ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 12 of 75 |
| A000 B302 C577 C8442 D309 E093393 E1344 F19280 G9761 H21341 H52203 I369 I70221 J682 K7031 L89200 M06812 M23203 M4841XS M71811 M84529D M87842 N468 O1214 O336XX3 O368234 O714 P913 R062 S0092XA S0303XA S069X2A S14106D S21312S S25809S S31811D S32499S S37012A S42123D S42449D S46329S S52045R S52291A S52552B S56112S S60359A S61509A S62321G S62660D S63637S S66529S S72024G S72114B S72326D S72451B S7711XD S82045J S82251P S8261XA S83521A S89309D S92044S S92426G S96802A T20219S T23229S T25739S T391X5S T444X2S T498X3S T602X4S T7805XS T83728S Z315 Z96641 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| I369 | 05 | 306-307 | I63012 | 01 | 023-024 | I63542 | 01 | 023-024 | ||
| I370 | 05 | 306-307 | I63012 | 01 | 061-063 | I63542 | 01 | 061-063 | ||
| I371 | 05 | 306-307 | I63012 | 01 | 064-066 | I63542 | 01 | 064-066 | ||
| I372 | 05 | 306-307 | I63012 | 15 | 791 | I63542 | 15 | 791 | ||
| I378 | 05 | 306-307 | I63012 | 15 | 793 | I63542 | 15 | 793 | ||
| I379 | 05 | 306-307 | I63013 | 01 | 023-024 | I63543 | 01 | 023-024 | ||
| I38 | 05 | 306-307 | I63013 | 01 | 061-063 | I63543 | 01 | 061-063 | ||
| I38 | 15 | 791 | I63013 | 01 | 064-066 | I63543 | 01 | 064-066 | ||
| I38 | 15 | 793 | I63013 | 15 | 791 | I63543 | 15 | 791 | ||
| I39 | 05 | 306-307 | I63013 | 15 | 793 | I63543 | 15 | 793 | ||
| I39 | 15 | 791 | I63019 | 01 | 023-024 | I63549 | 01 | 023-024 | ||
| I39 | 15 | 793 | I63019 | 01 | 061-063 | I63549 | 01 | 061-063 | ||
| I400 | 05 | 314-316 | I63019 | 01 | 064-066 | I63549 | 01 | 064-066 | ||
| I400 | 15 | 791 | I63019 | 15 | 791 | I63549 | 15 | 791 | ||
| I400 | 15 | 793 | I63019 | 15 | 793 | I63549 | 15 | 793 | ||
| I400 | 25 | 974-976 | I6302 | 01 | 023-024 | I6359 | 01 | 023-024 | ||
| I401 | 05 | 314-316 | I6302 | 01 | 061-063 | I6359 | 01 | 061-063 | ||
| I401 | 25 | 974-976 | I6302 | 01 | 064-066 | I6359 | 01 | 064-066 | ||
| I408 | 05 | 314-316 | I6302 | 15 | 791 | I6359 | 15 | 791 | ||
| I408 | 25 | 974-976 | I6302 | 15 | 793 | I6359 | 15 | 793 | ||
| I409 | 05 | 314-316 | I63031 | 01 | 023-024 | I636 | 01 | 023-024 | ||
| I409 | 25 | 974-976 | I63031 | 01 | 061-063 | I636 | 01 | 061-063 | ||
| I41 | 05 | 314-316 | I63031 | 01 | 064-066 | I636 | 01 | 064-066 | ||
| I41 | 15 | 791 | I63031 | 15 | 791 | I636 | 15 | 791 | ||
| I41 | 15 | 793 | I63031 | 15 | 793 | I636 | 15 | 793 | ||
| I420 | 05 | 314-316 | I63032 | 01 | 023-024 | I6381 | 01 | 023-024 | ||
| I421 | 05 | 314-316 | I63032 | 01 | 061-063 | I6381 | 01 | 061-063 | ||
| I422 | 05 | 314-316 | I63032 | 01 | 064-066 | I6381 | 01 | 064-066 | ||
| I423 | 05 | 314-316 | I63032 | 15 | 791 | I6381 | 15 | 791 | ||
| I424 | 05 | 314-316 | I63032 | 15 | 793 | I6381 | 15 | 793 | ||
| I425 | 05 | 314-316 | I63033 | 01 | 023-024 | I6389 | 01 | 023-024 | ||
| I426 | 05 | 314-316 | I63033 | 01 | 061-063 | I6389 | 01 | 061-063 | ||
| I427 | 05 | 314-316 | I63033 | 01 | 064-066 | I6389 | 01 | 064-066 | ||
| I428 | 05 | 314-316 | I63033 | 15 | 791 | I6389 | 15 | 791 | ||
| I429 | 05 | 314-316 | I63033 | 15 | 793 | I6389 | 15 | 793 | ||
| I43 | 05 | 314-316 | I63039 | 01 | 023-024 | I639 | 01 | 023-024 | ||
| I43 | 15 | 791 | I63039 | 01 | 061-063 | I639 | 01 | 061-063 | ||
| I43 | 15 | 793 | I63039 | 01 | 064-066 | I639 | 01 | 064-066 | ||
| I440 | 05 | 308-310 | I63039 | 15 | 791 | I639 | 15 | 791 | ||
| I441 | 05 | 308-310 | I63039 | 15 | 793 | I639 | 15 | 793 | ||
| I442 | 05 | 308-310 | I6309 | 01 | 023-024 | I6501 | 01 | 061-063 | ||
| I442 | 15 | 791 | I6309 | 01 | 061-063 | I6501 | 01 | 067-068 | ||
| I442 | 15 | 793 | I6309 | 01 | 064-066 | I6502 | 01 | 061-063 | ||
| I4430 | 05 | 308-310 | I6309 | 15 | 791 | I6502 | 01 | 067-068 | ||
| I4439 | 05 | 308-310 | I6309 | 15 | 793 | I6503 | 01 | 061-063 | ||
| I444 | 05 | 308-310 | I6310 | 01 | 023-024 | I6503 | 01 | 067-068 | ||
| I445 | 05 | 308-310 | I6310 | 01 | 061-063 | I6509 | 01 | 061-063 | ||
| I4460 | 05 | 308-310 | I6310 | 01 | 064-066 | I6509 | 01 | 067-068 | ||
| I4469 | 05 | 308-310 | I6310 | 15 | 791 | I651 | 01 | 061-063 | ||
| I447 | 05 | 308-310 | I6310 | 15 | 793 | I651 | 01 | 067-068 | ||
| I450 | 05 | 308-310 | I63111 | 01 | 023-024 | I6521 | 01 | 061-063 | ||
| I4510 | 05 | 308-310 | I63111 | 01 | 061-063 | I6521 | 01 | 067-068 | ||
| I4519 | 05 | 308-310 | I63111 | 01 | 064-066 | I6522 | 01 | 061-063 | ||
| I452 | 05 | 308-310 | I63111 | 15 | 791 | I6522 | 01 | 067-068 | ||
| I452 | 15 | 791 | I63111 | 15 | 793 | I6523 | 01 | 061-063 | ||
| I452 | 15 | 793 | I63112 | 01 | 023-024 | I6523 | 01 | 067-068 | ||
| I453 | 05 | 308-310 | I63112 | 01 | 061-063 | I6529 | 01 | 061-063 | ||
| I453 | 15 | 791 | I63112 | 01 | 064-066 | I6529 | 01 | 067-068 | ||
| I453 | 15 | 793 | I63112 | 15 | 791 | I658 | 01 | 061-063 | ||
| I454 | 05 | 308-310 | I63112 | 15 | 793 | I658 | 01 | 067-068 | ||
| I455 | 05 | 308-310 | I63113 | 01 | 023-024 | I659 | 01 | 061-063 | ||
| I456 | 05 | 308-310 | I63113 | 01 | 061-063 | I659 | 01 | 067-068 | ||
| I456 | 15 | 791 | I63113 | 01 | 064-066 | I6601 | 01 | 061-063 | ||
| I456 | 15 | 793 | I63113 | 15 | 791 | I6601 | 01 | 067-068 | ||
| I4581 | 05 | 308-310 | I63113 | 15 | 793 | I6601 | 15 | 791 | ||
| I4589 | 05 | 308-310 | I63119 | 01 | 023-024 | I6601 | 15 | 793 | ||
| I4589 | 15 | 791 | I63119 | 01 | 061-063 | I6602 | 01 | 061-063 | ||
| I4589 | 15 | 793 | I63119 | 01 | 064-066 | I6602 | 01 | 067-068 | ||
| I459 | 05 | 308-310 | I63119 | 15 | 791 | I6602 | 15 | 791 | ||
| I462 | 05 | 296-298 | I63119 | 15 | 793 | I6602 | 15 | 793 | ||
| I462 | 15 | 791 | I6312 | 01 | 023-024 | I6603 | 01 | 061-063 | ||
| I462 | 15 | 793 | I6312 | 01 | 061-063 | I6603 | 01 | 067-068 | ||
| I468 | 05 | 296-298 | I6312 | 01 | 064-066 | I6603 | 15 | 791 | ||
| I468 | 15 | 791 | I6312 | 15 | 791 | I6603 | 15 | 793 | ||
| I468 | 15 | 793 | I6312 | 15 | 793 | I6609 | 01 | 061-063 | ||
| I469 | 05 | 296-298 | I63131 | 01 | 023-024 | I6609 | 01 | 067-068 | ||
| I469 | 15 | 791 | I63131 | 01 | 061-063 | I6609 | 15 | 791 | ||
| I469 | 15 | 793 | I63131 | 01 | 064-066 | I6609 | 15 | 793 | ||
| I470 | 05 | 308-310 | I63131 | 15 | 791 | I6611 | 01 | 061-063 | ||
| I470 | 15 | 791 | I63131 | 15 | 793 | I6611 | 01 | 067-068 | ||
| I470 | 15 | 793 | I63132 | 01 | 023-024 | I6611 | 15 | 791 | ||
| I471 | 05 | 308-310 | I63132 | 01 | 061-063 | I6611 | 15 | 793 | ||
| I4720 | 05 | 308-310 | I63132 | 01 | 064-066 | I6612 | 01 | 061-063 | ||
| I4720 | 15 | 791 | I63132 | 15 | 791 | I6612 | 01 | 067-068 | ||
| I4720 | 15 | 793 | I63132 | 15 | 793 | I6612 | 15 | 791 | ||
| I4721 | 05 | 308-310 | I63133 | 01 | 023-024 | I6612 | 15 | 793 | ||
| I4721 | 15 | 791 | I63133 | 01 | 061-063 | I6613 | 01 | 061-063 | ||
| I4721 | 15 | 793 | I63133 | 01 | 064-066 | I6613 | 01 | 067-068 | ||
| I4729 | 05 | 308-310 | I63133 | 15 | 791 | I6613 | 15 | 791 | ||
| I4729 | 15 | 791 | I63133 | 15 | 793 | I6613 | 15 | 793 | ||
| I4729 | 15 | 793 | I63139 | 01 | 023-024 | I6619 | 01 | 061-063 | ||
| I479 | 05 | 308-310 | I63139 | 01 | 061-063 | I6619 | 01 | 067-068 | ||
| I480 | 05 | 308-310 | I63139 | 01 | 064-066 | I6619 | 15 | 791 | ||
| I480 | 15 | 791 | I63139 | 15 | 791 | I6619 | 15 | 793 | ||
| I480 | 15 | 793 | I63139 | 15 | 793 | I6621 | 01 | 061-063 | ||
| I4811 | 05 | 308-310 | I6319 | 01 | 023-024 | I6621 | 01 | 067-068 | ||
| I4819 | 05 | 308-310 | I6319 | 01 | 061-063 | I6621 | 15 | 791 | ||
| I4819 | 15 | 791 | I6319 | 01 | 064-066 | I6621 | 15 | 793 | ||
| I4819 | 15 | 793 | I6319 | 15 | 791 | I6622 | 01 | 061-063 | ||
| I4820 | 05 | 308-310 | I6319 | 15 | 793 | I6622 | 01 | 067-068 | ||
| I4821 | 05 | 308-310 | I6320 | 01 | 023-024 | I6622 | 15 | 791 | ||
| I4821 | 15 | 791 | I6320 | 01 | 061-063 | I6622 | 15 | 793 | ||
| I4821 | 15 | 793 | I6320 | 01 | 064-066 | I6623 | 01 | 061-063 | ||
| I483 | 05 | 308-310 | I6320 | 15 | 791 | I6623 | 01 | 067-068 | ||
| I483 | 15 | 791 | I6320 | 15 | 793 | I6623 | 15 | 791 | ||
| I483 | 15 | 793 | I63211 | 01 | 023-024 | I6623 | 15 | 793 | ||
| I484 | 05 | 308-310 | I63211 | 01 | 061-063 | I6629 | 01 | 061-063 | ||
| I484 | 15 | 791 | I63211 | 01 | 064-066 | I6629 | 01 | 067-068 | ||
| I484 | 15 | 793 | I63211 | 15 | 791 | I6629 | 15 | 791 | ||
| I4891 | 05 | 308-310 | I63211 | 15 | 793 | I6629 | 15 | 793 | ||
| I4891 | 15 | 791 | I63212 | 01 | 023-024 | I663 | 01 | 061-063 | ||
| I4891 | 15 | 793 | I63212 | 01 | 061-063 | I663 | 01 | 067-068 | ||
| I4892 | 05 | 308-310 | I63212 | 01 | 064-066 | I663 | 15 | 791 | ||
| I4892 | 15 | 791 | I63212 | 15 | 791 | I663 | 15 | 793 | ||
| I4892 | 15 | 793 | I63212 | 15 | 793 | I668 | 01 | 061-063 | ||
| I4901 | 05 | 308-310 | I63213 | 01 | 023-024 | I668 | 01 | 067-068 | ||
| I4901 | 15 | 791 | I63213 | 01 | 061-063 | I668 | 15 | 791 | ||
| I4901 | 15 | 793 | I63213 | 01 | 064-066 | I668 | 15 | 793 | ||
| I4902 | 05 | 308-310 | I63213 | 15 | 791 | I669 | 01 | 061-063 | ||
| I4902 | 15 | 791 | I63213 | 15 | 793 | I669 | 01 | 067-068 | ||
| I4902 | 15 | 793 | I63219 | 01 | 023-024 | I669 | 15 | 791 | ||
| I491 | 05 | 308-310 | I63219 | 01 | 061-063 | I669 | 15 | 793 | ||
| I492 | 05 | 308-310 | I63219 | 01 | 064-066 | I670 | 05 | 299-301 | ||
| I493 | 05 | 308-310 | I63219 | 15 | 791 | I671 | 01 | 091-093 | ||
| I4940 | 05 | 308-310 | I63219 | 15 | 793 | I672 | 01 | 070-072 | ||
| I4949 | 05 | 308-310 | I6322 | 01 | 023-024 | I673 | 01 | 056-057 | ||
| I495 | 05 | 308-310 | I6322 | 01 | 061-063 | I673 | 25 | 974-976 | ||
| I498 | 05 | 308-310 | I6322 | 01 | 064-066 | I674 | 01 | 077-079 | ||
| I499 | 05 | 308-310 | I6322 | 15 | 791 | I675 | 01 | 091-093 | ||
| I501 | 05 | 222-223 | I6322 | 15 | 793 | I676 | 01 | 091-093 | ||
| I501 | 05 | 291-293 | I63231 | 01 | 023-024 | I677 | 01 | 102-103 | ||
| I501 | 15 | 791 | I63231 | 01 | 061-063 | I6781 | 01 | 061-063 | ||
| I501 | 15 | 793 | I63231 | 01 | 064-066 | I6781 | 01 | 069 | ||
| I5020 | 05 | 222-223 | I63231 | 15 | 791 | I6782 | 01 | 061-063 | ||
| I5020 | 05 | 291-293 | I63231 | 15 | 793 | I6782 | 01 | 069 | ||
| I5020 | 15 | 791 | I63232 | 01 | 023-024 | I6783 | 01 | 070-072 | ||
| I5020 | 15 | 793 | I63232 | 01 | 061-063 | I6783 | 25 | 974-976 | ||
| I5021 | 05 | 222-223 | I63232 | 01 | 064-066 | I67841 | 01 | 061-063 | ||
| I5021 | 05 | 291-293 | I63232 | 15 | 791 | I67841 | 01 | 069 | ||
| I5021 | 15 | 791 | I63232 | 15 | 793 | I67848 | 01 | 061-063 | ||
| I5021 | 15 | 793 | I63233 | 01 | 023-024 | I67848 | 01 | 069 | ||
| I5022 | 05 | 222-223 | I63233 | 01 | 061-063 | I67850 | 01 | 070-072 | ||
| I5022 | 05 | 291-293 | I63233 | 01 | 064-066 | I67858 | 01 | 070-072 | ||
| I5022 | 15 | 791 | I63233 | 15 | 791 | I6789 | 01 | 061-063 | ||
| I5022 | 15 | 793 | I63233 | 15 | 793 | I6789 | 01 | 069 | ||
| I5023 | 05 | 222-223 | I63239 | 01 | 023-024 | I679 | 01 | 070-072 | ||
| I5023 | 05 | 291-293 | I63239 | 01 | 061-063 | I680 | 01 | 070-072 | ||
| I5023 | 15 | 791 | I63239 | 01 | 064-066 | I682 | 01 | 102-103 | ||
| I5023 | 15 | 793 | I63239 | 15 | 791 | I688 | 01 | 070-072 | ||
| I5030 | 05 | 222-223 | I63239 | 15 | 793 | I6900 | 01 | 056-057 | ||
| I5030 | 05 | 291-293 | I6329 | 01 | 023-024 | I69010 | 01 | 056-057 | ||
| I5030 | 15 | 791 | I6329 | 01 | 061-063 | I69011 | 01 | 056-057 | ||
| I5030 | 15 | 793 | I6329 | 01 | 064-066 | I69012 | 01 | 056-057 | ||
| I5031 | 05 | 222-223 | I6329 | 15 | 791 | I69013 | 01 | 056-057 | ||
| I5031 | 05 | 291-293 | I6329 | 15 | 793 | I69014 | 01 | 056-057 | ||
| I5031 | 15 | 791 | I6330 | 01 | 023-024 | I69015 | 01 | 056-057 | ||
| I5031 | 15 | 793 | I6330 | 01 | 061-063 | I69018 | 01 | 056-057 | ||
| I5032 | 05 | 222-223 | I6330 | 01 | 064-066 | I69019 | 01 | 056-057 | ||
| I5032 | 05 | 291-293 | I6330 | 15 | 791 | I69020 | 01 | 056-057 | ||
| I5032 | 15 | 791 | I6330 | 15 | 793 | I69021 | 01 | 056-057 | ||
| I5032 | 15 | 793 | I63311 | 01 | 023-024 | I69022 | 01 | 056-057 | ||
| I5033 | 05 | 222-223 | I63311 | 01 | 061-063 | I69023 | 01 | 056-057 | ||
| I5033 | 05 | 291-293 | I63311 | 01 | 064-066 | I69028 | 01 | 056-057 | ||
| I5033 | 15 | 791 | I63311 | 15 | 791 | I69031 | 01 | 056-057 | ||
| I5033 | 15 | 793 | I63311 | 15 | 793 | I69032 | 01 | 056-057 | ||
| I5040 | 05 | 222-223 | I63312 | 01 | 023-024 | I69033 | 01 | 056-057 | ||
| I5040 | 05 | 291-293 | I63312 | 01 | 061-063 | I69034 | 01 | 056-057 | ||
| I5040 | 15 | 791 | I63312 | 01 | 064-066 | I69039 | 01 | 056-057 | ||
| I5040 | 15 | 793 | I63312 | 15 | 791 | I69041 | 01 | 056-057 | ||
| I5041 | 05 | 222-223 | I63312 | 15 | 793 | I69042 | 01 | 056-057 | ||
| I5041 | 05 | 291-293 | I63313 | 01 | 023-024 | I69043 | 01 | 056-057 | ||
| I5041 | 15 | 791 | I63313 | 01 | 061-063 | I69044 | 01 | 056-057 | ||
| I5041 | 15 | 793 | I63313 | 01 | 064-066 | I69049 | 01 | 056-057 | ||
| I5042 | 05 | 222-223 | I63313 | 15 | 791 | I69051 | 01 | 056-057 | ||
| I5042 | 05 | 291-293 | I63313 | 15 | 793 | I69052 | 01 | 056-057 | ||
| I5042 | 15 | 791 | I63319 | 01 | 023-024 | I69053 | 01 | 056-057 | ||
| I5042 | 15 | 793 | I63319 | 01 | 061-063 | I69054 | 01 | 056-057 | ||
| I5043 | 05 | 222-223 | I63319 | 01 | 064-066 | I69059 | 01 | 056-057 | ||
| I5043 | 05 | 291-293 | I63319 | 15 | 791 | I69061 | 01 | 056-057 | ||
| I5043 | 15 | 791 | I63319 | 15 | 793 | I69062 | 01 | 056-057 | ||
| I5043 | 15 | 793 | I63321 | 01 | 023-024 | I69063 | 01 | 056-057 | ||
| I50810 | 05 | 222-223 | I63321 | 01 | 061-063 | I69064 | 01 | 056-057 | ||
| I50810 | 05 | 291-293 | I63321 | 01 | 064-066 | I69065 | 01 | 056-057 | ||
| I50810 | 15 | 791 | I63321 | 15 | 791 | I69069 | 01 | 056-057 | ||
| I50810 | 15 | 793 | I63321 | 15 | 793 | I69090 | 01 | 056-057 | ||
| I50811 | 05 | 222-223 | I63322 | 01 | 023-024 | I69091 | 01 | 056-057 | ||
| I50811 | 05 | 291-293 | I63322 | 01 | 061-063 | I69092 | 01 | 056-057 | ||
| I50811 | 15 | 791 | I63322 | 01 | 064-066 | I69093 | 01 | 056-057 | ||
| I50811 | 15 | 793 | I63322 | 15 | 791 | I69098 | 01 | 056-057 | ||
| I50812 | 05 | 222-223 | I63322 | 15 | 793 | I6910 | 01 | 056-057 | ||
| I50812 | 05 | 291-293 | I63323 | 01 | 023-024 | I69110 | 01 | 056-057 | ||
| I50812 | 15 | 791 | I63323 | 01 | 061-063 | I69111 | 01 | 056-057 | ||
| I50812 | 15 | 793 | I63323 | 01 | 064-066 | I69112 | 01 | 056-057 | ||
| I50813 | 05 | 222-223 | I63323 | 15 | 791 | I69113 | 01 | 056-057 | ||
| I50813 | 05 | 291-293 | I63323 | 15 | 793 | I69114 | 01 | 056-057 | ||
| I50813 | 15 | 791 | I63329 | 01 | 023-024 | I69115 | 01 | 056-057 | ||
| I50813 | 15 | 793 | I63329 | 01 | 061-063 | I69118 | 01 | 056-057 | ||
| I50814 | 05 | 222-223 | I63329 | 01 | 064-066 | I69119 | 01 | 056-057 | ||
| I50814 | 05 | 291-293 | I63329 | 15 | 791 | I69120 | 01 | 056-057 | ||
| I50814 | 15 | 791 | I63329 | 15 | 793 | I69121 | 01 | 056-057 | ||
| I50814 | 15 | 793 | I63331 | 01 | 023-024 | I69122 | 01 | 056-057 | ||
| I5082 | 05 | 222-223 | I63331 | 01 | 061-063 | I69123 | 01 | 056-057 | ||
| I5082 | 05 | 291-293 | I63331 | 01 | 064-066 | I69128 | 01 | 056-057 | ||
| I5082 | 15 | 791 | I63331 | 15 | 791 | I69131 | 01 | 056-057 | ||
| I5082 | 15 | 793 | I63331 | 15 | 793 | I69132 | 01 | 056-057 | ||
| I5083 | 05 | 222-223 | I63332 | 01 | 023-024 | I69133 | 01 | 056-057 | ||
| I5083 | 05 | 291-293 | I63332 | 01 | 061-063 | I69134 | 01 | 056-057 | ||
| I5083 | 15 | 791 | I63332 | 01 | 064-066 | I69139 | 01 | 056-057 | ||
| I5083 | 15 | 793 | I63332 | 15 | 791 | I69141 | 01 | 056-057 | ||
| I5084 | 05 | 222-223 | I63332 | 15 | 793 | I69142 | 01 | 056-057 | ||
| I5084 | 05 | 291-293 | I63333 | 01 | 023-024 | I69143 | 01 | 056-057 | ||
| I5084 | 15 | 791 | I63333 | 01 | 061-063 | I69144 | 01 | 056-057 | ||
| I5084 | 15 | 793 | I63333 | 01 | 064-066 | I69149 | 01 | 056-057 | ||
| I5089 | 05 | 222-223 | I63333 | 15 | 791 | I69151 | 01 | 056-057 | ||
| I5089 | 05 | 291-293 | I63333 | 15 | 793 | I69152 | 01 | 056-057 | ||
| I5089 | 15 | 791 | I63339 | 01 | 023-024 | I69153 | 01 | 056-057 | ||
| I5089 | 15 | 793 | I63339 | 01 | 061-063 | I69154 | 01 | 056-057 | ||
| I509 | 05 | 222-223 | I63339 | 01 | 064-066 | I69159 | 01 | 056-057 | ||
| I509 | 05 | 291-293 | I63339 | 15 | 791 | I69161 | 01 | 056-057 | ||
| I509 | 15 | 791 | I63339 | 15 | 793 | I69162 | 01 | 056-057 | ||
| I509 | 15 | 793 | I63341 | 01 | 023-024 | I69163 | 01 | 056-057 | ||
| I510 | 05 | 314-316 | I63341 | 01 | 061-063 | I69164 | 01 | 056-057 | ||
| I511 | 05 | 306-307 | I63341 | 01 | 064-066 | I69165 | 01 | 056-057 | ||
| I512 | 05 | 306-307 | I63341 | 15 | 791 | I69169 | 01 | 056-057 | ||
| I513 | 05 | 302-303 | I63341 | 15 | 793 | I69190 | 01 | 056-057 | ||
| I514 | 05 | 314-316 | I63342 | 01 | 023-024 | I69191 | 01 | 056-057 | ||
| I515 | 05 | 314-316 | I63342 | 01 | 061-063 | I69192 | 01 | 056-057 | ||
| I517 | 05 | 302-303 | I63342 | 01 | 064-066 | I69193 | 01 | 056-057 | ||
| I5181 | 05 | 314-316 | I63342 | 15 | 791 | I69198 | 01 | 056-057 | ||
| I5189 | 05 | 302-303 | I63342 | 15 | 793 | I6920 | 01 | 056-057 | ||
| I519 | 05 | 302-303 | I63343 | 01 | 023-024 | I69210 | 01 | 056-057 | ||
| I52 | 05 | 302-303 | I63343 | 01 | 061-063 | I69211 | 01 | 056-057 | ||
| I5A | 05 | 314-316 | I63343 | 01 | 064-066 | I69212 | 01 | 056-057 | ||
| I6000 | 01 | 020-022 | I63343 | 15 | 791 | I69213 | 01 | 056-057 | ||
| I6000 | 01 | 023-024 | I63343 | 15 | 793 | I69214 | 01 | 056-057 | ||
| I6000 | 01 | 064-066 | I63349 | 01 | 023-024 | I69215 | 01 | 056-057 | ||
| I6000 | 15 | 791 | I63349 | 01 | 061-063 | I69218 | 01 | 056-057 | ||
| I6000 | 15 | 793 | I63349 | 01 | 064-066 | I69219 | 01 | 056-057 | ||
| I6001 | 01 | 020-022 | I63349 | 15 | 791 | I69220 | 01 | 056-057 | ||
| I6001 | 01 | 023-024 | I63349 | 15 | 793 | I69221 | 01 | 056-057 | ||
| I6001 | 01 | 064-066 | I6339 | 01 | 023-024 | I69222 | 01 | 056-057 | ||
| I6001 | 15 | 791 | I6339 | 01 | 061-063 | I69223 | 01 | 056-057 | ||
| I6001 | 15 | 793 | I6339 | 01 | 064-066 | I69228 | 01 | 056-057 | ||
| I6002 | 01 | 020-022 | I6339 | 15 | 791 | I69231 | 01 | 056-057 | ||
| I6002 | 01 | 023-024 | I6339 | 15 | 793 | I69232 | 01 | 056-057 | ||
| I6002 | 01 | 064-066 | I6340 | 01 | 023-024 | I69233 | 01 | 056-057 | ||
| I6002 | 15 | 791 | I6340 | 01 | 061-063 | I69234 | 01 | 056-057 | ||
| I6002 | 15 | 793 | I6340 | 01 | 064-066 | I69239 | 01 | 056-057 | ||
| I6010 | 01 | 020-022 | I6340 | 15 | 791 | I69241 | 01 | 056-057 | ||
| I6010 | 01 | 023-024 | I6340 | 15 | 793 | I69242 | 01 | 056-057 | ||
| I6010 | 01 | 064-066 | I63411 | 01 | 023-024 | I69243 | 01 | 056-057 | ||
| I6010 | 15 | 791 | I63411 | 01 | 061-063 | I69244 | 01 | 056-057 | ||
| I6010 | 15 | 793 | I63411 | 01 | 064-066 | I69249 | 01 | 056-057 | ||
| I6011 | 01 | 020-022 | I63411 | 15 | 791 | I69251 | 01 | 056-057 | ||
| I6011 | 01 | 023-024 | I63411 | 15 | 793 | I69252 | 01 | 056-057 | ||
| I6011 | 01 | 064-066 | I63412 | 01 | 023-024 | I69253 | 01 | 056-057 | ||
| I6011 | 15 | 791 | I63412 | 01 | 061-063 | I69254 | 01 | 056-057 | ||
| I6011 | 15 | 793 | I63412 | 01 | 064-066 | I69259 | 01 | 056-057 | ||
| I6012 | 01 | 020-022 | I63412 | 15 | 791 | I69261 | 01 | 056-057 | ||
| I6012 | 01 | 023-024 | I63412 | 15 | 793 | I69262 | 01 | 056-057 | ||
| I6012 | 01 | 064-066 | I63413 | 01 | 023-024 | I69263 | 01 | 056-057 | ||
| I6012 | 15 | 791 | I63413 | 01 | 061-063 | I69264 | 01 | 056-057 | ||
| I6012 | 15 | 793 | I63413 | 01 | 064-066 | I69265 | 01 | 056-057 | ||
| I602 | 01 | 020-022 | I63413 | 15 | 791 | I69269 | 01 | 056-057 | ||
| I602 | 01 | 023-024 | I63413 | 15 | 793 | I69290 | 01 | 056-057 | ||
| I602 | 01 | 064-066 | I63419 | 01 | 023-024 | I69291 | 01 | 056-057 | ||
| I602 | 15 | 791 | I63419 | 01 | 061-063 | I69292 | 01 | 056-057 | ||
| I602 | 15 | 793 | I63419 | 01 | 064-066 | I69293 | 01 | 056-057 | ||
| I6030 | 01 | 020-022 | I63419 | 15 | 791 | I69298 | 01 | 056-057 | ||
| I6030 | 01 | 023-024 | I63419 | 15 | 793 | I6930 | 01 | 056-057 | ||
| I6030 | 01 | 064-066 | I63421 | 01 | 023-024 | I69310 | 01 | 056-057 | ||
| I6030 | 15 | 791 | I63421 | 01 | 061-063 | I69311 | 01 | 056-057 | ||
| I6030 | 15 | 793 | I63421 | 01 | 064-066 | I69312 | 01 | 056-057 | ||
| I6031 | 01 | 020-022 | I63421 | 15 | 791 | I69313 | 01 | 056-057 | ||
| I6031 | 01 | 023-024 | I63421 | 15 | 793 | I69314 | 01 | 056-057 | ||
| I6031 | 01 | 064-066 | I63422 | 01 | 023-024 | I69315 | 01 | 056-057 | ||
| I6031 | 15 | 791 | I63422 | 01 | 061-063 | I69318 | 01 | 056-057 | ||
| I6031 | 15 | 793 | I63422 | 01 | 064-066 | I69319 | 01 | 056-057 | ||
| I6032 | 01 | 020-022 | I63422 | 15 | 791 | I69320 | 01 | 056-057 | ||
| I6032 | 01 | 023-024 | I63422 | 15 | 793 | I69321 | 01 | 056-057 | ||
| I6032 | 01 | 064-066 | I63423 | 01 | 023-024 | I69322 | 01 | 056-057 | ||
| I6032 | 15 | 791 | I63423 | 01 | 061-063 | I69323 | 01 | 056-057 | ||
| I6032 | 15 | 793 | I63423 | 01 | 064-066 | I69328 | 01 | 056-057 | ||
| I604 | 01 | 020-022 | I63423 | 15 | 791 | I69331 | 01 | 056-057 | ||
| I604 | 01 | 023-024 | I63423 | 15 | 793 | I69332 | 01 | 056-057 | ||
| I604 | 01 | 064-066 | I63429 | 01 | 023-024 | I69333 | 01 | 056-057 | ||
| I604 | 15 | 791 | I63429 | 01 | 061-063 | I69334 | 01 | 056-057 | ||
| I604 | 15 | 793 | I63429 | 01 | 064-066 | I69339 | 01 | 056-057 | ||
| I6050 | 01 | 020-022 | I63429 | 15 | 791 | I69341 | 01 | 056-057 | ||
| I6050 | 01 | 023-024 | I63429 | 15 | 793 | I69342 | 01 | 056-057 | ||
| I6050 | 01 | 064-066 | I63431 | 01 | 023-024 | I69343 | 01 | 056-057 | ||
| I6050 | 15 | 791 | I63431 | 01 | 061-063 | I69344 | 01 | 056-057 | ||
| I6050 | 15 | 793 | I63431 | 01 | 064-066 | I69349 | 01 | 056-057 | ||
| I6051 | 01 | 020-022 | I63431 | 15 | 791 | I69351 | 01 | 056-057 | ||
| I6051 | 01 | 023-024 | I63431 | 15 | 793 | I69352 | 01 | 056-057 | ||
| I6051 | 01 | 064-066 | I63432 | 01 | 023-024 | I69353 | 01 | 056-057 | ||
| I6051 | 15 | 791 | I63432 | 01 | 061-063 | I69354 | 01 | 056-057 | ||
| I6051 | 15 | 793 | I63432 | 01 | 064-066 | I69359 | 01 | 056-057 | ||
| I6052 | 01 | 020-022 | I63432 | 15 | 791 | I69361 | 01 | 056-057 | ||
| I6052 | 01 | 023-024 | I63432 | 15 | 793 | I69362 | 01 | 056-057 | ||
| I6052 | 01 | 064-066 | I63433 | 01 | 023-024 | I69363 | 01 | 056-057 | ||
| I6052 | 15 | 791 | I63433 | 01 | 061-063 | I69364 | 01 | 056-057 | ||
| I6052 | 15 | 793 | I63433 | 01 | 064-066 | I69365 | 01 | 056-057 | ||
| I606 | 01 | 020-022 | I63433 | 15 | 791 | I69369 | 01 | 056-057 | ||
| I606 | 01 | 023-024 | I63433 | 15 | 793 | I69390 | 01 | 056-057 | ||
| I606 | 01 | 064-066 | I63439 | 01 | 023-024 | I69391 | 01 | 056-057 | ||
| I606 | 15 | 791 | I63439 | 01 | 061-063 | I69392 | 01 | 056-057 | ||
| I606 | 15 | 793 | I63439 | 01 | 064-066 | I69393 | 01 | 056-057 | ||
| I607 | 01 | 020-022 | I63439 | 15 | 791 | I69398 | 01 | 056-057 | ||
| I607 | 01 | 023-024 | I63439 | 15 | 793 | I6980 | 01 | 056-057 | ||
| I607 | 01 | 064-066 | I63441 | 01 | 023-024 | I69810 | 01 | 056-057 | ||
| I607 | 15 | 791 | I63441 | 01 | 061-063 | I69811 | 01 | 056-057 | ||
| I607 | 15 | 793 | I63441 | 01 | 064-066 | I69812 | 01 | 056-057 | ||
| I608 | 01 | 020-022 | I63441 | 15 | 791 | I69813 | 01 | 056-057 | ||
| I608 | 01 | 023-024 | I63441 | 15 | 793 | I69814 | 01 | 056-057 | ||
| I608 | 01 | 064-066 | I63442 | 01 | 023-024 | I69815 | 01 | 056-057 | ||
| I608 | 15 | 791 | I63442 | 01 | 061-063 | I69818 | 01 | 056-057 | ||
| I608 | 15 | 793 | I63442 | 01 | 064-066 | I69819 | 01 | 056-057 | ||
| I609 | 01 | 020-022 | I63442 | 15 | 791 | I69820 | 01 | 056-057 | ||
| I609 | 01 | 023-024 | I63442 | 15 | 793 | I69821 | 01 | 056-057 | ||
| I609 | 01 | 064-066 | I63443 | 01 | 023-024 | I69822 | 01 | 056-057 | ||
| I609 | 15 | 791 | I63443 | 01 | 061-063 | I69823 | 01 | 056-057 | ||
| I609 | 15 | 793 | I63443 | 01 | 064-066 | I69828 | 01 | 056-057 | ||
| I610 | 01 | 020-022 | I63443 | 15 | 791 | I69831 | 01 | 056-057 | ||
| I610 | 01 | 023-024 | I63443 | 15 | 793 | I69832 | 01 | 056-057 | ||
| I610 | 01 | 064-066 | I63449 | 01 | 023-024 | I69833 | 01 | 056-057 | ||
| I610 | 15 | 791 | I63449 | 01 | 061-063 | I69834 | 01 | 056-057 | ||
| I610 | 15 | 793 | I63449 | 01 | 064-066 | I69839 | 01 | 056-057 | ||
| I611 | 01 | 020-022 | I63449 | 15 | 791 | I69841 | 01 | 056-057 | ||
| I611 | 01 | 023-024 | I63449 | 15 | 793 | I69842 | 01 | 056-057 | ||
| I611 | 01 | 064-066 | I6349 | 01 | 023-024 | I69843 | 01 | 056-057 | ||
| I611 | 15 | 791 | I6349 | 01 | 061-063 | I69844 | 01 | 056-057 | ||
| I611 | 15 | 793 | I6349 | 01 | 064-066 | I69849 | 01 | 056-057 | ||
| I612 | 01 | 020-022 | I6349 | 15 | 791 | I69851 | 01 | 056-057 | ||
| I612 | 01 | 023-024 | I6349 | 15 | 793 | I69852 | 01 | 056-057 | ||
| I612 | 01 | 064-066 | I6350 | 01 | 023-024 | I69853 | 01 | 056-057 | ||
| I612 | 15 | 791 | I6350 | 01 | 061-063 | I69854 | 01 | 056-057 | ||
| I612 | 15 | 793 | I6350 | 01 | 064-066 | I69859 | 01 | 056-057 | ||
| I613 | 01 | 020-022 | I6350 | 15 | 791 | I69861 | 01 | 056-057 | ||
| I613 | 01 | 023-024 | I6350 | 15 | 793 | I69862 | 01 | 056-057 | ||
| I613 | 01 | 064-066 | I63511 | 01 | 023-024 | I69863 | 01 | 056-057 | ||
| I613 | 15 | 791 | I63511 | 01 | 061-063 | I69864 | 01 | 056-057 | ||
| I613 | 15 | 793 | I63511 | 01 | 064-066 | I69865 | 01 | 056-057 | ||
| I614 | 01 | 020-022 | I63511 | 15 | 791 | I69869 | 01 | 056-057 | ||
| I614 | 01 | 023-024 | I63511 | 15 | 793 | I69890 | 01 | 056-057 | ||
| I614 | 01 | 064-066 | I63512 | 01 | 023-024 | I69891 | 01 | 056-057 | ||
| I614 | 15 | 791 | I63512 | 01 | 061-063 | I69892 | 01 | 056-057 | ||
| I614 | 15 | 793 | I63512 | 01 | 064-066 | I69893 | 01 | 056-057 | ||
| I615 | 01 | 020-022 | I63512 | 15 | 791 | I69898 | 01 | 056-057 | ||
| I615 | 01 | 023-024 | I63512 | 15 | 793 | I6990 | 01 | 056-057 | ||
| I615 | 01 | 064-066 | I63513 | 01 | 023-024 | I69910 | 01 | 056-057 | ||
| I615 | 15 | 791 | I63513 | 01 | 061-063 | I69911 | 01 | 056-057 | ||
| I615 | 15 | 793 | I63513 | 01 | 064-066 | I69912 | 01 | 056-057 | ||
| I616 | 01 | 020-022 | I63513 | 15 | 791 | I69913 | 01 | 056-057 | ||
| I616 | 01 | 023-024 | I63513 | 15 | 793 | I69914 | 01 | 056-057 | ||
| I616 | 01 | 064-066 | I63519 | 01 | 023-024 | I69915 | 01 | 056-057 | ||
| I616 | 15 | 791 | I63519 | 01 | 061-063 | I69918 | 01 | 056-057 | ||
| I616 | 15 | 793 | I63519 | 01 | 064-066 | I69919 | 01 | 056-057 | ||
| I618 | 01 | 020-022 | I63519 | 15 | 791 | I69920 | 01 | 056-057 | ||
| I618 | 01 | 023-024 | I63519 | 15 | 793 | I69921 | 01 | 056-057 | ||
| I618 | 01 | 064-066 | I63521 | 01 | 023-024 | I69922 | 01 | 056-057 | ||
| I618 | 15 | 791 | I63521 | 01 | 061-063 | I69923 | 01 | 056-057 | ||
| I618 | 15 | 793 | I63521 | 01 | 064-066 | I69928 | 01 | 056-057 | ||
| I619 | 01 | 020-022 | I63521 | 15 | 791 | I69931 | 01 | 056-057 | ||
| I619 | 01 | 023-024 | I63521 | 15 | 793 | I69932 | 01 | 056-057 | ||
| I619 | 01 | 064-066 | I63522 | 01 | 023-024 | I69933 | 01 | 056-057 | ||
| I619 | 15 | 791 | I63522 | 01 | 061-063 | I69934 | 01 | 056-057 | ||
| I619 | 15 | 793 | I63522 | 01 | 064-066 | I69939 | 01 | 056-057 | ||
| I6200 | 01 | 020-022 | I63522 | 15 | 791 | I69941 | 01 | 056-057 | ||
| I6200 | 01 | 064-066 | I63522 | 15 | 793 | I69942 | 01 | 056-057 | ||
| I6200 | 15 | 791 | I63523 | 01 | 023-024 | I69943 | 01 | 056-057 | ||
| I6200 | 15 | 793 | I63523 | 01 | 061-063 | I69944 | 01 | 056-057 | ||
| I6201 | 01 | 020-022 | I63523 | 01 | 064-066 | I69949 | 01 | 056-057 | ||
| I6201 | 01 | 064-066 | I63523 | 15 | 791 | I69951 | 01 | 056-057 | ||
| I6201 | 15 | 791 | I63523 | 15 | 793 | I69952 | 01 | 056-057 | ||
| I6201 | 15 | 793 | I63529 | 01 | 023-024 | I69953 | 01 | 056-057 | ||
| I6202 | 01 | 020-022 | I63529 | 01 | 061-063 | I69954 | 01 | 056-057 | ||
| I6202 | 01 | 064-066 | I63529 | 01 | 064-066 | I69959 | 01 | 056-057 | ||
| I6202 | 15 | 791 | I63529 | 15 | 791 | I69961 | 01 | 056-057 | ||
| I6202 | 15 | 793 | I63529 | 15 | 793 | I69962 | 01 | 056-057 | ||
| I6203 | 01 | 020-022 | I63531 | 01 | 023-024 | I69963 | 01 | 056-057 | ||
| I6203 | 01 | 064-066 | I63531 | 01 | 061-063 | I69964 | 01 | 056-057 | ||
| I6203 | 15 | 791 | I63531 | 01 | 064-066 | I69965 | 01 | 056-057 | ||
| I6203 | 15 | 793 | I63531 | 15 | 791 | I69969 | 01 | 056-057 | ||
| I621 | 01 | 020-022 | I63531 | 15 | 793 | I69990 | 01 | 056-057 | ||
| I621 | 01 | 064-066 | I63532 | 01 | 023-024 | I69991 | 01 | 056-057 | ||
| I621 | 15 | 791 | I63532 | 01 | 061-063 | I69992 | 01 | 056-057 | ||
| I621 | 15 | 793 | I63532 | 01 | 064-066 | I69993 | 01 | 056-057 | ||
| I629 | 01 | 020-022 | I63532 | 15 | 791 | I69998 | 01 | 056-057 | ||
| I629 | 01 | 023-024 | I63532 | 15 | 793 | I700 | 05 | 299-301 | ||
| I629 | 01 | 064-066 | I63533 | 01 | 023-024 | I701 | 11 | 698-700 | ||
| I629 | 15 | 791 | I63533 | 01 | 061-063 | I70201 | 05 | 299-301 | ||
| I629 | 15 | 793 | I63533 | 01 | 064-066 | I70202 | 05 | 299-301 | ||
| I6300 | 01 | 023-024 | I63533 | 15 | 791 | I70203 | 05 | 299-301 | ||
| I6300 | 01 | 061-063 | I63533 | 15 | 793 | I70208 | 05 | 299-301 | ||
| I6300 | 01 | 064-066 | I63539 | 01 | 023-024 | I70209 | 05 | 299-301 | ||
| I6300 | 15 | 791 | I63539 | 01 | 061-063 | I70211 | 05 | 299-301 | ||
| I6300 | 15 | 793 | I63539 | 01 | 064-066 | I70212 | 05 | 299-301 | ||
| I63011 | 01 | 023-024 | I63539 | 15 | 791 | I70213 | 05 | 299-301 | ||
| I63011 | 01 | 061-063 | I63539 | 15 | 793 | I70218 | 05 | 299-301 | ||
| I63011 | 01 | 064-066 | I63541 | 01 | 023-024 | I70219 | 05 | 299-301 | ||
| I63011 | 15 | 791 | I63541 | 01 | 061-063 | |||||
| I63011 | 15 | 793 | I63541 | 01 | 064-066 | |||||
| I63541 | 15 | 791 | ||||||||
| I63541 | 15 | 793 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 17:08:13 CMS, code-revision=333, description-revision=1331 |