ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 30 of 75 |
| A000 B2781 C5712 C8395 D107 E083542 E1301 F13259 G543 H16041 H4303 H8393 I63541 I97610 K4020 L0882 M00239 M19072 M314 M6519 M84311S M84759P M96830 N8501 O2990 O35GXX1 O4192X9 O99845 Q51818 R502 S02118D S06319D S1192XA S15399D S22082B S30823D S32309A S35221D S39002D S42261D S43202A S4991XA S52201Q S52345P S52699N S56909D S60929A S62136P S62390B S63208D S65500D S68619D S72043S S72133F S72355A S7291XC S80211S S82132R S82399Q S82854P S85801A S90821D S92153B S93103D S99032A T2161XA T23661D T3371XA T40903A T457X5D T50B15D T632X3D T8112XD T8454XD Z4801 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| R502 | 18 | 864 | S00219A | 02 | 124-125 | S01149A | 02 | 124-125 | ||
| R5081 | 18 | 864 | S00219A | 24 | 963-965 | S01149A | 24 | 963-965 | ||
| R5082 | 18 | 864 | S00219D | 23 | 949-950 | S01149D | 23 | 949-950 | ||
| R5083 | 18 | 864 | S00219S | 09 | 604-605 | S01149S | 09 | 604-605 | ||
| R5084 | 18 | 864 | S00221A | 02 | 124-125 | S01151A | 02 | 124-125 | ||
| R509 | 18 | 864 | S00221A | 24 | 963-965 | S01151A | 24 | 963-965 | ||
| R510 | 01 | 102-103 | S00221D | 23 | 949-950 | S01151D | 23 | 949-950 | ||
| R519 | 01 | 102-103 | S00221S | 09 | 604-605 | S01151S | 09 | 604-605 | ||
| R52 | 23 | 947-948 | S00222A | 02 | 124-125 | S01152A | 02 | 124-125 | ||
| R530 | 23 | 947-948 | S00222A | 24 | 963-965 | S01152A | 24 | 963-965 | ||
| R531 | 23 | 947-948 | S00222D | 23 | 949-950 | S01152D | 23 | 949-950 | ||
| R532 | 23 | 947-948 | S00222S | 09 | 604-605 | S01152S | 09 | 604-605 | ||
| R5381 | 23 | 947-948 | S00229A | 02 | 124-125 | S01159A | 02 | 124-125 | ||
| R5382 | 23 | 947-948 | S00229A | 24 | 963-965 | S01159A | 24 | 963-965 | ||
| R5383 | 23 | 947-948 | S00229D | 23 | 949-950 | S01159D | 23 | 949-950 | ||
| R54 | 19 | 884 | S00229S | 09 | 604-605 | S01159S | 09 | 604-605 | ||
| R55 | 05 | 312 | S00241A | 02 | 124-125 | S0120XA | Pre | 011-013 | ||
| R5600 | 01 | 100-101 | S00241A | 24 | 963-965 | S0120XA | 03 | 154-156 | ||
| R5600 | 15 | 791 | S00241D | 23 | 949-950 | S0120XA | 24 | 963-965 | ||
| R5600 | 15 | 793 | S00241S | 09 | 604-605 | S0120XD | 23 | 949-950 | ||
| R5601 | 01 | 100-101 | S00242A | 02 | 124-125 | S0120XS | 09 | 604-605 | ||
| R561 | 01 | 100-101 | S00242A | 24 | 963-965 | S0121XA | Pre | 011-013 | ||
| R569 | 01 | 100-101 | S00242D | 23 | 949-950 | S0121XA | 03 | 154-156 | ||
| R569 | 15 | 791 | S00242S | 09 | 604-605 | S0121XA | 24 | 963-965 | ||
| R569 | 15 | 793 | S00249A | 02 | 124-125 | S0121XD | 23 | 949-950 | ||
| R570 | 05 | 291-293 | S00249A | 24 | 963-965 | S0121XS | 09 | 604-605 | ||
| R571 | 18 | 870-872 | S00249D | 23 | 949-950 | S0122XA | Pre | 011-013 | ||
| R578 | 18 | 870-872 | S00249S | 09 | 604-605 | S0122XA | 03 | 154-156 | ||
| R579 | 05 | 291-293 | S00251A | 02 | 124-125 | S0122XA | 24 | 963-965 | ||
| R579 | 15 | 791 | S00251A | 24 | 963-965 | S0122XD | 23 | 949-950 | ||
| R579 | 15 | 793 | S00251D | 23 | 949-950 | S0122XS | 09 | 604-605 | ||
| R58 | 05 | 314-316 | S00251S | 09 | 604-605 | S0123XA | Pre | 011-013 | ||
| R58 | 15 | 791 | S00252A | 02 | 124-125 | S0123XA | 03 | 154-156 | ||
| R58 | 15 | 793 | S00252A | 24 | 963-965 | S0123XA | 24 | 963-965 | ||
| R590 | 16 | 814-816 | S00252D | 23 | 949-950 | S0123XD | 23 | 949-950 | ||
| R591 | 16 | 814-816 | S00252S | 09 | 604-605 | S0123XS | 09 | 604-605 | ||
| R599 | 16 | 814-816 | S00259A | 02 | 124-125 | S0124XA | Pre | 011-013 | ||
| R600 | 23 | 947-948 | S00259A | 24 | 963-965 | S0124XA | 03 | 154-156 | ||
| R601 | 23 | 947-948 | S00259D | 23 | 949-950 | S0124XA | 24 | 963-965 | ||
| R609 | 23 | 947-948 | S00259S | 09 | 604-605 | S0124XD | 23 | 949-950 | ||
| R61 | 09 | 606-607 | S00261A | 02 | 124-125 | S0124XS | 09 | 604-605 | ||
| R620 | 10 | 640-641 | S00261A | 24 | 963-965 | S0125XA | Pre | 011-013 | ||
| R6250 | 10 | 640-641 | S00261D | 23 | 949-950 | S0125XA | 03 | 154-156 | ||
| R6251 | 10 | 640-641 | S00261S | 09 | 604-605 | S0125XA | 24 | 963-965 | ||
| R6252 | 10 | 640-641 | S00262A | 02 | 124-125 | S0125XD | 23 | 949-950 | ||
| R6259 | 10 | 640-641 | S00262A | 24 | 963-965 | S0125XS | 09 | 604-605 | ||
| R627 | 10 | 640-641 | S00262D | 23 | 949-950 | S01301A | 03 | 154-156 | ||
| R630 | 10 | 640-641 | S00262S | 09 | 604-605 | S01301A | 24 | 963-965 | ||
| R631 | 10 | 640-641 | S00269A | 02 | 124-125 | S01301D | 23 | 949-950 | ||
| R632 | 10 | 640-641 | S00269A | 24 | 963-965 | S01301S | 09 | 604-605 | ||
| R6330 | 10 | 640-641 | S00269D | 23 | 949-950 | S01302A | 03 | 154-156 | ||
| R6331 | 10 | 640-641 | S00269S | 09 | 604-605 | S01302A | 24 | 963-965 | ||
| R6332 | 10 | 640-641 | S00271A | 02 | 124-125 | S01302D | 23 | 949-950 | ||
| R6339 | 10 | 640-641 | S00271A | 24 | 963-965 | S01302S | 09 | 604-605 | ||
| R634 | 10 | 640-641 | S00271D | 23 | 949-950 | S01309A | 03 | 154-156 | ||
| R635 | 10 | 640-641 | S00271S | 09 | 604-605 | S01309A | 24 | 963-965 | ||
| R636 | 10 | 640-641 | S00272A | 02 | 124-125 | S01309D | 23 | 949-950 | ||
| R638 | 10 | 640-641 | S00272A | 24 | 963-965 | S01309S | 09 | 604-605 | ||
| R64 | 23 | 947-948 | S00272D | 23 | 949-950 | S01311A | 03 | 154-156 | ||
| R6510 | 18 | 864 | S00272S | 09 | 604-605 | S01311A | 24 | 963-965 | ||
| R6511 | 18 | 864 | S00279A | 02 | 124-125 | S01311D | 23 | 949-950 | ||
| R6520 | 18 | 870-872 | S00279A | 24 | 963-965 | S01311S | 09 | 604-605 | ||
| R6521 | 18 | 870-872 | S00279D | 23 | 949-950 | S01312A | 03 | 154-156 | ||
| R680 | 23 | 947-948 | S00279S | 09 | 604-605 | S01312A | 24 | 963-965 | ||
| R6811 | 23 | 947-948 | S0030XA | 09 | 604-605 | S01312D | 23 | 949-950 | ||
| R6812 | 23 | 947-948 | S0030XA | 24 | 963-965 | S01312S | 09 | 604-605 | ||
| R6813 | 23 | 951 | S0030XD | 23 | 949-950 | S01319A | 03 | 154-156 | ||
| R6819 | 23 | 951 | S0030XS | 09 | 604-605 | S01319A | 24 | 963-965 | ||
| R682 | Pre | 011-013 | S0031XA | 09 | 604-605 | S01319D | 23 | 949-950 | ||
| R682 | 03 | 154-156 | S0031XA | 24 | 963-965 | S01319S | 09 | 604-605 | ||
| R683 | 04 | 205-206 | S0031XD | 23 | 949-950 | S01321A | 03 | 154-156 | ||
| R6881 | 23 | 947-948 | S0031XS | 09 | 604-605 | S01321A | 24 | 963-965 | ||
| R6882 | 23 | 951 | S0032XA | 09 | 606-607 | S01321D | 23 | 949-950 | ||
| R6883 | 23 | 947-948 | S0032XA | 24 | 963-965 | S01321S | 09 | 604-605 | ||
| R6884 | Pre | 011-013 | S0032XD | 23 | 949-950 | S01322A | 03 | 154-156 | ||
| R6884 | 03 | 157-159 | S0032XS | 09 | 604-605 | S01322A | 24 | 963-965 | ||
| R6889 | 23 | 947-948 | S0033XA | 09 | 604-605 | S01322D | 23 | 949-950 | ||
| R69 | 23 | 951 | S0033XA | 24 | 963-965 | S01322S | 09 | 604-605 | ||
| R700 | 23 | 947-948 | S0033XD | 23 | 949-950 | S01329A | 03 | 154-156 | ||
| R701 | 23 | 947-948 | S0033XS | 09 | 604-605 | S01329A | 24 | 963-965 | ||
| R710 | 16 | 811-812 | S0034XA | 09 | 604-605 | S01329D | 23 | 949-950 | ||
| R718 | 16 | 811-812 | S0034XA | 24 | 963-965 | S01329S | 09 | 604-605 | ||
| R7301 | 10 | 640-641 | S0034XD | 23 | 949-950 | S01331A | 03 | 154-156 | ||
| R7302 | 10 | 640-641 | S0034XS | 09 | 604-605 | S01331A | 24 | 963-965 | ||
| R7303 | 10 | 640-641 | S0035XA | 09 | 604-605 | S01331D | 23 | 949-950 | ||
| R7309 | 10 | 640-641 | S0035XA | 24 | 963-965 | S01331S | 09 | 604-605 | ||
| R739 | 10 | 640-641 | S0035XD | 23 | 949-950 | S01332A | 03 | 154-156 | ||
| R7401 | 23 | 947-948 | S0035XS | 09 | 604-605 | S01332A | 24 | 963-965 | ||
| R7402 | 23 | 947-948 | S0036XA | 09 | 606-607 | S01332D | 23 | 949-950 | ||
| R748 | 23 | 947-948 | S0036XA | 24 | 963-965 | S01332S | 09 | 604-605 | ||
| R749 | 23 | 947-948 | S0036XD | 23 | 949-950 | S01339A | 03 | 154-156 | ||
| R75 | 16 | 814-816 | S0036XS | 09 | 604-605 | S01339A | 24 | 963-965 | ||
| R760 | 16 | 814-816 | S0037XA | 09 | 604-605 | S01339D | 23 | 949-950 | ||
| R7611 | 04 | 177-179 | S0037XA | 24 | 963-965 | S01339S | 09 | 604-605 | ||
| R7612 | 04 | 177-179 | S0037XD | 23 | 949-950 | S01341A | 03 | 154-156 | ||
| R768 | 16 | 814-816 | S0037XS | 09 | 604-605 | S01341A | 24 | 963-965 | ||
| R769 | 16 | 814-816 | S00401A | 09 | 604-605 | S01341D | 23 | 949-950 | ||
| R770 | 23 | 947-948 | S00401A | 24 | 963-965 | S01341S | 09 | 604-605 | ||
| R771 | 23 | 947-948 | S00401D | 23 | 949-950 | S01342A | 03 | 154-156 | ||
| R772 | 23 | 947-948 | S00401S | 09 | 604-605 | S01342A | 24 | 963-965 | ||
| R778 | 23 | 947-948 | S00402A | 09 | 604-605 | S01342D | 23 | 949-950 | ||
| R779 | 23 | 947-948 | S00402A | 24 | 963-965 | S01342S | 09 | 604-605 | ||
| R780 | 20 | 894-897 | S00402D | 23 | 949-950 | S01349A | 03 | 154-156 | ||
| R781 | 23 | 947-948 | S00402S | 09 | 604-605 | S01349A | 24 | 963-965 | ||
| R782 | 23 | 947-948 | S00409A | 09 | 604-605 | S01349D | 23 | 949-950 | ||
| R783 | 23 | 947-948 | S00409A | 24 | 963-965 | S01349S | 09 | 604-605 | ||
| R784 | 23 | 947-948 | S00409D | 23 | 949-950 | S01351A | 03 | 154-156 | ||
| R785 | 23 | 947-948 | S00409S | 09 | 604-605 | S01351A | 24 | 963-965 | ||
| R786 | 23 | 947-948 | S00411A | 09 | 604-605 | S01351D | 23 | 949-950 | ||
| R7871 | 23 | 947-948 | S00411A | 24 | 963-965 | S01351S | 09 | 604-605 | ||
| R7879 | 23 | 947-948 | S00411D | 23 | 949-950 | S01352A | 03 | 154-156 | ||
| R7881 | 15 | 791 | S00411S | 09 | 604-605 | S01352A | 24 | 963-965 | ||
| R7881 | 15 | 793 | S00412A | 09 | 604-605 | S01352D | 23 | 949-950 | ||
| R7881 | 18 | 870-872 | S00412A | 24 | 963-965 | S01352S | 09 | 604-605 | ||
| R7889 | 23 | 947-948 | S00412D | 23 | 949-950 | S01359A | 03 | 154-156 | ||
| R789 | 23 | 947-948 | S00412S | 09 | 604-605 | S01359A | 24 | 963-965 | ||
| R790 | 23 | 947-948 | S00419A | 09 | 604-605 | S01359D | 23 | 949-950 | ||
| R791 | 23 | 947-948 | S00419A | 24 | 963-965 | S01359S | 09 | 604-605 | ||
| R7981 | 23 | 947-948 | S00419D | 23 | 949-950 | S01401A | Pre | 011-013 | ||
| R7982 | 23 | 947-948 | S00419S | 09 | 604-605 | S01401A | 09 | 604-605 | ||
| R7983 | 23 | 947-948 | S00421A | 09 | 606-607 | S01401A | 24 | 963-965 | ||
| R7989 | 23 | 947-948 | S00421A | 24 | 963-965 | S01401D | 23 | 949-950 | ||
| R799 | 23 | 947-948 | S00421D | 23 | 949-950 | S01401S | 09 | 604-605 | ||
| R800 | 11 | 695-696 | S00421S | 09 | 604-605 | S01402A | Pre | 011-013 | ||
| R801 | 11 | 695-696 | S00422A | 09 | 606-607 | S01402A | 09 | 604-605 | ||
| R802 | 11 | 698-700 | S00422A | 24 | 963-965 | S01402A | 24 | 963-965 | ||
| R803 | 11 | 695-696 | S00422D | 23 | 949-950 | S01402D | 23 | 949-950 | ||
| R808 | 11 | 695-696 | S00422S | 09 | 604-605 | S01402S | 09 | 604-605 | ||
| R809 | 11 | 695-696 | S00429A | 09 | 606-607 | S01409A | Pre | 011-013 | ||
| R81 | 10 | 637-639 | S00429A | 24 | 963-965 | S01409A | 09 | 604-605 | ||
| R820 | 11 | 695-696 | S00429D | 23 | 949-950 | S01409A | 24 | 963-965 | ||
| R820 | 15 | 791 | S00429S | 09 | 604-605 | S01409D | 23 | 949-950 | ||
| R820 | 15 | 793 | S00431A | 09 | 604-605 | S01409S | 09 | 604-605 | ||
| R821 | 23 | 947-948 | S00431A | 24 | 963-965 | S01411A | Pre | 011-013 | ||
| R822 | 07 | 441-443 | S00431D | 23 | 949-950 | S01411A | 09 | 604-605 | ||
| R823 | 11 | 695-696 | S00431S | 09 | 604-605 | S01411A | 24 | 963-965 | ||
| R824 | 10 | 640-641 | S00432A | 09 | 604-605 | S01411D | 23 | 949-950 | ||
| R825 | 11 | 695-696 | S00432A | 24 | 963-965 | S01411S | 09 | 604-605 | ||
| R826 | 11 | 695-696 | S00432D | 23 | 949-950 | S01412A | Pre | 011-013 | ||
| R8271 | 11 | 695-696 | S00432S | 09 | 604-605 | S01412A | 09 | 604-605 | ||
| R8279 | 11 | 695-696 | S00439A | 09 | 604-605 | S01412A | 24 | 963-965 | ||
| R8281 | 11 | 695-696 | S00439A | 24 | 963-965 | S01412D | 23 | 949-950 | ||
| R8289 | 11 | 695-696 | S00439D | 23 | 949-950 | S01412S | 09 | 604-605 | ||
| R8290 | 11 | 695-696 | S00439S | 09 | 604-605 | S01419A | Pre | 011-013 | ||
| R8291 | 11 | 695-696 | S00441A | 09 | 604-605 | S01419A | 09 | 604-605 | ||
| R82991 | 11 | 695-696 | S00441A | 24 | 963-965 | S01419A | 24 | 963-965 | ||
| R82992 | 11 | 695-696 | S00441D | 23 | 949-950 | S01419D | 23 | 949-950 | ||
| R82993 | 11 | 695-696 | S00441S | 09 | 604-605 | S01419S | 09 | 604-605 | ||
| R82994 | 11 | 695-696 | S00442A | 09 | 604-605 | S01421A | Pre | 011-013 | ||
| R82998 | 11 | 695-696 | S00442A | 24 | 963-965 | S01421A | 09 | 604-605 | ||
| R830 | 01 | 091-093 | S00442D | 23 | 949-950 | S01421A | 24 | 963-965 | ||
| R831 | 01 | 091-093 | S00442S | 09 | 604-605 | S01421D | 23 | 949-950 | ||
| R832 | 01 | 091-093 | S00449A | 09 | 604-605 | S01421S | 09 | 604-605 | ||
| R833 | 01 | 091-093 | S00449A | 24 | 963-965 | S01422A | Pre | 011-013 | ||
| R834 | 01 | 091-093 | S00449D | 23 | 949-950 | S01422A | 09 | 604-605 | ||
| R835 | 01 | 091-093 | S00449S | 09 | 604-605 | S01422A | 24 | 963-965 | ||
| R836 | 01 | 091-093 | S00451A | 09 | 604-605 | S01422D | 23 | 949-950 | ||
| R838 | 01 | 091-093 | S00451A | 24 | 963-965 | S01422S | 09 | 604-605 | ||
| R839 | 01 | 091-093 | S00451D | 23 | 949-950 | S01429A | Pre | 011-013 | ||
| R840 | 23 | 947-948 | S00451S | 09 | 604-605 | S01429A | 09 | 604-605 | ||
| R841 | 23 | 947-948 | S00452A | 09 | 604-605 | S01429A | 24 | 963-965 | ||
| R842 | 23 | 947-948 | S00452A | 24 | 963-965 | S01429D | 23 | 949-950 | ||
| R843 | 23 | 947-948 | S00452D | 23 | 949-950 | S01429S | 09 | 604-605 | ||
| R844 | 23 | 947-948 | S00452S | 09 | 604-605 | S01431A | Pre | 011-013 | ||
| R845 | 23 | 947-948 | S00459A | 09 | 604-605 | S01431A | 09 | 604-605 | ||
| R846 | 23 | 947-948 | S00459A | 24 | 963-965 | S01431A | 24 | 963-965 | ||
| R847 | 23 | 947-948 | S00459D | 23 | 949-950 | S01431D | 23 | 949-950 | ||
| R848 | 23 | 947-948 | S00459S | 09 | 604-605 | S01431S | 09 | 604-605 | ||
| R849 | 23 | 947-948 | S00461A | 09 | 606-607 | S01432A | Pre | 011-013 | ||
| R850 | 23 | 947-948 | S00461A | 24 | 963-965 | S01432A | 09 | 604-605 | ||
| R851 | 23 | 947-948 | S00461D | 23 | 949-950 | S01432A | 24 | 963-965 | ||
| R852 | 23 | 947-948 | S00461S | 09 | 604-605 | S01432D | 23 | 949-950 | ||
| R853 | 23 | 947-948 | S00462A | 09 | 606-607 | S01432S | 09 | 604-605 | ||
| R854 | 23 | 947-948 | S00462A | 24 | 963-965 | S01439A | Pre | 011-013 | ||
| R855 | 23 | 947-948 | S00462D | 23 | 949-950 | S01439A | 09 | 604-605 | ||
| R85610 | 06 | 393-395 | S00462S | 09 | 604-605 | S01439A | 24 | 963-965 | ||
| R85611 | 06 | 393-395 | S00469A | 09 | 606-607 | S01439D | 23 | 949-950 | ||
| R85612 | 06 | 393-395 | S00469A | 24 | 963-965 | S01439S | 09 | 604-605 | ||
| R85613 | 06 | 393-395 | S00469D | 23 | 949-950 | S01441A | Pre | 011-013 | ||
| R85614 | 06 | 393-395 | S00469S | 09 | 604-605 | S01441A | 09 | 604-605 | ||
| R85615 | 06 | 393-395 | S00471A | 09 | 604-605 | S01441A | 24 | 963-965 | ||
| R85616 | 06 | 393-395 | S00471A | 24 | 963-965 | S01441D | 23 | 949-950 | ||
| R85618 | 06 | 393-395 | S00471D | 23 | 949-950 | S01441S | 09 | 604-605 | ||
| R85619 | 06 | 393-395 | S00471S | 09 | 604-605 | S01442A | Pre | 011-013 | ||
| R8569 | 23 | 947-948 | S00472A | 09 | 604-605 | S01442A | 09 | 604-605 | ||
| R857 | 23 | 947-948 | S00472A | 24 | 963-965 | S01442A | 24 | 963-965 | ||
| R8581 | 06 | 393-395 | S00472D | 23 | 949-950 | S01442D | 23 | 949-950 | ||
| R8582 | 06 | 393-395 | S00472S | 09 | 604-605 | S01442S | 09 | 604-605 | ||
| R8589 | 23 | 947-948 | S00479A | 09 | 604-605 | S01449A | Pre | 011-013 | ||
| R859 | 23 | 947-948 | S00479A | 24 | 963-965 | S01449A | 09 | 604-605 | ||
| R860 | 12 | 729-730 | S00479D | 23 | 949-950 | S01449A | 24 | 963-965 | ||
| R861 | 12 | 729-730 | S00479S | 09 | 604-605 | S01449D | 23 | 949-950 | ||
| R862 | 12 | 729-730 | S00501A | 09 | 604-605 | S01449S | 09 | 604-605 | ||
| R863 | 12 | 729-730 | S00501A | 24 | 963-965 | S01451A | Pre | 011-013 | ||
| R864 | 12 | 729-730 | S00501D | 23 | 949-950 | S01451A | 09 | 604-605 | ||
| R865 | 12 | 729-730 | S00501S | 09 | 604-605 | S01451A | 24 | 963-965 | ||
| R866 | 12 | 729-730 | S00502A | 09 | 604-605 | S01451D | 23 | 949-950 | ||
| R867 | 12 | 729-730 | S00502A | 24 | 963-965 | S01451S | 09 | 604-605 | ||
| R868 | 12 | 729-730 | S00502D | 23 | 949-950 | S01452A | Pre | 011-013 | ||
| R869 | 12 | 729-730 | S00502S | 09 | 604-605 | S01452A | 09 | 604-605 | ||
| R870 | 23 | 947-948 | S00511A | 09 | 604-605 | S01452A | 24 | 963-965 | ||
| R871 | 23 | 947-948 | S00511A | 24 | 963-965 | S01452D | 23 | 949-950 | ||
| R872 | 23 | 947-948 | S00511D | 23 | 949-950 | S01452S | 09 | 604-605 | ||
| R873 | 23 | 947-948 | S00511S | 09 | 604-605 | S01459A | Pre | 011-013 | ||
| R874 | 23 | 947-948 | S00512A | 09 | 604-605 | S01459A | 09 | 604-605 | ||
| R875 | 23 | 947-948 | S00512A | 24 | 963-965 | S01459A | 24 | 963-965 | ||
| R87610 | 13 | 742-743 | S00512D | 23 | 949-950 | S01459D | 23 | 949-950 | ||
| R87610 | 13 | 760-761 | S00512S | 09 | 604-605 | S01459S | 09 | 604-605 | ||
| R87611 | 13 | 742-743 | S00521A | 09 | 606-607 | S01501A | Pre | 011-013 | ||
| R87611 | 13 | 760-761 | S00521A | 24 | 963-965 | S01501A | 03 | 157-159 | ||
| R87612 | 13 | 742-743 | S00521D | 23 | 949-950 | S01501A | 24 | 963-965 | ||
| R87612 | 13 | 760-761 | S00521S | 09 | 604-605 | S01501D | 23 | 949-950 | ||
| R87613 | 13 | 742-743 | S00522A | 09 | 606-607 | S01501S | 09 | 604-605 | ||
| R87613 | 13 | 760-761 | S00522A | 24 | 963-965 | S01502A | Pre | 011-013 | ||
| R87614 | 13 | 742-743 | S00522D | 23 | 949-950 | S01502A | 03 | 157-159 | ||
| R87614 | 13 | 760-761 | S00522S | 09 | 604-605 | S01502A | 24 | 963-965 | ||
| R87615 | 13 | 742-743 | S00531A | 09 | 604-605 | S01502D | 23 | 949-950 | ||
| R87615 | 13 | 760-761 | S00531A | 24 | 963-965 | S01502S | 09 | 604-605 | ||
| R87616 | 13 | 742-743 | S00531D | 23 | 949-950 | S01511A | Pre | 011-013 | ||
| R87616 | 13 | 760-761 | S00531S | 09 | 604-605 | S01511A | 03 | 157-159 | ||
| R87618 | 15 | 795 | S00532A | 09 | 604-605 | S01511A | 24 | 963-965 | ||
| R87618 | 23 | 947-948 | S00532A | 24 | 963-965 | S01511D | 23 | 949-950 | ||
| R87619 | 15 | 795 | S00532D | 23 | 949-950 | S01511S | 09 | 604-605 | ||
| R87619 | 23 | 947-948 | S00532S | 09 | 604-605 | S01512A | Pre | 011-013 | ||
| R87620 | 13 | 742-743 | S00541A | 09 | 604-605 | S01512A | 03 | 157-159 | ||
| R87620 | 13 | 760-761 | S00541A | 24 | 963-965 | S01512A | 24 | 963-965 | ||
| R87621 | 13 | 742-743 | S00541D | 23 | 949-950 | S01512D | 23 | 949-950 | ||
| R87621 | 13 | 760-761 | S00541S | 09 | 604-605 | S01512S | 09 | 604-605 | ||
| R87622 | 13 | 742-743 | S00542A | 09 | 604-605 | S01521A | Pre | 011-013 | ||
| R87622 | 13 | 760-761 | S00542A | 24 | 963-965 | S01521A | 03 | 157-159 | ||
| R87623 | 13 | 742-743 | S00542D | 23 | 949-950 | S01521A | 24 | 963-965 | ||
| R87623 | 13 | 760-761 | S00542S | 09 | 604-605 | S01521D | 23 | 949-950 | ||
| R87624 | 13 | 742-743 | S00551A | 09 | 604-605 | S01521S | 09 | 604-605 | ||
| R87624 | 13 | 760-761 | S00551A | 24 | 963-965 | S01522A | Pre | 011-013 | ||
| R87625 | 13 | 742-743 | S00551D | 23 | 949-950 | S01522A | 03 | 157-159 | ||
| R87625 | 13 | 760-761 | S00551S | 09 | 604-605 | S01522A | 24 | 963-965 | ||
| R87628 | 13 | 742-743 | S00552A | 09 | 604-605 | S01522D | 23 | 949-950 | ||
| R87628 | 13 | 760-761 | S00552A | 24 | 963-965 | S01522S | 09 | 604-605 | ||
| R87629 | 15 | 795 | S00552D | 23 | 949-950 | S01531A | Pre | 011-013 | ||
| R87629 | 23 | 947-948 | S00552S | 09 | 604-605 | S01531A | 03 | 157-159 | ||
| R8769 | 23 | 947-948 | S00561A | 09 | 606-607 | S01531A | 24 | 963-965 | ||
| R877 | 23 | 947-948 | S00561A | 24 | 963-965 | S01531D | 23 | 949-950 | ||
| R87810 | 13 | 742-743 | S00561D | 23 | 949-950 | S01531S | 09 | 604-605 | ||
| R87810 | 13 | 760-761 | S00561S | 09 | 604-605 | S01532A | Pre | 011-013 | ||
| R87811 | 13 | 742-743 | S00562A | 09 | 606-607 | S01532A | 03 | 157-159 | ||
| R87811 | 13 | 760-761 | S00562A | 24 | 963-965 | S01532A | 24 | 963-965 | ||
| R87820 | 13 | 742-743 | S00562D | 23 | 949-950 | S01532D | 23 | 949-950 | ||
| R87820 | 13 | 760-761 | S00562S | 09 | 604-605 | S01532S | 09 | 604-605 | ||
| R87821 | 13 | 742-743 | S00571A | 09 | 604-605 | S01541A | Pre | 011-013 | ||
| R87821 | 13 | 760-761 | S00571A | 24 | 963-965 | S01541A | 03 | 157-159 | ||
| R8789 | 23 | 947-948 | S00571D | 23 | 949-950 | S01541A | 24 | 963-965 | ||
| R879 | 23 | 947-948 | S00571S | 09 | 604-605 | S01541D | 23 | 949-950 | ||
| R880 | 23 | 947-948 | S00572A | 09 | 604-605 | S01541S | 09 | 604-605 | ||
| R888 | 23 | 947-948 | S00572A | 24 | 963-965 | S01542A | Pre | 011-013 | ||
| R890 | 23 | 947-948 | S00572D | 23 | 949-950 | S01542A | 03 | 157-159 | ||
| R891 | 23 | 947-948 | S00572S | 09 | 604-605 | S01542A | 24 | 963-965 | ||
| R892 | 23 | 947-948 | S0080XA | 09 | 604-605 | S01542D | 23 | 949-950 | ||
| R893 | 23 | 947-948 | S0080XA | 24 | 963-965 | S01542S | 09 | 604-605 | ||
| R894 | 23 | 947-948 | S0080XD | 23 | 949-950 | S01551A | Pre | 011-013 | ||
| R895 | 23 | 947-948 | S0080XS | 09 | 604-605 | S01551A | 03 | 157-159 | ||
| R896 | 23 | 947-948 | S0081XA | 09 | 604-605 | S01551A | 24 | 963-965 | ||
| R897 | 15 | 795 | S0081XA | 24 | 963-965 | S01551D | 23 | 949-950 | ||
| R897 | 23 | 947-948 | S0081XD | 23 | 949-950 | S01551S | 09 | 604-605 | ||
| R898 | 23 | 947-948 | S0081XS | 09 | 604-605 | S01552A | Pre | 011-013 | ||
| R899 | 18 | 867-869 | S0082XA | 09 | 606-607 | S01552A | 03 | 157-159 | ||
| R900 | 09 | 606-607 | S0082XA | 24 | 963-965 | S01552A | 24 | 963-965 | ||
| R9081 | 01 | 091-093 | S0082XD | 23 | 949-950 | S01552D | 23 | 949-950 | ||
| R9082 | 01 | 091-093 | S0082XS | 09 | 604-605 | S01552S | 09 | 604-605 | ||
| R9089 | 23 | 947-948 | S0083XA | 09 | 604-605 | S0180XA | 09 | 604-605 | ||
| R911 | 04 | 205-206 | S0083XA | 24 | 963-965 | S0180XA | 24 | 963-965 | ||
| R918 | 04 | 204 | S0083XD | 23 | 949-950 | S0180XD | 23 | 949-950 | ||
| R920 | 09 | 600-601 | S0083XS | 09 | 604-605 | S0180XS | 09 | 604-605 | ||
| R921 | 09 | 600-601 | S0084XA | 09 | 604-605 | S0181XA | 09 | 604-605 | ||
| R922 | 09 | 600-601 | S0084XA | 24 | 963-965 | S0181XA | 24 | 963-965 | ||
| R9230 | 09 | 600-601 | S0084XD | 23 | 949-950 | S0181XD | 23 | 949-950 | ||
| R92311 | 09 | 600-601 | S0084XS | 09 | 604-605 | S0181XS | 09 | 604-605 | ||
| R92312 | 09 | 600-601 | S0085XA | 09 | 604-605 | S0182XA | 09 | 604-605 | ||
| R92313 | 09 | 600-601 | S0085XA | 24 | 963-965 | S0182XA | 24 | 963-965 | ||
| R92321 | 09 | 600-601 | S0085XD | 23 | 949-950 | S0182XD | 23 | 949-950 | ||
| R92322 | 09 | 600-601 | S0085XS | 09 | 604-605 | S0182XS | 09 | 604-605 | ||
| R92323 | 09 | 600-601 | S0086XA | 09 | 606-607 | S0183XA | 09 | 604-605 | ||
| R92331 | 09 | 600-601 | S0086XA | 24 | 963-965 | S0183XA | 24 | 963-965 | ||
| R92332 | 09 | 600-601 | S0086XD | 23 | 949-950 | S0183XD | 23 | 949-950 | ||
| R92333 | 09 | 600-601 | S0086XS | 09 | 604-605 | S0183XS | 09 | 604-605 | ||
| R92341 | 09 | 600-601 | S0087XA | 09 | 604-605 | S0184XA | 09 | 604-605 | ||
| R92342 | 09 | 600-601 | S0087XA | 24 | 963-965 | S0184XA | 24 | 963-965 | ||
| R92343 | 09 | 600-601 | S0087XD | 23 | 949-950 | S0184XD | 23 | 949-950 | ||
| R928 | 09 | 600-601 | S0087XS | 09 | 604-605 | S0184XS | 09 | 604-605 | ||
| R930 | 01 | 091-093 | S0090XA | 09 | 604-605 | S0185XA | 09 | 604-605 | ||
| R931 | 05 | 302-303 | S0090XA | 24 | 963-965 | S0185XA | 24 | 963-965 | ||
| R932 | 07 | 444-446 | S0090XD | 23 | 949-950 | S0185XD | 23 | 949-950 | ||
| R933 | 06 | 391-392 | S0090XS | 09 | 604-605 | S0185XS | 09 | 604-605 | ||
| R9341 | 11 | 695-696 | S0091XA | 09 | 604-605 | S0190XA | 09 | 604-605 | ||
| R93421 | 11 | 695-696 | S0091XA | 24 | 963-965 | S0190XA | 24 | 963-965 | ||
| R93422 | 11 | 695-696 | S0091XD | 23 | 949-950 | S0190XD | 23 | 949-950 | ||
| R93429 | 11 | 695-696 | S0091XS | 09 | 604-605 | S0190XS | 09 | 604-605 | ||
| R9349 | 11 | 695-696 | S0092XA | 09 | 606-607 | S0191XA | 09 | 604-605 | ||
| R935 | 06 | 391-392 | S0092XA | 24 | 963-965 | S0191XA | 24 | 963-965 | ||
| R936 | 08 | 564-566 | S0092XD | 23 | 949-950 | S0191XD | 23 | 949-950 | ||
| R937 | 08 | 564-566 | S0092XS | 09 | 604-605 | S0191XS | 09 | 604-605 | ||
| R93811 | 12 | 729-730 | S0093XA | 09 | 604-605 | S0192XA | 09 | 604-605 | ||
| R93812 | 12 | 729-730 | S0093XA | 24 | 963-965 | S0192XA | 24 | 963-965 | ||
| R93813 | 12 | 729-730 | S0093XD | 23 | 949-950 | S0192XD | 23 | 949-950 | ||
| R93819 | 12 | 729-730 | S0093XS | 09 | 604-605 | S0192XS | 09 | 604-605 | ||
| R9389 | 23 | 947-948 | S0094XA | 09 | 604-605 | S0193XA | 09 | 604-605 | ||
| R939 | 23 | 947-948 | S0094XA | 24 | 963-965 | S0193XA | 24 | 963-965 | ||
| R9401 | 01 | 091-093 | S0094XD | 23 | 949-950 | S0193XD | 23 | 949-950 | ||
| R9402 | 01 | 091-093 | S0094XS | 09 | 604-605 | S0193XS | 09 | 604-605 | ||
| R9409 | 01 | 091-093 | S0095XA | 09 | 604-605 | S0194XA | 09 | 604-605 | ||
| R94110 | 02 | 124-125 | S0095XA | 24 | 963-965 | S0194XA | 24 | 963-965 | ||
| R94111 | 02 | 124-125 | S0095XD | 23 | 949-950 | S0194XD | 23 | 949-950 | ||
| R94112 | 02 | 124-125 | S0095XS | 09 | 604-605 | S0194XS | 09 | 604-605 | ||
| R94113 | 02 | 124-125 | S0096XA | 09 | 606-607 | S0195XA | 09 | 604-605 | ||
| R94118 | 01 | 091-093 | S0096XA | 24 | 963-965 | S0195XA | 24 | 963-965 | ||
| R94120 | 03 | 154-156 | S0096XD | 23 | 949-950 | S0195XD | 23 | 949-950 | ||
| R94120 | 15 | 795 | S0096XS | 09 | 604-605 | S0195XS | 09 | 604-605 | ||
| R94121 | 03 | 154-156 | S0097XA | 09 | 604-605 | S020XXA | 01 | 082-084 | ||
| R94128 | 01 | 091-093 | S0097XA | 24 | 963-965 | S020XXA | 01 | 085-087 | ||
| R94130 | 01 | 091-093 | S0097XD | 23 | 949-950 | S020XXA | 24 | 963-965 | ||
| R94131 | 08 | 564-566 | S0097XS | 09 | 604-605 | S020XXB | 01 | 082-084 | ||
| R94138 | 01 | 091-093 | S0100XA | 09 | 604-605 | S020XXB | 01 | 085-087 | ||
| R942 | 04 | 205-206 | S0100XA | 24 | 963-965 | S020XXB | 24 | 963-965 | ||
| R9430 | 05 | 314-316 | S0100XD | 23 | 949-950 | S020XXD | 08 | 559-561 | ||
| R9431 | 05 | 314-316 | S0100XS | 09 | 604-605 | S020XXG | 08 | 559-561 | ||
| R9439 | 05 | 314-316 | S0101XA | 09 | 604-605 | S020XXK | 08 | 564-566 | ||
| R944 | 11 | 695-696 | S0101XA | 24 | 963-965 | S020XXS | 01 | 091-093 | ||
| R945 | 07 | 441-443 | S0101XD | 23 | 949-950 | S02101A | 01 | 082-084 | ||
| R946 | 10 | 643-645 | S0101XS | 09 | 604-605 | S02101A | 01 | 085-087 | ||
| R947 | 10 | 643-645 | S0102XA | 09 | 604-605 | S02101A | 24 | 963-965 | ||
| R948 | 11 | 695-696 | S0102XA | 24 | 963-965 | S02101B | 01 | 082-084 | ||
| R970 | 23 | 947-948 | S0102XD | 23 | 949-950 | S02101B | 01 | 085-087 | ||
| R971 | 23 | 947-948 | S0102XS | 09 | 604-605 | S02101B | 24 | 963-965 | ||
| R9720 | 23 | 947-948 | S0103XA | 09 | 604-605 | S02101D | 08 | 559-561 | ||
| R9721 | 23 | 947-948 | S0103XA | 24 | 963-965 | S02101G | 08 | 559-561 | ||
| R978 | 23 | 947-948 | S0103XD | 23 | 949-950 | S02101K | 08 | 564-566 | ||
| R99 | 23 | 951 | S0103XS | 09 | 604-605 | S02101S | 01 | 091-093 | ||
| S0000XA | 09 | 604-605 | S0104XA | 09 | 604-605 | S02102A | 01 | 082-084 | ||
| S0000XA | 24 | 963-965 | S0104XA | 24 | 963-965 | S02102A | 01 | 085-087 | ||
| S0000XD | 23 | 949-950 | S0104XD | 23 | 949-950 | S02102A | 24 | 963-965 | ||
| S0000XS | 09 | 604-605 | S0104XS | 09 | 604-605 | S02102B | 01 | 082-084 | ||
| S0001XA | 09 | 604-605 | S0105XA | 09 | 604-605 | S02102B | 01 | 085-087 | ||
| S0001XA | 24 | 963-965 | S0105XA | 24 | 963-965 | S02102B | 24 | 963-965 | ||
| S0001XD | 23 | 949-950 | S0105XD | 23 | 949-950 | S02102D | 08 | 559-561 | ||
| S0001XS | 09 | 604-605 | S0105XS | 09 | 604-605 | S02102G | 08 | 559-561 | ||
| S0002XA | 09 | 606-607 | S01101A | 02 | 124-125 | S02102K | 08 | 564-566 | ||
| S0002XA | 24 | 963-965 | S01101A | 24 | 963-965 | S02102S | 01 | 091-093 | ||
| S0002XD | 23 | 949-950 | S01101D | 23 | 949-950 | S02109A | 01 | 082-084 | ||
| S0002XS | 09 | 604-605 | S01101S | 09 | 604-605 | S02109A | 01 | 085-087 | ||
| S0003XA | 09 | 604-605 | S01102A | 02 | 124-125 | S02109A | 24 | 963-965 | ||
| S0003XA | 24 | 963-965 | S01102A | 24 | 963-965 | S02109B | 01 | 082-084 | ||
| S0003XD | 23 | 949-950 | S01102D | 23 | 949-950 | S02109B | 01 | 085-087 | ||
| S0003XS | 09 | 604-605 | S01102S | 09 | 604-605 | S02109B | 24 | 963-965 | ||
| S0004XA | 09 | 604-605 | S01109A | 02 | 124-125 | S02109D | 08 | 559-561 | ||
| S0004XA | 24 | 963-965 | S01109A | 24 | 963-965 | S02109G | 08 | 559-561 | ||
| S0004XD | 23 | 949-950 | S01109D | 23 | 949-950 | S02109K | 08 | 564-566 | ||
| S0004XS | 09 | 604-605 | S01109S | 09 | 604-605 | S02109S | 01 | 091-093 | ||
| S0005XA | 09 | 604-605 | S01111A | 02 | 124-125 | S02110A | 01 | 082-084 | ||
| S0005XA | 24 | 963-965 | S01111A | 24 | 963-965 | S02110A | 01 | 085-087 | ||
| S0005XD | 23 | 949-950 | S01111D | 23 | 949-950 | S02110A | 24 | 963-965 | ||
| S0005XS | 09 | 604-605 | S01111S | 09 | 604-605 | S02110B | 01 | 082-084 | ||
| S0006XA | 09 | 606-607 | S01112A | 02 | 124-125 | S02110B | 01 | 085-087 | ||
| S0006XA | 24 | 963-965 | S01112A | 24 | 963-965 | S02110B | 24 | 963-965 | ||
| S0006XD | 23 | 949-950 | S01112D | 23 | 949-950 | S02110D | 08 | 559-561 | ||
| S0006XS | 09 | 604-605 | S01112S | 09 | 604-605 | S02110G | 08 | 559-561 | ||
| S0007XA | 09 | 604-605 | S01119A | 02 | 124-125 | S02110K | 08 | 564-566 | ||
| S0007XA | 24 | 963-965 | S01119A | 24 | 963-965 | S02110S | 01 | 091-093 | ||
| S0007XD | 23 | 949-950 | S01119D | 23 | 949-950 | S02111A | 01 | 082-084 | ||
| S0007XS | 09 | 604-605 | S01119S | 09 | 604-605 | S02111A | 01 | 085-087 | ||
| S0010XA | 02 | 124-125 | S01121A | 02 | 124-125 | S02111A | 24 | 963-965 | ||
| S0010XA | 24 | 963-965 | S01121A | 24 | 963-965 | S02111B | 01 | 082-084 | ||
| S0010XD | 23 | 949-950 | S01121D | 23 | 949-950 | S02111B | 01 | 085-087 | ||
| S0010XS | 09 | 604-605 | S01121S | 09 | 604-605 | S02111B | 24 | 963-965 | ||
| S0011XA | 02 | 124-125 | S01122A | 02 | 124-125 | S02111D | 08 | 559-561 | ||
| S0011XA | 24 | 963-965 | S01122A | 24 | 963-965 | S02111G | 08 | 559-561 | ||
| S0011XD | 23 | 949-950 | S01122D | 23 | 949-950 | S02111K | 08 | 564-566 | ||
| S0011XS | 09 | 604-605 | S01122S | 09 | 604-605 | S02111S | 01 | 091-093 | ||
| S0012XA | 02 | 124-125 | S01129A | 02 | 124-125 | S02112A | 01 | 082-084 | ||
| S0012XA | 24 | 963-965 | S01129A | 24 | 963-965 | S02112A | 01 | 085-087 | ||
| S0012XD | 23 | 949-950 | S01129D | 23 | 949-950 | S02112A | 24 | 963-965 | ||
| S0012XS | 09 | 604-605 | S01129S | 09 | 604-605 | S02112B | 01 | 082-084 | ||
| S00201A | 02 | 124-125 | S01131A | 02 | 124-125 | S02112B | 01 | 085-087 | ||
| S00201A | 24 | 963-965 | S01131A | 24 | 963-965 | S02112B | 24 | 963-965 | ||
| S00201D | 23 | 949-950 | S01131D | 23 | 949-950 | S02112D | 08 | 559-561 | ||
| S00201S | 09 | 604-605 | S01131S | 09 | 604-605 | S02112G | 08 | 559-561 | ||
| S00202A | 02 | 124-125 | S01132A | 02 | 124-125 | S02112K | 08 | 564-566 | ||
| S00202A | 24 | 963-965 | S01132A | 24 | 963-965 | S02112S | 01 | 091-093 | ||
| S00202D | 23 | 949-950 | S01132D | 23 | 949-950 | S02113A | 01 | 082-084 | ||
| S00202S | 09 | 604-605 | S01132S | 09 | 604-605 | S02113A | 01 | 085-087 | ||
| S00209A | 02 | 124-125 | S01139A | 02 | 124-125 | S02113A | 24 | 963-965 | ||
| S00209A | 24 | 963-965 | S01139A | 24 | 963-965 | S02113B | 01 | 082-084 | ||
| S00209D | 23 | 949-950 | S01139D | 23 | 949-950 | S02113B | 01 | 085-087 | ||
| S00209S | 09 | 604-605 | S01139S | 09 | 604-605 | S02113B | 24 | 963-965 | ||
| S00211A | 02 | 124-125 | S01141A | 02 | 124-125 | S02113D | 08 | 559-561 | ||
| S00211A | 24 | 963-965 | S01141A | 24 | 963-965 | S02113G | 08 | 559-561 | ||
| S00211D | 23 | 949-950 | S01141D | 23 | 949-950 | S02113K | 08 | 564-566 | ||
| S00211S | 09 | 604-605 | S01141S | 09 | 604-605 | S02113S | 01 | 091-093 | ||
| S00212A | 02 | 124-125 | S01142A | 02 | 124-125 | S02118A | 01 | 082-084 | ||
| S00212A | 24 | 963-965 | S01142A | 24 | 963-965 | S02118A | 01 | 085-087 | ||
| S00212D | 23 | 949-950 | S01142D | 23 | 949-950 | S02118A | 24 | 963-965 | ||
| S00212S | 09 | 604-605 | S01142S | 09 | 604-605 | S02118B | 01 | 082-084 | ||
| S02118B | 01 | 085-087 | ||||||||
| S02118B | 24 | 963-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 29 Mar 2024 17:03:46 CMS, code-revision=361, description-revision=1397 |