ICD-10-CM/PCS MS-DRG v36.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v36.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 42 of 70 |
| A000 B400 C7640 C84A9 D4412 E1069 F13930 G808 H18732 H47621 I2609 I70534 K05223 L03111 L98498 M151 M2759 M65152 M84375P M86669 N35813 O2292 O352XX1 O418X22 O99353 Q659 S0000XA S02611K S066X9S S13110A S21309S S2599XS S31824S S33141S S37539D S42213A S4292XK S49032D S52126N S52331Q S52611B S56419A S60476S S62102G S62351D S63063D S65012D S68111D S72062B S72335Q S72465N S79129D S82121J S82299P S82843P S85211S S90462D S92131D S92599B S98329A T2121XS T23529A T3253 T40903S T462X1S T524X1S T63632S T81718D T85828S Z85040 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S56419A | 08 | 562-563 | S59041D | 08 | 559-561 | S60059D | 23 | 949-950 | ||
| S56419A | 24 | 955-965 | S59041G | 08 | 559-561 | S60059S | 09 | 604-605 | ||
| S56419D | 23 | 949-950 | S59041K | 08 | 564-566 | S6010XA | 09 | 604-605 | ||
| S56419S | 08 | 562-563 | S59041P | 08 | 564-566 | S6010XA | 24 | 955-965 | ||
| S56421A | 08 | 564-566 | S59041S | 08 | 559-561 | S6010XD | 23 | 949-950 | ||
| S56421A | 24 | 955-965 | S59042A | 08 | 562-563 | S6010XS | 09 | 604-605 | ||
| S56421D | 23 | 949-950 | S59042A | 24 | 955-965 | S60111A | 09 | 604-605 | ||
| S56421S | 09 | 604-605 | S59042D | 08 | 559-561 | S60111A | 24 | 955-965 | ||
| S56422A | 08 | 564-566 | S59042G | 08 | 559-561 | S60111D | 23 | 949-950 | ||
| S56422A | 24 | 955-965 | S59042K | 08 | 564-566 | S60111S | 09 | 604-605 | ||
| S56422D | 23 | 949-950 | S59042P | 08 | 564-566 | S60112A | 09 | 604-605 | ||
| S56422S | 09 | 604-605 | S59042S | 08 | 559-561 | S60112A | 24 | 955-965 | ||
| S56423A | 08 | 564-566 | S59049A | 08 | 562-563 | S60112D | 23 | 949-950 | ||
| S56423A | 24 | 955-965 | S59049A | 24 | 955-965 | S60112S | 09 | 604-605 | ||
| S56423D | 23 | 949-950 | S59049D | 08 | 559-561 | S60119A | 09 | 604-605 | ||
| S56423S | 09 | 604-605 | S59049G | 08 | 559-561 | S60119A | 24 | 955-965 | ||
| S56424A | 08 | 564-566 | S59049K | 08 | 564-566 | S60119D | 23 | 949-950 | ||
| S56424A | 24 | 955-965 | S59049P | 08 | 564-566 | S60119S | 09 | 604-605 | ||
| S56424D | 23 | 949-950 | S59049S | 08 | 559-561 | S60121A | 09 | 604-605 | ||
| S56424S | 09 | 604-605 | S59091A | 08 | 562-563 | S60121A | 24 | 955-965 | ||
| S56425A | 08 | 564-566 | S59091A | 24 | 955-965 | S60121D | 23 | 949-950 | ||
| S56425A | 24 | 955-965 | S59091D | 08 | 559-561 | S60121S | 09 | 604-605 | ||
| S56425D | 23 | 949-950 | S59091G | 08 | 559-561 | S60122A | 09 | 604-605 | ||
| S56425S | 09 | 604-605 | S59091K | 08 | 564-566 | S60122A | 24 | 955-965 | ||
| S56426A | 08 | 564-566 | S59091P | 08 | 564-566 | S60122D | 23 | 949-950 | ||
| S56426A | 24 | 955-965 | S59091S | 08 | 559-561 | S60122S | 09 | 604-605 | ||
| S56426D | 23 | 949-950 | S59092A | 08 | 562-563 | S60129A | 09 | 604-605 | ||
| S56426S | 09 | 604-605 | S59092A | 24 | 955-965 | S60129A | 24 | 955-965 | ||
| S56427A | 08 | 564-566 | S59092D | 08 | 559-561 | S60129D | 23 | 949-950 | ||
| S56427A | 24 | 955-965 | S59092G | 08 | 559-561 | S60129S | 09 | 604-605 | ||
| S56427D | 23 | 949-950 | S59092K | 08 | 564-566 | S60131A | 09 | 604-605 | ||
| S56427S | 09 | 604-605 | S59092P | 08 | 564-566 | S60131A | 24 | 955-965 | ||
| S56428A | 08 | 564-566 | S59092S | 08 | 559-561 | S60131D | 23 | 949-950 | ||
| S56428A | 24 | 955-965 | S59099A | 08 | 562-563 | S60131S | 09 | 604-605 | ||
| S56428D | 23 | 949-950 | S59099A | 24 | 955-965 | S60132A | 09 | 604-605 | ||
| S56428S | 09 | 604-605 | S59099D | 08 | 559-561 | S60132A | 24 | 955-965 | ||
| S56429A | 08 | 564-566 | S59099G | 08 | 559-561 | S60132D | 23 | 949-950 | ||
| S56429A | 24 | 955-965 | S59099K | 08 | 564-566 | S60132S | 09 | 604-605 | ||
| S56429D | 23 | 949-950 | S59099P | 08 | 564-566 | S60139A | 09 | 604-605 | ||
| S56429S | 09 | 604-605 | S59099S | 08 | 559-561 | S60139A | 24 | 955-965 | ||
| S56491A | 21 | 913-914 | S59101A | 08 | 562-563 | S60139D | 23 | 949-950 | ||
| S56491A | 24 | 955-965 | S59101A | 24 | 955-965 | S60139S | 09 | 604-605 | ||
| S56491D | 23 | 949-950 | S59101D | 08 | 559-561 | S60141A | 09 | 604-605 | ||
| S56491S | 21 | 913-914 | S59101G | 08 | 559-561 | S60141A | 24 | 955-965 | ||
| S56492A | 21 | 913-914 | S59101K | 08 | 564-566 | S60141D | 23 | 949-950 | ||
| S56492A | 24 | 955-965 | S59101P | 08 | 564-566 | S60141S | 09 | 604-605 | ||
| S56492D | 23 | 949-950 | S59101S | 08 | 559-561 | S60142A | 09 | 604-605 | ||
| S56492S | 21 | 913-914 | S59102A | 08 | 562-563 | S60142A | 24 | 955-965 | ||
| S56493A | 21 | 913-914 | S59102A | 24 | 955-965 | S60142D | 23 | 949-950 | ||
| S56493A | 24 | 955-965 | S59102D | 08 | 559-561 | S60142S | 09 | 604-605 | ||
| S56493D | 23 | 949-950 | S59102G | 08 | 559-561 | S60149A | 09 | 604-605 | ||
| S56493S | 21 | 913-914 | S59102K | 08 | 564-566 | S60149A | 24 | 955-965 | ||
| S56494A | 21 | 913-914 | S59102P | 08 | 564-566 | S60149D | 23 | 949-950 | ||
| S56494A | 24 | 955-965 | S59102S | 08 | 559-561 | S60149S | 09 | 604-605 | ||
| S56494D | 23 | 949-950 | S59109A | 08 | 562-563 | S60151A | 09 | 604-605 | ||
| S56494S | 21 | 913-914 | S59109A | 24 | 955-965 | S60151A | 24 | 955-965 | ||
| S56495A | 21 | 913-914 | S59109D | 08 | 559-561 | S60151D | 23 | 949-950 | ||
| S56495A | 24 | 955-965 | S59109G | 08 | 559-561 | S60151S | 09 | 604-605 | ||
| S56495D | 23 | 949-950 | S59109K | 08 | 564-566 | S60152A | 09 | 604-605 | ||
| S56495S | 21 | 913-914 | S59109P | 08 | 564-566 | S60152A | 24 | 955-965 | ||
| S56496A | 21 | 913-914 | S59109S | 08 | 559-561 | S60152D | 23 | 949-950 | ||
| S56496A | 24 | 955-965 | S59111A | 08 | 562-563 | S60152S | 09 | 604-605 | ||
| S56496D | 23 | 949-950 | S59111A | 24 | 955-965 | S60159A | 09 | 604-605 | ||
| S56496S | 21 | 913-914 | S59111D | 08 | 559-561 | S60159A | 24 | 955-965 | ||
| S56497A | 21 | 913-914 | S59111G | 08 | 559-561 | S60159D | 23 | 949-950 | ||
| S56497A | 24 | 955-965 | S59111K | 08 | 564-566 | S60159S | 09 | 604-605 | ||
| S56497D | 23 | 949-950 | S59111P | 08 | 564-566 | S60211A | 09 | 604-605 | ||
| S56497S | 21 | 913-914 | S59111S | 08 | 559-561 | S60211A | 24 | 955-965 | ||
| S56498A | 21 | 913-914 | S59112A | 08 | 562-563 | S60211D | 23 | 949-950 | ||
| S56498A | 24 | 955-965 | S59112A | 24 | 955-965 | S60211S | 09 | 604-605 | ||
| S56498D | 23 | 949-950 | S59112D | 08 | 559-561 | S60212A | 09 | 604-605 | ||
| S56498S | 21 | 913-914 | S59112G | 08 | 559-561 | S60212A | 24 | 955-965 | ||
| S56499A | 21 | 913-914 | S59112K | 08 | 564-566 | S60212D | 23 | 949-950 | ||
| S56499A | 24 | 955-965 | S59112P | 08 | 564-566 | S60212S | 09 | 604-605 | ||
| S56499D | 23 | 949-950 | S59112S | 08 | 559-561 | S60219A | 09 | 604-605 | ||
| S56499S | 21 | 913-914 | S59119A | 08 | 562-563 | S60219A | 24 | 955-965 | ||
| S56501A | 21 | 913-914 | S59119A | 24 | 955-965 | S60219D | 23 | 949-950 | ||
| S56501A | 24 | 955-965 | S59119D | 08 | 559-561 | S60219S | 09 | 604-605 | ||
| S56501D | 23 | 949-950 | S59119G | 08 | 559-561 | S60221A | 09 | 604-605 | ||
| S56501S | 21 | 913-914 | S59119K | 08 | 564-566 | S60221A | 24 | 955-965 | ||
| S56502A | 21 | 913-914 | S59119P | 08 | 564-566 | S60221D | 23 | 949-950 | ||
| S56502A | 24 | 955-965 | S59119S | 08 | 559-561 | S60221S | 09 | 604-605 | ||
| S56502D | 23 | 949-950 | S59121A | 08 | 562-563 | S60222A | 09 | 604-605 | ||
| S56502S | 21 | 913-914 | S59121A | 24 | 955-965 | S60222A | 24 | 955-965 | ||
| S56509A | 21 | 913-914 | S59121D | 08 | 559-561 | S60222D | 23 | 949-950 | ||
| S56509A | 24 | 955-965 | S59121G | 08 | 559-561 | S60222S | 09 | 604-605 | ||
| S56509D | 23 | 949-950 | S59121K | 08 | 564-566 | S60229A | 09 | 604-605 | ||
| S56509S | 21 | 913-914 | S59121P | 08 | 564-566 | S60229A | 24 | 955-965 | ||
| S56511A | 08 | 562-563 | S59121S | 08 | 559-561 | S60229D | 23 | 949-950 | ||
| S56511A | 24 | 955-965 | S59122A | 08 | 562-563 | S60229S | 09 | 604-605 | ||
| S56511D | 23 | 949-950 | S59122A | 24 | 955-965 | S60311A | 09 | 604-605 | ||
| S56511S | 08 | 562-563 | S59122D | 08 | 559-561 | S60311A | 24 | 955-965 | ||
| S56512A | 08 | 562-563 | S59122G | 08 | 559-561 | S60311D | 23 | 949-950 | ||
| S56512A | 24 | 955-965 | S59122K | 08 | 564-566 | S60311S | 09 | 604-605 | ||
| S56512D | 23 | 949-950 | S59122P | 08 | 564-566 | S60312A | 09 | 604-605 | ||
| S56512S | 08 | 562-563 | S59122S | 08 | 559-561 | S60312A | 24 | 955-965 | ||
| S56519A | 08 | 562-563 | S59129A | 08 | 562-563 | S60312D | 23 | 949-950 | ||
| S56519A | 24 | 955-965 | S59129A | 24 | 955-965 | S60312S | 09 | 604-605 | ||
| S56519D | 23 | 949-950 | S59129D | 08 | 559-561 | S60319A | 09 | 604-605 | ||
| S56519S | 08 | 562-563 | S59129G | 08 | 559-561 | S60319A | 24 | 955-965 | ||
| S56521A | 08 | 564-566 | S59129K | 08 | 564-566 | S60319D | 23 | 949-950 | ||
| S56521A | 24 | 955-965 | S59129P | 08 | 564-566 | S60319S | 09 | 604-605 | ||
| S56521D | 23 | 949-950 | S59129S | 08 | 559-561 | S60321A | 09 | 606-607 | ||
| S56521S | 09 | 604-605 | S59131A | 08 | 562-563 | S60321A | 24 | 955-965 | ||
| S56522A | 08 | 564-566 | S59131A | 24 | 955-965 | S60321D | 23 | 949-950 | ||
| S56522A | 24 | 955-965 | S59131D | 08 | 559-561 | S60321S | 09 | 604-605 | ||
| S56522D | 23 | 949-950 | S59131G | 08 | 559-561 | S60322A | 09 | 606-607 | ||
| S56522S | 09 | 604-605 | S59131K | 08 | 564-566 | S60322A | 24 | 955-965 | ||
| S56529A | 08 | 564-566 | S59131P | 08 | 564-566 | S60322D | 23 | 949-950 | ||
| S56529A | 24 | 955-965 | S59131S | 08 | 559-561 | S60322S | 09 | 604-605 | ||
| S56529D | 23 | 949-950 | S59132A | 08 | 562-563 | S60329A | 09 | 606-607 | ||
| S56529S | 09 | 604-605 | S59132A | 24 | 955-965 | S60329A | 24 | 955-965 | ||
| S56591A | 21 | 913-914 | S59132D | 08 | 559-561 | S60329D | 23 | 949-950 | ||
| S56591A | 24 | 955-965 | S59132G | 08 | 559-561 | S60329S | 09 | 604-605 | ||
| S56591D | 23 | 949-950 | S59132K | 08 | 564-566 | S60341A | 09 | 604-605 | ||
| S56591S | 21 | 913-914 | S59132P | 08 | 564-566 | S60341A | 24 | 955-965 | ||
| S56592A | 21 | 913-914 | S59132S | 08 | 559-561 | S60341D | 23 | 949-950 | ||
| S56592A | 24 | 955-965 | S59139A | 08 | 562-563 | S60341S | 09 | 604-605 | ||
| S56592D | 23 | 949-950 | S59139A | 24 | 955-965 | S60342A | 09 | 604-605 | ||
| S56592S | 21 | 913-914 | S59139D | 08 | 559-561 | S60342A | 24 | 955-965 | ||
| S56599A | 21 | 913-914 | S59139G | 08 | 559-561 | S60342D | 23 | 949-950 | ||
| S56599A | 24 | 955-965 | S59139K | 08 | 564-566 | S60342S | 09 | 604-605 | ||
| S56599D | 23 | 949-950 | S59139P | 08 | 564-566 | S60349A | 09 | 604-605 | ||
| S56599S | 21 | 913-914 | S59139S | 08 | 559-561 | S60349A | 24 | 955-965 | ||
| S56801A | 21 | 913-914 | S59141A | 08 | 562-563 | S60349D | 23 | 949-950 | ||
| S56801A | 24 | 955-965 | S59141A | 24 | 955-965 | S60349S | 09 | 604-605 | ||
| S56801D | 23 | 949-950 | S59141D | 08 | 559-561 | S60351A | 09 | 604-605 | ||
| S56801S | 21 | 913-914 | S59141G | 08 | 559-561 | S60351A | 24 | 955-965 | ||
| S56802A | 21 | 913-914 | S59141K | 08 | 564-566 | S60351D | 23 | 949-950 | ||
| S56802A | 24 | 955-965 | S59141P | 08 | 564-566 | S60351S | 09 | 604-605 | ||
| S56802D | 23 | 949-950 | S59141S | 08 | 559-561 | S60352A | 09 | 604-605 | ||
| S56802S | 21 | 913-914 | S59142A | 08 | 562-563 | S60352A | 24 | 955-965 | ||
| S56809A | 21 | 913-914 | S59142A | 24 | 955-965 | S60352D | 23 | 949-950 | ||
| S56809A | 24 | 955-965 | S59142D | 08 | 559-561 | S60352S | 09 | 604-605 | ||
| S56809D | 23 | 949-950 | S59142G | 08 | 559-561 | S60359A | 09 | 604-605 | ||
| S56809S | 21 | 913-914 | S59142K | 08 | 564-566 | S60359A | 24 | 955-965 | ||
| S56811A | 08 | 562-563 | S59142P | 08 | 564-566 | S60359D | 23 | 949-950 | ||
| S56811A | 24 | 955-965 | S59142S | 08 | 559-561 | S60359S | 09 | 604-605 | ||
| S56811D | 23 | 949-950 | S59149A | 08 | 562-563 | S60361A | 09 | 606-607 | ||
| S56811S | 08 | 562-563 | S59149A | 24 | 955-965 | S60361A | 24 | 955-965 | ||
| S56812A | 08 | 562-563 | S59149D | 08 | 559-561 | S60361D | 23 | 949-950 | ||
| S56812A | 24 | 955-965 | S59149G | 08 | 559-561 | S60361S | 09 | 604-605 | ||
| S56812D | 23 | 949-950 | S59149K | 08 | 564-566 | S60362A | 09 | 606-607 | ||
| S56812S | 08 | 562-563 | S59149P | 08 | 564-566 | S60362A | 24 | 955-965 | ||
| S56819A | 08 | 562-563 | S59149S | 08 | 559-561 | S60362D | 23 | 949-950 | ||
| S56819A | 24 | 955-965 | S59191A | 08 | 562-563 | S60362S | 09 | 604-605 | ||
| S56819D | 23 | 949-950 | S59191A | 24 | 955-965 | S60369A | 09 | 606-607 | ||
| S56819S | 08 | 562-563 | S59191D | 08 | 559-561 | S60369A | 24 | 955-965 | ||
| S56821A | 08 | 564-566 | S59191G | 08 | 559-561 | S60369D | 23 | 949-950 | ||
| S56821A | 24 | 955-965 | S59191K | 08 | 564-566 | S60369S | 09 | 604-605 | ||
| S56821D | 23 | 949-950 | S59191P | 08 | 564-566 | S60371A | 09 | 604-605 | ||
| S56821S | 09 | 604-605 | S59191S | 08 | 559-561 | S60371A | 24 | 955-965 | ||
| S56822A | 08 | 564-566 | S59192A | 08 | 562-563 | S60371D | 23 | 949-950 | ||
| S56822A | 24 | 955-965 | S59192A | 24 | 955-965 | S60371S | 09 | 604-605 | ||
| S56822D | 23 | 949-950 | S59192D | 08 | 559-561 | S60372A | 09 | 604-605 | ||
| S56822S | 09 | 604-605 | S59192G | 08 | 559-561 | S60372A | 24 | 955-965 | ||
| S56829A | 08 | 564-566 | S59192K | 08 | 564-566 | S60372D | 23 | 949-950 | ||
| S56829A | 24 | 955-965 | S59192P | 08 | 564-566 | S60372S | 09 | 604-605 | ||
| S56829D | 23 | 949-950 | S59192S | 08 | 559-561 | S60379A | 09 | 604-605 | ||
| S56829S | 09 | 604-605 | S59199A | 08 | 562-563 | S60379A | 24 | 955-965 | ||
| S56891A | 21 | 913-914 | S59199A | 24 | 955-965 | S60379D | 23 | 949-950 | ||
| S56891A | 24 | 955-965 | S59199D | 08 | 559-561 | S60379S | 09 | 604-605 | ||
| S56891D | 23 | 949-950 | S59199G | 08 | 559-561 | S60391A | 09 | 604-605 | ||
| S56891S | 21 | 913-914 | S59199K | 08 | 564-566 | S60391A | 24 | 955-965 | ||
| S56892A | 21 | 913-914 | S59199P | 08 | 564-566 | S60391D | 23 | 949-950 | ||
| S56892A | 24 | 955-965 | S59199S | 08 | 559-561 | S60391S | 09 | 604-605 | ||
| S56892D | 23 | 949-950 | S59201A | 08 | 562-563 | S60392A | 09 | 604-605 | ||
| S56892S | 21 | 913-914 | S59201A | 24 | 955-965 | S60392A | 24 | 955-965 | ||
| S56899A | 21 | 913-914 | S59201D | 08 | 559-561 | S60392D | 23 | 949-950 | ||
| S56899A | 24 | 955-965 | S59201G | 08 | 559-561 | S60392S | 09 | 604-605 | ||
| S56899D | 23 | 949-950 | S59201K | 08 | 564-566 | S60399A | 09 | 604-605 | ||
| S56899S | 21 | 913-914 | S59201P | 08 | 564-566 | S60399A | 24 | 955-965 | ||
| S56901A | 21 | 913-914 | S59201S | 08 | 559-561 | S60399D | 23 | 949-950 | ||
| S56901A | 24 | 955-965 | S59202A | 08 | 562-563 | S60399S | 09 | 604-605 | ||
| S56901D | 23 | 949-950 | S59202A | 24 | 955-965 | S60410A | 09 | 604-605 | ||
| S56901S | 21 | 913-914 | S59202D | 08 | 559-561 | S60410A | 24 | 955-965 | ||
| S56902A | 21 | 913-914 | S59202G | 08 | 559-561 | S60410D | 23 | 949-950 | ||
| S56902A | 24 | 955-965 | S59202K | 08 | 564-566 | S60410S | 09 | 604-605 | ||
| S56902D | 23 | 949-950 | S59202P | 08 | 564-566 | S60411A | 09 | 604-605 | ||
| S56902S | 21 | 913-914 | S59202S | 08 | 559-561 | S60411A | 24 | 955-965 | ||
| S56909A | 21 | 913-914 | S59209A | 08 | 562-563 | S60411D | 23 | 949-950 | ||
| S56909A | 24 | 955-965 | S59209A | 24 | 955-965 | S60411S | 09 | 604-605 | ||
| S56909D | 23 | 949-950 | S59209D | 08 | 559-561 | S60412A | 09 | 604-605 | ||
| S56909S | 21 | 913-914 | S59209G | 08 | 559-561 | S60412A | 24 | 955-965 | ||
| S56911A | 08 | 562-563 | S59209K | 08 | 564-566 | S60412D | 23 | 949-950 | ||
| S56911A | 24 | 955-965 | S59209P | 08 | 564-566 | S60412S | 09 | 604-605 | ||
| S56911D | 23 | 949-950 | S59209S | 08 | 559-561 | S60413A | 09 | 604-605 | ||
| S56911S | 08 | 562-563 | S59211A | 08 | 562-563 | S60413A | 24 | 955-965 | ||
| S56912A | 08 | 562-563 | S59211A | 24 | 955-965 | S60413D | 23 | 949-950 | ||
| S56912A | 24 | 955-965 | S59211D | 08 | 559-561 | S60413S | 09 | 604-605 | ||
| S56912D | 23 | 949-950 | S59211G | 08 | 559-561 | S60414A | 09 | 604-605 | ||
| S56912S | 08 | 562-563 | S59211K | 08 | 564-566 | S60414A | 24 | 955-965 | ||
| S56919A | 08 | 562-563 | S59211P | 08 | 564-566 | S60414D | 23 | 949-950 | ||
| S56919A | 24 | 955-965 | S59211S | 08 | 559-561 | S60414S | 09 | 604-605 | ||
| S56919D | 23 | 949-950 | S59212A | 08 | 562-563 | S60415A | 09 | 604-605 | ||
| S56919S | 08 | 562-563 | S59212A | 24 | 955-965 | S60415A | 24 | 955-965 | ||
| S56921A | 08 | 564-566 | S59212D | 08 | 559-561 | S60415D | 23 | 949-950 | ||
| S56921A | 24 | 955-965 | S59212G | 08 | 559-561 | S60415S | 09 | 604-605 | ||
| S56921D | 23 | 949-950 | S59212K | 08 | 564-566 | S60416A | 09 | 604-605 | ||
| S56921S | 09 | 604-605 | S59212P | 08 | 564-566 | S60416A | 24 | 955-965 | ||
| S56922A | 08 | 564-566 | S59212S | 08 | 559-561 | S60416D | 23 | 949-950 | ||
| S56922A | 24 | 955-965 | S59219A | 08 | 562-563 | S60416S | 09 | 604-605 | ||
| S56922D | 23 | 949-950 | S59219A | 24 | 955-965 | S60417A | 09 | 604-605 | ||
| S56922S | 09 | 604-605 | S59219D | 08 | 559-561 | S60417A | 24 | 955-965 | ||
| S56929A | 08 | 564-566 | S59219G | 08 | 559-561 | S60417D | 23 | 949-950 | ||
| S56929A | 24 | 955-965 | S59219K | 08 | 564-566 | S60417S | 09 | 604-605 | ||
| S56929D | 23 | 949-950 | S59219P | 08 | 564-566 | S60418A | 09 | 604-605 | ||
| S56929S | 09 | 604-605 | S59219S | 08 | 559-561 | S60418A | 24 | 955-965 | ||
| S56991A | 21 | 913-914 | S59221A | 08 | 562-563 | S60418D | 23 | 949-950 | ||
| S56991A | 24 | 955-965 | S59221A | 24 | 955-965 | S60418S | 09 | 604-605 | ||
| S56991D | 23 | 949-950 | S59221D | 08 | 559-561 | S60419A | 09 | 604-605 | ||
| S56991S | 21 | 913-914 | S59221G | 08 | 559-561 | S60419A | 24 | 955-965 | ||
| S56992A | 21 | 913-914 | S59221K | 08 | 564-566 | S60419D | 23 | 949-950 | ||
| S56992A | 24 | 955-965 | S59221P | 08 | 564-566 | S60419S | 09 | 604-605 | ||
| S56992D | 23 | 949-950 | S59221S | 08 | 559-561 | S60420A | 09 | 606-607 | ||
| S56992S | 21 | 913-914 | S59222A | 08 | 562-563 | S60420A | 24 | 955-965 | ||
| S56999A | 21 | 913-914 | S59222A | 24 | 955-965 | S60420D | 23 | 949-950 | ||
| S56999A | 24 | 955-965 | S59222D | 08 | 559-561 | S60420S | 09 | 604-605 | ||
| S56999D | 23 | 949-950 | S59222G | 08 | 559-561 | S60421A | 09 | 606-607 | ||
| S56999S | 21 | 913-914 | S59222K | 08 | 564-566 | S60421A | 24 | 955-965 | ||
| S5700XA | 21 | 913-914 | S59222P | 08 | 564-566 | S60421D | 23 | 949-950 | ||
| S5700XA | 24 | 955-965 | S59222S | 08 | 559-561 | S60421S | 09 | 604-605 | ||
| S5700XD | 23 | 949-950 | S59229A | 08 | 562-563 | S60422A | 09 | 606-607 | ||
| S5700XS | 09 | 604-605 | S59229A | 24 | 955-965 | S60422A | 24 | 955-965 | ||
| S5701XA | 21 | 913-914 | S59229D | 08 | 559-561 | S60422D | 23 | 949-950 | ||
| S5701XA | 24 | 955-965 | S59229G | 08 | 559-561 | S60422S | 09 | 604-605 | ||
| S5701XD | 23 | 949-950 | S59229K | 08 | 564-566 | S60423A | 09 | 606-607 | ||
| S5701XS | 09 | 604-605 | S59229P | 08 | 564-566 | S60423A | 24 | 955-965 | ||
| S5702XA | 21 | 913-914 | S59229S | 08 | 559-561 | S60423D | 23 | 949-950 | ||
| S5702XA | 24 | 955-965 | S59231A | 08 | 562-563 | S60423S | 09 | 604-605 | ||
| S5702XD | 23 | 949-950 | S59231A | 24 | 955-965 | S60424A | 09 | 606-607 | ||
| S5702XS | 09 | 604-605 | S59231D | 08 | 559-561 | S60424A | 24 | 955-965 | ||
| S5780XA | 21 | 913-914 | S59231G | 08 | 559-561 | S60424D | 23 | 949-950 | ||
| S5780XA | 24 | 955-965 | S59231K | 08 | 564-566 | S60424S | 09 | 604-605 | ||
| S5780XD | 23 | 949-950 | S59231P | 08 | 564-566 | S60425A | 09 | 606-607 | ||
| S5780XS | 09 | 604-605 | S59231S | 08 | 559-561 | S60425A | 24 | 955-965 | ||
| S5781XA | 21 | 913-914 | S59232A | 08 | 562-563 | S60425D | 23 | 949-950 | ||
| S5781XA | 24 | 955-965 | S59232A | 24 | 955-965 | S60425S | 09 | 604-605 | ||
| S5781XD | 23 | 949-950 | S59232D | 08 | 559-561 | S60426A | 09 | 606-607 | ||
| S5781XS | 09 | 604-605 | S59232G | 08 | 559-561 | S60426A | 24 | 955-965 | ||
| S5782XA | 21 | 913-914 | S59232K | 08 | 564-566 | S60426D | 23 | 949-950 | ||
| S5782XA | 24 | 955-965 | S59232P | 08 | 564-566 | S60426S | 09 | 604-605 | ||
| S5782XD | 23 | 949-950 | S59232S | 08 | 559-561 | S60427A | 09 | 606-607 | ||
| S5782XS | 09 | 604-605 | S59239A | 08 | 562-563 | S60427A | 24 | 955-965 | ||
| S58011A | 21 | 913-914 | S59239A | 24 | 955-965 | S60427D | 23 | 949-950 | ||
| S58011A | 24 | 955-965 | S59239D | 08 | 559-561 | S60427S | 09 | 604-605 | ||
| S58011D | 23 | 949-950 | S59239G | 08 | 559-561 | S60428A | 09 | 606-607 | ||
| S58011S | 08 | 559-561 | S59239K | 08 | 564-566 | S60428A | 24 | 955-965 | ||
| S58012A | 21 | 913-914 | S59239P | 08 | 564-566 | S60428D | 23 | 949-950 | ||
| S58012A | 24 | 955-965 | S59239S | 08 | 559-561 | S60428S | 09 | 604-605 | ||
| S58012D | 23 | 949-950 | S59241A | 08 | 562-563 | S60429A | 09 | 606-607 | ||
| S58012S | 08 | 559-561 | S59241A | 24 | 955-965 | S60429A | 24 | 955-965 | ||
| S58019A | 21 | 913-914 | S59241D | 08 | 559-561 | S60429D | 23 | 949-950 | ||
| S58019A | 24 | 955-965 | S59241G | 08 | 559-561 | S60429S | 09 | 604-605 | ||
| S58019D | 23 | 949-950 | S59241K | 08 | 564-566 | S60440A | 09 | 604-605 | ||
| S58019S | 08 | 559-561 | S59241P | 08 | 564-566 | S60440A | 24 | 955-965 | ||
| S58021A | 21 | 913-914 | S59241S | 08 | 559-561 | S60440D | 23 | 949-950 | ||
| S58021A | 24 | 955-965 | S59242A | 08 | 562-563 | S60440S | 09 | 604-605 | ||
| S58021D | 23 | 949-950 | S59242A | 24 | 955-965 | S60441A | 09 | 604-605 | ||
| S58021S | 08 | 559-561 | S59242D | 08 | 559-561 | S60441A | 24 | 955-965 | ||
| S58022A | 21 | 913-914 | S59242G | 08 | 559-561 | S60441D | 23 | 949-950 | ||
| S58022A | 24 | 955-965 | S59242K | 08 | 564-566 | S60441S | 09 | 604-605 | ||
| S58022D | 23 | 949-950 | S59242P | 08 | 564-566 | S60442A | 09 | 604-605 | ||
| S58022S | 08 | 559-561 | S59242S | 08 | 559-561 | S60442A | 24 | 955-965 | ||
| S58029A | 21 | 913-914 | S59249A | 08 | 562-563 | S60442D | 23 | 949-950 | ||
| S58029A | 24 | 955-965 | S59249A | 24 | 955-965 | S60442S | 09 | 604-605 | ||
| S58029D | 23 | 949-950 | S59249D | 08 | 559-561 | S60443A | 09 | 604-605 | ||
| S58029S | 08 | 559-561 | S59249G | 08 | 559-561 | S60443A | 24 | 955-965 | ||
| S58111A | 21 | 913-914 | S59249K | 08 | 564-566 | S60443D | 23 | 949-950 | ||
| S58111A | 24 | 955-965 | S59249P | 08 | 564-566 | S60443S | 09 | 604-605 | ||
| S58111D | 23 | 949-950 | S59249S | 08 | 559-561 | S60444A | 09 | 604-605 | ||
| S58111S | 08 | 559-561 | S59291A | 08 | 562-563 | S60444A | 24 | 955-965 | ||
| S58112A | 21 | 913-914 | S59291A | 24 | 955-965 | S60444D | 23 | 949-950 | ||
| S58112A | 24 | 955-965 | S59291D | 08 | 559-561 | S60444S | 09 | 604-605 | ||
| S58112D | 23 | 949-950 | S59291G | 08 | 559-561 | S60445A | 09 | 604-605 | ||
| S58112S | 08 | 559-561 | S59291K | 08 | 564-566 | S60445A | 24 | 955-965 | ||
| S58119A | 21 | 913-914 | S59291P | 08 | 564-566 | S60445D | 23 | 949-950 | ||
| S58119A | 24 | 955-965 | S59291S | 08 | 559-561 | S60445S | 09 | 604-605 | ||
| S58119D | 23 | 949-950 | S59292A | 08 | 562-563 | S60446A | 09 | 604-605 | ||
| S58119S | 08 | 559-561 | S59292A | 24 | 955-965 | S60446A | 24 | 955-965 | ||
| S58121A | 21 | 913-914 | S59292D | 08 | 559-561 | S60446D | 23 | 949-950 | ||
| S58121A | 24 | 955-965 | S59292G | 08 | 559-561 | S60446S | 09 | 604-605 | ||
| S58121D | 23 | 949-950 | S59292K | 08 | 564-566 | S60447A | 09 | 604-605 | ||
| S58121S | 08 | 559-561 | S59292P | 08 | 564-566 | S60447A | 24 | 955-965 | ||
| S58122A | 21 | 913-914 | S59292S | 08 | 559-561 | S60447D | 23 | 949-950 | ||
| S58122A | 24 | 955-965 | S59299A | 08 | 562-563 | S60447S | 09 | 604-605 | ||
| S58122D | 23 | 949-950 | S59299A | 24 | 955-965 | S60448A | 09 | 604-605 | ||
| S58122S | 08 | 559-561 | S59299D | 08 | 559-561 | S60448A | 24 | 955-965 | ||
| S58129A | 21 | 913-914 | S59299G | 08 | 559-561 | S60448D | 23 | 949-950 | ||
| S58129A | 24 | 955-965 | S59299K | 08 | 564-566 | S60448S | 09 | 604-605 | ||
| S58129D | 23 | 949-950 | S59299P | 08 | 564-566 | S60449A | 09 | 604-605 | ||
| S58129S | 08 | 559-561 | S59299S | 08 | 559-561 | S60449A | 24 | 955-965 | ||
| S58911A | 21 | 913-914 | S59801A | 21 | 913-914 | S60449D | 23 | 949-950 | ||
| S58911A | 24 | 955-965 | S59801A | 24 | 955-965 | S60449S | 09 | 604-605 | ||
| S58911D | 23 | 949-950 | S59801D | 23 | 949-950 | S60450A | 09 | 604-605 | ||
| S58911S | 08 | 559-561 | S59801S | 21 | 913-914 | S60450A | 24 | 955-965 | ||
| S58912A | 21 | 913-914 | S59802A | 21 | 913-914 | S60450D | 23 | 949-950 | ||
| S58912A | 24 | 955-965 | S59802A | 24 | 955-965 | S60450S | 09 | 604-605 | ||
| S58912D | 23 | 949-950 | S59802D | 23 | 949-950 | S60451A | 09 | 604-605 | ||
| S58912S | 08 | 559-561 | S59802S | 21 | 913-914 | S60451A | 24 | 955-965 | ||
| S58919A | 21 | 913-914 | S59809A | 21 | 913-914 | S60451D | 23 | 949-950 | ||
| S58919A | 24 | 955-965 | S59809A | 24 | 955-965 | S60451S | 09 | 604-605 | ||
| S58919D | 23 | 949-950 | S59809D | 23 | 949-950 | S60452A | 09 | 604-605 | ||
| S58919S | 08 | 559-561 | S59809S | 21 | 913-914 | S60452A | 24 | 955-965 | ||
| S58921A | 21 | 913-914 | S59811A | 21 | 913-914 | S60452D | 23 | 949-950 | ||
| S58921A | 24 | 955-965 | S59811A | 24 | 955-965 | S60452S | 09 | 604-605 | ||
| S58921D | 23 | 949-950 | S59811D | 23 | 949-950 | S60453A | 09 | 604-605 | ||
| S58921S | 08 | 559-561 | S59811S | 21 | 913-914 | S60453A | 24 | 955-965 | ||
| S58922A | 21 | 913-914 | S59812A | 21 | 913-914 | S60453D | 23 | 949-950 | ||
| S58922A | 24 | 955-965 | S59812A | 24 | 955-965 | S60453S | 09 | 604-605 | ||
| S58922D | 23 | 949-950 | S59812D | 23 | 949-950 | S60454A | 09 | 604-605 | ||
| S58922S | 08 | 559-561 | S59812S | 21 | 913-914 | S60454A | 24 | 955-965 | ||
| S58929A | 21 | 913-914 | S59819A | 21 | 913-914 | S60454D | 23 | 949-950 | ||
| S58929A | 24 | 955-965 | S59819A | 24 | 955-965 | S60454S | 09 | 604-605 | ||
| S58929D | 23 | 949-950 | S59819D | 23 | 949-950 | S60455A | 09 | 604-605 | ||
| S58929S | 08 | 559-561 | S59819S | 21 | 913-914 | S60455A | 24 | 955-965 | ||
| S59001A | 08 | 562-563 | S59901A | 21 | 913-914 | S60455D | 23 | 949-950 | ||
| S59001A | 24 | 955-965 | S59901A | 24 | 955-965 | S60455S | 09 | 604-605 | ||
| S59001D | 08 | 559-561 | S59901D | 23 | 949-950 | S60456A | 09 | 604-605 | ||
| S59001G | 08 | 559-561 | S59901S | 21 | 913-914 | S60456A | 24 | 955-965 | ||
| S59001K | 08 | 564-566 | S59902A | 21 | 913-914 | S60456D | 23 | 949-950 | ||
| S59001P | 08 | 564-566 | S59902A | 24 | 955-965 | S60456S | 09 | 604-605 | ||
| S59001S | 08 | 559-561 | S59902D | 23 | 949-950 | S60457A | 09 | 604-605 | ||
| S59002A | 08 | 562-563 | S59902S | 21 | 913-914 | S60457A | 24 | 955-965 | ||
| S59002A | 24 | 955-965 | S59909A | 21 | 913-914 | S60457D | 23 | 949-950 | ||
| S59002D | 08 | 559-561 | S59909A | 24 | 955-965 | S60457S | 09 | 604-605 | ||
| S59002G | 08 | 559-561 | S59909D | 23 | 949-950 | S60458A | 09 | 604-605 | ||
| S59002K | 08 | 564-566 | S59909S | 21 | 913-914 | S60458A | 24 | 955-965 | ||
| S59002P | 08 | 564-566 | S59911A | 21 | 913-914 | S60458D | 23 | 949-950 | ||
| S59002S | 08 | 559-561 | S59911A | 24 | 955-965 | S60458S | 09 | 604-605 | ||
| S59009A | 08 | 562-563 | S59911D | 23 | 949-950 | S60459A | 09 | 604-605 | ||
| S59009A | 24 | 955-965 | S59911S | 21 | 913-914 | S60459A | 24 | 955-965 | ||
| S59009D | 08 | 559-561 | S59912A | 21 | 913-914 | S60459D | 23 | 949-950 | ||
| S59009G | 08 | 559-561 | S59912A | 24 | 955-965 | S60459S | 09 | 604-605 | ||
| S59009K | 08 | 564-566 | S59912D | 23 | 949-950 | S60460A | 09 | 606-607 | ||
| S59009P | 08 | 564-566 | S59912S | 21 | 913-914 | S60460A | 24 | 955-965 | ||
| S59009S | 08 | 559-561 | S59919A | 21 | 913-914 | S60460D | 23 | 949-950 | ||
| S59011A | 08 | 562-563 | S59919A | 24 | 955-965 | S60460S | 09 | 604-605 | ||
| S59011A | 24 | 955-965 | S59919D | 23 | 949-950 | S60461A | 09 | 606-607 | ||
| S59011D | 08 | 559-561 | S59919S | 21 | 913-914 | S60461A | 24 | 955-965 | ||
| S59011G | 08 | 559-561 | S6000XA | 09 | 604-605 | S60461D | 23 | 949-950 | ||
| S59011K | 08 | 564-566 | S6000XA | 24 | 955-965 | S60461S | 09 | 604-605 | ||
| S59011P | 08 | 564-566 | S6000XD | 23 | 949-950 | S60462A | 09 | 606-607 | ||
| S59011S | 08 | 559-561 | S6000XS | 09 | 604-605 | S60462A | 24 | 955-965 | ||
| S59012A | 08 | 562-563 | S60011A | 09 | 604-605 | S60462D | 23 | 949-950 | ||
| S59012A | 24 | 955-965 | S60011A | 24 | 955-965 | S60462S | 09 | 604-605 | ||
| S59012D | 08 | 559-561 | S60011D | 23 | 949-950 | S60463A | 09 | 606-607 | ||
| S59012G | 08 | 559-561 | S60011S | 09 | 604-605 | S60463A | 24 | 955-965 | ||
| S59012K | 08 | 564-566 | S60012A | 09 | 604-605 | S60463D | 23 | 949-950 | ||
| S59012P | 08 | 564-566 | S60012A | 24 | 955-965 | S60463S | 09 | 604-605 | ||
| S59012S | 08 | 559-561 | S60012D | 23 | 949-950 | S60464A | 09 | 606-607 | ||
| S59019A | 08 | 562-563 | S60012S | 09 | 604-605 | S60464A | 24 | 955-965 | ||
| S59019A | 24 | 955-965 | S60019A | 09 | 604-605 | S60464D | 23 | 949-950 | ||
| S59019D | 08 | 559-561 | S60019A | 24 | 955-965 | S60464S | 09 | 604-605 | ||
| S59019G | 08 | 559-561 | S60019D | 23 | 949-950 | S60465A | 09 | 606-607 | ||
| S59019K | 08 | 564-566 | S60019S | 09 | 604-605 | S60465A | 24 | 955-965 | ||
| S59019P | 08 | 564-566 | S60021A | 09 | 604-605 | S60465D | 23 | 949-950 | ||
| S59019S | 08 | 559-561 | S60021A | 24 | 955-965 | S60465S | 09 | 604-605 | ||
| S59021A | 08 | 562-563 | S60021D | 23 | 949-950 | S60466A | 09 | 606-607 | ||
| S59021A | 24 | 955-965 | S60021S | 09 | 604-605 | S60466A | 24 | 955-965 | ||
| S59021D | 08 | 559-561 | S60022A | 09 | 604-605 | S60466D | 23 | 949-950 | ||
| S59021G | 08 | 559-561 | S60022A | 24 | 955-965 | S60466S | 09 | 604-605 | ||
| S59021K | 08 | 564-566 | S60022D | 23 | 949-950 | S60467A | 09 | 606-607 | ||
| S59021P | 08 | 564-566 | S60022S | 09 | 604-605 | S60467A | 24 | 955-965 | ||
| S59021S | 08 | 559-561 | S60029A | 09 | 604-605 | S60467D | 23 | 949-950 | ||
| S59022A | 08 | 562-563 | S60029A | 24 | 955-965 | S60467S | 09 | 604-605 | ||
| S59022A | 24 | 955-965 | S60029D | 23 | 949-950 | S60468A | 09 | 606-607 | ||
| S59022D | 08 | 559-561 | S60029S | 09 | 604-605 | S60468A | 24 | 955-965 | ||
| S59022G | 08 | 559-561 | S60031A | 09 | 604-605 | S60468D | 23 | 949-950 | ||
| S59022K | 08 | 564-566 | S60031A | 24 | 955-965 | S60468S | 09 | 604-605 | ||
| S59022P | 08 | 564-566 | S60031D | 23 | 949-950 | S60469A | 09 | 606-607 | ||
| S59022S | 08 | 559-561 | S60031S | 09 | 604-605 | S60469A | 24 | 955-965 | ||
| S59029A | 08 | 562-563 | S60032A | 09 | 604-605 | S60469D | 23 | 949-950 | ||
| S59029A | 24 | 955-965 | S60032A | 24 | 955-965 | S60469S | 09 | 604-605 | ||
| S59029D | 08 | 559-561 | S60032D | 23 | 949-950 | S60470A | 09 | 604-605 | ||
| S59029G | 08 | 559-561 | S60032S | 09 | 604-605 | S60470A | 24 | 955-965 | ||
| S59029K | 08 | 564-566 | S60039A | 09 | 604-605 | S60470D | 23 | 949-950 | ||
| S59029P | 08 | 564-566 | S60039A | 24 | 955-965 | S60470S | 09 | 604-605 | ||
| S59029S | 08 | 559-561 | S60039D | 23 | 949-950 | S60471A | 09 | 604-605 | ||
| S59031A | 08 | 562-563 | S60039S | 09 | 604-605 | S60471A | 24 | 955-965 | ||
| S59031A | 24 | 955-965 | S60041A | 09 | 604-605 | S60471D | 23 | 949-950 | ||
| S59031D | 08 | 559-561 | S60041A | 24 | 955-965 | S60471S | 09 | 604-605 | ||
| S59031G | 08 | 559-561 | S60041D | 23 | 949-950 | S60472A | 09 | 604-605 | ||
| S59031K | 08 | 564-566 | S60041S | 09 | 604-605 | S60472A | 24 | 955-965 | ||
| S59031P | 08 | 564-566 | S60042A | 09 | 604-605 | S60472D | 23 | 949-950 | ||
| S59031S | 08 | 559-561 | S60042A | 24 | 955-965 | S60472S | 09 | 604-605 | ||
| S59032A | 08 | 562-563 | S60042D | 23 | 949-950 | S60473A | 09 | 604-605 | ||
| S59032A | 24 | 955-965 | S60042S | 09 | 604-605 | S60473A | 24 | 955-965 | ||
| S59032D | 08 | 559-561 | S60049A | 09 | 604-605 | S60473D | 23 | 949-950 | ||
| S59032G | 08 | 559-561 | S60049A | 24 | 955-965 | S60473S | 09 | 604-605 | ||
| S59032K | 08 | 564-566 | S60049D | 23 | 949-950 | S60474A | 09 | 604-605 | ||
| S59032P | 08 | 564-566 | S60049S | 09 | 604-605 | S60474A | 24 | 955-965 | ||
| S59032S | 08 | 559-561 | S60051A | 09 | 604-605 | S60474D | 23 | 949-950 | ||
| S59039A | 08 | 562-563 | S60051A | 24 | 955-965 | S60474S | 09 | 604-605 | ||
| S59039A | 24 | 955-965 | S60051D | 23 | 949-950 | S60475A | 09 | 604-605 | ||
| S59039D | 08 | 559-561 | S60051S | 09 | 604-605 | S60475A | 24 | 955-965 | ||
| S59039G | 08 | 559-561 | S60052A | 09 | 604-605 | S60475D | 23 | 949-950 | ||
| S59039K | 08 | 564-566 | S60052A | 24 | 955-965 | S60475S | 09 | 604-605 | ||
| S59039P | 08 | 564-566 | S60052D | 23 | 949-950 | S60476A | 09 | 604-605 | ||
| S59039S | 08 | 559-561 | S60052S | 09 | 604-605 | S60476A | 24 | 955-965 | ||
| S59041A | 08 | 562-563 | S60059A | 09 | 604-605 | S60476D | 23 | 949-950 | ||
| S59041A | 24 | 955-965 | S60059A | 24 | 955-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 04 Oct 2018 16:21:08 CMS, code-revision=145, description-revision=1114 |