2024 CMS HCC Changes Desk Reference

M87134 Osteonecrosis due to drugs of right ulna 39 Yes No M87135 Osteonecrosis due to drugs of left ulna 39 Yes No M87136 Osteonecrosis due to drugs of unspecified ulna 39 Yes No M87137 Osteonecrosis due to drugs of right carpus 39 Yes No M87138 Osteonecrosis due to drugs of left carpus 39 Yes No M87139 Osteonecrosis due to drugs of unspecified carpus 39 Yes No M87141 Osteonecrosis due to drugs, right hand 39 Yes No M87142 Osteonecrosis due to drugs, left hand 39 Yes No M87143 Osteonecrosis due to drugs, unspecified hand 39 Yes No M87144 Osteonecrosis due to drugs, right finger(s) 39 Yes No M87145 Osteonecrosis due to drugs, left finger(s) 39 Yes No M87146 Osteonecrosis due to drugs, unspecified finger(s) 39 Yes No M87150 Osteonecrosis due to drugs, pelvis 39 Yes No M87151 Osteonecrosis due to drugs, right femur 39 Yes No M87152 Osteonecrosis due to drugs, left femur 39 Yes No M87159 Osteonecrosis due to drugs, unspecified femur 39 Yes No M87161 Osteonecrosis due to drugs, right tibia 39 Yes No M87162 Osteonecrosis due to drugs, left tibia 39 Yes No M87163 Osteonecrosis due to drugs, unspecified tibia 39 Yes No M87164 Osteonecrosis due to drugs, right fibula 39 Yes No M87165 Osteonecrosis due to drugs, left fibula 39 Yes No M87166 Osteonecrosis due to drugs, unspecified fibula 39 Yes No M87171 Osteonecrosis due to drugs, right ankle 39 Yes No M87172 Osteonecrosis due to drugs, left ankle 39 Yes No M87173 Osteonecrosis due to drugs, unspecified ankle 39 Yes No M87174 Osteonecrosis due to drugs, right foot 39 Yes No M87175 Osteonecrosis due to drugs, left foot 39 Yes No M87176 Osteonecrosis due to drugs, unspecified foot 39 Yes No M87177 Osteonecrosis due to drugs, right toe(s) 39 Yes No M87178 Osteonecrosis due to drugs, left toe(s) 39 Yes No M87179 Osteonecrosis due to drugs, unspecified toe(s) 39 Yes No M87180 Osteonecrosis due to drugs, jaw 39 Yes No M87188 Osteonecrosis due to drugs, other site 39 Yes No M8719 Osteonecrosis due to drugs, multiple sites 39 Yes No M320 Drug-induced systemic lupus erythematosus 40 Yes No M342 Systemic sclerosis induced by drug and chemical 40 Yes No M3500 Sjogren syndrome, unspecified 40 Yes No M3501 Sjogren syndrome with keratoconjunctivitis 40 Yes No M3503 Sjogren syndrome with myopathy 40 Yes No M3504 Sjogren syndrome with tubulo-interstitial nephropathy 40 Yes No M3505 Sjogren syndrome with inflammatory arthritis 40 Yes No M3506 Sjogren syndrome with peripheral nervous system involvement 40 Yes No M3507 Sjogren syndrome with central nervous system involvement 40 Yes No M3508 Sjogren syndrome with gastrointestinal involvement 40 Yes No M3509 Sjogren syndrome with other organ involvement 40 Yes No M350A Sjogren syndrome with glomerular disease 40 Yes No M350B Sjogren syndrome with vasculitis 40 Yes No M350C Sjogren syndrome with dental involvement 40 Yes No M351 Other overlap syndromes 40 Yes No M353 Polymyalgia rheumatica 40 Yes No M355 Multifocal fibrosclerosis 40 Yes No M3589 Other specified systemic involvement of connective tissue 40 Yes No M359 Systemic involvement of connective tissue, unspecified 40 Yes No M368 Systemic disorders of connective tissue in other diseases classified elsewhere 40 Yes No M4600 Spinal enthesopathy, site unspecified 40 Yes No M4601 Spinal enthesopathy, occipito-atlanto-axial region 40 Yes No M4602 Spinal enthesopathy, cervical region 40 Yes No M4603 Spinal enthesopathy, cervicothoracic region 40 Yes No

M4604 Spinal enthesopathy, thoracic region 40 Yes No M4605 Spinal enthesopathy, thoracolumbar region 40 Yes No M4606 Spinal enthesopathy, lumbar region 40 Yes No M4607 Spinal enthesopathy, lumbosacral region 40 Yes No M4608 Spinal enthesopathy, sacral and sacrococcygeal region 40 Yes No M4609 Spinal enthesopathy, multiple sites in spine 40 Yes No M461 Sacroiliitis, not elsewhere classified 40 Yes No M4650 Other infective spondylopathies, site unspecified 40 Yes No M4651 Other infective spondylopathies, occipito-atlanto-axial region 40 Yes No M4652 Other infective spondylopathies, cervical region 40 Yes No M4653 Other infective spondylopathies, cervicothoracic region 40 Yes No M4654 Other infective spondylopathies, thoracic region 40 Yes No M4655 Other infective spondylopathies, thoracolumbar region 40 Yes No M4656 Other infective spondylopathies, lumbar region 40 Yes No M4657 Other infective spondylopathies, lumbosacral region 40 Yes No M4658 Other infective spondylopathies, sacral and sacrococcygeal region 40 Yes No M4659 Other infective spondylopathies, multiple sites in spine 40 Yes No M4680 Other specified inflammatory spondylopathies, site unspecified 40 Yes No M4681 Other specified inflammatory spondylopathies, occipito-atlanto-axial region 40 Yes No M4682 Other specified inflammatory spondylopathies, cervical region 40 Yes No M4683 Other specified inflammatory spondylopathies, cervicothoracic region 40 Yes No M4684 Other specified inflammatory spondylopathies, thoracic region 40 Yes No M4685 Other specified inflammatory spondylopathies, thoracolumbar region 40 Yes No M4686 Other specified inflammatory spondylopathies, lumbar region 40 Yes No M4687 Other specified inflammatory spondylopathies, lumbosacral region 40 Yes No M4688 Other specified inflammatory spondylopathies, sacral and sacrococcygeal region 40 Yes No M4689 Other specified inflammatory spondylopathies, multiple sites in spine 40 Yes No M4690 Unspecified inflammatory spondylopathy, site unspecified 40 Yes No M4691 Unspecified inflammatory spondylopathy, occipito-atlanto-axial region 40 Yes No M4692 Unspecified inflammatory spondylopathy, cervical region 40 Yes No M4693 Unspecified inflammatory spondylopathy, cervicothoracic region 40 Yes No M4694 Unspecified inflammatory spondylopathy, thoracic region 40 Yes No M4695 Unspecified inflammatory spondylopathy, thoracolumbar region 40 Yes No M4696 Unspecified inflammatory spondylopathy, lumbar region 40 Yes No M4697 Unspecified inflammatory spondylopathy, lumbosacral region 40 Yes No M4698 Unspecified inflammatory spondylopathy, sacral and sacrococcygeal region 40 Yes No M4699 Unspecified inflammatory spondylopathy, multiple sites in spine 40 Yes No M4980 Spondylopathy in diseases classified elsewhere, site unspecified 40 Yes No M4981 Spondylopathy in diseases classified elsewhere, occipito-atlanto-axial region 40 Yes No M4982 Spondylopathy in diseases classified elsewhere, cervical region 40 Yes No M4983 Spondylopathy in diseases classified elsewhere, cervicothoracic region 40 Yes No M4984 Spondylopathy in diseases classified elsewhere, thoracic region 40 Yes No M4985 Spondylopathy in diseases classified elsewhere, thoracolumbar region 40 Yes No M4986 Spondylopathy in diseases classified elsewhere, lumbar region 40 Yes No M4987 Spondylopathy in diseases classified elsewhere, lumbosacral region 40 Yes No M4988 Spondylopathy in diseases classified elsewhere, sacral and sacrococcygeal region 40 Yes No M4989 Spondylopathy in diseases classified elsewhere, multiple sites in spine 40 Yes No D590 Drug-induced autoimmune hemolytic anemia 46 Yes No D592 Drug-induced nonautoimmune hemolytic anemia 46 Yes No D601 Transient acquired pure red cell aplasia 46 Yes No D611 Drug-induced aplastic anemia 46 Yes No D619 Aplastic anemia, unspecified 46 Yes No D61810 Antineoplastic chemotherapy induced pancytopenia 47 Yes No D61811 Other drug-induced pancytopenia 47 Yes No D701 Agranulocytosis secondary to cancer chemotherapy 47 Yes No D702 Other drug-induced agranulocytosis 47 Yes No D703 Neutropenia due to infection 47 Yes No D708 Other neutropenia 47 Yes No

D709 Neutropenia, unspecified 47 Yes No D762 Hemophagocytic syndrome, infection-associated 47 Yes No D801 Nonfamilial hypogammaglobulinemia 47 Yes No D806 Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia 47 Yes No D807 Transient hypogammaglobulinemia of infancy 47 Yes No D808 Other immunodeficiencies with predominantly antibody defects 47 Yes No D809 Immunodeficiency with predominantly antibody defects, unspecified 47 Yes No D822 Immunodeficiency with short-limbed stature 47 Yes No D823 Immunodeficiency following hereditary defective response to Epstein-Barr virus 47 Yes No D824 Hyperimmunoglobulin E [IgE] syndrome 47 Yes No D828 Immunodeficiency associated with other specified major defects 47 Yes No D829 Immunodeficiency associated with major defect, unspecified 47 Yes No D840 Lymphocyte function antigen-1 [LFA-1] defect 47 Yes No D8481 Immunodeficiency due to conditions classified elsewhere 47 Yes No D84821 Immunodeficiency due to drugs 47 Yes No D84822 Immunodeficiency due to external causes 47 Yes No D8489 Other immunodeficiencies 47 Yes No D849 Immunodeficiency, unspecified 47 Yes No D893 Immune reconstitution syndrome 47 Yes No D8940 Mast cell activation, unspecified 47 Yes No D8941 Monoclonal mast cell activation syndrome 47 Yes No D8942 Idiopathic mast cell activation syndrome 47 Yes No D8943 Secondary mast cell activation 47 Yes No D8944 Hereditary alpha tryptasemia 47 Yes No D8949 Other mast cell activation disorder 47 Yes No D8982 Autoimmune lymphoproliferative syndrome [ALPS] 47 Yes No D8989 Other specified disorders involving the immune mechanism, not elsewhere classified 47 Yes No D899 Disorder involving the immune mechanism, unspecified 47 Yes No D550 Anemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency 48 Yes No D551 Anemia due to other disorders of glutathione metabolism 48 Yes No D5521 Anemia due to pyruvate kinase deficiency 48 Yes No D5529 Anemia due to other disorders of glycolytic enzymes 48 Yes No D553 Anemia due to disorders of nucleotide metabolism 48 Yes No D558 Other anemias due to enzyme disorders 48 Yes No D559 Anemia due to enzyme disorder, unspecified 48 Yes No D560 Alpha thalassemia 48 Yes No D564 Hereditary persistence of fetal hemoglobin [HPFH] 48 Yes No D568 Other thalassemias 48 Yes No D573 Sickle-cell trait 48 Yes No D580 Hereditary spherocytosis 48 Yes No D581 Hereditary elliptocytosis 48 Yes No D582 Other hemoglobinopathies 48 Yes No D588 Other specified hereditary hemolytic anemias 48 Yes No D589 Hereditary hemolytic anemia, unspecified 48 Yes No D642 Secondary sideroblastic anemia due to drugs and toxins 48 Yes No D65 Disseminated intravascular coagulation [defibrination syndrome] 48 Yes No D68312 Antiphospholipid antibody with hemorrhagic disorder 48 Yes No D68318 Other hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors 48 Yes No D6832 Hemorrhagic disorder due to extrinsic circulating anticoagulants 48 Yes No D684 Acquired coagulation factor deficiency 48 Yes No D6851 Activated protein C resistance 48 Yes No D6852 Prothrombin gene mutation 48 Yes No D6859 Other primary thrombophilia 48 Yes No D6861 Antiphospholipid syndrome 48 Yes No D6862 Lupus anticoagulant syndrome 48 Yes No D6869 Other thrombophilia 48 Yes No D688 Other specified coagulation defects 48 Yes No D689 Coagulation defect, unspecified 48 Yes No

D690 Allergic purpura 48 Yes No D692 Other nonthrombocytopenic purpura 48 Yes No D696 Thrombocytopenia, unspecified 48 Yes No D698 Other specified hemorrhagic conditions 48 Yes No D699 Hemorrhagic condition, unspecified 48 Yes No D7582 Heparin induced thrombocytopenia (HIT) 48 Yes No D75821 Non-immune heparin-induced thrombocytopenia 48 Yes No D75822 Immune-mediated heparin-induced thrombocytopenia 48 Yes No D75828 Other heparin-induced thrombocytopenia syndrome 48 Yes No D75829 Heparin-induced thrombocytopenia, unspecified 48 Yes No E7500 GM2 gangliosidosis, unspecified 52 Yes No E7501 Sandhoff disease 52 Yes No E7502 Tay-Sachs disease 52 Yes No E7509 Other GM2 gangliosidosis 52 Yes No E7510 Unspecified gangliosidosis 52 Yes No E7511 Mucolipidosis IV 52 Yes No E7519 Other gangliosidosis 52 Yes No E7523 Krabbe disease 52 Yes No E7525 Metachromatic leukodystrophy 52 Yes No E7526 Sulfatase deficiency 52 Yes No E7529 Other sphingolipidosis 52 Yes No E754 Neuronal ceroid lipofuscinosis 52 Yes No F04 Amnestic disorder due to known physiological condition 52 Yes No G132 Systemic atrophy primarily affecting the central nervous system in myxedema 52 Yes No G138 Systemic atrophy primarily affecting central nervous system in other diseases classified elsewhere 52 Yes No G311 Senile degeneration of brain, not elsewhere classified 52 Yes No G312 Degeneration of nervous system due to alcohol 52 Yes No G3185 Corticobasal degeneration 52 Yes No G3189 Other specified degenerative diseases of nervous system 52 Yes No G319 Degenerative disease of nervous system, unspecified 52 Yes No F10120 Alcohol abuse with intoxication, uncomplicated 55 Yes No F10121 Alcohol abuse with intoxication delirium 55 Yes No F10129 Alcohol abuse with intoxication, unspecified 55 Yes No F1019 Alcohol abuse with unspecified alcohol-induced disorder 55 Yes No F10920 Alcohol use, unspecified with intoxication, uncomplicated 55 Yes No F10921 Alcohol use, unspecified with intoxication delirium 55 Yes No F10929 Alcohol use, unspecified with intoxication, unspecified 55 Yes No F1099 Alcohol use, unspecified with unspecified alcohol-induced disorder 55 Yes No F12120 Cannabis abuse with intoxication, uncomplicated 55 Yes No F12121 Cannabis abuse with intoxication delirium 55 Yes No F12122 Cannabis abuse with intoxication with perceptual disturbance 55 Yes No F12129 Cannabis abuse with intoxication, unspecified 55 Yes No F1219 Cannabis abuse with unspecified cannabis-induced disorder 55 Yes No F12920 Cannabis use, unspecified with intoxication, uncomplicated 55 Yes No F12921 Cannabis use, unspecified with intoxication delirium 55 Yes No F12922 Cannabis use, unspecified with intoxication with perceptual disturbance 55 Yes No F12929 Cannabis use, unspecified with intoxication, unspecified 55 Yes No F1299 Cannabis use, unspecified with unspecified cannabis-induced disorder 55 Yes No T510X1A Toxic effect of ethanol, accidental (unintentional), initial encounter 55 Yes No T510X4A Toxic effect of ethanol, undetermined, initial encounter 55 Yes No F304 Manic episode in full remission 59 Yes No F3170 Bipolar disorder, currently in remission, most recent episode unspecified 59 Yes No F3172 Bipolar disorder, in full remission, most recent episode hypomanic 59 Yes No F3174 Bipolar disorder, in full remission, most recent episode manic 59 Yes No F3176 Bipolar disorder, in full remission, most recent episode depressed 59 Yes No F3178 Bipolar disorder, in full remission, most recent episode mixed 59 Yes No F320 Major depressive disorder, single episode, mild 59 Yes No F324 Major depressive disorder, single episode, in partial remission 59 Yes No

F325 Major depressive disorder, single episode, in full remission 59 Yes No F330 Major depressive disorder, recurrent, mild 59 Yes No F3340 Major depressive disorder, recurrent, in remission, unspecified 59 Yes No F3341 Major depressive disorder, recurrent, in partial remission 59 Yes No F3342 Major depressive disorder, recurrent, in full remission 59 Yes No F338 Other recurrent depressive disorders 59 Yes No F339 Major depressive disorder, recurrent, unspecified 59 Yes No F3481 Disruptive mood dysregulation disorder 59 Yes No F3489 Other specified persistent mood disorders 59 Yes No F349 Persistent mood [affective] disorder, unspecified 59 Yes No F39 Unspecified mood [affective] disorder 59 Yes No T1491XD Suicide attempt, subsequent encounter 59 Yes No T1491XS Suicide attempt, sequela 59 Yes No T360X2S Poisoning by penicillins, intentional self-harm, sequela 59 Yes No T361X2S Poisoning by cephalosporins and other beta-lactam antibiotics, intentional self-harm, sequela 59 Yes No T362X2S Poisoning by chloramphenicol group, intentional self-harm, sequela 59 Yes No T363X2S Poisoning by macrolides, intentional self-harm, sequela 59 Yes No T364X2S Poisoning by tetracyclines, intentional self-harm, sequela 59 Yes No T365X2S Poisoning by aminoglycosides, intentional self-harm, sequela 59 Yes No T366X2S Poisoning by rifampicins, intentional self-harm, sequela 59 Yes No T367X2S Poisoning by antifungal antibiotics, systemically used, intentional self-harm, sequela 59 Yes No T368X2S Poisoning by other systemic antibiotics, intentional self-harm, sequela 59 Yes No T3692XS Poisoning by unspecified systemic antibiotic, intentional self-harm, sequela 59 Yes No T370X2S Poisoning by sulfonamides, intentional self-harm, sequela 59 Yes No T371X2S Poisoning by antimycobacterial drugs, intentional self-harm, sequela 59 Yes No T372X2S Poisoning by antimalarials and drugs acting on other blood protozoa, intentional self-harm, sequela 59 Yes No T373X2S Poisoning by other antiprotozoal drugs, intentional self-harm, sequela 59 Yes No T374X2S Poisoning by anthelminthics, intentional self-harm, sequela 59 Yes No T375X2S Poisoning by antiviral drugs, intentional self-harm, sequela 59 Yes No T378X2S Poisoning by other specified systemic anti-infectives and antiparasitics, intentional self-harm, sequela 59 Yes No T3792XS Poisoning by unspecified systemic anti-infective and antiparasitics, intentional self-harm, sequela 59 Yes No T380X2S Poisoning by glucocorticoids and synthetic analogues, intentional self-harm, sequela 59 Yes No T381X2S Poisoning by thyroid hormones and substitutes, intentional self-harm, sequela 59 Yes No T382X2S Poisoning by antithyroid drugs, intentional self-harm, sequela 59 Yes No T383X2S Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, intentional self-harm, sequela 59 Yes No T384X2S Poisoning by oral contraceptives, intentional self-harm, sequela 59 Yes No T385X2S Poisoning by other estrogens and progestogens, intentional self-harm, sequela 59 Yes No T386X2S Poisoning by antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, intentional self-harm, 59 Yes No T387X2S Poisoning by androgens and anabolic congeners, intentional self-harm, sequela 59 Yes No T38802S Poisoning by unspecified hormones and synthetic substitutes, intentional self-harm, sequela 59 Yes No T38812S Poisoning by anterior pituitary [adenohypophyseal] hormones, intentional self-harm, sequela 59 Yes No T38892S Poisoning by other hormones and synthetic substitutes, intentional self-harm, sequela 59 Yes No T38902S Poisoning by unspecified hormone antagonists, intentional self-harm, sequela 59 Yes No T38992S Poisoning by other hormone antagonists, intentional self-harm, sequela 59 Yes No T39012S Poisoning by aspirin, intentional self-harm, sequela 59 Yes No T39092S Poisoning by salicylates, intentional self-harm, sequela 59 Yes No T391X2S Poisoning by 4-Aminophenol derivatives, intentional self-harm, sequela 59 Yes No T392X2S Poisoning by pyrazolone derivatives, intentional self-harm, sequela 59 Yes No T39312S Poisoning by propionic acid derivatives, intentional self-harm, sequela 59 Yes No T39392S Poisoning by other nonsteroidal anti-inflammatory drugs [NSAID], intentional self-harm, sequela 59 Yes No T394X2S Poisoning by antirheumatics, not elsewhere classified, intentional self-harm, sequela 59 Yes No T398X2S Poisoning by other nonopioid analgesics and antipyretics, not elsewhere classified, intentional self-harm, sequela 59 Yes No T3992XS Poisoning by unspecified nonopioid analgesic, antipyretic and antirheumatic, intentional self-harm, sequela 59 Yes No T400X2S Poisoning by opium, intentional self-harm, sequela 59 Yes No T401X2S Poisoning by heroin, intentional self-harm, sequela 59 Yes No T402X2S Poisoning by other opioids, intentional self-harm, sequela 59 Yes No T403X2S Poisoning by methadone, intentional self-harm, sequela 59 Yes No T40412S Poisoning by fentanyl or fentanyl analogs, intentional self-harm, sequela 59 Yes No

T40422S Poisoning by tramadol, intentional self-harm, sequela 59 Yes No T40492S Poisoning by other synthetic narcotics, intentional self-harm, sequela 59 Yes No T405X2S Poisoning by cocaine, intentional self-harm, sequela 59 Yes No T40602S Poisoning by unspecified narcotics, intentional self-harm, sequela 59 Yes No T40692S Poisoning by other narcotics, intentional self-harm, sequela 59 Yes No T40712S Poisoning by cannabis, intentional self-harm, sequela 59 Yes No T40722S Poisoning by synthetic cannabinoids, intentional self-harm, sequela 59 Yes No T408X2S Poisoning by lysergide [LSD], intentional self-harm, sequela 59 Yes No T40902S Poisoning by unspecified psychodysleptics [hallucinogens], intentional self-harm, sequela 59 Yes No T40992S Poisoning by other psychodysleptics [hallucinogens], intentional self-harm, sequela 59 Yes No T410X2S Poisoning by inhaled anesthetics, intentional self-harm, sequela 59 Yes No T411X2S Poisoning by intravenous anesthetics, intentional self-harm, sequela 59 Yes No T41202S Poisoning by unspecified general anesthetics, intentional self-harm, sequela 59 Yes No T41292S Poisoning by other general anesthetics, intentional self-harm, sequela 59 Yes No T413X2S Poisoning by local anesthetics, intentional self-harm, sequela 59 Yes No T4142XS Poisoning by unspecified anesthetic, intentional self-harm, sequela 59 Yes No T415X2S Poisoning by therapeutic gases, intentional self-harm, sequela 59 Yes No T420X2S Poisoning by hydantoin derivatives, intentional self-harm, sequela 59 Yes No T421X2S Poisoning by iminostilbenes, intentional self-harm, sequela 59 Yes No T422X2S Poisoning by succinimides and oxazolidinediones, intentional self-harm, sequela 59 Yes No T423X2S Poisoning by barbiturates, intentional self-harm, sequela 59 Yes No T424X2S Poisoning by benzodiazepines, intentional self-harm, sequela 59 Yes No T425X2S Poisoning by mixed antiepileptics, intentional self-harm, sequela 59 Yes No T426X2S Poisoning by other antiepileptic and sedative-hypnotic drugs, intentional self-harm, sequela 59 Yes No T4272XS Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, intentional self-harm, sequela 59 Yes No T428X2S Poisoning by antiparkinsonism drugs and other central muscle-tone depressants, intentional self-harm, sequela 59 Yes No T43012S Poisoning by tricyclic antidepressants, intentional self-harm, sequela 59 Yes No T43022S Poisoning by tetracyclic antidepressants, intentional self-harm, sequela 59 Yes No T431X2S Poisoning by monoamine-oxidase-inhibitor antidepressants, intentional self-harm, sequela 59 Yes No T43202S Poisoning by unspecified antidepressants, intentional self-harm, sequela 59 Yes No T43212S Poisoning by selective serotonin and norepinephrine reuptake inhibitors, intentional self-harm, sequela 59 Yes No T43222S Poisoning by selective serotonin reuptake inhibitors, intentional self-harm, sequela 59 Yes No T43292S Poisoning by other antidepressants, intentional self-harm, sequela 59 Yes No T433X2S Poisoning by phenothiazine antipsychotics and neuroleptics, intentional self-harm, sequela 59 Yes No T434X2S Poisoning by butyrophenone and thiothixene neuroleptics, intentional self-harm, sequela 59 Yes No T43502S Poisoning by unspecified antipsychotics and neuroleptics, intentional self-harm, sequela 59 Yes No T43592S Poisoning by other antipsychotics and neuroleptics, intentional self-harm, sequela 59 Yes No T43602S Poisoning by unspecified psychostimulants, intentional self-harm, sequela 59 Yes No T43612S Poisoning by caffeine, intentional self-harm, sequela 59 Yes No T43622S Poisoning by amphetamines, intentional self-harm, sequela 59 Yes No T43632S Poisoning by methylphenidate, intentional self-harm, sequela 59 Yes No T43642S Poisoning by ecstasy, intentional self-harm, sequela 59 Yes No T43652S Poisoning by methamphetamines intentional self-harm, sequela 59 Yes No T43692S Poisoning by other psychostimulants, intentional self-harm, sequela 59 Yes No T438X2S Poisoning by other psychotropic drugs, intentional self-harm, sequela 59 Yes No T4392XS Poisoning by unspecified psychotropic drug, intentional self-harm, sequela 59 Yes No T440X2S Poisoning by anticholinesterase agents, intentional self-harm, sequela 59 Yes No T441X2S Poisoning by other parasympathomimetics [cholinergics], intentional self-harm, sequela 59 Yes No T442X2S Poisoning by ganglionic blocking drugs, intentional self-harm, sequela 59 Yes No T443X2S Poisoning by other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, intentional self-harm, 59 Yes No T444X2S Poisoning by predominantly alpha-adrenoreceptor agonists, intentional self-harm, sequela 59 Yes No T445X2S Poisoning by predominantly beta-adrenoreceptor agonists, intentional self-harm, sequela 59 Yes No T446X2S Poisoning by alpha-adrenoreceptor antagonists, intentional self-harm, sequela 59 Yes No T447X2S Poisoning by beta-adrenoreceptor antagonists, intentional self-harm, sequela 59 Yes No T448X2S Poisoning by centrally-acting and adrenergic-neuron-blocking agents, intentional self-harm, sequela 59 Yes No T44902S Poisoning by unspecified drugs primarily affecting the autonomic nervous system, intentional self-harm, sequela 59 Yes No T44992S Poisoning by other drug primarily affecting the autonomic nervous system, intentional self-harm, sequela 59 Yes No T450X2S Poisoning by antiallergic and antiemetic drugs, intentional self-harm, sequela 59 Yes No

T451X2S Poisoning by antineoplastic and immunosuppressive drugs, intentional self-harm, sequela 59 Yes No T452X2S Poisoning by vitamins, intentional self-harm, sequela 59 Yes No T453X2S Poisoning by enzymes, intentional self-harm, sequela 59 Yes No T454X2S Poisoning by iron and its compounds, intentional self-harm, sequela 59 Yes No T45512S Poisoning by anticoagulants, intentional self-harm, sequela 59 Yes No T45522S Poisoning by antithrombotic drugs, intentional self-harm, sequela 59 Yes No T45602S Poisoning by unspecified fibrinolysis-affecting drugs, intentional self-harm, sequela 59 Yes No T45612S Poisoning by thrombolytic drug, intentional self-harm, sequela 59 Yes No T45622S Poisoning by hemostatic drug, intentional self-harm, sequela 59 Yes No T45692S Poisoning by other fibrinolysis-affecting drugs, intentional self-harm, sequela 59 Yes No T457X2S Poisoning by anticoagulant antagonists, vitamin K and other coagulants, intentional self-harm, sequela 59 Yes No T458X2S Poisoning by other primarily systemic and hematological agents, intentional self-harm, sequela 59 Yes No T4592XS Poisoning by unspecified primarily systemic and hematological agent, intentional self-harm, sequela 59 Yes No T460X2S Poisoning by cardiac-stimulant glycosides and drugs of similar action, intentional self-harm, sequela 59 Yes No T461X2S Poisoning by calcium-channel blockers, intentional self-harm, sequela 59 Yes No T462X2S Poisoning by other antidysrhythmic drugs, intentional self-harm, sequela 59 Yes No T463X2S Poisoning by coronary vasodilators, intentional self-harm, sequela 59 Yes No T464X2S Poisoning by angiotensin-converting-enzyme inhibitors, intentional self-harm, sequela 59 Yes No T465X2S Poisoning by other antihypertensive drugs, intentional self-harm, sequela 59 Yes No T466X2S Poisoning by antihyperlipidemic and antiarteriosclerotic drugs, intentional self-harm, sequela 59 Yes No T467X2S Poisoning by peripheral vasodilators, intentional self-harm, sequela 59 Yes No T468X2S Poisoning by antivaricose drugs, including sclerosing agents, intentional self-harm, sequela 59 Yes No T46902S Poisoning by unspecified agents primarily affecting the cardiovascular system, intentional self-harm, sequela 59 Yes No T46992S Poisoning by other agents primarily affecting the cardiovascular system, intentional self-harm, sequela 59 Yes No T470X2S Poisoning by histamine H2-receptor blockers, intentional self-harm, sequela 59 Yes No T471X2S Poisoning by other antacids and anti-gastric-secretion drugs, intentional self-harm, sequela 59 Yes No T472X2S Poisoning by stimulant laxatives, intentional self-harm, sequela 59 Yes No T473X2S Poisoning by saline and osmotic laxatives, intentional self-harm, sequela 59 Yes No T474X2S Poisoning by other laxatives, intentional self-harm, sequela 59 Yes No T475X2S Poisoning by digestants, intentional self-harm, sequela 59 Yes No T476X2S Poisoning by antidiarrheal drugs, intentional self-harm, sequela 59 Yes No T477X2S Poisoning by emetics, intentional self-harm, sequela 59 Yes No T478X2S Poisoning by other agents primarily affecting gastrointestinal system, intentional self-harm, sequela 59 Yes No T4792XS Poisoning by unspecified agents primarily affecting the gastrointestinal system, intentional self-harm, sequela 59 Yes No T480X2S Poisoning by oxytocic drugs, intentional self-harm, sequela 59 Yes No T481X2S Poisoning by skeletal muscle relaxants [neuromuscular blocking agents], intentional self-harm, sequela 59 Yes No T48202S Poisoning by unspecified drugs acting on muscles, intentional self-harm, sequela 59 Yes No T48292S Poisoning by other drugs acting on muscles, intentional self-harm, sequela 59 Yes No T483X2S Poisoning by antitussives, intentional self-harm, sequela 59 Yes No T484X2S Poisoning by expectorants, intentional self-harm, sequela 59 Yes No T485X2S Poisoning by other anti-common-cold drugs, intentional self-harm, sequela 59 Yes No T486X2S Poisoning by antiasthmatics, intentional self-harm, sequela 59 Yes No T48902S Poisoning by unspecified agents primarily acting on the respiratory system, intentional self-harm, sequela 59 Yes No T48992S Poisoning by other agents primarily acting on the respiratory system, intentional self-harm, sequela 59 Yes No T490X2S Poisoning by local antifungal, anti-infective and anti-inflammatory drugs, intentional self-harm, sequela 59 Yes No T491X2S Poisoning by antipruritics, intentional self-harm, sequela 59 Yes No T492X2S Poisoning by local astringents and local detergents, intentional self-harm, sequela 59 Yes No T493X2S Poisoning by emollients, demulcents and protectants, intentional self-harm, sequela 59 Yes No T494X2S Poisoning by keratolytics, keratoplastics, and other hair treatment drugs and preparations, intentional self-harm, 59 Yes No T495X2S Poisoning by ophthalmological drugs and preparations, intentional self-harm, sequela 59 Yes No T496X2S Poisoning by otorhinolaryngological drugs and preparations, intentional self-harm, sequela 59 Yes No T497X2S Poisoning by dental drugs, topically applied, intentional self-harm, sequela 59 Yes No T498X2S Poisoning by other topical agents, intentional self-harm, sequela 59 Yes No T4992XS Poisoning by unspecified topical agent, intentional self-harm, sequela 59 Yes No T500X2S Poisoning by mineralocorticoids and their antagonists, intentional self-harm, sequela 59 Yes No T501X2S Poisoning by loop [high-ceiling] diuretics, intentional self-harm, sequela 59 Yes No T502X2S Poisoning by carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, intentional self-harm, sequela 59 Yes No T503X2S Poisoning by electrolytic, caloric and water-balance agents, intentional self-harm, sequela 59 Yes No

T504X2S Poisoning by drugs affecting uric acid metabolism, intentional self-harm, sequela 59 Yes No T505X2S Poisoning by appetite depressants, intentional self-harm, sequela 59 Yes No T506X2S Poisoning by antidotes and chelating agents, intentional self-harm, sequela 59 Yes No T507X2S Poisoning by analeptics and opioid receptor antagonists, intentional self-harm, sequela 59 Yes No T508X2S Poisoning by diagnostic agents, intentional self-harm, sequela 59 Yes No T50902S Poisoning by unspecified drugs, medicaments and biological substances, intentional self-harm, sequela 59 Yes No T50912S Poisoning by multiple unspecified drugs, medicaments and biological substances, intentional self-harm, sequela 59 Yes No T50992S Poisoning by other drugs, medicaments and biological substances, intentional self-harm, sequela 59 Yes No T50A12S Poisoning by pertussis vaccine, including combinations with a pertussis component, intentional self-harm, sequela 59 Yes No T50A22S Poisoning by mixed bacterial vaccines without a pertussis component, intentional self-harm, sequela 59 Yes No T50A92S Poisoning by other bacterial vaccines, intentional self-harm, sequela 59 Yes No T50B12S Poisoning by smallpox vaccines, intentional self-harm, sequela 59 Yes No T50B92S Poisoning by other viral vaccines, intentional self-harm, sequela 59 Yes No T50Z12S Poisoning by immunoglobulin, intentional self-harm, sequela 59 Yes No T50Z92S Poisoning by other vaccines and biological substances, intentional self-harm, sequela 59 Yes No T510X2S Toxic effect of ethanol, intentional self-harm, sequela 59 Yes No T511X2S Toxic effect of methanol, intentional self-harm, sequela 59 Yes No T512X2S Toxic effect of 2-Propanol, intentional self-harm, sequela 59 Yes No T513X2S Toxic effect of fusel oil, intentional self-harm, sequela 59 Yes No T518X2S Toxic effect of other alcohols, intentional self-harm, sequela 59 Yes No T5192XS Toxic effect of unspecified alcohol, intentional self-harm, sequela 59 Yes No T520X2S Toxic effect of petroleum products, intentional self-harm, sequela 59 Yes No T521X2S Toxic effect of benzene, intentional self-harm, sequela 59 Yes No T522X2S Toxic effect of homologues of benzene, intentional self-harm, sequela 59 Yes No T523X2S Toxic effect of glycols, intentional self-harm, sequela 59 Yes No T524X2S Toxic effect of ketones, intentional self-harm, sequela 59 Yes No T528X2S Toxic effect of other organic solvents, intentional self-harm, sequela 59 Yes No T5292XS Toxic effect of unspecified organic solvent, intentional self-harm, sequela 59 Yes No T530X2S Toxic effect of carbon tetrachloride, intentional self-harm, sequela 59 Yes No T531X2S Toxic effect of chloroform, intentional self-harm, sequela 59 Yes No T532X2S Toxic effect of trichloroethylene, intentional self-harm, sequela 59 Yes No T533X2S Toxic effect of tetrachloroethylene, intentional self-harm, sequela 59 Yes No T534X2S Toxic effect of dichloromethane, intentional self-harm, sequela 59 Yes No T535X2S Toxic effect of chlorofluorocarbons, intentional self-harm, sequela 59 Yes No T536X2S Toxic effect of other halogen derivatives of aliphatic hydrocarbons, intentional self-harm, sequela 59 Yes No T537X2S Toxic effect of other halogen derivatives of aromatic hydrocarbons, intentional self-harm, sequela 59 Yes No T5392XS Toxic effect of unspecified halogen derivatives of aliphatic and aromatic hydrocarbons, intentional self-harm, sequela 59 Yes No T540X2S Toxic effect of phenol and phenol homologues, intentional self-harm, sequela 59 Yes No T541X2S Toxic effect of other corrosive organic compounds, intentional self-harm, sequela 59 Yes No T542X2S Toxic effect of corrosive acids and acid-like substances, intentional self-harm, sequela 59 Yes No T543X2S Toxic effect of corrosive alkalis and alkali-like substances, intentional self-harm, sequela 59 Yes No T5492XS Toxic effect of unspecified corrosive substance, intentional self-harm, sequela 59 Yes No T550X2S Toxic effect of soaps, intentional self-harm, sequela 59 Yes No T551X2S Toxic effect of detergents, intentional self-harm, sequela 59 Yes No T560X2S Toxic effect of lead and its compounds, intentional self-harm, sequela 59 Yes No T561X2S Toxic effect of mercury and its compounds, intentional self-harm, sequela 59 Yes No T562X2S Toxic effect of chromium and its compounds, intentional self-harm, sequela 59 Yes No T563X2S Toxic effect of cadmium and its compounds, intentional self-harm, sequela 59 Yes No T564X2S Toxic effect of copper and its compounds, intentional self-harm, sequela 59 Yes No T565X2S Toxic effect of zinc and its compounds, intentional self-harm, sequela 59 Yes No T566X2S Toxic effect of tin and its compounds, intentional self-harm, sequela 59 Yes No T567X2S Toxic effect of beryllium and its compounds, intentional self-harm, sequela 59 Yes No T56812S Toxic effect of thallium, intentional self-harm, sequela 59 Yes No T56892S Toxic effect of other metals, intentional self-harm, sequela 59 Yes No T5692XS Toxic effect of unspecified metal, intentional self-harm, sequela 59 Yes No T570X2S Toxic effect of arsenic and its compounds, intentional self-harm, sequela 59 Yes No T571X2S Toxic effect of phosphorus and its compounds, intentional self-harm, sequela 59 Yes No T572X2S Toxic effect of manganese and its compounds, intentional self-harm, sequela 59 Yes No

T573X2S Toxic effect of hydrogen cyanide, intentional self-harm, sequela 59 Yes No T578X2S Toxic effect of other specified inorganic substances, intentional self-harm, sequela 59 Yes No T5792XS Toxic effect of unspecified inorganic substance, intentional self-harm, sequela 59 Yes No T5802XS Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, sequela 59 Yes No T5812XS Toxic effect of carbon monoxide from utility gas, intentional self-harm, sequela 59 Yes No T582X2S Toxic effect of carbon monoxide from incomplete combustion of other domestic fuels, intentional self-harm, sequela 59 Yes No T588X2S Toxic effect of carbon monoxide from other source, intentional self-harm, sequela 59 Yes No T5892XS Toxic effect of carbon monoxide from unspecified source, intentional self-harm, sequela 59 Yes No T590X2S Toxic effect of nitrogen oxides, intentional self-harm, sequela 59 Yes No T591X2S Toxic effect of sulfur dioxide, intentional self-harm, sequela 59 Yes No T592X2S Toxic effect of formaldehyde, intentional self-harm, sequela 59 Yes No T593X2S Toxic effect of lacrimogenic gas, intentional self-harm, sequela 59 Yes No T594X2S Toxic effect of chlorine gas, intentional self-harm, sequela 59 Yes No T595X2S Toxic effect of fluorine gas and hydrogen fluoride, intentional self-harm, sequela 59 Yes No T596X2S Toxic effect of hydrogen sulfide, intentional self-harm, sequela 59 Yes No T597X2S Toxic effect of carbon dioxide, intentional self-harm, sequela 59 Yes No T59812S Toxic effect of smoke, intentional self-harm, sequela 59 Yes No T59892S Toxic effect of other specified gases, fumes and vapors, intentional self-harm, sequela 59 Yes No T5992XS Toxic effect of unspecified gases, fumes and vapors, intentional self-harm, sequela 59 Yes No T600X2S Toxic effect of organophosphate and carbamate insecticides, intentional self-harm, sequela 59 Yes No T601X2S Toxic effect of halogenated insecticides, intentional self-harm, sequela 59 Yes No T602X2S Toxic effect of other insecticides, intentional self-harm, sequela 59 Yes No T603X2S Toxic effect of herbicides and fungicides, intentional self-harm, sequela 59 Yes No T604X2S Toxic effect of rodenticides, intentional self-harm, sequela 59 Yes No T608X2S Toxic effect of other pesticides, intentional self-harm, sequela 59 Yes No T6092XS Toxic effect of unspecified pesticide, intentional self-harm, sequela 59 Yes No T6102XS Ciguatera fish poisoning, intentional self-harm, sequela 59 Yes No T6112XS Scombroid fish poisoning, intentional self-harm, sequela 59 Yes No T61772S Other fish poisoning, intentional self-harm, sequela 59 Yes No T61782S Other shellfish poisoning, intentional self-harm, sequela 59 Yes No T618X2S Toxic effect of other seafood, intentional self-harm, sequela 59 Yes No T6192XS Toxic effect of unspecified seafood, intentional self-harm, sequela 59 Yes No T620X2S Toxic effect of ingested mushrooms, intentional self-harm, sequela 59 Yes No T621X2S Toxic effect of ingested berries, intentional self-harm, sequela 59 Yes No T622X2S Toxic effect of other ingested (parts of) plant(s), intentional self-harm, sequela 59 Yes No T628X2S Toxic effect of other specified noxious substances eaten as food, intentional self-harm, sequela 59 Yes No T6292XS Toxic effect of unspecified noxious substance eaten as food, intentional self-harm, sequela 59 Yes No T63002S Toxic effect of unspecified snake venom, intentional self-harm, sequela 59 Yes No T63012S Toxic effect of rattlesnake venom, intentional self-harm, sequela 59 Yes No T63022S Toxic effect of coral snake venom, intentional self-harm, sequela 59 Yes No T63032S Toxic effect of taipan venom, intentional self-harm, sequela 59 Yes No T63042S Toxic effect of cobra venom, intentional self-harm, sequela 59 Yes No T63062S Toxic effect of venom of other North and South American snake, intentional self-harm, sequela 59 Yes No T63072S Toxic effect of venom of other Australian snake, intentional self-harm, sequela 59 Yes No T63082S Toxic effect of venom of other African and Asian snake, intentional self-harm, sequela 59 Yes No T63092S Toxic effect of venom of other snake, intentional self-harm, sequela 59 Yes No T63112S Toxic effect of venom of gila monster, intentional self-harm, sequela 59 Yes No T63122S Toxic effect of venom of other venomous lizard, intentional self-harm, sequela 59 Yes No T63192S Toxic effect of venom of other reptiles, intentional self-harm, sequela 59 Yes No T632X2S Toxic effect of venom of scorpion, intentional self-harm, sequela 59 Yes No T63302S Toxic effect of unspecified spider venom, intentional self-harm, sequela 59 Yes No T63312S Toxic effect of venom of black widow spider, intentional self-harm, sequela 59 Yes No T63322S Toxic effect of venom of tarantula, intentional self-harm, sequela 59 Yes No T63332S Toxic effect of venom of brown recluse spider, intentional self-harm, sequela 59 Yes No T63392S Toxic effect of venom of other spider, intentional self-harm, sequela 59 Yes No T63412S Toxic effect of venom of centipedes and venomous millipedes, intentional self-harm, sequela 59 Yes No T63422S Toxic effect of venom of ants, intentional self-harm, sequela 59 Yes No T63432S Toxic effect of venom of caterpillars, intentional self-harm, sequela 59 Yes No

T63442S Toxic effect of venom of bees, intentional self-harm, sequela 59 Yes No T63452S Toxic effect of venom of hornets, intentional self-harm, sequela 59 Yes No T63462S Toxic effect of venom of wasps, intentional self-harm, sequela 59 Yes No T63482S Toxic effect of venom of other arthropod, intentional self-harm, sequela 59 Yes No T63512S Toxic effect of contact with stingray, intentional self-harm, sequela 59 Yes No T63592S Toxic effect of contact with other venomous fish, intentional self-harm, sequela 59 Yes No T63612S Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, sequela 59 Yes No T63622S Toxic effect of contact with other jellyfish, intentional self-harm, sequela 59 Yes No T63632S Toxic effect of contact with sea anemone, intentional self-harm, sequela 59 Yes No T63692S Toxic effect of contact with other venomous marine animals, intentional self-harm, sequela 59 Yes No T63712S Toxic effect of contact with venomous marine plant, intentional self-harm, sequela 59 Yes No T63792S Toxic effect of contact with other venomous plant, intentional self-harm, sequela 59 Yes No T63812S Toxic effect of contact with venomous frog, intentional self-harm, sequela 59 Yes No T63822S Toxic effect of contact with venomous toad, intentional self-harm, sequela 59 Yes No T63832S Toxic effect of contact with other venomous amphibian, intentional self-harm, sequela 59 Yes No T63892S Toxic effect of contact with other venomous animals, intentional self-harm, sequela 59 Yes No T6392XS Toxic effect of contact with unspecified venomous animal, intentional self-harm, sequela 59 Yes No T6402XS Toxic effect of aflatoxin, intentional self-harm, sequela 59 Yes No T6482XS Toxic effect of other mycotoxin food contaminants, intentional self-harm, sequela 59 Yes No T650X2S Toxic effect of cyanides, intentional self-harm, sequela 59 Yes No T651X2S Toxic effect of strychnine and its salts, intentional self-harm, sequela 59 Yes No T65212S Toxic effect of chewing tobacco, intentional self-harm, sequela 59 Yes No T65222S Toxic effect of tobacco cigarettes, intentional self-harm, sequela 59 Yes No T65292S Toxic effect of other tobacco and nicotine, intentional self-harm, sequela 59 Yes No T653X2S Toxic effect of nitroderivatives and aminoderivatives of benzene and its homologues, intentional self-harm, sequela 59 Yes No T654X2S Toxic effect of carbon disulfide, intentional self-harm, sequela 59 Yes No T655X2S Toxic effect of nitroglycerin and other nitric acids and esters, intentional self-harm, sequela 59 Yes No T656X2S Toxic effect of paints and dyes, not elsewhere classified, intentional self-harm, sequela 59 Yes No T65812S Toxic effect of latex, intentional self-harm, sequela 59 Yes No T65822S Toxic effect of harmful algae and algae toxins, intentional self-harm, sequela 59 Yes No T65832S Toxic effect of fiberglass, intentional self-harm, sequela 59 Yes No T65892S Toxic effect of other specified substances, intentional self-harm, sequela 59 Yes No T6592XS Toxic effect of unspecified substance, intentional self-harm, sequela 59 Yes No T71112S Asphyxiation due to smothering under pillow, intentional self-harm, sequela 59 Yes No T71122S Asphyxiation due to plastic bag, intentional self-harm, sequela 59 Yes No T71132S Asphyxiation due to being trapped in bed linens, intentional self-harm, sequela 59 Yes No T71152S Asphyxiation due to smothering in furniture, intentional self-harm, sequela 59 Yes No T71162S Asphyxiation due to hanging, intentional self-harm, sequela 59 Yes No T71192S Asphyxiation due to mechanical threat to breathing due to other causes, intentional self-harm, sequela 59 Yes No T71222S Asphyxiation due to being trapped in a car trunk, intentional self-harm, sequela 59 Yes No T71232S Asphyxiation due to being trapped in a (discarded) refrigerator, intentional self-harm, sequela 59 Yes No X710XXD Intentional self-harm by drowning and submersion while in bathtub, subsequent encounter 59 Yes No X710XXS Intentional self-harm by drowning and submersion while in bathtub, sequela 59 Yes No X711XXD Intentional self-harm by drowning and submersion while in swimming pool, subsequent encounter 59 Yes No X711XXS Intentional self-harm by drowning and submersion while in swimming pool, sequela 59 Yes No X712XXD Intentional self-harm by drowning and submersion after jump into swimming pool, subsequent encounter 59 Yes No X712XXS Intentional self-harm by drowning and submersion after jump into swimming pool, sequela 59 Yes No X713XXD Intentional self-harm by drowning and submersion in natural water, subsequent encounter 59 Yes No X713XXS Intentional self-harm by drowning and submersion in natural water, sequela 59 Yes No X718XXD Other intentional self-harm by drowning and submersion, subsequent encounter 59 Yes No X718XXS Other intentional self-harm by drowning and submersion, sequela 59 Yes No X719XXD Intentional self-harm by drowning and submersion, unspecified, subsequent encounter 59 Yes No X719XXS Intentional self-harm by drowning and submersion, unspecified, sequela 59 Yes No X72XXXD Intentional self-harm by handgun discharge, subsequent encounter 59 Yes No X72XXXS Intentional self-harm by handgun discharge, sequela 59 Yes No X730XXD Intentional self-harm by shotgun discharge, subsequent encounter 59 Yes No X730XXS Intentional self-harm by shotgun discharge, sequela 59 Yes No X731XXD Intentional self-harm by hunting rifle discharge, subsequent encounter 59 Yes No

X731XXS Intentional self-harm by hunting rifle discharge, sequela 59 Yes No X732XXD Intentional self-harm by machine gun discharge, subsequent encounter 59 Yes No X732XXS Intentional self-harm by machine gun discharge, sequela 59 Yes No X738XXD Intentional self-harm by other larger firearm discharge, subsequent encounter 59 Yes No X738XXS Intentional self-harm by other larger firearm discharge, sequela 59 Yes No X739XXD Intentional self-harm by unspecified larger firearm discharge, subsequent encounter 59 Yes No X739XXS Intentional self-harm by unspecified larger firearm discharge, sequela 59 Yes No X7401XD Intentional self-harm by airgun, subsequent encounter 59 Yes No X7401XS Intentional self-harm by airgun, sequela 59 Yes No X7402XD Intentional self-harm by paintball gun, subsequent encounter 59 Yes No X7402XS Intentional self-harm by paintball gun, sequela 59 Yes No X7409XD Intentional self-harm by other gas, air or spring-operated gun, subsequent encounter 59 Yes No X7409XS Intentional self-harm by other gas, air or spring-operated gun, sequela 59 Yes No X748XXD Intentional self-harm by other firearm discharge, subsequent encounter 59 Yes No X748XXS Intentional self-harm by other firearm discharge, sequela 59 Yes No X749XXD Intentional self-harm by unspecified firearm discharge, subsequent encounter 59 Yes No X749XXS Intentional self-harm by unspecified firearm discharge, sequela 59 Yes No X75XXXD Intentional self-harm by explosive material, subsequent encounter 59 Yes No X75XXXS Intentional self-harm by explosive material, sequela 59 Yes No X76XXXD Intentional self-harm by smoke, fire and flames, subsequent encounter 59 Yes No X76XXXS Intentional self-harm by smoke, fire and flames, sequela 59 Yes No X770XXD Intentional self-harm by steam or hot vapors, subsequent encounter 59 Yes No X770XXS Intentional self-harm by steam or hot vapors, sequela 59 Yes No X771XXD Intentional self-harm by hot tap water, subsequent encounter 59 Yes No X771XXS Intentional self-harm by hot tap water, sequela 59 Yes No X772XXD Intentional self-harm by other hot fluids, subsequent encounter 59 Yes No X772XXS Intentional self-harm by other hot fluids, sequela 59 Yes No X773XXD Intentional self-harm by hot household appliances, subsequent encounter 59 Yes No X773XXS Intentional self-harm by hot household appliances, sequela 59 Yes No X778XXD Intentional self-harm by other hot objects, subsequent encounter 59 Yes No X778XXS Intentional self-harm by other hot objects, sequela 59 Yes No X779XXD Intentional self-harm by unspecified hot objects, subsequent encounter 59 Yes No X779XXS Intentional self-harm by unspecified hot objects, sequela 59 Yes No X780XXD Intentional self-harm by sharp glass, subsequent encounter 59 Yes No X780XXS Intentional self-harm by sharp glass, sequela 59 Yes No X781XXD Intentional self-harm by knife, subsequent encounter 59 Yes No X781XXS Intentional self-harm by knife, sequela 59 Yes No X782XXD Intentional self-harm by sword or dagger, subsequent encounter 59 Yes No X782XXS Intentional self-harm by sword or dagger, sequela 59 Yes No X788XXD Intentional self-harm by other sharp object, subsequent encounter 59 Yes No X788XXS Intentional self-harm by other sharp object, sequela 59 Yes No X789XXD Intentional self-harm by unspecified sharp object, subsequent encounter 59 Yes No X789XXS Intentional self-harm by unspecified sharp object, sequela 59 Yes No X79XXXD Intentional self-harm by blunt object, subsequent encounter 59 Yes No X79XXXS Intentional self-harm by blunt object, sequela 59 Yes No X80XXXD Intentional self-harm by jumping from a high place, subsequent encounter 59 Yes No X80XXXS Intentional self-harm by jumping from a high place, sequela 59 Yes No X810XXD Intentional self-harm by jumping or lying in front of motor vehicle, subsequent encounter 59 Yes No X810XXS Intentional self-harm by jumping or lying in front of motor vehicle, sequela 59 Yes No X811XXD Intentional self-harm by jumping or lying in front of (subway) train, subsequent encounter 59 Yes No X811XXS Intentional self-harm by jumping or lying in front of (subway) train, sequela 59 Yes No X818XXD Intentional self-harm by jumping or lying in front of other moving object, subsequent encounter 59 Yes No X818XXS Intentional self-harm by jumping or lying in front of other moving object, sequela 59 Yes No X820XXD Intentional collision of motor vehicle with other motor vehicle, subsequent encounter 59 Yes No X820XXS Intentional collision of motor vehicle with other motor vehicle, sequela 59 Yes No X821XXD Intentional collision of motor vehicle with train, subsequent encounter 59 Yes No X821XXS Intentional collision of motor vehicle with train, sequela 59 Yes No X822XXD Intentional collision of motor vehicle with tree, subsequent encounter 59 Yes No

X822XXS Intentional collision of motor vehicle with tree, sequela 59 Yes No X828XXD Other intentional self-harm by crashing of motor vehicle, subsequent encounter 59 Yes No X828XXS Other intentional self-harm by crashing of motor vehicle, sequela 59 Yes No X830XXD Intentional self-harm by crashing of aircraft, subsequent encounter 59 Yes No X830XXS Intentional self-harm by crashing of aircraft, sequela 59 Yes No X831XXD Intentional self-harm by electrocution, subsequent encounter 59 Yes No X831XXS Intentional self-harm by electrocution, sequela 59 Yes No X832XXD Intentional self-harm by exposure to extremes of cold, subsequent encounter 59 Yes No X832XXS Intentional self-harm by exposure to extremes of cold, sequela 59 Yes No X838XXD Intentional self-harm by other specified means, subsequent encounter 59 Yes No X838XXS Intentional self-harm by other specified means, sequela 59 Yes No 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 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 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 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 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 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 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 E0952 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene 106 Yes No

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 E0951 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene 108 Yes No 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 108 Yes No I70319 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, unspecified 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 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 108 Yes No I70518 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, other 108 Yes No I70519 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, 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 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 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 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 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 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 122 Yes No E093521 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment 122 Yes No E093522 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment 122 Yes No E093523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment 122 Yes No E093529 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment 122 Yes No E093531 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment 122 Yes No E093532 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment 122 Yes No E093533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment 122 Yes No E093539 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment 122 Yes No E093541 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal 122 Yes No E093542 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal 122 Yes No E093543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal 122 Yes No E093549 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal 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, 122 Yes No 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 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 S020XXS Fracture of vault of skull, sequela 167 Yes No S02101S Fracture of base of skull, right side, sequela 167 Yes No S02102S Fracture of base of skull, left side, sequela 167 Yes No S02109S Fracture of base of skull, unspecified side, sequela 167 Yes No S02110S Type I occipital condyle fracture, unspecified side, sequela 167 Yes No S02111S Type II occipital condyle fracture, unspecified side, sequela 167 Yes No S02112S Type III occipital condyle fracture, unspecified side, sequela 167 Yes No S02113S Unspecified occipital condyle fracture, sequela 167 Yes No S02118S Other fracture of occiput, unspecified side, sequela 167 Yes No S02119S Unspecified fracture of occiput, sequela 167 Yes No S0211AS Type I occipital condyle fracture, right side, sequela 167 Yes No S0211BS Type I occipital condyle fracture, left side, sequela 167 Yes No S0211CS Type II occipital condyle fracture, right side, sequela 167 Yes No S0211DS Type II occipital condyle fracture, left side, sequela 167 Yes No S0211ES Type III occipital condyle fracture, right side, sequela 167 Yes No S0211FS Type III occipital condyle fracture, left side, sequela 167 Yes No S0211GS Other fracture of occiput, right side, sequela 167 Yes No S0211HS Other fracture of occiput, left side, sequela 167 Yes No S02121S Fracture of orbital roof, right side, sequela 167 Yes No S02122S Fracture of orbital roof, left side, sequela 167 Yes No S02129S Fracture of orbital roof, unspecified side, sequela 167 Yes No S0219XS Other fracture of base of skull, sequela 167 Yes No S0230XS Fracture of orbital floor, unspecified side, sequela 167 Yes No S0231XS Fracture of orbital floor, right side, sequela 167 Yes No S0232XS Fracture of orbital floor, left side, sequela 167 Yes No S02400S Malar fracture, unspecified side, sequela 167 Yes No S02401S Maxillary fracture, unspecified side, sequela 167 Yes No S02402S Zygomatic fracture, unspecified side, sequela 167 Yes No S0240AS Malar fracture, right side, sequela 167 Yes No S0240BS Malar fracture, left side, sequela 167 Yes No S0240CS Maxillary fracture, right side, sequela 167 Yes No S0240DS Maxillary fracture, left side, sequela 167 Yes No S0240ES Zygomatic fracture, right side, sequela 167 Yes No S0240FS Zygomatic fracture, left side, sequela 167 Yes No S02411S LeFort I fracture, sequela 167 Yes No S02412S LeFort II fracture, sequela 167 Yes No S02413S LeFort III fracture, sequela 167 Yes No S0242XS Fracture of alveolus of maxilla, sequela 167 Yes No S02600S Fracture of unspecified part of body of mandible, unspecified side, sequela 167 Yes No S02601S Fracture of unspecified part of body of right mandible, sequela 167 Yes No S02602S Fracture of unspecified part of body of left mandible, sequela 167 Yes No S02609S Fracture of mandible, unspecified, sequela 167 Yes No S02610S Fracture of condylar process of mandible, unspecified side, sequela 167 Yes No S02611S Fracture of condylar process of right mandible, sequela 167 Yes No S02612S Fracture of condylar process of left mandible, sequela 167 Yes No

S02620S Fracture of subcondylar process of mandible, unspecified side, sequela 167 Yes No S02621S Fracture of subcondylar process of right mandible, sequela 167 Yes No S02622S Fracture of subcondylar process of left mandible, sequela 167 Yes No S02630S Fracture of coronoid process of mandible, unspecified side, sequela 167 Yes No S02631S Fracture of coronoid process of right mandible, sequela 167 Yes No S02632S Fracture of coronoid process of left mandible, sequela 167 Yes No S02640S Fracture of ramus of mandible, unspecified side, sequela 167 Yes No S02641S Fracture of ramus of right mandible, sequela 167 Yes No S02642S Fracture of ramus of left mandible, sequela 167 Yes No S02650S Fracture of angle of mandible, unspecified side, sequela 167 Yes No S02651S Fracture of angle of right mandible, sequela 167 Yes No S02652S Fracture of angle of left mandible, sequela 167 Yes No S0266XS Fracture of symphysis of mandible, sequela 167 Yes No S02670S Fracture of alveolus of mandible, unspecified side, sequela 167 Yes No S02671S Fracture of alveolus of right mandible, sequela 167 Yes No S02672S Fracture of alveolus of left mandible, sequela 167 Yes No S0269XS Fracture of mandible of other specified site, sequela 167 Yes No S0280XS Fracture of other specified skull and facial bones, unspecified side, sequela 167 Yes No S0281XS Fracture of other specified skull and facial bones, right side, sequela 167 Yes No S0282XS Fracture of other specified skull and facial bones, left side, sequela 167 Yes No S02831S Fracture of medial orbital wall, right side, sequela 167 Yes No S02832S Fracture of medial orbital wall, left side, sequela 167 Yes No S02839S Fracture of medial orbital wall, unspecified side, sequela 167 Yes No S02841S Fracture of lateral orbital wall, right side, sequela 167 Yes No S02842S Fracture of lateral orbital wall, left side, sequela 167 Yes No S02849S Fracture of lateral orbital wall, unspecified side, sequela 167 Yes No S0285XS Fracture of orbit, unspecified, sequela 167 Yes No S0291XS Unspecified fracture of skull, sequela 167 Yes No S0292XS Unspecified fracture of facial bones, sequela 167 Yes No S060X0S Concussion without loss of consciousness, sequela 167 Yes No S060X1S Concussion with loss of consciousness of 30 minutes or less, sequela 167 Yes No S060X9S Concussion with loss of consciousness of unspecified duration, sequela 167 Yes No S060XAS Concussion with loss of consciousness status unknown, sequela 167 Yes No S061X0S Traumatic cerebral edema without loss of consciousness, sequela 167 Yes No S061X1S Traumatic cerebral edema with loss of consciousness of 30 minutes or less, sequela 167 Yes No S061X2S Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S061X3S Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S061X4S Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S061X5S Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious 167 Yes No S061X6S Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious 167 Yes No S061X9S Traumatic cerebral edema with loss of consciousness of unspecified duration, sequela 167 Yes No S061XAS Traumatic cerebral edema with loss of consciousness status unknown, sequela 167 Yes No S062X0S Diffuse traumatic brain injury without loss of consciousness, sequela 167 Yes No S062X1S Diffuse traumatic brain injury with loss of consciousness of 30 minutes or less, sequela 167 Yes No S062X2S Diffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S062X3S Diffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S062X4S Diffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S062X5S Diffuse traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious 167 Yes No S062X6S Diffuse traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing 167 Yes No S062X9S Diffuse traumatic brain injury with loss of consciousness of unspecified duration, sequela 167 Yes No S062XAS Diffuse traumatic brain injury with loss of consciousness status unknown, sequela 167 Yes No S06300S Unspecified focal traumatic brain injury without loss of consciousness, sequela 167 Yes No S06301S Unspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06302S Unspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06303S Unspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S06304S Unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06305S Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing 167 Yes No S06306S Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours without return to pre- 167 Yes No

S06309S Unspecified focal traumatic brain injury with loss of consciousness of unspecified duration, sequela 167 Yes No S0630AS Unspecified focal traumatic brain injury with loss of consciousness status unknown, sequela 167 Yes No S06310S Contusion and laceration of right cerebrum without loss of consciousness, sequela 167 Yes No S06311S Contusion and laceration of right cerebrum with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06312S Contusion and laceration of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06313S Contusion and laceration of right cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S06314S Contusion and laceration of right cerebrum with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06315S Contusion and laceration of right cerebrum with loss of consciousness greater than 24 hours with return to pre- 167 Yes No S06316S Contusion and laceration of right cerebrum with loss of consciousness greater than 24 hours without return to pre- 167 Yes No S06319S Contusion and laceration of right cerebrum with loss of consciousness of unspecified duration, sequela 167 Yes No S0631AS Contusion and laceration of right cerebrum with loss of consciousness status unknown, sequela 167 Yes No S06320S Contusion and laceration of left cerebrum without loss of consciousness, sequela 167 Yes No S06321S Contusion and laceration of left cerebrum with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06322S Contusion and laceration of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06323S Contusion and laceration of left cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S06324S Contusion and laceration of left cerebrum with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06325S Contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing 167 Yes No S06326S Contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours without return to pre- 167 Yes No S06329S Contusion and laceration of left cerebrum with loss of consciousness of unspecified duration, sequela 167 Yes No S0632AS Contusion and laceration of left cerebrum with loss of consciousness status unknown, sequela 167 Yes No S06330S Contusion and laceration of cerebrum, unspecified, without loss of consciousness, sequela 167 Yes No S06331S Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06332S Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06333S Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 1 hour to 5 hours 59 minutes, 167 Yes No S06334S Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06335S Contusion and laceration of cerebrum, unspecified, with loss of consciousness greater than 24 hours with return to 167 Yes No S06336S Contusion and laceration of cerebrum, unspecified, with loss of consciousness greater than 24 hours without return 167 Yes No S06339S Contusion and laceration of cerebrum, unspecified, with loss of consciousness of unspecified duration, sequela 167 Yes No S0633AS Contusion and laceration of cerebrum, unspecified, with loss of consciousness status unknown, sequela 167 Yes No S06340S Traumatic hemorrhage of right cerebrum without loss of consciousness, sequela 167 Yes No S06341S Traumatic hemorrhage of right cerebrum with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06342S Traumatic hemorrhage of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06343S Traumatic hemorrhage of right cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, sequela 167 Yes No S06344S Traumatic hemorrhage of right cerebrum with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06345S Traumatic hemorrhage of right cerebrum with loss of consciousness greater than 24 hours with return to pre-existing 167 Yes No S06346S Traumatic hemorrhage of right cerebrum with loss of consciousness greater than 24 hours without return to pre- 167 Yes No S06349S Traumatic hemorrhage of right cerebrum with loss of consciousness of unspecified duration, sequela 167 Yes No S0634AS Traumatic hemorrhage of right cerebrum with loss of consciousness status unknown, sequela 167 Yes No S06350S Traumatic hemorrhage of left cerebrum without loss of consciousness, sequela 167 Yes No S06351S Traumatic hemorrhage of left cerebrum with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06352S Traumatic hemorrhage of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06353S Traumatic hemorrhage of left cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, sequela 167 Yes No S06354S Traumatic hemorrhage of left cerebrum with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06355S Traumatic hemorrhage of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing 167 Yes No S06356S Traumatic hemorrhage of left cerebrum with loss of consciousness greater than 24 hours without return to pre- 167 Yes No S06359S Traumatic hemorrhage of left cerebrum with loss of consciousness of unspecified duration, sequela 167 Yes No S0635AS Traumatic hemorrhage of left cerebrum with loss of consciousness status unknown, sequela 167 Yes No S06360S Traumatic hemorrhage of cerebrum, unspecified, without loss of consciousness, sequela 167 Yes No S06361S Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06362S Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06363S Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, 167 Yes No S06364S Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06365S Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness greater than 24 hours with return to pre- 167 Yes No S06366S Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness greater than 24 hours without return to 167 Yes No S06369S Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of unspecified duration, sequela 167 Yes No S0636AS Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness status unknown, sequela 167 Yes No S06370S Contusion, laceration, and hemorrhage of cerebellum without loss of consciousness, sequela 167 Yes No S06371S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 30 minutes or less, sequela 167 Yes No

S06372S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 31 minutes to 59 minutes, 167 Yes No S06373S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 1 hour to 5 hours 59 minutes, 167 Yes No S06374S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06375S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours with return to 167 Yes No S06376S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours without return 167 Yes No S06379S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of unspecified duration, sequela 167 Yes No S0637AS Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness status unknown, sequela 167 Yes No S06380S Contusion, laceration, and hemorrhage of brainstem without loss of consciousness, sequela 167 Yes No S06381S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06382S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06383S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 1 hour to 5 hours 59 minutes, 167 Yes No S06384S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06385S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to 167 Yes No S06386S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours without return 167 Yes No S06389S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of unspecified duration, sequela 167 Yes No S0638AS Contusion, laceration, and hemorrhage of brainstem with loss of consciousness status unknown, sequela 167 Yes No S064X0S Epidural hemorrhage without loss of consciousness, sequela 167 Yes No S064X1S Epidural hemorrhage with loss of consciousness of 30 minutes or less, sequela 167 Yes No S064X2S Epidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S064X3S Epidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S064X4S Epidural hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S064X5S Epidural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, 167 Yes No S064X6S Epidural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level 167 Yes No S064X9S Epidural hemorrhage with loss of consciousness of unspecified duration, sequela 167 Yes No S064XAS Epidural hemorrhage with loss of consciousness status unknown, sequela 167 Yes No S065X0S Traumatic subdural hemorrhage without loss of consciousness, sequela 167 Yes No S065X1S Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, sequela 167 Yes No S065X2S Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S065X3S Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S065X4S Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S065X5S Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing 167 Yes No S065X6S Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing 167 Yes No S065X9S Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, sequela 167 Yes No S065XAS Traumatic subdural hemorrhage with loss of consciousness status unknown, sequela 167 Yes No S066X0S Traumatic subarachnoid hemorrhage without loss of consciousness, sequela 167 Yes No S066X1S Traumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, sequela 167 Yes No S066X2S Traumatic subarachnoid hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S066X3S Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S066X4S Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S066X5S Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing 167 Yes No S066X6S Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing 167 Yes No S066X9S Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, sequela 167 Yes No S066XAS Traumatic subarachnoid hemorrhage with loss of consciousness status unknown, sequela 167 Yes No S06810S Injury of right internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, 167 Yes No S06811S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 167 Yes No S06812S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 167 Yes No S06813S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 167 Yes No S06814S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 167 Yes No S06815S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater 167 Yes No S06816S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater 167 Yes No S06819S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 167 Yes No S0681AS Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness status 167 Yes No S06820S Injury of left internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, 167 Yes No S06821S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 167 Yes No S06822S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 167 Yes No S06823S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour 167 Yes No S06824S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours 167 Yes No S06825S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater 167 Yes No

S06826S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater 167 Yes No S06829S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 167 Yes No S0682AS Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness status 167 Yes No S06890S Other specified intracranial injury without loss of consciousness, sequela 167 Yes No S06891S Other specified intracranial injury with loss of consciousness of 30 minutes or less, sequela 167 Yes No S06892S Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S06893S Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S06894S Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S06895S Other specified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing 167 Yes No S06896S Other specified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing 167 Yes No S06899S Other specified intracranial injury with loss of consciousness of unspecified duration, sequela 167 Yes No S0689AS Other specified intracranial injury with loss of consciousness status unknown, sequela 167 Yes No S068A0S Primary blast injury of brain, not elsewhere classified without loss of consciousness, sequela 167 Yes No S068A1S Primary blast injury of brain, not elsewhere classified with loss of consciousness of 30 minutes or less, sequela 167 Yes No S068A2S Primary blast injury of brain, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S068A3S Primary blast injury of brain, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, 167 Yes No S068A4S Primary blast injury of brain, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S068A5S Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours with return to 167 Yes No S068A6S Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours without return 167 Yes No S068A9S Primary blast injury of brain, not elsewhere classified with loss of consciousness of unspecified duration, sequela 167 Yes No S068AAS Primary blast injury of brain, not elsewhere classified with loss of consciousness status unknown, sequela 167 Yes No S069X0S Unspecified intracranial injury without loss of consciousness, sequela 167 Yes No S069X1S Unspecified intracranial injury with loss of consciousness of 30 minutes or less, sequela 167 Yes No S069X2S Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela 167 Yes No S069X3S Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela 167 Yes No S069X4S Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, sequela 167 Yes No S069X5S Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious 167 Yes No S069X6S Unspecified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing 167 Yes No S069X9S Unspecified intracranial injury with loss of consciousness of unspecified duration, sequela 167 Yes No S069XAS Unspecified intracranial injury with loss of consciousness status unknown, sequela 167 Yes No S06A0XS Traumatic brain compression without herniation, sequela 167 Yes No S06A1XS Traumatic brain compression with herniation, sequela 167 Yes No S98111A Complete traumatic amputation of right great toe, initial encounter 173 Yes No S98112A Complete traumatic amputation of left great toe, initial encounter 173 Yes No S98119A Complete traumatic amputation of unspecified great toe, initial encounter 173 Yes No S98121A Partial traumatic amputation of right great toe, initial encounter 173 Yes No S98122A Partial traumatic amputation of left great toe, initial encounter 173 Yes No S98129A Partial traumatic amputation of unspecified great toe, initial encounter 173 Yes No S98131A Complete traumatic amputation of one right lesser toe, initial encounter 173 Yes No S98132A Complete traumatic amputation of one left lesser toe, initial encounter 173 Yes No S98139A Complete traumatic amputation of one unspecified lesser toe, initial encounter 173 Yes No S98141A Partial traumatic amputation of one right lesser toe, initial encounter 173 Yes No S98142A Partial traumatic amputation of one left lesser toe, initial encounter 173 Yes No S98149A Partial traumatic amputation of one unspecified lesser toe, initial encounter 173 Yes No S98211A Complete traumatic amputation of two or more right lesser toes, initial encounter 173 Yes No S98212A Complete traumatic amputation of two or more left lesser toes, initial encounter 173 Yes No S98219A Complete traumatic amputation of two or more unspecified lesser toes, initial encounter 173 Yes No S98221A Partial traumatic amputation of two or more right lesser toes, initial encounter 173 Yes No S98222A Partial traumatic amputation of two or more left lesser toes, initial encounter 173 Yes No S98229A Partial traumatic amputation of two or more unspecified lesser toes, initial encounter 173 Yes No T792XXA Traumatic secondary and recurrent hemorrhage and seroma, initial encounter 173 Yes No T795XXA Traumatic anuria, initial encounter 173 Yes No T796XXA Traumatic ischemia of muscle, initial encounter 173 Yes No T797XXA Traumatic subcutaneous emphysema, initial encounter 173 Yes No T798XXA Other early complications of trauma, initial encounter 173 Yes No T799XXA Unspecified early complication of trauma, initial encounter 173 Yes No T79A0XA Compartment syndrome, unspecified, initial encounter 173 Yes No T79A11A Traumatic compartment syndrome of right upper extremity, initial encounter 173 Yes No

T79A12A Traumatic compartment syndrome of left upper extremity, initial encounter 173 Yes No T79A19A Traumatic compartment syndrome of unspecified upper extremity, initial encounter 173 Yes No T79A21A Traumatic compartment syndrome of right lower extremity, initial encounter 173 Yes No T79A22A Traumatic compartment syndrome of left lower extremity, initial encounter 173 Yes No T79A29A Traumatic compartment syndrome of unspecified lower extremity, initial encounter 173 Yes No T79A3XA Traumatic compartment syndrome of abdomen, initial encounter 173 Yes No T79A9XA Traumatic compartment syndrome of other sites, initial encounter 173 Yes No T872 Complications of other reattached body part 173 Yes No M96621 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, right arm 176 Yes No M96622 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, left arm 176 Yes No M96629 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm 176 Yes No M96631 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, right arm 176 Yes No M96632 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, left arm 176 Yes No M96639 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm 176 Yes No M9665 Fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate 176 Yes No M96661 Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, right leg 176 Yes No M96662 Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg 176 Yes No M96669 Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified leg 176 Yes No M96671 Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, right leg 176 Yes No M96672 Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg 176 Yes No M96679 Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified leg 176 Yes No M9669 Fracture of other bone following insertion of orthopedic implant, joint prosthesis, or bone plate 176 Yes No N99510 Cystostomy hemorrhage 176 Yes No N99511 Cystostomy infection 176 Yes No N99512 Cystostomy malfunction 176 Yes No N99518 Other cystostomy complication 176 Yes No N99520 Hemorrhage of incontinent external stoma of urinary tract 176 Yes No N99521 Infection of incontinent external stoma of urinary tract 176 Yes No N99522 Malfunction of incontinent external stoma of urinary tract 176 Yes No N99523 Herniation of incontinent stoma of urinary tract 176 Yes No N99524 Stenosis of incontinent stoma of urinary tract 176 Yes No N99528 Other complication of incontinent external stoma of urinary tract 176 Yes No N99530 Hemorrhage of continent stoma of urinary tract 176 Yes No N99531 Infection of continent stoma of urinary tract 176 Yes No N99532 Malfunction of continent stoma of urinary tract 176 Yes No N99533 Herniation of continent stoma of urinary tract 176 Yes No N99534 Stenosis of continent stoma of urinary tract 176 Yes No N99538 Other complication of continent stoma of urinary tract 176 Yes No T82310A Breakdown (mechanical) of aortic (bifurcation) graft (replacement), initial encounter 176 Yes No T82311A Breakdown (mechanical) of carotid arterial graft (bypass), initial encounter 176 Yes No T82312A Breakdown (mechanical) of femoral arterial graft (bypass), initial encounter 176 Yes No T82318A Breakdown (mechanical) of other vascular grafts, initial encounter 176 Yes No T82319A Breakdown (mechanical) of unspecified vascular grafts, initial encounter 176 Yes No T82320A Displacement of aortic (bifurcation) graft (replacement), initial encounter 176 Yes No T82321A Displacement of carotid arterial graft (bypass), initial encounter 176 Yes No T82322A Displacement of femoral arterial graft (bypass), initial encounter 176 Yes No T82328A Displacement of other vascular grafts, initial encounter 176 Yes No T82329A Displacement of unspecified vascular grafts, initial encounter 176 Yes No T82330A Leakage of aortic (bifurcation) graft (replacement), initial encounter 176 Yes No T82331A Leakage of carotid arterial graft (bypass), initial encounter 176 Yes No T82332A Leakage of femoral arterial graft (bypass), initial encounter 176 Yes No T82338A Leakage of other vascular grafts, initial encounter 176 Yes No T82339A Leakage of unspecified vascular graft, initial encounter 176 Yes No T82390A Other mechanical complication of aortic (bifurcation) graft (replacement), initial encounter 176 Yes No T82391A Other mechanical complication of carotid arterial graft (bypass), initial encounter 176 Yes No T82392A Other mechanical complication of femoral arterial graft (bypass), initial encounter 176 Yes No T82398A Other mechanical complication of other vascular grafts, initial encounter 176 Yes No T82399A Other mechanical complication of unspecified vascular grafts, initial encounter 176 Yes No

T82510A Breakdown (mechanical) of surgically created arteriovenous fistula, initial encounter 176 Yes No T82511A Breakdown (mechanical) of surgically created arteriovenous shunt, initial encounter 176 Yes No T82513A Breakdown (mechanical) of balloon (counterpulsation) device, initial encounter 176 Yes No T82514A Breakdown (mechanical) of infusion catheter, initial encounter 176 Yes No T82515A Breakdown (mechanical) of umbrella device, initial encounter 176 Yes No T82518A Breakdown (mechanical) of other cardiac and vascular devices and implants, initial encounter 176 Yes No T82520A Displacement of surgically created arteriovenous fistula, initial encounter 176 Yes No T82521A Displacement of surgically created arteriovenous shunt, initial encounter 176 Yes No T82523A Displacement of balloon (counterpulsation) device, initial encounter 176 Yes No T82524A Displacement of infusion catheter, initial encounter 176 Yes No T82525A Displacement of umbrella device, initial encounter 176 Yes No T82528A Displacement of other cardiac and vascular devices and implants, initial encounter 176 Yes No T82530A Leakage of surgically created arteriovenous fistula, initial encounter 176 Yes No T82531A Leakage of surgically created arteriovenous shunt, initial encounter 176 Yes No T82533A Leakage of balloon (counterpulsation) device, initial encounter 176 Yes No T82534A Leakage of infusion catheter, initial encounter 176 Yes No T82535A Leakage of umbrella device, initial encounter 176 Yes No T82538A Leakage of other cardiac and vascular devices and implants, initial encounter 176 Yes No T82590A Other mechanical complication of surgically created arteriovenous fistula, initial encounter 176 Yes No T82591A Other mechanical complication of surgically created arteriovenous shunt, initial encounter 176 Yes No T82593A Other mechanical complication of balloon (counterpulsation) device, initial encounter 176 Yes No T82594A Other mechanical complication of infusion catheter, initial encounter 176 Yes No T82595A Other mechanical complication of umbrella device, initial encounter 176 Yes No T82598A Other mechanical complication of other cardiac and vascular devices and implants, initial encounter 176 Yes No T826XXA Infection and inflammatory reaction due to cardiac valve prosthesis, initial encounter 176 Yes No T827XXA Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter 176 Yes No T82818A Embolism due to vascular prosthetic devices, implants and grafts, initial encounter 176 Yes No T82828A Fibrosis due to vascular prosthetic devices, implants and grafts, initial encounter 176 Yes No T82838A Hemorrhage due to vascular prosthetic devices, implants and grafts, initial encounter 176 Yes No T82848A Pain due to vascular prosthetic devices, implants and grafts, initial encounter 176 Yes No T82856A Stenosis of peripheral vascular stent, initial encounter 176 Yes No T82858A Stenosis of other vascular prosthetic devices, implants and grafts, initial encounter 176 Yes No T82868A Thrombosis due to vascular prosthetic devices, implants and grafts, initial encounter 176 Yes No T82898A Other specified complication of vascular prosthetic devices, implants and grafts, initial encounter 176 Yes No T83010A Breakdown (mechanical) of cystostomy catheter, initial encounter 176 Yes No T83011A Breakdown (mechanical) of indwelling urethral catheter, initial encounter 176 Yes No T83012A Breakdown (mechanical) of nephrostomy catheter, initial encounter 176 Yes No T83018A Breakdown (mechanical) of other urinary catheter, initial encounter 176 Yes No T83020A Displacement of cystostomy catheter, initial encounter 176 Yes No T83021A Displacement of indwelling urethral catheter, initial encounter 176 Yes No T83022A Displacement of nephrostomy catheter, initial encounter 176 Yes No T83028A Displacement of other urinary catheter, initial encounter 176 Yes No T83030A Leakage of cystostomy catheter, initial encounter 176 Yes No T83031A Leakage of indwelling urethral catheter, initial encounter 176 Yes No T83032A Leakage of nephrostomy catheter, initial encounter 176 Yes No T83038A Leakage of other urinary catheter, initial encounter 176 Yes No T83090A Other mechanical complication of cystostomy catheter, initial encounter 176 Yes No T83091A Other mechanical complication of indwelling urethral catheter, initial encounter 176 Yes No T83092A Other mechanical complication of nephrostomy catheter, initial encounter 176 Yes No T83098A Other mechanical complication of other urinary catheter, initial encounter 176 Yes No T83110A Breakdown (mechanical) of urinary electronic stimulator device, initial encounter 176 Yes No T83111A Breakdown (mechanical) of implanted urinary sphincter, initial encounter 176 Yes No T83112A Breakdown (mechanical) of indwelling ureteral stent, initial encounter 176 Yes No T83113A Breakdown (mechanical) of other urinary stents, initial encounter 176 Yes No T83118A Breakdown (mechanical) of other urinary devices and implants, initial encounter 176 Yes No T83120A Displacement of urinary electronic stimulator device, initial encounter 176 Yes No T83121A Displacement of implanted urinary sphincter, initial encounter 176 Yes No T83122A Displacement of indwelling ureteral stent, initial encounter 176 Yes No

T83123A Displacement of other urinary stents, initial encounter 176 Yes No T83128A Displacement of other urinary devices and implants, initial encounter 176 Yes No T83190A Other mechanical complication of urinary electronic stimulator device, initial encounter 176 Yes No T83191A Other mechanical complication of implanted urinary sphincter, initial encounter 176 Yes No T83192A Other mechanical complication of indwelling ureteral stent, initial encounter 176 Yes No T83193A Other mechanical complication of other urinary stent, initial encounter 176 Yes No T83198A Other mechanical complication of other urinary devices and implants, initial encounter 176 Yes No T8321XA Breakdown (mechanical) of graft of urinary organ, initial encounter 176 Yes No T8322XA Displacement of graft of urinary organ, initial encounter 176 Yes No T8323XA Leakage of graft of urinary organ, initial encounter 176 Yes No T8324XA Erosion of graft of urinary organ, initial encounter 176 Yes No T8325XA Exposure of graft of urinary organ, initial encounter 176 Yes No T8329XA Other mechanical complication of graft of urinary organ, initial encounter 176 Yes No T83410A Breakdown (mechanical) of implanted penile prosthesis, initial encounter 176 Yes No T83411A Breakdown (mechanical) of implanted testicular prosthesis, initial encounter 176 Yes No T83418A Breakdown (mechanical) of other prosthetic devices, implants and grafts of genital tract, initial encounter 176 Yes No T83420A Displacement of implanted penile prosthesis, initial encounter 176 Yes No T83421A Displacement of implanted testicular prosthesis, initial encounter 176 Yes No T83428A Displacement of other prosthetic devices, implants and grafts of genital tract, initial encounter 176 Yes No T83490A Other mechanical complication of implanted penile prosthesis, initial encounter 176 Yes No T83491A Other mechanical complication of implanted testicular prosthesis, initial encounter 176 Yes No T83498A Other mechanical complication of other prosthetic devices, implants and grafts of genital tract, initial encounter 176 Yes No T83510A Infection and inflammatory reaction due to cystostomy catheter, initial encounter 176 Yes No T83511A Infection and inflammatory reaction due to indwelling urethral catheter, initial encounter 176 Yes No T83512A Infection and inflammatory reaction due to nephrostomy catheter, initial encounter 176 Yes No T83518A Infection and inflammatory reaction due to other urinary catheter, initial encounter 176 Yes No T83590A Infection and inflammatory reaction due to implanted urinary neurostimulation device, initial encounter 176 Yes No T83591A Infection and inflammatory reaction due to implanted urinary sphincter, initial encounter 176 Yes No T83592A Infection and inflammatory reaction due to indwelling ureteral stent, initial encounter 176 Yes No T83593A Infection and inflammatory reaction due to other urinary stents, initial encounter 176 Yes No T83598A Infection and inflammatory reaction due to other prosthetic device, implant and graft in urinary system, initial 176 Yes No T8361XA Infection and inflammatory reaction due to implanted penile prosthesis, initial encounter 176 Yes No T8362XA Infection and inflammatory reaction due to implanted testicular prosthesis, initial encounter 176 Yes No T8369XA Infection and inflammatory reaction due to other prosthetic device, implant and graft in genital tract, initial 176 Yes No T83711A Erosion of implanted vaginal mesh to surrounding organ or tissue, initial encounter 176 Yes No T83712A Erosion of implanted urethral mesh to surrounding organ or tissue, initial encounter 176 Yes No T83713A Erosion of implanted urethral bulking agent to surrounding organ or tissue, initial encounter 176 Yes No T83714A Erosion of implanted ureteral bulking agent to surrounding organ or tissue, initial encounter 176 Yes No T83718A Erosion of other implanted mesh to organ or tissue, initial encounter 176 Yes No T83719A Erosion of other prosthetic materials to surrounding organ or tissue, initial encounter 176 Yes No T83721A Exposure of implanted vaginal mesh into vagina, initial encounter 176 Yes No T83722A Exposure of implanted urethral mesh into urethra, initial encounter 176 Yes No T83723A Exposure of implanted urethral bulking agent into urethra, initial encounter 176 Yes No T83724A Exposure of implanted ureteral bulking agent into ureter, initial encounter 176 Yes No T83728A Exposure of other implanted mesh into organ or tissue, initial encounter 176 Yes No T83729A Exposure of other prosthetic materials into organ or tissue, initial encounter 176 Yes No T8379XA Other specified complications due to other genitourinary prosthetic materials, initial encounter 176 Yes No T8381XA Embolism due to genitourinary prosthetic devices, implants and grafts, initial encounter 176 Yes No T8382XA Fibrosis due to genitourinary prosthetic devices, implants and grafts, initial encounter 176 Yes No T8383XA Hemorrhage due to genitourinary prosthetic devices, implants and grafts, initial encounter 176 Yes No T8384XA Pain due to genitourinary prosthetic devices, implants and grafts, initial encounter 176 Yes No T8385XA Stenosis due to genitourinary prosthetic devices, implants and grafts, initial encounter 176 Yes No T8386XA Thrombosis due to genitourinary prosthetic devices, implants and grafts, initial encounter 176 Yes No T8389XA Other specified complication of genitourinary prosthetic devices, implants and grafts, initial encounter 176 Yes No T839XXA Unspecified complication of genitourinary prosthetic device, implant and graft, initial encounter 176 Yes No T84010A Broken internal right hip prosthesis, initial encounter 176 Yes No T84011A Broken internal left hip prosthesis, initial encounter 176 Yes No T84012A Broken internal right knee prosthesis, initial encounter 176 Yes No

T84013A Broken internal left knee prosthesis, initial encounter 176 Yes No T84018A Broken internal joint prosthesis, other site, initial encounter 176 Yes No T84019A Broken internal joint prosthesis, unspecified site, initial encounter 176 Yes No T84020A Dislocation of internal right hip prosthesis, initial encounter 176 Yes No T84021A Dislocation of internal left hip prosthesis, initial encounter 176 Yes No T84022A Instability of internal right knee prosthesis, initial encounter 176 Yes No T84023A Instability of internal left knee prosthesis, initial encounter 176 Yes No T84028A Dislocation of other internal joint prosthesis, initial encounter 176 Yes No T84029A Dislocation of unspecified internal joint prosthesis, initial encounter 176 Yes No T84030A Mechanical loosening of internal right hip prosthetic joint, initial encounter 176 Yes No T84031A Mechanical loosening of internal left hip prosthetic joint, initial encounter 176 Yes No T84032A Mechanical loosening of internal right knee prosthetic joint, initial encounter 176 Yes No T84033A Mechanical loosening of internal left knee prosthetic joint, initial encounter 176 Yes No T84038A Mechanical loosening of other internal prosthetic joint, initial encounter 176 Yes No T84039A Mechanical loosening of unspecified internal prosthetic joint, initial encounter 176 Yes No T84050A Periprosthetic osteolysis of internal prosthetic right hip joint, initial encounter 176 Yes No T84051A Periprosthetic osteolysis of internal prosthetic left hip joint, initial encounter 176 Yes No T84052A Periprosthetic osteolysis of internal prosthetic right knee joint, initial encounter 176 Yes No T84053A Periprosthetic osteolysis of internal prosthetic left knee joint, initial encounter 176 Yes No T84058A Periprosthetic osteolysis of other internal prosthetic joint, initial encounter 176 Yes No T84059A Periprosthetic osteolysis of unspecified internal prosthetic joint, initial encounter 176 Yes No T84060A Wear of articular bearing surface of internal prosthetic right hip joint, initial encounter 176 Yes No T84061A Wear of articular bearing surface of internal prosthetic left hip joint, initial encounter 176 Yes No T84062A Wear of articular bearing surface of internal prosthetic right knee joint, initial encounter 176 Yes No T84063A Wear of articular bearing surface of internal prosthetic left knee joint, initial encounter 176 Yes No T84068A Wear of articular bearing surface of other internal prosthetic joint, initial encounter 176 Yes No T84069A Wear of articular bearing surface of unspecified internal prosthetic joint, initial encounter 176 Yes No T84090A Other mechanical complication of internal right hip prosthesis, initial encounter 176 Yes No T84091A Other mechanical complication of internal left hip prosthesis, initial encounter 176 Yes No T84092A Other mechanical complication of internal right knee prosthesis, initial encounter 176 Yes No T84093A Other mechanical complication of internal left knee prosthesis, initial encounter 176 Yes No T84098A Other mechanical complication of other internal joint prosthesis, initial encounter 176 Yes No T84099A Other mechanical complication of unspecified internal joint prosthesis, initial encounter 176 Yes No T84110A Breakdown (mechanical) of internal fixation device of right humerus, initial encounter 176 Yes No T84111A Breakdown (mechanical) of internal fixation device of left humerus, initial encounter 176 Yes No T84112A Breakdown (mechanical) of internal fixation device of bone of right forearm, initial encounter 176 Yes No T84113A Breakdown (mechanical) of internal fixation device of bone of left forearm, initial encounter 176 Yes No T84114A Breakdown (mechanical) of internal fixation device of right femur, initial encounter 176 Yes No T84115A Breakdown (mechanical) of internal fixation device of left femur, initial encounter 176 Yes No T84116A Breakdown (mechanical) of internal fixation device of bone of right lower leg, initial encounter 176 Yes No T84117A Breakdown (mechanical) of internal fixation device of bone of left lower leg, initial encounter 176 Yes No T84119A Breakdown (mechanical) of internal fixation device of unspecified bone of limb, initial encounter 176 Yes No T84120A Displacement of internal fixation device of right humerus, initial encounter 176 Yes No T84121A Displacement of internal fixation device of left humerus, initial encounter 176 Yes No T84122A Displacement of internal fixation device of bone of right forearm, initial encounter 176 Yes No T84123A Displacement of internal fixation device of bone of left forearm, initial encounter 176 Yes No T84124A Displacement of internal fixation device of right femur, initial encounter 176 Yes No T84125A Displacement of internal fixation device of left femur, initial encounter 176 Yes No T84126A Displacement of internal fixation device of bone of right lower leg, initial encounter 176 Yes No T84127A Displacement of internal fixation device of bone of left lower leg, initial encounter 176 Yes No T84129A Displacement of internal fixation device of unspecified bone of limb, initial encounter 176 Yes No T84190A Other mechanical complication of internal fixation device of right humerus, initial encounter 176 Yes No T84191A Other mechanical complication of internal fixation device of left humerus, initial encounter 176 Yes No T84192A Other mechanical complication of internal fixation device of bone of right forearm, initial encounter 176 Yes No T84193A Other mechanical complication of internal fixation device of bone of left forearm, initial encounter 176 Yes No T84194A Other mechanical complication of internal fixation device of right femur, initial encounter 176 Yes No T84195A Other mechanical complication of internal fixation device of left femur, initial encounter 176 Yes No T84196A Other mechanical complication of internal fixation device of bone of right lower leg, initial encounter 176 Yes No

T84197A Other mechanical complication of internal fixation device of bone of left lower leg, initial encounter 176 Yes No T84199A Other mechanical complication of internal fixation device of unspecified bone of limb, initial encounter 176 Yes No T84210A Breakdown (mechanical) of internal fixation device of bones of hand and fingers, initial encounter 176 Yes No T84213A Breakdown (mechanical) of internal fixation device of bones of foot and toes, initial encounter 176 Yes No T84216A Breakdown (mechanical) of internal fixation device of vertebrae, initial encounter 176 Yes No T84218A Breakdown (mechanical) of internal fixation device of other bones, initial encounter 176 Yes No T84220A Displacement of internal fixation device of bones of hand and fingers, initial encounter 176 Yes No T84223A Displacement of internal fixation device of bones of foot and toes, initial encounter 176 Yes No T84226A Displacement of internal fixation device of vertebrae, initial encounter 176 Yes No T84228A Displacement of internal fixation device of other bones, initial encounter 176 Yes No T84290A Other mechanical complication of internal fixation device of bones of hand and fingers, initial encounter 176 Yes No T84293A Other mechanical complication of internal fixation device of bones of foot and toes, initial encounter 176 Yes No T84296A Other mechanical complication of internal fixation device of vertebrae, initial encounter 176 Yes No T84298A Other mechanical complication of internal fixation device of other bones, initial encounter 176 Yes No T84310A Breakdown (mechanical) of electronic bone stimulator, initial encounter 176 Yes No T84318A Breakdown (mechanical) of other bone devices, implants and grafts, initial encounter 176 Yes No T84320A Displacement of electronic bone stimulator, initial encounter 176 Yes No T84328A Displacement of other bone devices, implants and grafts, initial encounter 176 Yes No T84390A Other mechanical complication of electronic bone stimulator, initial encounter 176 Yes No T84398A Other mechanical complication of other bone devices, implants and grafts, initial encounter 176 Yes No T84410A Breakdown (mechanical) of muscle and tendon graft, initial encounter 176 Yes No T84418A Breakdown (mechanical) of other internal orthopedic devices, implants and grafts, initial encounter 176 Yes No T84420A Displacement of muscle and tendon graft, initial encounter 176 Yes No T84428A Displacement of other internal orthopedic devices, implants and grafts, initial encounter 176 Yes No T84490A Other mechanical complication of muscle and tendon graft, initial encounter 176 Yes No T84498A Other mechanical complication of other internal orthopedic devices, implants and grafts, initial encounter 176 Yes No T8450XA Infection and inflammatory reaction due to unspecified internal joint prosthesis, initial encounter 176 Yes No T8451XA Infection and inflammatory reaction due to internal right hip prosthesis, initial encounter 176 Yes No T8452XA Infection and inflammatory reaction due to internal left hip prosthesis, initial encounter 176 Yes No T8453XA Infection and inflammatory reaction due to internal right knee prosthesis, initial encounter 176 Yes No T8454XA Infection and inflammatory reaction due to internal left knee prosthesis, initial encounter 176 Yes No T8459XA Infection and inflammatory reaction due to other internal joint prosthesis, initial encounter 176 Yes No T8460XA Infection and inflammatory reaction due to internal fixation device of unspecified site, initial encounter 176 Yes No T84610A Infection and inflammatory reaction due to internal fixation device of right humerus, initial encounter 176 Yes No T84611A Infection and inflammatory reaction due to internal fixation device of left humerus, initial encounter 176 Yes No T84612A Infection and inflammatory reaction due to internal fixation device of right radius, initial encounter 176 Yes No T84613A Infection and inflammatory reaction due to internal fixation device of left radius, initial encounter 176 Yes No T84614A Infection and inflammatory reaction due to internal fixation device of right ulna, initial encounter 176 Yes No T84615A Infection and inflammatory reaction due to internal fixation device of left ulna, initial encounter 176 Yes No T84619A Infection and inflammatory reaction due to internal fixation device of unspecified bone of arm, initial encounter 176 Yes No T84620A Infection and inflammatory reaction due to internal fixation device of right femur, initial encounter 176 Yes No T84621A Infection and inflammatory reaction due to internal fixation device of left femur, initial encounter 176 Yes No T84622A Infection and inflammatory reaction due to internal fixation device of right tibia, initial encounter 176 Yes No T84623A Infection and inflammatory reaction due to internal fixation device of left tibia, initial encounter 176 Yes No T84624A Infection and inflammatory reaction due to internal fixation device of right fibula, initial encounter 176 Yes No T84625A Infection and inflammatory reaction due to internal fixation device of left fibula, initial encounter 176 Yes No T84629A Infection and inflammatory reaction due to internal fixation device of unspecified bone of leg, initial encounter 176 Yes No T8463XA Infection and inflammatory reaction due to internal fixation device of spine, initial encounter 176 Yes No T8469XA Infection and inflammatory reaction due to internal fixation device of other site, initial encounter 176 Yes No T847XXA Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants and grafts, initial 176 Yes No T8481XA Embolism due to internal orthopedic prosthetic devices, implants and grafts, initial encounter 176 Yes No T8482XA Fibrosis due to internal orthopedic prosthetic devices, implants and grafts, initial encounter 176 Yes No T8483XA Hemorrhage due to internal orthopedic prosthetic devices, implants and grafts, initial encounter 176 Yes No T8484XA Pain due to internal orthopedic prosthetic devices, implants and grafts, initial encounter 176 Yes No T8485XA Stenosis due to internal orthopedic prosthetic devices, implants and grafts, initial encounter 176 Yes No T8486XA Thrombosis due to internal orthopedic prosthetic devices, implants and grafts, initial encounter 176 Yes No T8489XA Other specified complication of internal orthopedic prosthetic devices, implants and grafts, initial encounter 176 Yes No T849XXA Unspecified complication of internal orthopedic prosthetic device, implant and graft, initial encounter 176 Yes No

T8501XA Breakdown (mechanical) of ventricular intracranial (communicating) shunt, initial encounter 176 Yes No T8502XA Displacement of ventricular intracranial (communicating) shunt, initial encounter 176 Yes No T8503XA Leakage of ventricular intracranial (communicating) shunt, initial encounter 176 Yes No T8509XA Other mechanical complication of ventricular intracranial (communicating) shunt, initial encounter 176 Yes No T85110A Breakdown (mechanical) of implanted electronic neurostimulator of brain electrode (lead), initial encounter 176 Yes No T85111A Breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial 176 Yes No T85112A Breakdown (mechanical) of implanted electronic neurostimulator of spinal cord electrode (lead), initial encounter 176 Yes No T85113A Breakdown (mechanical) of implanted electronic neurostimulator, generator, initial encounter 176 Yes No T85118A Breakdown (mechanical) of other implanted electronic stimulator of nervous system, initial encounter 176 Yes No T85120A Displacement of implanted electronic neurostimulator of brain electrode (lead), initial encounter 176 Yes No T85121A Displacement of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial encounter 176 Yes No T85122A Displacement of implanted electronic neurostimulator of spinal cord electrode (lead), initial encounter 176 Yes No T85123A Displacement of implanted electronic neurostimulator, generator, initial encounter 176 Yes No T85128A Displacement of other implanted electronic stimulator of nervous system, initial encounter 176 Yes No T85190A Other mechanical complication of implanted electronic neurostimulator of brain electrode (lead), initial encounter 176 Yes No T85191A Other mechanical complication of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial 176 Yes No T85192A Other mechanical complication of implanted electronic neurostimulator of spinal cord electrode (lead), initial 176 Yes No T85193A Other mechanical complication of implanted electronic neurostimulator, generator, initial encounter 176 Yes No T85199A Other mechanical complication of other implanted electronic stimulator of nervous system, initial encounter 176 Yes No T85615A Breakdown (mechanical) of other nervous system device, implant or graft, initial encounter 176 Yes No T85625A Displacement of other nervous system device, implant or graft, initial encounter 176 Yes No T85635A Leakage of other nervous system device, implant or graft, initial encounter 176 Yes No T85695A Other mechanical complication of other nervous system device, implant or graft, initial encounter 176 Yes No T8572XA Infection and inflammatory reaction due to insulin pump, initial encounter 176 Yes No T85730A Infection and inflammatory reaction due to ventricular intracranial (communicating) shunt, initial encounter 176 Yes No T85731A Infection and inflammatory reaction due to implanted electronic neurostimulator of brain, electrode (lead), initial 176 Yes No T85732A Infection and inflammatory reaction due to implanted electronic neurostimulator of peripheral nerve, electrode 176 Yes No T85733A Infection and inflammatory reaction due to implanted electronic neurostimulator of spinal cord, electrode (lead), 176 Yes No T85734A Infection and inflammatory reaction due to implanted electronic neurostimulator, generator, initial encounter 176 Yes No T85735A Infection and inflammatory reaction due to cranial or spinal infusion catheter, initial encounter 176 Yes No T85738A Infection and inflammatory reaction due to other nervous system device, implant or graft, initial encounter 176 Yes No T8579XA Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, initial encounter 176 Yes No T85810A Embolism due to nervous system prosthetic devices, implants and grafts, initial encounter 176 Yes No T85820A Fibrosis due to nervous system prosthetic devices, implants and grafts, initial encounter 176 Yes No T85830A Hemorrhage due to nervous system prosthetic devices, implants and grafts, initial encounter 176 Yes No T85840A Pain due to nervous system prosthetic devices, implants and grafts, initial encounter 176 Yes No T85850A Stenosis due to nervous system prosthetic devices, implants and grafts, initial encounter 176 Yes No T85860A Thrombosis due to nervous system prosthetic devices, implants and grafts, initial encounter 176 Yes No T85890A Other specified complication of nervous system prosthetic devices, implants and grafts, initial encounter 176 Yes No T868421 Corneal transplant infection, right eye 176 Yes No T868422 Corneal transplant infection, left eye 176 Yes No T868423 Corneal transplant infection, bilateral 176 Yes No T868429 Corneal transplant infection, unspecified eye 176 Yes No S48011S Complete traumatic amputation at right shoulder joint, sequela 189 Yes No S48012S Complete traumatic amputation at left shoulder joint, sequela 189 Yes No S48019S Complete traumatic amputation at unspecified shoulder joint, sequela 189 Yes No S48021S Partial traumatic amputation at right shoulder joint, sequela 189 Yes No S48022S Partial traumatic amputation at left shoulder joint, sequela 189 Yes No S48029S Partial traumatic amputation at unspecified shoulder joint, sequela 189 Yes No S48111S Complete traumatic amputation at level between right shoulder and elbow, sequela 189 Yes No S48112S Complete traumatic amputation at level between left shoulder and elbow, sequela 189 Yes No S48119S Complete traumatic amputation at level between unspecified shoulder and elbow, sequela 189 Yes No S48121S Partial traumatic amputation at level between right shoulder and elbow, sequela 189 Yes No S48122S Partial traumatic amputation at level between left shoulder and elbow, sequela 189 Yes No S48129S Partial traumatic amputation at level between unspecified shoulder and elbow, sequela 189 Yes No S48911S Complete traumatic amputation of right shoulder and upper arm, level unspecified, sequela 189 Yes No S48912S Complete traumatic amputation of left shoulder and upper arm, level unspecified, sequela 189 Yes No S48919S Complete traumatic amputation of unspecified shoulder and upper arm, level unspecified, sequela 189 Yes No

S48921S Partial traumatic amputation of right shoulder and upper arm, level unspecified, sequela 189 Yes No S48922S Partial traumatic amputation of left shoulder and upper arm, level unspecified, sequela 189 Yes No S48929S Partial traumatic amputation of unspecified shoulder and upper arm, level unspecified, sequela 189 Yes No S58011S Complete traumatic amputation at elbow level, right arm, sequela 189 Yes No S58012S Complete traumatic amputation at elbow level, left arm, sequela 189 Yes No S58019S Complete traumatic amputation at elbow level, unspecified arm, sequela 189 Yes No S58021S Partial traumatic amputation at elbow level, right arm, sequela 189 Yes No S58022S Partial traumatic amputation at elbow level, left arm, sequela 189 Yes No S58029S Partial traumatic amputation at elbow level, unspecified arm, sequela 189 Yes No S58111S Complete traumatic amputation at level between elbow and wrist, right arm, sequela 189 Yes No S58112S Complete traumatic amputation at level between elbow and wrist, left arm, sequela 189 Yes No S58119S Complete traumatic amputation at level between elbow and wrist, unspecified arm, sequela 189 Yes No S58121S Partial traumatic amputation at level between elbow and wrist, right arm, sequela 189 Yes No S58122S Partial traumatic amputation at level between elbow and wrist, left arm, sequela 189 Yes No S58129S Partial traumatic amputation at level between elbow and wrist, unspecified arm, sequela 189 Yes No S58911S Complete traumatic amputation of right forearm, level unspecified, sequela 189 Yes No S58912S Complete traumatic amputation of left forearm, level unspecified, sequela 189 Yes No S58919S Complete traumatic amputation of unspecified forearm, level unspecified, sequela 189 Yes No S58921S Partial traumatic amputation of right forearm, level unspecified, sequela 189 Yes No S58922S Partial traumatic amputation of left forearm, level unspecified, sequela 189 Yes No S58929S Partial traumatic amputation of unspecified forearm, level unspecified, sequela 189 Yes No S68011S Complete traumatic metacarpophalangeal amputation of right thumb, sequela 189 Yes No S68012S Complete traumatic metacarpophalangeal amputation of left thumb, sequela 189 Yes No S68019S Complete traumatic metacarpophalangeal amputation of unspecified thumb, sequela 189 Yes No S68021S Partial traumatic metacarpophalangeal amputation of right thumb, sequela 189 Yes No S68022S Partial traumatic metacarpophalangeal amputation of left thumb, sequela 189 Yes No S68029S Partial traumatic metacarpophalangeal amputation of unspecified thumb, sequela 189 Yes No S68110S Complete traumatic metacarpophalangeal amputation of right index finger, sequela 189 Yes No S68111S Complete traumatic metacarpophalangeal amputation of left index finger, sequela 189 Yes No S68112S Complete traumatic metacarpophalangeal amputation of right middle finger, sequela 189 Yes No S68113S Complete traumatic metacarpophalangeal amputation of left middle finger, sequela 189 Yes No S68114S Complete traumatic metacarpophalangeal amputation of right ring finger, sequela 189 Yes No S68115S Complete traumatic metacarpophalangeal amputation of left ring finger, sequela 189 Yes No S68116S Complete traumatic metacarpophalangeal amputation of right little finger, sequela 189 Yes No S68117S Complete traumatic metacarpophalangeal amputation of left little finger, sequela 189 Yes No S68118S Complete traumatic metacarpophalangeal amputation of other finger, sequela 189 Yes No S68119S Complete traumatic metacarpophalangeal amputation of unspecified finger, sequela 189 Yes No S68120S Partial traumatic metacarpophalangeal amputation of right index finger, sequela 189 Yes No S68121S Partial traumatic metacarpophalangeal amputation of left index finger, sequela 189 Yes No S68122S Partial traumatic metacarpophalangeal amputation of right middle finger, sequela 189 Yes No S68123S Partial traumatic metacarpophalangeal amputation of left middle finger, sequela 189 Yes No S68124S Partial traumatic metacarpophalangeal amputation of right ring finger, sequela 189 Yes No S68125S Partial traumatic metacarpophalangeal amputation of left ring finger, sequela 189 Yes No S68126S Partial traumatic metacarpophalangeal amputation of right little finger, sequela 189 Yes No S68127S Partial traumatic metacarpophalangeal amputation of left little finger, sequela 189 Yes No S68128S Partial traumatic metacarpophalangeal amputation of other finger, sequela 189 Yes No S68129S Partial traumatic metacarpophalangeal amputation of unspecified finger, sequela 189 Yes No S68411S Complete traumatic amputation of right hand at wrist level, sequela 189 Yes No S68412S Complete traumatic amputation of left hand at wrist level, sequela 189 Yes No S68419S Complete traumatic amputation of unspecified hand at wrist level, sequela 189 Yes No S68421S Partial traumatic amputation of right hand at wrist level, sequela 189 Yes No S68422S Partial traumatic amputation of left hand at wrist level, sequela 189 Yes No S68429S Partial traumatic amputation of unspecified hand at wrist level, sequela 189 Yes No S68511S Complete traumatic transphalangeal amputation of right thumb, sequela 189 Yes No S68512S Complete traumatic transphalangeal amputation of left thumb, sequela 189 Yes No S68519S Complete traumatic transphalangeal amputation of unspecified thumb, sequela 189 Yes No S68521S Partial traumatic transphalangeal amputation of right thumb, sequela 189 Yes No S68522S Partial traumatic transphalangeal amputation of left thumb, sequela 189 Yes No

S68529S Partial traumatic transphalangeal amputation of unspecified thumb, sequela 189 Yes No S68610S Complete traumatic transphalangeal amputation of right index finger, sequela 189 Yes No S68611S Complete traumatic transphalangeal amputation of left index finger, sequela 189 Yes No S68612S Complete traumatic transphalangeal amputation of right middle finger, sequela 189 Yes No S68613S Complete traumatic transphalangeal amputation of left middle finger, sequela 189 Yes No S68614S Complete traumatic transphalangeal amputation of right ring finger, sequela 189 Yes No S68615S Complete traumatic transphalangeal amputation of left ring finger, sequela 189 Yes No S68616S Complete traumatic transphalangeal amputation of right little finger, sequela 189 Yes No S68617S Complete traumatic transphalangeal amputation of left little finger, sequela 189 Yes No S68618S Complete traumatic transphalangeal amputation of other finger, sequela 189 Yes No S68619S Complete traumatic transphalangeal amputation of unspecified finger, sequela 189 Yes No S68620S Partial traumatic transphalangeal amputation of right index finger, sequela 189 Yes No S68621S Partial traumatic transphalangeal amputation of left index finger, sequela 189 Yes No S68622S Partial traumatic transphalangeal amputation of right middle finger, sequela 189 Yes No S68623S Partial traumatic transphalangeal amputation of left middle finger, sequela 189 Yes No S68624S Partial traumatic transphalangeal amputation of right ring finger, sequela 189 Yes No S68625S Partial traumatic transphalangeal amputation of left ring finger, sequela 189 Yes No S68626S Partial traumatic transphalangeal amputation of right little finger, sequela 189 Yes No S68627S Partial traumatic transphalangeal amputation of left little finger, sequela 189 Yes No S68628S Partial traumatic transphalangeal amputation of other finger, sequela 189 Yes No S68629S Partial traumatic transphalangeal amputation of unspecified finger, sequela 189 Yes No S68711S Complete traumatic transmetacarpal amputation of right hand, sequela 189 Yes No S68712S Complete traumatic transmetacarpal amputation of left hand, sequela 189 Yes No S68719S Complete traumatic transmetacarpal amputation of unspecified hand, sequela 189 Yes No S68721S Partial traumatic transmetacarpal amputation of right hand, sequela 189 Yes No S68722S Partial traumatic transmetacarpal amputation of left hand, sequela 189 Yes No S68729S Partial traumatic transmetacarpal amputation of unspecified hand, sequela 189 Yes No S78011D Complete traumatic amputation at right hip joint, subsequent encounter 189 Yes No S78011S Complete traumatic amputation at right hip joint, sequela 189 Yes No S78012D Complete traumatic amputation at left hip joint, subsequent encounter 189 Yes No S78012S Complete traumatic amputation at left hip joint, sequela 189 Yes No S78019D Complete traumatic amputation at unspecified hip joint, subsequent encounter 189 Yes No S78019S Complete traumatic amputation at unspecified hip joint, sequela 189 Yes No S78021D Partial traumatic amputation at right hip joint, subsequent encounter 189 Yes No S78021S Partial traumatic amputation at right hip joint, sequela 189 Yes No S78022D Partial traumatic amputation at left hip joint, subsequent encounter 189 Yes No S78022S Partial traumatic amputation at left hip joint, sequela 189 Yes No S78029D Partial traumatic amputation at unspecified hip joint, subsequent encounter 189 Yes No S78029S Partial traumatic amputation at unspecified hip joint, sequela 189 Yes No S78111D Complete traumatic amputation at level between right hip and knee, subsequent encounter 189 Yes No S78111S Complete traumatic amputation at level between right hip and knee, sequela 189 Yes No S78112D Complete traumatic amputation at level between left hip and knee, subsequent encounter 189 Yes No S78112S Complete traumatic amputation at level between left hip and knee, sequela 189 Yes No S78119D Complete traumatic amputation at level between unspecified hip and knee, subsequent encounter 189 Yes No S78119S Complete traumatic amputation at level between unspecified hip and knee, sequela 189 Yes No S78121D Partial traumatic amputation at level between right hip and knee, subsequent encounter 189 Yes No S78121S Partial traumatic amputation at level between right hip and knee, sequela 189 Yes No S78122D Partial traumatic amputation at level between left hip and knee, subsequent encounter 189 Yes No S78122S Partial traumatic amputation at level between left hip and knee, sequela 189 Yes No S78129D Partial traumatic amputation at level between unspecified hip and knee, subsequent encounter 189 Yes No S78129S Partial traumatic amputation at level between unspecified hip and knee, sequela 189 Yes No S78911D Complete traumatic amputation of right hip and thigh, level unspecified, subsequent encounter 189 Yes No S78911S Complete traumatic amputation of right hip and thigh, level unspecified, sequela 189 Yes No S78912D Complete traumatic amputation of left hip and thigh, level unspecified, subsequent encounter 189 Yes No S78912S Complete traumatic amputation of left hip and thigh, level unspecified, sequela 189 Yes No S78919D Complete traumatic amputation of unspecified hip and thigh, level unspecified, subsequent encounter 189 Yes No S78919S Complete traumatic amputation of unspecified hip and thigh, level unspecified, sequela 189 Yes No S78921D Partial traumatic amputation of right hip and thigh, level unspecified, subsequent encounter 189 Yes No

S78921S Partial traumatic amputation of right hip and thigh, level unspecified, sequela 189 Yes No S78922D Partial traumatic amputation of left hip and thigh, level unspecified, subsequent encounter 189 Yes No S78922S Partial traumatic amputation of left hip and thigh, level unspecified, sequela 189 Yes No S78929D Partial traumatic amputation of unspecified hip and thigh, level unspecified, subsequent encounter 189 Yes No S78929S Partial traumatic amputation of unspecified hip and thigh, level unspecified, sequela 189 Yes No S88011D Complete traumatic amputation at knee level, right lower leg, subsequent encounter 189 Yes No S88011S Complete traumatic amputation at knee level, right lower leg, sequela 189 Yes No S88012D Complete traumatic amputation at knee level, left lower leg, subsequent encounter 189 Yes No S88012S Complete traumatic amputation at knee level, left lower leg, sequela 189 Yes No S88019D Complete traumatic amputation at knee level, unspecified lower leg, subsequent encounter 189 Yes No S88019S Complete traumatic amputation at knee level, unspecified lower leg, sequela 189 Yes No S88021D Partial traumatic amputation at knee level, right lower leg, subsequent encounter 189 Yes No S88021S Partial traumatic amputation at knee level, right lower leg, sequela 189 Yes No S88022D Partial traumatic amputation at knee level, left lower leg, subsequent encounter 189 Yes No S88022S Partial traumatic amputation at knee level, left lower leg, sequela 189 Yes No S88029D Partial traumatic amputation at knee level, unspecified lower leg, subsequent encounter 189 Yes No S88029S Partial traumatic amputation at knee level, unspecified lower leg, sequela 189 Yes No S88111D Complete traumatic amputation at level between knee and ankle, right lower leg, subsequent encounter 189 Yes No S88111S Complete traumatic amputation at level between knee and ankle, right lower leg, sequela 189 Yes No S88112D Complete traumatic amputation at level between knee and ankle, left lower leg, subsequent encounter 189 Yes No S88112S Complete traumatic amputation at level between knee and ankle, left lower leg, sequela 189 Yes No S88119D Complete traumatic amputation at level between knee and ankle, unspecified lower leg, subsequent encounter 189 Yes No S88119S Complete traumatic amputation at level between knee and ankle, unspecified lower leg, sequela 189 Yes No S88121D Partial traumatic amputation at level between knee and ankle, right lower leg, subsequent encounter 189 Yes No S88121S Partial traumatic amputation at level between knee and ankle, right lower leg, sequela 189 Yes No S88122D Partial traumatic amputation at level between knee and ankle, left lower leg, subsequent encounter 189 Yes No S88122S Partial traumatic amputation at level between knee and ankle, left lower leg, sequela 189 Yes No S88129D Partial traumatic amputation at level between knee and ankle, unspecified lower leg, subsequent encounter 189 Yes No S88129S Partial traumatic amputation at level between knee and ankle, unspecified lower leg, sequela 189 Yes No S88911D Complete traumatic amputation of right lower leg, level unspecified, subsequent encounter 189 Yes No S88911S Complete traumatic amputation of right lower leg, level unspecified, sequela 189 Yes No S88912D Complete traumatic amputation of left lower leg, level unspecified, subsequent encounter 189 Yes No S88912S Complete traumatic amputation of left lower leg, level unspecified, sequela 189 Yes No S88919D Complete traumatic amputation of unspecified lower leg, level unspecified, subsequent encounter 189 Yes No S88919S Complete traumatic amputation of unspecified lower leg, level unspecified, sequela 189 Yes No S88921D Partial traumatic amputation of right lower leg, level unspecified, subsequent encounter 189 Yes No S88921S Partial traumatic amputation of right lower leg, level unspecified, sequela 189 Yes No S88922D Partial traumatic amputation of left lower leg, level unspecified, subsequent encounter 189 Yes No S88922S Partial traumatic amputation of left lower leg, level unspecified, sequela 189 Yes No S88929D Partial traumatic amputation of unspecified lower leg, level unspecified, subsequent encounter 189 Yes No S88929S Partial traumatic amputation of unspecified lower leg, level unspecified, sequela 189 Yes No S98011D Complete traumatic amputation of right foot at ankle level, subsequent encounter 189 Yes No S98011S Complete traumatic amputation of right foot at ankle level, sequela 189 Yes No S98012D Complete traumatic amputation of left foot at ankle level, subsequent encounter 189 Yes No S98012S Complete traumatic amputation of left foot at ankle level, sequela 189 Yes No S98019D Complete traumatic amputation of unspecified foot at ankle level, subsequent encounter 189 Yes No S98019S Complete traumatic amputation of unspecified foot at ankle level, sequela 189 Yes No S98021D Partial traumatic amputation of right foot at ankle level, subsequent encounter 189 Yes No S98021S Partial traumatic amputation of right foot at ankle level, sequela 189 Yes No S98022D Partial traumatic amputation of left foot at ankle level, subsequent encounter 189 Yes No S98022S Partial traumatic amputation of left foot at ankle level, sequela 189 Yes No S98029D Partial traumatic amputation of unspecified foot at ankle level, subsequent encounter 189 Yes No S98029S Partial traumatic amputation of unspecified foot at ankle level, sequela 189 Yes No S98111D Complete traumatic amputation of right great toe, subsequent encounter 189 Yes No S98111S Complete traumatic amputation of right great toe, sequela 189 Yes No S98112D Complete traumatic amputation of left great toe, subsequent encounter 189 Yes No S98112S Complete traumatic amputation of left great toe, sequela 189 Yes No S98119D Complete traumatic amputation of unspecified great toe, subsequent encounter 189 Yes No

S98119S Complete traumatic amputation of unspecified great toe, sequela 189 Yes No S98121D Partial traumatic amputation of right great toe, subsequent encounter 189 Yes No S98121S Partial traumatic amputation of right great toe, sequela 189 Yes No S98122D Partial traumatic amputation of left great toe, subsequent encounter 189 Yes No S98122S Partial traumatic amputation of left great toe, sequela 189 Yes No S98129D Partial traumatic amputation of unspecified great toe, subsequent encounter 189 Yes No S98129S Partial traumatic amputation of unspecified great toe, sequela 189 Yes No S98131D Complete traumatic amputation of one right lesser toe, subsequent encounter 189 Yes No S98131S Complete traumatic amputation of one right lesser toe, sequela 189 Yes No S98132D Complete traumatic amputation of one left lesser toe, subsequent encounter 189 Yes No S98132S Complete traumatic amputation of one left lesser toe, sequela 189 Yes No S98139D Complete traumatic amputation of one unspecified lesser toe, subsequent encounter 189 Yes No S98139S Complete traumatic amputation of one unspecified lesser toe, sequela 189 Yes No S98141D Partial traumatic amputation of one right lesser toe, subsequent encounter 189 Yes No S98141S Partial traumatic amputation of one right lesser toe, sequela 189 Yes No S98142D Partial traumatic amputation of one left lesser toe, subsequent encounter 189 Yes No S98142S Partial traumatic amputation of one left lesser toe, sequela 189 Yes No S98149D Partial traumatic amputation of one unspecified lesser toe, subsequent encounter 189 Yes No S98149S Partial traumatic amputation of one unspecified lesser toe, sequela 189 Yes No S98211D Complete traumatic amputation of two or more right lesser toes, subsequent encounter 189 Yes No S98211S Complete traumatic amputation of two or more right lesser toes, sequela 189 Yes No S98212D Complete traumatic amputation of two or more left lesser toes, subsequent encounter 189 Yes No S98212S Complete traumatic amputation of two or more left lesser toes, sequela 189 Yes No S98219D Complete traumatic amputation of two or more unspecified lesser toes, subsequent encounter 189 Yes No S98219S Complete traumatic amputation of two or more unspecified lesser toes, sequela 189 Yes No S98221D Partial traumatic amputation of two or more right lesser toes, subsequent encounter 189 Yes No S98221S Partial traumatic amputation of two or more right lesser toes, sequela 189 Yes No S98222D Partial traumatic amputation of two or more left lesser toes, subsequent encounter 189 Yes No S98222S Partial traumatic amputation of two or more left lesser toes, sequela 189 Yes No S98229D Partial traumatic amputation of two or more unspecified lesser toes, subsequent encounter 189 Yes No S98229S Partial traumatic amputation of two or more unspecified lesser toes, sequela 189 Yes No S98311D Complete traumatic amputation of right midfoot, subsequent encounter 189 Yes No S98311S Complete traumatic amputation of right midfoot, sequela 189 Yes No S98312D Complete traumatic amputation of left midfoot, subsequent encounter 189 Yes No S98312S Complete traumatic amputation of left midfoot, sequela 189 Yes No S98319D Complete traumatic amputation of unspecified midfoot, subsequent encounter 189 Yes No S98319S Complete traumatic amputation of unspecified midfoot, sequela 189 Yes No S98321D Partial traumatic amputation of right midfoot, subsequent encounter 189 Yes No S98321S Partial traumatic amputation of right midfoot, sequela 189 Yes No S98322D Partial traumatic amputation of left midfoot, subsequent encounter 189 Yes No S98322S Partial traumatic amputation of left midfoot, sequela 189 Yes No S98329D Partial traumatic amputation of unspecified midfoot, subsequent encounter 189 Yes No S98329S Partial traumatic amputation of unspecified midfoot, sequela 189 Yes No S98911D Complete traumatic amputation of right foot, level unspecified, subsequent encounter 189 Yes No S98911S Complete traumatic amputation of right foot, level unspecified, sequela 189 Yes No S98912D Complete traumatic amputation of left foot, level unspecified, subsequent encounter 189 Yes No S98912S Complete traumatic amputation of left foot, level unspecified, sequela 189 Yes No S98919D Complete traumatic amputation of unspecified foot, level unspecified, subsequent encounter 189 Yes No S98919S Complete traumatic amputation of unspecified foot, level unspecified, sequela 189 Yes No S98921D Partial traumatic amputation of right foot, level unspecified, subsequent encounter 189 Yes No S98921S Partial traumatic amputation of right foot, level unspecified, sequela 189 Yes No S98922D Partial traumatic amputation of left foot, level unspecified, subsequent encounter 189 Yes No S98922S Partial traumatic amputation of left foot, level unspecified, sequela 189 Yes No S98929D Partial traumatic amputation of unspecified foot, level unspecified, subsequent encounter 189 Yes No S98929S Partial traumatic amputation of unspecified foot, level unspecified, sequela 189 Yes No Z89411 Acquired absence of right great toe 189 Yes No Z89412 Acquired absence of left great toe 189 Yes No Z89419 Acquired absence of unspecified great toe 189 Yes No

Z89421 Acquired absence of other right toe(s) 189 Yes No Z89422 Acquired absence of other left toe(s) 189 Yes No Z89429 Acquired absence of other toe(s), unspecified side 189 Yes No

Codes Added in V28

ICD 10 Descriptor V24 V28 V24 V28 D3A00 Benign carcinoid tumor of unspecified site 22 No Yes D3A010 Benign carcinoid tumor of the duodenum 22 No Yes D3A011 Benign carcinoid tumor of the jejunum 22 No Yes D3A012 Benign carcinoid tumor of the ileum 22 No Yes D3A019 Benign carcinoid tumor of the small intestine, unspecified portion 22 No Yes D3A020 Benign carcinoid tumor of the appendix 22 No Yes D3A021 Benign carcinoid tumor of the cecum 22 No Yes D3A022 Benign carcinoid tumor of the ascending colon 22 No Yes D3A023 Benign carcinoid tumor of the transverse colon 22 No Yes D3A024 Benign carcinoid tumor of the descending colon 22 No Yes D3A025 Benign carcinoid tumor of the sigmoid colon 22 No Yes D3A026 Benign carcinoid tumor of the rectum 22 No Yes D3A029 Benign carcinoid tumor of the large intestine, unspecified portion 22 No Yes D3A090 Benign carcinoid tumor of the bronchus and lung 22 No Yes D3A091 Benign carcinoid tumor of the thymus 22 No Yes D3A092 Benign carcinoid tumor of the stomach 22 No Yes D3A093 Benign carcinoid tumor of the kidney 22 No Yes D3A094 Benign carcinoid tumor of the foregut, unspecified 22 No Yes D3A095 Benign carcinoid tumor of the midgut, unspecified 22 No Yes D3A096 Benign carcinoid tumor of the hindgut, unspecified 22 No Yes D3A098 Benign carcinoid tumors of other sites 22 No Yes D3A8 Other benign neuroendocrine tumors 22 No Yes D644 Congenital dyserythropoietic anemia 109 No Yes D863 Sarcoidosis of skin 387 No Yes D8686 Sarcoid arthropathy 93 No Yes D8687 Sarcoid myositis 93 No Yes E08311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular 298 -- Yes E083211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with 298 -- Yes E083212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with 298 -- Yes E083213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with 298 -- Yes E083219 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with 298 -- Yes E083311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with 298 -- Yes E083312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with 298 -- Yes E083313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with 298 -- Yes E083319 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with 298 -- Yes E083411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with 298 -- Yes E083412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with 298 -- Yes E083413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with 298 -- Yes E083419 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with 298 -- 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, 298 -- Yes E103311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E103312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left 298 -- Yes E103313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E103319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E103411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right 298 -- Yes E103412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left 298 -- Yes E103413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E103419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, 298 -- 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, 298 -- Yes E113311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E113312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left 298 -- Yes E113313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E113319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E113411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right 298 -- Yes E113412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left 298 -- Yes E113413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E113419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, 298 -- 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, 298 -- Yes E133212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E133213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E133219 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, 298 -- Yes E133311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular 298 -- Yes E133312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular 298 -- Yes E133313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular 298 -- Yes E133319 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular 298 -- Yes E133411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular 298 -- Yes E133412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular 298 -- Yes E133413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular 298 -- Yes E133419 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular 298 -- Yes E8300 Disorder of copper metabolism, unspecified 50 No Yes E8301 Wilson's disease 50 No Yes E8309 Other disorders of copper metabolism 50 No Yes E8331 Familial hypophosphatemia 50 No Yes F5000 Anorexia nervosa, unspecified 153 No Yes F5001 Anorexia nervosa, restricting type 153 No Yes F5002 Anorexia nervosa, binge eating/purging type 153 No Yes F502 Bulimia nervosa 153 No Yes G14 Postpolio syndrome 182 No Yes G7241 Inclusion body myositis [IBM] 93 No 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 I3131 Malignant pericardial effusion in diseases classified elsewhere 17 No 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 J910 Malignant pleural effusion 17 No Yes K7010 Alcoholic hepatitis without ascites 65 No Yes K7011 Alcoholic hepatitis with ascites 65 No Yes K713 Toxic liver disease with chronic persistent hepatitis 65 No Yes K714 Toxic liver disease with chronic lobular hepatitis 65 No Yes K7150 Toxic liver disease with chronic active hepatitis without ascites 65 No Yes K7151 Toxic liver disease with chronic active hepatitis with ascites 65 No Yes K717 Toxic liver disease with fibrosis and cirrhosis of liver 64 No Yes K8301 Primary sclerosing cholangitis 68 No Yes K8309 Other cholangitis 68 No Yes K831 Obstruction of bile duct 68 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 N493 Fournier gangrene 92 No Yes P040 Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery 137 No Yes P0411 Newborn affected by maternal antineoplastic chemotherapy 137 No Yes P0412 Newborn affected by maternal cytotoxic drugs 137 No Yes P0413 Newborn affected by maternal use of anticonvulsants 137 No Yes P0414 Newborn affected by maternal use of opiates 137 No Yes P0415 Newborn affected by maternal use of antidepressants 137 No Yes P0416 Newborn affected by maternal use of amphetamines 137 No Yes P0417 Newborn affected by maternal use of sedative-hypnotics 137 No Yes P0418 Newborn affected by other maternal medication 137 No Yes P0419 Newborn affected by maternal use of unspecified medication 137 No Yes P041A Newborn affected by maternal use of anxiolytics 137 No Yes P042 Newborn affected by maternal use of tobacco 137 No Yes P043 Newborn affected by maternal use of alcohol 137 No Yes P0440 Newborn affected by maternal use of unspecified drugs of addiction 137 No Yes P0441 Newborn affected by maternal use of cocaine 137 No Yes P0442 Newborn affected by maternal use of hallucinogens 137 No Yes P0449 Newborn affected by maternal use of other drugs of addiction 137 No Yes

P045 Newborn affected by maternal use of nutritional chemical substances 137 No Yes P046 Newborn affected by maternal exposure to environmental chemical substances 137 No Yes P0481 Newborn affected by maternal use of cannabis 137 No Yes P0489 Newborn affected by other maternal noxious substances 137 No Yes P049 Newborn affected by maternal noxious substance, unspecified 137 No 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 P115 Birth injury to spine and spinal cord 182 No Yes P122 Epicranial subaponeurotic hemorrhage due to birth injury 399 No 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 P2881 Respiratory arrest of newborn 212 No Yes P290 Neonatal cardiac failure 225 No Yes P2981 Cardiac arrest of newborn 213 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 P550 Rh isoimmunization of newborn 109 No Yes P551 ABO isoimmunization of newborn 109 No Yes P558 Other hemolytic diseases of newborn 109 No Yes P559 Hemolytic disease of newborn, unspecified 109 No Yes P560 Hydrops fetalis due to isoimmunization 109 No Yes P5690 Hydrops fetalis due to unspecified hemolytic disease 109 No Yes P5699 Hydrops fetalis due to other hemolytic disease 109 No Yes P570 Kernicterus due to isoimmunization 192 No Yes P578 Other specified kernicterus 192 No Yes

P579 Kernicterus, unspecified 192 No Yes P771 Stage 1 necrotizing enterocolitis in newborn 78 No Yes P772 Stage 2 necrotizing enterocolitis in newborn 78 No Yes P773 Stage 3 necrotizing enterocolitis in newborn 78 No Yes P779 Necrotizing enterocolitis in newborn, unspecified 78 No Yes P780 Perinatal intestinal perforation 78 No Yes P90 Convulsions of newborn 201 No 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 P930 Grey baby syndrome 137 No Yes P938 Other reactions and intoxications due to drugs administered to newborn 137 No Yes P961 Neonatal withdrawal symptoms from maternal use of drugs of addiction 137 No Yes P962 Withdrawal symptoms from therapeutic use of drugs in newborn 137 No Yes Q400 Congenital hypertrophic pyloric stenosis 78 No Yes Q410 Congenital absence, atresia and stenosis of duodenum 78 No Yes Q411 Congenital absence, atresia and stenosis of jejunum 78 No Yes Q412 Congenital absence, atresia and stenosis of ileum 78 No Yes Q418 Congenital absence, atresia and stenosis of other specified parts of small intestine 78 No Yes Q419 Congenital absence, atresia and stenosis of small intestine, part unspecified 78 No Yes Q420 Congenital absence, atresia and stenosis of rectum with fistula 78 No Yes Q421 Congenital absence, atresia and stenosis of rectum without fistula 78 No Yes Q422 Congenital absence, atresia and stenosis of anus with fistula 78 No Yes Q423 Congenital absence, atresia and stenosis of anus without fistula 78 No Yes Q428 Congenital absence, atresia and stenosis of other parts of large intestine 78 No Yes Q429 Congenital absence, atresia and stenosis of large intestine, part unspecified 78 No Yes Q431 Hirschsprung's disease 78 No Yes Q432 Other congenital functional disorders of colon 78 No Yes Q433 Congenital malformations of intestinal fixation 78 No Yes Q442 Atresia of bile ducts 68 No Yes Q443 Congenital stenosis and stricture of bile ducts 68 No Yes R180 Malignant ascites 17 No 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 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 Z48280 Encounter for aftercare following heart-lung transplant 276 -- Yes

Z943 Heart and lungs transplant status 276 -- Yes Z9713 Presence of artificial right leg (complete) (partial) 409 No Yes Z9714 Presence of artificial left leg (complete) (partial) 409 No Yes Z9716 Presence of artificial legs, bilateral (complete) (partial) 409 No Yes

136 Table VI-2. 2024 CMS-HCC Model Relative Factors for Aged and Disabled New Enrollees Non-Medicaid & Non-Originally Disabled Medicaid & Non-Originally Disabled Non-Medicaid & Originally Disabled Medicaid & Originally Disabled Female 0-34 Years 0.711 1.025 - - 35-44 Years 0.950 1.303 - - 45-54 Years 1.155 1.415 - - 55-59 Years 1.152 1.289 - - 60-64 Years 1.212 1.396 - - 65 Years 0.532 0.986 1.212 1.599 66 Years 0.532 0.990 1.276 1.599 67 Years 0.557 1.004 1.276 1.599 68 Years 0.584 1.004 1.276 2.021 69 Years 0.625 1.004 1.276 2.021 70-74 Years 0.694 1.043 1.276 2.021 75-79 Years 0.901 1.128 1.276 2.021 80-84 Years 0.988 1.342 1.276 2.021 85-89 Years 1.287 1.563 1.287 2.021 90-94 Years 1.287 1.712 1.287 2.021 95 Years or Over 1.287 1.712 1.287 2.021 Male 0-34 Years 0.409 0.738 - - 35-44 Years 0.669 1.264 - - 45-54 Years 0.906 1.420 - - 55-59 Years 0.984 1.477 - - 60-64 Years 1.057 1.542 - - 65 Years 0.567 1.182 1.057 1.727 66 Years 0.576 1.234 1.155 1.959 67 Years 0.617 1.319 1.155 1.959 68 Years 0.678 1.367 1.155 1.959 69 Years 0.684 1.455 1.297 1.959 70-74 Years 0.808 1.455 1.297 1.959 75-79 Years 1.049 1.455 1.297 2.813 80-84 Years 1.245 1.503 1.297 2.813 85-89 Years 1.516 1.682 1.516 2.813 90-94 Years 1.516 1.981 1.516 2.813 95 Years or Over 1.516 1.981 1.516 2.813 NOTES: 1. The denominator used is $10,402.34. 2. For payment purposes, a new enrollee is a beneficiary who did not have 12 months of Part B eligibility in the data collection year. CMS-HCC new enrollee models are not based on diagnoses, but include factors for different age and sex combinations by Medicaid and the original reason for Medicare entitlement. SOURCE: 2018-2019 100% Medicare data.

137 Table VI-3. 2024 CMS-HCC Model Relative Factors for New Enrollees in Chronic Condition Special Needs Plans (C-SNPs) Non-Medicaid & Non-Originally Disabled Medicaid & Non-Originally Disabled Non-Medicaid & Originally Disabled Medicaid & Originally Disabled Female 0-34 Years 1.332 1.655 - - 35-44 Years 1.332 1.655 - - 45-54 Years 1.536 1.965 - - 55-59 Years 1.536 1.989 - - 60-64 Years 1.628 2.030 - - 65 Years 0.900 1.285 1.708 2.085 66 Years 0.900 1.285 1.708 2.085 67 Years 0.940 1.351 1.719 2.148 68 Years 1.004 1.351 1.745 2.148 69 Years 1.020 1.467 1.755 2.233 70-74 Years 1.195 1.634 1.929 2.295 75-79 Years 1.419 1.885 2.032 2.484 80-84 Years 1.612 2.061 2.239 2.735 85-89 Years 1.833 2.250 2.239 2.735 90-94 Years 2.016 2.400 2.239 2.735 95 Years or Over 2.016 2.400 2.239 2.735 Male 0-34 Years 1.206 1.485 - - 35-44 Years 1.206 1.485 - - 45-54 Years 1.472 1.845 - - 55-59 Years 1.552 1.994 - - 60-64 Years 1.642 2.035 - - 65 Years 0.944 1.422 1.642 2.035 66 Years 0.944 1.422 1.659 2.150 67 Years 0.985 1.477 1.659 2.195 68 Years 1.005 1.477 1.659 2.195 69 Years 1.065 1.477 1.677 2.246 70-74 Years 1.216 1.735 1.807 2.316 75-79 Years 1.496 1.952 2.039 2.487 80-84 Years 1.704 2.194 2.155 2.573 85-89 Years 1.924 2.403 2.346 2.573 90-94 Years 2.142 2.403 2.346 2.573 95 Years or Over 2.142 2.403 2.346 2.573 NOTES: 1. The denominator used is $10,402.34. 2. For payment purposes, a new enrollee is a beneficiary who did not have 12 months of Part B eligibility in the data collection year. CMS-HCC new enrollee models are not based on diagnoses, but include factors for different age and sex combinations by Medicaid and the original reason for Medicare entitlement. SOURCE: 2018-2019 100% Medicare data.

Attachment VI. CMS-HCC Risk Adjustment Factors Table VI-1. 2024 CMS-HCC Model Relative Factors for Continuing Enrollees Variable Description Label Community, NonDual, Aged CommuniNonDualDisabledFemale 0-34 Years - 0.238 35-44 Years - 0.288 45-54 Years - 0.340 55-59 Years - 0.385 60-64 Years - 0.436 65-69 Years 0.330 - 70-74 Years 0.395 - 75-79 Years 0.465 - 80-84 Years 0.524 - 85-89 Years 0.624 - 90-94 Years 0.737 - 95 Years or Over 0.742 - Male 0-34 Years - 0.106 35-44 Years - 0.154 45-54 Years - 0.215 55-59 Years - 0.283 60-64 Years - 0.345 65-69 Years 0.332 - 70-74 Years 0.396 - 75-79 Years 0.502 - 80-84 Years 0.571 - 85-89 Years 0.664 - 90-94 Years 0.800 - 95 Years or Over 0.896 - Medicaid and Originally Disabled Interactions Originally Disabled, Female 0.228 - Originally Disabled, Male 0.135 -

126 ty, l, d Community, FBDual, Aged Community, FBDual, Disabled Community, PBDual, Aged Community, PBDual, Disabled Institutional - 0.346 - 0.454 0.948 - 0.332 - 0.420 0.810 - 0.384 - 0.404 1.031 - 0.421 - 0.424 0.949 - 0.502 - 0.414 0.881 0.435 - 0.365 - 1.188 0.506 - 0.423 - 1.119 0.596 - 0.485 - 0.965 0.665 - 0.544 - 0.862 0.775 - 0.618 - 0.750 0.869 - 0.738 - 0.627 0.877 - 0.835 - 0.481 - 0.191 - 0.306 0.826 - 0.204 - 0.261 0.719 - 0.293 - 0.300 0.991 - 0.410 - 0.353 0.989 - 0.504 - 0.374 0.917 0.531 - 0.375 - 1.275 0.626 - 0.417 - 1.224 0.714 - 0.498 - 1.319 0.789 - 0.565 - 1.238 0.907 - 0.615 - 1.135 0.993 - 0.712 - 0.946 1.058 - 0.904 - 0.825 0.160 - 0.103 - - 0.158 - 0.075 - -

Variable Description Label Community, NonDual, Aged CommuniNonDualDisabledMedicaid - - Disease Coefficients HCC1 HIV/AIDS 0.301 0.213 HCC2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock 0.500 0.598 HCC6 Opportunistic Infections 0.381 0.763 HCC17 Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic 4.209 3.995 HCC18 Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid 2.341 2.486 HCC19 Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers 1.798 1.989 HCC20 Lung and Other Severe Cancers 1.136 0.978 HCC21 Lymphoma and Other Cancers 0.671 0.540 HCC22 Bladder, Colorectal, and Other Cancers 0.363 0.366 HCC23 Prostate, Breast, and Other Cancers and Tumors 0.186 0.233 HCC35 Pancreas Transplant Status 0.949 1.393 HCC36 Diabetes with Severe Acute Complications 0.166 0.191 HCC37 Diabetes with Chronic Complications 0.166 0.191 HCC38 Diabetes with Glycemic, Unspecified, or No Complications 0.166 0.191 HCC48 Morbid Obesity 0.186 0.144

127 ty, l, d Community, FBDual, Aged Community, FBDual, Disabled Community, PBDual, Aged Community, PBDual, Disabled Institutional - - - - 0.130 0.397 0.237 0.196 0.109 1.322 0.649 0.780 0.447 0.591 0.605 0.588 0.833 0.518 0.685 0.728 3.896 4.235 3.946 4.103 1.952 2.277 2.537 2.166 2.403 1.110 1.563 1.661 1.520 1.554 0.957 1.166 1.173 1.214 1.067 0.672 0.654 0.739 0.627 0.618 0.493 0.382 0.409 0.410 0.351 0.314 0.196 0.218 0.203 0.237 0.197 1.117 0.573 1.117 2.740 1.106 0.186 0.235 0.166 0.210 0.280 0.186 0.235 0.166 0.210 0.280 0.186 0.235 0.166 0.210 0.280 0.300 0.178 0.164 0.118 0.442

Variable Description Label Community, NonDual, Aged CommuniNonDualDisabledHCC49 Specified Lysosomal Storage Disorders 9.256 13.778 HCC50 Amyloidosis, Porphyria, and Other Specified Metabolic Disorders 0.648 0.883 HCC51 Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders 0.510 0.606 HCC62 Liver Transplant Status/Complications 0.376 0.184 HCC63 Chronic Liver Failure/EndStage Liver Disorders 0.962 1.032 HCC64 Cirrhosis of Liver 0.447 0.383 HCC65 Chronic Hepatitis 0.185 0.248 HCC68 Cholangitis and Obstruction of Bile Duct Without Gallstones 0.388 0.383 HCC77 Intestine Transplant Status/Complications 1.172 6.301 HCC78 Intestinal Obstruction/Perforation 0.326 0.534 HCC79 Chronic Pancreatitis 0.357 0.574 HCC80 Crohn's Disease (Regional Enteritis) 0.550 0.635 HCC81 Ulcerative Colitis 0.244 0.285 HCC92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis 0.479 0.529 HCC93 Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders 0.617 0.470 HCC94 Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders 0.268 0.239

128 ty, l, d Community, FBDual, Aged Community, FBDual, Disabled Community, PBDual, Aged Community, PBDual, Disabled Institutional 2.833 6.399 3.269 7.771 1.528 0.555 0.789 0.435 0.529 0.362 0.634 0.654 0.313 0.393 0.620 0.261 0.409 0.571 0.271 0.593 1.102 1.209 0.861 1.101 0.894 0.475 0.414 0.391 0.270 0.378 0.101 0.220 0.156 0.189 0.378 0.085 0.354 0.391 0.270 0.090 5.039 6.161 5.039 5.039 5.089 0.382 0.548 0.478 0.688 0.380 0.525 0.799 0.444 0.709 0.218 0.490 0.651 0.479 0.603 0.374 0.201 0.286 0.205 0.237 0.258 0.611 0.632 0.471 0.539 0.556 0.439 0.384 0.405 0.288 0.297 0.237 0.250 0.224 0.196 0.297