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 29 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| R062 | 04 | 204 | R402342 | 01 | 080-081 | R93429 | 11 | 695-696 | ||
| R063 | 04 | 204 | R402342 | 15 | 791 | R9349 | 11 | 695-696 | ||
| R064 | 04 | 204 | R402342 | 15 | 793 | R935 | 06 | 391-392 | ||
| R065 | 03 | 154-156 | R402343 | 01 | 080-081 | R936 | 08 | 564-566 | ||
| R066 | 04 | 204 | R402343 | 15 | 791 | R937 | 08 | 564-566 | ||
| R067 | 03 | 154-156 | R402343 | 15 | 793 | R93811 | 12 | 729-730 | ||
| R0681 | 04 | 204 | R402344 | 01 | 080-081 | R93812 | 12 | 729-730 | ||
| R0682 | 04 | 204 | R402344 | 15 | 791 | R93813 | 12 | 729-730 | ||
| R0683 | 04 | 204 | R402344 | 15 | 793 | R93819 | 12 | 729-730 | ||
| R0689 | 04 | 204 | R402350 | 23 | 951 | R9389 | 23 | 947-948 | ||
| R069 | 04 | 204 | R402351 | 23 | 951 | R939 | 23 | 947-948 | ||
| R070 | 03 | 154-156 | R402352 | 23 | 951 | R9401 | 01 | 091-093 | ||
| R071 | 04 | 204 | R402353 | 23 | 951 | R9402 | 01 | 091-093 | ||
| R072 | 05 | 313 | R402354 | 23 | 951 | R9409 | 01 | 091-093 | ||
| R0781 | 04 | 204 | R402360 | 23 | 951 | R94110 | 02 | 124-125 | ||
| R0782 | 05 | 313 | R402361 | 23 | 951 | R94111 | 02 | 124-125 | ||
| R0789 | 05 | 313 | R402362 | 23 | 951 | R94112 | 02 | 124-125 | ||
| R079 | 05 | 313 | R402363 | 23 | 951 | R94113 | 02 | 124-125 | ||
| R0901 | 04 | 205-206 | R402364 | 23 | 951 | R94118 | 01 | 091-093 | ||
| R0902 | 04 | 205-206 | R402410 | 23 | 951 | R94120 | 03 | 154-156 | ||
| R091 | 04 | 193-195 | R402411 | 23 | 951 | R94120 | 15 | 795 | ||
| R092 | 04 | 205-206 | R402412 | 23 | 951 | R94121 | 03 | 154-156 | ||
| R092 | 15 | 791 | R402413 | 23 | 951 | R94128 | 01 | 091-093 | ||
| R092 | 15 | 793 | R402414 | 23 | 951 | R94130 | 01 | 091-093 | ||
| R093 | 04 | 204 | R402420 | 23 | 951 | R94131 | 08 | 564-566 | ||
| R0981 | 03 | 154-156 | R402421 | 23 | 951 | R94138 | 01 | 091-093 | ||
| R0981 | 15 | 795 | R402422 | 23 | 951 | R942 | 04 | 205-206 | ||
| R0982 | 03 | 154-156 | R402423 | 23 | 951 | R9430 | 05 | 314-316 | ||
| R0989 | 05 | 314-316 | R402424 | 23 | 951 | R9431 | 05 | 314-316 | ||
| R100 | 06 | 391-392 | R402430 | 23 | 951 | R9439 | 05 | 314-316 | ||
| R1010 | 06 | 391-392 | R402431 | 23 | 951 | R944 | 11 | 695-696 | ||
| R1011 | 06 | 391-392 | R402432 | 23 | 951 | R945 | 07 | 441-443 | ||
| R1012 | 06 | 391-392 | R402433 | 23 | 951 | R946 | 10 | 643-645 | ||
| R1013 | 06 | 391-392 | R402434 | 23 | 951 | R947 | 10 | 643-645 | ||
| R102 | 06 | 391-392 | R402440 | 23 | 951 | R948 | 11 | 695-696 | ||
| R1030 | 06 | 391-392 | R402441 | 23 | 951 | R970 | 23 | 947-948 | ||
| R1031 | 06 | 391-392 | R402442 | 23 | 951 | R971 | 23 | 947-948 | ||
| R1032 | 06 | 391-392 | R402443 | 23 | 951 | R9720 | 23 | 947-948 | ||
| R1033 | 06 | 391-392 | R402444 | 23 | 951 | R9721 | 23 | 947-948 | ||
| R10811 | 06 | 391-392 | R403 | 01 | 080-081 | R978 | 23 | 947-948 | ||
| R10812 | 06 | 391-392 | R403 | 15 | 791 | R99 | 23 | 951 | ||
| R10813 | 06 | 391-392 | R403 | 15 | 793 | S0000XA | 09 | 604-605 | ||
| R10814 | 06 | 391-392 | R404 | 19 | 884 | S0000XA | 24 | 963-965 | ||
| R10815 | 06 | 391-392 | R410 | 23 | 947-948 | S0000XD | 23 | 949-950 | ||
| R10816 | 06 | 391-392 | R411 | 23 | 947-948 | S0000XS | 09 | 604-605 | ||
| R10817 | 06 | 391-392 | R412 | 23 | 947-948 | S0001XA | 09 | 604-605 | ||
| R10819 | 06 | 391-392 | R413 | 23 | 947-948 | S0001XA | 24 | 963-965 | ||
| R10821 | 06 | 391-392 | R414 | 01 | 091-093 | S0001XD | 23 | 949-950 | ||
| R10822 | 06 | 391-392 | R4181 | 19 | 884 | S0001XS | 09 | 604-605 | ||
| R10823 | 06 | 391-392 | R4182 | 23 | 947-948 | S0002XA | 09 | 606-607 | ||
| R10824 | 06 | 391-392 | R4183 | 23 | 951 | S0002XA | 24 | 963-965 | ||
| R10825 | 06 | 391-392 | R41840 | 19 | 886 | S0002XD | 23 | 949-950 | ||
| R10826 | 06 | 391-392 | R41841 | 19 | 884 | S0002XS | 09 | 604-605 | ||
| R10827 | 06 | 391-392 | R41842 | 01 | 091-093 | S0003XA | 09 | 604-605 | ||
| R10829 | 06 | 391-392 | R41843 | 19 | 884 | S0003XA | 24 | 963-965 | ||
| R1083 | 06 | 391-392 | R41844 | 19 | 884 | S0003XD | 23 | 949-950 | ||
| R1084 | 06 | 391-392 | R4189 | 19 | 884 | S0003XS | 09 | 604-605 | ||
| R109 | 06 | 391-392 | R419 | 23 | 947-948 | S0004XA | 09 | 604-605 | ||
| R110 | 06 | 391-392 | R42 | 03 | 149 | S0004XA | 24 | 963-965 | ||
| R1110 | 06 | 391-392 | R430 | 01 | 091-093 | S0004XD | 23 | 949-950 | ||
| R1111 | 06 | 391-392 | R431 | 01 | 091-093 | S0004XS | 09 | 604-605 | ||
| R1112 | 06 | 391-392 | R432 | 01 | 091-093 | S0005XA | 09 | 604-605 | ||
| R1113 | 06 | 393-395 | R438 | 01 | 091-093 | S0005XA | 24 | 963-965 | ||
| R1114 | 06 | 391-392 | R439 | 01 | 091-093 | S0005XD | 23 | 949-950 | ||
| R1115 | 06 | 393-395 | R440 | 19 | 880 | S0005XS | 09 | 604-605 | ||
| R112 | 06 | 391-392 | R441 | 02 | 124-125 | S0006XA | 09 | 606-607 | ||
| R12 | 06 | 391-392 | R442 | 19 | 880 | S0006XA | 24 | 963-965 | ||
| R130 | 06 | 391-392 | R443 | 19 | 880 | S0006XD | 23 | 949-950 | ||
| R1310 | 06 | 391-392 | R448 | 23 | 951 | S0006XS | 09 | 604-605 | ||
| R1311 | 06 | 391-392 | R449 | 23 | 951 | S0007XA | 09 | 604-605 | ||
| R1312 | 06 | 391-392 | R450 | 19 | 880 | S0007XA | 24 | 963-965 | ||
| R1313 | 06 | 391-392 | R451 | 19 | 884 | S0007XD | 23 | 949-950 | ||
| R1314 | 06 | 391-392 | R452 | 19 | 880 | S0007XS | 09 | 604-605 | ||
| R1319 | 06 | 391-392 | R453 | 19 | 880 | S0010XA | 02 | 124-125 | ||
| R140 | 06 | 391-392 | R454 | 19 | 880 | S0010XA | 24 | 963-965 | ||
| R141 | 06 | 391-392 | R455 | 19 | 880 | S0010XD | 23 | 949-950 | ||
| R142 | 06 | 391-392 | R456 | 19 | 880 | S0010XS | 09 | 604-605 | ||
| R143 | 06 | 391-392 | R457 | 19 | 880 | S0011XA | 02 | 124-125 | ||
| R150 | 06 | 391-392 | R4581 | 19 | 884 | S0011XA | 24 | 963-965 | ||
| R151 | 06 | 391-392 | R4582 | 19 | 884 | S0011XD | 23 | 949-950 | ||
| R152 | 06 | 391-392 | R4583 | 23 | 947-948 | S0011XS | 09 | 604-605 | ||
| R159 | 06 | 391-392 | R4584 | 23 | 947-948 | S0012XA | 02 | 124-125 | ||
| R160 | 07 | 441-443 | R45850 | 23 | 951 | S0012XA | 24 | 963-965 | ||
| R161 | 16 | 814-816 | R45851 | 19 | 880 | S0012XD | 23 | 949-950 | ||
| R162 | 07 | 441-443 | R4586 | 19 | 883 | S0012XS | 09 | 604-605 | ||
| R17 | 07 | 441-443 | R4587 | 19 | 882 | S00201A | 02 | 124-125 | ||
| R180 | 23 | 947-948 | R4588 | 19 | 883 | S00201A | 24 | 963-965 | ||
| R188 | 23 | 947-948 | R4589 | 19 | 880 | S00201D | 23 | 949-950 | ||
| R1900 | 06 | 391-392 | R460 | 23 | 951 | S00201S | 09 | 604-605 | ||
| R1901 | 06 | 391-392 | R461 | 23 | 951 | S00202A | 02 | 124-125 | ||
| R1902 | 06 | 391-392 | R462 | 23 | 951 | S00202A | 24 | 963-965 | ||
| R1903 | 06 | 391-392 | R463 | 23 | 951 | S00202D | 23 | 949-950 | ||
| R1904 | 06 | 391-392 | R464 | 23 | 951 | S00202S | 09 | 604-605 | ||
| R1905 | 06 | 391-392 | R465 | 23 | 951 | S00209A | 02 | 124-125 | ||
| R1906 | 06 | 391-392 | R466 | 23 | 951 | S00209A | 24 | 963-965 | ||
| R1907 | 06 | 391-392 | R467 | 23 | 951 | S00209D | 23 | 949-950 | ||
| R1909 | 06 | 391-392 | R4681 | 23 | 951 | S00209S | 09 | 604-605 | ||
| R1911 | 06 | 391-392 | R4689 | 23 | 951 | S00211A | 02 | 124-125 | ||
| R1912 | 06 | 391-392 | R4701 | 01 | 091-093 | S00211A | 24 | 963-965 | ||
| R1915 | 06 | 391-392 | R4702 | 01 | 091-093 | S00211D | 23 | 949-950 | ||
| R192 | 06 | 391-392 | R471 | 01 | 091-093 | S00211S | 09 | 604-605 | ||
| R1930 | 06 | 393-395 | R4781 | 01 | 091-093 | S00212A | 02 | 124-125 | ||
| R1931 | 06 | 393-395 | R4782 | 01 | 091-093 | S00212A | 24 | 963-965 | ||
| R1932 | 06 | 393-395 | R4789 | 01 | 091-093 | S00212D | 23 | 949-950 | ||
| R1933 | 06 | 393-395 | R479 | 01 | 091-093 | S00212S | 09 | 604-605 | ||
| R1934 | 06 | 393-395 | R480 | 19 | 886 | S00219A | 02 | 124-125 | ||
| R1935 | 06 | 393-395 | R481 | 19 | 886 | S00219A | 24 | 963-965 | ||
| R1936 | 06 | 393-395 | R482 | 19 | 886 | S00219D | 23 | 949-950 | ||
| R1937 | 06 | 393-395 | R483 | 02 | 124-125 | S00219S | 09 | 604-605 | ||
| R194 | 06 | 391-392 | R488 | 19 | 886 | S00221A | 02 | 124-125 | ||
| R195 | 06 | 391-392 | R489 | 19 | 887 | S00221A | 24 | 963-965 | ||
| R196 | 03 | 154-156 | R490 | 03 | 154-156 | S00221D | 23 | 949-950 | ||
| R197 | 06 | 391-392 | R491 | 03 | 154-156 | S00221S | 09 | 604-605 | ||
| R198 | 06 | 391-392 | R4921 | 03 | 154-156 | S00222A | 02 | 124-125 | ||
| R200 | 01 | 091-093 | R4922 | 03 | 154-156 | S00222A | 24 | 963-965 | ||
| R201 | 01 | 091-093 | R498 | 03 | 154-156 | S00222D | 23 | 949-950 | ||
| R202 | 01 | 091-093 | R499 | 03 | 154-156 | S00222S | 09 | 604-605 | ||
| R203 | 01 | 091-093 | R502 | 18 | 864 | S00229A | 02 | 124-125 | ||
| R208 | 01 | 091-093 | R5081 | 18 | 864 | S00229A | 24 | 963-965 | ||
| R209 | 01 | 091-093 | R5082 | 18 | 864 | S00229D | 23 | 949-950 | ||
| R21 | 09 | 606-607 | R5083 | 18 | 864 | S00229S | 09 | 604-605 | ||
| R220 | 09 | 606-607 | R5084 | 18 | 864 | S00241A | 02 | 124-125 | ||
| R221 | 09 | 606-607 | R509 | 18 | 864 | S00241A | 24 | 963-965 | ||
| R222 | 09 | 606-607 | R510 | 01 | 102-103 | S00241D | 23 | 949-950 | ||
| R2230 | 09 | 606-607 | R519 | 01 | 102-103 | S00241S | 09 | 604-605 | ||
| R2231 | 09 | 606-607 | R52 | 23 | 947-948 | S00242A | 02 | 124-125 | ||
| R2232 | 09 | 606-607 | R530 | 23 | 947-948 | S00242A | 24 | 963-965 | ||
| R2233 | 09 | 606-607 | R531 | 23 | 947-948 | S00242D | 23 | 949-950 | ||
| R2240 | 09 | 606-607 | R532 | 23 | 947-948 | S00242S | 09 | 604-605 | ||
| R2241 | 09 | 606-607 | R5381 | 23 | 947-948 | S00249A | 02 | 124-125 | ||
| R2242 | 09 | 606-607 | R5382 | 23 | 947-948 | S00249A | 24 | 963-965 | ||
| R2243 | 09 | 606-607 | R5383 | 23 | 947-948 | S00249D | 23 | 949-950 | ||
| R229 | 09 | 606-607 | R54 | 19 | 884 | S00249S | 09 | 604-605 | ||
| R230 | 23 | 947-948 | R55 | 05 | 312 | S00251A | 02 | 124-125 | ||
| R231 | 23 | 947-948 | R5600 | 01 | 100-101 | S00251A | 24 | 963-965 | ||
| R232 | 23 | 947-948 | R5600 | 15 | 791 | S00251D | 23 | 949-950 | ||
| R233 | 16 | 813 | R5600 | 15 | 793 | S00251S | 09 | 604-605 | ||
| R234 | 09 | 606-607 | R5601 | 01 | 100-101 | S00252A | 02 | 124-125 | ||
| R238 | 09 | 606-607 | R561 | 01 | 100-101 | S00252A | 24 | 963-965 | ||
| R239 | 09 | 606-607 | R569 | 01 | 100-101 | S00252D | 23 | 949-950 | ||
| R250 | 01 | 091-093 | R569 | 15 | 791 | S00252S | 09 | 604-605 | ||
| R251 | 01 | 091-093 | R569 | 15 | 793 | S00259A | 02 | 124-125 | ||
| R252 | 01 | 091-093 | R570 | 05 | 222-223 | S00259A | 24 | 963-965 | ||
| R253 | 01 | 091-093 | R570 | 05 | 291-293 | S00259D | 23 | 949-950 | ||
| R258 | 01 | 091-093 | R571 | 18 | 870-872 | S00259S | 09 | 604-605 | ||
| R259 | 01 | 091-093 | R578 | 18 | 870-872 | S00261A | 02 | 124-125 | ||
| R260 | 01 | 091-093 | R579 | 05 | 222-223 | S00261A | 24 | 963-965 | ||
| R261 | 01 | 091-093 | R579 | 05 | 291-293 | S00261D | 23 | 949-950 | ||
| R262 | 08 | 555-556 | R579 | 15 | 791 | S00261S | 09 | 604-605 | ||
| R2681 | 01 | 091-093 | R579 | 15 | 793 | S00262A | 02 | 124-125 | ||
| R2689 | 01 | 091-093 | R58 | 05 | 314-316 | S00262A | 24 | 963-965 | ||
| R269 | 01 | 091-093 | R58 | 15 | 791 | S00262D | 23 | 949-950 | ||
| R270 | 01 | 091-093 | R58 | 15 | 793 | S00262S | 09 | 604-605 | ||
| R278 | 01 | 091-093 | R590 | 16 | 814-816 | S00269A | 02 | 124-125 | ||
| R279 | 01 | 091-093 | R591 | 16 | 814-816 | S00269A | 24 | 963-965 | ||
| R290 | 10 | 640-641 | R599 | 16 | 814-816 | S00269D | 23 | 949-950 | ||
| R290 | 15 | 791 | R600 | 23 | 947-948 | S00269S | 09 | 604-605 | ||
| R290 | 15 | 793 | R601 | 23 | 947-948 | S00271A | 02 | 124-125 | ||
| R291 | 01 | 091-093 | R609 | 23 | 947-948 | S00271A | 24 | 963-965 | ||
| R292 | 01 | 091-093 | R61 | 09 | 606-607 | S00271D | 23 | 949-950 | ||
| R293 | 01 | 091-093 | R620 | 10 | 640-641 | S00271S | 09 | 604-605 | ||
| R294 | 08 | 555-556 | R6250 | 10 | 640-641 | S00272A | 02 | 124-125 | ||
| R295 | 01 | 091-093 | R6251 | 10 | 640-641 | S00272A | 24 | 963-965 | ||
| R296 | 01 | 091-093 | R6252 | 10 | 640-641 | S00272D | 23 | 949-950 | ||
| R29700 | 23 | 951 | R6259 | 10 | 640-641 | S00272S | 09 | 604-605 | ||
| R29701 | 23 | 951 | R627 | 10 | 640-641 | S00279A | 02 | 124-125 | ||
| R29702 | 23 | 951 | R630 | 10 | 640-641 | S00279A | 24 | 963-965 | ||
| R29703 | 23 | 951 | R631 | 10 | 640-641 | S00279D | 23 | 949-950 | ||
| R29704 | 23 | 951 | R632 | 10 | 640-641 | S00279S | 09 | 604-605 | ||
| R29705 | 23 | 951 | R6330 | 10 | 640-641 | S0030XA | 09 | 604-605 | ||
| R29706 | 23 | 951 | R6331 | 10 | 640-641 | S0030XA | 24 | 963-965 | ||
| R29707 | 23 | 951 | R6332 | 10 | 640-641 | S0030XD | 23 | 949-950 | ||
| R29708 | 23 | 951 | R6339 | 10 | 640-641 | S0030XS | 09 | 604-605 | ||
| R29709 | 23 | 951 | R634 | 10 | 640-641 | S0031XA | 09 | 604-605 | ||
| R29710 | 23 | 951 | R635 | 10 | 640-641 | S0031XA | 24 | 963-965 | ||
| R29711 | 23 | 951 | R636 | 10 | 640-641 | S0031XD | 23 | 949-950 | ||
| R29712 | 23 | 951 | R638 | 10 | 640-641 | S0031XS | 09 | 604-605 | ||
| R29713 | 23 | 951 | R64 | 23 | 947-948 | S0032XA | 09 | 606-607 | ||
| R29714 | 23 | 951 | R6510 | 18 | 864 | S0032XA | 24 | 963-965 | ||
| R29715 | 23 | 951 | R6511 | 18 | 864 | S0032XD | 23 | 949-950 | ||
| R29716 | 23 | 951 | R6520 | 18 | 870-872 | S0032XS | 09 | 604-605 | ||
| R29717 | 23 | 951 | R6521 | 18 | 870-872 | S0033XA | 09 | 604-605 | ||
| R29718 | 23 | 951 | R680 | 23 | 947-948 | S0033XA | 24 | 963-965 | ||
| R29719 | 23 | 951 | R6811 | 23 | 947-948 | S0033XD | 23 | 949-950 | ||
| R29720 | 23 | 951 | R6812 | 23 | 947-948 | S0033XS | 09 | 604-605 | ||
| R29721 | 23 | 951 | R6813 | 23 | 951 | S0034XA | 09 | 604-605 | ||
| R29722 | 23 | 951 | R6819 | 23 | 951 | S0034XA | 24 | 963-965 | ||
| R29723 | 23 | 951 | R682 | Pre | 011-013 | S0034XD | 23 | 949-950 | ||
| R29724 | 23 | 951 | R682 | 03 | 154-156 | S0034XS | 09 | 604-605 | ||
| R29725 | 23 | 951 | R683 | 04 | 205-206 | S0035XA | 09 | 604-605 | ||
| R29726 | 23 | 951 | R6881 | 23 | 947-948 | S0035XA | 24 | 963-965 | ||
| R29727 | 23 | 951 | R6882 | 23 | 951 | S0035XD | 23 | 949-950 | ||
| R29728 | 23 | 951 | R6883 | 23 | 947-948 | S0035XS | 09 | 604-605 | ||
| R29729 | 23 | 951 | R6884 | Pre | 011-013 | S0036XA | 09 | 606-607 | ||
| R29730 | 23 | 951 | R6884 | 03 | 157-159 | S0036XA | 24 | 963-965 | ||
| R29731 | 23 | 951 | R6889 | 23 | 947-948 | S0036XD | 23 | 949-950 | ||
| R29732 | 23 | 951 | R69 | 23 | 951 | S0036XS | 09 | 604-605 | ||
| R29733 | 23 | 951 | R700 | 23 | 947-948 | S0037XA | 09 | 604-605 | ||
| R29734 | 23 | 951 | R701 | 23 | 947-948 | S0037XA | 24 | 963-965 | ||
| R29735 | 23 | 951 | R710 | 16 | 811-812 | S0037XD | 23 | 949-950 | ||
| R29736 | 23 | 951 | R718 | 16 | 811-812 | S0037XS | 09 | 604-605 | ||
| R29737 | 23 | 951 | R7301 | 10 | 640-641 | S00401A | 09 | 604-605 | ||
| R29738 | 23 | 951 | R7302 | 10 | 640-641 | S00401A | 24 | 963-965 | ||
| R29739 | 23 | 951 | R7303 | 10 | 640-641 | S00401D | 23 | 949-950 | ||
| R29740 | 23 | 951 | R7309 | 10 | 640-641 | S00401S | 09 | 604-605 | ||
| R29741 | 23 | 951 | R739 | 10 | 640-641 | S00402A | 09 | 604-605 | ||
| R29742 | 23 | 951 | R7401 | 23 | 947-948 | S00402A | 24 | 963-965 | ||
| R29810 | 01 | 091-093 | R7402 | 23 | 947-948 | S00402D | 23 | 949-950 | ||
| R29818 | 01 | 091-093 | R748 | 23 | 947-948 | S00402S | 09 | 604-605 | ||
| R29890 | 01 | 091-093 | R749 | 23 | 947-948 | S00409A | 09 | 604-605 | ||
| R29891 | 08 | 551-552 | R75 | 16 | 814-816 | S00409A | 24 | 963-965 | ||
| R29898 | 08 | 555-556 | R760 | 16 | 814-816 | S00409D | 23 | 949-950 | ||
| R2990 | 01 | 091-093 | R7611 | 04 | 177-179 | S00409S | 09 | 604-605 | ||
| R2991 | 01 | 091-093 | R7612 | 04 | 177-179 | S00411A | 09 | 604-605 | ||
| R300 | 11 | 695-696 | R768 | 16 | 814-816 | S00411A | 24 | 963-965 | ||
| R301 | 11 | 695-696 | R769 | 16 | 814-816 | S00411D | 23 | 949-950 | ||
| R309 | 11 | 695-696 | R770 | 23 | 947-948 | S00411S | 09 | 604-605 | ||
| R310 | 11 | 695-696 | R771 | 23 | 947-948 | S00412A | 09 | 604-605 | ||
| R310 | 15 | 791 | R772 | 23 | 947-948 | S00412A | 24 | 963-965 | ||
| R310 | 15 | 793 | R778 | 23 | 947-948 | S00412D | 23 | 949-950 | ||
| R311 | 11 | 695-696 | R779 | 23 | 947-948 | S00412S | 09 | 604-605 | ||
| R311 | 15 | 791 | R780 | 20 | 894-897 | S00419A | 09 | 604-605 | ||
| R311 | 15 | 793 | R781 | 23 | 947-948 | S00419A | 24 | 963-965 | ||
| R3121 | 11 | 695-696 | R782 | 23 | 947-948 | S00419D | 23 | 949-950 | ||
| R3121 | 15 | 791 | R783 | 23 | 947-948 | S00419S | 09 | 604-605 | ||
| R3121 | 15 | 793 | R784 | 23 | 947-948 | S00421A | 09 | 606-607 | ||
| R3129 | 11 | 695-696 | R785 | 23 | 947-948 | S00421A | 24 | 963-965 | ||
| R3129 | 15 | 791 | R786 | 23 | 947-948 | S00421D | 23 | 949-950 | ||
| R3129 | 15 | 793 | R7871 | 23 | 947-948 | S00421S | 09 | 604-605 | ||
| R319 | 11 | 695-696 | R7879 | 23 | 947-948 | S00422A | 09 | 606-607 | ||
| R319 | 15 | 791 | R7881 | 15 | 791 | S00422A | 24 | 963-965 | ||
| R319 | 15 | 793 | R7881 | 15 | 793 | S00422D | 23 | 949-950 | ||
| R32 | 11 | 695-696 | R7881 | 18 | 870-872 | S00422S | 09 | 604-605 | ||
| R330 | 11 | 695-696 | R7889 | 23 | 947-948 | S00429A | 09 | 606-607 | ||
| R330 | 15 | 791 | R789 | 23 | 947-948 | S00429A | 24 | 963-965 | ||
| R330 | 15 | 793 | R790 | 23 | 947-948 | S00429D | 23 | 949-950 | ||
| R338 | 11 | 695-696 | R791 | 23 | 947-948 | S00429S | 09 | 604-605 | ||
| R338 | 15 | 791 | R7981 | 23 | 947-948 | S00431A | 09 | 604-605 | ||
| R338 | 15 | 793 | R7982 | 23 | 947-948 | S00431A | 24 | 963-965 | ||
| R339 | 11 | 695-696 | R7983 | 23 | 947-948 | S00431D | 23 | 949-950 | ||
| R339 | 15 | 791 | R7989 | 23 | 947-948 | S00431S | 09 | 604-605 | ||
| R339 | 15 | 793 | R799 | 23 | 947-948 | S00432A | 09 | 604-605 | ||
| R34 | 11 | 673-675 | R800 | 11 | 695-696 | S00432A | 24 | 963-965 | ||
| R34 | 11 | 682-684 | R801 | 11 | 695-696 | S00432D | 23 | 949-950 | ||
| R350 | 11 | 695-696 | R802 | 11 | 698-700 | S00432S | 09 | 604-605 | ||
| R351 | 11 | 695-696 | R803 | 11 | 695-696 | S00439A | 09 | 604-605 | ||
| R3581 | 11 | 695-696 | R808 | 11 | 695-696 | S00439A | 24 | 963-965 | ||
| R3589 | 11 | 695-696 | R809 | 11 | 695-696 | S00439D | 23 | 949-950 | ||
| R360 | 11 | 695-696 | R81 | 10 | 637-639 | S00439S | 09 | 604-605 | ||
| R361 | 12 | 729-730 | R820 | 11 | 695-696 | S00441A | 09 | 604-605 | ||
| R369 | 11 | 695-696 | R820 | 15 | 791 | S00441A | 24 | 963-965 | ||
| R37 | 19 | 887 | R820 | 15 | 793 | S00441D | 23 | 949-950 | ||
| R390 | 11 | 695-696 | R821 | 23 | 947-948 | S00441S | 09 | 604-605 | ||
| R3911 | 11 | 695-696 | R822 | 07 | 441-443 | S00442A | 09 | 604-605 | ||
| R3912 | 11 | 695-696 | R823 | 11 | 695-696 | S00442A | 24 | 963-965 | ||
| R3913 | 11 | 695-696 | R824 | 10 | 640-641 | S00442D | 23 | 949-950 | ||
| R3914 | 11 | 695-696 | R825 | 11 | 695-696 | S00442S | 09 | 604-605 | ||
| R3914 | 15 | 791 | R826 | 11 | 695-696 | S00449A | 09 | 604-605 | ||
| R3914 | 15 | 793 | R8271 | 11 | 695-696 | S00449A | 24 | 963-965 | ||
| R3915 | 11 | 695-696 | R8279 | 11 | 695-696 | S00449D | 23 | 949-950 | ||
| R3916 | 11 | 695-696 | R8281 | 11 | 695-696 | S00449S | 09 | 604-605 | ||
| R39191 | 11 | 695-696 | R8289 | 11 | 695-696 | S00451A | 09 | 604-605 | ||
| R39192 | 11 | 695-696 | R8290 | 11 | 695-696 | S00451A | 24 | 963-965 | ||
| R39198 | 11 | 695-696 | R8291 | 11 | 695-696 | S00451D | 23 | 949-950 | ||
| R392 | 11 | 695-696 | R82991 | 11 | 695-696 | S00451S | 09 | 604-605 | ||
| R3981 | 11 | 695-696 | R82992 | 11 | 695-696 | S00452A | 09 | 604-605 | ||
| R3982 | 11 | 695-696 | R82993 | 11 | 695-696 | S00452A | 24 | 963-965 | ||
| R3983 | 11 | 695-696 | R82994 | 11 | 695-696 | S00452D | 23 | 949-950 | ||
| R3984 | 11 | 695-696 | R82998 | 11 | 695-696 | S00452S | 09 | 604-605 | ||
| R3989 | 11 | 695-696 | R830 | 01 | 091-093 | S00459A | 09 | 604-605 | ||
| R399 | 11 | 695-696 | R831 | 01 | 091-093 | S00459A | 24 | 963-965 | ||
| R400 | 01 | 080-081 | R832 | 01 | 091-093 | S00459D | 23 | 949-950 | ||
| R401 | 01 | 080-081 | R833 | 01 | 091-093 | S00459S | 09 | 604-605 | ||
| R4020 | 01 | 080-081 | R834 | 01 | 091-093 | S00461A | 09 | 606-607 | ||
| R4020 | 15 | 791 | R835 | 01 | 091-093 | S00461A | 24 | 963-965 | ||
| R4020 | 15 | 793 | R836 | 01 | 091-093 | S00461D | 23 | 949-950 | ||
| R402110 | 01 | 080-081 | R838 | 01 | 091-093 | S00461S | 09 | 604-605 | ||
| R402110 | 15 | 791 | R839 | 01 | 091-093 | S00462A | 09 | 606-607 | ||
| R402110 | 15 | 793 | R840 | 23 | 947-948 | S00462A | 24 | 963-965 | ||
| R402111 | 01 | 080-081 | R841 | 23 | 947-948 | S00462D | 23 | 949-950 | ||
| R402111 | 15 | 791 | R842 | 23 | 947-948 | S00462S | 09 | 604-605 | ||
| R402111 | 15 | 793 | R843 | 23 | 947-948 | S00469A | 09 | 606-607 | ||
| R402112 | 01 | 080-081 | R844 | 23 | 947-948 | S00469A | 24 | 963-965 | ||
| R402112 | 15 | 791 | R845 | 23 | 947-948 | S00469D | 23 | 949-950 | ||
| R402112 | 15 | 793 | R846 | 23 | 947-948 | S00469S | 09 | 604-605 | ||
| R402113 | 01 | 080-081 | R847 | 23 | 947-948 | S00471A | 09 | 604-605 | ||
| R402113 | 15 | 791 | R848 | 23 | 947-948 | S00471A | 24 | 963-965 | ||
| R402113 | 15 | 793 | R849 | 23 | 947-948 | S00471D | 23 | 949-950 | ||
| R402114 | 01 | 080-081 | R850 | 23 | 947-948 | S00471S | 09 | 604-605 | ||
| R402114 | 15 | 791 | R851 | 23 | 947-948 | S00472A | 09 | 604-605 | ||
| R402114 | 15 | 793 | R852 | 23 | 947-948 | S00472A | 24 | 963-965 | ||
| R402120 | 01 | 080-081 | R853 | 23 | 947-948 | S00472D | 23 | 949-950 | ||
| R402120 | 15 | 791 | R854 | 23 | 947-948 | S00472S | 09 | 604-605 | ||
| R402120 | 15 | 793 | R855 | 23 | 947-948 | S00479A | 09 | 604-605 | ||
| R402121 | 01 | 080-081 | R85610 | 06 | 393-395 | S00479A | 24 | 963-965 | ||
| R402121 | 15 | 791 | R85611 | 06 | 393-395 | S00479D | 23 | 949-950 | ||
| R402121 | 15 | 793 | R85612 | 06 | 393-395 | S00479S | 09 | 604-605 | ||
| R402122 | 01 | 080-081 | R85613 | 06 | 393-395 | S00501A | 09 | 604-605 | ||
| R402122 | 15 | 791 | R85614 | 06 | 393-395 | S00501A | 24 | 963-965 | ||
| R402122 | 15 | 793 | R85615 | 06 | 393-395 | S00501D | 23 | 949-950 | ||
| R402123 | 01 | 080-081 | R85616 | 06 | 393-395 | S00501S | 09 | 604-605 | ||
| R402123 | 15 | 791 | R85618 | 06 | 393-395 | S00502A | 09 | 604-605 | ||
| R402123 | 15 | 793 | R85619 | 06 | 393-395 | S00502A | 24 | 963-965 | ||
| R402124 | 01 | 080-081 | R8569 | 23 | 947-948 | S00502D | 23 | 949-950 | ||
| R402124 | 15 | 791 | R857 | 23 | 947-948 | S00502S | 09 | 604-605 | ||
| R402124 | 15 | 793 | R8581 | 06 | 393-395 | S00511A | 09 | 604-605 | ||
| R402130 | 23 | 951 | R8582 | 06 | 393-395 | S00511A | 24 | 963-965 | ||
| R402131 | 23 | 951 | R8589 | 23 | 947-948 | S00511D | 23 | 949-950 | ||
| R402132 | 23 | 951 | R859 | 23 | 947-948 | S00511S | 09 | 604-605 | ||
| R402133 | 23 | 951 | R860 | 12 | 729-730 | S00512A | 09 | 604-605 | ||
| R402134 | 23 | 951 | R861 | 12 | 729-730 | S00512A | 24 | 963-965 | ||
| R402140 | 23 | 951 | R862 | 12 | 729-730 | S00512D | 23 | 949-950 | ||
| R402141 | 23 | 951 | R863 | 12 | 729-730 | S00512S | 09 | 604-605 | ||
| R402142 | 23 | 951 | R864 | 12 | 729-730 | S00521A | 09 | 606-607 | ||
| R402143 | 23 | 951 | R865 | 12 | 729-730 | S00521A | 24 | 963-965 | ||
| R402144 | 23 | 951 | R866 | 12 | 729-730 | S00521D | 23 | 949-950 | ||
| R402210 | 01 | 080-081 | R867 | 12 | 729-730 | S00521S | 09 | 604-605 | ||
| R402210 | 15 | 791 | R868 | 12 | 729-730 | S00522A | 09 | 606-607 | ||
| R402210 | 15 | 793 | R869 | 12 | 729-730 | S00522A | 24 | 963-965 | ||
| R402211 | 01 | 080-081 | R870 | 23 | 947-948 | S00522D | 23 | 949-950 | ||
| R402211 | 15 | 791 | R871 | 23 | 947-948 | S00522S | 09 | 604-605 | ||
| R402211 | 15 | 793 | R872 | 23 | 947-948 | S00531A | 09 | 604-605 | ||
| R402212 | 01 | 080-081 | R873 | 23 | 947-948 | S00531A | 24 | 963-965 | ||
| R402212 | 15 | 791 | R874 | 23 | 947-948 | S00531D | 23 | 949-950 | ||
| R402212 | 15 | 793 | R875 | 23 | 947-948 | S00531S | 09 | 604-605 | ||
| R402213 | 01 | 080-081 | R87610 | 13 | 742-743 | S00532A | 09 | 604-605 | ||
| R402213 | 15 | 791 | R87610 | 13 | 760-761 | S00532A | 24 | 963-965 | ||
| R402213 | 15 | 793 | R87611 | 13 | 742-743 | S00532D | 23 | 949-950 | ||
| R402214 | 01 | 080-081 | R87611 | 13 | 760-761 | S00532S | 09 | 604-605 | ||
| R402214 | 15 | 791 | R87612 | 13 | 742-743 | S00541A | 09 | 604-605 | ||
| R402214 | 15 | 793 | R87612 | 13 | 760-761 | S00541A | 24 | 963-965 | ||
| R402220 | 01 | 080-081 | R87613 | 13 | 742-743 | S00541D | 23 | 949-950 | ||
| R402220 | 15 | 791 | R87613 | 13 | 760-761 | S00541S | 09 | 604-605 | ||
| R402220 | 15 | 793 | R87614 | 13 | 742-743 | S00542A | 09 | 604-605 | ||
| R402221 | 01 | 080-081 | R87614 | 13 | 760-761 | S00542A | 24 | 963-965 | ||
| R402221 | 15 | 791 | R87615 | 13 | 742-743 | S00542D | 23 | 949-950 | ||
| R402221 | 15 | 793 | R87615 | 13 | 760-761 | S00542S | 09 | 604-605 | ||
| R402222 | 01 | 080-081 | R87616 | 13 | 742-743 | S00551A | 09 | 604-605 | ||
| R402222 | 15 | 791 | R87616 | 13 | 760-761 | S00551A | 24 | 963-965 | ||
| R402222 | 15 | 793 | R87618 | 15 | 795 | S00551D | 23 | 949-950 | ||
| R402223 | 01 | 080-081 | R87618 | 23 | 947-948 | S00551S | 09 | 604-605 | ||
| R402223 | 15 | 791 | R87619 | 15 | 795 | S00552A | 09 | 604-605 | ||
| R402223 | 15 | 793 | R87619 | 23 | 947-948 | S00552A | 24 | 963-965 | ||
| R402224 | 01 | 080-081 | R87620 | 13 | 742-743 | S00552D | 23 | 949-950 | ||
| R402224 | 15 | 791 | R87620 | 13 | 760-761 | S00552S | 09 | 604-605 | ||
| R402224 | 15 | 793 | R87621 | 13 | 742-743 | S00561A | 09 | 606-607 | ||
| R402230 | 23 | 951 | R87621 | 13 | 760-761 | S00561A | 24 | 963-965 | ||
| R402231 | 23 | 951 | R87622 | 13 | 742-743 | S00561D | 23 | 949-950 | ||
| R402232 | 23 | 951 | R87622 | 13 | 760-761 | S00561S | 09 | 604-605 | ||
| R402233 | 23 | 951 | R87623 | 13 | 742-743 | S00562A | 09 | 606-607 | ||
| R402234 | 23 | 951 | R87623 | 13 | 760-761 | S00562A | 24 | 963-965 | ||
| R402240 | 23 | 951 | R87624 | 13 | 742-743 | S00562D | 23 | 949-950 | ||
| R402241 | 23 | 951 | R87624 | 13 | 760-761 | S00562S | 09 | 604-605 | ||
| R402242 | 23 | 951 | R87625 | 13 | 742-743 | S00571A | 09 | 604-605 | ||
| R402243 | 23 | 951 | R87625 | 13 | 760-761 | S00571A | 24 | 963-965 | ||
| R402244 | 23 | 951 | R87628 | 13 | 742-743 | S00571D | 23 | 949-950 | ||
| R402250 | 23 | 951 | R87628 | 13 | 760-761 | S00571S | 09 | 604-605 | ||
| R402251 | 23 | 951 | R87629 | 15 | 795 | S00572A | 09 | 604-605 | ||
| R402252 | 23 | 951 | R87629 | 23 | 947-948 | S00572A | 24 | 963-965 | ||
| R402253 | 23 | 951 | R8769 | 23 | 947-948 | S00572D | 23 | 949-950 | ||
| R402254 | 23 | 951 | R877 | 23 | 947-948 | S00572S | 09 | 604-605 | ||
| R402310 | 01 | 080-081 | R87810 | 13 | 742-743 | S0080XA | 09 | 604-605 | ||
| R402310 | 15 | 791 | R87810 | 13 | 760-761 | S0080XA | 24 | 963-965 | ||
| R402310 | 15 | 793 | R87811 | 13 | 742-743 | S0080XD | 23 | 949-950 | ||
| R402311 | 01 | 080-081 | R87811 | 13 | 760-761 | S0080XS | 09 | 604-605 | ||
| R402311 | 15 | 791 | R87820 | 13 | 742-743 | S0081XA | 09 | 604-605 | ||
| R402311 | 15 | 793 | R87820 | 13 | 760-761 | S0081XA | 24 | 963-965 | ||
| R402312 | 01 | 080-081 | R87821 | 13 | 742-743 | S0081XD | 23 | 949-950 | ||
| R402312 | 15 | 791 | R87821 | 13 | 760-761 | S0081XS | 09 | 604-605 | ||
| R402312 | 15 | 793 | R8789 | 23 | 947-948 | S0082XA | 09 | 606-607 | ||
| R402313 | 01 | 080-081 | R879 | 23 | 947-948 | S0082XA | 24 | 963-965 | ||
| R402313 | 15 | 791 | R880 | 23 | 947-948 | S0082XD | 23 | 949-950 | ||
| R402313 | 15 | 793 | R888 | 23 | 947-948 | S0082XS | 09 | 604-605 | ||
| R402314 | 01 | 080-081 | R890 | 23 | 947-948 | S0083XA | 09 | 604-605 | ||
| R402314 | 15 | 791 | R891 | 23 | 947-948 | S0083XA | 24 | 963-965 | ||
| R402314 | 15 | 793 | R892 | 23 | 947-948 | S0083XD | 23 | 949-950 | ||
| R402320 | 01 | 080-081 | R893 | 23 | 947-948 | S0083XS | 09 | 604-605 | ||
| R402320 | 15 | 791 | R894 | 23 | 947-948 | S0084XA | 09 | 604-605 | ||
| R402320 | 15 | 793 | R895 | 23 | 947-948 | S0084XA | 24 | 963-965 | ||
| R402321 | 01 | 080-081 | R896 | 23 | 947-948 | S0084XD | 23 | 949-950 | ||
| R402321 | 15 | 791 | R897 | 15 | 795 | S0084XS | 09 | 604-605 | ||
| R402321 | 15 | 793 | R897 | 23 | 947-948 | S0085XA | 09 | 604-605 | ||
| R402322 | 01 | 080-081 | R898 | 23 | 947-948 | S0085XA | 24 | 963-965 | ||
| R402322 | 15 | 791 | R899 | 18 | 867-869 | S0085XD | 23 | 949-950 | ||
| R402322 | 15 | 793 | R900 | 09 | 606-607 | S0085XS | 09 | 604-605 | ||
| R402323 | 01 | 080-081 | R9081 | 01 | 091-093 | S0086XA | 09 | 606-607 | ||
| R402323 | 15 | 791 | R9082 | 01 | 091-093 | S0086XA | 24 | 963-965 | ||
| R402323 | 15 | 793 | R9089 | 23 | 947-948 | S0086XD | 23 | 949-950 | ||
| R402324 | 01 | 080-081 | R911 | 04 | 205-206 | S0086XS | 09 | 604-605 | ||
| R402324 | 15 | 791 | R918 | 04 | 204 | S0087XA | 09 | 604-605 | ||
| R402324 | 15 | 793 | R920 | 09 | 600-601 | S0087XA | 24 | 963-965 | ||
| R402330 | 23 | 951 | R921 | 09 | 600-601 | S0087XD | 23 | 949-950 | ||
| R402331 | 23 | 951 | R922 | 09 | 600-601 | S0087XS | 09 | 604-605 | ||
| R402332 | 23 | 951 | R928 | 09 | 600-601 | S0090XA | 09 | 604-605 | ||
| R402333 | 23 | 951 | R930 | 01 | 091-093 | S0090XA | 24 | 963-965 | ||
| R402334 | 23 | 951 | R931 | 05 | 302-303 | S0090XD | 23 | 949-950 | ||
| R402340 | 01 | 080-081 | R932 | 07 | 444-446 | S0090XS | 09 | 604-605 | ||
| R402340 | 15 | 791 | R933 | 06 | 391-392 | S0091XA | 09 | 604-605 | ||
| R402340 | 15 | 793 | R9341 | 11 | 695-696 | S0091XA | 24 | 963-965 | ||
| R402341 | 01 | 080-081 | R93421 | 11 | 695-696 | S0091XD | 23 | 949-950 | ||
| R402341 | 15 | 791 | R93422 | 11 | 695-696 | S0091XS | 09 | 604-605 | ||
| R402341 | 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 |