104 254 Yes Yes G8384 Todd's paralysis (postepileptic) 104 254 Yes Yes G8389 Other specified paralytic syndromes 104 254 Yes Yes G839 Paralytic syndrome, unspecified 104 254 Yes Yes I69031 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting right do 104 254 Yes Yes I69032 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting left dom 104 254 Yes Yes I69033 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting right no 104 254 Yes Yes I69034 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting left non 104 254 Yes Yes I69039 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting unspeci 104 254 Yes Yes I69041 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting right do 104 254 Yes Yes I69042 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting left dom 104 254 Yes Yes I69043 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting right no 104 254 Yes Yes I69044 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting left non 104 254 Yes Yes I69049 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting unspecif 104 254 Yes Yes I69061 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting right do 104 254 Yes Yes I69062 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting left dom 104 254 Yes Yes I69063 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting right no 104 254 Yes Yes I69064 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting left non- 104 254 Yes Yes I69065 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage, bilateral 104 254 Yes Yes I69069 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting unspecif 104 254 Yes Yes I69131 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting right dom 104 254 Yes Yes I69132 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting left dom 104 254 Yes Yes I69133 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting right non 104 254 Yes Yes I69134 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting left non- 104 254 Yes Yes I69139 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting unspecif 104 254 Yes Yes I69141 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting right dom 104 254 Yes Yes I69142 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left dom 104 254 Yes Yes I69143 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting right non 104 254 Yes Yes I69144 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left non- 104 254 Yes Yes I69149 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting unspecif 104 254 Yes Yes I69161 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right dom 104 254 Yes Yes I69162 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting left dom 104 254 Yes Yes

I69163 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right non 104 254 Yes Yes I69164 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting left non- 104 254 Yes Yes I69165 Other paralytic syndrome following nontraumatic intracerebral hemorrhage, bilateral 104 254 Yes Yes I69169 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting unspecif 104 254 Yes Yes I69231 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting righ 104 254 Yes Yes I69232 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting left 104 254 Yes Yes I69233 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting righ 104 254 Yes Yes I69234 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting left 104 254 Yes Yes I69239 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting uns 104 254 Yes Yes I69241 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting right 104 254 Yes Yes I69242 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting left 104 254 Yes Yes I69243 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting right 104 254 Yes Yes I69244 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting left 104 254 Yes Yes I69249 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting unsp 104 254 Yes Yes I69261 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting right 104 254 Yes Yes I69262 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting left 104 254 Yes Yes I69263 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting right 104 254 Yes Yes I69264 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting left 104 254 Yes Yes I69265 Other paralytic syndrome following other nontraumatic intracranial hemorrhage, bilateral 104 254 Yes Yes I69269 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting unsp 104 254 Yes Yes I69331 Monoplegia of upper limb following cerebral infarction affecting right dominant side 104 254 Yes Yes I69332 Monoplegia of upper limb following cerebral infarction affecting left dominant side 104 254 Yes Yes I69333 Monoplegia of upper limb following cerebral infarction affecting right non-dominant side 104 254 Yes Yes I69334 Monoplegia of upper limb following cerebral infarction affecting left non-dominant side 104 254 Yes Yes I69339 Monoplegia of upper limb following cerebral infarction affecting unspecified side 104 254 Yes Yes I69341 Monoplegia of lower limb following cerebral infarction affecting right dominant side 104 254 Yes Yes I69342 Monoplegia of lower limb following cerebral infarction affecting left dominant side 104 254 Yes Yes I69343 Monoplegia of lower limb following cerebral infarction affecting right non-dominant side 104 254 Yes Yes I69344 Monoplegia of lower limb following cerebral infarction affecting left non-dominant side 104 254 Yes Yes I69349 Monoplegia of lower limb following cerebral infarction affecting unspecified side 104 254 Yes Yes I69361 Other paralytic syndrome following cerebral infarction affecting right dominant side 104 254 Yes Yes I69362 Other paralytic syndrome following cerebral infarction affecting left dominant side 104 254 Yes Yes I69363 Other paralytic syndrome following cerebral infarction affecting right non-dominant side 104 254 Yes Yes I69364 Other paralytic syndrome following cerebral infarction affecting left non-dominant side 104 254 Yes Yes I69365 Other paralytic syndrome following cerebral infarction, bilateral 104 254 Yes Yes I69369 Other paralytic syndrome following cerebral infarction affecting unspecified side 104 254 Yes Yes I69831 Monoplegia of upper limb following other cerebrovascular disease affecting right dominant sid 104 254 Yes Yes I69832 Monoplegia of upper limb following other cerebrovascular disease affecting left dominant side 104 254 Yes Yes I69833 Monoplegia of upper limb following other cerebrovascular disease affecting right non-dominan 104 254 Yes Yes I69834 Monoplegia of upper limb following other cerebrovascular disease affecting left non-dominant 104 254 Yes Yes I69839 Monoplegia of upper limb following other cerebrovascular disease affecting unspecified side 104 254 Yes Yes I69841 Monoplegia of lower limb following other cerebrovascular disease affecting right dominant sid 104 254 Yes Yes I69842 Monoplegia of lower limb following other cerebrovascular disease affecting left dominant side 104 254 Yes Yes I69843 Monoplegia of lower limb following other cerebrovascular disease affecting right non-dominan 104 254 Yes Yes I69844 Monoplegia of lower limb following other cerebrovascular disease affecting left non-dominant 104 254 Yes Yes I69849 Monoplegia of lower limb following other cerebrovascular disease affecting unspecified side 104 254 Yes Yes I69861 Other paralytic syndrome following other cerebrovascular disease affecting right dominant side 104 254 Yes Yes I69862 Other paralytic syndrome following other cerebrovascular disease affecting left dominant side 104 254 Yes Yes I69863 Other paralytic syndrome following other cerebrovascular disease affecting right non-dominan 104 254 Yes Yes I69864 Other paralytic syndrome following other cerebrovascular disease affecting left non-dominant 104 254 Yes Yes I69865 Other paralytic syndrome following other cerebrovascular disease, bilateral 104 254 Yes Yes I69869 Other paralytic syndrome following other cerebrovascular disease affecting unspecified side 104 254 Yes Yes I69931 Monoplegia of upper limb following unspecified cerebrovascular disease affecting right domina 104 254 Yes Yes I69932 Monoplegia of upper limb following unspecified cerebrovascular disease affecting left dominan 104 254 Yes Yes I69933 Monoplegia of upper limb following unspecified cerebrovascular disease affecting right non-do 104 254 Yes Yes I69934 Monoplegia of upper limb following unspecified cerebrovascular disease affecting left non-dom 104 254 Yes Yes I69939 Monoplegia of upper limb following unspecified cerebrovascular disease affecting unspecified s 104 254 Yes Yes I69941 Monoplegia of lower limb following unspecified cerebrovascular disease affecting right domina 104 254 Yes Yes I69942 Monoplegia of lower limb following unspecified cerebrovascular disease affecting left dominan 104 254 Yes Yes I69943 Monoplegia of lower limb following unspecified cerebrovascular disease affecting right non-do 104 254 Yes Yes I69944 Monoplegia of lower limb following unspecified cerebrovascular disease affecting left non-dom 104 254 Yes Yes

I69949 Monoplegia of lower limb following unspecified cerebrovascular disease affecting unspecified s 104 254 Yes Yes I69961 Other paralytic syndrome following unspecified cerebrovascular disease affecting right domina 104 254 Yes Yes I69962 Other paralytic syndrome following unspecified cerebrovascular disease affecting left dominan 104 254 Yes Yes I69963 Other paralytic syndrome following unspecified cerebrovascular disease affecting right non-do 104 254 Yes Yes I69964 Other paralytic syndrome following unspecified cerebrovascular disease affecting left non-dom 104 254 Yes Yes I69965 Other paralytic syndrome following unspecified cerebrovascular disease, bilateral 104 254 Yes Yes I69969 Other paralytic syndrome following unspecified cerebrovascular disease affecting unspecified s 104 254 Yes Yes I97810 Intraoperative cerebrovascular infarction during cardiac surgery 100 Yes No I97811 Intraoperative cerebrovascular infarction during other surgery 100 Yes No I97820 Postprocedural cerebrovascular infarction following cardiac surgery 100 Yes No I97821 Postprocedural cerebrovascular infarction following other surgery 100 Yes No

Vascular Disease Group V24 V28 Vascular Disease Group: 3 HCCs Vascular Disease Group: 3 HCCs • HCC 106 (Atherosclerosis of the Extremities with • HCC 263 (Atherosclerosis of Arteries of the Ulceration or Gangrene) Extremities with Ulceration or Gangrene) • HCC 107 (Vascular Disease with Complications) • HCC 264 (Vascular Disease with Complications) • HCC 108 (Vascular Disease) • HCC 267 (Deep Vein Thrombosis and Pulmonary Embolism)

ICD 10 Desccriptor V24 V28 V24 V28 M318 Other specified necrotizing vasculopathies 108 94 Yes Yes M319 Necrotizing vasculopathy, unspecified 108 94 Yes Yes A480 Gas gangrene 106 263 Yes Yes E0852 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene 106 263 Yes Yes E1052 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene 106 263 Yes Yes E1152 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene 106 263 Yes Yes E1352 Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene 106 263 Yes Yes I70231 Atherosclerosis of native arteries of right leg with ulceration of thigh 106 263 Yes Yes I70232 Atherosclerosis of native arteries of right leg with ulceration of calf 106 263 Yes Yes I70233 Atherosclerosis of native arteries of right leg with ulceration of ankle 106 263 Yes Yes I70234 Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot 106 263 Yes Yes I70235 Atherosclerosis of native arteries of right leg with ulceration of other part of foot 106 263 Yes Yes I70238 Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg 106 263 Yes Yes I70239 Atherosclerosis of native arteries of right leg with ulceration of unspecified site 106 263 Yes Yes I70241 Atherosclerosis of native arteries of left leg with ulceration of thigh 106 263 Yes Yes I70242 Atherosclerosis of native arteries of left leg with ulceration of calf 106 263 Yes Yes I70243 Atherosclerosis of native arteries of left leg with ulceration of ankle 106 263 Yes Yes I70244 Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot 106 263 Yes Yes I70245 Atherosclerosis of native arteries of left leg with ulceration of other part of foot 106 263 Yes Yes I70248 Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg 106 263 Yes Yes I70249 Atherosclerosis of native arteries of left leg with ulceration of unspecified site 106 263 Yes Yes I7025 Atherosclerosis of native arteries of other extremities with ulceration 106 263 Yes Yes I70261 Atherosclerosis of native arteries of extremities with gangrene, right leg 106 263 Yes Yes I70262 Atherosclerosis of native arteries of extremities with gangrene, left leg 106 263 Yes Yes I70263 Atherosclerosis of native arteries of extremities with gangrene, bilateral legs 106 263 Yes Yes I70268 Atherosclerosis of native arteries of extremities with gangrene, other extremity 106 263 Yes Yes I70269 Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity 106 263 Yes Yes I70331 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of thigh 106 263 Yes Yes I70332 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of calf 106 263 Yes Yes I70333 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of ankle 106 263 Yes Yes I70334 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot 106 263 Yes Yes I70335 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of foot 106 263 Yes Yes I70338 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of lower leg 106 263 Yes Yes I70339 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of unspecified site 106 263 Yes Yes I70341 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of thigh 106 263 Yes Yes I70342 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of calf 106 263 Yes Yes I70343 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of ankle 106 263 Yes Yes I70344 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of heel and midfoot 106 263 Yes Yes I70345 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of foot 106 263 Yes Yes I70348 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of lower leg 106 263 Yes Yes I70349 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of unspecified site 106 263 Yes Yes I7035 Atherosclerosis of unspecified type of bypass graft(s) of other extremity with ulceration 106 263 Yes Yes I70361 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, right leg 106 263 Yes Yes I70362 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, left leg 106 263 Yes Yes I70363 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, bilateral legs 106 263 Yes Yes I70368 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other extremity 106 263 Yes Yes I70369 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, unspecified extremity 106 263 Yes Yes I70431 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of thigh 106 263 Yes Yes I70432 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of calf 106 263 Yes Yes I70433 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of ankle 106 263 Yes Yes I70434 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of heel and midfoot 106 263 Yes Yes I70435 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot 106 263 Yes Yes I70438 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of lower leg 106 263 Yes Yes I70439 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of unspecified site 106 263 Yes Yes I70441 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of thigh 106 263 Yes Yes I70442 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of calf 106 263 Yes Yes I70443 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of ankle 106 263 Yes Yes I70444 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of heel and midfoot 106 263 Yes Yes I70445 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of foot 106 263 Yes Yes I70448 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of lower leg 106 263 Yes Yes I70449 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of unspecified site 106 263 Yes Yes I7045 Atherosclerosis of autologous vein bypass graft(s) of other extremity with ulceration 106 263 Yes Yes I70461 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg 106 263 Yes Yes I70462 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, left leg 106 263 Yes Yes I70463 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, bilateral legs 106 263 Yes Yes I70468 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, other extremity 106 263 Yes Yes I70469 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, unspecified extremity 106 263 Yes Yes I70531 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of thigh 106 263 Yes Yes I70532 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of calf 106 263 Yes Yes I70533 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of ankle 106 263 Yes Yes I70534 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of heel and midfoot 106 263 Yes Yes I70535 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of foot 106 263 Yes Yes I70538 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of lower leg 106 263 Yes Yes I70539 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of unspecified site 106 263 Yes Yes I70541 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of thigh 106 263 Yes Yes

I70542 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of calf 106 263 Yes Yes I70543 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of ankle 106 263 Yes Yes I70544 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of heel and midfoot 106 263 Yes Yes I70545 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of foot 106 263 Yes Yes I70548 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of lower leg 106 263 Yes Yes I70549 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of unspecified site 106 263 Yes Yes I7055 Atherosclerosis of nonautologous biological bypass graft(s) of other extremity with ulceration 106 263 Yes Yes I70561 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, right leg 106 263 Yes Yes I70562 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, left leg 106 263 Yes Yes I70563 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, bilateral legs 106 263 Yes Yes I70568 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, other extremity 106 263 Yes Yes I70569 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, unspecified extremity 106 263 Yes Yes I70631 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of thigh 106 263 Yes Yes I70632 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of calf 106 263 Yes Yes I70633 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of ankle 106 263 Yes Yes I70634 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of heel and midfoot 106 263 Yes Yes I70635 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of foot 106 263 Yes Yes I70638 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of lower leg 106 263 Yes Yes I70639 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of unspecified site 106 263 Yes Yes I70641 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of thigh 106 263 Yes Yes I70642 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of calf 106 263 Yes Yes I70643 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of ankle 106 263 Yes Yes I70644 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of heel and midfoot 106 263 Yes Yes I70645 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other part of foot 106 263 Yes Yes I70648 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other part of lower leg 106 263 Yes Yes I70649 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of unspecified site 106 263 Yes Yes I7065 Atherosclerosis of nonbiological bypass graft(s) of other extremity with ulceration 106 263 Yes Yes I70661 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, right leg 106 263 Yes Yes I70662 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, left leg 106 263 Yes Yes I70663 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, bilateral legs 106 263 Yes Yes I70668 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, other extremity 106 263 Yes Yes I70669 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, unspecified extremity 106 263 Yes Yes I70731 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of thigh 106 263 Yes Yes I70732 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of calf 106 263 Yes Yes I70733 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of ankle 106 263 Yes Yes I70734 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of heel and midfoot 106 263 Yes Yes I70735 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of other part of foot 106 263 Yes Yes I70738 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of other part of lower leg 106 263 Yes Yes I70739 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of unspecified site 106 263 Yes Yes I70741 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of thigh 106 263 Yes Yes I70742 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of calf 106 263 Yes Yes I70743 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of ankle 106 263 Yes Yes I70744 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of heel and midfoot 106 263 Yes Yes I70745 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other part of foot 106 263 Yes Yes I70748 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other part of lower leg 106 263 Yes Yes I70749 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of unspecified site 106 263 Yes Yes I7075 Atherosclerosis of other type of bypass graft(s) of other extremity with ulceration 106 263 Yes Yes I70761 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, right leg 106 263 Yes Yes I70762 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, left leg 106 263 Yes Yes I70763 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, bilateral legs 106 263 Yes Yes I70768 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, other extremity 106 263 Yes Yes I70769 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, unspecified extremity 106 263 Yes Yes I7301 Raynaud's syndrome with gangrene 106 263 Yes Yes I96 Gangrene, not elsewhere classified 106 263 Yes Yes I7100 Dissection of unspecified site of aorta 107 264 Yes Yes I7101 Dissection of thoracic aorta 107 264 Yes Yes I71010 Dissection of ascending aorta 107 264 Yes Yes I71011 Dissection of aortic arch 107 264 Yes Yes I71012 Dissection of descending thoracic aorta 107 264 Yes Yes I71019 Dissection of thoracic aorta, unspecified 107 264 Yes Yes I7102 Dissection of abdominal aorta 107 264 Yes Yes I7103 Dissection of thoracoabdominal aorta 107 264 Yes Yes I711 Thoracic aortic aneurysm, ruptured 107 264 Yes Yes I7110 Thoracic aortic aneurysm, ruptured, unspecified 107 264 Yes Yes I7111 Aneurysm of the ascending aorta, ruptured 107 264 Yes Yes I7112 Aneurysm of the aortic arch, ruptured 107 264 Yes Yes I7113 Aneurysm of the descending thoracic aorta, ruptured 107 264 Yes Yes I713 Abdominal aortic aneurysm, ruptured 107 264 Yes Yes I7130 Abdominal aortic aneurysm, ruptured, unspecified 107 264 Yes Yes I7131 Pararenal abdominal aortic aneurysm, ruptured 107 264 Yes Yes I7132 Juxtarenal abdominal aortic aneurysm, ruptured 107 264 Yes Yes I7133 Infrarenal abdominal aortic aneurysm, ruptured 107 264 Yes Yes I715 Thoracoabdominal aortic aneurysm, ruptured 107 264 Yes Yes I7150 Thoracoabdominal aortic aneurysm, ruptured, unspecified 107 264 Yes Yes I7151 Supraceliac aneurysm of the abdominal aorta, ruptured 107 264 Yes Yes I7152 Paravisceral aneurysm of the abdominal aorta, ruptured 107 264 Yes Yes

I718 Aortic aneurysm of unspecified site, ruptured 107 264 Yes Yes I7401 Saddle embolus of abdominal aorta 107 264 Yes Yes I7409 Other arterial embolism and thrombosis of abdominal aorta 107 264 Yes Yes I7410 Embolism and thrombosis of unspecified parts of aorta 107 264 Yes Yes I7411 Embolism and thrombosis of thoracic aorta 107 264 Yes Yes I7419 Embolism and thrombosis of other parts of aorta 107 264 Yes Yes I742 Embolism and thrombosis of arteries of the upper extremities 107 264 Yes Yes I743 Embolism and thrombosis of arteries of the lower extremities 107 264 Yes Yes I744 Embolism and thrombosis of arteries of extremities, unspecified 107 264 Yes Yes I745 Embolism and thrombosis of iliac artery 107 264 Yes Yes I748 Embolism and thrombosis of other arteries 107 264 Yes Yes I749 Embolism and thrombosis of unspecified artery 107 264 Yes Yes I75011 Atheroembolism of right upper extremity 107 264 Yes Yes I75012 Atheroembolism of left upper extremity 107 264 Yes Yes I75013 Atheroembolism of bilateral upper extremities 107 264 Yes Yes I75019 Atheroembolism of unspecified upper extremity 107 264 Yes Yes I75021 Atheroembolism of right lower extremity 107 264 Yes Yes I75022 Atheroembolism of left lower extremity 107 264 Yes Yes I75023 Atheroembolism of bilateral lower extremities 107 264 Yes Yes I75029 Atheroembolism of unspecified lower extremity 107 264 Yes Yes I7581 Atheroembolism of kidney 107 264 Yes Yes I7589 Atheroembolism of other site 107 264 Yes Yes I76 Septic arterial embolism 107 264 Yes Yes I70221 Atherosclerosis of native arteries of extremities with rest pain, right leg 108 264 Yes Yes I70222 Atherosclerosis of native arteries of extremities with rest pain, left leg 108 264 Yes Yes I70223 Atherosclerosis of native arteries of extremities with rest pain, bilateral legs 108 264 Yes Yes I70228 Atherosclerosis of native arteries of extremities with rest pain, other extremity 108 264 Yes Yes I70229 Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity 108 264 Yes Yes I70321 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, right leg 108 264 Yes Yes I70322 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, left leg 108 264 Yes Yes I70323 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, bilateral legs 108 264 Yes Yes I70328 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, other extremity 108 264 Yes Yes I70329 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, unspecified extremity 108 264 Yes Yes I70421 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, right leg 108 264 Yes Yes I70422 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, left leg 108 264 Yes Yes I70423 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, bilateral legs 108 264 Yes Yes I70428 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, other extremity 108 264 Yes Yes I70429 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, unspecified extremity 108 264 Yes Yes I70521 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, right leg 108 264 Yes Yes I70522 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, left leg 108 264 Yes Yes I70523 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, bilateral legs 108 264 Yes Yes I70528 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, other extremity 108 264 Yes Yes I70529 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, unspecified extremity 108 264 Yes Yes I70621 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, right leg 108 264 Yes Yes I70622 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, left leg 108 264 Yes Yes I70623 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, bilateral legs 108 264 Yes Yes I70628 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, other extremity 108 264 Yes Yes I70629 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, unspecified extremity 108 264 Yes Yes I70721 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, right leg 108 264 Yes Yes I70722 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg 108 264 Yes Yes I70723 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, bilateral legs 108 264 Yes Yes I70728 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, other extremity 108 264 Yes Yes I70729 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, unspecified extremity 108 264 Yes Yes I2690 Septic pulmonary embolism without acute cor pulmonale 107 267 Yes Yes I2692 Saddle embolus of pulmonary artery without acute cor pulmonale 107 267 Yes Yes I2693 Single subsegmental pulmonary embolism without acute cor pulmonale 107 267 Yes Yes I2694 Multiple subsegmental pulmonary emboli without acute cor pulmonale 107 267 Yes Yes I2699 Other pulmonary embolism without acute cor pulmonale 107 267 Yes Yes I2782 Chronic pulmonary embolism 107 267 Yes Yes I8010 Phlebitis and thrombophlebitis of unspecified femoral vein 108 267 Yes Yes I8011 Phlebitis and thrombophlebitis of right femoral vein 108 267 Yes Yes I8012 Phlebitis and thrombophlebitis of left femoral vein 108 267 Yes Yes I8013 Phlebitis and thrombophlebitis of femoral vein, bilateral 108 267 Yes Yes I80201 Phlebitis and thrombophlebitis of unspecified deep vessels of right lower extremity 108 267 Yes Yes I80202 Phlebitis and thrombophlebitis of unspecified deep vessels of left lower extremity 108 267 Yes Yes I80203 Phlebitis and thrombophlebitis of unspecified deep vessels of lower extremities, bilateral 108 267 Yes Yes I80209 Phlebitis and thrombophlebitis of unspecified deep vessels of unspecified lower extremity 108 267 Yes Yes I80211 Phlebitis and thrombophlebitis of right iliac vein 108 267 Yes Yes I80212 Phlebitis and thrombophlebitis of left iliac vein 108 267 Yes Yes I80213 Phlebitis and thrombophlebitis of iliac vein, bilateral 108 267 Yes Yes I80219 Phlebitis and thrombophlebitis of unspecified iliac vein 108 267 Yes Yes I80221 Phlebitis and thrombophlebitis of right popliteal vein 108 267 Yes Yes I80222 Phlebitis and thrombophlebitis of left popliteal vein 108 267 Yes Yes I80223 Phlebitis and thrombophlebitis of popliteal vein, bilateral 108 267 Yes Yes I80229 Phlebitis and thrombophlebitis of unspecified popliteal vein 108 267 Yes Yes I80231 Phlebitis and thrombophlebitis of right tibial vein 108 267 Yes Yes

I80232 Phlebitis and thrombophlebitis of left tibial vein 108 267 Yes Yes I80233 Phlebitis and thrombophlebitis of tibial vein, bilateral 108 267 Yes Yes I80239 Phlebitis and thrombophlebitis of unspecified tibial vein 108 267 Yes Yes I80241 Phlebitis and thrombophlebitis of right peroneal vein 108 267 Yes Yes I80242 Phlebitis and thrombophlebitis of left peroneal vein 108 267 Yes Yes I80243 Phlebitis and thrombophlebitis of peroneal vein, bilateral 108 267 Yes Yes I80249 Phlebitis and thrombophlebitis of unspecified peroneal vein 108 267 Yes Yes I80251 Phlebitis and thrombophlebitis of right calf muscular vein 108 267 Yes Yes I80252 Phlebitis and thrombophlebitis of left calf muscular vein 108 267 Yes Yes I80253 Phlebitis and thrombophlebitis of calf muscular vein, bilateral 108 267 Yes Yes I80259 Phlebitis and thrombophlebitis of unspecified calf muscular vein 108 267 Yes Yes I80291 Phlebitis and thrombophlebitis of other deep vessels of right lower extremity 108 267 Yes Yes I80292 Phlebitis and thrombophlebitis of other deep vessels of left lower extremity 108 267 Yes Yes I80293 Phlebitis and thrombophlebitis of other deep vessels of lower extremity, bilateral 108 267 Yes Yes I80299 Phlebitis and thrombophlebitis of other deep vessels of unspecified lower extremity 108 267 Yes Yes I820 Budd-Chiari syndrome 108 267 Yes Yes I82210 Acute embolism and thrombosis of superior vena cava 108 267 Yes Yes I82211 Chronic embolism and thrombosis of superior vena cava 108 267 Yes Yes I82220 Acute embolism and thrombosis of inferior vena cava 108 267 Yes Yes I82221 Chronic embolism and thrombosis of inferior vena cava 108 267 Yes Yes I82290 Acute embolism and thrombosis of other thoracic veins 108 267 Yes Yes I82291 Chronic embolism and thrombosis of other thoracic veins 108 267 Yes Yes I823 Embolism and thrombosis of renal vein 108 267 Yes Yes I82401 Acute embolism and thrombosis of unspecified deep veins of right lower extremity 108 267 Yes Yes I82402 Acute embolism and thrombosis of unspecified deep veins of left lower extremity 108 267 Yes Yes I82403 Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral 108 267 Yes Yes I82409 Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity 108 267 Yes Yes I82411 Acute embolism and thrombosis of right femoral vein 108 267 Yes Yes I82412 Acute embolism and thrombosis of left femoral vein 108 267 Yes Yes I82413 Acute embolism and thrombosis of femoral vein, bilateral 108 267 Yes Yes I82419 Acute embolism and thrombosis of unspecified femoral vein 108 267 Yes Yes I82421 Acute embolism and thrombosis of right iliac vein 108 267 Yes Yes I82422 Acute embolism and thrombosis of left iliac vein 108 267 Yes Yes I82423 Acute embolism and thrombosis of iliac vein, bilateral 108 267 Yes Yes I82429 Acute embolism and thrombosis of unspecified iliac vein 108 267 Yes Yes I82431 Acute embolism and thrombosis of right popliteal vein 108 267 Yes Yes I82432 Acute embolism and thrombosis of left popliteal vein 108 267 Yes Yes I82433 Acute embolism and thrombosis of popliteal vein, bilateral 108 267 Yes Yes I82439 Acute embolism and thrombosis of unspecified popliteal vein 108 267 Yes Yes I82441 Acute embolism and thrombosis of right tibial vein 108 267 Yes Yes I82442 Acute embolism and thrombosis of left tibial vein 108 267 Yes Yes I82443 Acute embolism and thrombosis of tibial vein, bilateral 108 267 Yes Yes I82449 Acute embolism and thrombosis of unspecified tibial vein 108 267 Yes Yes I82451 Acute embolism and thrombosis of right peroneal vein 108 267 Yes Yes I82452 Acute embolism and thrombosis of left peroneal vein 108 267 Yes Yes I82453 Acute embolism and thrombosis of peroneal vein, bilateral 108 267 Yes Yes I82459 Acute embolism and thrombosis of unspecified peroneal vein 108 267 Yes Yes I82461 Acute embolism and thrombosis of right calf muscular vein 108 267 Yes Yes I82462 Acute embolism and thrombosis of left calf muscular vein 108 267 Yes Yes I82463 Acute embolism and thrombosis of calf muscular vein, bilateral 108 267 Yes Yes I82469 Acute embolism and thrombosis of unspecified calf muscular vein 108 267 Yes Yes I82491 Acute embolism and thrombosis of other specified deep vein of right lower extremity 108 267 Yes Yes I82492 Acute embolism and thrombosis of other specified deep vein of left lower extremity 108 267 Yes Yes I82493 Acute embolism and thrombosis of other specified deep vein of lower extremity, bilateral 108 267 Yes Yes I82499 Acute embolism and thrombosis of other specified deep vein of unspecified lower extremity 108 267 Yes Yes I824Y1 Acute embolism and thrombosis of unspecified deep veins of right proximal lower extremity 108 267 Yes Yes I824Y2 Acute embolism and thrombosis of unspecified deep veins of left proximal lower extremity 108 267 Yes Yes I824Y3 Acute embolism and thrombosis of unspecified deep veins of proximal lower extremity, bilateral 108 267 Yes Yes I824Y9 Acute embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity 108 267 Yes Yes I824Z1 Acute embolism and thrombosis of unspecified deep veins of right distal lower extremity 108 267 Yes Yes I824Z2 Acute embolism and thrombosis of unspecified deep veins of left distal lower extremity 108 267 Yes Yes I824Z3 Acute embolism and thrombosis of unspecified deep veins of distal lower extremity, bilateral 108 267 Yes Yes I824Z9 Acute embolism and thrombosis of unspecified deep veins of unspecified distal lower extremity 108 267 Yes Yes I82501 Chronic embolism and thrombosis of unspecified deep veins of right lower extremity 108 267 Yes Yes I82502 Chronic embolism and thrombosis of unspecified deep veins of left lower extremity 108 267 Yes Yes I82503 Chronic embolism and thrombosis of unspecified deep veins of lower extremity, bilateral 108 267 Yes Yes I82509 Chronic embolism and thrombosis of unspecified deep veins of unspecified lower extremity 108 267 Yes Yes I82511 Chronic embolism and thrombosis of right femoral vein 108 267 Yes Yes I82512 Chronic embolism and thrombosis of left femoral vein 108 267 Yes Yes I82513 Chronic embolism and thrombosis of femoral vein, bilateral 108 267 Yes Yes I82519 Chronic embolism and thrombosis of unspecified femoral vein 108 267 Yes Yes I82521 Chronic embolism and thrombosis of right iliac vein 108 267 Yes Yes I82522 Chronic embolism and thrombosis of left iliac vein 108 267 Yes Yes I82523 Chronic embolism and thrombosis of iliac vein, bilateral 108 267 Yes Yes I82529 Chronic embolism and thrombosis of unspecified iliac vein 108 267 Yes Yes I82531 Chronic embolism and thrombosis of right popliteal vein 108 267 Yes Yes

I82532 Chronic embolism and thrombosis of left popliteal vein 108 267 Yes Yes I82533 Chronic embolism and thrombosis of popliteal vein, bilateral 108 267 Yes Yes I82539 Chronic embolism and thrombosis of unspecified popliteal vein 108 267 Yes Yes I82541 Chronic embolism and thrombosis of right tibial vein 108 267 Yes Yes I82542 Chronic embolism and thrombosis of left tibial vein 108 267 Yes Yes I82543 Chronic embolism and thrombosis of tibial vein, bilateral 108 267 Yes Yes I82549 Chronic embolism and thrombosis of unspecified tibial vein 108 267 Yes Yes I82551 Chronic embolism and thrombosis of right peroneal vein 108 267 Yes Yes I82552 Chronic embolism and thrombosis of left peroneal vein 108 267 Yes Yes I82553 Chronic embolism and thrombosis of peroneal vein, bilateral 108 267 Yes Yes I82559 Chronic embolism and thrombosis of unspecified peroneal vein 108 267 Yes Yes I82561 Chronic embolism and thrombosis of right calf muscular vein 108 267 Yes Yes I82562 Chronic embolism and thrombosis of left calf muscular vein 108 267 Yes Yes I82563 Chronic embolism and thrombosis of calf muscular vein, bilateral 108 267 Yes Yes I82569 Chronic embolism and thrombosis of unspecified calf muscular vein 108 267 Yes Yes I82591 Chronic embolism and thrombosis of other specified deep vein of right lower extremity 108 267 Yes Yes I82592 Chronic embolism and thrombosis of other specified deep vein of left lower extremity 108 267 Yes Yes I82593 Chronic embolism and thrombosis of other specified deep vein of lower extremity, bilateral 108 267 Yes Yes I82599 Chronic embolism and thrombosis of other specified deep vein of unspecified lower extremity 108 267 Yes Yes I825Y1 Chronic embolism and thrombosis of unspecified deep veins of right proximal lower extremity 108 267 Yes Yes I825Y2 Chronic embolism and thrombosis of unspecified deep veins of left proximal lower extremity 108 267 Yes Yes I825Y3 Chronic embolism and thrombosis of unspecified deep veins of proximal lower extremity, bilateral 108 267 Yes Yes I825Y9 Chronic embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity 108 267 Yes Yes I825Z1 Chronic embolism and thrombosis of unspecified deep veins of right distal lower extremity 108 267 Yes Yes I825Z2 Chronic embolism and thrombosis of unspecified deep veins of left distal lower extremity 108 267 Yes Yes I825Z3 Chronic embolism and thrombosis of unspecified deep veins of distal lower extremity, bilateral 108 267 Yes Yes I825Z9 Chronic embolism and thrombosis of unspecified deep veins of unspecified distal lower extremity 108 267 Yes Yes I82621 Acute embolism and thrombosis of deep veins of right upper extremity 108 267 Yes Yes I82622 Acute embolism and thrombosis of deep veins of left upper extremity 108 267 Yes Yes I82623 Acute embolism and thrombosis of deep veins of upper extremity, bilateral 108 267 Yes Yes I82629 Acute embolism and thrombosis of deep veins of unspecified upper extremity 108 267 Yes Yes I82721 Chronic embolism and thrombosis of deep veins of right upper extremity 108 267 Yes Yes I82722 Chronic embolism and thrombosis of deep veins of left upper extremity 108 267 Yes Yes I82723 Chronic embolism and thrombosis of deep veins of upper extremity, bilateral 108 267 Yes Yes I82729 Chronic embolism and thrombosis of deep veins of unspecified upper extremity 108 267 Yes Yes I82A11 Acute embolism and thrombosis of right axillary vein 108 267 Yes Yes I82A12 Acute embolism and thrombosis of left axillary vein 108 267 Yes Yes I82A13 Acute embolism and thrombosis of axillary vein, bilateral 108 267 Yes Yes I82A19 Acute embolism and thrombosis of unspecified axillary vein 108 267 Yes Yes I82A21 Chronic embolism and thrombosis of right axillary vein 108 267 Yes Yes I82A22 Chronic embolism and thrombosis of left axillary vein 108 267 Yes Yes I82A23 Chronic embolism and thrombosis of axillary vein, bilateral 108 267 Yes Yes I82A29 Chronic embolism and thrombosis of unspecified axillary vein 108 267 Yes Yes I82B11 Acute embolism and thrombosis of right subclavian vein 108 267 Yes Yes I82B12 Acute embolism and thrombosis of left subclavian vein 108 267 Yes Yes I82B13 Acute embolism and thrombosis of subclavian vein, bilateral 108 267 Yes Yes I82B19 Acute embolism and thrombosis of unspecified subclavian vein 108 267 Yes Yes I82B21 Chronic embolism and thrombosis of right subclavian vein 108 267 Yes Yes I82B22 Chronic embolism and thrombosis of left subclavian vein 108 267 Yes Yes I82B23 Chronic embolism and thrombosis of subclavian vein, bilateral 108 267 Yes Yes I82B29 Chronic embolism and thrombosis of unspecified subclavian vein 108 267 Yes Yes I82C11 Acute embolism and thrombosis of right internal jugular vein 108 267 Yes Yes I82C12 Acute embolism and thrombosis of left internal jugular vein 108 267 Yes Yes I82C13 Acute embolism and thrombosis of internal jugular vein, bilateral 108 267 Yes Yes I82C19 Acute embolism and thrombosis of unspecified internal jugular vein 108 267 Yes Yes I82C21 Chronic embolism and thrombosis of right internal jugular vein 108 267 Yes Yes I82C22 Chronic embolism and thrombosis of left internal jugular vein 108 267 Yes Yes I82C23 Chronic embolism and thrombosis of internal jugular vein, bilateral 108 267 Yes Yes I82C29 Chronic embolism and thrombosis of unspecified internal jugular vein 108 267 Yes Yes T790XXA Air embolism (traumatic), initial encounter 173 267 Yes Yes T791XXA Fat embolism (traumatic), initial encounter 173 267 Yes Yes I83001 Varicose veins of unspecified lower extremity with ulcer of thigh 107 383 Yes Yes I83002 Varicose veins of unspecified lower extremity with ulcer of calf 107 383 Yes Yes I83003 Varicose veins of unspecified lower extremity with ulcer of ankle 107 383 Yes Yes I83004 Varicose veins of unspecified lower extremity with ulcer of heel and midfoot 107 383 Yes Yes I83005 Varicose veins of unspecified lower extremity with ulcer other part of foot 107 383 Yes Yes I83008 Varicose veins of unspecified lower extremity with ulcer other part of lower leg 107 383 Yes Yes I83009 Varicose veins of unspecified lower extremity with ulcer of unspecified site 107 383 Yes Yes I83011 Varicose veins of right lower extremity with ulcer of thigh 107 383 Yes Yes I83012 Varicose veins of right lower extremity with ulcer of calf 107 383 Yes Yes I83013 Varicose veins of right lower extremity with ulcer of ankle 107 383 Yes Yes I83014 Varicose veins of right lower extremity with ulcer of heel and midfoot 107 383 Yes Yes I83015 Varicose veins of right lower extremity with ulcer other part of foot 107 383 Yes Yes I83018 Varicose veins of right lower extremity with ulcer other part of lower leg 107 383 Yes Yes I83019 Varicose veins of right lower extremity with ulcer of unspecified site 107 383 Yes Yes I83021 Varicose veins of left lower extremity with ulcer of thigh 107 383 Yes Yes

I83022 Varicose veins of left lower extremity with ulcer of calf 107 383 Yes Yes I83023 Varicose veins of left lower extremity with ulcer of ankle 107 383 Yes Yes I83024 Varicose veins of left lower extremity with ulcer of heel and midfoot 107 383 Yes Yes I83025 Varicose veins of left lower extremity with ulcer other part of foot 107 383 Yes Yes I83028 Varicose veins of left lower extremity with ulcer other part of lower leg 107 383 Yes Yes I83029 Varicose veins of left lower extremity with ulcer of unspecified site 107 383 Yes Yes I83201 Varicose veins of unspecified lower extremity with both ulcer of thigh and inflammation 107 383 Yes Yes I83202 Varicose veins of unspecified lower extremity with both ulcer of calf and inflammation 107 383 Yes Yes I83203 Varicose veins of unspecified lower extremity with both ulcer of ankle and inflammation 107 383 Yes Yes I83204 Varicose veins of unspecified lower extremity with both ulcer of heel and midfoot and inflammation 107 383 Yes Yes I83205 Varicose veins of unspecified lower extremity with both ulcer other part of foot and inflammation 107 383 Yes Yes I83208 Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation 107 383 Yes Yes I83209 Varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation 107 383 Yes Yes I83211 Varicose veins of right lower extremity with both ulcer of thigh and inflammation 107 383 Yes Yes I83212 Varicose veins of right lower extremity with both ulcer of calf and inflammation 107 383 Yes Yes I83213 Varicose veins of right lower extremity with both ulcer of ankle and inflammation 107 383 Yes Yes I83214 Varicose veins of right lower extremity with both ulcer of heel and midfoot and inflammation 107 383 Yes Yes I83215 Varicose veins of right lower extremity with both ulcer other part of foot and inflammation 107 383 Yes Yes I83218 Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation 107 383 Yes Yes I83219 Varicose veins of right lower extremity with both ulcer of unspecified site and inflammation 107 383 Yes Yes I83221 Varicose veins of left lower extremity with both ulcer of thigh and inflammation 107 383 Yes Yes I83222 Varicose veins of left lower extremity with both ulcer of calf and inflammation 107 383 Yes Yes I83223 Varicose veins of left lower extremity with both ulcer of ankle and inflammation 107 383 Yes Yes I83224 Varicose veins of left lower extremity with both ulcer of heel and midfoot and inflammation 107 383 Yes Yes I83225 Varicose veins of left lower extremity with both ulcer other part of foot and inflammation 107 383 Yes Yes I83228 Varicose veins of left lower extremity with both ulcer of other part of lower extremity and inflammation 107 383 Yes Yes I83229 Varicose veins of left lower extremity with both ulcer of unspecified site and inflammation 107 383 Yes Yes I87011 Postthrombotic syndrome with ulcer of right lower extremity 107 383 Yes Yes I87012 Postthrombotic syndrome with ulcer of left lower extremity 107 383 Yes Yes I87013 Postthrombotic syndrome with ulcer of bilateral lower extremity 107 383 Yes Yes I87019 Postthrombotic syndrome with ulcer of unspecified lower extremity 107 383 Yes Yes I87031 Postthrombotic syndrome with ulcer and inflammation of right lower extremity 107 383 Yes Yes I87032 Postthrombotic syndrome with ulcer and inflammation of left lower extremity 107 383 Yes Yes I87033 Postthrombotic syndrome with ulcer and inflammation of bilateral lower extremity 107 383 Yes Yes I87039 Postthrombotic syndrome with ulcer and inflammation of unspecified lower extremity 107 383 Yes Yes I87311 Chronic venous hypertension (idiopathic) with ulcer of right lower extremity 107 383 Yes Yes I87312 Chronic venous hypertension (idiopathic) with ulcer of left lower extremity 107 383 Yes Yes I87313 Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity 107 383 Yes Yes I87319 Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity 107 383 Yes Yes I87331 Chronic venous hypertension (idiopathic) with ulcer and inflammation of right lower extremity 107 383 Yes Yes I87332 Chronic venous hypertension (idiopathic) with ulcer and inflammation of left lower extremity 107 383 Yes Yes I87333 Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity 107 383 Yes Yes I87339 Chronic venous hypertension (idiopathic) with ulcer and inflammation of unspecified lower extremity 107 383 Yes Yes E0952 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene 106 Yes No I2601 Septic pulmonary embolism with acute cor pulmonale 107 Yes -- I2602 Saddle embolus of pulmonary artery with acute cor pulmonale 107 Yes -- I2609 Other pulmonary embolism with acute cor pulmonale 107 Yes -- I670 Dissection of cerebral arteries, nonruptured 107 Yes No I7770 Dissection of unspecified artery 107 Yes No I7771 Dissection of carotid artery 107 Yes No I7772 Dissection of iliac artery 107 Yes No I7773 Dissection of renal artery 107 Yes No I7774 Dissection of vertebral artery 107 Yes No I7775 Dissection of other precerebral arteries 107 Yes No I7776 Dissection of artery of upper extremity 107 Yes No I7777 Dissection of artery of lower extremity 107 Yes No I7779 Dissection of other specified artery 107 Yes No K55011 Focal (segmental) acute (reversible) ischemia of small intestine 107 Yes No K55012 Diffuse acute (reversible) ischemia of small intestine 107 Yes No K55019 Acute (reversible) ischemia of small intestine, extent unspecified 107 Yes No K55021 Focal (segmental) acute infarction of small intestine 107 Yes No K55022 Diffuse acute infarction of small intestine 107 Yes No K55029 Acute infarction of small intestine, extent unspecified 107 Yes No K55031 Focal (segmental) acute (reversible) ischemia of large intestine 107 Yes No K55032 Diffuse acute (reversible) ischemia of large intestine 107 Yes No K55039 Acute (reversible) ischemia of large intestine, extent unspecified 107 Yes No K55041 Focal (segmental) acute infarction of large intestine 107 Yes No K55042 Diffuse acute infarction of large intestine 107 Yes No K55049 Acute infarction of large intestine, extent unspecified 107 Yes No K55051 Focal (segmental) acute (reversible) ischemia of intestine, part unspecified 107 Yes No K55052 Diffuse acute (reversible) ischemia of intestine, part unspecified 107 Yes No K55059 Acute (reversible) ischemia of intestine, part and extent unspecified 107 Yes No K55061 Focal (segmental) acute infarction of intestine, part unspecified 107 Yes No K55062 Diffuse acute infarction of intestine, part unspecified 107 Yes No K55069 Acute infarction of intestine, part and extent unspecified 107 Yes No K5530 Necrotizing enterocolitis, unspecified 107 Yes No

K5531 Stage 1 necrotizing enterocolitis 107 Yes No K5532 Stage 2 necrotizing enterocolitis 107 Yes No K5533 Stage 3 necrotizing enterocolitis 107 Yes No N280 Ischemia and infarction of kidney 107 Yes No E0851 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene 108 Yes -- E0951 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene 108 Yes No E1051 Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene 108 Yes -- E1151 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene 108 Yes -- E1351 Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene 108 Yes -- I700 Atherosclerosis of aorta 108 Yes No I701 Atherosclerosis of renal artery 108 Yes No I70201 Unspecified atherosclerosis of native arteries of extremities, right leg 108 Yes No I70202 Unspecified atherosclerosis of native arteries of extremities, left leg 108 Yes No I70203 Unspecified atherosclerosis of native arteries of extremities, bilateral legs 108 Yes No I70208 Unspecified atherosclerosis of native arteries of extremities, other extremity 108 Yes No I70209 Unspecified atherosclerosis of native arteries of extremities, unspecified extremity 108 Yes No I70211 Atherosclerosis of native arteries of extremities with intermittent claudication, right leg 108 Yes No I70212 Atherosclerosis of native arteries of extremities with intermittent claudication, left leg 108 Yes No I70213 Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs 108 Yes No I70218 Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity 108 Yes No I70219 Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity 108 Yes No I70291 Other atherosclerosis of native arteries of extremities, right leg 108 Yes No I70292 Other atherosclerosis of native arteries of extremities, left leg 108 Yes No I70293 Other atherosclerosis of native arteries of extremities, bilateral legs 108 Yes No I70298 Other atherosclerosis of native arteries of extremities, other extremity 108 Yes No I70299 Other atherosclerosis of native arteries of extremities, unspecified extremity 108 Yes No I70301 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, right leg 108 Yes No I70302 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, left leg 108 Yes No I70303 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, bilateral legs 108 Yes No I70308 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, other extremity 108 Yes No I70309 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70311 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, right leg 108 Yes No I70312 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, left leg 108 Yes No I70313 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, bilateral legs 108 Yes No I70318 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, other extremity 108 Yes No I70319 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, unspecified extremity 108 Yes No I70391 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, right leg 108 Yes No I70392 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, left leg 108 Yes No I70393 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, bilateral legs 108 Yes No I70398 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, other extremity 108 Yes No I70399 Other atherosclerosis of unspecified type of bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70401 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, right leg 108 Yes No I70402 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, left leg 108 Yes No I70403 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, bilateral legs 108 Yes No I70408 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, other extremity 108 Yes No I70409 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70411 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, right leg 108 Yes No I70412 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, left leg 108 Yes No I70413 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, bilateral legs 108 Yes No I70418 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, other extremity 108 Yes No I70419 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, unspecified extremity 108 Yes No I70491 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, right leg 108 Yes No I70492 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, left leg 108 Yes No I70493 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, bilateral legs 108 Yes No I70498 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, other extremity 108 Yes No I70499 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70501 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, right leg 108 Yes No I70502 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, left leg 108 Yes No I70503 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, bilateral legs 108 Yes No I70508 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, other extremity 108 Yes No I70509 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70511 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, right leg 108 Yes No I70512 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, left leg 108 Yes No I70513 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, bilateral legs 108 Yes No I70518 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, other extremity 108 Yes No I70519 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, unspecified extremity 108 Yes No I70591 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, right leg 108 Yes No I70592 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, left leg 108 Yes No I70593 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, bilateral legs 108 Yes No I70598 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, other extremity 108 Yes No I70599 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70601 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, right leg 108 Yes No I70602 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, left leg 108 Yes No I70603 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, bilateral legs 108 Yes No I70608 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, other extremity 108 Yes No

I70609 Unspecified atherosclerosis of nonbiological bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70611 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, right leg 108 Yes No I70612 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, left leg 108 Yes No I70613 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, bilateral legs 108 Yes No I70618 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, other extremity 108 Yes No I70619 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, unspecified extremity 108 Yes No I70691 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, right leg 108 Yes No I70692 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, left leg 108 Yes No I70693 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, bilateral legs 108 Yes No I70698 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, other extremity 108 Yes No I70699 Other atherosclerosis of nonbiological bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70701 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, right leg 108 Yes No I70702 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, left leg 108 Yes No I70703 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, bilateral legs 108 Yes No I70708 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, other extremity 108 Yes No I70709 Unspecified atherosclerosis of other type of bypass graft(s) of the extremities, unspecified extremity 108 Yes No I70711 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, right leg 108 Yes No I70712 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, left leg 108 Yes No I70713 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, bilateral legs 108 Yes No I70718 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, other extremity 108 Yes No I70719 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, unspecified extremity 108 Yes No I70791 Other atherosclerosis of other type of bypass graft(s) of the extremities, right leg 108 Yes No I70792 Other atherosclerosis of other type of bypass graft(s) of the extremities, left leg 108 Yes No I70793 Other atherosclerosis of other type of bypass graft(s) of the extremities, bilateral legs 108 Yes No I70798 Other atherosclerosis of other type of bypass graft(s) of the extremities, other extremity 108 Yes No I70799 Other atherosclerosis of other type of bypass graft(s) of the extremities, unspecified extremity 108 Yes No I7092 Chronic total occlusion of artery of the extremities 108 Yes No I712 Thoracic aortic aneurysm, without rupture 108 Yes No I7120 Thoracic aortic aneurysm, without rupture, unspecified 108 Yes No I7121 Aneurysm of the ascending aorta, without rupture 108 Yes No I7122 Aneurysm of the aortic arch, without rupture 108 Yes No I7123 Aneurysm of the descending thoracic aorta, without rupture 108 Yes No I714 Abdominal aortic aneurysm, without rupture 108 Yes No I7140 Abdominal aortic aneurysm, without rupture, unspecified 108 Yes No I7141 Pararenal abdominal aortic aneurysm, without rupture 108 Yes No I7142 Juxtarenal abdominal aortic aneurysm, without rupture 108 Yes No I7143 Infrarenal abdominal aortic aneurysm, without rupture 108 Yes No I716 Thoracoabdominal aortic aneurysm, without rupture 108 Yes No I7160 Thoracoabdominal aortic aneurysm, without rupture, unspecified 108 Yes No I7161 Supraceliac aneurysm of the abdominal aorta, without rupture 108 Yes No I7162 Paravisceral aneurysm of the abdominal aorta, without rupture 108 Yes No I719 Aortic aneurysm of unspecified site, without rupture 108 Yes No I720 Aneurysm of carotid artery 108 Yes No I721 Aneurysm of artery of upper extremity 108 Yes No I722 Aneurysm of renal artery 108 Yes No I723 Aneurysm of iliac artery 108 Yes No I724 Aneurysm of artery of lower extremity 108 Yes No I725 Aneurysm of other precerebral arteries 108 Yes No I726 Aneurysm of vertebral artery 108 Yes No I728 Aneurysm of other specified arteries 108 Yes No I729 Aneurysm of unspecified site 108 Yes No I731 Thromboangiitis obliterans [Buerger's disease] 108 Yes No I7381 Erythromelalgia 108 Yes No I7389 Other specified peripheral vascular diseases 108 Yes No I739 Peripheral vascular disease, unspecified 108 Yes No I770 Arteriovenous fistula, acquired 108 Yes No I771 Stricture of artery 108 Yes No I772 Rupture of artery 108 Yes No I773 Arterial fibromuscular dysplasia 108 Yes No I774 Celiac artery compression syndrome 108 Yes No I775 Necrosis of artery 108 Yes No I776 Arteritis, unspecified 108 Yes No I77810 Thoracic aortic ectasia 108 Yes No I77811 Abdominal aortic ectasia 108 Yes No I77812 Thoracoabdominal aortic ectasia 108 Yes No I77819 Aortic ectasia, unspecified site 108 Yes No I7789 Other specified disorders of arteries and arterioles 108 Yes No I779 Disorder of arteries and arterioles, unspecified 108 Yes No I780 Hereditary hemorrhagic telangiectasia 108 Yes No I790 Aneurysm of aorta in diseases classified elsewhere 108 Yes No I791 Aortitis in diseases classified elsewhere 108 Yes No I798 Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere 108 Yes No K551 Chronic vascular disorders of intestine 108 Yes No K558 Other vascular disorders of intestine 108 Yes No K559 Vascular disorder of intestine, unspecified 108 Yes No

Lung Disease Group V24 V28 Lung Disease Group: 5 HCCs • HCC 110 (Cystic Fibrosis) • HCC 111 (Chronic Obstructive Pulmonary Disease) • HCC 112 (Fibrosis of Lung and Other Chronic Lung Disorders) • HCC 114 (Aspiration and Specified Bacterial Pneumonias) • HCC 115 (Pneumococcal Pneumonia, Empyema, Lung Abscess) Lung Disease Group: 7 HCCs • HCC 276 (Lung Transplant Status/Complications) • HCC 277 (Cystic Fibrosis) • HCC 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis) • HCC 279 (Severe Persistent Asthma) • HCC 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) • HCC 282 (Aspiration and Specified Bacterial Pneumonias) • HCC 283 (Empyema, Lung Abscess)

ICD 10 Desccriptor V24 V28 V24 V28 J95851 Ventilator associated pneumonia 114 211 Yes Yes T8630 Unspecified complication of heart-lung transplant 276 -- Yes T8631 Heart-lung transplant rejection 276 -- Yes T8632 Heart-lung transplant failure 276 -- Yes T8633 Heart-lung transplant infection 276 -- Yes T8639 Other complications of heart-lung transplant 276 -- Yes T86810 Lung transplant rejection 186 276 Yes Yes T86811 Lung transplant failure 186 276 Yes Yes T86812 Lung transplant infection 186 276 Yes Yes T86818 Other complications of lung transplant 186 276 Yes Yes T86819 Unspecified complication of lung transplant 186 276 Yes Yes Z4824 Encounter for aftercare following lung transplant 186 276 Yes Yes Z48280 Encounter for aftercare following heart-lung transplant 276 -- Yes Z942 Lung transplant status 186 276 Yes Yes Z943 Heart and lungs transplant status 276 -- Yes E840 Cystic fibrosis with pulmonary manifestations 110 277 Yes Yes E8411 Meconium ileus in cystic fibrosis 110 277 Yes Yes E8419 Cystic fibrosis with other intestinal manifestations 110 277 Yes Yes E848 Cystic fibrosis with other manifestations 110 277 Yes Yes E849 Cystic fibrosis, unspecified 110 277 Yes Yes J84112 Idiopathic pulmonary fibrosis 112 278 Yes Yes J84170 Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere 112 278 Yes Yes M3481 Systemic sclerosis with lung involvement 112 278 Yes Yes M301 Polyarteritis with lung involvement [Churg-Strauss] 40 278 Yes Yes J4550 Severe persistent asthma, uncomplicated 279 No Yes J4551 Severe persistent asthma with (acute) exacerbation 279 No Yes J4552 Severe persistent asthma with status asthmaticus 279 No Yes J410 Simple chronic bronchitis 111 280 Yes Yes J411 Mucopurulent chronic bronchitis 111 280 Yes Yes J418 Mixed simple and mucopurulent chronic bronchitis 111 280 Yes Yes J42 Unspecified chronic bronchitis 111 280 Yes Yes J430 Unilateral pulmonary emphysema [MacLeod's syndrome] 111 280 Yes Yes J431 Panlobular emphysema 111 280 Yes Yes J432 Centrilobular emphysema 111 280 Yes Yes J438 Other emphysema 111 280 Yes Yes J439 Emphysema, unspecified 111 280 Yes Yes J440 Chronic obstructive pulmonary disease with (acute) lower respiratory infection 111 280 Yes Yes J441 Chronic obstructive pulmonary disease with (acute) exacerbation 111 280 Yes Yes J449 Chronic obstructive pulmonary disease, unspecified 111 280 Yes Yes J8281 Chronic eosinophilic pneumonia 111 280 Yes Yes J982 Interstitial emphysema 111 280 Yes Yes J983 Compensatory emphysema 111 280 Yes Yes B4481 Allergic bronchopulmonary aspergillosis 112 280 Yes Yes J470 Bronchiectasis with acute lower respiratory infection 112 280 Yes Yes J471 Bronchiectasis with (acute) exacerbation 112 280 Yes Yes J479 Bronchiectasis, uncomplicated 112 280 Yes Yes J60 Coalworker's pneumoconiosis 112 280 Yes Yes J61 Pneumoconiosis due to asbestos and other mineral fibers 112 280 Yes Yes J620 Pneumoconiosis due to talc dust 112 280 Yes Yes J628 Pneumoconiosis due to other dust containing silica 112 280 Yes Yes J630 Aluminosis (of lung) 112 280 Yes Yes J631 Bauxite fibrosis (of lung) 112 280 Yes Yes J632 Berylliosis 112 280 Yes Yes J633 Graphite fibrosis (of lung) 112 280 Yes Yes J634 Siderosis 112 280 Yes Yes J635 Stannosis 112 280 Yes Yes J636 Pneumoconiosis due to other specified inorganic dusts 112 280 Yes Yes J64 Unspecified pneumoconiosis 112 280 Yes Yes J65 Pneumoconiosis associated with tuberculosis 112 280 Yes Yes J660 Byssinosis 112 280 Yes Yes J661 Flax-dressers' disease 112 280 Yes Yes J662 Cannabinosis 112 280 Yes Yes J668 Airway disease due to other specific organic dusts 112 280 Yes Yes J670 Farmer's lung 112 280 Yes Yes J671 Bagassosis 112 280 Yes Yes J672 Bird fancier's lung 112 280 Yes Yes J673 Suberosis 112 280 Yes Yes J674 Maltworker's lung 112 280 Yes Yes J675 Mushroom-worker's lung 112 280 Yes Yes J676 Maple-bark-stripper's lung 112 280 Yes Yes J677 Air conditioner and humidifier lung 112 280 Yes Yes J678 Hypersensitivity pneumonitis due to other organic dusts 112 280 Yes Yes J679 Hypersensitivity pneumonitis due to unspecified organic dust 112 280 Yes Yes J680 Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors 112 280 Yes Yes J681 Pulmonary edema due to chemicals, gases, fumes and vapors 112 280 Yes Yes

J682 Upper respiratory inflammation due to chemicals, gases, fumes and vapors, not elsewhere classified 112 280 Yes Yes J683 Other acute and subacute respiratory conditions due to chemicals, gases, fumes and vapors 112 280 Yes Yes J684 Chronic respiratory conditions due to chemicals, gases, fumes and vapors 112 280 Yes Yes J688 Other respiratory conditions due to chemicals, gases, fumes and vapors 112 280 Yes Yes J689 Unspecified respiratory condition due to chemicals, gases, fumes and vapors 112 280 Yes Yes J8401 Alveolar proteinosis 112 280 Yes Yes J8402 Pulmonary alveolar microlithiasis 112 280 Yes Yes J8403 Idiopathic pulmonary hemosiderosis 112 280 Yes Yes J8409 Other alveolar and parieto-alveolar conditions 112 280 Yes Yes J8410 Pulmonary fibrosis, unspecified 112 280 Yes Yes J84111 Idiopathic interstitial pneumonia, not otherwise specified 112 280 Yes Yes J84113 Idiopathic non-specific interstitial pneumonitis 112 280 Yes Yes J84114 Acute interstitial pneumonitis 112 280 Yes Yes J84115 Respiratory bronchiolitis interstitial lung disease 112 280 Yes Yes J84116 Cryptogenic organizing pneumonia 112 280 Yes Yes J84117 Desquamative interstitial pneumonia 112 280 Yes Yes J84178 Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere 112 280 Yes Yes J842 Lymphoid interstitial pneumonia 112 280 Yes Yes J8481 Lymphangioleiomyomatosis 112 280 Yes Yes J8482 Adult pulmonary Langerhans cell histiocytosis 112 280 Yes Yes J8489 Other specified interstitial pulmonary diseases 112 280 Yes Yes J849 Interstitial pulmonary disease, unspecified 112 280 Yes Yes J99 Respiratory disorders in diseases classified elsewhere 112 280 Yes Yes M3213 Lung involvement in systemic lupus erythematosus 112 280 Yes Yes M3301 Juvenile dermatomyositis with respiratory involvement 112 280 Yes Yes M3311 Other dermatomyositis with respiratory involvement 112 280 Yes Yes M3321 Polymyositis with respiratory involvement 112 280 Yes Yes M3391 Dermatopolymyositis, unspecified with respiratory involvement 112 280 Yes Yes A481 Legionnaires' disease 114 282 Yes Yes J150 Pneumonia due to Klebsiella pneumoniae 114 282 Yes Yes J151 Pneumonia due to Pseudomonas 114 282 Yes Yes J1520 Pneumonia due to staphylococcus, unspecified 114 282 Yes Yes J15211 Pneumonia due to Methicillin susceptible Staphylococcus aureus 114 282 Yes Yes J15212 Pneumonia due to Methicillin resistant Staphylococcus aureus 114 282 Yes Yes J1529 Pneumonia due to other staphylococcus 114 282 Yes Yes J155 Pneumonia due to Escherichia coli 114 282 Yes Yes J156 Pneumonia due to other Gram-negative bacteria 114 282 Yes Yes J158 Pneumonia due to other specified bacteria 114 282 Yes Yes J690 Pneumonitis due to inhalation of food and vomit 114 282 Yes Yes J691 Pneumonitis due to inhalation of oils and essences 114 282 Yes Yes J698 Pneumonitis due to inhalation of other solids and liquids 114 282 Yes Yes A065 Amebic lung abscess 115 283 Yes Yes J850 Gangrene and necrosis of lung 115 283 Yes Yes J851 Abscess of lung with pneumonia 115 283 Yes Yes J852 Abscess of lung without pneumonia 115 283 Yes Yes J853 Abscess of mediastinum 115 283 Yes Yes J860 Pyothorax with fistula 115 283 Yes Yes J869 Pyothorax without fistula 115 283 Yes Yes D860 Sarcoidosis of lung 112 Yes No D862 Sarcoidosis of lung with sarcoidosis of lymph nodes 112 Yes No J700 Acute pulmonary manifestations due to radiation 112 Yes No J701 Chronic and other pulmonary manifestations due to radiation 112 Yes No J702 Acute drug-induced interstitial lung disorders 112 Yes No J703 Chronic drug-induced interstitial lung disorders 112 Yes No J704 Drug-induced interstitial lung disorders, unspecified 112 Yes No J705 Respiratory conditions due to smoke inhalation 112 Yes No J708 Respiratory conditions due to other specified external agents 112 Yes No J709 Respiratory conditions due to unspecified external agent 112 Yes No J8289 Other pulmonary eosinophilia, not elsewhere classified 112 Yes No J8483 Surfactant mutations of the lung 112 Yes No J84841 Neuroendocrine cell hyperplasia of infancy 112 Yes No J84842 Pulmonary interstitial glycogenosis 112 Yes No J84843 Alveolar capillary dysplasia with vein misalignment 112 Yes No J84848 Other interstitial lung diseases of childhood 112 Yes No M3502 Sjogren syndrome with lung involvement 112 Yes -- A0103 Typhoid pneumonia 115 Yes No A0222 Salmonella pneumonia 115 Yes No A202 Pneumonic plague 115 Yes No A212 Pulmonary tularemia 115 Yes No A221 Pulmonary anthrax 115 Yes No A420 Pulmonary actinomycosis 115 Yes No A430 Pulmonary nocardiosis 115 Yes No A5484 Gonococcal pneumonia 115 Yes No B380 Acute pulmonary coccidioidomycosis 115 Yes No B381 Chronic pulmonary coccidioidomycosis 115 Yes No B382 Pulmonary coccidioidomycosis, unspecified 115 Yes No

B390 Acute pulmonary histoplasmosis capsulati 115 Yes No B391 Chronic pulmonary histoplasmosis capsulati 115 Yes No B392 Pulmonary histoplasmosis capsulati, unspecified 115 Yes No B400 Acute pulmonary blastomycosis 115 Yes No B401 Chronic pulmonary blastomycosis 115 Yes No B402 Pulmonary blastomycosis, unspecified 115 Yes No B410 Pulmonary paracoccidioidomycosis 115 Yes No B664 Paragonimiasis 115 Yes No B671 Echinococcus granulosus infection of lung 115 Yes No J13 Pneumonia due to Streptococcus pneumoniae 115 Yes No J14 Pneumonia due to Hemophilus influenzae 115 Yes No J153 Pneumonia due to streptococcus, group B 115 Yes No J154 Pneumonia due to other streptococci 115 Yes No J181 Lobar pneumonia, unspecified organism 115 Yes No

Eye Disease Group V24 V28 Eye Disease Group: 2 HCCs Eye Disease Group: 2 HCCs • HCC 122 (Proliferative Diabetic Retinopathy and • HCC 298 (Severe Diabetic Eye Disease, Retinal Vein Vitreous Hemorrhage) Occlusion, and Vitreous Hemorrhage) • HCC 124 (Exudative Macular Degeneration) • HCC 300 (Exudative Macular Degeneration)

ICD 10 Desccriptor V24 V28 V24 V28 E08311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema 298 -- Yes E083211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E083212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E083213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E083219 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E083311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E083312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E083313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E083319 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E083411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E083412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E083413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E083419 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E083511 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye 122 298 Yes Yes E083512 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye 122 298 Yes Yes E083513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral 122 298 Yes Yes E083519 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye 122 298 Yes Yes E083521 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye 122 298 Yes Yes E083522 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye 122 298 Yes Yes E083523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral 122 298 Yes Yes E083529 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye 122 298 Yes Yes E083531 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye 122 298 Yes Yes E083532 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye 122 298 Yes Yes E083533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral 122 298 Yes Yes E083539 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye 122 298 Yes Yes E083541 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye 122 298 Yes Yes E083542 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye 122 298 Yes Yes E083543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral 122 298 Yes Yes E083549 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye 122 298 Yes Yes E083551 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye 122 298 Yes Yes E083552 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye 122 298 Yes Yes E083553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral 122 298 Yes Yes E083559 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye 122 298 Yes Yes E083591 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye 122 298 Yes Yes E083592 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye 122 298 Yes Yes E083593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral 122 298 Yes Yes E083599 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye 122 298 Yes Yes E10311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema 298 -- Yes E103211 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E103212 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes

E103213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E103219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E103311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E103312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E103313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E103319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E103411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E103412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E103413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E103419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E103511 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye 122 298 Yes Yes E103512 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye 122 298 Yes Yes E103513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral 122 298 Yes Yes E103519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye 122 298 Yes Yes E103521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye 122 298 Yes Yes E103522 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye 122 298 Yes Yes E103523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral 122 298 Yes Yes E103529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye 122 298 Yes Yes E103531 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye 122 298 Yes Yes E103532 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye 122 298 Yes Yes E103533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral 122 298 Yes Yes E103539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye 122 298 Yes Yes E103541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye 122 298 Yes Yes E103542 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye 122 298 Yes Yes E103543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral 122 298 Yes Yes E103549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye 122 298 Yes Yes E103551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye 122 298 Yes Yes E103552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye 122 298 Yes Yes E103553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral 122 298 Yes Yes E103559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye 122 298 Yes Yes E103591 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye 122 298 Yes Yes E103592 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye 122 298 Yes Yes E103593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral 122 298 Yes Yes E103599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye 122 298 Yes Yes E11311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema 298 -- Yes E113211 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E113212 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E113213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E113219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E113311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E113312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E113313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E113319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E113411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes

E113412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E113413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E113419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E113511 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye 122 298 Yes Yes E113512 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye 122 298 Yes Yes E113513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral 122 298 Yes Yes E113519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye 122 298 Yes Yes E113521 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye 122 298 Yes Yes E113522 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye 122 298 Yes Yes E113523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral 122 298 Yes Yes E113529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye 122 298 Yes Yes E113531 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye 122 298 Yes Yes E113532 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye 122 298 Yes Yes E113533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral 122 298 Yes Yes E113539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye 122 298 Yes Yes E113541 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye 122 298 Yes Yes E113542 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye 122 298 Yes Yes E113543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral 122 298 Yes Yes E113549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye 122 298 Yes Yes E113551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye 122 298 Yes Yes E113552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye 122 298 Yes Yes E113553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral 122 298 Yes Yes E113559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye 122 298 Yes Yes E113591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye 122 298 Yes Yes E113592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye 122 298 Yes Yes E113593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral 122 298 Yes Yes E113599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye 122 298 Yes Yes E13311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema 298 -- Yes E133211 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E133212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E133213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E133219 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E133311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E133312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E133313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E133319 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E133411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye 298 -- Yes E133412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye 298 -- Yes E133413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral 298 -- Yes E133419 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye 298 -- Yes E133511 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye 122 298 Yes Yes E133512 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye 122 298 Yes Yes E133513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral 122 298 Yes Yes E133519 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye 122 298 Yes Yes E133521 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye 122 298 Yes Yes

E133522 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye 122 298 Yes Yes E133523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral 122 298 Yes Yes E133529 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye 122 298 Yes Yes E133531 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye 122 298 Yes Yes E133532 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye 122 298 Yes Yes E133533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral 122 298 Yes Yes E133539 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye 122 298 Yes Yes E133541 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye 122 298 Yes Yes E133542 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye 122 298 Yes Yes E133543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral 122 298 Yes Yes E133549 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye 122 298 Yes Yes E133551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye 122 298 Yes Yes E133552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye 122 298 Yes Yes E133553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral 122 298 Yes Yes E133559 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye 122 298 Yes Yes E133591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye 122 298 Yes Yes E133592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye 122 298 Yes Yes E133593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral 122 298 Yes Yes E133599 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye 122 298 Yes Yes H348110 Central retinal vein occlusion, right eye, with macular edema 298 No Yes H348111 Central retinal vein occlusion, right eye, with retinal neovascularization 298 No Yes H348112 Central retinal vein occlusion, right eye, stable 298 No Yes H348120 Central retinal vein occlusion, left eye, with macular edema 298 No Yes H348121 Central retinal vein occlusion, left eye, with retinal neovascularization 298 No Yes H348122 Central retinal vein occlusion, left eye, stable 298 No Yes H348130 Central retinal vein occlusion, bilateral, with macular edema 298 No Yes H348131 Central retinal vein occlusion, bilateral, with retinal neovascularization 298 No Yes H348132 Central retinal vein occlusion, bilateral, stable 298 No Yes H348190 Central retinal vein occlusion, unspecified eye, with macular edema 298 No Yes H348191 Central retinal vein occlusion, unspecified eye, with retinal neovascularization 298 No Yes H348192 Central retinal vein occlusion, unspecified eye, stable 298 No Yes H348310 Tributary (branch) retinal vein occlusion, right eye, with macular edema 298 No Yes H348311 Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization 298 No Yes H348312 Tributary (branch) retinal vein occlusion, right eye, stable 298 No Yes H348320 Tributary (branch) retinal vein occlusion, left eye, with macular edema 298 No Yes H348321 Tributary (branch) retinal vein occlusion, left eye, with retinal neovascularization 298 No Yes H348322 Tributary (branch) retinal vein occlusion, left eye, stable 298 No Yes H348330 Tributary (branch) retinal vein occlusion, bilateral, with macular edema 298 No Yes H348331 Tributary (branch) retinal vein occlusion, bilateral, with retinal neovascularization 298 No Yes H348332 Tributary (branch) retinal vein occlusion, bilateral, stable 298 No Yes H348390 Tributary (branch) retinal vein occlusion, unspecified eye, with macular edema 298 No Yes H348391 Tributary (branch) retinal vein occlusion, unspecified eye, with retinal neovascularization 298 No Yes H348392 Tributary (branch) retinal vein occlusion, unspecified eye, stable 298 No Yes H4310 Vitreous hemorrhage, unspecified eye 122 298 Yes Yes H4311 Vitreous hemorrhage, right eye 122 298 Yes Yes H4312 Vitreous hemorrhage, left eye 122 298 Yes Yes H4313 Vitreous hemorrhage, bilateral 122 298 Yes Yes H353210 Exudative age-related macular degeneration, right eye, stage unspecified 124 300 Yes Yes H353211 Exudative age-related macular degeneration, right eye, with active choroidal neovascularization 124 300 Yes Yes H353212 Exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization 124 300 Yes Yes H353213 Exudative age-related macular degeneration, right eye, with inactive scar 124 300 Yes Yes H353220 Exudative age-related macular degeneration, left eye, stage unspecified 124 300 Yes Yes H353221 Exudative age-related macular degeneration, left eye, with active choroidal neovascularization 124 300 Yes Yes H353222 Exudative age-related macular degeneration, left eye, with inactive choroidal neovascularization 124 300 Yes Yes H353223 Exudative age-related macular degeneration, left eye, with inactive scar 124 300 Yes Yes H353230 Exudative age-related macular degeneration, bilateral, stage unspecified 124 300 Yes Yes H353231 Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization 124 300 Yes Yes H353232 Exudative age-related macular degeneration, bilateral, with inactive choroidal neovascularization 124 300 Yes Yes H353233 Exudative age-related macular degeneration, bilateral, with inactive scar 124 300 Yes Yes H353290 Exudative age-related macular degeneration, unspecified eye, stage unspecified 124 300 Yes Yes

H353291 Exudative age-related macular degeneration, unspecified eye, with active choroidal neovascularization 124 300 Yes Yes H353292 Exudative age-related macular degeneration, unspecified eye, with inactive choroidal neovascularization 124 300 Yes Yes H353293 Exudative age-related macular degeneration, unspecified eye, with inactive scar 124 300 Yes Yes E093511 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye 122 Yes No E093512 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye 122 Yes No E093513 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral 122 Yes No E093519 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye 122 Yes No E093521 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye 122 Yes No E093522 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye 122 Yes No E093523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral 122 Yes No E093529 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye 122 Yes No E093531 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye 122 Yes No E093532 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye 122 Yes No E093533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral 122 Yes No E093539 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye 122 Yes No E093541 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye 122 Yes No E093542 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye 122 Yes No E093543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral 122 Yes No E093549 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye 122 Yes No E093551 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye 122 Yes No E093552 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left eye 122 Yes No E093553 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral 122 Yes No E093559 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye 122 Yes No E093591 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye 122 Yes No E093592 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye 122 Yes No E093593 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral 122 Yes No E093599 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye 122 Yes No

Kidney Disease Group V24 V28 Kidney Disease Group: 5 HCCs • HCC 134 (Dialysis Status) • HCC 135 (Acute Renal Failure) • HCC 136 (Chronic Kidney Disease, Stage 5) • HCC 137 (Chronic Kidney Disease, Severe (Stage 4)) • HCC 138 (Chronic Kidney Disease, Moderate (Stage 3)) Kidney Disease Group: 4 HCCs • HCC 326 (Chronic Kidney Disease, Stage 5) • HCC 327 (Chronic Kidney Disease, Severe (Stage 4)) • HCC 328 (Chronic Kidney Disease, Moderate (Stage 3B)) • HCC 329 (Chronic Kidney Disease, Moderate (Stage 3, Except 3B))

ICD 10 Desccriptor V24 V28 V24 V28 I120 Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease 136 326 Yes Yes I1311 Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease 136 326 Yes Yes I132 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease 136 326 Yes Yes N185 Chronic kidney disease, stage 5 136 326 Yes Yes N186 End stage renal disease 136 326 Yes Yes N184 Chronic kidney disease, stage 4 (severe) 137 327 Yes Yes N1832 Chronic kidney disease, stage 3b 138 328 Yes Yes N1830 Chronic kidney disease, stage 3 unspecified 138 329 Yes Yes N1831 Chronic kidney disease, stage 3a 138 329 Yes Yes T81502A Unspecified complication of foreign body accidentally left in body following kidney dialysis, initial encounter 134 Yes No T81502D Unspecified complication of foreign body accidentally left in body following kidney dialysis, subsequent encounter 134 Yes No T81502S Unspecified complication of foreign body accidentally left in body following kidney dialysis, sequela 134 Yes No T81512A Adhesions due to foreign body accidentally left in body following kidney dialysis, initial encounter 134 Yes No T81512D Adhesions due to foreign body accidentally left in body following kidney dialysis, subsequent encounter 134 Yes No T81512S Adhesions due to foreign body accidentally left in body following kidney dialysis, sequela 134 Yes No T81522A Obstruction due to foreign body accidentally left in body following kidney dialysis, initial encounter 134 Yes No T81522D Obstruction due to foreign body accidentally left in body following kidney dialysis, subsequent encounter 134 Yes No T81522S Obstruction due to foreign body accidentally left in body following kidney dialysis, sequela 134 Yes No T81532A Perforation due to foreign body accidentally left in body following kidney dialysis, initial encounter 134 Yes No T81532D Perforation due to foreign body accidentally left in body following kidney dialysis, subsequent encounter 134 Yes No T81532S Perforation due to foreign body accidentally left in body following kidney dialysis, sequela 134 Yes No T81592A Other complications of foreign body accidentally left in body following kidney dialysis, initial encounter 134 Yes No T81592D Other complications of foreign body accidentally left in body following kidney dialysis, subsequent encounter 134 Yes No T81592S Other complications of foreign body accidentally left in body following kidney dialysis, sequela 134 Yes No T8241XA Breakdown (mechanical) of vascular dialysis catheter, initial encounter 134 Yes No T8241XD Breakdown (mechanical) of vascular dialysis catheter, subsequent encounter 134 Yes No T8241XS Breakdown (mechanical) of vascular dialysis catheter, sequela 134 Yes No T8242XA Displacement of vascular dialysis catheter, initial encounter 134 Yes No T8242XD Displacement of vascular dialysis catheter, subsequent encounter 134 Yes No T8242XS Displacement of vascular dialysis catheter, sequela 134 Yes No T8243XA Leakage of vascular dialysis catheter, initial encounter 134 Yes No T8243XD Leakage of vascular dialysis catheter, subsequent encounter 134 Yes No T8243XS Leakage of vascular dialysis catheter, sequela 134 Yes No T8249XA Other complication of vascular dialysis catheter, initial encounter 134 Yes No T8249XD Other complication of vascular dialysis catheter, subsequent encounter 134 Yes No T8249XS Other complication of vascular dialysis catheter, sequela 134 Yes No T85611A Breakdown (mechanical) of intraperitoneal dialysis catheter, initial encounter 134 Yes No T85611D Breakdown (mechanical) of intraperitoneal dialysis catheter, subsequent encounter 134 Yes No T85611S Breakdown (mechanical) of intraperitoneal dialysis catheter, sequela 134 Yes No T85621A Displacement of intraperitoneal dialysis catheter, initial encounter 134 Yes No T85621D Displacement of intraperitoneal dialysis catheter, subsequent encounter 134 Yes No T85621S Displacement of intraperitoneal dialysis catheter, sequela 134 Yes No T85631A Leakage of intraperitoneal dialysis catheter, initial encounter 134 Yes No T85631D Leakage of intraperitoneal dialysis catheter, subsequent encounter 134 Yes No T85631S Leakage of intraperitoneal dialysis catheter, sequela 134 Yes No T85691A Other mechanical complication of intraperitoneal dialysis catheter, initial encounter 134 Yes No T85691D Other mechanical complication of intraperitoneal dialysis catheter, subsequent encounter 134 Yes No T85691S Other mechanical complication of intraperitoneal dialysis catheter, sequela 134 Yes No T8571XA Infection and inflammatory reaction due to peritoneal dialysis catheter, initial encounter 134 Yes No T8571XD Infection and inflammatory reaction due to peritoneal dialysis catheter, subsequent encounter 134 Yes No T8571XS Infection and inflammatory reaction due to peritoneal dialysis catheter, sequela 134 Yes No Y622 Failure of sterile precautions during kidney dialysis and other perfusion 134 Yes No Z4901 Encounter for fitting and adjustment of extracorporeal dialysis catheter 134 Yes No Z4902 Encounter for fitting and adjustment of peritoneal dialysis catheter 134 Yes No Z4931 Encounter for adequacy testing for hemodialysis 134 Yes No Z4932 Encounter for adequacy testing for peritoneal dialysis 134 Yes No Z9115 Patient's noncompliance with renal dialysis 134 Yes No Z91A5 Caregiver's noncompliance with patient's renal dialysis 134 Yes No Z992 Dependence on renal dialysis 134 Yes No N170 Acute kidney failure with tubular necrosis 135 Yes No N171 Acute kidney failure with acute cortical necrosis 135 Yes No N172 Acute kidney failure with medullary necrosis 135 Yes No N178 Other acute kidney failure 135 Yes No N179 Acute kidney failure, unspecified 135 Yes No

Skin Disease Group V24 V28 Skin Disease Group: 5 HCCs • HCC 157 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) • HCC 158 (Pressure Ulcer of Skin with Full Thickness Skin Loss) • HCC 159 (Pressure Ulcer of Skin with Partial Thickness Skin Loss) • HCC 161 (Chronic Ulcer of Skin, Except Pressure) • HCC 162 (Severe Skin Burn or Condition) Skin Disease Group: 7 HCCs • HCC 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) • HCC 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle) • HCC 381 (Pressure Ulcer of Skin with Full Thickness Skin Loss) • HCC 382 (Pressure Ulcer of Skin with Partial Thickness Skin Loss) • HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle) • HCC 385 (Severe Skin Burn) • HCC 387 (Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders)

ICD 10 Desccriptor V24 V28 V24 V28 L89004 Pressure ulcer of unspecified elbow, stage 4 157 379 Yes Yes L89014 Pressure ulcer of right elbow, stage 4 157 379 Yes Yes L89024 Pressure ulcer of left elbow, stage 4 157 379 Yes Yes L89104 Pressure ulcer of unspecified part of back, stage 4 157 379 Yes Yes L89114 Pressure ulcer of right upper back, stage 4 157 379 Yes Yes L89124 Pressure ulcer of left upper back, stage 4 157 379 Yes Yes L89134 Pressure ulcer of right lower back, stage 4 157 379 Yes Yes L89144 Pressure ulcer of left lower back, stage 4 157 379 Yes Yes L89154 Pressure ulcer of sacral region, stage 4 157 379 Yes Yes L89204 Pressure ulcer of unspecified hip, stage 4 157 379 Yes Yes L89214 Pressure ulcer of right hip, stage 4 157 379 Yes Yes L89224 Pressure ulcer of left hip, stage 4 157 379 Yes Yes L89304 Pressure ulcer of unspecified buttock, stage 4 157 379 Yes Yes L89314 Pressure ulcer of right buttock, stage 4 157 379 Yes Yes L89324 Pressure ulcer of left buttock, stage 4 157 379 Yes Yes L8944 Pressure ulcer of contiguous site of back, buttock and hip, stage 4 157 379 Yes Yes L89504 Pressure ulcer of unspecified ankle, stage 4 157 379 Yes Yes L89514 Pressure ulcer of right ankle, stage 4 157 379 Yes Yes L89524 Pressure ulcer of left ankle, stage 4 157 379 Yes Yes L89604 Pressure ulcer of unspecified heel, stage 4 157 379 Yes Yes L89614 Pressure ulcer of right heel, stage 4 157 379 Yes Yes L89624 Pressure ulcer of left heel, stage 4 157 379 Yes Yes L89814 Pressure ulcer of head, stage 4 157 379 Yes Yes L89894 Pressure ulcer of other site, stage 4 157 379 Yes Yes L8994 Pressure ulcer of unspecified site, stage 4 157 379 Yes Yes L97103 Non-pressure chronic ulcer of unspecified thigh with necrosis of muscle 161 380 Yes Yes L97104 Non-pressure chronic ulcer of unspecified thigh with necrosis of bone 161 380 Yes Yes L97105 Non-pressure chronic ulcer of unspecified thigh with muscle involvement without evidence of necrosis 161 380 Yes Yes L97106 Non-pressure chronic ulcer of unspecified thigh with bone involvement without evidence of necrosis 161 380 Yes Yes L97113 Non-pressure chronic ulcer of right thigh with necrosis of muscle 161 380 Yes Yes L97114 Non-pressure chronic ulcer of right thigh with necrosis of bone 161 380 Yes Yes L97115 Non-pressure chronic ulcer of right thigh with muscle involvement without evidence of necrosis 161 380 Yes Yes L97116 Non-pressure chronic ulcer of right thigh with bone involvement without evidence of necrosis 161 380 Yes Yes L97123 Non-pressure chronic ulcer of left thigh with necrosis of muscle 161 380 Yes Yes L97124 Non-pressure chronic ulcer of left thigh with necrosis of bone 161 380 Yes Yes L97125 Non-pressure chronic ulcer of left thigh with muscle involvement without evidence of necrosis 161 380 Yes Yes L97126 Non-pressure chronic ulcer of left thigh with bone involvement without evidence of necrosis 161 380 Yes Yes L97203 Non-pressure chronic ulcer of unspecified calf with necrosis of muscle 161 380 Yes Yes L97204 Non-pressure chronic ulcer of unspecified calf with necrosis of bone 161 380 Yes Yes L97205 Non-pressure chronic ulcer of unspecified calf with muscle involvement without evidence of necrosis 161 380 Yes Yes L97206 Non-pressure chronic ulcer of unspecified calf with bone involvement without evidence of necrosis 161 380 Yes Yes L97213 Non-pressure chronic ulcer of right calf with necrosis of muscle 161 380 Yes Yes L97214 Non-pressure chronic ulcer of right calf with necrosis of bone 161 380 Yes Yes L97215 Non-pressure chronic ulcer of right calf with muscle involvement without evidence of necrosis 161 380 Yes Yes L97216 Non-pressure chronic ulcer of right calf with bone involvement without evidence of necrosis 161 380 Yes Yes L97223 Non-pressure chronic ulcer of left calf with necrosis of muscle 161 380 Yes Yes L97224 Non-pressure chronic ulcer of left calf with necrosis of bone 161 380 Yes Yes L97225 Non-pressure chronic ulcer of left calf with muscle involvement without evidence of necrosis 161 380 Yes Yes L97226 Non-pressure chronic ulcer of left calf with bone involvement without evidence of necrosis 161 380 Yes Yes L97303 Non-pressure chronic ulcer of unspecified ankle with necrosis of muscle 161 380 Yes Yes L97304 Non-pressure chronic ulcer of unspecified ankle with necrosis of bone 161 380 Yes Yes L97305 Non-pressure chronic ulcer of unspecified ankle with muscle involvement without evidence of necrosis 161 380 Yes Yes L97306 Non-pressure chronic ulcer of unspecified ankle with bone involvement without evidence of necrosis 161 380 Yes Yes L97313 Non-pressure chronic ulcer of right ankle with necrosis of muscle 161 380 Yes Yes L97314 Non-pressure chronic ulcer of right ankle with necrosis of bone 161 380 Yes Yes L97315 Non-pressure chronic ulcer of right ankle with muscle involvement without evidence of necrosis 161 380 Yes Yes L97316 Non-pressure chronic ulcer of right ankle with bone involvement without evidence of necrosis 161 380 Yes Yes L97323 Non-pressure chronic ulcer of left ankle with necrosis of muscle 161 380 Yes Yes L97324 Non-pressure chronic ulcer of left ankle with necrosis of bone 161 380 Yes Yes L97325 Non-pressure chronic ulcer of left ankle with muscle involvement without evidence of necrosis 161 380 Yes Yes L97326 Non-pressure chronic ulcer of left ankle with bone involvement without evidence of necrosis 161 380 Yes Yes L97403 Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of muscle 161 380 Yes Yes L97404 Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of bone 161 380 Yes Yes L97405 Non-pressure chronic ulcer of unspecified heel and midfoot with muscle involvement without evidence of necrosis 161 380 Yes Yes L97406 Non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement without evidence of necrosis 161 380 Yes Yes L97413 Non-pressure chronic ulcer of right heel and midfoot with necrosis of muscle 161 380 Yes Yes L97414 Non-pressure chronic ulcer of right heel and midfoot with necrosis of bone 161 380 Yes Yes L97415 Non-pressure chronic ulcer of right heel and midfoot with muscle involvement without evidence of necrosis 161 380 Yes Yes L97416 Non-pressure chronic ulcer of right heel and midfoot with bone involvement without evidence of necrosis 161 380 Yes Yes L97423 Non-pressure chronic ulcer of left heel and midfoot with necrosis of muscle 161 380 Yes Yes L97424 Non-pressure chronic ulcer of left heel and midfoot with necrosis of bone 161 380 Yes Yes L97425 Non-pressure chronic ulcer of left heel and midfoot with muscle involvement without evidence of necrosis 161 380 Yes Yes L97426 Non-pressure chronic ulcer of left heel and midfoot with bone involvement without evidence of necrosis 161 380 Yes Yes

L97503 Non-pressure chronic ulcer of other part of unspecified foot with necrosis of muscle 161 380 Yes Yes L97504 Non-pressure chronic ulcer of other part of unspecified foot with necrosis of bone 161 380 Yes Yes L97505 Non-pressure chronic ulcer of other part of unspecified foot with muscle involvement without evidence of necrosis 161 380 Yes Yes L97506 Non-pressure chronic ulcer of other part of unspecified foot with bone involvement without evidence of necrosis 161 380 Yes Yes L97513 Non-pressure chronic ulcer of other part of right foot with necrosis of muscle 161 380 Yes Yes L97514 Non-pressure chronic ulcer of other part of right foot with necrosis of bone 161 380 Yes Yes L97515 Non-pressure chronic ulcer of other part of right foot with muscle involvement without evidence of necrosis 161 380 Yes Yes L97516 Non-pressure chronic ulcer of other part of right foot with bone involvement without evidence of necrosis 161 380 Yes Yes L97523 Non-pressure chronic ulcer of other part of left foot with necrosis of muscle 161 380 Yes Yes L97524 Non-pressure chronic ulcer of other part of left foot with necrosis of bone 161 380 Yes Yes L97525 Non-pressure chronic ulcer of other part of left foot with muscle involvement without evidence of necrosis 161 380 Yes Yes L97526 Non-pressure chronic ulcer of other part of left foot with bone involvement without evidence of necrosis 161 380 Yes Yes L97803 Non-pressure chronic ulcer of other part of unspecified lower leg with necrosis of muscle 161 380 Yes Yes L97804 Non-pressure chronic ulcer of other part of unspecified lower leg with necrosis of bone 161 380 Yes Yes L97805 Non-pressure chronic ulcer of other part of unspecified lower leg with muscle involvement without evidence of necrosis 161 380 Yes Yes L97806 Non-pressure chronic ulcer of other part of unspecified lower leg with bone involvement without evidence of necrosis 161 380 Yes Yes L97813 Non-pressure chronic ulcer of other part of right lower leg with necrosis of muscle 161 380 Yes Yes L97814 Non-pressure chronic ulcer of other part of right lower leg with necrosis of bone 161 380 Yes Yes L97815 Non-pressure chronic ulcer of other part of right lower leg with muscle involvement without evidence of necrosis 161 380 Yes Yes L97816 Non-pressure chronic ulcer of other part of right lower leg with bone involvement without evidence of necrosis 161 380 Yes Yes L97823 Non-pressure chronic ulcer of other part of left lower leg with necrosis of muscle 161 380 Yes Yes L97824 Non-pressure chronic ulcer of other part of left lower leg with necrosis of bone 161 380 Yes Yes L97825 Non-pressure chronic ulcer of other part of left lower leg with muscle involvement without evidence of necrosis 161 380 Yes Yes L97826 Non-pressure chronic ulcer of other part of left lower leg with bone involvement without evidence of necrosis 161 380 Yes Yes L97903 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of muscle 161 380 Yes Yes L97904 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of bone 161 380 Yes Yes L97905 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with muscle involvement without evidence of necrosis 161 380 Yes Yes L97906 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with bone involvement without evidence of necrosis 161 380 Yes Yes L97913 Non-pressure chronic ulcer of unspecified part of right lower leg with necrosis of muscle 161 380 Yes Yes L97914 Non-pressure chronic ulcer of unspecified part of right lower leg with necrosis of bone 161 380 Yes Yes L97915 Non-pressure chronic ulcer of unspecified part of right lower leg with muscle involvement without evidence of necrosis 161 380 Yes Yes L97916 Non-pressure chronic ulcer of unspecified part of right lower leg with bone involvement without evidence of necrosis 161 380 Yes Yes L97923 Non-pressure chronic ulcer of unspecified part of left lower leg with necrosis of muscle 161 380 Yes Yes L97924 Non-pressure chronic ulcer of unspecified part of left lower leg with necrosis of bone 161 380 Yes Yes L97925 Non-pressure chronic ulcer of unspecified part of left lower leg with muscle involvement without evidence of necrosis 161 380 Yes Yes L97926 Non-pressure chronic ulcer of unspecified part of left lower leg with bone involvement without evidence of necrosis 161 380 Yes Yes L98413 Non-pressure chronic ulcer of buttock with necrosis of muscle 161 380 Yes Yes L98414 Non-pressure chronic ulcer of buttock with necrosis of bone 161 380 Yes Yes L98415 Non-pressure chronic ulcer of buttock with muscle involvement without evidence of necrosis 161 380 Yes Yes L98416 Non-pressure chronic ulcer of buttock with bone involvement without evidence of necrosis 161 380 Yes Yes L98423 Non-pressure chronic ulcer of back with necrosis of muscle 161 380 Yes Yes L98424 Non-pressure chronic ulcer of back with necrosis of bone 161 380 Yes Yes L98425 Non-pressure chronic ulcer of back with muscle involvement without evidence of necrosis 161 380 Yes Yes L98426 Non-pressure chronic ulcer of back with bone involvement without evidence of necrosis 161 380 Yes Yes L98493 Non-pressure chronic ulcer of skin of other sites with necrosis of muscle 161 380 Yes Yes L98494 Non-pressure chronic ulcer of skin of other sites with necrosis of bone 161 380 Yes Yes L98495 Non-pressure chronic ulcer of skin of other sites with muscle involvement without evidence of necrosis 161 380 Yes Yes L98496 Non-pressure chronic ulcer of skin of other sites with bone involvement without evidence of necrosis 161 380 Yes Yes L89000 Pressure ulcer of unspecified elbow, unstageable 158 381 Yes Yes L89003 Pressure ulcer of unspecified elbow, stage 3 158 381 Yes Yes L89010 Pressure ulcer of right elbow, unstageable 158 381 Yes Yes L89013 Pressure ulcer of right elbow, stage 3 158 381 Yes Yes L89020 Pressure ulcer of left elbow, unstageable 158 381 Yes Yes L89023 Pressure ulcer of left elbow, stage 3 158 381 Yes Yes L89100 Pressure ulcer of unspecified part of back, unstageable 158 381 Yes Yes L89103 Pressure ulcer of unspecified part of back, stage 3 158 381 Yes Yes L89110 Pressure ulcer of right upper back, unstageable 158 381 Yes Yes L89113 Pressure ulcer of right upper back, stage 3 158 381 Yes Yes L89120 Pressure ulcer of left upper back, unstageable 158 381 Yes Yes L89123 Pressure ulcer of left upper back, stage 3 158 381 Yes Yes L89130 Pressure ulcer of right lower back, unstageable 158 381 Yes Yes L89133 Pressure ulcer of right lower back, stage 3 158 381 Yes Yes L89140 Pressure ulcer of left lower back, unstageable 158 381 Yes Yes

L89143 Pressure ulcer of left lower back, stage 3 158 381 Yes Yes L89150 Pressure ulcer of sacral region, unstageable 158 381 Yes Yes L89153 Pressure ulcer of sacral region, stage 3 158 381 Yes Yes L89200 Pressure ulcer of unspecified hip, unstageable 158 381 Yes Yes L89203 Pressure ulcer of unspecified hip, stage 3 158 381 Yes Yes L89210 Pressure ulcer of right hip, unstageable 158 381 Yes Yes L89213 Pressure ulcer of right hip, stage 3 158 381 Yes Yes L89220 Pressure ulcer of left hip, unstageable 158 381 Yes Yes L89223 Pressure ulcer of left hip, stage 3 158 381 Yes Yes L89300 Pressure ulcer of unspecified buttock, unstageable 158 381 Yes Yes L89303 Pressure ulcer of unspecified buttock, stage 3 158 381 Yes Yes L89310 Pressure ulcer of right buttock, unstageable 158 381 Yes Yes L89313 Pressure ulcer of right buttock, stage 3 158 381 Yes Yes L89320 Pressure ulcer of left buttock, unstageable 158 381 Yes Yes L89323 Pressure ulcer of left buttock, stage 3 158 381 Yes Yes L8943 Pressure ulcer of contiguous site of back, buttock and hip, stage 3 158 381 Yes Yes L8945 Pressure ulcer of contiguous site of back, buttock and hip, unstageable 158 381 Yes Yes L89500 Pressure ulcer of unspecified ankle, unstageable 158 381 Yes Yes L89503 Pressure ulcer of unspecified ankle, stage 3 158 381 Yes Yes L89510 Pressure ulcer of right ankle, unstageable 158 381 Yes Yes L89513 Pressure ulcer of right ankle, stage 3 158 381 Yes Yes L89520 Pressure ulcer of left ankle, unstageable 158 381 Yes Yes L89523 Pressure ulcer of left ankle, stage 3 158 381 Yes Yes L89600 Pressure ulcer of unspecified heel, unstageable 158 381 Yes Yes L89603 Pressure ulcer of unspecified heel, stage 3 158 381 Yes Yes L89610 Pressure ulcer of right heel, unstageable 158 381 Yes Yes L89613 Pressure ulcer of right heel, stage 3 158 381 Yes Yes L89620 Pressure ulcer of left heel, unstageable 158 381 Yes Yes L89623 Pressure ulcer of left heel, stage 3 158 381 Yes Yes L89810 Pressure ulcer of head, unstageable 158 381 Yes Yes L89813 Pressure ulcer of head, stage 3 158 381 Yes Yes L89890 Pressure ulcer of other site, unstageable 158 381 Yes Yes L89893 Pressure ulcer of other site, stage 3 158 381 Yes Yes L8993 Pressure ulcer of unspecified site, stage 3 158 381 Yes Yes L8995 Pressure ulcer of unspecified site, unstageable 158 381 Yes Yes L89002 Pressure ulcer of unspecified elbow, stage 2 159 382 Yes Yes L89012 Pressure ulcer of right elbow, stage 2 159 382 Yes Yes L89022 Pressure ulcer of left elbow, stage 2 159 382 Yes Yes L89102 Pressure ulcer of unspecified part of back, stage 2 159 382 Yes Yes L89112 Pressure ulcer of right upper back, stage 2 159 382 Yes Yes L89122 Pressure ulcer of left upper back, stage 2 159 382 Yes Yes L89132 Pressure ulcer of right lower back, stage 2 159 382 Yes Yes L89142 Pressure ulcer of left lower back, stage 2 159 382 Yes Yes L89152 Pressure ulcer of sacral region, stage 2 159 382 Yes Yes L89202 Pressure ulcer of unspecified hip, stage 2 159 382 Yes Yes L89212 Pressure ulcer of right hip, stage 2 159 382 Yes Yes L89222 Pressure ulcer of left hip, stage 2 159 382 Yes Yes L89302 Pressure ulcer of unspecified buttock, stage 2 159 382 Yes Yes L89312 Pressure ulcer of right buttock, stage 2 159 382 Yes Yes L89322 Pressure ulcer of left buttock, stage 2 159 382 Yes Yes L8942 Pressure ulcer of contiguous site of back, buttock and hip, stage 2 159 382 Yes Yes L89502 Pressure ulcer of unspecified ankle, stage 2 159 382 Yes Yes L89512 Pressure ulcer of right ankle, stage 2 159 382 Yes Yes L89522 Pressure ulcer of left ankle, stage 2 159 382 Yes Yes L89602 Pressure ulcer of unspecified heel, stage 2 159 382 Yes Yes L89612 Pressure ulcer of right heel, stage 2 159 382 Yes Yes L89622 Pressure ulcer of left heel, stage 2 159 382 Yes Yes L89812 Pressure ulcer of head, stage 2 159 382 Yes Yes L89892 Pressure ulcer of other site, stage 2 159 382 Yes Yes L8992 Pressure ulcer of unspecified site, stage 2 159 382 Yes Yes E08621 Diabetes mellitus due to underlying condition with foot ulcer 161 383 Yes Yes E08622 Diabetes mellitus due to underlying condition with other skin ulcer 161 383 Yes Yes E10621 Type 1 diabetes mellitus with foot ulcer 161 383 Yes Yes E10622 Type 1 diabetes mellitus with other skin ulcer 161 383 Yes Yes E11621 Type 2 diabetes mellitus with foot ulcer 161 383 Yes Yes E11622 Type 2 diabetes mellitus with other skin ulcer 161 383 Yes Yes E13621 Other specified diabetes mellitus with foot ulcer 161 383 Yes Yes E13622 Other specified diabetes mellitus with other skin ulcer 161 383 Yes Yes I70231 Atherosclerosis of native arteries of right leg with ulceration of thigh 161 383 Yes Yes I70232 Atherosclerosis of native arteries of right leg with ulceration of calf 161 383 Yes Yes I70233 Atherosclerosis of native arteries of right leg with ulceration of ankle 161 383 Yes Yes I70234 Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot 161 383 Yes Yes I70235 Atherosclerosis of native arteries of right leg with ulceration of other part of foot 161 383 Yes Yes I70238 Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg 161 383 Yes Yes I70239 Atherosclerosis of native arteries of right leg with ulceration of unspecified site 161 383 Yes Yes I70241 Atherosclerosis of native arteries of left leg with ulceration of thigh 161 383 Yes Yes

I70242 Atherosclerosis of native arteries of left leg with ulceration of calf 161 383 Yes Yes I70243 Atherosclerosis of native arteries of left leg with ulceration of ankle 161 383 Yes Yes I70244 Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot 161 383 Yes Yes I70245 Atherosclerosis of native arteries of left leg with ulceration of other part of foot 161 383 Yes Yes I70248 Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg 161 383 Yes Yes I70249 Atherosclerosis of native arteries of left leg with ulceration of unspecified site 161 383 Yes Yes I7025 Atherosclerosis of native arteries of other extremities with ulceration 161 383 Yes Yes I70331 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of thigh 161 383 Yes Yes I70332 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of calf 161 383 Yes Yes I70333 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of ankle 161 383 Yes Yes I70334 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot 161 383 Yes Yes I70335 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of foot 161 383 Yes Yes I70338 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of lower leg 161 383 Yes Yes I70339 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of unspecified site 161 383 Yes Yes I70341 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of thigh 161 383 Yes Yes I70342 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of calf 161 383 Yes Yes I70343 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of ankle 161 383 Yes Yes I70344 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of heel and midfoot 161 383 Yes Yes I70345 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of foot 161 383 Yes Yes I70348 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of lower leg 161 383 Yes Yes I70349 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of unspecified site 161 383 Yes Yes I7035 Atherosclerosis of unspecified type of bypass graft(s) of other extremity with ulceration 161 383 Yes Yes I70431 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of thigh 161 383 Yes Yes I70432 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of calf 161 383 Yes Yes I70433 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of ankle 161 383 Yes Yes I70434 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of heel and midfoot 161 383 Yes Yes I70435 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot 161 383 Yes Yes I70438 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of lower leg 161 383 Yes Yes I70439 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of unspecified site 161 383 Yes Yes I70441 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of thigh 161 383 Yes Yes I70442 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of calf 161 383 Yes Yes I70443 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of ankle 161 383 Yes Yes I70444 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of heel and midfoot 161 383 Yes Yes I70445 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of foot 161 383 Yes Yes I70448 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of lower leg 161 383 Yes Yes I70449 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of unspecified site 161 383 Yes Yes I7045 Atherosclerosis of autologous vein bypass graft(s) of other extremity with ulceration 161 383 Yes Yes I70531 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of thigh 161 383 Yes Yes I70532 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of calf 161 383 Yes Yes I70533 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of ankle 161 383 Yes Yes I70534 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of heel and midfoot 161 383 Yes Yes I70535 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of foot 161 383 Yes Yes I70538 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of lower leg 161 383 Yes Yes I70539 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of unspecified site 161 383 Yes Yes I70541 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of thigh 161 383 Yes Yes I70542 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of calf 161 383 Yes Yes I70543 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of ankle 161 383 Yes Yes I70544 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of heel and midfoot 161 383 Yes Yes I70545 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of foot 161 383 Yes Yes I70548 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of lower leg 161 383 Yes Yes I70549 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of unspecified site 161 383 Yes Yes I7055 Atherosclerosis of nonautologous biological bypass graft(s) of other extremity with ulceration 161 383 Yes Yes I70631 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of thigh 161 383 Yes Yes I70632 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of calf 161 383 Yes Yes I70633 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of ankle 161 383 Yes Yes I70634 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of heel and midfoot 161 383 Yes Yes I70635 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of foot 161 383 Yes Yes I70638 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of lower leg 161 383 Yes Yes I70639 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of unspecified site 161 383 Yes Yes I70641 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of thigh 161 383 Yes Yes I70642 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of calf 161 383 Yes Yes I70643 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of ankle 161 383 Yes Yes I70644 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of heel and midfoot 161 383 Yes Yes I70645 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other part of foot 161 383 Yes Yes I70648 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other part of lower leg 161 383 Yes Yes I70649 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of unspecified site 161 383 Yes Yes I7065 Atherosclerosis of nonbiological bypass graft(s) of other extremity with ulceration 161 383 Yes Yes I70731 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of thigh 161 383 Yes Yes I70732 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of calf 161 383 Yes Yes I70733 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of ankle 161 383 Yes Yes I70734 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of heel and midfoot 161 383 Yes Yes I70735 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of other part of foot 161 383 Yes Yes

I70738 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of other part of lower leg 161 383 Yes Yes I70739 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of unspecified site 161 383 Yes Yes I70741 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of thigh 161 383 Yes Yes I70742 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of calf 161 383 Yes Yes I70743 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of ankle 161 383 Yes Yes I70744 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of heel and midfoot 161 383 Yes Yes I70745 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other part of foot 161 383 Yes Yes I70748 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other part of lower leg 161 383 Yes Yes I70749 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of unspecified site 161 383 Yes Yes I7075 Atherosclerosis of other type of bypass graft(s) of other extremity with ulceration 161 383 Yes Yes L97101 Non-pressure chronic ulcer of unspecified thigh limited to breakdown of skin 161 383 Yes Yes L97102 Non-pressure chronic ulcer of unspecified thigh with fat layer exposed 161 383 Yes Yes L97108 Non-pressure chronic ulcer of unspecified thigh with other specified severity 161 383 Yes Yes L97109 Non-pressure chronic ulcer of unspecified thigh with unspecified severity 161 383 Yes Yes L97111 Non-pressure chronic ulcer of right thigh limited to breakdown of skin 161 383 Yes Yes L97112 Non-pressure chronic ulcer of right thigh with fat layer exposed 161 383 Yes Yes L97118 Non-pressure chronic ulcer of right thigh with other specified severity 161 383 Yes Yes L97119 Non-pressure chronic ulcer of right thigh with unspecified severity 161 383 Yes Yes L97121 Non-pressure chronic ulcer of left thigh limited to breakdown of skin 161 383 Yes Yes L97122 Non-pressure chronic ulcer of left thigh with fat layer exposed 161 383 Yes Yes L97128 Non-pressure chronic ulcer of left thigh with other specified severity 161 383 Yes Yes L97129 Non-pressure chronic ulcer of left thigh with unspecified severity 161 383 Yes Yes L97201 Non-pressure chronic ulcer of unspecified calf limited to breakdown of skin 161 383 Yes Yes L97202 Non-pressure chronic ulcer of unspecified calf with fat layer exposed 161 383 Yes Yes L97208 Non-pressure chronic ulcer of unspecified calf with other specified severity 161 383 Yes Yes L97209 Non-pressure chronic ulcer of unspecified calf with unspecified severity 161 383 Yes Yes L97211 Non-pressure chronic ulcer of right calf limited to breakdown of skin 161 383 Yes Yes L97212 Non-pressure chronic ulcer of right calf with fat layer exposed 161 383 Yes Yes L97218 Non-pressure chronic ulcer of right calf with other specified severity 161 383 Yes Yes L97219 Non-pressure chronic ulcer of right calf with unspecified severity 161 383 Yes Yes L97221 Non-pressure chronic ulcer of left calf limited to breakdown of skin 161 383 Yes Yes L97222 Non-pressure chronic ulcer of left calf with fat layer exposed 161 383 Yes Yes L97228 Non-pressure chronic ulcer of left calf with other specified severity 161 383 Yes Yes L97229 Non-pressure chronic ulcer of left calf with unspecified severity 161 383 Yes Yes L97301 Non-pressure chronic ulcer of unspecified ankle limited to breakdown of skin 161 383 Yes Yes L97302 Non-pressure chronic ulcer of unspecified ankle with fat layer exposed 161 383 Yes Yes L97308 Non-pressure chronic ulcer of unspecified ankle with other specified severity 161 383 Yes Yes L97309 Non-pressure chronic ulcer of unspecified ankle with unspecified severity 161 383 Yes Yes L97311 Non-pressure chronic ulcer of right ankle limited to breakdown of skin 161 383 Yes Yes L97312 Non-pressure chronic ulcer of right ankle with fat layer exposed 161 383 Yes Yes L97318 Non-pressure chronic ulcer of right ankle with other specified severity 161 383 Yes Yes L97319 Non-pressure chronic ulcer of right ankle with unspecified severity 161 383 Yes Yes L97321 Non-pressure chronic ulcer of left ankle limited to breakdown of skin 161 383 Yes Yes L97322 Non-pressure chronic ulcer of left ankle with fat layer exposed 161 383 Yes Yes L97328 Non-pressure chronic ulcer of left ankle with other specified severity 161 383 Yes Yes L97329 Non-pressure chronic ulcer of left ankle with unspecified severity 161 383 Yes Yes L97401 Non-pressure chronic ulcer of unspecified heel and midfoot limited to breakdown of skin 161 383 Yes Yes L97402 Non-pressure chronic ulcer of unspecified heel and midfoot with fat layer exposed 161 383 Yes Yes L97408 Non-pressure chronic ulcer of unspecified heel and midfoot with other specified severity 161 383 Yes Yes L97409 Non-pressure chronic ulcer of unspecified heel and midfoot with unspecified severity 161 383 Yes Yes L97411 Non-pressure chronic ulcer of right heel and midfoot limited to breakdown of skin 161 383 Yes Yes L97412 Non-pressure chronic ulcer of right heel and midfoot with fat layer exposed 161 383 Yes Yes L97418 Non-pressure chronic ulcer of right heel and midfoot with other specified severity 161 383 Yes Yes L97419 Non-pressure chronic ulcer of right heel and midfoot with unspecified severity 161 383 Yes Yes L97421 Non-pressure chronic ulcer of left heel and midfoot limited to breakdown of skin 161 383 Yes Yes L97422 Non-pressure chronic ulcer of left heel and midfoot with fat layer exposed 161 383 Yes Yes L97428 Non-pressure chronic ulcer of left heel and midfoot with other specified severity 161 383 Yes Yes L97429 Non-pressure chronic ulcer of left heel and midfoot with unspecified severity 161 383 Yes Yes L97501 Non-pressure chronic ulcer of other part of unspecified foot limited to breakdown of skin 161 383 Yes Yes L97502 Non-pressure chronic ulcer of other part of unspecified foot with fat layer exposed 161 383 Yes Yes L97508 Non-pressure chronic ulcer of other part of unspecified foot with other specified severity 161 383 Yes Yes L97509 Non-pressure chronic ulcer of other part of unspecified foot with unspecified severity 161 383 Yes Yes L97511 Non-pressure chronic ulcer of other part of right foot limited to breakdown of skin 161 383 Yes Yes L97512 Non-pressure chronic ulcer of other part of right foot with fat layer exposed 161 383 Yes Yes L97518 Non-pressure chronic ulcer of other part of right foot with other specified severity 161 383 Yes Yes L97519 Non-pressure chronic ulcer of other part of right foot with unspecified severity 161 383 Yes Yes L97521 Non-pressure chronic ulcer of other part of left foot limited to breakdown of skin 161 383 Yes Yes L97522 Non-pressure chronic ulcer of other part of left foot with fat layer exposed 161 383 Yes Yes L97528 Non-pressure chronic ulcer of other part of left foot with other specified severity 161 383 Yes Yes L97529 Non-pressure chronic ulcer of other part of left foot with unspecified severity 161 383 Yes Yes L97801 Non-pressure chronic ulcer of other part of unspecified lower leg limited to breakdown of skin 161 383 Yes Yes L97802 Non-pressure chronic ulcer of other part of unspecified lower leg with fat layer exposed 161 383 Yes Yes L97808 Non-pressure chronic ulcer of other part of unspecified lower leg with other specified severity 161 383 Yes Yes L97809 Non-pressure chronic ulcer of other part of unspecified lower leg with unspecified severity 161 383 Yes Yes L97811 Non-pressure chronic ulcer of other part of right lower leg limited to breakdown of skin 161 383 Yes Yes L97812 Non-pressure chronic ulcer of other part of right lower leg with fat layer exposed 161 383 Yes Yes

L97818 Non-pressure chronic ulcer of other part of right lower leg with other specified severity 161 383 Yes Yes L97819 Non-pressure chronic ulcer of other part of right lower leg with unspecified severity 161 383 Yes Yes L97821 Non-pressure chronic ulcer of other part of left lower leg limited to breakdown of skin 161 383 Yes Yes L97822 Non-pressure chronic ulcer of other part of left lower leg with fat layer exposed 161 383 Yes Yes L97828 Non-pressure chronic ulcer of other part of left lower leg with other specified severity 161 383 Yes Yes L97829 Non-pressure chronic ulcer of other part of left lower leg with unspecified severity 161 383 Yes Yes L97901 Non-pressure chronic ulcer of unspecified part of unspecified lower leg limited to breakdown of skin 161 383 Yes Yes L97902 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with fat layer exposed 161 383 Yes Yes L97908 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with other specified severity 161 383 Yes Yes L97909 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with unspecified severity 161 383 Yes Yes L97911 Non-pressure chronic ulcer of unspecified part of right lower leg limited to breakdown of skin 161 383 Yes Yes L97912 Non-pressure chronic ulcer of unspecified part of right lower leg with fat layer exposed 161 383 Yes Yes L97918 Non-pressure chronic ulcer of unspecified part of right lower leg with other specified severity 161 383 Yes Yes L97919 Non-pressure chronic ulcer of unspecified part of right lower leg with unspecified severity 161 383 Yes Yes L97921 Non-pressure chronic ulcer of unspecified part of left lower leg limited to breakdown of skin 161 383 Yes Yes L97922 Non-pressure chronic ulcer of unspecified part of left lower leg with fat layer exposed 161 383 Yes Yes L97928 Non-pressure chronic ulcer of unspecified part of left lower leg with other specified severity 161 383 Yes Yes L97929 Non-pressure chronic ulcer of unspecified part of left lower leg with unspecified severity 161 383 Yes Yes L98411 Non-pressure chronic ulcer of buttock limited to breakdown of skin 161 383 Yes Yes L98412 Non-pressure chronic ulcer of buttock with fat layer exposed 161 383 Yes Yes L98418 Non-pressure chronic ulcer of buttock with other specified severity 161 383 Yes Yes L98419 Non-pressure chronic ulcer of buttock with unspecified severity 161 383 Yes Yes L98421 Non-pressure chronic ulcer of back limited to breakdown of skin 161 383 Yes Yes L98422 Non-pressure chronic ulcer of back with fat layer exposed 161 383 Yes Yes L98428 Non-pressure chronic ulcer of back with other specified severity 161 383 Yes Yes L98429 Non-pressure chronic ulcer of back with unspecified severity 161 383 Yes Yes L98491 Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin 161 383 Yes Yes L98492 Non-pressure chronic ulcer of skin of other sites with fat layer exposed 161 383 Yes Yes L98498 Non-pressure chronic ulcer of skin of other sites with other specified severity 161 383 Yes Yes L98499 Non-pressure chronic ulcer of skin of other sites with unspecified severity 161 383 Yes Yes I83001 Varicose veins of unspecified lower extremity with ulcer of thigh 107 383 Yes Yes I83002 Varicose veins of unspecified lower extremity with ulcer of calf 107 383 Yes Yes I83003 Varicose veins of unspecified lower extremity with ulcer of ankle 107 383 Yes Yes I83004 Varicose veins of unspecified lower extremity with ulcer of heel and midfoot 107 383 Yes Yes I83005 Varicose veins of unspecified lower extremity with ulcer other part of foot 107 383 Yes Yes I83008 Varicose veins of unspecified lower extremity with ulcer other part of lower leg 107 383 Yes Yes I83009 Varicose veins of unspecified lower extremity with ulcer of unspecified site 107 383 Yes Yes I83011 Varicose veins of right lower extremity with ulcer of thigh 107 383 Yes Yes I83012 Varicose veins of right lower extremity with ulcer of calf 107 383 Yes Yes I83013 Varicose veins of right lower extremity with ulcer of ankle 107 383 Yes Yes I83014 Varicose veins of right lower extremity with ulcer of heel and midfoot 107 383 Yes Yes I83015 Varicose veins of right lower extremity with ulcer other part of foot 107 383 Yes Yes I83018 Varicose veins of right lower extremity with ulcer other part of lower leg 107 383 Yes Yes I83019 Varicose veins of right lower extremity with ulcer of unspecified site 107 383 Yes Yes I83021 Varicose veins of left lower extremity with ulcer of thigh 107 383 Yes Yes I83022 Varicose veins of left lower extremity with ulcer of calf 107 383 Yes Yes I83023 Varicose veins of left lower extremity with ulcer of ankle 107 383 Yes Yes I83024 Varicose veins of left lower extremity with ulcer of heel and midfoot 107 383 Yes Yes I83025 Varicose veins of left lower extremity with ulcer other part of foot 107 383 Yes Yes I83028 Varicose veins of left lower extremity with ulcer other part of lower leg 107 383 Yes Yes I83029 Varicose veins of left lower extremity with ulcer of unspecified site 107 383 Yes Yes I83201 Varicose veins of unspecified lower extremity with both ulcer of thigh and inflammation 107 383 Yes Yes I83202 Varicose veins of unspecified lower extremity with both ulcer of calf and inflammation 107 383 Yes Yes I83203 Varicose veins of unspecified lower extremity with both ulcer of ankle and inflammation 107 383 Yes Yes I83204 Varicose veins of unspecified lower extremity with both ulcer of heel and midfoot and inflammation 107 383 Yes Yes I83205 Varicose veins of unspecified lower extremity with both ulcer other part of foot and inflammation 107 383 Yes Yes I83208 Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation 107 383 Yes Yes I83209 Varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation 107 383 Yes Yes I83211 Varicose veins of right lower extremity with both ulcer of thigh and inflammation 107 383 Yes Yes I83212 Varicose veins of right lower extremity with both ulcer of calf and inflammation 107 383 Yes Yes I83213 Varicose veins of right lower extremity with both ulcer of ankle and inflammation 107 383 Yes Yes I83214 Varicose veins of right lower extremity with both ulcer of heel and midfoot and inflammation 107 383 Yes Yes I83215 Varicose veins of right lower extremity with both ulcer other part of foot and inflammation 107 383 Yes Yes I83218 Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation 107 383 Yes Yes I83219 Varicose veins of right lower extremity with both ulcer of unspecified site and inflammation 107 383 Yes Yes I83221 Varicose veins of left lower extremity with both ulcer of thigh and inflammation 107 383 Yes Yes I83222 Varicose veins of left lower extremity with both ulcer of calf and inflammation 107 383 Yes Yes I83223 Varicose veins of left lower extremity with both ulcer of ankle and inflammation 107 383 Yes Yes I83224 Varicose veins of left lower extremity with both ulcer of heel and midfoot and inflammation 107 383 Yes Yes I83225 Varicose veins of left lower extremity with both ulcer other part of foot and inflammation 107 383 Yes Yes I83228 Varicose veins of left lower extremity with both ulcer of other part of lower extremity and inflammation 107 383 Yes Yes I83229 Varicose veins of left lower extremity with both ulcer of unspecified site and inflammation 107 383 Yes Yes I87011 Postthrombotic syndrome with ulcer of right lower extremity 107 383 Yes Yes I87012 Postthrombotic syndrome with ulcer of left lower extremity 107 383 Yes Yes I87013 Postthrombotic syndrome with ulcer of bilateral lower extremity 107 383 Yes Yes

I87019 Postthrombotic syndrome with ulcer of unspecified lower extremity 107 383 Yes Yes I87031 Postthrombotic syndrome with ulcer and inflammation of right lower extremity 107 383 Yes Yes I87032 Postthrombotic syndrome with ulcer and inflammation of left lower extremity 107 383 Yes Yes I87033 Postthrombotic syndrome with ulcer and inflammation of bilateral lower extremity 107 383 Yes Yes I87039 Postthrombotic syndrome with ulcer and inflammation of unspecified lower extremity 107 383 Yes Yes I87311 Chronic venous hypertension (idiopathic) with ulcer of right lower extremity 107 383 Yes Yes I87312 Chronic venous hypertension (idiopathic) with ulcer of left lower extremity 107 383 Yes Yes I87313 Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity 107 383 Yes Yes I87319 Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity 107 383 Yes Yes I87331 Chronic venous hypertension (idiopathic) with ulcer and inflammation of right lower extremity 107 383 Yes Yes I87332 Chronic venous hypertension (idiopathic) with ulcer and inflammation of left lower extremity 107 383 Yes Yes I87333 Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity 107 383 Yes Yes I87339 Chronic venous hypertension (idiopathic) with ulcer and inflammation of unspecified lower extremity 107 383 Yes Yes T3111 Burns involving 10-19% of body surface with 10-19% third degree burns 162 385 Yes Yes T3121 Burns involving 20-29% of body surface with 10-19% third degree burns 162 385 Yes Yes T3122 Burns involving 20-29% of body surface with 20-29% third degree burns 162 385 Yes Yes T3131 Burns involving 30-39% of body surface with 10-19% third degree burns 162 385 Yes Yes T3132 Burns involving 30-39% of body surface with 20-29% third degree burns 162 385 Yes Yes T3133 Burns involving 30-39% of body surface with 30-39% third degree burns 162 385 Yes Yes T3141 Burns involving 40-49% of body surface with 10-19% third degree burns 162 385 Yes Yes T3142 Burns involving 40-49% of body surface with 20-29% third degree burns 162 385 Yes Yes T3143 Burns involving 40-49% of body surface with 30-39% third degree burns 162 385 Yes Yes T3144 Burns involving 40-49% of body surface with 40-49% third degree burns 162 385 Yes Yes T3151 Burns involving 50-59% of body surface with 10-19% third degree burns 162 385 Yes Yes T3152 Burns involving 50-59% of body surface with 20-29% third degree burns 162 385 Yes Yes T3153 Burns involving 50-59% of body surface with 30-39% third degree burns 162 385 Yes Yes T3154 Burns involving 50-59% of body surface with 40-49% third degree burns 162 385 Yes Yes T3155 Burns involving 50-59% of body surface with 50-59% third degree burns 162 385 Yes Yes T3161 Burns involving 60-69% of body surface with 10-19% third degree burns 162 385 Yes Yes T3162 Burns involving 60-69% of body surface with 20-29% third degree burns 162 385 Yes Yes T3163 Burns involving 60-69% of body surface with 30-39% third degree burns 162 385 Yes Yes T3164 Burns involving 60-69% of body surface with 40-49% third degree burns 162 385 Yes Yes T3165 Burns involving 60-69% of body surface with 50-59% third degree burns 162 385 Yes Yes T3166 Burns involving 60-69% of body surface with 60-69% third degree burns 162 385 Yes Yes T3171 Burns involving 70-79% of body surface with 10-19% third degree burns 162 385 Yes Yes T3172 Burns involving 70-79% of body surface with 20-29% third degree burns 162 385 Yes Yes T3173 Burns involving 70-79% of body surface with 30-39% third degree burns 162 385 Yes Yes T3174 Burns involving 70-79% of body surface with 40-49% third degree burns 162 385 Yes Yes T3175 Burns involving 70-79% of body surface with 50-59% third degree burns 162 385 Yes Yes T3176 Burns involving 70-79% of body surface with 60-69% third degree burns 162 385 Yes Yes T3177 Burns involving 70-79% of body surface with 70-79% third degree burns 162 385 Yes Yes T3181 Burns involving 80-89% of body surface with 10-19% third degree burns 162 385 Yes Yes T3182 Burns involving 80-89% of body surface with 20-29% third degree burns 162 385 Yes Yes T3183 Burns involving 80-89% of body surface with 30-39% third degree burns 162 385 Yes Yes T3184 Burns involving 80-89% of body surface with 40-49% third degree burns 162 385 Yes Yes T3185 Burns involving 80-89% of body surface with 50-59% third degree burns 162 385 Yes Yes T3186 Burns involving 80-89% of body surface with 60-69% third degree burns 162 385 Yes Yes T3187 Burns involving 80-89% of body surface with 70-79% third degree burns 162 385 Yes Yes T3188 Burns involving 80-89% of body surface with 80-89% third degree burns 162 385 Yes Yes T3191 Burns involving 90% or more of body surface with 10-19% third degree burns 162 385 Yes Yes T3192 Burns involving 90% or more of body surface with 20-29% third degree burns 162 385 Yes Yes T3193 Burns involving 90% or more of body surface with 30-39% third degree burns 162 385 Yes Yes T3194 Burns involving 90% or more of body surface with 40-49% third degree burns 162 385 Yes Yes T3195 Burns involving 90% or more of body surface with 50-59% third degree burns 162 385 Yes Yes T3196 Burns involving 90% or more of body surface with 60-69% third degree burns 162 385 Yes Yes T3197 Burns involving 90% or more of body surface with 70-79% third degree burns 162 385 Yes Yes T3198 Burns involving 90% or more of body surface with 80-89% third degree burns 162 385 Yes Yes T3199 Burns involving 90% or more of body surface with 90% or more third degree burns 162 385 Yes Yes T3211 Corrosions involving 10-19% of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3221 Corrosions involving 20-29% of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3222 Corrosions involving 20-29% of body surface with 20-29% third degree corrosion 162 385 Yes Yes T3231 Corrosions involving 30-39% of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3232 Corrosions involving 30-39% of body surface with 20-29% third degree corrosion 162 385 Yes Yes T3233 Corrosions involving 30-39% of body surface with 30-39% third degree corrosion 162 385 Yes Yes T3241 Corrosions involving 40-49% of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3242 Corrosions involving 40-49% of body surface with 20-29% third degree corrosion 162 385 Yes Yes T3243 Corrosions involving 40-49% of body surface with 30-39% third degree corrosion 162 385 Yes Yes T3244 Corrosions involving 40-49% of body surface with 40-49% third degree corrosion 162 385 Yes Yes T3251 Corrosions involving 50-59% of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3252 Corrosions involving 50-59% of body surface with 20-29% third degree corrosion 162 385 Yes Yes T3253 Corrosions involving 50-59% of body surface with 30-39% third degree corrosion 162 385 Yes Yes T3254 Corrosions involving 50-59% of body surface with 40-49% third degree corrosion 162 385 Yes Yes T3255 Corrosions involving 50-59% of body surface with 50-59% third degree corrosion 162 385 Yes Yes T3261 Corrosions involving 60-69% of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3262 Corrosions involving 60-69% of body surface with 20-29% third degree corrosion 162 385 Yes Yes T3263 Corrosions involving 60-69% of body surface with 30-39% third degree corrosion 162 385 Yes Yes

T3264 Corrosions involving 60-69% of body surface with 40-49% third degree corrosion 162 385 Yes Yes T3265 Corrosions involving 60-69% of body surface with 50-59% third degree corrosion 162 385 Yes Yes T3266 Corrosions involving 60-69% of body surface with 60-69% third degree corrosion 162 385 Yes Yes T3271 Corrosions involving 70-79% of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3272 Corrosions involving 70-79% of body surface with 20-29% third degree corrosion 162 385 Yes Yes T3273 Corrosions involving 70-79% of body surface with 30-39% third degree corrosion 162 385 Yes Yes T3274 Corrosions involving 70-79% of body surface with 40-49% third degree corrosion 162 385 Yes Yes T3275 Corrosions involving 70-79% of body surface with 50-59% third degree corrosion 162 385 Yes Yes T3276 Corrosions involving 70-79% of body surface with 60-69% third degree corrosion 162 385 Yes Yes T3277 Corrosions involving 70-79% of body surface with 70-79% third degree corrosion 162 385 Yes Yes T3281 Corrosions involving 80-89% of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3282 Corrosions involving 80-89% of body surface with 20-29% third degree corrosion 162 385 Yes Yes T3283 Corrosions involving 80-89% of body surface with 30-39% third degree corrosion 162 385 Yes Yes T3284 Corrosions involving 80-89% of body surface with 40-49% third degree corrosion 162 385 Yes Yes T3285 Corrosions involving 80-89% of body surface with 50-59% third degree corrosion 162 385 Yes Yes T3286 Corrosions involving 80-89% of body surface with 60-69% third degree corrosion 162 385 Yes Yes T3287 Corrosions involving 80-89% of body surface with 70-79% third degree corrosion 162 385 Yes Yes T3288 Corrosions involving 80-89% of body surface with 80-89% third degree corrosion 162 385 Yes Yes T3291 Corrosions involving 90% or more of body surface with 10-19% third degree corrosion 162 385 Yes Yes T3292 Corrosions involving 90% or more of body surface with 20-29% third degree corrosion 162 385 Yes Yes T3293 Corrosions involving 90% or more of body surface with 30-39% third degree corrosion 162 385 Yes Yes T3294 Corrosions involving 90% or more of body surface with 40-49% third degree corrosion 162 385 Yes Yes T3295 Corrosions involving 90% or more of body surface with 50-59% third degree corrosion 162 385 Yes Yes T3296 Corrosions involving 90% or more of body surface with 60-69% third degree corrosion 162 385 Yes Yes T3297 Corrosions involving 90% or more of body surface with 70-79% third degree corrosion 162 385 Yes Yes T3298 Corrosions involving 90% or more of body surface with 80-89% third degree corrosion 162 385 Yes Yes T3299 Corrosions involving 90% or more of body surface with 90% or more third degree corrosion 162 385 Yes Yes D863 Sarcoidosis of skin 387 No Yes L100 Pemphigus vulgaris 387 No Yes L101 Pemphigus vegetans 387 No Yes L102 Pemphigus foliaceous 387 No Yes L103 Brazilian pemphigus [fogo selvagem] 387 No Yes L104 Pemphigus erythematosus 387 No Yes L1081 Paraneoplastic pemphigus 387 No Yes L1089 Other pemphigus 387 No Yes L109 Pemphigus, unspecified 387 No Yes L120 Bullous pemphigoid 387 No Yes L121 Cicatricial pemphigoid 387 No Yes L128 Other pemphigoid 387 No Yes L129 Pemphigoid, unspecified 387 No Yes L88 Pyoderma gangrenosum 387 No Yes E09621 Drug or chemical induced diabetes mellitus with foot ulcer 161 Yes No E09622 Drug or chemical induced diabetes mellitus with other skin ulcer 161 Yes No L1230 Acquired epidermolysis bullosa, unspecified 162 Yes No L1231 Epidermolysis bullosa due to drug 162 Yes No L1235 Other acquired epidermolysis bullosa 162 Yes No L511 Stevens-Johnson syndrome 162 Yes No L512 Toxic epidermal necrolysis [Lyell] 162 Yes No L513 Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome 162 Yes No