FOLLOW-UP AFTER EMERGENCY DEPARTMENT VISIT FOR PEOPLE WITH HIGH-RISK MULTIPLE CHRONIC CONDITIONS (FMC) HEDIS (Administrative)

Transcription

1 FOLLOW-UP AFTER EMERGENCY DEPARTMENT VISIT FOR PEOPLE WITH HIGH-RISK MULTIPLE CHRONIC CONDITIONS (FMC) APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE NCQA ACCPETED CODES HEDIS (Administrative) To ensure members ages eighteen (18) years and older who were seen in the emergency department (ED)for treatment and have high-risk multiple chronic conditions received appropriate followup care within 7 days of discharge. Members age eighteen (18) years and older as of the ED visit. *Members in hospice are excluded. Exclude ED visits followed by an admission to an acute or nonacute inpatient care setting on the date of the ED visit or within 7 days after ED visit. Members eighteen (18) years and older who were seen in the emergency department for treatment and who have high-risk multiple chronic conditions and had a follow-up service within 7 days of the ED visit. Please see code table. The Following are eligible chronic condition diagnoses: COPD and Asthma Alzheimer s disease and related disorders Chronic Kidney Disease Depression Heart Failure Acute myocardial infarction Atrial Fibrillation Stroke and Transient ischemic attack DOCUMENTATION REQUIREMENTS What documentation The medical record should document the DOS for follow-up visit and all aspects of the visit, including but not limited to: physical exam findings, thorough and diagnosis-appropriate mental health

2 should be submitted? REFERENCES assessment, medication list, medication side effects, compliance with prescribed treatment, questions/concerns member and/or caregiver may have, etc. Follow-up service within 7 days include the following and may occur on the date of the ED visit: An outpatient visit A behavioral health visit A telephone visit Transitional care management services Case management visits Complex Care Management Services For more information, please refer to Passport Health Plan s Clinical Practice Guidelines. The criteria above are based on standards established under NCQA s HEDIS 2018 Technical Specifications. HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). If you have any questions about Passport Health Plan s Case Management Services, please call a Care Advisor at

3 FOLLOW-UP AFTER EMERGENCY DEPARTMENT VISIT FOR PEOPLE WITH HIGH-RISK MULTIPLE CHRONIC CONDITIONS Meet Screening Criteria COPD Diagnosis ICD10CM J41.0 [J41.0] Simple chronic bronchitis ICD10CM J41.1 [J41.1] Mucopurulent chronic bronchitis ICD10CM J41.8 [J41.8] Mixed simple and mucopurulent chronic bronchitis ICD10CM J42 [J42] Unspecified chronic bronchitis ICD10CM J43.0 [J43.0] Unilateral pulmonary emphysema [MacLeod's syndrome] ICD10CM J43.1 [J43.1] Panlobular emphysema ICD10CM J43.2 [J43.2] Centrilobular emphysema ICD10CM J43.8 [J43.8] Other emphysema ICD10CM J43.9 [J43.9] Emphysema, unspecified ICD10CM J44.0 [J44.0] Chronic obstructive pulmonary disease with acute lower respiratory infection ICD10CM J44.1 [J44.1] Chronic obstructive pulmonary disease with (acute) exacerbation ICD10CM J44.9 [J44.9] Chronic obstructive pulmonary disease, unspecified ICD10CM J47.0 [J47.0] Bronchiectasis with acute lower respiratory infection ICD10CM J47.1 [J47.1] Bronchiectasis with (acute) exacerbation ICD10CM J47.9 [J47.9] Bronchiectasis, uncomplicated ICD9CM Simple chronic bronchitis ICD9CM Mucopurulent chronic bronchitis ICD9CM Obstructive chronic bronchitis without exacerbation ICD9CM Obstructive chronic bronchitis with (acute) exacerbation ICD9CM Obstructive chronic bronchitis with acute bronchitis ICD9CM Other chronic bronchitis ICD9CM Unspecified chronic bronchitis ICD9CM Emphysematous bleb ICD9CM Other emphysema ICD9CM Bronchiectasis without acute exacerbation ICD9CM Bronchiectasis with acute exacerbation ICD9CM 496 Chronic airway obstruction, not elsewhere classified Asthma Diagnosis ICD10CM J45.21 [J45.21] Mild intermittent asthma with (acute) exacerbation ICD10CM J45.22 [J45.22] Mild intermittent asthma with status asthmaticus ICD10CM J45.31 [J45.31] Mild persistent asthma with (acute) exacerbation ICD10CM J45.32 [J45.32] Mild persistent asthma with status asthmaticus ICD10CM J45.41 [J45.41] Moderate persistent asthma with (acute) exacerbation ICD10CM J45.42 [J45.42] Moderate persistent asthma with status asthmaticus ICD10CM J45.51 [J45.51] Severe persistent asthma with (acute) exacerbation ICD10CM J45.52 [J45.52] Severe persistent asthma with status asthmaticus ICD10CM J [J45.901] Unspecified asthma with (acute) exacerbation

4 ICD10CM J [J45.902] Unspecified asthma with status asthmaticus ICD10CM J [J45.990] Exercise induced bronchospasm ICD10CM J [J45.991] Cough variant asthma ICD10CM J [J45.998] Other asthma ICD9CM Extrinsic asthma, unspecified ICD9CM Extrinsic asthma with status asthmaticus ICD9CM Extrinsic asthma with (acute) exacerbation ICD9CM Intrinsic asthma, unspecified ICD9CM Intrinsic asthma with status asthmaticus ICD9CM Intrinsic asthma with (acute) exacerbation ICD9CM Chronic obstructive asthma, unspecified ICD9CM Chronic obstructive asthma with status asthmaticus ICD9CM Chronic obstructive asthma with (acute) exacerbation ICD9CM Exercise induced bronchospasm ICD9CM Cough variant asthma ICD9CM Asthma,unspecified type, unspecified ICD9CM Asthma, unspecified type, with status asthmaticus ICD9CM Asthma, unspecified type, with (acute) exacerbation Unspecified Bronchitis ICD10CM J40 [J40] Bronchitis, not specified as acute or chronic Dementia ICD10CM F01.50 [F01.50] Vascular dementia without behavioral disturbance ICD10CM F01.51 [F01.51] Vascular dementia with behavioral disturbance ICD10CM F02.80 [F02.80] Dementia in other diseases classified elsewhere without behavioral disturbance ICD10CM F02.81 [F02.81] Dementia in other diseases classified elsewhere with behavioral disturbance ICD10CM F03.90 [F03.90] Unspecified dementia without behavioral disturbance ICD10CM F03.91 [F03.91] Unspecified dementia with behavioral disturbance ICD10CM F04 [F04] Amnestic disorder due to known physiological condition ICD10CM F10.27 [F10.27] Alcohol dependence with alcohol-induced persisting dementia ICD10CM F10.97 [F10.97] Alcohol use, unspecified with alcohol-induced persisting dementia ICD10CM F13.27 [F13.27] Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced persisting dementia ICD10CM F13.97 [F13.97] Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting dementia ICD10CM F18.17 [F18.17] Inhalant abuse with inhalant-induced dementia ICD10CM F18.27 [F18.27] Inhalant dependence with inhalant-induced dementia ICD10CM F18.97 [F18.97] Inhalant use, unspecified with inhalant-induced persisting dementia ICD10CM F19.17 [F19.17] Other psychoactive substance abuse with psychoactive substanceinduced persisting dementia

5 ICD10CM F19.27 [F19.27] Other psychoactive substance dependence with psychoactive substance-induced persisting dementia ICD10CM F19.97 [F19.97] Other psychoactive substance use, unspecified with psychoactive substance-induced persisting dementia ICD10CM G30.0 [G30.0] Alzheimer's disease with early onset ICD10CM G30.1 [G30.1] Alzheimer's disease with late onset ICD10CM G30.8 [G30.8] Other Alzheimer's disease ICD10CM G30.9 [G30.9] Alzheimer's disease, unspecified ICD10CM G31.83 [G31.83] Dementia with Lewy bodies ICD9CM Senile dementia, uncomplicated ICD9CM Presenile dementia, uncomplicated ICD9CM Presenile dementia with delirium ICD9CM Presenile dementia with delusional features ICD9CM Presenile dementia with depressive features ICD9CM Senile dementia with delusional features ICD9CM Senile dementia with depressive features ICD9CM Senile dementia with delirium ICD9CM Vascular dementia, uncomplicated ICD9CM Vascular dementia, with delirium ICD9CM Vascular dementia, with delusions ICD9CM Vascular dementia, with depressed mood ICD9CM Other specified senile psychotic conditions ICD9CM Unspecified senile psychotic condition ICD9CM Alcohol-induced persisting dementia ICD9CM Drug-induced persisting dementia ICD9CM Amnestic disorder in conditions classified elsewhere ICD9CM Dementia in conditions classified elsewhere without behavioral disturbance ICD9CM Dementia in conditions classified elsewhere with behavioral disturbance ICD9CM Dementia, unspecified, without behavioral disturbance ICD9CM Dementia, unspecified, with behavioral disturbance ICD9CM Alzheimer's disease ICD9CM Dementia with lewy bodies Frontotemporal Dementia ICD10CM G31.01 [G31.01] Pick's disease ICD10CM G31.09 [G31.09] Other frontotemporal dementia ICD9CM Pick's disease ICD9CM Other frontotemporal dementia Chronic Kidney Disease ICD10CM A18.11 [A18.11] Tuberculosis of kidney and ureter ICD10CM A52.75 [A52.75] Syphilis of kidney and ureter ICD10CM B52.0 [B52.0] Plasmodium malariae malaria with nephropathy ICD10CM C64.1 [C64.1] Malignant neoplasm of right kidney, except renal pelvis ICD10CM C64.2 [C64.2] Malignant neoplasm of left kidney, except renal pelvis

6 ICD10CM C64.9 [C64.9] Malignant neoplasm of unspecified kidney, except renal pelvis ICD10CM C68.9 [C68.9] Malignant neoplasm of urinary organ, unspecified ICD10CM D30.00 [D30.00] Benign neoplasm of unspecified kidney ICD10CM D30.01 [D30.01] Benign neoplasm of right kidney ICD10CM D30.02 [D30.02] Benign neoplasm of left kidney ICD10CM D41.00 [D41.00] Neoplasm of uncertain behavior of unspecified kidney ICD10CM D41.01 [D41.01] Neoplasm of uncertain behavior of right kidney ICD10CM D41.02 [D41.02] Neoplasm of uncertain behavior of left kidney ICD10CM D41.10 [D41.10] Neoplasm of uncertain behavior of unspecified renal pelvis ICD10CM D41.11 [D41.11] Neoplasm of uncertain behavior of right renal pelvis ICD10CM D41.12 [D41.12] Neoplasm of uncertain behavior of left renal pelvis ICD10CM D41.20 [D41.20] Neoplasm of uncertain behavior of unspecified ureter ICD10CM D41.21 [D41.21] Neoplasm of uncertain behavior of right ureter ICD10CM D41.22 [D41.22] Neoplasm of uncertain behavior of left ureter ICD10CM D59.3 [D59.3] Hemolytic-uremic syndrome ICD10CM E08.21 [E08.21] Diabetes mellitus due to underlying condition with diabetic nephropathy ICD10CM E08.22 [E08.22] Diabetes mellitus due to underlying condition with diabetic chronic kidney disease ICD10CM E08.29 [E08.29] Diabetes mellitus due to underlying condition with other diabetic kidney complication ICD10CM E08.65 [E08.65] Diabetes mellitus due to underlying condition with hyperglycemia ICD10CM E09.21 [E09.21] Drug or chemical induced diabetes mellitus with diabetic nephropathy ICD10CM E09.22 [E09.22] Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease ICD10CM E09.29 [E09.29] Drug or chemical induced diabetes mellitus with other diabetic kidney complication ICD10CM E10.21 [E10.21] Type 1 diabetes mellitus with diabetic nephropathy ICD10CM E10.22 [E10.22] Type 1 diabetes mellitus with diabetic chronic kidney disease ICD10CM E10.29 [E10.29] Type 1 diabetes mellitus with other diabetic kidney complication ICD10CM E10.65 [E10.65] Type 1 diabetes mellitus with hyperglycemia ICD10CM E11.21 [E11.21] Type 2 diabetes mellitus with diabetic nephropathy ICD10CM E11.22 [E11.22] Type 2 diabetes mellitus with diabetic chronic kidney disease ICD10CM E11.29 [E11.29] Type 2 diabetes mellitus with other diabetic kidney complication ICD10CM E11.65 [E11.65] Type 2 diabetes mellitus with hyperglycemia ICD10CM E13.21 [E13.21] Other specified diabetes mellitus with diabetic nephropathy ICD10CM E13.22 [E13.22] Other specified diabetes mellitus with diabetic chronic kidney disease ICD10CM E13.29 [E13.29] Other specified diabetes mellitus with other diabetic kidney complication ICD10CM E74.8 [E74.8] Other specified disorders of carbohydrate metabolism ICD10CM I12.0 [I12.0] Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease ICD10CM I13.11 [I13.11] Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease ICD10CM I13.2 [I13.2] Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease

7 ICD10CM I70.1 [I70.1] Atherosclerosis of renal artery ICD10CM I72.2 [I72.2] Aneurysm of renal artery ICD10CM K76.7 [K76.7] Hepatorenal syndrome ICD10CM M10.30 [M10.30] Gout due to renal impairment, unspecified site ICD10CM M [M10.311] Gout due to renal impairment, right shoulder ICD10CM M [M10.312] Gout due to renal impairment, left shoulder ICD10CM M [M10.319] Gout due to renal impairment, unspecified shoulder ICD10CM M [M10.321] Gout due to renal impairment, right elbow ICD10CM M [M10.322] Gout due to renal impairment, left elbow ICD10CM M [M10.329] Gout due to renal impairment, unspecified elbow ICD10CM M [M10.331] Gout due to renal impairment, right wrist ICD10CM M [M10.332] Gout due to renal impairment, left wrist ICD10CM M [M10.339] Gout due to renal impairment, unspecified wrist ICD10CM M [M10.341] Gout due to renal impairment, right hand ICD10CM M [M10.342] Gout due to renal impairment, left hand ICD10CM M [M10.349] Gout due to renal impairment, unspecified hand ICD10CM M [M10.351] Gout due to renal impairment, right hip ICD10CM M [M10.352] Gout due to renal impairment, left hip ICD10CM M [M10.359] Gout due to renal impairment, unspecified hip ICD10CM M [M10.361] Gout due to renal impairment, right knee ICD10CM M [M10.362] Gout due to renal impairment, left knee ICD10CM M [M10.369] Gout due to renal impairment, unspecified knee ICD10CM M [M10.371] Gout due to renal impairment, right ankle and foot ICD10CM M [M10.372] Gout due to renal impairment, left ankle and foot ICD10CM M [M10.379] Gout due to renal impairment, unspecified ankle and foot ICD10CM M10.38 [M10.38] Gout due to renal impairment, vertebrae ICD10CM M10.39 [M10.39] Gout due to renal impairment, multiple sites ICD10CM M32.14 [M32.14] Glomerular disease in systemic lupus erythematosus ICD10CM M32.15 [M32.15] Tubulo-interstitial nephropathy in systemic lupus erythematosus ICD10CM M35.04 [M35.04] Sicca syndrome with tubulo-interstitial nephropathy ICD10CM N00.0 [N00.0] Acute nephritic syndrome with minor glomerular abnormality ICD10CM N00.1 [N00.1] Acute nephritic syndrome with focal and segmental glomerular lesions ICD10CM N00.2 [N00.2] Acute nephritic syndrome with diffuse membranous ICD10CM N00.3 [N00.3] Acute nephritic syndrome with diffuse mesangial proliferative ICD10CM N00.4 [N00.4] Acute nephritic syndrome with diffuse endocapillary proliferative ICD10CM N00.5 [N00.5] Acute nephritic syndrome with diffuse mesangiocapillary ICD10CM N00.6 [N00.6] Acute nephritic syndrome with dense deposit disease ICD10CM N00.7 [N00.7] Acute nephritic syndrome with diffuse crescentic ICD10CM N00.8 [N00.8] Acute nephritic syndrome with other morphologic changes ICD10CM N00.9 [N00.9] Acute nephritic syndrome with unspecified morphologic changes ICD10CM N01.0 [N01.0] Rapidly progressive nephritic syndrome with minor glomerular abnormality

8 ICD10CM N01.1 [N01.1] Rapidly progressive nephritic syndrome with focal and segmental glomerular lesions ICD10CM N01.2 [N01.2] Rapidly progressive nephritic syndrome with diffuse membranous ICD10CM N01.3 [N01.3] Rapidly progressive nephritic syndrome with diffuse mesangial proliferative ICD10CM N01.4 [N01.4] Rapidly progressive nephritic syndrome with diffuse endocapillary proliferative ICD10CM N01.5 [N01.5] Rapidly progressive nephritic syndrome with diffuse mesangiocapillary ICD10CM N01.6 [N01.6] Rapidly progressive nephritic syndrome with dense deposit disease ICD10CM N01.7 [N01.7] Rapidly progressive nephritic syndrome with diffuse crescentic ICD10CM N01.8 [N01.8] Rapidly progressive nephritic syndrome with other morphologic changes ICD10CM N01.9 [N01.9] Rapidly progressive nephritic syndrome with unspecified morphologic changes ICD10CM N02.0 [N02.0] Recurrent and persistent hematuria with minor glomerular abnormality ICD10CM N02.1 [N02.1] Recurrent and persistent hematuria with focal and segmental glomerular lesions ICD10CM N02.2 [N02.2] Recurrent and persistent hematuria with diffuse membranous ICD10CM N02.3 [N02.3] Recurrent and persistent hematuria with diffuse mesangial proliferative ICD10CM N02.4 [N02.4] Recurrent and persistent hematuria with diffuse endocapillary proliferative ICD10CM N02.5 [N02.5] Recurrent and persistent hematuria with diffuse mesangiocapillary ICD10CM N02.6 [N02.6] Recurrent and persistent hematuria with dense deposit disease ICD10CM N02.7 [N02.7] Recurrent and persistent hematuria with diffuse crescentic ICD10CM N02.8 [N02.8] Recurrent and persistent hematuria with other morphologic changes ICD10CM N02.9 [N02.9] Recurrent and persistent hematuria with unspecified morphologic changes ICD10CM N03.0 [N03.0] Chronic nephritic syndrome with minor glomerular abnormality ICD10CM N03.1 [N03.1] Chronic nephritic syndrome with focal and segmental glomerular lesions ICD10CM N03.2 [N03.2] Chronic nephritic syndrome with diffuse membranous ICD10CM N03.3 [N03.3] Chronic nephritic syndrome with diffuse mesangial proliferative ICD10CM N03.4 [N03.4] Chronic nephritic syndrome with diffuse endocapillary proliferative ICD10CM N03.5 [N03.5] Chronic nephritic syndrome with diffuse mesangiocapillary ICD10CM N03.6 [N03.6] Chronic nephritic syndrome with dense deposit disease ICD10CM N03.7 [N03.7] Chronic nephritic syndrome with diffuse crescentic ICD10CM N03.8 [N03.8] Chronic nephritic syndrome with other morphologic changes

9 ICD10CM N03.9 [N03.9] Chronic nephritic syndrome with unspecified morphologic changes ICD10CM N04.0 [N04.0] Nephrotic syndrome with minor glomerular abnormality ICD10CM N04.1 [N04.1] Nephrotic syndrome with focal and segmental glomerular lesions ICD10CM N04.2 [N04.2] Nephrotic syndrome with diffuse membranous ICD10CM N04.3 [N04.3] Nephrotic syndrome with diffuse mesangial proliferative ICD10CM N04.4 [N04.4] Nephrotic syndrome with diffuse endocapillary proliferative ICD10CM N04.5 [N04.5] Nephrotic syndrome with diffuse mesangiocapillary ICD10CM N04.6 [N04.6] Nephrotic syndrome with dense deposit disease ICD10CM N04.7 [N04.7] Nephrotic syndrome with diffuse crescentic ICD10CM N04.8 [N04.8] Nephrotic syndrome with other morphologic changes ICD10CM N04.9 [N04.9] Nephrotic syndrome with unspecified morphologic changes ICD10CM N05.0 [N05.0] Unspecified nephritic syndrome with minor glomerular abnormality ICD10CM N05.1 [N05.1] Unspecified nephritic syndrome with focal and segmental glomerular lesions ICD10CM N05.2 [N05.2] Unspecified nephritic syndrome with diffuse membranous ICD10CM N05.3 [N05.3] Unspecified nephritic syndrome with diffuse mesangial proliferative ICD10CM N05.4 [N05.4] Unspecified nephritic syndrome with diffuse endocapillary proliferative ICD10CM N05.5 [N05.5] Unspecified nephritic syndrome with diffuse mesangiocapillary ICD10CM N05.6 [N05.6] Unspecified nephritic syndrome with dense deposit disease ICD10CM N05.7 [N05.7] Unspecified nephritic syndrome with diffuse crescentic ICD10CM N05.8 [N05.8] Unspecified nephritic syndrome with other morphologic changes ICD10CM N05.9 [N05.9] Unspecified nephritic syndrome with unspecified morphologic changes ICD10CM N06.0 [N06.0] Isolated proteinuria with minor glomerular abnormality ICD10CM N06.1 [N06.1] Isolated proteinuria with focal and segmental glomerular lesions ICD10CM N06.2 [N06.2] Isolated proteinuria with diffuse membranous ICD10CM N06.3 [N06.3] Isolated proteinuria with diffuse mesangial proliferative ICD10CM N06.4 [N06.4] Isolated proteinuria with diffuse endocapillary proliferative ICD10CM N06.5 [N06.5] Isolated proteinuria with diffuse mesangiocapillary ICD10CM N06.6 [N06.6] Isolated proteinuria with dense deposit disease ICD10CM N06.7 [N06.7] Isolated proteinuria with diffuse crescentic ICD10CM N06.8 [N06.8] Isolated proteinuria with other morphologic lesion ICD10CM N06.9 [N06.9] Isolated proteinuria with unspecified morphologic lesion ICD10CM N07.0 [N07.0] Hereditary nephropathy, not elsewhere classified with minor glomerular abnormality ICD10CM N07.1 [N07.1] Hereditary nephropathy, not elsewhere classified with focal and segmental glomerular lesions

10 ICD10CM N07.2 [N07.2] Hereditary nephropathy, not elsewhere classified with diffuse membranous ICD10CM N07.3 [N07.3] Hereditary nephropathy, not elsewhere classified with diffuse mesangial proliferative ICD10CM N07.4 [N07.4] Hereditary nephropathy, not elsewhere classified with diffuse endocapillary proliferative ICD10CM N07.5 [N07.5] Hereditary nephropathy, not elsewhere classified with diffuse mesangiocapillary ICD10CM N07.6 [N07.6] Hereditary nephropathy, not elsewhere classified with dense deposit disease ICD10CM N07.7 [N07.7] Hereditary nephropathy, not elsewhere classified with diffuse crescentic ICD10CM N07.8 [N07.8] Hereditary nephropathy, not elsewhere classified with other morphologic lesions ICD10CM N07.9 [N07.9] Hereditary nephropathy, not elsewhere classified with unspecified morphologic lesions ICD10CM N08 [N08] Glomerular disorders in diseases classified elsewhere ICD10CM N13.1 [N13.1] Hydronephrosis with ureteral stricture, not elsewhere classified ICD10CM N13.2 [N13.2] Hydronephrosis with renal and ureteral calculous obstruction ICD10CM N13.30 [N13.30] Unspecified hydronephrosis ICD10CM N13.39 [N13.39] Other hydronephrosis ICD10CM N14.0 [N14.0] Analgesic nephropathy ICD10CM N14.1 [N14.1] Nephropathy induced by other drugs, medicaments and biological substances ICD10CM N14.2 [N14.2] Nephropathy induced by unspecified drug, medicament or biological substance ICD10CM N14.3 [N14.3] Nephropathy induced by heavy metals ICD10CM N14.4 [N14.4] Toxic nephropathy, not elsewhere classified ICD10CM N15.0 [N15.0] Balkan nephropathy ICD10CM N15.8 [N15.8] Other specified renal tubulo-interstitial diseases ICD10CM N15.9 [N15.9] Renal tubulo-interstitial disease, unspecified ICD10CM N16 [N16] Renal tubulo-interstitial disorders in diseases classified elsewhere ICD10CM N17.0 [N17.0] Acute kidney failure with tubular necrosis ICD10CM N17.1 [N17.1] Acute kidney failure with acute cortical necrosis ICD10CM N17.2 [N17.2] Acute kidney failure with medullary necrosis ICD10CM N17.8 [N17.8] Other acute kidney failure ICD10CM N17.9 [N17.9] Acute kidney failure, unspecified ICD10CM N18.1 [N18.1] Chronic kidney disease, stage 1 ICD10CM N18.2 [N18.2] Chronic kidney disease, stage 2 (mild) ICD10CM N18.3 [N18.3] Chronic kidney disease, stage 3 (moderate) ICD10CM N18.4 [N18.4] Chronic kidney disease, stage 4 (severe) ICD10CM N18.5 [N18.5] Chronic kidney disease, stage 5 ICD10CM N18.6 [N18.6] End stage renal disease ICD10CM N18.9 [N18.9] Chronic kidney disease, unspecified ICD10CM N19 [N19] Unspecified kidney failure ICD10CM N25.0 [N25.0] Renal osteodystrophy

11 ICD10CM N25.1 [N25.1] Nephrogenic diabetes insipidus ICD10CM N25.81 [N25.81] Secondary hyperparathyroidism of renal origin ICD10CM N25.89 [N25.89] Other disorders resulting from impaired renal tubular function ICD10CM N25.9 [N25.9] Disorder resulting from impaired renal tubular function, unspecified ICD10CM N26.1 [N26.1] Atrophy of kidney (terminal) ICD10CM N26.9 [N26.9] Renal sclerosis, unspecified ICD10CM Q61.02 [Q61.02] Congenital multiple renal cysts ICD10CM Q61.11 [Q61.11] Cystic dilatation of collecting ducts ICD10CM Q61.19 [Q61.19] Other polycystic kidney, infantile type ICD10CM Q61.2 [Q61.2] Polycystic kidney, adult type ICD10CM Q61.3 [Q61.3] Polycystic kidney, unspecified ICD10CM Q61.4 [Q61.4] Renal dysplasia ICD10CM Q61.5 [Q61.5] Medullary cystic kidney ICD10CM Q61.8 [Q61.8] Other cystic kidney diseases ICD10CM Q62.0 [Q62.0] Congenital hydronephrosis ICD10CM Q62.10 [Q62.10] Congenital occlusion of ureter, unspecified ICD10CM Q62.11 [Q62.11] Congenital occlusion of ureteropelvic junction ICD10CM Q62.12 [Q62.12] Congenital occlusion of ureterovesical orifice ICD10CM Q62.2 [Q62.2] Congenital megaureter ICD10CM Q62.31 [Q62.31] Congenital ureterocele, orthotopic ICD10CM Q62.32 [Q62.32] Cecoureterocele ICD10CM Q62.39 [Q62.39] Other obstructive defects of renal pelvis and ureter ICD10CM R94.4 [R94.4] Abnormal results of kidney function studies Major Depression ICD10CM F32.0 [F32.0] Major depressive disorder, single episode, mild ICD10CM F32.1 [F32.1] Major depressive disorder, single episode, moderate ICD10CM F32.2 [F32.2] Major depressive disorder, single episode, severe without psychotic features ICD10CM F32.3 [F32.3] Major depressive disorder, single episode, severe with psychotic features ICD10CM F32.4 [F32.4] Major depressive disorder, single episode, in partial remission ICD10CM F32.9 [F32.9] Major depressive disorder, single episode, unspecified ICD10CM F33.0 [F33.0] Major depressive disorder, recurrent, mild ICD10CM F33.1 [F33.1] Major depressive disorder, recurrent, moderate ICD10CM F33.2 [F33.2] Major depressive disorder, recurrent severe without psychotic features ICD10CM F33.3 [F33.3] Major depressive disorder, recurrent, severe with psychotic symptoms ICD10CM F33.41 [F33.41] Major depressive disorder, recurrent, in partial remission ICD10CM F33.9 [F33.9] Major depressive disorder, recurrent, unspecified ICD9CM Major depressive affective disorder, single episode, unspecified ICD9CM Major depressive affective disorder, single episode, mild ICD9CM Major depressive affective disorder, single episode, moderate ICD9CM Major depressive affective disorder, single episode, severe, without mention of psychotic behavior ICD9CM Major depressive affective disorder, single episode, severe, specified as with psychotic behavior

12 ICD9CM Major depressive affective disorder, single episode, in partial or unspecified remission ICD9CM Major depressive affective disorder, recurrent episode, unspecified ICD9CM Major depressive affective disorder, recurrent episode, mild ICD9CM Major depressive affective disorder, recurrent episode, moderate ICD9CM Major depressive affective disorder, recurrent episode, severe, without mention of psychotic behavior ICD9CM Major depressive affective disorder, recurrent episode, severe, specified as with psychotic behavior ICD9CM Major depressive affective disorder, recurrent episode, in partial or unspecified remission ICD9CM Depressive type psychosis ICD9CM 311 Depressive disorder, not elsewhere classified Dysthymic Disorder ICD10CM F34.1 [F34.1] Dysthymic disorder Chronic Heart Failure ICD10CM I42.0 [I42.0] Dilated cardiomyopathy ICD10CM I42.1 [I42.1] Obstructive hypertrophic cardiomyopathy ICD10CM I42.2 [I42.2] Other hypertrophic cardiomyopathy ICD10CM I42.3 [I42.3] Endomyocardial (eosinophilic) disease ICD10CM I42.4 [I42.4] Endocardial fibroelastosis ICD10CM I42.5 [I42.5] Other restrictive cardiomyopathy ICD10CM I42.6 [I42.6] Alcoholic cardiomyopathy ICD10CM I42.7 [I42.7] Cardiomyopathy due to drug and external agent ICD10CM I42.8 [I42.8] Other cardiomyopathies ICD10CM I42.9 [I42.9] Cardiomyopathy, unspecified ICD10CM I43 [I43] Cardiomyopathy in diseases classified elsewhere ICD10CM I50.1 [I50.1] Left ventricular failure, unspecified ICD10CM I50.20 [I50.20] Unspecified systolic (congestive) heart failure ICD10CM I50.21 [I50.21] Acute systolic (congestive) heart failure ICD10CM I50.22 [I50.22] Chronic systolic (congestive) heart failure ICD10CM I50.23 [I50.23] Acute on chronic systolic (congestive) heart failure ICD10CM I50.30 [I50.30] Unspecified diastolic (congestive) heart failure ICD10CM I50.31 [I50.31] Acute diastolic (congestive) heart failure ICD10CM I50.32 [I50.32] Chronic diastolic (congestive) heart failure ICD10CM I50.33 [I50.33] Acute on chronic diastolic (congestive) heart failure ICD10CM I50.40 [I50.40] Unspecified combined systolic (congestive) and diastolic (congestive) heart failure ICD10CM I50.41 [I50.41] Acute combined systolic (congestive) and diastolic (congestive) heart failure ICD10CM I50.42 [I50.42] Chronic combined systolic (congestive) and diastolic (congestive) heart failure

13 ICD10CM I50.43 [I50.43] Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure ICD10CM I50.9 [I50.9] Heart failure, unspecified ICD9CM Endomyocardial fibrosis ICD9CM Hypertrophic obstructive cardiomyopathy ICD9CM Other hypertrophic cardiomyopathy ICD9CM Obscure cardiomyopathy of Africa ICD9CM Endocardial fibroelastosis ICD9CM Other primary cardiomyopathies ICD9CM Alcoholic cardiomyopathy ICD9CM Nutritional and metabolic cardiomyopathy ICD9CM Cardiomyopathy in other diseases classified elsewhere ICD9CM Secondary cardiomyopathy, unspecified ICD9CM Congestive heart failure, unspecified ICD9CM Left heart failure ICD9CM Systolic heart failure, unspecified ICD9CM Acute systolic heart failure ICD9CM Chronic systolic heart failure ICD9CM Acute on chronic systolic heart failure ICD9CM Diastolic heart failure, unspecified ICD9CM Acute diastolic heart failure ICD9CM Chronic diastolic heart failure ICD9CM Acute on chronic diastolic heart failure ICD9CM Combined systolic and diastolic heart failure, unspecified ICD9CM Acute combined systolic and diastolic heart failure ICD9CM Chronic combined systolic and diastolic heart failure ICD9CM Acute on chronic combined systolic and diastolic heart failure ICD9CM Heart failure, unspecified Heart Failure ICD10CM I09.81 [I09.81] Rheumatic heart failure ICD10CM I11.0 [I11.0] Hypertensive heart disease with heart failure ICD10CM I13.0 [I13.0] Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease ICD10CM I13.2 [I13.2] Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease ICD10CM I50.1 [I50.1] Left ventricular failure, unspecified ICD10CM I50.20 [I50.20] Unspecified systolic (congestive) heart failure ICD10CM I50.21 [I50.21] Acute systolic (congestive) heart failure ICD10CM I50.22 [I50.22] Chronic systolic (congestive) heart failure ICD10CM I50.23 [I50.23] Acute on chronic systolic (congestive) heart failure ICD10CM I50.30 [I50.30] Unspecified diastolic (congestive) heart failure ICD10CM I50.31 [I50.31] Acute diastolic (congestive) heart failure ICD10CM I50.32 [I50.32] Chronic diastolic (congestive) heart failure

14 ICD10CM I50.33 [I50.33] Acute on chronic diastolic (congestive) heart failure ICD10CM I50.40 [I50.40] Unspecified combined systolic (congestive) and diastolic (congestive) heart failure ICD10CM I50.41 [I50.41] Acute combined systolic (congestive) and diastolic (congestive) heart failure ICD10CM I50.42 [I50.42] Chronic combined systolic (congestive) and diastolic (congestive) heart failure ICD10CM I50.43 [I50.43] Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure ICD10CM I50.9 [I50.9] Heart failure, unspecified ICD9CM Rheumatic heart failure (congestive) ICD9CM Malignant hypertensive heart disease with heart failure ICD9CM Benign hypertensive heart disease with heart failure ICD9CM Unspecified hypertensive heart disease with heart failure ICD9CM Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage I through stage IV, or unspecified ICD9CM Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage V or end stage renal disease ICD9CM Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage I through stage IV, or unspecified ICD9CM Hypertensive heart and chronic kidney disease, benign, with heart failure and chronic kidney disease stage V or end stage renal disease ICD9CM Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage I through stage IV, or unspecified ICD9CM Hypertensive heart and chronic kidney disease, unspecified, with heart failure and chronic kidney disease stage V or end stage renal disease ICD9CM Congestive heart failure, unspecified ICD9CM Left heart failure ICD9CM Systolic heart failure, unspecified ICD9CM Acute systolic heart failure ICD9CM Chronic systolic heart failure ICD9CM Acute on chronic systolic heart failure ICD9CM Diastolic heart failure, unspecified ICD9CM Acute diastolic heart failure ICD9CM Chronic diastolic heart failure ICD9CM Acute on chronic diastolic heart failure ICD9CM Combined systolic and diastolic heart failure, unspecified ICD9CM Acute combined systolic and diastolic heart failure ICD9CM Chronic combined systolic and diastolic heart failure ICD9CM Acute on chronic combined systolic and diastolic heart failure ICD9CM Heart failure, unspecified MI ICD10CM I21.01 [I21.01] ST elevation (STEMI) myocardial infarction involving left main coronary artery

15 ICD10CM I21.02 [I21.02] ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery ICD10CM I21.09 [I21.09] ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall ICD10CM I21.11 [I21.11] ST elevation (STEMI) myocardial infarction involving right coronary artery ICD10CM I21.19 [I21.19] ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall ICD10CM I21.21 [I21.21] ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery ICD10CM I21.29 [I21.29] ST elevation (STEMI) myocardial infarction involving other sites ICD10CM I21.3 [I21.3] ST elevation (STEMI) myocardial infarction of unspecified site ICD10CM I21.4 [I21.4] Non-ST elevation (NSTEMI) myocardial infarction ICD10CM I22.0 [I22.0] Subsequent ST elevation (STEMI) myocardial infarction of anterior wall ICD10CM I22.1 [I22.1] Subsequent ST elevation (STEMI) myocardial infarction of inferior wall ICD10CM I22.2 [I22.2] Subsequent non-st elevation (NSTEMI) myocardial infarction ICD10CM I22.8 [I22.8] Subsequent ST elevation (STEMI) myocardial infarction of other sites ICD10CM I22.9 [I22.9] Subsequent ST elevation (STEMI) myocardial infarction of unspecified site ICD10CM I23.0 [I23.0] Hemopericardium as current complication following acute myocardial infarction ICD10CM I23.1 [I23.1] Atrial septal defect as current complication following acute myocardial infarction ICD10CM I23.2 [I23.2] Ventricular septal defect as current complication following acute myocardial infarction ICD10CM I23.3 [I23.3] Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction ICD10CM I23.4 [I23.4] Rupture of chordae tendineae as current complication following acute myocardial infarction ICD10CM I23.5 [I23.5] Rupture of papillary muscle as current complication following acute myocardial infarction ICD10CM I23.6 [I23.6] Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction ICD10CM I23.7 [I23.7] Postinfarction angina ICD10CM I23.8 [I23.8] Other current complications following acute myocardial infarction ICD10CM I25.2 [I25.2] Old myocardial infarction ICD9CM Acute myocardial infarction of anterolateral wall, episode of care unspecified ICD9CM Acute myocardial infarction of anterolateral wall, initial episode of care ICD9CM Acute myocardial infarction of anterolateral wall, subsequent episode of care ICD9CM Acute myocardial infarction of other anterior wall, episode of care unspecified ICD9CM Acute myocardial infarction of other anterior wall, initial episode of care ICD9CM Acute myocardial infarction of other anterior wall, subsequent episode of care ICD9CM Acute myocardial infarction of inferolateral wall, episode of care unspecified ICD9CM Acute myocardial infarction of inferolateral wall, initial episode of care ICD9CM Acute myocardial infarction of inferolateral wall, subsequent episode of care ICD9CM Acute myocardial infarction of inferoposterior wall, episode of care unspecified

16 ICD9CM Acute myocardial infarction of inferoposterior wall, initial episode of care ICD9CM Acute myocardial infarction of inferoposterior wall, subsequent episode of care ICD9CM Acute myocardial infarction of other inferior wall, episode of care unspecified ICD9CM Acute myocardial infarction of other inferior wall, initial episode of care ICD9CM Acute myocardial infarction of other inferior wall, subsequent episode of care ICD9CM Acute myocardial infarction of other lateral wall, episode of care unspecified ICD9CM Acute myocardial infarction of other lateral wall, initial episode of care ICD9CM Acute myocardial infarction of other lateral wall, subsequent episode of care ICD9CM True posterior wall infarction, episode of care unspecified ICD9CM True posterior wall infarction, initial episode of care ICD9CM True posterior wall infarction, subsequent episode of care ICD9CM Subendocardial infarction, episode of care unspecified ICD9CM Subendocardial infarction, initial episode of care ICD9CM Subendocardial infarction, subsequent episode of care ICD9CM Acute myocardial infarction of other specified sites, episode of care unspecified ICD9CM Acute myocardial infarction of other specified sites, initial episode of care ICD9CM Acute myocardial infarction of other specified sites, subsequent episode of care ICD9CM Acute myocardial infarction of unspecified site, episode of care unspecified ICD9CM Acute myocardial infarction of unspecified site, initial episode of care ICD9CM Acute myocardial infarction of unspecified site, subsequent episode of care ICD9CM 412 Old myocardial infarction Atrial Fibrilation ICD10CM I48.0 [I48.0] Paroxysmal atrial fibrillation ICD10CM I48.2 [I48.2] Chronic atrial fibrillation ICD10CM I48.91 [I48.91] Unspecified atrial fibrillation Stroke ICD10CM G45.0 [G45.0] Vertebro-basilar artery syndrome ICD10CM G45.1 [G45.1] Carotid artery syndrome (hemispheric) ICD10CM G45.2 [G45.2] Multiple and bilateral precerebral artery syndromes ICD10CM G45.8 [G45.8] Other transient cerebral ischemic attacks and related syndromes ICD10CM G45.9 [G45.9] Transient cerebral ischemic attack, unspecified ICD10CM G46.0 [G46.0] Middle cerebral artery syndrome ICD10CM G46.1 [G46.1] Anterior cerebral artery syndrome ICD10CM G46.2 [G46.2] Posterior cerebral artery syndrome ICD10CM G97.31 [G97.31] Intraoperative hemorrhage and hematoma of a nervous system organ or structure complicating a nervous system procedure ICD10CM G97.32 [G97.32] Intraoperative hemorrhage and hematoma of a nervous system organ or structure complicating other procedure ICD10CM I60.00 [I60.00] Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation ICD10CM I60.01 [I60.01] Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation

17 ICD10CM I60.02 [I60.02] Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation ICD10CM I61.0 [I61.0] Nontraumatic intracerebral hemorrhage in hemisphere, subcortical ICD10CM I61.1 [I61.1] Nontraumatic intracerebral hemorrhage in hemisphere, cortical ICD10CM I61.2 [I61.2] Nontraumatic intracerebral hemorrhage in hemisphere, unspecified ICD10CM I61.3 [I61.3] Nontraumatic intracerebral hemorrhage in brain stem ICD10CM I61.4 [I61.4] Nontraumatic intracerebral hemorrhage in cerebellum ICD10CM I61.5 [I61.5] Nontraumatic intracerebral hemorrhage, intraventricular ICD10CM I61.6 [I61.6] Nontraumatic intracerebral hemorrhage, multiple localized ICD10CM I61.8 [I61.8] Other nontraumatic intracerebral hemorrhage ICD10CM I61.9 [I61.9] Nontraumatic intracerebral hemorrhage, unspecified ICD10CM I63.00 [I63.00] Cerebral infarction due to thrombosis of unspecified precerebral artery ICD10CM I [I63.011] Cerebral infarction due to thrombosis of right vertebral artery ICD10CM I [I63.012] Cerebral infarction due to thrombosis of left vertebral artery ICD10CM I [I63.019] Cerebral infarction due to thrombosis of unspecified vertebral artery ICD10CM I63.02 [I63.02] Cerebral infarction due to thrombosis of basilar artery ICD10CM I [I63.031] Cerebral infarction due to thrombosis of right carotid artery ICD10CM I [I63.032] Cerebral infarction due to thrombosis of left carotid artery ICD10CM I [I63.039] Cerebral infarction due to thrombosis of unspecified carotid artery ICD10CM I63.09 [I63.09] Cerebral infarction due to thrombosis of other precerebral artery ICD10CM I63.10 [I63.10] Cerebral infarction due to embolism of unspecified precerebral artery ICD10CM I [I63.111] Cerebral infarction due to embolism of right vertebral artery ICD10CM I [I63.112] Cerebral infarction due to embolism of left vertebral artery ICD10CM I [I63.113] Cerebral infarction due to embolism of bilateral vertebral arteries ICD10CM I [I63.119] Cerebral infarction due to embolism of unspecified vertebral artery ICD10CM I63.12 [I63.12] Cerebral infarction due to embolism of basilar artery ICD10CM I [I63.131] Cerebral infarction due to embolism of right carotid artery ICD10CM I [I63.132] Cerebral infarction due to embolism of left carotid artery ICD10CM I [I63.133] Cerebral infarction due to embolism of bilateral carotid arteries ICD10CM I [I63.139] Cerebral infarction due to embolism of unspecified carotid artery ICD10CM I63.19 [I63.19] Cerebral infarction due to embolism of other precerebral artery ICD10CM I63.20 [I63.20] Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries ICD10CM I [I63.211] Cerebral infarction due to unspecified occlusion or stenosis of right vertebral artery ICD10CM I [I63.212] Cerebral infarction due to unspecified occlusion or stenosis of left vertebral artery ICD10CM I [I63.213] Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries ICD10CM I [I63.219] Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral arteries ICD10CM I63.22 [I63.22] Cerebral infarction due to unspecified occlusion or stenosis of basilar artery ICD10CM I [I63.231] Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries

18 ICD10CM I [I63.232] Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries ICD10CM I [I63.233] Cerebral infarction due to unspecified occlusion or stenosis of bilateral carotid arteries ICD10CM I [I63.239] Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid arteries ICD10CM I63.29 [I63.29] Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries ICD10CM I63.30 [I63.30] Cerebral infarction due to thrombosis of unspecified cerebral artery ICD10CM I [I63.311] Cerebral infarction due to thrombosis of right middle cerebral artery ICD10CM I [I63.312] Cerebral infarction due to thrombosis of left middle cerebral artery ICD10CM I [I63.313] Cerebral infarction due to thrombosis of bilateral middle cerebral arteries ICD10CM I [I63.319] Cerebral infarction due to thrombosis of unspecified middle cerebral artery ICD10CM I [I63.321] Cerebral infarction due to thrombosis of right anterior cerebral artery ICD10CM I [I63.322] Cerebral infarction due to thrombosis of left anterior cerebral artery ICD10CM I [I63.323] Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries ICD10CM I [I63.329] Cerebral infarction due to thrombosis of unspecified anterior cerebral artery ICD10CM I [I63.331] Cerebral infarction due to thrombosis of right posterior cerebral artery ICD10CM I [I63.332] Cerebral infarction due to thrombosis of left posterior cerebral artery ICD10CM I [I63.333] Cerebral infarction to thrombosis of bilateral posterior cerebral arteries ICD10CM I [I63.339] Cerebral infarction due to thrombosis of unspecified posterior cerebral artery ICD10CM I [I63.341] Cerebral infarction due to thrombosis of right cerebellar artery ICD10CM I [I63.342] Cerebral infarction due to thrombosis of left cerebellar artery ICD10CM I [I63.343] Cerebral infarction to thrombosis of bilateral cerebellar arteries ICD10CM I [I63.349] Cerebral infarction due to thrombosis of unspecified cerebellar artery ICD10CM I63.39 [I63.39] Cerebral infarction due to thrombosis of other cerebral artery ICD10CM I63.40 [I63.40] Cerebral infarction due to embolism of unspecified cerebral artery ICD10CM I [I63.411] Cerebral infarction due to embolism of right middle cerebral artery ICD10CM I [I63.412] Cerebral infarction due to embolism of left middle cerebral artery ICD10CM I [I63.413] Cerebral infarction due to embolism of bilateral middle cerebral arteries ICD10CM I [I63.419] Cerebral infarction due to embolism of unspecified middle cerebral artery ICD10CM I [I63.421] Cerebral infarction due to embolism of right anterior cerebral artery ICD10CM I [I63.422] Cerebral infarction due to embolism of left anterior cerebral artery ICD10CM I [I63.423] Cerebral infarction due to embolism of bilateral anterior cerebral arteries ICD10CM I [I63.429] Cerebral infarction due to embolism of unspecified anterior cerebral artery ICD10CM I [I63.431] Cerebral infarction due to embolism of right posterior cerebral artery

19 ICD10CM I [I63.432] Cerebral infarction due to embolism of left posterior cerebral artery ICD10CM I [I63.433] Cerebral infarction due to embolism of bilateral posterior cerebral arteries ICD10CM I [I63.439] Cerebral infarction due to embolism of unspecified posterior cerebral artery ICD10CM I [I63.441] Cerebral infarction due to embolism of right cerebellar artery ICD10CM I [I63.442] Cerebral infarction due to embolism of left cerebellar artery ICD10CM I [I63.443] Cerebral infarction due to embolism of bilateral cerebellar arteries ICD10CM I [I63.449] Cerebral infarction due to embolism of unspecified cerebellar artery ICD10CM I63.49 [I63.49] Cerebral infarction due to embolism of other cerebral artery ICD10CM I63.50 [I63.50] Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery ICD10CM I [I63.511] Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery ICD10CM I [I63.512] Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery ICD10CM I [I63.513] Cerebral infarction due to unspecified occlusion or stenosis of bilateral middle cerebral arteries ICD10CM I [I63.519] Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery ICD10CM I [I63.521] Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery ICD10CM I [I63.522] Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery ICD10CM I [I63.523] Cerebral infarction due to unspecified occlusion or stenosis of bilateral anterior cerebral arteries ICD10CM I [I63.529] Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery ICD10CM I [I63.531] Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery ICD10CM I [I63.532] Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery ICD10CM I [I63.533] Cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior cerebral arteries ICD10CM I [I63.539] Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery ICD10CM I [I63.541] Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery ICD10CM I [I63.542] Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery ICD10CM I [I63.543] Cerebral infarction due to unspecified occlusion or stenosis of bilateral cerebellar arteries ICD10CM I [I63.549] Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery ICD10CM I63.59 [I63.59] Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery

20 ICD10CM I63.6 [I63.6] Cerebral infarction due to cerebral venous thrombosis, nonpyogenic ICD10CM I63.8 [I63.8] Other cerebral infarction ICD10CM I63.9 [I63.9] Cerebral infarction, unspecified ICD10CM I66.01 [I66.01] Occlusion and stenosis of right middle cerebral artery ICD10CM I66.02 [I66.02] Occlusion and stenosis of left middle cerebral artery ICD10CM I66.03 [I66.03] Occlusion and stenosis of bilateral middle cerebral arteries ICD10CM I66.09 [I66.09] Occlusion and stenosis of unspecified middle cerebral artery ICD10CM I66.11 [I66.11] Occlusion and stenosis of right anterior cerebral artery ICD10CM I66.12 [I66.12] Occlusion and stenosis of left anterior cerebral artery ICD10CM I66.13 [I66.13] Occlusion and stenosis of bilateral anterior cerebral arteries ICD10CM I66.19 [I66.19] Occlusion and stenosis of unspecified anterior cerebral artery ICD10CM I66.21 [I66.21] Occlusion and stenosis of right posterior cerebral artery ICD10CM I66.22 [I66.22] Occlusion and stenosis of left posterior cerebral artery ICD10CM I66.23 [I66.23] Occlusion and stenosis of bilateral posterior cerebral arteries ICD10CM I66.29 [I66.29] Occlusion and stenosis of unspecified posterior cerebral artery ICD10CM I66.3 [I66.3] Occlusion and stenosis of cerebellar arteries ICD10CM I66.8 [I66.8] Occlusion and stenosis of other cerebral arteries ICD10CM I66.9 [I66.9] Occlusion and stenosis of unspecified cerebral artery ICD10CM I [I67.841] Reversible cerebrovascular vasoconstriction syndrome ICD10CM I [I67.848] Other cerebrovascular vasospasm and vasoconstriction ICD10CM I67.89 [I67.89] Other cerebrovascular disease ICD10CM I [I97.810] Intraoperative cerebrovascular infarction during cardiac surgery ICD10CM I [I97.811] Intraoperative cerebrovascular infarction during other surgery ICD10CM I [I97.820] Postprocedural cerebrovascular infarction following cardiac surgery ICD10CM I [I97.821] Postprocedural cerebrovascular infarction following other surgery FUH Stand Alone Visit CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT 99220

21 CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT HCPCS G0155 Services of clinical social worker in home health or hospice settings, each 15 minutes (G0155) HCPCS G0176 Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) (G0176) HCPCS G0177 Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more) (G0177) HCPCS G0409 Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf) (G0409) HCPCS G0410 Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes (G0410) HCPCS G0411 Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes (G0411)

22 HCPCS G0463 Hospital outpatient clinic visit for assessment and management of a patient (G0463) HCPCS H0002 Behavioral health screening to determine eligibility for admission to treatment program (H0002) HCPCS H0004 Behavioral health counseling and therapy, per 15 minutes (H0004) HCPCS H0031 Mental health assessment, by non-physician (H0031) HCPCS H0034 Medication training and support, per 15 minutes (H0034) HCPCS H0035 Mental health partial hospitalization, treatment, less than 24 hours (H0035) HCPCS H0036 Community psychiatric supportive treatment, face-to-face, per 15 minutes (H0036) HCPCS H0037 Community psychiatric supportive treatment program, per diem (H0037) HCPCS H0039 Assertive community treatment, face-to-face, per 15 minutes (H0039) HCPCS H0040 Assertive community treatment program, per diem (H0040) HCPCS H2000 Comprehensive multidisciplinary evaluation (H2000) HCPCS H2001 Rehabilitation program, per 1/2 day (H2001) HCPCS H2010 Comprehensive medication services, per 15 minutes (H2010) HCPCS H2011 Crisis intervention service, per 15 minutes (H2011) HCPCS H2012 Behavioral health day treatment, per hour (H2012) HCPCS H2013 Psychiatric health facility service, per diem (H2013) HCPCS H2014 Skills training and development, per 15 minutes (H2014) HCPCS H2015 Comprehensive community support services, per 15 minutes (H2015) HCPCS H2016 Comprehensive community support services, per diem (H2016) HCPCS H2017 Psychosocial rehabilitation services, per 15 minutes (H2017) HCPCS H2018 Psychosocial rehabilitation services, per diem (H2018) HCPCS H2019 Therapeutic behavioral services, per 15 minutes (H2019) HCPCS H2020 Therapeutic behavioral services, per diem (H2020) HCPCS M0064 Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders (M0064) HCPCS S0201 Partial hospitalization services, less than 24 hours, per diem (S0201) HCPCS S9480 Intensive outpatient psychiatric services, per diem (S9480) HCPCS S9484 Crisis intervention mental health services, per hour (S9484) HCPCS S9485 Crisis intervention mental health services, per diem (S9485) HCPCS T1015 Clinic visit/encounter, all-inclusive (T1015) FUH Visits Group 1 CPT CPT CPT CPT CPT CPT CPT CPT CPT 90839

23 CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT FUH POS Group 1 POS 02 Telehealth POS 03 School POS 05 Indian Health Service Free-standing Facility POS 07 Tribal 638 Free-standing Facility POS 09 Prison/Correctional Facility POS 11 Office POS 12 Home POS 13 Assisted Living Facility POS 14 Group Home POS 15 Mobile Unit POS 16 Temporary Lodging POS 17 Walk-in Retail Health Clinic POS 18 Place of Employment-Worksite POS 19 Off Campus-Outpatient Hospital POS 20 Urgent Care Facility POS 22 On Campus-Outpatient Hospital POS 24 Ambulatory Surgical Center POS 33 Custodial Care Facility POS 49 Independent Clinic POS 50 Federally Qualified Health Center POS 52 Psychiatric Facility-Partial Hospitalization POS 53 Community Mental Health Center POS 71 Public Health Clinic POS 72 Rural Health Clinic FUH Visits Group 2 CPT CPT CPT CPT CPT CPT 99233

24 CPT CPT CPT CPT CPT CPT CPT FUH POS Group 2 POS 02 Telehealth POS 52 Psychiatric Facility-Partial Hospitalization POS 53 Community Mental Health Center FUH RevCodes Group 1 UBREV 0513 UBREV 0900 UBREV 0901 UBREV 0902 UBREV 0903 UBREV 0904 UBREV 0905 UBREV 0907 UBREV 0911 UBREV 0912 UBREV 0913 UBREV 0914 UBREV 0915 UBREV 0916 UBREV 0917 UBREV 0919 FUH RevCodes Group 2 UBREV 0510 UBREV 0515 UBREV 0516 UBREV 0517 UBREV 0519 UBREV 0520 UBREV 0521 UBREV 0522 UBREV 0523 UBREV 0526 UBREV 0527 UBREV 0528 UBREV 0529

25 UBREV 0982 UBREV 0983 IET Stand Alone Visits CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT 99401

26 CPT CPT CPT CPT CPT CPT CPT CPT HCPCS G0155 Services of clinical social worker in home health or hospice settings, each 15 minutes (G0155) HCPCS G0176 Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) (G0176) HCPCS G0177 Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more) (G0177) HCPCS G0396 Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes (G0396) HCPCS G0397 Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes (G0397) HCPCS G0409 Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf) (G0409) HCPCS G0410 Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes (G0410) HCPCS G0411 Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes (G0411) HCPCS G0443 Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes (G0443) HCPCS G0463 Hospital outpatient clinic visit for assessment and management of a patient (G0463) HCPCS H0001 Alcohol and/or drug assessment (H0001) HCPCS H0002 Behavioral health screening to determine eligibility for admission to treatment program (H0002) HCPCS H0004 Behavioral health counseling and therapy, per 15 minutes (H0004) HCPCS H0005 Alcohol and/or drug services; group counseling by a clinician (H0005) HCPCS H0007 Alcohol and/or drug services; crisis intervention (outpatient) (H0007) HCPCS H0015 Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therap HCPCS H0016 Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) (H0016) HCPCS H0022 Alcohol and/or drug intervention service (planned facilitation) (H0022) HCPCS H0031 Mental health assessment, by non-physician (H0031) HCPCS H0034 Medication training and support, per 15 minutes (H0034) HCPCS H0035 Mental health partial hospitalization, treatment, less than 24 hours (H0035)

27 HCPCS H0036 Community psychiatric supportive treatment, face-to-face, per 15 minutes (H0036) HCPCS H0037 Community psychiatric supportive treatment program, per diem (H0037) HCPCS H0039 Assertive community treatment, face-to-face, per 15 minutes (H0039) HCPCS H0040 Assertive community treatment program, per diem (H0040) HCPCS H0047 Alcohol and/or other drug abuse services, not otherwise specified (H0047) HCPCS H2000 Comprehensive multidisciplinary evaluation (H2000) HCPCS H2001 Rehabilitation program, per 1/2 day (H2001) HCPCS H2010 Comprehensive medication services, per 15 minutes (H2010) HCPCS H2011 Crisis intervention service, per 15 minutes (H2011) HCPCS H2012 Behavioral health day treatment, per hour (H2012) HCPCS H2013 Psychiatric health facility service, per diem (H2013) HCPCS H2014 Skills training and development, per 15 minutes (H2014) HCPCS H2015 Comprehensive community support services, per 15 minutes (H2015) HCPCS H2016 Comprehensive community support services, per diem (H2016) HCPCS H2017 Psychosocial rehabilitation services, per 15 minutes (H2017) HCPCS H2018 Psychosocial rehabilitation services, per diem (H2018) HCPCS H2019 Therapeutic behavioral services, per 15 minutes (H2019) HCPCS H2020 Therapeutic behavioral services, per diem (H2020) HCPCS H2035 Alcohol and/or other drug treatment program, per hour (H2035) HCPCS H2036 Alcohol and/or other drug treatment program, per diem (H2036) HCPCS M0064 Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders (M0064) HCPCS S0201 Partial hospitalization services, less than 24 hours, per diem (S0201) HCPCS S9480 Intensive outpatient psychiatric services, per diem (S9480) HCPCS S9484 Crisis intervention mental health services, per hour (S9484) HCPCS S9485 Crisis intervention mental health services, per diem (S9485) HCPCS T1006 Alcohol and/or substance abuse services, family/couple counseling (T1006) HCPCS T1012 Alcohol and/or substance abuse services, skills development (T1012) HCPCS T1015 Clinic visit/encounter, all-inclusive (T1015) UBREV 0510 UBREV 0513 UBREV 0515 UBREV 0516 UBREV 0517 UBREV 0519 UBREV 0520 UBREV 0521 UBREV 0522 UBREV 0523 UBREV 0526 UBREV 0527 UBREV 0528 UBREV 0529

28 UBREV 0900 UBREV 0902 UBREV 0903 UBREV 0904 UBREV 0905 UBREV 0906 UBREV 0907 UBREV 0911 UBREV 0912 UBREV 0913 UBREV 0914 UBREV 0915 UBREV 0916 UBREV 0917 UBREV 0919 UBREV 0944 UBREV 0945 UBREV 0982 UBREV 0983 IET Visits Group 1 CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT IET POS Group 1 POS 02 Telehealth POS 03 School POS 05 Indian Health Service Free-standing Facility POS 07 Tribal 638 Free-standing Facility POS 09 Prison/Correctional Facility POS 11 Office

29 POS 12 Home POS 13 Assisted Living Facility POS 14 Group Home POS 15 Mobile Unit POS 16 Temporary Lodging POS 17 Walk-in Retail Health Clinic POS 18 Place of Employment-Worksite POS 19 Off Campus-Outpatient Hospital POS 20 Urgent Care Facility POS 22 On Campus-Outpatient Hospital POS 33 Custodial Care Facility POS 49 Independent Clinic POS 50 Federally Qualified Health Center POS 52 Psychiatric Facility-Partial Hospitalization POS 53 Community Mental Health Center POS 57 Non-residential Substance Abuse Treatment Facility POS 71 Public Health Clinic POS 72 Rural Health Clinic IET Visits Group 2 CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT IET POS Goup 2 POS 02 Telehealth POS 52 Psychiatric Facility-Partial Hospitalization POS 53 Community Mental Health Center Telephone Visit CPT CPT CPT CPT CPT 99442

30 CPT Transitional Care Management Services CPT CPT Case Management Encounter CPT HCPCS T1016 Case management, each 15 minutes (T1016) HCPCS T1017 Targeted case management, each 15 minutes (T1017) HCPCS T2022 Case management, per month (T2022) HCPCS T2023 Targeted case management; per month (T2023) Complex Care Management Services CPT CPT CPT HCPCS G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) (G0506) Exclusions Stroke Exclusion ICD10CM Z51.89 [Z51.89] Encounter for other specified aftercare Other Stroke Exclusion ICD10CM S02.0XXA [S02.0XXA] Fracture of vault of skull, initial encounter for closed fracture ICD10CM S02.0XXB [S02.0XXB] Fracture of vault of skull, initial encounter for open fracture ICD10CM S06.0X1A [S06.0X1A] Concussion with loss of consciousness of 30 minutes or less, initial encounter ICD10CM S06.0X1D [S06.0X1D] Concussion with loss of consciousness of 30 minutes or less, subsequent encounter ICD10CM S06.0X1S [S06.0X1S] Concussion with loss of consciousness of 30 minutes or less, sequela ICD10CM S06.0X2A [S06.0X2A] Concussion with loss of consciousness of 31 minutes to 59 minutes, initial encounter ICD10CM S06.0X2D [S06.0X2D] Concussion with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter ICD10CM S06.0X2S [S06.0X2S] Concussion with loss of consciousness of 31 minutes to 59 minutes, sequela ICD10CM S06.0X3A [S06.0X3A] Concussion with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter ICD10CM S06.0X3D [S06.0X3D] Concussion with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter ICD10CM S06.0X3S [S06.0X3S] Concussion with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

31 ICD10CM S06.0X4A [S06.0X4A] Concussion with loss of consciousness of 6 hours to 24 hours, initial encounter ICD10CM S06.0X4D [S06.0X4D] Concussion with loss of consciousness of 6 hours to 24 hours, subsequent encounter ICD10CM S06.0X4S [S06.0X4S] Concussion with loss of consciousness of 6 hours to 24 hours, sequela ICD10CM S06.0X5A [S06.0X5A] Concussion with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter ICD10CM S06.0X5D [S06.0X5D] Concussion with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter ICD10CM S06.0X5S [S06.0X5S] Concussion with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela ICD10CM S06.0X6A [S06.0X6A] Concussion with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter ICD10CM S06.0X6D [S06.0X6D] Concussion with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter ICD10CM S06.0X6S [S06.0X6S] Concussion with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela ICD10CM S06.0X7A [S06.0X7A] Concussion with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter ICD10CM S06.0X7D [S06.0X7D] Concussion with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, subsequent encounter ICD10CM S06.0X7S [S06.0X7S] Concussion with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, sequela ICD10CM S06.0X8A [S06.0X8A] Concussion with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter ICD10CM S06.0X8D [S06.0X8D] Concussion with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, subsequent encounter ICD10CM S06.0X8S [S06.0X8S] Concussion with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, sequela ICD10CM S06.0X9A [S06.0X9A] Concussion with loss of consciousness of unspecified duration, initial encounter ICD10CM S06.0X9D [S06.0X9D] Concussion with loss of consciousness of unspecified duration, subsequent encounter ICD10CM S06.0X9S [S06.0X9S] Concussion with loss of consciousness of unspecified duration, sequela