CMS Limitations Guide - Cardiovascular Services

Transcription

1 Guide - Cardiovascular Services Starting July 1, 2008, CMS has placed numerous medical necessity limits on tests and procedures. This reference guide provides you with all of the latest changes. This guide is not an all-inclusive list of National Coverage Documents (NCD) and Local Coverage Documents (LCD). Please consult the CMS website for additional information at cms.hhs.gov/mcd/search.asp?clickon=search. You can search by LCD or NCD or keyword and region. CMS will deny payment if the correct diagnosis codes are not entered on the order form, and your patient s test or procedure will not be covered. We compiled this information in one location to make it easier for you to find the proper codes for medically necessary diagnoses. It is the responsibility of the provider to code to the highest level specified in the ICD-9-CM (e.g. to the fourth or fifth digit). The correct use of an ICD-9-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in this determination. We will continue to update this list as new CMS limitations are announced. You can always find the most current list on mymunson.org. If you have any questions, please contact Kari Smith, Office Coordinator, at (231) , or Karen Popa, Director, Patient Access Services, at (231)

2 Cardiolite Stress Testing LCD # L2611, Effective date: 09/30/2008 CPT/HCPCS Codes: CPT 78460, CPT 78461, CPT 78464, CPT 78465, CPT 78472, CPT 78478, CPT 78481, CPT 78483, CPT 93015, CPT 93016, CPT 93017, CPT ICD-9 codes that SUPPORT medical necessity for perfusion with or without functional studies (CPT codes 78460, 78461, 78464, 78465, 78472, 78473, 78478, 78480, 78481, 78483, 93015, 93016, 93017, and 93018): acute myocardial infarction of anterolateral wall episode of care unspecified acute myocardial infarction of anterolateral wall initial episode of care acute myocardial infarction of anterolateral wall subsequent episode of care acute myocardial infarction of other anterior wall episode of care unspecified acute myocardial infarction of other anterior wall initial episode of care acute myocardial infarction of other anterior wall subsequent episode of care acute myocardial infarction of inferolateral wall episode of care unspecified acute myocardial infarction of inferolateral wall initial episode of care acute myocardial infarction of inferolateral wall subsequent episode of care acute myocardial infarction of inferoposterior wall episode of care unspecified acute myocardial infarction of inferoposterior wall initial episode of care acute myocardial infarction of inferoposterior wall subsequent episode of care acute myocardial infarction of other inferior wall episode of care unspecified acute myocardial infarction of other inferior wall initial episode of care acute myocardial infarction of other inferior wall subsequent episode of care acute myocardial infarction of other lateral wall episode of care unspecified acute myocardial infarction of other lateral wall initial episode of care acute myocardial infarction of other lateral wall subsequent episode of care true posterior wall infarction episode of care unspecified true posterior wall infarction initial episode of care true posterior wall infarction subsequent episode of care subendocardial infarction episode of care unspecified subendocardial infarction initial episode of care subendocardial infarction subsequent episode of care acute myocardial infarction of other specified sites episode of care unspecified acute myocardial infarction of other specified sites initial episode of care acute myocardial infarction of other specified sites subsequent episode of care acute myocardial infarction of unspecified site episode of care unspecified acute myocardial infarction of unspecified site initial episode of care acute myocardial infarction of unspecified site subsequent episode of care postmyocardial infarction syndrome intermediate coronary syndrome acute coronary occlusion without myocardial infarction other acute and subacute forms of ischemic heart disease other 412 old myocardial infarction angina decubitus prinzmetal angina other and unspecified angina pectoris coronary atherosclerosis of unspecified type of vessel native or graft coronary atherosclerosis of native coronary artery coronary atherosclerosis of autologous vein bypass graft coronary atherosclerosis of nonautologous biological bypass graft

3 Cardiolite Stress Testing (con t) coronary atherosclerosis of artery bypass graft coronary atherosclerosis of native coronary artery of transplanted heart coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart aneurysm of heart (wall) aneurysm of coronary vessels dissection of coronary artery other aneurysm of heart chronic total occlusion of coronary artery other specified forms of chronic ischemic heart disease chronic ischemic heart disease unspecified ventricular fibrillation ventricular flutter cardiac arrest congestive heart failure unspecified left heart failure unspecified systolic heart failure acute systolic heart failure chronic systolic heart failure acute on chronic systolic heart failure unspecified combined systolic and diastolic heart failure acute combined systolic and diastolic heart failure chronic combined systolic and diastolic heart failure acute on chronic combined systolic and diastolic heart failure certain sequelae of myocardial infarction not elsewhere classified other takotsubo syndrome other ill-defined heart diseases coronary artery anomaly congenital shortness of breath unspecified chest pain precordial pain other chest pain nonspecific abnormal electrocardiogram (ecg) (ekg) other complications due to other cardiac device implant and graft complications of transplanted heart V42.1 heart replaced by transplant V45.81 postsurgical aortocoronary bypass status V45.82 percutaneous transluminal coronary angioplasty status

4 Dobutamine Stress Echocardiograms LCD # L14293, L23620, L26409, Effective date: 01/01/2009 ICD-9 Codes that SUPPORT medical necessity for Dobutamine Stress Echocardiograms: acute myocardial infarction of anterolateral wall subsequent episode of care acute myocardial infarction of other anterior wall subsequent episode of care acute myocardial infarction of inferolateral wall subsequent episode of care acute myocardial infarction of inferoposterior wall subsequent episode of care acute myocardial infarction of other inferior wall subsequent episode of care acute myocardial infarction of other lateral wall subsequent episode of care true posterior wall infarction subsequent episode of care subendocardial infarction subsequent episode of care postmyocardial infarction syndrome intermediate coronary syndrome acute coronary occlusion without myocardial infarction other acute and subacute forms of ischemic heart disease other angina decubitus prinzmetal angina other and unspecified angina pectoris coronary atherosclerosis of unspecified type of vessel native or graft coronary atherosclerosis of native coronary artery coronary atherosclerosis of autologous vein bypass graft coronary atherosclerosis of nonautologous biological bypass graft coronary atherosclerosis of artery bypass graft coronary atherosclerosis of unspecified bypass graft coronary atherosclerosis of native coronary artery of transplanted heart coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart chronic total occlusion of coronary artery other specified forms of chronic ischemic heart disease 424. mitral valve disorders aortic valve disorders tricuspid valve disorders specified as nonrheumatic pulmonary valve disorders hypertrophic obstructive cardiomyopathy obscure cardiomyopathy of africa endocardial fibroelastosis other primary cardiomyopathies alcoholic cardiomyopathy nutritional and metabolic cardiomyopathy cardiomyopathy in other diseases classified elsewhere secondary cardiomyopathy unspecified left bundle branch hemiblock other left bundle branch block right bundle branch block long qt syndrome congestive heart failure unspecified left heart failure unspecified systolic heart failure acute systolic heart failure chronic systolic heart failure

5 Dobutamine Stress Echocardiograms (con t) acute on chronic systolic heart failure unspecified diastolic heart failure acute diastolic heart failure chronic diastolic heart failure acute on chronic diastolic heart failure unspecified combined systolic and diastolic heart failure acute combined systolic and diastolic heart failure chronic combined systolic and diastolic heart failure acute on chronic combined systolic and diastolic heart failure heart failure unspecified myocarditis unspecified myocardial degeneration cardiovascular disease unspecified cardiomegaly functional disturbances following cardiac surgery syncope and collapse orthopnea shortness of breath respiratory abnormality other unspecified chest pain precordial pain nonspecific abnormal electrocardiogram (ecg) (ekg) mechanical complication of other vascular device implant and graft other complications due to other cardiac device implant and graft complications of transplanted heart v58.69 long-term (current) use of other medications

6 Electrocardiography (ECG or EKG) LCD # L27427; Effective Date: 06/05/2009 CPT/HCPCS Codes: CPT 93005, CPT ICD-9 codes that SUPPORT medical necessity for electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report (CPT 93005); and electrocardiogram, routine ecg with at least 12 leads; interpretation and report only (CPT 93010): typhoid fever paratyphoid fever a paratyphoid fever b paratyphoid fever c botulism food poisoning tuberculosis of other specified organs unspecified examination tuberculosis of other specified organs bacteriological or histological examination not done tuberculosis of other specified organs bacteriological or histological examination results unknown (at present) tuberculosis of other specified organs tubercle bacilli found (in sputum) by microscopy tuberculosis of other specified organs tubercle bacilli not found (in sputum) by microscopy but found by bacterial culture tuberculosis of other specified organs tubercle bacilli not found by bacteriological examination but tuberculosis confirmed histologically tuberculosis of other specified organs tubercle bacilli not found by bacteriological or histological examination but tuberculosis confirmed by other methods (inoculation of animals) acute miliary tuberculosis unspecified examination acute miliary tuberculosis bacteriological or histological examination not done acute miliary tuberculosis bacteriological or histological examination results unknown (at present) acute miliary tuberculosis tubercle bacilli found (in sputum) by microscopy acute miliary tuberculosis tubercle bacilli not found (in sputum) by microscopy but found by bacterial culture acute miliary tuberculosis tubercle bacilli not found by bacteriological examination but tuberculosis confirmed histologically acute miliary tuberculosis tubercle bacilli not found by bacteriological or histological examination but tuberculosis confirmed by other methods (inoculation of animals) other specified miliary tuberculosis unspecified examination other specified miliary tuberculosis bacteriological or histological examination not done other specified miliary tuberculosis bacteriological or histological examination results unknown (at present) other specified miliary tuberculosis tubercle bacilli found (in sputum) by microscopy other specified miliary tuberculosis tubercle bacilli not found (in sputum) by microscopy but found by bacterial culture other specified miliary tuberculosis tubercle bacilli not found by bacteriological examination but tuberculosis confirmed histologically other specified miliary tuberculosis tubercle bacilli not found by bacteriological or histological examination but tuberculosis confirmed by other methods (inoculation of animals) septicemic plague anthrax septicemia faucial diphtheria diphtheritic myocarditis scarlet fever

7 036.2 meningococcemia meningococcal carditis unspecified meningococcal pericarditis meningococcal endocarditis meningococcal myocarditis streptococcal septicemia staphylococcal septicemia unspecified methicillin susceptible staphylococcus aureus septicemia methicillin resistant staphylococcus aureus septicemia other staphylococcal septicemia pneumococcal septicemia septicemia due to anaerobes septicemia due to gram-negative organism unspecified septicemia due to hemophilus influenzae (h. influenzae) septicemia due to escherichia coli (e. coli) septicemia due to pseudomonas septicemia due to serratia other septicemia due to gram-negative organisms other specified septicemias unspecified septicemia gas gangrene toxic shock syndrome 042 human immunodeficiency virus (hiv) disease herpetic septicemia west nile fever, unspecified west nile fever with encephalitis west nile fever with other neurologic manifestation west nile fever with other complications epidemic pleurodynia coxsackie carditis unspecified coxsackie pericarditis coxsackie endocarditis coxsackie myocarditis 075 infectious mononucleosis chagas disease with heart involvement lyme disease aneurysm of aorta specified as syphilitic syphilitic aortitis syphilitic endocarditis of valve unspecified syphilitic endocarditis of mitral valve syphilitic endocarditis of aortic valve syphilitic endocarditis of tricuspid valve syphilitic endocarditis of pulmonary valve syphilitic pericarditis syphilitic myocarditis other specified cardiovascular syphilis cardiovascular syphilis unspecified gonococcal pericarditis gonococcal endocarditis other gonococcal heart disease

8 112.5 disseminated candidiasis candidal endocarditis histoplasma capsulatum pericarditis histoplasma capsulatum endocarditis histoplasma duboisii pericarditis histoplasma duboisii endocarditis histoplasmosis pericarditis unspecified histoplasmosis endocarditis myocarditis due to toxoplasmosis multisystemic disseminated toxoplasmosis 135 sarcoidosis malignant neoplasm of hepatic flexure malignant neoplasm of transverse colon malignant neoplasm of descending colon malignant neoplasm of sigmoid colon malignant neoplasm of cecum malignant neoplasm of appendix vermiformis malignant neoplasm of ascending colon malignant neoplasm of splenic flexure malignant neoplasm of other specified sites of large intestine malignant neoplasm of colon unspecified site malignant neoplasm of bronchus and lung unspecified malignant neoplasm of parietal pleura malignant neoplasm of visceral pleura malignant neoplasm of other specified sites of pleura malignant neoplasm of pleura unspecified malignant neoplasm of thymus malignant neoplasm of heart malignant neoplasm of anterior mediastinum malignant neoplasm of posterior mediastinum malignant neoplasm of other parts of mediastinum malignant neoplasm of mediastinum part unspecified malignant neoplasm of nipple and areola of female breast malignant neoplasm of central portion of female breast malignant neoplasm of upper-inner quadrant of female breast malignant neoplasm of lower-inner quadrant of female breast malignant neoplasm of upper-outer quadrant of female breast malignant neoplasm of lower-outer quadrant of female breast malignant neoplasm of axillary tail of female breast malignant neoplasm of other specified sites of female breast malignant neoplasm of breast (female) unspecified site secondary malignant neoplasm of mediastinum benign neoplasm of pleura benign neoplasm of mediastinum benign neoplasm of heart polycythemia vera goiter specified as simple goiter unspecified nontoxic uninodular goiter nontoxic multinodular goiter

9 241.9 unspecified nontoxic nodular goiter toxic diffuse goiter without thyrotoxic crisis or storm toxic diffuse goiter with thyrotoxic crisis or storm toxic uninodular goiter without thyrotoxic crisis or storm toxic uninodular goiter with thyrotoxic crisis or storm toxic multinodular goiter without thyrotoxic crisis or storm toxic multinodular goiter with thyrotoxic crisis or storm toxic nodular goiter unspecified type without thyrotoxic crisis or storm toxic nodular goiter unspecified type with thyrotoxic crisis or storm thyrotoxicosis from ectopic thyroid nodule without thyrotoxic crisis or storm thyrotoxicosis from ectopic thyroid nodule with thyrotoxic crisis or storm thyrotoxicosis of other specified origin without thyrotoxic crisis or storm thyrotoxicosis of other specified origin with thyrotoxic crisis or storm thyrotoxicosis without goiter or other cause and without thyrotoxic crisis or storm thyrotoxicosis without goiter or other cause with thyrotoxic crisis or storm 243 congenital hypothyroidism postsurgical hypothyroidism other postablative hypothyroidism iodine hypothyroidism other iatrogenic hypothyroidism other specified acquired hypothyroidism unspecified acquired hypothyroidism acute thyroiditis subacute thyroiditis chronic lymphocytic thyroiditis secondary diabetes mellitus without mention of complication, not stated as uncontrolled, or unspecified secondary diabetes mellitus without mention of complication, uncontrolled secondary diabetes mellitus with ketoacidosis, not stated as uncontrolled, or unspecified secondary diabetes mellitus with ketoacidosis, uncontrolled secondary diabetes mellitus with hyperosmolarity, not stated as uncontrolled, or unspecified secondary diabetes mellitus with hyperosmolarity, uncontrolled secondary diabetes mellitus with other coma, not stated as uncontrolled, or unspecified secondary diabetes mellitus with other coma, uncontrolled secondary diabetes mellitus with other specified manifestations, not stated as uncontrolled, or unspecified secondary diabetes mellitus with other specified manifestations, uncontrolled diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled diabetes mellitus without mention of complication, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type ii or unspecified type, not stated as uncontrolled diabetes with ketoacidosis, type i [juvenile type], not stated as uncontrolled diabetes with ketoacidosis, type ii or unspecified type, uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled diabetes with hyperosmolarity, type ii or unspecified type, not stated as uncontrolled diabetes with hyperosmolarity, type i [juvenile type], not stated as uncontrolled diabetes with hyperosmolarity, type ii or unspecified type, uncontrolled diabetes with hyperosmolarity, type i [juvenile type], uncontrolled

10 diabetes with other coma, type ii or unspecified type, not stated as uncontrolled diabetes with other coma, type i [juvenile type], not stated as uncontrolled diabetes with other coma, type ii or unspecified type, uncontrolled diabetes with other coma, type i [juvenile type], uncontrolled diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled diabetes with renal manifestations, type ii or unspecified type, uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], not stated as uncontrolled diabetes with ophthalmic manifestations, type ii or unspecified type, uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled diabetes with neurological manifestations, type ii or unspecified type, uncontrolled diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with peripheral circulatory disorders, type ii or unspecified type, not stated as uncontrolled diabetes with peripheral circulatory disorders, type i [juvenile type], not stated as uncontrolled diabetes with peripheral circulatory disorders, type ii or unspecified type, uncontrolled diabetes with peripheral circulatory disorders, type i [juvenile type], uncontrolled diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled diabetes with other specified manifestations, type ii or unspecified type, uncontrolled diabetes with other specified manifestations, type i [juvenile type], uncontrolled diabetes with unspecified complication, type ii or unspecified type, not stated as uncontrolled diabetes with unspecified complication, type i [juvenile type], not stated as uncontrolled diabetes with unspecified complication, type ii or unspecified type, uncontrolled diabetes with unspecified complication, type i [juvenile type], uncontrolled hypoglycemic coma other specified hypoglycemia hypoglycemia unspecified postsurgical hypoinsulinemia hyperparathyroidism, unspecified primary hyperparathyroidism secondary hyperparathyroidism, non-renal other hyperparathyroidism hypoparathyroidism other specified disorders of parathyroid gland unspecified disorder of parathyroid gland acromegaly and gigantism panhypopituitarism diabetes insipidus cushing s syndrome hyperaldosteronism, unspecified glucocorticoid-remediable aldosteronism conn s syndrome bartter s syndrome other secondary aldosteronism adrenogenital disorders other corticoadrenal overactivity

11 glucocorticoid deficiency mineralocorticoid deficiency other adrenal hypofunction medulloadrenal hyperfunction other specified disorders of adrenal glands beriberi other and unspecified manifestations of thiamine deficiency pellagra pure hypercholesterolemia pure hyperglyceridemia mixed hyperlipidemia hyperchylomicronemia other and unspecified hyperlipidemia lipoprotein deficiencies lipodystrophy lipidoses other disorders of lipoid metabolism unspecified disorder of lipoid metabolism disorders of iron metabolism disorders of copper metabolism disorders of magnesium metabolism disorders of phosphorus metabolism unspecified disorder of calcium metabolism hypocalcemia hypercalcemia other disorders of calcium metabolism unspecified disorder of mineral metabolism hyperosmolality and/or hypernatremia hyposmolality and/or hyponatremia acidosis alkalosis mixed acid-base balance disorder volume depletion, unspecified dehydration hypovolemia fluid overload disorder hyperpotassemia hypopotassemia electrolyte and fluid disorders not elsewhere classified amyloidosis, unspecified familial mediterranean fever other amyloidosis mucopolysaccharidosis sickle-cell thalassemia without crisis sickle-cell thalassemia with crisis other thalassemia sickle-cell trait sickle-cell disease unspecified hb-ss disease without crisis hb-ss disease with crisis

12 sickle-cell/hb-c disease without crisis sickle-cell/hb c disease with crisis other sickle-cell disease without crisis other sickle-cell disease with crisis anemia unspecified polycythemia secondary methemoglobinemia opioid type dependence continuous use opioid type dependence episodic use cocaine dependence continuous use cocaine dependence episodic use amphetamine and other psychostimulant dependence continuous use hallucinogen dependence continuous use combinations of opioid type drug with any other drug dependence continuous use combinations of opioid type drug with any other drug dependence episodic use cardiovascular malfunction arising from mental factors organic sleep apnea, unspecified primary central sleep apnea high altitude periodic breathing obstructive sleep apnea (adult) (pediatric) idiopathic sleep related non obstructive alveolar hypoventilation congenital central alveolar hypoventilation syndrome sleep related hypoventilation/hypoxemia in conditions classifiable elsewhere central sleep apnea in conditions classified elsewhere other organic sleep apnea huntington s chorea friedreich s ataxia idiopathic peripheral autonomic neuropathy, unspecified carotid sinus syndrome other idiopathic peripheral autonomic neuropathy myotonic muscular dystrophy 390 rheumatic fever without heart involvement acute rheumatic pericarditis acute rheumatic endocarditis acute rheumatic myocarditis other acute rheumatic heart disease acute rheumatic heart disease unspecified rheumatic chorea with heart involvement rheumatic chorea without heart involvement 393 chronic rheumatic pericarditis mitral stenosis rheumatic mitral insufficiency mitral stenosis with insufficiency other and unspecified mitral valve diseases rheumatic aortic stenosis rheumatic aortic insufficiency rheumatic aortic stenosis with insufficiency other and unspecified rheumatic aortic diseases mitral valve stenosis and aortic valve stenosis mitral valve stenosis and aortic valve insufficiency

13 396.2 mitral valve insufficiency and aortic valve stenosis mitral valve insufficiency and aortic valve insufficiency multiple involvement of mitral and aortic valves mitral and aortic valve diseases unspecified diseases of tricuspid valve rheumatic diseases of pulmonary valve rheumatic diseases of endocardium valve unspecified rheumatic myocarditis rheumatic heart disease unspecified rheumatic heart failure (congestive) other rheumatic heart diseases malignant essential hypertension benign essential hypertension unspecified essential hypertension malignant hypertensive heart disease without heart failure malignant hypertensive heart disease with heart failure benign hypertensive heart disease without heart failure benign hypertensive heart disease with heart failure unspecified hypertensive heart disease without heart failure unspecified hypertensive heart disease with heart failure hypertensive chronic kidney disease, malignant, with chronic kidney disease stage i through stage iv, or unspecified hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease hypertensive chronic kidney disease, benign, with chronic kidney disease stage i through stage iv, or unspecified hypertensive chronic kidney disease, benign, with chronic kidney disease stage v or end stage renal disease hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage i through stage iv, or unspecified hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage i through stage iv, or unspecified hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage v or end stage renal disease hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage v or end stage renal disease hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage i through stage iv, or unspecified hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage i through stage iv, or unspecified hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage v or end stage renal disease hypertensive heart and chronic kidney disease, benign, with heart failure and chronic kidney disease stage v or end stage renal disease hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage i through stage iv, or unspecified

14 hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage i through stage iv, or unspecified hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage v or end stage renal disease hypertensive heart and chronic kidney disease, unspecified, with heart failure and chronic kidney disease stage v or end stage renal disease malignant renovascular hypertension other malignant secondary hypertension benign renovascular hypertension other benign secondary hypertension unspecified renovascular hypertension other unspecified secondary hypertension acute myocardial infarction of anterolateral wall episode of care unspecified acute myocardial infarction of anterolateral wall initial episode of care acute myocardial infarction of anterolateral wall subsequent episode of care acute myocardial infarction of other anterior wall episode of care unspecified acute myocardial infarction of other anterior wall initial episode of care acute myocardial infarction of other anterior wall subsequent episode of care acute myocardial infarction of inferolateral wall episode of care unspecified acute myocardial infarction of inferolateral wall initial episode of care acute myocardial infarction of inferolateral wall subsequent episode of care acute myocardial infarction of inferoposterior wall episode of care unspecified acute myocardial infarction of inferoposterior wall initial episode of care acute myocardial infarction of inferoposterior wall subsequent episode of care acute myocardial infarction of other inferior wall episode of care unspecified acute myocardial infarction of other inferior wall initial episode of care acute myocardial infarction of other inferior wall subsequent episode of care acute myocardial infarction of other lateral wall episode of care unspecified acute myocardial infarction of other lateral wall initial episode of care acute myocardial infarction of other lateral wall subsequent episode of care true posterior wall infarction episode of care unspecified true posterior wall infarction initial episode of care true posterior wall infarction subsequent episode of care subendocardial infarction episode of care unspecified subendocardial infarction initial episode of care subendocardial infarction subsequent episode of care acute myocardial infarction of other specified sites episode of care unspecified acute myocardial infarction of other specified sites initial episode of care acute myocardial infarction of other specified sites subsequent episode of care acute myocardial infarction of unspecified site episode of care unspecified acute myocardial infarction of unspecified site initial episode of care acute myocardial infarction of unspecified site subsequent episode of care postmyocardial infarction syndrome intermediate coronary syndrome acute coronary occlusion without myocardial infarction other acute and subacute forms of ischemic heart disease other 412 old myocardial infarction angina decubitus prinzmetal angina other and unspecified angina pectoris

15 coronary atherosclerosis of unspecified type of vessel native or graft coronary atherosclerosis of native coronary artery coronary atherosclerosis of autologous vein bypass graft coronary atherosclerosis of nonautologous biological bypass graft coronary atherosclerosis of artery bypass graft coronary atherosclerosis of unspecified bypass graft coronary atherosclerosis of native coronary artery of transplanted heart coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart aneurysm of heart (wall) aneurysm of coronary vessels dissection of coronary artery other aneurysm of heart chronic total occlusion of coronary artery coronary atherosclerosis due to lipid rich plaque other specified forms of chronic ischemic heart disease chronic ischemic heart disease unspecified acute cor pulmonale iatrogenic pulmonary embolism and infarction septic pulmonary embolism other pulmonary embolism and infarction primary pulmonary hypertension kyphoscoliotic heart disease other chronic pulmonary heart diseases chronic pulmonary heart disease unspecified arteriovenous fistula of pulmonary vessels aneurysm of pulmonary artery other specified diseases of pulmonary circulation unspecified disease of pulmonary circulation acute pericarditis in diseases classified elsewhere acute pericarditis unspecified acute idiopathic pericarditis other acute pericarditis acute and subacute bacterial endocarditis acute and subacute infective endocarditis in diseases classified elsewhere acute endocarditis unspecified acute myocarditis in diseases classified elsewhere acute myocarditis unspecified idiopathic myocarditis septic myocarditis toxic myocarditis other acute myocarditis hemopericardium adhesive pericarditis constrictive pericarditis cardiac tamponade other specified diseases of pericardium unspecified disease of pericardium mitral valve disorders aortic valve disorders tricuspid valve disorders specified as nonrheumatic

16 424.3 pulmonary valve disorders endocarditis valve unspecified unspecified cause endocarditis in diseases classified elsewhere other endocarditis valve unspecified endomyocardial fibrosis hypertrophic obstructive cardiomyopathy obscure cardiomyopathy of africa endocardial fibroelastosis other primary cardiomyopathies alcoholic cardiomyopathy nutritional and metabolic cardiomyopathy cardiomyopathy in other diseases classified elsewhere secondary cardiomyopathy unspecified atrioventricular block complete atrioventricular block unspecified first degree atrioventricular block mobitz (type) ii atrioventricular block other second degree atrioventricular block left bundle branch hemiblock other left bundle branch block right bundle branch block bundle branch block unspecified right bundle branch block and left posterior fascicular block right bundle branch block and left anterior fascicular block other bilateral bundle branch block trifascicular block other heart block anomalous atrioventricular excitation lown-ganong-levine syndrome long qt syndrome other specified conduction disorders conduction disorder unspecified paroxysmal supraventricular tachycardia paroxysmal ventricular tachycardia paroxysmal tachycardia unspecified atrial fibrillation atrial flutter ventricular fibrillation ventricular flutter cardiac arrest premature beats unspecified supraventricular premature beats other premature beats sinoatrial node dysfunction other specified cardiac dysrhythmias cardiac dysrhythmia unspecified congestive heart failure unspecified left heart failure unspecified systolic heart failure acute systolic heart failure

17 chronic systolic heart failure acute on chronic systolic heart failure unspecified diastolic heart failure acute diastolic heart failure chronic diastolic heart failure acute on chronic diastolic heart failure unspecified combined systolic and diastolic heart failure acute combined systolic and diastolic heart failure chronic combined systolic and diastolic heart failure acute on chronic combined systolic and diastolic heart failure heart failure unspecified myocarditis unspecified myocardial degeneration cardiovascular disease unspecified cardiomegaly functional disturbances following cardiac surgery rupture of chordae tendineae rupture of papillary muscle certain sequelae of myocardial infarction not elsewhere classified acquired cardiac septal defect certain sequelae of myocardial infarction not elsewhere classified other other disorders of papillary muscle hyperkinetic heart disease takotsubo syndrome other ill-defined heart diseases heart disease unspecified 430 subarachnoid hemorrhage 431 intracerebral hemorrhage nontraumatic extradural hemorrhage subdural hemorrhage unspecified intracranial hemorrhage occlusion and stenosis of basilar artery without cerebral infarction occlusion and stenosis of basilar artery with cerebral infarction occlusion and stenosis of carotid artery without cerebral infarction occlusion and stenosis of carotid artery with cerebral infarction occlusion and stenosis of vertebral artery without cerebral infarction occlusion and stenosis of vertebral artery with cerebral infarction occlusion and stenosis of multiple and bilateral precerebral arteries without cerebral infarction occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction occlusion and stenosis of other specified precerebral artery without cerebral infarction occlusion and stenosis of other specified precerebral artery with cerebral infarction cerebral thrombosis without cerebral infarction cerebral thrombosis with cerebral infarction cerebral embolism without cerebral infarction cerebral embolism with cerebral infarction cerebral artery occlusion unspecified without cerebral infarction cerebral artery occlusion unspecified with cerebral infarction basilar artery syndrome vertebral artery syndrome subclavian steal syndrome vertebrobasilar artery syndrome

18 435.8 other specified transient cerebral ischemias unspecified transient cerebral ischemia 436 acute but ill-defined cerebrovascular disease cerebral atherosclerosis other generalized ischemic cerebrovascular disease hypertensive encephalopathy cerebral aneurysm nonruptured cerebral arteritis moyamoya disease nonpyogenic thrombosis of intracranial venous sinus transient global amnesia other ill-defined cerebrovascular disease unspecified cerebrovascular disease atherosclerosis of aorta atherosclerosis of renal artery atherosclerosis of native arteries of the extremities unspecified atherosclerosis of native arteries of the extremities with intermittent claudication atherosclerosis of native arteries of the extremities with rest pain atherosclerosis of native arteries of the extremities with ulceration atherosclerosis of native arteries of the extremities with gangrene other atherosclerosis of native arteries of the extremities chronic total occlusion of artery of the extremities dissection of aorta aneurysm unspecified site dissection of aorta thoracic dissection of aorta abdominal dissection of aorta thoracoabdominal thoracic aneurysm ruptured thoracic aneurysm without rupture abdominal aneurysm ruptured abdominal aneurysm without rupture aortic aneurysm of unspecified site ruptured thoracoabdominal aneurysm ruptured thoracoabdominal aneurysm without rupture aortic aneurysm of unspecified site without rupture aneurysm of artery of upper extremity aneurysm of renal artery aneurysm of iliac artery aneurysm of artery of lower extremity aneurysm of artery of neck aneurysm of subclavian artery aneurysm of splenic artery aneurysm of other visceral artery aneurysm of other specified site other aneurysm of unspecified site raynaud s syndrome thromboangiitis obliterans (buerger s disease) dissection of carotid artery dissection of iliac artery dissection of renal artery dissection of vertebral artery

19 dissection of other artery peripheral angiopathy in diseases classified elsewhere other peripheral vascular disease peripheral vascular disease unspecified embolism and thrombosis of abdominal aorta embolism and thrombosis of thoracic aorta arterial embolism and thrombosis of upper extremity arterial embolism and thrombosis of lower extremity embolism and thrombosis of iliac artery embolism and thrombosis of other artery embolism and thrombosis of unspecified artery atheroembolism of upper extremity atheroembolism of lower extremity atheroembolism of kidney atheroembolism of other site polyarteritis nodosa acute febrile mucocutaneous lymph node syndrome (mcls) hypersensitivity angiitis unspecified goodpasture s syndrome other specified hypersensitivity angiitis lethal midline granuloma wegener s granulomatosis giant cell arteritis thrombotic microangiopathy takayasu s disease arteriovenous fistula acquired stricture of artery rupture of artery hyperplasia of renal artery celiac artery compression syndrome necrosis of artery arteritis unspecified other specified disorders of arteries and arterioles unspecified disorders of arteries and arterioles 449 septic arterial embolism orthostatic hypotension chronic hypotension hypotension of hemodialysis other iatrogenic hypotension other specified hypotension hypotension unspecified compression of vein acute bronchiolitis due to respiratory syncytial virus (rsv) acute bronciolitis due to other infectious organisms pneumonia due to chlamydia 488 influenza due to identified avian influenza virus obstructive chronic bronchitis without exacerbation obstructive chronic bronchitis with (acute) exacerbation extrinsic asthma with status asthmaticus extrinsic asthma with (acute) exacerbation

20 intrinsic asthma unspecified intrinsic asthma with status asthmaticus intrinsic asthma with (acute) exacerbation chronic obstructive asthma unspecified chronic obstructive asthma with status asthmaticus chronic obstructive asthma with (acute) exacerbation exercise-induced bronchospasm cough variant asthma asthma unspecified type with status asthmaticus asthma unspecified with (acute) exacerbation acute pulmonary edema due to fumes and vapors spontaneous tension pneumothorax acute chest syndrome pulmonary collapse interstitial emphysema pulmonary eosinophilia acute edema of lung unspecified pulmonary insufficiency following trauma and surgery acute respiratory failure other pulmonary insufficiency not elsewhere classified chronic respiratory failure acute and chronic respiratory failure other diseases of lung not elsewhere classified mediastinitis other diseases of mediastinum not elsewhere classified unspecified disease of the jaws achalasia and cardiospasm esophagitis unspecified reflux esophagitis acute esophagitis other esophagitis ulcer of esophagus without bleeding ulcer of esophagus with bleeding stricture and stenosis of esophagus perforation of esophagus dyskinesia of esophagus diverticulum of esophagus acquired esophageal reflux barrett s esophagus diaphragmatic hernia with gangrene diaphragmatic hernia with obstruction diaphragmatic hernia without obstruction or gangrene acute cholecystitis cholecystitis unspecified chronic cholecystitis acute and chronic cholecystitis obstruction of gallbladder perforation of gallbladder acute pancreatitis hemorrhage of gastrointestinal tract unspecified

21 585.3 chronic kidney disease, stage iii (moderate) chronic kidney disease, stage iv (severe) chronic kidney disease, stage v end stage renal disease mastodynia spontaneous abortion unspecified complicated by shock spontaneous abortion incomplete complicated by shock spontaneous abortion complete complicated by shock spontaneous abortion unspecified complicated by embolism spontaneous abortion incomplete complicated by embolism spontaneous abortion complete complicated by embolism legally induced abortion unspecified complicated by shock legally induced abortion incomplete complicated by shock legally induced abortion complete complicated by shock legally induced abortion unspecified complicated by embolism legally induced abortion incomplete complicated by embolism legally induced abortion complete complicated by embolism illegal abortion unspecified complicated by shock illegal abortion incomplete complicated by shock illegal abortion complete complicated by shock illegal abortion unspecified complicated by embolism illegal abortion incomplete complicated by embolism illegal abortion complete complicated by embolism legally unspecified type of abortion unspecified complicated by shock legally unspecified abortion incomplete complicated by shock legally unspecified abortion complete complicated by shock legally unspecified type of abortion unspecified complicated by embolism legally unspecified abortion incomplete complicated by embolism legally unspecified abortion complete complicated by embolism failed attempted abortion complicated by shock failed attempted abortion complicated by embolism shock following abortion or ectopic and molar pregnancies embolism following abortion or ectopic and molar pregnancies other specified complications following abortion or ectopic and molar pregnancies benign essential hypertension complicating pregnancy childbirth and the puerperium unspecified as to episode of care benign essential hypertension with delivery benign essential hypertension with delivery with postpartum complication antepartum benign essential hypertension postpartum benign essential hypertension hypertension secondary to renal disease complicating pregnancy childbirth and the puerperium unspecified as to episode of care hypertension secondary to renal disease with delivery hypertension secondary to renal disease with delivery with postpartum complication hypertension secondary to renal disease antepartum hypertension secondary to renal disease postpartum other pre-existing hypertension complicating pregnancy childbirth and the puerperium unspecified as to episode of care other pre-existing hypertension with delivery other pre-existing hypertension with delivery with postpartum complication