DRAFT
ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual |
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Diagnosis Code/MDC/MS-DRG Index |
Page 32 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 | ||
---|---|---|---|---|---|---|---|---|---|---|
S069X2A | 01 | 082-084 | S1112XA | Pre | 011-013 | S12330K | 08 | 564-566 | ||
S069X2A | 01 | 085-087 | S1112XA | 10 | 643-645 | S12330S | 08 | 551-552 | ||
S069X2A | 24 | 963-965 | S1112XA | 24 | 963-965 | S12331A | 08 | 551-552 | ||
S069X2D | 23 | 949-950 | S1112XD | 23 | 949-950 | S12331A | 24 | 963-965 | ||
S069X2S | 01 | 091-093 | S1112XS | 09 | 604-605 | S12331B | 08 | 551-552 | ||
S069X3A | 01 | 082-084 | S1113XA | Pre | 011-013 | S12331B | 24 | 963-965 | ||
S069X3A | 24 | 963-965 | S1113XA | 10 | 643-645 | S12331D | 08 | 559-561 | ||
S069X3D | 23 | 949-950 | S1113XA | 24 | 963-965 | S12331G | 08 | 559-561 | ||
S069X3S | 01 | 091-093 | S1113XD | 23 | 949-950 | S12331K | 08 | 564-566 | ||
S069X4A | 01 | 082-084 | S1113XS | 09 | 604-605 | S12331S | 08 | 551-552 | ||
S069X4A | 24 | 963-965 | S1114XA | Pre | 011-013 | S1234XA | 08 | 551-552 | ||
S069X4D | 23 | 949-950 | S1114XA | 10 | 643-645 | S1234XA | 24 | 963-965 | ||
S069X4S | 01 | 091-093 | S1114XA | 24 | 963-965 | S1234XB | 08 | 551-552 | ||
S069X5A | 01 | 082-084 | S1114XD | 23 | 949-950 | S1234XB | 24 | 963-965 | ||
S069X5A | 24 | 963-965 | S1114XS | 09 | 604-605 | S1234XD | 08 | 559-561 | ||
S069X5D | 23 | 949-950 | S1115XA | Pre | 011-013 | S1234XG | 08 | 559-561 | ||
S069X5S | 01 | 091-093 | S1115XA | 10 | 643-645 | S1234XK | 08 | 564-566 | ||
S069X6A | 01 | 082-084 | S1115XA | 24 | 963-965 | S1234XS | 08 | 551-552 | ||
S069X6A | 24 | 963-965 | S1115XD | 23 | 949-950 | S12350A | 08 | 551-552 | ||
S069X6D | 23 | 949-950 | S1115XS | 09 | 604-605 | S12350A | 24 | 963-965 | ||
S069X6S | 01 | 091-093 | S1120XA | Pre | 011-013 | S12350B | 08 | 551-552 | ||
S069X7A | 01 | 082-084 | S1120XA | 03 | 154-156 | S12350B | 24 | 963-965 | ||
S069X7A | 24 | 963-965 | S1120XA | 24 | 963-965 | S12350D | 08 | 559-561 | ||
S069X8A | 01 | 082-084 | S1120XD | 23 | 949-950 | S12350G | 08 | 559-561 | ||
S069X8A | 24 | 963-965 | S1120XS | 09 | 604-605 | S12350K | 08 | 564-566 | ||
S069X9A | 01 | 082-084 | S1121XA | Pre | 011-013 | S12350S | 08 | 551-552 | ||
S069X9A | 24 | 963-965 | S1121XA | 03 | 154-156 | S12351A | 08 | 551-552 | ||
S069X9D | 23 | 949-950 | S1121XA | 24 | 963-965 | S12351A | 24 | 963-965 | ||
S069X9S | 01 | 091-093 | S1121XD | 23 | 949-950 | S12351B | 08 | 551-552 | ||
S069XAA | 01 | 082-084 | S1121XS | 09 | 604-605 | S12351B | 24 | 963-965 | ||
S069XAA | 24 | 963-965 | S1122XA | Pre | 011-013 | S12351D | 08 | 559-561 | ||
S069XAD | 23 | 949-950 | S1122XA | 03 | 154-156 | S12351G | 08 | 559-561 | ||
S069XAS | 01 | 091-093 | S1122XA | 24 | 963-965 | S12351K | 08 | 564-566 | ||
S06A0XA | Pre | 011-013 | S1122XD | 23 | 949-950 | S12351S | 08 | 551-552 | ||
S06A0XA | 01 | 085-087 | S1122XS | 09 | 604-605 | S12390A | 08 | 551-552 | ||
S06A0XA | 24 | 963-965 | S1123XA | Pre | 011-013 | S12390A | 24 | 963-965 | ||
S06A0XD | 23 | 949-950 | S1123XA | 03 | 154-156 | S12390B | 08 | 551-552 | ||
S06A0XS | 21 | 913-914 | S1123XA | 24 | 963-965 | S12390B | 24 | 963-965 | ||
S06A1XA | Pre | 011-013 | S1123XD | 23 | 949-950 | S12390D | 08 | 559-561 | ||
S06A1XA | 01 | 085-087 | S1123XS | 09 | 604-605 | S12390G | 08 | 559-561 | ||
S06A1XA | 24 | 963-965 | S1124XA | Pre | 011-013 | S12390K | 08 | 564-566 | ||
S06A1XD | 23 | 949-950 | S1124XA | 03 | 154-156 | S12390S | 08 | 551-552 | ||
S06A1XS | 21 | 913-914 | S1124XA | 24 | 963-965 | S12391A | 08 | 551-552 | ||
S070XXA | Pre | 011-013 | S1124XD | 23 | 949-950 | S12391A | 24 | 963-965 | ||
S070XXA | 21 | 913-914 | S1124XS | 09 | 604-605 | S12391B | 08 | 551-552 | ||
S070XXA | 24 | 963-965 | S1125XA | Pre | 011-013 | S12391B | 24 | 963-965 | ||
S070XXD | 23 | 949-950 | S1125XA | 03 | 154-156 | S12391D | 08 | 559-561 | ||
S070XXS | 09 | 604-605 | S1125XA | 24 | 963-965 | S12391G | 08 | 559-561 | ||
S071XXA | Pre | 011-013 | S1125XD | 23 | 949-950 | S12391K | 08 | 564-566 | ||
S071XXA | 21 | 913-914 | S1125XS | 09 | 604-605 | S12391S | 08 | 551-552 | ||
S071XXA | 24 | 963-965 | S1180XA | Pre | 011-013 | S12400A | 08 | 551-552 | ||
S071XXD | 23 | 949-950 | S1180XA | 09 | 604-605 | S12400A | 24 | 963-965 | ||
S071XXS | 09 | 604-605 | S1180XA | 24 | 963-965 | S12400B | 08 | 551-552 | ||
S078XXA | Pre | 011-013 | S1180XD | 23 | 949-950 | S12400B | 24 | 963-965 | ||
S078XXA | 21 | 913-914 | S1180XS | 09 | 604-605 | S12400D | 08 | 559-561 | ||
S078XXA | 24 | 963-965 | S1181XA | Pre | 011-013 | S12400G | 08 | 559-561 | ||
S078XXD | 23 | 949-950 | S1181XA | 09 | 604-605 | S12400K | 08 | 564-566 | ||
S078XXS | 09 | 604-605 | S1181XA | 24 | 963-965 | S12400S | 08 | 551-552 | ||
S079XXA | Pre | 011-013 | S1181XD | 23 | 949-950 | S12401A | 08 | 551-552 | ||
S079XXA | 21 | 913-914 | S1181XS | 09 | 604-605 | S12401A | 24 | 963-965 | ||
S079XXA | 24 | 963-965 | S1182XA | Pre | 011-013 | S12401B | 08 | 551-552 | ||
S079XXD | 23 | 949-950 | S1182XA | 09 | 604-605 | S12401B | 24 | 963-965 | ||
S079XXS | 09 | 604-605 | S1182XA | 24 | 963-965 | S12401D | 08 | 559-561 | ||
S080XXA | 09 | 604-605 | S1182XD | 23 | 949-950 | S12401G | 08 | 559-561 | ||
S080XXA | 24 | 963-965 | S1182XS | 09 | 604-605 | S12401K | 08 | 564-566 | ||
S080XXD | 23 | 949-950 | S1183XA | Pre | 011-013 | S12401S | 08 | 551-552 | ||
S080XXS | 09 | 604-605 | S1183XA | 09 | 604-605 | S12430A | 08 | 551-552 | ||
S08111A | 03 | 154-156 | S1183XA | 24 | 963-965 | S12430A | 24 | 963-965 | ||
S08111A | 24 | 963-965 | S1183XD | 23 | 949-950 | S12430B | 08 | 551-552 | ||
S08111D | 23 | 949-950 | S1183XS | 09 | 604-605 | S12430B | 24 | 963-965 | ||
S08111S | 09 | 604-605 | S1184XA | Pre | 011-013 | S12430D | 08 | 559-561 | ||
S08112A | 03 | 154-156 | S1184XA | 09 | 604-605 | S12430G | 08 | 559-561 | ||
S08112A | 24 | 963-965 | S1184XA | 24 | 963-965 | S12430K | 08 | 564-566 | ||
S08112D | 23 | 949-950 | S1184XD | 23 | 949-950 | S12430S | 08 | 551-552 | ||
S08112S | 09 | 604-605 | S1184XS | 09 | 604-605 | S12431A | 08 | 551-552 | ||
S08119A | 03 | 154-156 | S1185XA | Pre | 011-013 | S12431A | 24 | 963-965 | ||
S08119A | 24 | 963-965 | S1185XA | 09 | 604-605 | S12431B | 08 | 551-552 | ||
S08119D | 23 | 949-950 | S1185XA | 24 | 963-965 | S12431B | 24 | 963-965 | ||
S08119S | 09 | 604-605 | S1185XD | 23 | 949-950 | S12431D | 08 | 559-561 | ||
S08121A | 03 | 154-156 | S1185XS | 09 | 604-605 | S12431G | 08 | 559-561 | ||
S08121A | 24 | 963-965 | S1189XA | Pre | 011-013 | S12431K | 08 | 564-566 | ||
S08121D | 23 | 949-950 | S1189XA | 09 | 604-605 | S12431S | 08 | 551-552 | ||
S08121S | 09 | 604-605 | S1189XA | 24 | 963-965 | S1244XA | 08 | 551-552 | ||
S08122A | 03 | 154-156 | S1189XD | 23 | 949-950 | S1244XA | 24 | 963-965 | ||
S08122A | 24 | 963-965 | S1189XS | 09 | 604-605 | S1244XB | 08 | 551-552 | ||
S08122D | 23 | 949-950 | S1190XA | Pre | 011-013 | S1244XB | 24 | 963-965 | ||
S08122S | 09 | 604-605 | S1190XA | 09 | 604-605 | S1244XD | 08 | 559-561 | ||
S08129A | 03 | 154-156 | S1190XA | 24 | 963-965 | S1244XG | 08 | 559-561 | ||
S08129A | 24 | 963-965 | S1190XD | 23 | 949-950 | S1244XK | 08 | 564-566 | ||
S08129D | 23 | 949-950 | S1190XS | 09 | 604-605 | S1244XS | 08 | 551-552 | ||
S08129S | 09 | 604-605 | S1191XA | Pre | 011-013 | S12450A | 08 | 551-552 | ||
S08811A | Pre | 011-013 | S1191XA | 09 | 604-605 | S12450A | 24 | 963-965 | ||
S08811A | 03 | 154-156 | S1191XA | 24 | 963-965 | S12450B | 08 | 551-552 | ||
S08811A | 24 | 963-965 | S1191XD | 23 | 949-950 | S12450B | 24 | 963-965 | ||
S08811D | 23 | 949-950 | S1191XS | 09 | 604-605 | S12450D | 08 | 559-561 | ||
S08811S | 09 | 604-605 | S1192XA | Pre | 011-013 | S12450G | 08 | 559-561 | ||
S08812A | Pre | 011-013 | S1192XA | 09 | 604-605 | S12450K | 08 | 564-566 | ||
S08812A | 03 | 154-156 | S1192XA | 24 | 963-965 | S12450S | 08 | 551-552 | ||
S08812A | 24 | 963-965 | S1192XD | 23 | 949-950 | S12451A | 08 | 551-552 | ||
S08812D | 23 | 949-950 | S1192XS | 09 | 604-605 | S12451A | 24 | 963-965 | ||
S08812S | 09 | 604-605 | S1193XA | Pre | 011-013 | S12451B | 08 | 551-552 | ||
S0889XA | 09 | 604-605 | S1193XA | 09 | 604-605 | S12451B | 24 | 963-965 | ||
S0889XA | 24 | 963-965 | S1193XA | 24 | 963-965 | S12451D | 08 | 559-561 | ||
S0889XD | 23 | 949-950 | S1193XD | 23 | 949-950 | S12451G | 08 | 559-561 | ||
S0889XS | 09 | 604-605 | S1193XS | 09 | 604-605 | S12451K | 08 | 564-566 | ||
S090XXA | Pre | 011-013 | S1194XA | Pre | 011-013 | S12451S | 08 | 551-552 | ||
S090XXA | 21 | 913-914 | S1194XA | 09 | 604-605 | S12490A | 08 | 551-552 | ||
S090XXA | 24 | 963-965 | S1194XA | 24 | 963-965 | S12490A | 24 | 963-965 | ||
S090XXD | 23 | 949-950 | S1194XD | 23 | 949-950 | S12490B | 08 | 551-552 | ||
S090XXS | 05 | 299-301 | S1194XS | 09 | 604-605 | S12490B | 24 | 963-965 | ||
S0910XA | Pre | 011-013 | S1195XA | Pre | 011-013 | S12490D | 08 | 559-561 | ||
S0910XA | 21 | 913-914 | S1195XA | 09 | 604-605 | S12490G | 08 | 559-561 | ||
S0910XA | 24 | 963-965 | S1195XA | 24 | 963-965 | S12490K | 08 | 564-566 | ||
S0910XD | 23 | 949-950 | S1195XD | 23 | 949-950 | S12490S | 08 | 551-552 | ||
S0910XS | 21 | 913-914 | S1195XS | 09 | 604-605 | S12491A | 08 | 551-552 | ||
S0911XA | Pre | 011-013 | S12000A | 08 | 551-552 | S12491A | 24 | 963-965 | ||
S0911XA | 21 | 913-914 | S12000A | 24 | 963-965 | S12491B | 08 | 551-552 | ||
S0911XA | 24 | 963-965 | S12000B | 08 | 551-552 | S12491B | 24 | 963-965 | ||
S0911XD | 23 | 949-950 | S12000B | 24 | 963-965 | S12491D | 08 | 559-561 | ||
S0911XS | 08 | 562-563 | S12000D | 08 | 559-561 | S12491G | 08 | 559-561 | ||
S0912XA | 09 | 604-605 | S12000G | 08 | 559-561 | S12491K | 08 | 564-566 | ||
S0912XA | 24 | 963-965 | S12000K | 08 | 564-566 | S12491S | 08 | 551-552 | ||
S0912XD | 23 | 949-950 | S12000S | 08 | 551-552 | S12500A | 08 | 551-552 | ||
S0912XS | 09 | 604-605 | S12001A | 08 | 551-552 | S12500A | 24 | 963-965 | ||
S0919XA | Pre | 011-013 | S12001A | 24 | 963-965 | S12500B | 08 | 551-552 | ||
S0919XA | 21 | 913-914 | S12001B | 08 | 551-552 | S12500B | 24 | 963-965 | ||
S0919XA | 24 | 963-965 | S12001B | 24 | 963-965 | S12500D | 08 | 559-561 | ||
S0919XD | 23 | 949-950 | S12001D | 08 | 559-561 | S12500G | 08 | 559-561 | ||
S0919XS | 21 | 913-914 | S12001G | 08 | 559-561 | S12500K | 08 | 564-566 | ||
S0920XA | 03 | 154-156 | S12001K | 08 | 564-566 | S12500S | 08 | 551-552 | ||
S0920XA | 24 | 963-965 | S12001S | 08 | 551-552 | S12501A | 08 | 551-552 | ||
S0920XD | 23 | 949-950 | S1201XA | 08 | 551-552 | S12501A | 24 | 963-965 | ||
S0920XS | 21 | 913-914 | S1201XA | 24 | 963-965 | S12501B | 08 | 551-552 | ||
S0921XA | 03 | 154-156 | S1201XB | 08 | 551-552 | S12501B | 24 | 963-965 | ||
S0921XA | 24 | 963-965 | S1201XB | 24 | 963-965 | S12501D | 08 | 559-561 | ||
S0921XD | 23 | 949-950 | S1201XD | 08 | 559-561 | S12501G | 08 | 559-561 | ||
S0921XS | 09 | 604-605 | S1201XG | 08 | 559-561 | S12501K | 08 | 564-566 | ||
S0922XA | 03 | 154-156 | S1201XK | 08 | 564-566 | S12501S | 08 | 551-552 | ||
S0922XA | 24 | 963-965 | S1201XS | 08 | 551-552 | S12530A | 08 | 551-552 | ||
S0922XD | 23 | 949-950 | S1202XA | 08 | 551-552 | S12530A | 24 | 963-965 | ||
S0922XS | 09 | 604-605 | S1202XA | 24 | 963-965 | S12530B | 08 | 551-552 | ||
S09301A | 03 | 154-156 | S1202XB | 08 | 551-552 | S12530B | 24 | 963-965 | ||
S09301A | 24 | 963-965 | S1202XB | 24 | 963-965 | S12530D | 08 | 559-561 | ||
S09301D | 23 | 949-950 | S1202XD | 08 | 559-561 | S12530G | 08 | 559-561 | ||
S09301S | 21 | 913-914 | S1202XG | 08 | 559-561 | S12530K | 08 | 564-566 | ||
S09302A | 03 | 154-156 | S1202XK | 08 | 564-566 | S12530S | 08 | 551-552 | ||
S09302A | 24 | 963-965 | S1202XS | 08 | 551-552 | S12531A | 08 | 551-552 | ||
S09302D | 23 | 949-950 | S12030A | 08 | 551-552 | S12531A | 24 | 963-965 | ||
S09302S | 21 | 913-914 | S12030A | 24 | 963-965 | S12531B | 08 | 551-552 | ||
S09309A | 03 | 154-156 | S12030B | 08 | 551-552 | S12531B | 24 | 963-965 | ||
S09309A | 24 | 963-965 | S12030B | 24 | 963-965 | S12531D | 08 | 559-561 | ||
S09309D | 23 | 949-950 | S12030D | 08 | 559-561 | S12531G | 08 | 559-561 | ||
S09309S | 21 | 913-914 | S12030G | 08 | 559-561 | S12531K | 08 | 564-566 | ||
S09311A | 03 | 154-156 | S12030K | 08 | 564-566 | S12531S | 08 | 551-552 | ||
S09311A | 24 | 963-965 | S12030S | 08 | 551-552 | S1254XA | 08 | 551-552 | ||
S09311D | 23 | 949-950 | S12031A | 08 | 551-552 | S1254XA | 24 | 963-965 | ||
S09311S | 09 | 604-605 | S12031A | 24 | 963-965 | S1254XB | 08 | 551-552 | ||
S09312A | 03 | 154-156 | S12031B | 08 | 551-552 | S1254XB | 24 | 963-965 | ||
S09312A | 24 | 963-965 | S12031B | 24 | 963-965 | S1254XD | 08 | 559-561 | ||
S09312D | 23 | 949-950 | S12031D | 08 | 559-561 | S1254XG | 08 | 559-561 | ||
S09312S | 09 | 604-605 | S12031G | 08 | 559-561 | S1254XK | 08 | 564-566 | ||
S09313A | 03 | 154-156 | S12031K | 08 | 564-566 | S1254XS | 08 | 551-552 | ||
S09313A | 24 | 963-965 | S12031S | 08 | 551-552 | S12550A | 08 | 551-552 | ||
S09313D | 23 | 949-950 | S12040A | 08 | 551-552 | S12550A | 24 | 963-965 | ||
S09313S | 09 | 604-605 | S12040A | 24 | 963-965 | S12550B | 08 | 551-552 | ||
S09319A | 03 | 154-156 | S12040B | 08 | 551-552 | S12550B | 24 | 963-965 | ||
S09319A | 24 | 963-965 | S12040B | 24 | 963-965 | S12550D | 08 | 559-561 | ||
S09319D | 23 | 949-950 | S12040D | 08 | 559-561 | S12550G | 08 | 559-561 | ||
S09319S | 09 | 604-605 | S12040G | 08 | 559-561 | S12550K | 08 | 564-566 | ||
S09391A | 03 | 154-156 | S12040K | 08 | 564-566 | S12550S | 08 | 551-552 | ||
S09391A | 24 | 963-965 | S12040S | 08 | 551-552 | S12551A | 08 | 551-552 | ||
S09391D | 23 | 949-950 | S12041A | 08 | 551-552 | S12551A | 24 | 963-965 | ||
S09391S | 21 | 913-914 | S12041A | 24 | 963-965 | S12551B | 08 | 551-552 | ||
S09392A | 03 | 154-156 | S12041B | 08 | 551-552 | S12551B | 24 | 963-965 | ||
S09392A | 24 | 963-965 | S12041B | 24 | 963-965 | S12551D | 08 | 559-561 | ||
S09392D | 23 | 949-950 | S12041D | 08 | 559-561 | S12551G | 08 | 559-561 | ||
S09392S | 21 | 913-914 | S12041G | 08 | 559-561 | S12551K | 08 | 564-566 | ||
S09399A | 03 | 154-156 | S12041K | 08 | 564-566 | S12551S | 08 | 551-552 | ||
S09399A | 24 | 963-965 | S12041S | 08 | 551-552 | S12590A | 08 | 551-552 | ||
S09399D | 23 | 949-950 | S12090A | 08 | 551-552 | S12590A | 24 | 963-965 | ||
S09399S | 21 | 913-914 | S12090A | 24 | 963-965 | S12590B | 08 | 551-552 | ||
S098XXA | Pre | 011-013 | S12090B | 08 | 551-552 | S12590B | 24 | 963-965 | ||
S098XXA | 21 | 913-914 | S12090B | 24 | 963-965 | S12590D | 08 | 559-561 | ||
S098XXA | 24 | 963-965 | S12090D | 08 | 559-561 | S12590G | 08 | 559-561 | ||
S098XXD | 23 | 949-950 | S12090G | 08 | 559-561 | S12590K | 08 | 564-566 | ||
S098XXS | 21 | 913-914 | S12090K | 08 | 564-566 | S12590S | 08 | 551-552 | ||
S0990XA | Pre | 011-013 | S12090S | 08 | 551-552 | S12591A | 08 | 551-552 | ||
S0990XA | 21 | 913-914 | S12091A | 08 | 551-552 | S12591A | 24 | 963-965 | ||
S0990XA | 24 | 963-965 | S12091A | 24 | 963-965 | S12591B | 08 | 551-552 | ||
S0990XD | 23 | 949-950 | S12091B | 08 | 551-552 | S12591B | 24 | 963-965 | ||
S0990XS | 21 | 913-914 | S12091B | 24 | 963-965 | S12591D | 08 | 559-561 | ||
S0991XA | 03 | 154-156 | S12091D | 08 | 559-561 | S12591G | 08 | 559-561 | ||
S0991XA | 24 | 963-965 | S12091G | 08 | 559-561 | S12591K | 08 | 564-566 | ||
S0991XD | 23 | 949-950 | S12091K | 08 | 564-566 | S12591S | 08 | 551-552 | ||
S0991XS | 21 | 913-914 | S12091S | 08 | 551-552 | S12600A | 08 | 551-552 | ||
S0992XA | Pre | 011-013 | S12100A | 08 | 551-552 | S12600A | 24 | 963-965 | ||
S0992XA | 21 | 913-914 | S12100A | 24 | 963-965 | S12600B | 08 | 551-552 | ||
S0992XA | 24 | 963-965 | S12100B | 08 | 551-552 | S12600B | 24 | 963-965 | ||
S0992XD | 23 | 949-950 | S12100B | 24 | 963-965 | S12600D | 08 | 559-561 | ||
S0992XS | 21 | 913-914 | S12100D | 08 | 559-561 | S12600G | 08 | 559-561 | ||
S0993XA | Pre | 011-013 | S12100G | 08 | 559-561 | S12600K | 08 | 564-566 | ||
S0993XA | 21 | 913-914 | S12100K | 08 | 564-566 | S12600S | 08 | 551-552 | ||
S0993XA | 24 | 963-965 | S12100S | 08 | 551-552 | S12601A | 08 | 551-552 | ||
S0993XD | 23 | 949-950 | S12101A | 08 | 551-552 | S12601A | 24 | 963-965 | ||
S0993XS | 21 | 913-914 | S12101A | 24 | 963-965 | S12601B | 08 | 551-552 | ||
S100XXA | 09 | 604-605 | S12101B | 08 | 551-552 | S12601B | 24 | 963-965 | ||
S100XXA | 24 | 963-965 | S12101B | 24 | 963-965 | S12601D | 08 | 559-561 | ||
S100XXD | 23 | 949-950 | S12101D | 08 | 559-561 | S12601G | 08 | 559-561 | ||
S100XXS | 09 | 604-605 | S12101G | 08 | 559-561 | S12601K | 08 | 564-566 | ||
S1010XA | 09 | 604-605 | S12101K | 08 | 564-566 | S12601S | 08 | 551-552 | ||
S1010XA | 24 | 963-965 | S12101S | 08 | 551-552 | S12630A | 08 | 551-552 | ||
S1010XD | 23 | 949-950 | S12110A | 08 | 551-552 | S12630A | 24 | 963-965 | ||
S1010XS | 09 | 604-605 | S12110A | 24 | 963-965 | S12630B | 08 | 551-552 | ||
S1011XA | 09 | 604-605 | S12110B | 08 | 551-552 | S12630B | 24 | 963-965 | ||
S1011XA | 24 | 963-965 | S12110B | 24 | 963-965 | S12630D | 08 | 559-561 | ||
S1011XD | 23 | 949-950 | S12110D | 08 | 559-561 | S12630G | 08 | 559-561 | ||
S1011XS | 09 | 604-605 | S12110G | 08 | 559-561 | S12630K | 08 | 564-566 | ||
S1012XA | 09 | 606-607 | S12110K | 08 | 564-566 | S12630S | 08 | 551-552 | ||
S1012XA | 24 | 963-965 | S12110S | 08 | 551-552 | S12631A | 08 | 551-552 | ||
S1012XD | 23 | 949-950 | S12111A | 08 | 551-552 | S12631A | 24 | 963-965 | ||
S1012XS | 09 | 604-605 | S12111A | 24 | 963-965 | S12631B | 08 | 551-552 | ||
S1014XA | 09 | 604-605 | S12111B | 08 | 551-552 | S12631B | 24 | 963-965 | ||
S1014XA | 24 | 963-965 | S12111B | 24 | 963-965 | S12631D | 08 | 559-561 | ||
S1014XD | 23 | 949-950 | S12111D | 08 | 559-561 | S12631G | 08 | 559-561 | ||
S1014XS | 09 | 604-605 | S12111G | 08 | 559-561 | S12631K | 08 | 564-566 | ||
S1015XA | 09 | 604-605 | S12111K | 08 | 564-566 | S12631S | 08 | 551-552 | ||
S1015XA | 24 | 963-965 | S12111S | 08 | 551-552 | S1264XA | 08 | 551-552 | ||
S1015XD | 23 | 949-950 | S12112A | 08 | 551-552 | S1264XA | 24 | 963-965 | ||
S1015XS | 09 | 604-605 | S12112A | 24 | 963-965 | S1264XB | 08 | 551-552 | ||
S1016XA | 09 | 606-607 | S12112B | 08 | 551-552 | S1264XB | 24 | 963-965 | ||
S1016XA | 24 | 963-965 | S12112B | 24 | 963-965 | S1264XD | 08 | 559-561 | ||
S1016XD | 23 | 949-950 | S12112D | 08 | 559-561 | S1264XG | 08 | 559-561 | ||
S1016XS | 09 | 604-605 | S12112G | 08 | 559-561 | S1264XK | 08 | 564-566 | ||
S1017XA | 09 | 604-605 | S12112K | 08 | 564-566 | S1264XS | 08 | 551-552 | ||
S1017XA | 24 | 963-965 | S12112S | 08 | 551-552 | S12650A | 08 | 551-552 | ||
S1017XD | 23 | 949-950 | S12120A | 08 | 551-552 | S12650A | 24 | 963-965 | ||
S1017XS | 09 | 604-605 | S12120A | 24 | 963-965 | S12650B | 08 | 551-552 | ||
S1080XA | 09 | 604-605 | S12120B | 08 | 551-552 | S12650B | 24 | 963-965 | ||
S1080XA | 24 | 963-965 | S12120B | 24 | 963-965 | S12650D | 08 | 559-561 | ||
S1080XD | 23 | 949-950 | S12120D | 08 | 559-561 | S12650G | 08 | 559-561 | ||
S1080XS | 09 | 604-605 | S12120G | 08 | 559-561 | S12650K | 08 | 564-566 | ||
S1081XA | 09 | 604-605 | S12120K | 08 | 564-566 | S12650S | 08 | 551-552 | ||
S1081XA | 24 | 963-965 | S12120S | 08 | 551-552 | S12651A | 08 | 551-552 | ||
S1081XD | 23 | 949-950 | S12121A | 08 | 551-552 | S12651A | 24 | 963-965 | ||
S1081XS | 09 | 604-605 | S12121A | 24 | 963-965 | S12651B | 08 | 551-552 | ||
S1082XA | 09 | 606-607 | S12121B | 08 | 551-552 | S12651B | 24 | 963-965 | ||
S1082XA | 24 | 963-965 | S12121B | 24 | 963-965 | S12651D | 08 | 559-561 | ||
S1082XD | 23 | 949-950 | S12121D | 08 | 559-561 | S12651G | 08 | 559-561 | ||
S1082XS | 09 | 604-605 | S12121G | 08 | 559-561 | S12651K | 08 | 564-566 | ||
S1083XA | 09 | 604-605 | S12121K | 08 | 564-566 | S12651S | 08 | 551-552 | ||
S1083XA | 24 | 963-965 | S12121S | 08 | 551-552 | S12690A | 08 | 551-552 | ||
S1083XD | 23 | 949-950 | S12130A | 08 | 551-552 | S12690A | 24 | 963-965 | ||
S1083XS | 09 | 604-605 | S12130A | 24 | 963-965 | S12690B | 08 | 551-552 | ||
S1084XA | 09 | 604-605 | S12130B | 08 | 551-552 | S12690B | 24 | 963-965 | ||
S1084XA | 24 | 963-965 | S12130B | 24 | 963-965 | S12690D | 08 | 559-561 | ||
S1084XD | 23 | 949-950 | S12130D | 08 | 559-561 | S12690G | 08 | 559-561 | ||
S1084XS | 09 | 604-605 | S12130G | 08 | 559-561 | S12690K | 08 | 564-566 | ||
S1085XA | 09 | 604-605 | S12130K | 08 | 564-566 | S12690S | 08 | 551-552 | ||
S1085XA | 24 | 963-965 | S12130S | 08 | 551-552 | S12691A | 08 | 551-552 | ||
S1085XD | 23 | 949-950 | S12131A | 08 | 551-552 | S12691A | 24 | 963-965 | ||
S1085XS | 09 | 604-605 | S12131A | 24 | 963-965 | S12691B | 08 | 551-552 | ||
S1086XA | 09 | 606-607 | S12131B | 08 | 551-552 | S12691B | 24 | 963-965 | ||
S1086XA | 24 | 963-965 | S12131B | 24 | 963-965 | S12691D | 08 | 559-561 | ||
S1086XD | 23 | 949-950 | S12131D | 08 | 559-561 | S12691G | 08 | 559-561 | ||
S1086XS | 09 | 604-605 | S12131G | 08 | 559-561 | S12691K | 08 | 564-566 | ||
S1087XA | 09 | 604-605 | S12131K | 08 | 564-566 | S12691S | 08 | 551-552 | ||
S1087XA | 24 | 963-965 | S12131S | 08 | 551-552 | S128XXA | Pre | 011-013 | ||
S1087XD | 23 | 949-950 | S1214XA | 08 | 551-552 | S128XXA | 03 | 154-156 | ||
S1087XS | 09 | 604-605 | S1214XA | 24 | 963-965 | S128XXA | 24 | 963-965 | ||
S1090XA | 09 | 604-605 | S1214XB | 08 | 551-552 | S128XXD | 08 | 559-561 | ||
S1090XA | 24 | 963-965 | S1214XB | 24 | 963-965 | S128XXS | 08 | 551-552 | ||
S1090XD | 23 | 949-950 | S1214XD | 08 | 559-561 | S129XXA | 08 | 551-552 | ||
S1090XS | 09 | 604-605 | S1214XG | 08 | 559-561 | S129XXA | 24 | 963-965 | ||
S1091XA | 09 | 604-605 | S1214XK | 08 | 564-566 | S129XXD | 08 | 559-561 | ||
S1091XA | 24 | 963-965 | S1214XS | 08 | 551-552 | S129XXS | 08 | 551-552 | ||
S1091XD | 23 | 949-950 | S12150A | 08 | 551-552 | S130XXA | 08 | 551-552 | ||
S1091XS | 09 | 604-605 | S12150A | 24 | 963-965 | S130XXA | 24 | 963-965 | ||
S1092XA | 09 | 606-607 | S12150B | 08 | 551-552 | S130XXD | 23 | 949-950 | ||
S1092XA | 24 | 963-965 | S12150B | 24 | 963-965 | S130XXS | 08 | 562-563 | ||
S1092XD | 23 | 949-950 | S12150D | 08 | 559-561 | S13100A | 08 | 551-552 | ||
S1092XS | 09 | 604-605 | S12150G | 08 | 559-561 | S13100A | 24 | 963-965 | ||
S1093XA | 09 | 604-605 | S12150K | 08 | 564-566 | S13100D | 23 | 949-950 | ||
S1093XA | 24 | 963-965 | S12150S | 08 | 551-552 | S13100S | 08 | 562-563 | ||
S1093XD | 23 | 949-950 | S12151A | 08 | 551-552 | S13101A | 08 | 551-552 | ||
S1093XS | 09 | 604-605 | S12151A | 24 | 963-965 | S13101A | 24 | 963-965 | ||
S1094XA | 09 | 604-605 | S12151B | 08 | 551-552 | S13101D | 23 | 949-950 | ||
S1094XA | 24 | 963-965 | S12151B | 24 | 963-965 | S13101S | 08 | 562-563 | ||
S1094XD | 23 | 949-950 | S12151D | 08 | 559-561 | S13110A | 08 | 551-552 | ||
S1094XS | 09 | 604-605 | S12151G | 08 | 559-561 | S13110A | 24 | 963-965 | ||
S1095XA | 09 | 604-605 | S12151K | 08 | 564-566 | S13110D | 23 | 949-950 | ||
S1095XA | 24 | 963-965 | S12151S | 08 | 551-552 | S13110S | 08 | 562-563 | ||
S1095XD | 23 | 949-950 | S12190A | 08 | 551-552 | S13111A | 08 | 551-552 | ||
S1095XS | 09 | 604-605 | S12190A | 24 | 963-965 | S13111A | 24 | 963-965 | ||
S1096XA | 09 | 606-607 | S12190B | 08 | 551-552 | S13111D | 23 | 949-950 | ||
S1096XA | 24 | 963-965 | S12190B | 24 | 963-965 | S13111S | 08 | 562-563 | ||
S1096XD | 23 | 949-950 | S12190D | 08 | 559-561 | S13120A | 08 | 551-552 | ||
S1096XS | 09 | 604-605 | S12190G | 08 | 559-561 | S13120A | 24 | 963-965 | ||
S1097XA | 09 | 604-605 | S12190K | 08 | 564-566 | S13120D | 23 | 949-950 | ||
S1097XA | 24 | 963-965 | S12190S | 08 | 551-552 | S13120S | 08 | 562-563 | ||
S1097XD | 23 | 949-950 | S12191A | 08 | 551-552 | S13121A | 08 | 551-552 | ||
S1097XS | 09 | 604-605 | S12191A | 24 | 963-965 | S13121A | 24 | 963-965 | ||
S11011A | Pre | 011-013 | S12191B | 08 | 551-552 | S13121D | 23 | 949-950 | ||
S11011A | 03 | 154-156 | S12191B | 24 | 963-965 | S13121S | 08 | 562-563 | ||
S11011A | 24 | 963-965 | S12191D | 08 | 559-561 | S13130A | 08 | 551-552 | ||
S11011D | 23 | 949-950 | S12191G | 08 | 559-561 | S13130A | 24 | 963-965 | ||
S11011S | 09 | 604-605 | S12191K | 08 | 564-566 | S13130D | 23 | 949-950 | ||
S11012A | Pre | 011-013 | S12191S | 08 | 551-552 | S13130S | 08 | 562-563 | ||
S11012A | 03 | 154-156 | S12200A | 08 | 551-552 | S13131A | 08 | 551-552 | ||
S11012A | 24 | 963-965 | S12200A | 24 | 963-965 | S13131A | 24 | 963-965 | ||
S11012D | 23 | 949-950 | S12200B | 08 | 551-552 | S13131D | 23 | 949-950 | ||
S11012S | 09 | 604-605 | S12200B | 24 | 963-965 | S13131S | 08 | 562-563 | ||
S11013A | Pre | 011-013 | S12200D | 08 | 559-561 | S13140A | 08 | 551-552 | ||
S11013A | 03 | 154-156 | S12200G | 08 | 559-561 | S13140A | 24 | 963-965 | ||
S11013A | 24 | 963-965 | S12200K | 08 | 564-566 | S13140D | 23 | 949-950 | ||
S11013D | 23 | 949-950 | S12200S | 08 | 551-552 | S13140S | 08 | 562-563 | ||
S11013S | 09 | 604-605 | S12201A | 08 | 551-552 | S13141A | 08 | 551-552 | ||
S11014A | Pre | 011-013 | S12201A | 24 | 963-965 | S13141A | 24 | 963-965 | ||
S11014A | 03 | 154-156 | S12201B | 08 | 551-552 | S13141D | 23 | 949-950 | ||
S11014A | 24 | 963-965 | S12201B | 24 | 963-965 | S13141S | 08 | 562-563 | ||
S11014D | 23 | 949-950 | S12201D | 08 | 559-561 | S13150A | 08 | 551-552 | ||
S11014S | 09 | 604-605 | S12201G | 08 | 559-561 | S13150A | 24 | 963-965 | ||
S11015A | Pre | 011-013 | S12201K | 08 | 564-566 | S13150D | 23 | 949-950 | ||
S11015A | 03 | 154-156 | S12201S | 08 | 551-552 | S13150S | 08 | 562-563 | ||
S11015A | 24 | 963-965 | S12230A | 08 | 551-552 | S13151A | 08 | 551-552 | ||
S11015D | 23 | 949-950 | S12230A | 24 | 963-965 | S13151A | 24 | 963-965 | ||
S11015S | 09 | 604-605 | S12230B | 08 | 551-552 | S13151D | 23 | 949-950 | ||
S11019A | Pre | 011-013 | S12230B | 24 | 963-965 | S13151S | 08 | 562-563 | ||
S11019A | 03 | 154-156 | S12230D | 08 | 559-561 | S13160A | 08 | 551-552 | ||
S11019A | 24 | 963-965 | S12230G | 08 | 559-561 | S13160A | 24 | 963-965 | ||
S11019D | 23 | 949-950 | S12230K | 08 | 564-566 | S13160D | 23 | 949-950 | ||
S11019S | 09 | 604-605 | S12230S | 08 | 551-552 | S13160S | 08 | 562-563 | ||
S11021A | Pre | 011-013 | S12231A | 08 | 551-552 | S13161A | 08 | 551-552 | ||
S11021A | 04 | 183-185 | S12231A | 24 | 963-965 | S13161A | 24 | 963-965 | ||
S11021A | 24 | 963-965 | S12231B | 08 | 551-552 | S13161D | 23 | 949-950 | ||
S11021D | 23 | 949-950 | S12231B | 24 | 963-965 | S13161S | 08 | 562-563 | ||
S11021S | 09 | 604-605 | S12231D | 08 | 559-561 | S13170A | 08 | 551-552 | ||
S11022A | Pre | 011-013 | S12231G | 08 | 559-561 | S13170A | 24 | 963-965 | ||
S11022A | 04 | 183-185 | S12231K | 08 | 564-566 | S13170D | 23 | 949-950 | ||
S11022A | 24 | 963-965 | S12231S | 08 | 551-552 | S13170S | 08 | 562-563 | ||
S11022D | 23 | 949-950 | S1224XA | 08 | 551-552 | S13171A | 08 | 551-552 | ||
S11022S | 09 | 604-605 | S1224XA | 24 | 963-965 | S13171A | 24 | 963-965 | ||
S11023A | Pre | 011-013 | S1224XB | 08 | 551-552 | S13171D | 23 | 949-950 | ||
S11023A | 04 | 183-185 | S1224XB | 24 | 963-965 | S13171S | 08 | 562-563 | ||
S11023A | 24 | 963-965 | S1224XD | 08 | 559-561 | S13180A | 08 | 551-552 | ||
S11023D | 23 | 949-950 | S1224XG | 08 | 559-561 | S13180A | 24 | 963-965 | ||
S11023S | 09 | 604-605 | S1224XK | 08 | 564-566 | S13180D | 23 | 949-950 | ||
S11024A | Pre | 011-013 | S1224XS | 08 | 551-552 | S13180S | 08 | 562-563 | ||
S11024A | 04 | 183-185 | S12250A | 08 | 551-552 | S13181A | 08 | 551-552 | ||
S11024A | 24 | 963-965 | S12250A | 24 | 963-965 | S13181A | 24 | 963-965 | ||
S11024D | 23 | 949-950 | S12250B | 08 | 551-552 | S13181D | 23 | 949-950 | ||
S11024S | 09 | 604-605 | S12250B | 24 | 963-965 | S13181S | 08 | 562-563 | ||
S11025A | Pre | 011-013 | S12250D | 08 | 559-561 | S1320XA | 08 | 551-552 | ||
S11025A | 04 | 183-185 | S12250G | 08 | 559-561 | S1320XA | 24 | 963-965 | ||
S11025A | 24 | 963-965 | S12250K | 08 | 564-566 | S1320XD | 23 | 949-950 | ||
S11025D | 23 | 949-950 | S12250S | 08 | 551-552 | S1320XS | 08 | 562-563 | ||
S11025S | 09 | 604-605 | S12251A | 08 | 551-552 | S1329XA | 08 | 551-552 | ||
S11029A | Pre | 011-013 | S12251A | 24 | 963-965 | S1329XA | 24 | 963-965 | ||
S11029A | 04 | 183-185 | S12251B | 08 | 551-552 | S1329XD | 23 | 949-950 | ||
S11029A | 24 | 963-965 | S12251B | 24 | 963-965 | S1329XS | 08 | 562-563 | ||
S11029D | 23 | 949-950 | S12251D | 08 | 559-561 | S134XXA | 08 | 551-552 | ||
S11029S | 09 | 604-605 | S12251G | 08 | 559-561 | S134XXA | 24 | 963-965 | ||
S11031A | Pre | 011-013 | S12251K | 08 | 564-566 | S134XXD | 23 | 949-950 | ||
S11031A | 03 | 154-156 | S12251S | 08 | 551-552 | S134XXS | 08 | 562-563 | ||
S11031A | 24 | 963-965 | S12290A | 08 | 551-552 | S135XXA | 08 | 564-566 | ||
S11031D | 23 | 949-950 | S12290A | 24 | 963-965 | S135XXA | 24 | 963-965 | ||
S11031S | 09 | 604-605 | S12290B | 08 | 551-552 | S135XXD | 23 | 949-950 | ||
S11032A | Pre | 011-013 | S12290B | 24 | 963-965 | S135XXS | 08 | 562-563 | ||
S11032A | 03 | 154-156 | S12290D | 08 | 559-561 | S138XXA | 08 | 551-552 | ||
S11032A | 24 | 963-965 | S12290G | 08 | 559-561 | S138XXA | 24 | 963-965 | ||
S11032D | 23 | 949-950 | S12290K | 08 | 564-566 | S138XXD | 23 | 949-950 | ||
S11032S | 09 | 604-605 | S12290S | 08 | 551-552 | S138XXS | 08 | 562-563 | ||
S11033A | Pre | 011-013 | S12291A | 08 | 551-552 | S139XXA | 08 | 551-552 | ||
S11033A | 03 | 154-156 | S12291A | 24 | 963-965 | S139XXA | 24 | 963-965 | ||
S11033A | 24 | 963-965 | S12291B | 08 | 551-552 | S139XXD | 23 | 949-950 | ||
S11033D | 23 | 949-950 | S12291B | 24 | 963-965 | S139XXS | 08 | 562-563 | ||
S11033S | 09 | 604-605 | S12291D | 08 | 559-561 | S140XXA | 01 | 052-053 | ||
S11034A | Pre | 011-013 | S12291G | 08 | 559-561 | S140XXA | 24 | 963-965 | ||
S11034A | 03 | 154-156 | S12291K | 08 | 564-566 | S140XXD | 23 | 949-950 | ||
S11034A | 24 | 963-965 | S12291S | 08 | 551-552 | S140XXS | 01 | 052-053 | ||
S11034D | 23 | 949-950 | S12300A | 08 | 551-552 | S14101A | 01 | 052-053 | ||
S11034S | 09 | 604-605 | S12300A | 24 | 963-965 | S14101A | 24 | 963-965 | ||
S11035A | Pre | 011-013 | S12300B | 08 | 551-552 | S14101D | 23 | 949-950 | ||
S11035A | 03 | 154-156 | S12300B | 24 | 963-965 | S14101S | 01 | 052-053 | ||
S11035A | 24 | 963-965 | S12300D | 08 | 559-561 | S14102A | 01 | 052-053 | ||
S11035D | 23 | 949-950 | S12300G | 08 | 559-561 | S14102A | 24 | 963-965 | ||
S11035S | 09 | 604-605 | S12300K | 08 | 564-566 | S14102D | 23 | 949-950 | ||
S11039A | Pre | 011-013 | S12300S | 08 | 551-552 | S14102S | 01 | 052-053 | ||
S11039A | 03 | 154-156 | S12301A | 08 | 551-552 | S14103A | 01 | 052-053 | ||
S11039A | 24 | 963-965 | S12301A | 24 | 963-965 | S14103A | 24 | 963-965 | ||
S11039D | 23 | 949-950 | S12301B | 08 | 551-552 | S14103D | 23 | 949-950 | ||
S11039S | 09 | 604-605 | S12301B | 24 | 963-965 | S14103S | 01 | 052-053 | ||
S1110XA | Pre | 011-013 | S12301D | 08 | 559-561 | S14104A | 01 | 052-053 | ||
S1110XA | 10 | 643-645 | S12301G | 08 | 559-561 | S14104A | 24 | 963-965 | ||
S1110XA | 24 | 963-965 | S12301K | 08 | 564-566 | S14104D | 23 | 949-950 | ||
S1110XD | 23 | 949-950 | S12301S | 08 | 551-552 | S14104S | 01 | 052-053 | ||
S1110XS | 09 | 604-605 | S12330A | 08 | 551-552 | S14105A | 01 | 052-053 | ||
S1111XA | Pre | 011-013 | S12330A | 24 | 963-965 | S14105A | 24 | 963-965 | ||
S1111XA | 10 | 643-645 | S12330B | 08 | 551-552 | S14105D | 23 | 949-950 | ||
S1111XA | 24 | 963-965 | S12330B | 24 | 963-965 | S14105S | 01 | 052-053 | ||
S1111XD | 23 | 949-950 | S12330D | 08 | 559-561 | S14106A | 01 | 052-053 | ||
S1111XS | 09 | 604-605 | S12330G | 08 | 559-561 | S14106A | 24 | 963-965 |
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 17:08:13 CMS, code-revision=333, description-revision=1331 |