ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 8 of 74 |
| A000 B302 C577 C8442 D309 E093493 E13621 F40232 H02049 H26499 H54415A I5033 I70592 J9602 K8502 L89814 M10062 M24444 M5383 M80021D M84575S M89539 N8112 O281 O361921 O45023 P111 Q685 R936 S0242XG S06384D S12500K S20469D S25102D S3141XD S32454K S36291D S42012D S42392D S45302S S52023C S52254D S52509J S5491XA S59242D S61310S S62246P S62629G S63416A S66312A S72002S S72092G S7225XB S72424H S76022A S82023A S82225C S82461F S83126S S89032P S91312S S92335P S95112A T17298S T2270XD T25039D T382X1S T43591D T484X5A T578X4A T71132A T82838S Z0571 Z89112 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| F40232 | 19 | 882 | G372 | 01 | 058-060 | G609 | 01 | 073-074 | ||
| F40233 | 19 | 882 | G373 | 01 | 023-024 | G610 | 01 | 094-096 | ||
| F40240 | 19 | 882 | G373 | 01 | 097-099 | G611 | 01 | 073-074 | ||
| F40241 | 19 | 882 | G374 | 01 | 023-024 | G6181 | 01 | 073-074 | ||
| F40242 | 19 | 882 | G374 | 01 | 097-099 | G6182 | 01 | 073-074 | ||
| F40243 | 19 | 882 | G374 | 25 | 974-976 | G6189 | 01 | 073-074 | ||
| F40248 | 19 | 882 | G375 | 01 | 058-060 | G619 | 01 | 073-074 | ||
| F40290 | 19 | 882 | G378 | 01 | 058-060 | G620 | 01 | 073-074 | ||
| F40291 | 19 | 882 | G379 | 01 | 058-060 | G621 | 01 | 073-074 | ||
| F40298 | 19 | 882 | G379 | 25 | 974-976 | G622 | 01 | 073-074 | ||
| F408 | 19 | 882 | G40001 | 01 | 023 | G6281 | 01 | 073-074 | ||
| F409 | 19 | 882 | G40001 | 01 | 100-101 | G6282 | 01 | 073-074 | ||
| F410 | 19 | 880 | G40009 | 01 | 023 | G6289 | 01 | 073-074 | ||
| F411 | 19 | 880 | G40009 | 01 | 100-101 | G629 | 01 | 073-074 | ||
| F413 | 19 | 880 | G40011 | 01 | 023 | G63 | 01 | 073-074 | ||
| F418 | 19 | 880 | G40011 | 01 | 100-101 | G64 | 01 | 073-074 | ||
| F419 | 19 | 880 | G40019 | 01 | 023 | G650 | 01 | 073-074 | ||
| F422 | 19 | 882 | G40019 | 01 | 100-101 | G651 | 01 | 073-074 | ||
| F423 | 19 | 882 | G40101 | 01 | 023 | G652 | 01 | 073-074 | ||
| F424 | 19 | 882 | G40101 | 01 | 100-101 | G7000 | 01 | 056-057 | ||
| F428 | 19 | 882 | G40109 | 01 | 023 | G7001 | 01 | 056-057 | ||
| F429 | 19 | 882 | G40109 | 01 | 100-101 | G701 | 01 | 073-074 | ||
| F430 | 19 | 880 | G40111 | 01 | 023 | G702 | 01 | 073-074 | ||
| F4310 | 19 | 882 | G40111 | 01 | 100-101 | G7080 | 01 | 056-057 | ||
| F4311 | 19 | 882 | G40119 | 01 | 023 | G7081 | 01 | 056-057 | ||
| F4312 | 19 | 882 | G40119 | 01 | 100-101 | G7089 | 01 | 073-074 | ||
| F4320 | 19 | 882 | G40201 | 01 | 023 | G709 | 01 | 073-074 | ||
| F4321 | 19 | 881 | G40201 | 01 | 100-101 | G7100 | 01 | 091-093 | ||
| F4322 | 19 | 882 | G40209 | 01 | 023 | G7101 | 01 | 091-093 | ||
| F4323 | 19 | 882 | G40209 | 01 | 100-101 | G7102 | 01 | 091-093 | ||
| F4324 | 19 | 882 | G40211 | 01 | 023 | G7109 | 01 | 091-093 | ||
| F4325 | 19 | 882 | G40211 | 01 | 100-101 | G7111 | 01 | 091-093 | ||
| F4329 | 19 | 882 | G40219 | 01 | 023 | G7112 | 01 | 091-093 | ||
| F438 | 19 | 882 | G40219 | 01 | 100-101 | G7113 | 01 | 091-093 | ||
| F439 | 19 | 882 | G40301 | 01 | 023 | G7114 | 01 | 091-093 | ||
| F440 | 19 | 880 | G40301 | 01 | 100-101 | G7119 | 01 | 091-093 | ||
| F441 | 19 | 880 | G40309 | 01 | 023 | G7120 | 01 | 091-093 | ||
| F442 | 19 | 880 | G40309 | 01 | 100-101 | G7121 | 01 | 091-093 | ||
| F444 | 19 | 880 | G40311 | 01 | 023 | G71220 | 01 | 091-093 | ||
| F445 | 19 | 880 | G40311 | 01 | 100-101 | G71228 | 01 | 091-093 | ||
| F446 | 19 | 880 | G40319 | 01 | 023 | G7129 | 01 | 091-093 | ||
| F447 | 19 | 880 | G40319 | 01 | 100-101 | G713 | 01 | 091-093 | ||
| F4481 | 19 | 883 | G40401 | 01 | 023 | G718 | 01 | 091-093 | ||
| F4489 | 19 | 887 | G40401 | 01 | 100-101 | G719 | 01 | 091-093 | ||
| F449 | 19 | 880 | G40409 | 01 | 023 | G720 | 01 | 091-093 | ||
| F450 | 19 | 882 | G40409 | 01 | 100-101 | G721 | 01 | 091-093 | ||
| F451 | 19 | 882 | G40411 | 01 | 023 | G722 | 01 | 091-093 | ||
| F4520 | 19 | 882 | G40411 | 01 | 100-101 | G723 | 01 | 091-093 | ||
| F4521 | 19 | 882 | G40419 | 01 | 023 | G7241 | 08 | 545-547 | ||
| F4522 | 19 | 882 | G40419 | 01 | 100-101 | G7249 | 08 | 545-547 | ||
| F4529 | 19 | 882 | G4042 | 01 | 023 | G7281 | 01 | 091-093 | ||
| F4541 | 19 | 882 | G4042 | 01 | 100-101 | G7289 | 01 | 091-093 | ||
| F4542 | 19 | 882 | G40501 | 01 | 023 | G729 | 01 | 091-093 | ||
| F458 | 19 | 882 | G40501 | 01 | 100-101 | G731 | 01 | 056-057 | ||
| F459 | 19 | 882 | G40509 | 01 | 023 | G733 | 01 | 056-057 | ||
| F481 | 19 | 882 | G40509 | 01 | 100-101 | G737 | 01 | 091-093 | ||
| F482 | 01 | 056-057 | G40801 | 01 | 023 | G800 | 01 | 052-053 | ||
| F488 | 19 | 882 | G40801 | 01 | 100-101 | G801 | 01 | 052-053 | ||
| F489 | 19 | 880 | G40802 | 01 | 023 | G802 | 01 | 052-053 | ||
| F5000 | 19 | 883 | G40802 | 01 | 100-101 | G803 | 01 | 056-057 | ||
| F5001 | 19 | 883 | G40803 | 01 | 023 | G804 | 01 | 091-093 | ||
| F5002 | 19 | 883 | G40803 | 01 | 100-101 | G808 | 01 | 091-093 | ||
| F502 | 19 | 887 | G40804 | 01 | 023 | G809 | 01 | 091-093 | ||
| F5081 | 19 | 887 | G40804 | 01 | 100-101 | G8100 | 01 | 056-057 | ||
| F5082 | 19 | 887 | G40811 | 01 | 023 | G8101 | 01 | 056-057 | ||
| F5089 | 19 | 887 | G40811 | 01 | 100-101 | G8102 | 01 | 056-057 | ||
| F509 | 19 | 887 | G40812 | 01 | 023 | G8103 | 01 | 056-057 | ||
| F5101 | 19 | 887 | G40812 | 01 | 100-101 | G8104 | 01 | 056-057 | ||
| F5102 | 19 | 887 | G40813 | 01 | 023 | G8110 | 01 | 056-057 | ||
| F5103 | 19 | 887 | G40813 | 01 | 100-101 | G8111 | 01 | 056-057 | ||
| F5104 | 19 | 887 | G40814 | 01 | 023 | G8112 | 01 | 056-057 | ||
| F5105 | 19 | 887 | G40814 | 01 | 100-101 | G8113 | 01 | 056-057 | ||
| F5109 | 19 | 887 | G40821 | 01 | 023 | G8114 | 01 | 056-057 | ||
| F5111 | 19 | 887 | G40821 | 01 | 100-101 | G8190 | 01 | 056-057 | ||
| F5112 | 19 | 887 | G40822 | 01 | 023 | G8191 | 01 | 056-057 | ||
| F5113 | 19 | 887 | G40822 | 01 | 100-101 | G8192 | 01 | 056-057 | ||
| F5119 | 19 | 887 | G40823 | 01 | 023 | G8193 | 01 | 056-057 | ||
| F513 | 19 | 887 | G40823 | 01 | 100-101 | G8194 | 01 | 056-057 | ||
| F514 | 19 | 887 | G40824 | 01 | 023 | G8220 | 01 | 052-053 | ||
| F515 | 19 | 887 | G40824 | 01 | 100-101 | G8221 | 01 | 052-053 | ||
| F518 | 19 | 887 | G40833 | 01 | 023 | G8222 | 01 | 052-053 | ||
| F519 | 19 | 887 | G40833 | 01 | 100-101 | G8250 | 01 | 052-053 | ||
| F520 | 19 | 887 | G40834 | 01 | 023 | G8251 | 01 | 052-053 | ||
| F521 | 19 | 887 | G40834 | 01 | 100-101 | G8252 | 01 | 052-053 | ||
| F5221 | 19 | 887 | G4089 | 01 | 023 | G8253 | 01 | 052-053 | ||
| F5222 | 19 | 887 | G4089 | 01 | 100-101 | G8254 | 01 | 052-053 | ||
| F5231 | 19 | 887 | G40901 | 01 | 023 | G830 | 01 | 052-053 | ||
| F5232 | 19 | 887 | G40901 | 01 | 100-101 | G8310 | 01 | 091-093 | ||
| F524 | 19 | 887 | G40909 | 01 | 023 | G8311 | 01 | 091-093 | ||
| F525 | 13 | 742-743 | G40909 | 01 | 100-101 | G8312 | 01 | 091-093 | ||
| F525 | 13 | 760-761 | G40911 | 01 | 023 | G8313 | 01 | 091-093 | ||
| F526 | 19 | 887 | G40911 | 01 | 100-101 | G8314 | 01 | 091-093 | ||
| F528 | 19 | 887 | G40919 | 01 | 023 | G8320 | 01 | 091-093 | ||
| F529 | 19 | 887 | G40919 | 01 | 100-101 | G8321 | 01 | 091-093 | ||
| F530 | 19 | 881 | G40A01 | 01 | 023 | G8322 | 01 | 091-093 | ||
| F531 | 19 | 885 | G40A01 | 01 | 100-101 | G8323 | 01 | 091-093 | ||
| F54 | 19 | 884 | G40A09 | 01 | 023 | G8324 | 01 | 091-093 | ||
| F550 | 20 | 894-897 | G40A09 | 01 | 100-101 | G8330 | 01 | 091-093 | ||
| F551 | 20 | 894-897 | G40A11 | 01 | 023 | G8331 | 01 | 091-093 | ||
| F552 | 20 | 894-897 | G40A11 | 01 | 100-101 | G8332 | 01 | 091-093 | ||
| F553 | 20 | 894-897 | G40A19 | 01 | 023 | G8333 | 01 | 091-093 | ||
| F554 | 20 | 894-897 | G40A19 | 01 | 100-101 | G8334 | 01 | 091-093 | ||
| F558 | 20 | 894-897 | G40B01 | 01 | 023 | G834 | 01 | 073-074 | ||
| F59 | 19 | 887 | G40B01 | 01 | 100-101 | G835 | 01 | 091-093 | ||
| F600 | 19 | 883 | G40B09 | 01 | 023 | G8381 | 01 | 091-093 | ||
| F601 | 19 | 883 | G40B09 | 01 | 100-101 | G8382 | 01 | 091-093 | ||
| F602 | 19 | 883 | G40B11 | 01 | 023 | G8383 | 01 | 091-093 | ||
| F603 | 19 | 883 | G40B11 | 01 | 100-101 | G8384 | 01 | 091-093 | ||
| F604 | 19 | 883 | G40B19 | 01 | 023 | G8389 | 01 | 091-093 | ||
| F605 | 19 | 883 | G40B19 | 01 | 100-101 | G839 | 01 | 091-093 | ||
| F606 | 19 | 883 | G43001 | 01 | 102-103 | G890 | 01 | 091-093 | ||
| F607 | 19 | 883 | G43009 | 01 | 102-103 | G8911 | 23 | 947-948 | ||
| F6081 | 19 | 883 | G43011 | 01 | 102-103 | G8912 | 23 | 947-948 | ||
| F6089 | 19 | 883 | G43019 | 01 | 102-103 | G8918 | 23 | 947-948 | ||
| F609 | 19 | 883 | G43101 | 01 | 102-103 | G8921 | 01 | 091-093 | ||
| F630 | 19 | 883 | G43109 | 01 | 102-103 | G8922 | 01 | 091-093 | ||
| F631 | 19 | 886 | G43111 | 01 | 102-103 | G8928 | 01 | 091-093 | ||
| F632 | 19 | 883 | G43119 | 01 | 102-103 | G8929 | 01 | 091-093 | ||
| F633 | 19 | 884 | G43401 | 01 | 102-103 | G893 | 23 | 947-948 | ||
| F6381 | 19 | 883 | G43409 | 01 | 102-103 | G894 | 01 | 091-093 | ||
| F6389 | 19 | 883 | G43411 | 01 | 102-103 | G9001 | 01 | 073-074 | ||
| F639 | 19 | 886 | G43419 | 01 | 102-103 | G9009 | 01 | 073-074 | ||
| F640 | 19 | 887 | G43501 | 01 | 102-103 | G901 | 01 | 091-093 | ||
| F641 | 19 | 887 | G43509 | 01 | 102-103 | G901 | 15 | 791 | ||
| F642 | 19 | 887 | G43511 | 01 | 102-103 | G901 | 15 | 793 | ||
| F648 | 19 | 887 | G43519 | 01 | 102-103 | G902 | 01 | 073-074 | ||
| F649 | 19 | 887 | G43601 | 01 | 102-103 | G903 | 01 | 056-057 | ||
| F650 | 19 | 887 | G43609 | 01 | 102-103 | G904 | 01 | 073-074 | ||
| F651 | 19 | 887 | G43611 | 01 | 102-103 | G9050 | 01 | 073-074 | ||
| F652 | 19 | 887 | G43619 | 01 | 102-103 | G90511 | 01 | 073-074 | ||
| F653 | 19 | 887 | G43701 | 01 | 102-103 | G90512 | 01 | 073-074 | ||
| F654 | 19 | 887 | G43709 | 01 | 102-103 | G90513 | 01 | 073-074 | ||
| F6550 | 19 | 887 | G43711 | 01 | 102-103 | G90519 | 01 | 073-074 | ||
| F6551 | 19 | 887 | G43719 | 01 | 102-103 | G90521 | 01 | 073-074 | ||
| F6552 | 19 | 887 | G43801 | 01 | 102-103 | G90522 | 01 | 073-074 | ||
| F6581 | 19 | 887 | G43809 | 01 | 102-103 | G90523 | 01 | 073-074 | ||
| F6589 | 19 | 887 | G43811 | 01 | 102-103 | G90529 | 01 | 073-074 | ||
| F659 | 19 | 887 | G43819 | 01 | 102-103 | G9059 | 01 | 073-074 | ||
| F66 | 19 | 887 | G43821 | 01 | 102-103 | G908 | 01 | 073-074 | ||
| F6810 | 19 | 883 | G43829 | 01 | 102-103 | G909 | 01 | 073-074 | ||
| F6811 | 19 | 880 | G43831 | 01 | 102-103 | G910 | 01 | 056-057 | ||
| F6812 | 19 | 883 | G43839 | 01 | 102-103 | G911 | 01 | 056-057 | ||
| F6813 | 19 | 880 | G43901 | 01 | 102-103 | G912 | 01 | 056-057 | ||
| F688 | 19 | 880 | G43909 | 01 | 102-103 | G913 | 01 | 056-057 | ||
| F68A | 19 | 883 | G43911 | 01 | 102-103 | G914 | 01 | 056-057 | ||
| F69 | 19 | 883 | G43919 | 01 | 102-103 | G918 | 01 | 056-057 | ||
| F70 | 19 | 884 | G43A0 | 01 | 102-103 | G919 | 01 | 056-057 | ||
| F71 | 19 | 884 | G43A1 | 01 | 102-103 | G9200 | 01 | 023-024 | ||
| F72 | 19 | 884 | G43B0 | 01 | 102-103 | G9200 | 01 | 091-093 | ||
| F73 | 19 | 884 | G43B1 | 01 | 102-103 | G9200 | 15 | 791 | ||
| F78A1 | 19 | 884 | G43C0 | 01 | 102-103 | G9200 | 15 | 793 | ||
| F78A9 | 19 | 884 | G43C1 | 01 | 102-103 | G9201 | 01 | 023-024 | ||
| F79 | 19 | 884 | G43D0 | 01 | 102-103 | G9201 | 01 | 091-093 | ||
| F800 | 19 | 886 | G43D1 | 01 | 102-103 | G9201 | 15 | 791 | ||
| F801 | 19 | 886 | G44001 | 01 | 102-103 | G9201 | 15 | 793 | ||
| F802 | 19 | 886 | G44009 | 01 | 102-103 | G9202 | 01 | 023-024 | ||
| F804 | 19 | 886 | G44011 | 01 | 102-103 | G9202 | 01 | 091-093 | ||
| F8081 | 01 | 091-093 | G44019 | 01 | 102-103 | G9202 | 15 | 791 | ||
| F8082 | 19 | 886 | G44021 | 01 | 102-103 | G9202 | 15 | 793 | ||
| F8089 | 19 | 886 | G44029 | 01 | 102-103 | G9203 | 01 | 023-024 | ||
| F809 | 19 | 886 | G44031 | 01 | 102-103 | G9203 | 01 | 091-093 | ||
| F810 | 19 | 886 | G44039 | 01 | 102-103 | G9203 | 15 | 791 | ||
| F812 | 19 | 886 | G44041 | 01 | 102-103 | G9203 | 15 | 793 | ||
| F8181 | 19 | 886 | G44049 | 01 | 102-103 | G9204 | 01 | 023-024 | ||
| F8189 | 19 | 886 | G44051 | 01 | 102-103 | G9204 | 01 | 091-093 | ||
| F819 | 19 | 886 | G44059 | 01 | 102-103 | G9204 | 15 | 791 | ||
| F82 | 19 | 886 | G44091 | 01 | 102-103 | G9204 | 15 | 793 | ||
| F840 | 19 | 884 | G44099 | 01 | 102-103 | G9205 | 01 | 023-024 | ||
| F842 | 01 | 056-057 | G441 | 01 | 102-103 | G9205 | 01 | 091-093 | ||
| F843 | 19 | 884 | G44201 | 01 | 102-103 | G9205 | 15 | 791 | ||
| F845 | 19 | 885 | G44209 | 01 | 102-103 | G9205 | 15 | 793 | ||
| F848 | 19 | 885 | G44211 | 01 | 102-103 | G928 | 01 | 023-024 | ||
| F849 | 19 | 885 | G44219 | 01 | 102-103 | G928 | 01 | 091-093 | ||
| F88 | 19 | 886 | G44221 | 01 | 102-103 | G928 | 15 | 791 | ||
| F89 | 19 | 886 | G44229 | 01 | 102-103 | G928 | 15 | 793 | ||
| F900 | 19 | 886 | G44301 | 01 | 102-103 | G929 | 01 | 023-024 | ||
| F901 | 19 | 886 | G44309 | 01 | 102-103 | G929 | 01 | 091-093 | ||
| F902 | 19 | 886 | G44311 | 01 | 102-103 | G929 | 15 | 791 | ||
| F908 | 19 | 886 | G44319 | 01 | 102-103 | G929 | 15 | 793 | ||
| F909 | 19 | 886 | G44321 | 01 | 102-103 | G930 | 01 | 091-093 | ||
| F910 | 19 | 886 | G44329 | 01 | 102-103 | G931 | 01 | 091-093 | ||
| F911 | 19 | 886 | G4440 | 01 | 102-103 | G931 | 15 | 791 | ||
| F912 | 19 | 886 | G4441 | 01 | 102-103 | G931 | 15 | 793 | ||
| F913 | 19 | 886 | G4451 | 01 | 102-103 | G932 | 01 | 102-103 | ||
| F918 | 19 | 886 | G4452 | 01 | 102-103 | G933 | 23 | 947-948 | ||
| F919 | 19 | 886 | G4453 | 01 | 102-103 | G9340 | 01 | 070-072 | ||
| F930 | 19 | 882 | G4459 | 01 | 102-103 | G9340 | 25 | 974-976 | ||
| F938 | 19 | 886 | G4481 | 01 | 102-103 | G9341 | 01 | 070-072 | ||
| F939 | 19 | 886 | G4482 | 01 | 102-103 | G9341 | 25 | 974-976 | ||
| F940 | 19 | 886 | G4483 | 01 | 102-103 | G9349 | 01 | 070-072 | ||
| F941 | 19 | 886 | G4484 | 01 | 102-103 | G9349 | 25 | 974-976 | ||
| F942 | 19 | 886 | G4485 | 01 | 102-103 | G935 | 01 | 080-081 | ||
| F948 | 19 | 886 | G4486 | 01 | 102-103 | G936 | 01 | 080-081 | ||
| F949 | 19 | 886 | G4489 | 01 | 102-103 | G937 | 01 | 091-093 | ||
| F950 | 01 | 091-093 | G450 | 01 | 061-063 | G9381 | 01 | 070-072 | ||
| F951 | 01 | 091-093 | G450 | 01 | 069 | G9382 | 01 | 080-081 | ||
| F952 | 01 | 091-093 | G451 | 01 | 061-063 | G9389 | 01 | 070-072 | ||
| F958 | 01 | 091-093 | G451 | 01 | 069 | G939 | 01 | 070-072 | ||
| F959 | 01 | 091-093 | G452 | 01 | 061-063 | G939 | 25 | 974-976 | ||
| F980 | 19 | 886 | G452 | 01 | 069 | G94 | 01 | 056-057 | ||
| F981 | 19 | 886 | G453 | 02 | 123 | G950 | 01 | 056-057 | ||
| F9821 | 19 | 882 | G454 | 01 | 070-072 | G9511 | 01 | 091-093 | ||
| F9829 | 19 | 887 | G458 | 01 | 061-063 | G9519 | 01 | 091-093 | ||
| F983 | 19 | 886 | G458 | 01 | 069 | G9520 | 01 | 091-093 | ||
| F984 | 19 | 887 | G459 | 01 | 061-063 | G9520 | 25 | 974-976 | ||
| F985 | 19 | 887 | G459 | 01 | 069 | G9529 | 01 | 091-093 | ||
| F988 | 19 | 886 | G460 | 01 | 061-063 | G9529 | 25 | 974-976 | ||
| F989 | 19 | 886 | G460 | 01 | 069 | G9581 | 01 | 091-093 | ||
| F99 | 19 | 880 | G461 | 01 | 061-063 | G9589 | 01 | 091-093 | ||
| G000 | 01 | 023-024 | G461 | 01 | 069 | G959 | 01 | 091-093 | ||
| G000 | 01 | 094-096 | G462 | 01 | 061-063 | G959 | 25 | 974-976 | ||
| G000 | 15 | 791 | G462 | 01 | 069 | G9600 | 01 | 091-093 | ||
| G000 | 15 | 793 | G463 | 01 | 070-072 | G9600 | 15 | 791 | ||
| G001 | 01 | 023-024 | G464 | 01 | 070-072 | G9600 | 15 | 793 | ||
| G001 | 01 | 094-096 | G465 | 01 | 070-072 | G9601 | 01 | 091-093 | ||
| G001 | 15 | 791 | G466 | 01 | 070-072 | G9601 | 15 | 791 | ||
| G001 | 15 | 793 | G467 | 01 | 070-072 | G9601 | 15 | 793 | ||
| G002 | 01 | 023-024 | G468 | 01 | 070-072 | G9602 | 01 | 091-093 | ||
| G002 | 01 | 094-096 | G4700 | 19 | 887 | G9602 | 15 | 791 | ||
| G002 | 15 | 791 | G4701 | 19 | 887 | G9602 | 15 | 793 | ||
| G002 | 15 | 793 | G4709 | 19 | 887 | G9608 | 01 | 091-093 | ||
| G003 | 01 | 023-024 | G4710 | 19 | 887 | G9608 | 15 | 791 | ||
| G003 | 01 | 094-096 | G4711 | 19 | 887 | G9608 | 15 | 793 | ||
| G003 | 15 | 791 | G4712 | 19 | 887 | G9609 | 01 | 091-093 | ||
| G003 | 15 | 793 | G4713 | 19 | 887 | G9609 | 15 | 791 | ||
| G008 | 01 | 023-024 | G4714 | 19 | 887 | G9609 | 15 | 793 | ||
| G008 | 01 | 094-096 | G4719 | 19 | 887 | G9611 | 15 | 791 | ||
| G008 | 15 | 791 | G4720 | Pre | 011-013 | G9611 | 15 | 793 | ||
| G008 | 15 | 793 | G4720 | 01 | 091-093 | G9611 | 21 | 919-921 | ||
| G009 | 01 | 023-024 | G4721 | Pre | 011-013 | G9612 | 01 | 091-093 | ||
| G009 | 01 | 094-096 | G4721 | 01 | 091-093 | G96191 | 01 | 091-093 | ||
| G009 | 15 | 791 | G4722 | Pre | 011-013 | G96198 | 01 | 091-093 | ||
| G009 | 15 | 793 | G4722 | 01 | 091-093 | G96810 | 01 | 070-072 | ||
| G01 | 01 | 023-024 | G4723 | Pre | 011-013 | G96811 | 01 | 070-072 | ||
| G01 | 01 | 094-096 | G4723 | 01 | 091-093 | G96819 | 01 | 070-072 | ||
| G01 | 15 | 791 | G4724 | Pre | 011-013 | G9689 | 01 | 070-072 | ||
| G01 | 15 | 793 | G4724 | 01 | 091-093 | G969 | 01 | 070-072 | ||
| G02 | 01 | 023-024 | G4725 | Pre | 011-013 | G969 | 25 | 974-976 | ||
| G02 | 01 | 097-099 | G4725 | 01 | 091-093 | G970 | 01 | 091-093 | ||
| G02 | 15 | 791 | G4726 | Pre | 011-013 | G970 | 15 | 791 | ||
| G02 | 15 | 793 | G4726 | 01 | 091-093 | G970 | 15 | 793 | ||
| G030 | 01 | 097-099 | G4727 | Pre | 011-013 | G971 | 01 | 102-103 | ||
| G030 | 15 | 791 | G4727 | 01 | 091-093 | G971 | 15 | 791 | ||
| G030 | 15 | 793 | G4729 | Pre | 011-013 | G971 | 15 | 793 | ||
| G031 | 01 | 097-099 | G4729 | 01 | 091-093 | G972 | 01 | 091-093 | ||
| G032 | 01 | 075-076 | G4730 | Pre | 011-013 | G972 | 15 | 791 | ||
| G038 | 01 | 097-099 | G4730 | 03 | 154-156 | G972 | 15 | 793 | ||
| G038 | 15 | 791 | G4731 | Pre | 011-013 | G9731 | 01 | 091-093 | ||
| G038 | 15 | 793 | G4731 | 01 | 091-093 | G9732 | 01 | 091-093 | ||
| G039 | 01 | 097-099 | G4732 | Pre | 011-013 | G9741 | 15 | 791 | ||
| G039 | 15 | 791 | G4732 | 04 | 204 | G9741 | 15 | 793 | ||
| G039 | 15 | 793 | G4733 | Pre | 011-013 | G9741 | 21 | 919-921 | ||
| G0400 | 01 | 023-024 | G4733 | 03 | 154-156 | G9748 | 15 | 791 | ||
| G0400 | 01 | 097-099 | G4734 | Pre | 011-013 | G9748 | 15 | 793 | ||
| G0401 | 01 | 023-024 | G4734 | 03 | 154-156 | G9748 | 21 | 919-921 | ||
| G0401 | 01 | 097-099 | G4735 | Pre | 011-013 | G9749 | 15 | 791 | ||
| G0402 | 01 | 023-024 | G4735 | 01 | 091-093 | G9749 | 15 | 793 | ||
| G0402 | 01 | 097-099 | G4736 | Pre | 011-013 | G9749 | 21 | 919-921 | ||
| G041 | 01 | 052-053 | G4736 | 03 | 154-156 | G9751 | 21 | 919-921 | ||
| G042 | 01 | 023-024 | G4737 | Pre | 011-013 | G9752 | 21 | 919-921 | ||
| G042 | 01 | 094-096 | G4737 | 01 | 091-093 | G9761 | 21 | 919-921 | ||
| G042 | 15 | 791 | G4739 | Pre | 011-013 | G9762 | 21 | 919-921 | ||
| G042 | 15 | 793 | G4739 | 03 | 154-156 | G9763 | 21 | 919-921 | ||
| G0430 | 01 | 023-024 | G47411 | 01 | 091-093 | G9764 | 21 | 919-921 | ||
| G0430 | 01 | 097-099 | G47419 | 01 | 091-093 | G9781 | 01 | 091-093 | ||
| G0431 | 01 | 023-024 | G47421 | 01 | 091-093 | G9781 | 15 | 791 | ||
| G0431 | 01 | 097-099 | G47429 | 01 | 091-093 | G9781 | 15 | 793 | ||
| G0432 | 01 | 023-024 | G4750 | Pre | 011-013 | G9782 | 01 | 091-093 | ||
| G0432 | 01 | 097-099 | G4750 | 03 | 154-156 | G9782 | 15 | 791 | ||
| G0439 | 01 | 023-024 | G4751 | Pre | 011-013 | G9782 | 15 | 793 | ||
| G0439 | 01 | 097-099 | G4751 | 01 | 091-093 | G9783 | 01 | 091-093 | ||
| G0481 | 01 | 023-024 | G4752 | Pre | 011-013 | G9783 | 15 | 791 | ||
| G0481 | 01 | 097-099 | G4752 | 03 | 154-156 | G9783 | 15 | 793 | ||
| G0481 | 25 | 974-976 | G4753 | Pre | 011-013 | G9784 | 01 | 091-093 | ||
| G0482 | 01 | 023-024 | G4753 | 01 | 091-093 | G9784 | 15 | 791 | ||
| G0482 | 01 | 097-099 | G4754 | Pre | 011-013 | G9784 | 15 | 793 | ||
| G0489 | 01 | 023-024 | G4754 | 03 | 154-156 | G980 | 01 | 070-072 | ||
| G0489 | 01 | 097-099 | G4759 | Pre | 011-013 | G988 | 01 | 070-072 | ||
| G0489 | 25 | 974-976 | G4759 | 03 | 154-156 | G988 | 25 | 974-976 | ||
| G0490 | 01 | 023-024 | G4761 | Pre | 011-013 | G990 | 01 | 073-074 | ||
| G0490 | 01 | 097-099 | G4761 | 01 | 091-093 | G992 | 01 | 091-093 | ||
| G0490 | 25 | 974-976 | G4762 | Pre | 011-013 | G998 | 01 | 070-072 | ||
| G0491 | 01 | 023-024 | G4762 | 01 | 091-093 | H00011 | 02 | 124-125 | ||
| G0491 | 01 | 097-099 | G4763 | Pre | 011-013 | H00012 | 02 | 124-125 | ||
| G0491 | 25 | 974-976 | G4763 | 03 | 154-156 | H00013 | 02 | 124-125 | ||
| G053 | 01 | 023-024 | G4769 | Pre | 011-013 | H00014 | 02 | 124-125 | ||
| G053 | 01 | 097-099 | G4769 | 03 | 154-156 | H00015 | 02 | 124-125 | ||
| G054 | 01 | 023-024 | G478 | Pre | 011-013 | H00016 | 02 | 124-125 | ||
| G054 | 01 | 097-099 | G478 | 03 | 154-156 | H00019 | 02 | 124-125 | ||
| G060 | 01 | 023-024 | G479 | 19 | 887 | H00021 | 02 | 124-125 | ||
| G060 | 01 | 094-096 | G500 | 01 | 073-074 | H00022 | 02 | 124-125 | ||
| G060 | 15 | 791 | G501 | 01 | 073-074 | H00023 | 02 | 124-125 | ||
| G060 | 15 | 793 | G508 | 01 | 073-074 | H00024 | 02 | 124-125 | ||
| G061 | 01 | 023-024 | G509 | 01 | 073-074 | H00025 | 02 | 124-125 | ||
| G061 | 01 | 094-096 | G510 | 01 | 073-074 | H00026 | 02 | 124-125 | ||
| G061 | 15 | 791 | G511 | 01 | 073-074 | H00029 | 02 | 124-125 | ||
| G061 | 15 | 793 | G512 | 01 | 073-074 | H00031 | 02 | 124-125 | ||
| G062 | 01 | 023-024 | G5131 | 01 | 073-074 | H00032 | 02 | 124-125 | ||
| G062 | 01 | 094-096 | G5132 | 01 | 073-074 | H00033 | 02 | 124-125 | ||
| G062 | 15 | 791 | G5133 | 01 | 073-074 | H00034 | 02 | 124-125 | ||
| G062 | 15 | 793 | G5139 | 01 | 073-074 | H00035 | 02 | 124-125 | ||
| G07 | 01 | 023-024 | G514 | 01 | 073-074 | H00036 | 02 | 124-125 | ||
| G07 | 01 | 094-096 | G518 | 01 | 073-074 | H00039 | 02 | 124-125 | ||
| G07 | 15 | 791 | G519 | 01 | 073-074 | H0011 | 02 | 124-125 | ||
| G07 | 15 | 793 | G520 | 01 | 073-074 | H0012 | 02 | 124-125 | ||
| G08 | 01 | 023-024 | G521 | 01 | 073-074 | H0013 | 02 | 124-125 | ||
| G08 | 01 | 091-093 | G522 | 01 | 073-074 | H0014 | 02 | 124-125 | ||
| G09 | 01 | 091-093 | G523 | 01 | 073-074 | H0015 | 02 | 124-125 | ||
| G10 | 01 | 056-057 | G527 | 01 | 073-074 | H0016 | 02 | 124-125 | ||
| G110 | 01 | 058-060 | G528 | 01 | 073-074 | H0019 | 02 | 124-125 | ||
| G1110 | 01 | 058-060 | G529 | 01 | 073-074 | H01001 | 02 | 124-125 | ||
| G1111 | 01 | 058-060 | G53 | 01 | 073-074 | H01002 | 02 | 124-125 | ||
| G1119 | 01 | 058-060 | G540 | 01 | 073-074 | H01003 | 02 | 124-125 | ||
| G112 | 01 | 058-060 | G541 | 01 | 073-074 | H01004 | 02 | 124-125 | ||
| G113 | 01 | 058-060 | G542 | 01 | 073-074 | H01005 | 02 | 124-125 | ||
| G114 | 01 | 058-060 | G543 | 01 | 073-074 | H01006 | 02 | 124-125 | ||
| G118 | 01 | 058-060 | G544 | 01 | 073-074 | H01009 | 02 | 124-125 | ||
| G119 | 01 | 058-060 | G545 | 01 | 073-074 | H0100A | 02 | 124-125 | ||
| G120 | 01 | 056-057 | G546 | 01 | 073-074 | H0100B | 02 | 124-125 | ||
| G121 | 01 | 056-057 | G547 | 01 | 073-074 | H01011 | 02 | 124-125 | ||
| G1220 | 01 | 056-057 | G548 | 01 | 073-074 | H01012 | 02 | 124-125 | ||
| G1221 | 01 | 056-057 | G549 | 01 | 073-074 | H01013 | 02 | 124-125 | ||
| G1222 | 01 | 056-057 | G55 | 01 | 073-074 | H01014 | 02 | 124-125 | ||
| G1223 | 01 | 056-057 | G5600 | 01 | 073-074 | H01015 | 02 | 124-125 | ||
| G1224 | 01 | 056-057 | G5601 | 01 | 073-074 | H01016 | 02 | 124-125 | ||
| G1225 | 01 | 056-057 | G5602 | 01 | 073-074 | H01019 | 02 | 124-125 | ||
| G1229 | 01 | 056-057 | G5603 | 01 | 073-074 | H0101A | 02 | 124-125 | ||
| G128 | 01 | 056-057 | G5610 | 01 | 073-074 | H0101B | 02 | 124-125 | ||
| G129 | 01 | 056-057 | G5611 | 01 | 073-074 | H01021 | 02 | 124-125 | ||
| G130 | 01 | 073-074 | G5612 | 01 | 073-074 | H01022 | 02 | 124-125 | ||
| G131 | 01 | 073-074 | G5613 | 01 | 073-074 | H01023 | 02 | 124-125 | ||
| G132 | 01 | 056-057 | G5620 | 01 | 073-074 | H01024 | 02 | 124-125 | ||
| G138 | 01 | 056-057 | G5621 | 01 | 073-074 | H01025 | 02 | 124-125 | ||
| G14 | 01 | 091-093 | G5622 | 01 | 073-074 | H01026 | 02 | 124-125 | ||
| G20 | 01 | 056-057 | G5623 | 01 | 073-074 | H01029 | 02 | 124-125 | ||
| G210 | 01 | 091-093 | G5630 | 01 | 073-074 | H0102A | 02 | 124-125 | ||
| G2111 | 01 | 056-057 | G5631 | 01 | 073-074 | H0102B | 02 | 124-125 | ||
| G2119 | 01 | 056-057 | G5632 | 01 | 073-074 | H01111 | 02 | 124-125 | ||
| G212 | 01 | 056-057 | G5633 | 01 | 073-074 | H01112 | 02 | 124-125 | ||
| G213 | 01 | 056-057 | G5640 | 01 | 073-074 | H01113 | 02 | 124-125 | ||
| G214 | 01 | 056-057 | G5641 | 01 | 073-074 | H01114 | 02 | 124-125 | ||
| G218 | 01 | 056-057 | G5642 | 01 | 073-074 | H01115 | 02 | 124-125 | ||
| G219 | 01 | 056-057 | G5643 | 01 | 073-074 | H01116 | 02 | 124-125 | ||
| G230 | 01 | 056-057 | G5680 | 01 | 073-074 | H01119 | 02 | 124-125 | ||
| G231 | 01 | 056-057 | G5681 | 01 | 073-074 | H01121 | 02 | 124-125 | ||
| G232 | 01 | 056-057 | G5682 | 01 | 073-074 | H01122 | 02 | 124-125 | ||
| G238 | 01 | 056-057 | G5683 | 01 | 073-074 | H01123 | 02 | 124-125 | ||
| G239 | 01 | 056-057 | G5690 | 01 | 073-074 | H01124 | 02 | 124-125 | ||
| G2401 | 01 | 091-093 | G5691 | 01 | 073-074 | H01125 | 02 | 124-125 | ||
| G2402 | 01 | 091-093 | G5692 | 01 | 073-074 | H01126 | 02 | 124-125 | ||
| G2409 | 01 | 091-093 | G5693 | 01 | 073-074 | H01129 | 02 | 124-125 | ||
| G241 | 01 | 056-057 | G5700 | 01 | 073-074 | H01131 | 02 | 124-125 | ||
| G242 | 01 | 091-093 | G5701 | 01 | 073-074 | H01132 | 02 | 124-125 | ||
| G243 | 01 | 091-093 | G5702 | 01 | 073-074 | H01133 | 02 | 124-125 | ||
| G244 | 01 | 091-093 | G5703 | 01 | 073-074 | H01134 | 02 | 124-125 | ||
| G245 | 02 | 124-125 | G5710 | 01 | 073-074 | H01135 | 02 | 124-125 | ||
| G248 | 01 | 091-093 | G5711 | 01 | 073-074 | H01136 | 02 | 124-125 | ||
| G249 | 01 | 091-093 | G5712 | 01 | 073-074 | H01139 | 02 | 124-125 | ||
| G250 | 01 | 091-093 | G5713 | 01 | 073-074 | H01141 | 02 | 124-125 | ||
| G251 | 01 | 091-093 | G5720 | 01 | 073-074 | H01142 | 02 | 124-125 | ||
| G252 | 01 | 091-093 | G5721 | 01 | 073-074 | H01143 | 02 | 124-125 | ||
| G253 | 01 | 091-093 | G5722 | 01 | 073-074 | H01144 | 02 | 124-125 | ||
| G254 | 01 | 056-057 | G5723 | 01 | 073-074 | H01145 | 02 | 124-125 | ||
| G255 | 01 | 056-057 | G5730 | 01 | 073-074 | H01146 | 02 | 124-125 | ||
| G2561 | 01 | 091-093 | G5731 | 01 | 073-074 | H01149 | 02 | 124-125 | ||
| G2569 | 01 | 091-093 | G5732 | 01 | 073-074 | H018 | 02 | 124-125 | ||
| G2570 | 01 | 056-057 | G5733 | 01 | 073-074 | H019 | 02 | 124-125 | ||
| G2571 | 01 | 056-057 | G5740 | 01 | 073-074 | H02001 | 02 | 124-125 | ||
| G2579 | 01 | 056-057 | G5741 | 01 | 073-074 | H02002 | 02 | 124-125 | ||
| G2581 | 01 | 056-057 | G5742 | 01 | 073-074 | H02003 | 02 | 124-125 | ||
| G2582 | 01 | 091-093 | G5743 | 01 | 073-074 | H02004 | 02 | 124-125 | ||
| G2583 | 01 | 091-093 | G5750 | 01 | 073-074 | H02005 | 02 | 124-125 | ||
| G2589 | 01 | 056-057 | G5751 | 01 | 073-074 | H02006 | 02 | 124-125 | ||
| G259 | 01 | 056-057 | G5752 | 01 | 073-074 | H02009 | 02 | 124-125 | ||
| G26 | 01 | 056-057 | G5753 | 01 | 073-074 | H02011 | 02 | 124-125 | ||
| G300 | 01 | 056-057 | G5760 | 01 | 073-074 | H02012 | 02 | 124-125 | ||
| G301 | 01 | 056-057 | G5761 | 01 | 073-074 | H02013 | 02 | 124-125 | ||
| G308 | 01 | 056-057 | G5762 | 01 | 073-074 | H02014 | 02 | 124-125 | ||
| G309 | 01 | 056-057 | G5763 | 01 | 073-074 | H02015 | 02 | 124-125 | ||
| G3101 | 01 | 056-057 | G5770 | 01 | 073-074 | H02016 | 02 | 124-125 | ||
| G3109 | 01 | 056-057 | G5771 | 01 | 073-074 | H02019 | 02 | 124-125 | ||
| G311 | 01 | 056-057 | G5772 | 01 | 073-074 | H02021 | 02 | 124-125 | ||
| G312 | 01 | 056-057 | G5773 | 01 | 073-074 | H02022 | 02 | 124-125 | ||
| G3181 | 01 | 056-057 | G5780 | 01 | 073-074 | H02023 | 02 | 124-125 | ||
| G3182 | 01 | 056-057 | G5781 | 01 | 073-074 | H02024 | 02 | 124-125 | ||
| G3183 | 01 | 056-057 | G5782 | 01 | 073-074 | H02025 | 02 | 124-125 | ||
| G3184 | 01 | 056-057 | G5783 | 01 | 073-074 | H02026 | 02 | 124-125 | ||
| G3185 | 01 | 056-057 | G5790 | 01 | 073-074 | H02029 | 02 | 124-125 | ||
| G3189 | 01 | 056-057 | G5791 | 01 | 073-074 | H02031 | 02 | 124-125 | ||
| G319 | 01 | 056-057 | G5792 | 01 | 073-074 | H02032 | 02 | 124-125 | ||
| G320 | 01 | 091-093 | G5793 | 01 | 073-074 | H02033 | 02 | 124-125 | ||
| G3281 | 01 | 058-060 | G580 | 01 | 073-074 | H02034 | 02 | 124-125 | ||
| G3289 | 01 | 070-072 | G587 | 01 | 073-074 | H02035 | 02 | 124-125 | ||
| G35 | 01 | 058-060 | G588 | 01 | 073-074 | H02036 | 02 | 124-125 | ||
| G360 | 01 | 058-060 | G589 | 01 | 073-074 | H02039 | 02 | 124-125 | ||
| G361 | 01 | 058-060 | G59 | 01 | 073-074 | H02041 | 02 | 124-125 | ||
| G368 | 01 | 058-060 | G600 | 01 | 073-074 | H02042 | 02 | 124-125 | ||
| G369 | 01 | 058-060 | G601 | 01 | 091-093 | H02043 | 02 | 124-125 | ||
| G369 | 25 | 974-976 | G602 | 01 | 073-074 | H02044 | 02 | 124-125 | ||
| G370 | 01 | 058-060 | G603 | 01 | 073-074 | H02045 | 02 | 124-125 | ||
| G371 | 01 | 058-060 | G608 | 01 | 073-074 | H02046 | 02 | 124-125 |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 08 Mar 2021 20:13:49 CMS, code-revision=301, description-revision=1298 |