Table 6I Major Complications or Comorbidities (MCC) List FY 2016

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1 Table 6I Major Complications or Comorbidities (MCC) List FY 2016 A02.1 Salmonella sepsis A02.21 Salmonella meningitis A02.22 Salmonella pneumonia A06.4 Amebic liver abscess A06.5 Amebic lung abscess A06.6 Amebic brain abscess A17.0 Tuberculous meningitis A17.1 Meningeal tuberculoma A17.81 Tuberculoma of brain and spinal cord A17.82 Tuberculous meningoencephalitis A17.83 Tuberculous neuritis A17.89 Other tuberculosis of nervous system A18.31 Tuberculous peritonitis A19.0 Acute miliary tuberculosis of a single specified site A19.1 Acute miliary tuberculosis of multiple sites A19.2 Acute miliary tuberculosis, unspecified A19.8 Other miliary tuberculosis A19.9 Miliary tuberculosis, unspecified A20.0 Bubonic plague A20.1 Cellulocutaneous plague A20.2 Pneumonic plague A20.3 Plague meningitis A20.7 Septicemic plague A20.8 Other forms of plague A20.9 Plague, unspecified A22.1 Pulmonary anthrax A22.7 Anthrax sepsis A26.7 Erysipelothrix sepsis A27.81 Aseptic meningitis in leptospirosis A32.7 Listerial sepsis A33 Tetanus neonatorum A35 Other tetanus A37.01 Whooping cough due to Bordetella pertussis with pneumonia A37.11 Whooping cough due to Bordetella parapertussis with pneumonia A37.81 Whooping cough due to other Bordetella species with pneumonia A37.91 Whooping cough, unspecified species with pneumonia A39.0 Meningococcal meningitis Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 1 of 82

2 A39.1 Waterhouse Friderichsen syndrome A39.2 Acute meningococcemia A39.3 Chronic meningococcemia A39.4 Meningococcemia, unspecified A39.50 Meningococcal carditis, unspecified A39.51 Meningococcal endocarditis A39.52 Meningococcal myocarditis A39.53 Meningococcal pericarditis A39.81 Meningococcal encephalitis A40.0 Sepsis due to streptococcus, group A A40.1 Sepsis due to streptococcus, group B A40.3 Sepsis due to Streptococcus pneumoniae A40.8 Other streptococcal sepsis A40.9 Streptococcal sepsis, unspecified A41.01 Sepsis due to Methicillin susceptible Staphylococcus aureus A41.02 Sepsis due to Methicillin resistant Staphylococcus aureus A41.1 Sepsis due to other specified staphylococcus A41.2 Sepsis due to unspecified staphylococcus A41.3 Sepsis due to Hemophilus influenzae A41.4 Sepsis due to anaerobes A41.50 Gram negative sepsis, unspecified A41.51 Sepsis due to Escherichia coli [E. coli] A41.52 Sepsis due to Pseudomonas A41.53 Sepsis due to Serratia A41.59 Other Gram negative sepsis A41.81 Sepsis due to Enterococcus A41.89 Other specified sepsis A41.9 Sepsis, unspecified organism A42.7 Actinomycotic sepsis A48.0 Gas gangrene A48.1 Legionnaires' disease A48.3 Toxic shock syndrome A50.41 Late congenital syphilitic meningitis A50.42 Late congenital syphilitic encephalitis A51.41 Secondary syphilitic meningitis A52.13 Late syphilitic meningitis A52.14 Late syphilitic encephalitis A54.81 Gonococcal meningitis A54.86 Gonococcal sepsis Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 2 of 82

3 A80.0 Acute paralytic poliomyelitis, vaccine associated A80.1 Acute paralytic poliomyelitis, wild virus, imported A80.2 Acute paralytic poliomyelitis, wild virus, indigenous A80.30 Acute paralytic poliomyelitis, unspecified A80.39 Other acute paralytic poliomyelitis A83.0 Japanese encephalitis A83.1 Western equine encephalitis A83.2 Eastern equine encephalitis A83.3 St Louis encephalitis A83.4 Australian encephalitis A83.5 California encephalitis A83.6 Rocio virus disease A83.8 Other mosquito borne viral encephalitis A83.9 Mosquito borne viral encephalitis, unspecified A84.0 Far Eastern tick borne encephalitis [Russian spring summer encephalitis] A84.1 Central European tick borne encephalitis A84.8 Other tick borne viral encephalitis A84.9 Tick borne viral encephalitis, unspecified A85.2 Arthropod borne viral encephalitis, unspecified A92.30 West Nile virus infection, unspecified A92.31 West Nile virus infection with encephalitis A92.32 West Nile virus infection with other neurologic manifestation A92.39 West Nile virus infection with other complications B00.3 Herpesviral meningitis B00.4 Herpesviral encephalitis B00.7 Disseminated herpesviral disease B00.82 Herpes simplex myelitis B01.11 Varicella encephalitis and encephalomyelitis B01.12 Varicella myelitis B01.2 Varicella pneumonia B02.1 Zoster meningitis B02.24 Postherpetic myelitis B05.0 Measles complicated by encephalitis B05.2 Measles complicated by pneumonia B06.01 Rubella encephalitis B10.01 Human herpesvirus 6 encephalitis B10.09 Other human herpesvirus encephalitis B15.0 Hepatitis A with hepatic coma B16.0 Acute hepatitis B with delta agent with hepatic coma Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 3 of 82

4 B16.2 Acute hepatitis B without delta agent with hepatic coma B17.11 Acute hepatitis C with hepatic coma B19.0 Unspecified viral hepatitis with hepatic coma B19.11 Unspecified viral hepatitis B with hepatic coma B19.21 Unspecified viral hepatitis C with hepatic coma B20 Human immunodeficiency virus [HIV] disease B25.0 Cytomegaloviral pneumonitis B25.2 Cytomegaloviral pancreatitis B26.1 Mumps meningitis B26.2 Mumps encephalitis B37.1 Pulmonary candidiasis B37.5 Candidal meningitis B37.6 Candidal endocarditis B37.7 Candidal sepsis B38.4 Coccidioidomycosis meningitis B39.0 Acute pulmonary histoplasmosis capsulati B39.1 Chronic pulmonary histoplasmosis capsulati B39.2 Pulmonary histoplasmosis capsulati, unspecified B44.0 Invasive pulmonary aspergillosis B45.1 Cerebral cryptococcosis B46.0 Pulmonary mucormycosis B46.1 Rhinocerebral mucormycosis B46.2 Gastrointestinal mucormycosis B46.3 Cutaneous mucormycosis B46.4 Disseminated mucormycosis B46.5 Mucormycosis, unspecified B46.8 Other zygomycoses B46.9 Zygomycosis, unspecified B50.9 Plasmodium falciparum malaria, unspecified B58.2 Toxoplasma meningoencephalitis B58.3 Pulmonary toxoplasmosis B58.81 Toxoplasma myocarditis B59 Pneumocystosis B77.81 Ascariasis pneumonia D57.00 Hb SS disease with crisis, unspecified D57.01 Hb SS disease with acute chest syndrome D57.02 Hb SS disease with splenic sequestration D Sickle cell/hb C disease with acute chest syndrome D Sickle cell/hb C disease with splenic sequestration Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 4 of 82

5 D Sickle cell/hb C disease with crisis, unspecified D Sickle cell thalassemia with acute chest syndrome D Sickle cell thalassemia with splenic sequestration D Sickle cell thalassemia with crisis, unspecified D Other sickle cell disorders with acute chest syndrome D Other sickle cell disorders with splenic sequestration D Other sickle cell disorders with crisis, unspecified D59.3 Hemolytic uremic syndrome D60.0 Chronic acquired pure red cell aplasia D60.1 Transient acquired pure red cell aplasia D60.8 Other acquired pure red cell aplasias D60.9 Acquired pure red cell aplasia, unspecified D61.1 Drug induced aplastic anemia D61.2 Aplastic anemia due to other external agents D61.3 Idiopathic aplastic anemia D Antineoplastic chemotherapy induced pancytopenia D Other drug induced pancytopenia D61.89 Other specified aplastic anemias and other bone marrow failure syndromes D65 Disseminated intravascular coagulation [defibrination syndrome] D66 Hereditary factor VIII deficiency D67 Hereditary factor IX deficiency E03.5 Myxedema coma E05.01 Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm E05.11 Thyrotoxicosis with toxic single thyroid nodule with thyrotoxic crisis or storm E05.21 Thyrotoxicosis with toxic multinodular goiter with thyrotoxic crisis or storm E05.31 Thyrotoxicosis from ectopic thyroid tissue with thyrotoxic crisis or storm E05.41 Thyrotoxicosis factitia with thyrotoxic crisis or storm E05.81 Other thyrotoxicosis with thyrotoxic crisis or storm E05.91 Thyrotoxicosis, unspecified with thyrotoxic crisis or storm E08.00 Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic hyperosmolar coma (NKHHC) E08.01 Diabetes mellitus due to underlying condition with hyperosmolarity with coma E08.10 Diabetes mellitus due to underlying condition with ketoacidosis without coma E08.11 Diabetes mellitus due to underlying condition with ketoacidosis with coma E Diabetes mellitus due to underlying condition with hypoglycemia with coma E09.00 Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic hyperosmolar coma (NKHHC) E09.01 Drug or chemical induced diabetes mellitus with hyperosmolarity with coma E09.10 Drug or chemical induced diabetes mellitus with ketoacidosis without coma E09.11 Drug or chemical induced diabetes mellitus with ketoacidosis with coma E Drug or chemical induced diabetes mellitus with hypoglycemia with coma Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 5 of 82

6 E10.10 Type 1 diabetes mellitus with ketoacidosis without coma E10.11 Type 1 diabetes mellitus with ketoacidosis with coma E Type 1 diabetes mellitus with hypoglycemia with coma E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic hyperosmolar coma (NKHHC) E11.01 Type 2 diabetes mellitus with hyperosmolarity with coma E Type 2 diabetes mellitus with hypoglycemia with coma E13.00 Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic hyperosmolar coma (NKHHC) E13.01 Other specified diabetes mellitus with hyperosmolarity with coma E13.10 Other specified diabetes mellitus with ketoacidosis without coma E13.11 Other specified diabetes mellitus with ketoacidosis with coma E Other specified diabetes mellitus with hypoglycemia with coma E40 Kwashiorkor E41 Nutritional marasmus E42 Marasmic kwashiorkor E43 Unspecified severe protein calorie malnutrition E84.0 Cystic fibrosis with pulmonary manifestations E84.11 Meconium ileus in cystic fibrosis E88.3 Tumor lysis syndrome G00.0 Hemophilus meningitis G00.1 Pneumococcal meningitis G00.2 Streptococcal meningitis G00.3 Staphylococcal meningitis G00.8 Other bacterial meningitis G00.9 Bacterial meningitis, unspecified G01 Meningitis in bacterial diseases classified elsewhere G02 Meningitis in other infectious and parasitic diseases classified elsewhere G03.0 Nonpyogenic meningitis G03.8 Meningitis due to other specified causes G03.9 Meningitis, unspecified G04.00 Acute disseminated encephalitis and encephalomyelitis, unspecified G04.01 Postinfectious acute disseminated encephalitis and encephalomyelitis (postinfectious ADEM) G04.02 Postimmunization acute disseminated encephalitis, myelitis and encephalomyelitis G04.2 Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified G04.30 Acute necrotizing hemorrhagic encephalopathy, unspecified G04.31 Postinfectious acute necrotizing hemorrhagic encephalopathy G04.32 Postimmunization acute necrotizing hemorrhagic encephalopathy G04.39 Other acute necrotizing hemorrhagic encephalopathy G04.81 Other encephalitis and encephalomyelitis G04.89 Other myelitis Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 6 of 82

7 G04.90 Encephalitis and encephalomyelitis, unspecified G04.91 Myelitis, unspecified G05.3 Encephalitis and encephalomyelitis in diseases classified elsewhere G05.4 Myelitis in diseases classified elsewhere G06.0 Intracranial abscess and granuloma G06.1 Intraspinal abscess and granuloma G06.2 Extradural and subdural abscess, unspecified G07 Intracranial and intraspinal abscess and granuloma in diseases classified elsewhere G08 Intracranial and intraspinal phlebitis and thrombophlebitis G21.0 Malignant neuroleptic syndrome G37.4 Subacute necrotizing myelitis of central nervous system G Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus G Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus G Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus G70.01 Myasthenia gravis with (acute) exacerbation G80.0 Spastic quadriplegic cerebral palsy G82.50 Quadriplegia, unspecified G82.51 Quadriplegia, C1 C4 complete G82.52 Quadriplegia, C1 C4 incomplete G82.53 Quadriplegia, C5 C7 complete G82.54 Quadriplegia, C5 C7 incomplete G83.5 Locked in state G92 Toxic encephalopathy G93.40 Encephalopathy, unspecified G93.41 Metabolic encephalopathy G93.49 Other encephalopathy G93.5 Compression of brain G93.6 Cerebral edema G93.7 Reye's syndrome G93.82 Brain death G95.11 Acute infarction of spinal cord (embolic) (nonembolic) G95.19 Other vascular myelopathies I21.01 ST elevation (STEMI) myocardial infarction involving left main coronary artery I21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall I21.21 ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery I21.29 ST elevation (STEMI) myocardial infarction involving other sites Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 7 of 82

8 I21.3 ST elevation (STEMI) myocardial infarction of unspecified site I21.4 Non ST elevation (NSTEMI) myocardial infarction I22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wall I22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wall I22.2 Subsequent non ST elevation (NSTEMI) myocardial infarction I22.8 Subsequent ST elevation (STEMI) myocardial infarction of other sites I22.9 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site I23.4 Rupture of chordae tendineae as current complication following acute myocardial infarction I23.5 Rupture of papillary muscle as current complication following acute myocardial infarction I25.42 Coronary artery dissection I26.01 Septic pulmonary embolism with acute cor pulmonale I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale I26.09 Other pulmonary embolism with acute cor pulmonale I26.90 Septic pulmonary embolism without acute cor pulmonale I26.92 Saddle embolus of pulmonary artery without acute cor pulmonale I26.99 Other pulmonary embolism without acute cor pulmonale I33.0 Acute and subacute infective endocarditis I33.9 Acute and subacute endocarditis, unspecified I40.0 Infective myocarditis I40.1 Isolated myocarditis I40.8 Other acute myocarditis I40.9 Acute myocarditis, unspecified I41 Myocarditis in diseases classified elsewhere I46.2 Cardiac arrest due to underlying cardiac condition I46.8 Cardiac arrest due to other underlying condition I46.9 Cardiac arrest, cause unspecified I49.01 Ventricular fibrillation I49.02 Ventricular flutter I50.21 Acute systolic (congestive) heart failure I50.23 Acute on chronic systolic (congestive) heart failure I50.31 Acute diastolic (congestive) heart failure I50.33 Acute on chronic diastolic (congestive) heart failure I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure I51.1 Rupture of chordae tendineae, not elsewhere classified I51.2 Rupture of papillary muscle, not elsewhere classified I60.00 Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation I60.01 Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation I60.02 Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 8 of 82

9 I60.10 Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery I60.11 Nontraumatic subarachnoid hemorrhage from right middle cerebral artery I60.12 Nontraumatic subarachnoid hemorrhage from left middle cerebral artery I60.20 Nontraumatic subarachnoid hemorrhage from unspecified anterior communicating artery I60.21 Nontraumatic subarachnoid hemorrhage from right anterior communicating artery I60.22 Nontraumatic subarachnoid hemorrhage from left anterior communicating artery I60.30 Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery I60.31 Nontraumatic subarachnoid hemorrhage from right posterior communicating artery I60.32 Nontraumatic subarachnoid hemorrhage from left posterior communicating artery I60.4 Nontraumatic subarachnoid hemorrhage from basilar artery I60.50 Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery I60.51 Nontraumatic subarachnoid hemorrhage from right vertebral artery I60.52 Nontraumatic subarachnoid hemorrhage from left vertebral artery I60.6 Nontraumatic subarachnoid hemorrhage from other intracranial arteries I60.7 Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery I60.8 Other nontraumatic subarachnoid hemorrhage I60.9 Nontraumatic subarachnoid hemorrhage, unspecified I61.0 Nontraumatic intracerebral hemorrhage in hemisphere, subcortical I61.1 Nontraumatic intracerebral hemorrhage in hemisphere, cortical I61.2 Nontraumatic intracerebral hemorrhage in hemisphere, unspecified I61.3 Nontraumatic intracerebral hemorrhage in brain stem I61.4 Nontraumatic intracerebral hemorrhage in cerebellum I61.5 Nontraumatic intracerebral hemorrhage, intraventricular I61.6 Nontraumatic intracerebral hemorrhage, multiple localized I61.8 Other nontraumatic intracerebral hemorrhage I61.9 Nontraumatic intracerebral hemorrhage, unspecified I62.00 Nontraumatic subdural hemorrhage, unspecified I62.01 Nontraumatic acute subdural hemorrhage I62.02 Nontraumatic subacute subdural hemorrhage I62.03 Nontraumatic chronic subdural hemorrhage I62.1 Nontraumatic extradural hemorrhage I63.00 Cerebral infarction due to thrombosis of unspecified precerebral artery I Cerebral infarction due to thrombosis of right vertebral artery I Cerebral infarction due to thrombosis of left vertebral artery I Cerebral infarction due to thrombosis of unspecified vertebral artery I63.02 Cerebral infarction due to thrombosis of basilar artery I Cerebral infarction due to thrombosis of right carotid artery I Cerebral infarction due to thrombosis of left carotid artery I Cerebral infarction due to thrombosis of unspecified carotid artery Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 9 of 82

10 I63.09 Cerebral infarction due to thrombosis of other precerebral artery I63.10 Cerebral infarction due to embolism of unspecified precerebral artery I Cerebral infarction due to embolism of right vertebral artery I Cerebral infarction due to embolism of left vertebral artery I Cerebral infarction due to embolism of unspecified vertebral artery I63.12 Cerebral infarction due to embolism of basilar artery I Cerebral infarction due to embolism of right carotid artery I Cerebral infarction due to embolism of left carotid artery I Cerebral infarction due to embolism of unspecified carotid artery I63.19 Cerebral infarction due to embolism of other precerebral artery I63.20 Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries I Cerebral infarction due to unspecified occlusion or stenosis of right vertebral arteries I Cerebral infarction due to unspecified occlusion or stenosis of left vertebral arteries I Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral arteries I63.22 Cerebral infarction due to unspecified occlusion or stenosis of basilar arteries I Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries I Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries I Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid arteries I63.29 Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries I63.30 Cerebral infarction due to thrombosis of unspecified cerebral artery I Cerebral infarction due to thrombosis of right middle cerebral artery I Cerebral infarction due to thrombosis of left middle cerebral artery I Cerebral infarction due to thrombosis of unspecified middle cerebral artery I Cerebral infarction due to thrombosis of right anterior cerebral artery I Cerebral infarction due to thrombosis of left anterior cerebral artery I Cerebral infarction due to thrombosis of unspecified anterior cerebral artery I Cerebral infarction due to thrombosis of right posterior cerebral artery I Cerebral infarction due to thrombosis of left posterior cerebral artery I Cerebral infarction due to thrombosis of unspecified posterior cerebral artery I Cerebral infarction due to thrombosis of right cerebellar artery I Cerebral infarction due to thrombosis of left cerebellar artery I Cerebral infarction due to thrombosis of unspecified cerebellar artery I63.39 Cerebral infarction due to thrombosis of other cerebral artery I63.40 Cerebral infarction due to embolism of unspecified cerebral artery I Cerebral infarction due to embolism of right middle cerebral artery I Cerebral infarction due to embolism of left middle cerebral artery I Cerebral infarction due to embolism of unspecified middle cerebral artery I Cerebral infarction due to embolism of right anterior cerebral artery I Cerebral infarction due to embolism of left anterior cerebral artery Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 10 of 82

11 I Cerebral infarction due to embolism of unspecified anterior cerebral artery I Cerebral infarction due to embolism of right posterior cerebral artery I Cerebral infarction due to embolism of left posterior cerebral artery I Cerebral infarction due to embolism of unspecified posterior cerebral artery I Cerebral infarction due to embolism of right cerebellar artery I Cerebral infarction due to embolism of left cerebellar artery I Cerebral infarction due to embolism of unspecified cerebellar artery I63.49 Cerebral infarction due to embolism of other cerebral artery I63.50 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery I Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery I Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery I Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery I63.59 Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery I63.6 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic I63.8 Other cerebral infarction I63.9 Cerebral infarction, unspecified I67.0 Dissection of cerebral arteries, nonruptured I67.83 Posterior reversible encephalopathy syndrome I71.00 Dissection of unspecified site of aorta I71.01 Dissection of thoracic aorta I71.02 Dissection of abdominal aorta I71.03 Dissection of thoracoabdominal aorta I71.1 Thoracic aortic aneurysm, ruptured I71.3 Abdominal aortic aneurysm, ruptured I71.5 Thoracoabdominal aortic aneurysm, ruptured I71.8 Aortic aneurysm of unspecified site, ruptured I74.01 Saddle embolus of abdominal aorta I77.71 Dissection of carotid artery I77.72 Dissection of iliac artery I77.73 Dissection of renal artery Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 11 of 82

12 I77.74 Dissection of vertebral artery I77.79 Dissection of other artery I81 Portal vein thrombosis I82.0 Budd Chiari syndrome I Acute embolism and thrombosis of inferior vena cava I Chronic embolism and thrombosis of inferior vena cava I85.01 Esophageal varices with bleeding I85.11 Secondary esophageal varices with bleeding J04.11 Acute tracheitis with obstruction J04.31 Supraglottitis, unspecified, with obstruction J05.11 Acute epiglottitis with obstruction J09.X1 Influenza due to identified novel influenza A virus with pneumonia J10.00 Influenza due to other identified influenza virus with unspecified type of pneumonia J10.01 Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia J10.08 Influenza due to other identified influenza virus with other specified pneumonia J11.00 Influenza due to unidentified influenza virus with unspecified type of pneumonia J11.08 Influenza due to unidentified influenza virus with specified pneumonia J12.0 Adenoviral pneumonia J12.1 Respiratory syncytial virus pneumonia J12.2 Parainfluenza virus pneumonia J12.3 Human metapneumovirus pneumonia J12.81 Pneumonia due to SARS associated coronavirus J12.89 Other viral pneumonia J12.9 Viral pneumonia, unspecified J13 Pneumonia due to Streptococcus pneumoniae J14 Pneumonia due to Hemophilus influenzae J15.0 Pneumonia due to Klebsiella pneumoniae J15.1 Pneumonia due to Pseudomonas J15.20 Pneumonia due to staphylococcus, unspecified J Pneumonia due to Methicillin susceptible Staphylococcus aureus J Pneumonia due to Methicillin resistant Staphylococcus aureus J15.29 Pneumonia due to other staphylococcus J15.3 Pneumonia due to streptococcus, group B J15.4 Pneumonia due to other streptococci J15.5 Pneumonia due to Escherichia coli J15.6 Pneumonia due to other aerobic Gram negative bacteria J15.7 Pneumonia due to Mycoplasma pneumoniae J15.8 Pneumonia due to other specified bacteria J15.9 Unspecified bacterial pneumonia Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 12 of 82

13 J16.0 Chlamydial pneumonia J16.8 Pneumonia due to other specified infectious organisms J17 Pneumonia in diseases classified elsewhere J18.0 Bronchopneumonia, unspecified organism J18.1 Lobar pneumonia, unspecified organism J18.8 Other pneumonia, unspecified organism J18.9 Pneumonia, unspecified organism J68.1 Pulmonary edema due to chemicals, gases, fumes and vapors J69.0 Pneumonitis due to inhalation of food and vomit J69.1 Pneumonitis due to inhalation of oils and essences J69.8 Pneumonitis due to inhalation of other solids and liquids J81.0 Acute pulmonary edema J84.81 Lymphangioleiomyomatosis J84.83 Surfactant mutations of the lung J Neuroendocrine cell hyperplasia of infancy J Pulmonary interstitial glycogenosis J Alveolar capillary dysplasia with vein misalignment J Other interstitial lung diseases of childhood J85.0 Gangrene and necrosis of lung J85.1 Abscess of lung with pneumonia J85.2 Abscess of lung without pneumonia J85.3 Abscess of mediastinum J86.0 Pyothorax with fistula J86.9 Pyothorax without fistula J93.0 Spontaneous tension pneumothorax J95.1 Acute pulmonary insufficiency following thoracic surgery J95.2 Acute pulmonary insufficiency following nonthoracic surgery J95.3 Chronic pulmonary insufficiency following surgery J Acute postprocedural respiratory failure J Acute and chronic postprocedural respiratory failure J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia J96.01 Acute respiratory failure with hypoxia J96.02 Acute respiratory failure with hypercapnia J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia J96.21 Acute and chronic respiratory failure with hypoxia J96.22 Acute and chronic respiratory failure with hypercapnia J96.90 Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia J96.91 Respiratory failure, unspecified with hypoxia J96.92 Respiratory failure, unspecified with hypercapnia Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 13 of 82

14 J98.5 Diseases of mediastinum, not elsewhere classified K22.11 Ulcer of esophagus with bleeding K22.3 Perforation of esophagus K22.6 Gastro esophageal laceration hemorrhage syndrome K25.0 Acute gastric ulcer with hemorrhage K25.1 Acute gastric ulcer with perforation K25.2 Acute gastric ulcer with both hemorrhage and perforation K25.4 Chronic or unspecified gastric ulcer with hemorrhage K25.5 Chronic or unspecified gastric ulcer with perforation K25.6 Chronic or unspecified gastric ulcer with both hemorrhage and perforation K26.0 Acute duodenal ulcer with hemorrhage K26.1 Acute duodenal ulcer with perforation K26.2 Acute duodenal ulcer with both hemorrhage and perforation K26.4 Chronic or unspecified duodenal ulcer with hemorrhage K26.5 Chronic or unspecified duodenal ulcer with perforation K26.6 Chronic or unspecified duodenal ulcer with both hemorrhage and perforation K27.0 Acute peptic ulcer, site unspecified, with hemorrhage K27.1 Acute peptic ulcer, site unspecified, with perforation K27.2 Acute peptic ulcer, site unspecified, with both hemorrhage and perforation K27.4 Chronic or unspecified peptic ulcer, site unspecified, with hemorrhage K27.5 Chronic or unspecified peptic ulcer, site unspecified, with perforation K27.6 Chronic or unspecified peptic ulcer, site unspecified, with both hemorrhage and perforation K28.0 Acute gastrojejunal ulcer with hemorrhage K28.1 Acute gastrojejunal ulcer with perforation K28.2 Acute gastrojejunal ulcer with both hemorrhage and perforation K28.4 Chronic or unspecified gastrojejunal ulcer with hemorrhage K28.5 Chronic or unspecified gastrojejunal ulcer with perforation K28.6 Chronic or unspecified gastrojejunal ulcer with both hemorrhage and perforation K29.01 Acute gastritis with bleeding K29.21 Alcoholic gastritis with bleeding K29.31 Chronic superficial gastritis with bleeding K29.41 Chronic atrophic gastritis with bleeding K29.51 Unspecified chronic gastritis with bleeding K29.61 Other gastritis with bleeding K29.71 Gastritis, unspecified, with bleeding K29.81 Duodenitis with bleeding K29.91 Gastroduodenitis, unspecified, with bleeding K Angiodysplasia of stomach and duodenum with bleeding K31.82 Dieulafoy lesion (hemorrhagic) of stomach and duodenum Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 14 of 82

15 K35.2 Acute appendicitis with generalized peritonitis K35.3 Acute appendicitis with localized peritonitis K40.10 Bilateral inguinal hernia, with gangrene, not specified as recurrent K40.11 Bilateral inguinal hernia, with gangrene, recurrent K40.40 Unilateral inguinal hernia, with gangrene, not specified as recurrent K40.41 Unilateral inguinal hernia, with gangrene, recurrent K41.10 Bilateral femoral hernia, with gangrene, not specified as recurrent K41.11 Bilateral femoral hernia, with gangrene, recurrent K41.40 Unilateral femoral hernia, with gangrene, not specified as recurrent K41.41 Unilateral femoral hernia, with gangrene, recurrent K42.1 Umbilical hernia with gangrene K43.1 Incisional hernia with gangrene K43.4 Parastomal hernia with gangrene K43.7 Other and unspecified ventral hernia with gangrene K44.1 Diaphragmatic hernia with gangrene K45.1 Other specified abdominal hernia with gangrene K46.1 Unspecified abdominal hernia with gangrene K55.0 Acute vascular disorders of intestine K55.21 Angiodysplasia of colon with hemorrhage K56.2 Volvulus K57.01 Diverticulitis of small intestine with perforation and abscess with bleeding K57.11 Diverticulosis of small intestine without perforation or abscess with bleeding K57.13 Diverticulitis of small intestine without perforation or abscess with bleeding K57.21 Diverticulitis of large intestine with perforation and abscess with bleeding K57.31 Diverticulosis of large intestine without perforation or abscess with bleeding K57.33 Diverticulitis of large intestine without perforation or abscess with bleeding K57.41 Diverticulitis of both small and large intestine with perforation and abscess with bleeding K57.51 Diverticulosis of both small and large intestine without perforation or abscess with bleeding K57.53 Diverticulitis of both small and large intestine without perforation or abscess with bleeding K57.81 Diverticulitis of intestine, part unspecified, with perforation and abscess with bleeding K57.91 Diverticulosis of intestine, part unspecified, without perforation or abscess with bleeding K57.93 Diverticulitis of intestine, part unspecified, without perforation or abscess with bleeding K63.1 Perforation of intestine (nontraumatic) K63.81 Dieulafoy lesion of intestine K65.0 Generalized (acute) peritonitis K65.1 Peritoneal abscess K65.2 Spontaneous bacterial peritonitis K65.3 Choleperitonitis K65.8 Other peritonitis Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 15 of 82

16 K65.9 Peritonitis, unspecified K66.1 Hemoperitoneum K67 Disorders of peritoneum in infectious diseases classified elsewhere K68.12 Psoas muscle abscess K68.19 Other retroperitoneal abscess K68.9 Other disorders of retroperitoneum K70.41 Alcoholic hepatic failure with coma K71.11 Toxic liver disease with hepatic necrosis, with coma K72.00 Acute and subacute hepatic failure without coma K72.01 Acute and subacute hepatic failure with coma K72.11 Chronic hepatic failure with coma K72.91 Hepatic failure, unspecified with coma K75.0 Abscess of liver K75.1 Phlebitis of portal vein K76.2 Central hemorrhagic necrosis of liver K76.3 Infarction of liver K76.7 Hepatorenal syndrome K80.67 Calculus of gallbladder and bile duct with acute and chronic cholecystitis with obstruction K82.2 Perforation of gallbladder K83.1 Obstruction of bile duct K83.2 Perforation of bile duct K85.0 Idiopathic acute pancreatitis K85.1 Biliary acute pancreatitis K85.2 Alcohol induced acute pancreatitis K85.3 Drug induced acute pancreatitis K85.8 Other acute pancreatitis K85.9 Acute pancreatitis, unspecified L Pressure ulcer of unspecified elbow, stage 3 L Pressure ulcer of unspecified elbow, stage 4 L Pressure ulcer of right elbow, stage 3 L Pressure ulcer of right elbow, stage 4 L Pressure ulcer of left elbow, stage 3 L Pressure ulcer of left elbow, stage 4 L Pressure ulcer of unspecified part of back, stage 3 L Pressure ulcer of unspecified part of back, stage 4 L Pressure ulcer of right upper back, stage 3 L Pressure ulcer of right upper back, stage 4 L Pressure ulcer of left upper back, stage 3 L Pressure ulcer of left upper back, stage 4 Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 16 of 82

17 L Pressure ulcer of right lower back, stage 3 L Pressure ulcer of right lower back, stage 4 L Pressure ulcer of left lower back, stage 3 L Pressure ulcer of left lower back, stage 4 L Pressure ulcer of sacral region, stage 3 L Pressure ulcer of sacral region, stage 4 L Pressure ulcer of unspecified hip, stage 3 L Pressure ulcer of unspecified hip, stage 4 L Pressure ulcer of right hip, stage 3 L Pressure ulcer of right hip, stage 4 L Pressure ulcer of left hip, stage 3 L Pressure ulcer of left hip, stage 4 L Pressure ulcer of unspecified buttock, stage 3 L Pressure ulcer of unspecified buttock, stage 4 L Pressure ulcer of right buttock, stage 3 L Pressure ulcer of right buttock, stage 4 L Pressure ulcer of left buttock, stage 3 L Pressure ulcer of left buttock, stage 4 L89.43 Pressure ulcer of contiguous site of back, buttock and hip, stage 3 L89.44 Pressure ulcer of contiguous site of back, buttock and hip, stage 4 L Pressure ulcer of unspecified ankle, stage 3 L Pressure ulcer of unspecified ankle, stage 4 L Pressure ulcer of right ankle, stage 3 L Pressure ulcer of right ankle, stage 4 L Pressure ulcer of left ankle, stage 3 L Pressure ulcer of left ankle, stage 4 L Pressure ulcer of unspecified heel, stage 3 L Pressure ulcer of unspecified heel, stage 4 L Pressure ulcer of right heel, stage 3 L Pressure ulcer of right heel, stage 4 L Pressure ulcer of left heel, stage 3 L Pressure ulcer of left heel, stage 4 L Pressure ulcer of head, stage 3 L Pressure ulcer of head, stage 4 L Pressure ulcer of other site, stage 3 L Pressure ulcer of other site, stage 4 L89.93 Pressure ulcer of unspecified site, stage 3 L89.94 Pressure ulcer of unspecified site, stage 4 M31.1 Thrombotic microangiopathy Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 17 of 82

18 M72.6 Necrotizing fasciitis N00.0 Acute nephritic syndrome with minor glomerular abnormality N00.1 Acute nephritic syndrome with focal and segmental glomerular lesions N00.2 Acute nephritic syndrome with diffuse membranous glomerulonephritis N00.3 Acute nephritic syndrome with diffuse mesangial proliferative glomerulonephritis N00.4 Acute nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis N00.5 Acute nephritic syndrome with diffuse mesangiocapillary glomerulonephritis N00.6 Acute nephritic syndrome with dense deposit disease N00.7 Acute nephritic syndrome with diffuse crescentic glomerulonephritis N00.8 Acute nephritic syndrome with other morphologic changes N00.9 Acute nephritic syndrome with unspecified morphologic changes N01.0 Rapidly progressive nephritic syndrome with minor glomerular abnormality N01.1 Rapidly progressive nephritic syndrome with focal and segmental glomerular lesions N01.2 Rapidly progressive nephritic syndrome with diffuse membranous glomerulonephritis N01.3 Rapidly progressive nephritic syndrome with diffuse mesangial proliferative glomerulonephritis N01.4 Rapidly progressive nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis N01.5 Rapidly progressive nephritic syndrome with diffuse mesangiocapillary glomerulonephritis N01.6 Rapidly progressive nephritic syndrome with dense deposit disease N01.7 Rapidly progressive nephritic syndrome with diffuse crescentic glomerulonephritis N01.8 Rapidly progressive nephritic syndrome with other morphologic changes N01.9 Rapidly progressive nephritic syndrome with unspecified morphologic changes N15.1 Renal and perinephric abscess N17.0 Acute kidney failure with tubular necrosis N17.1 Acute kidney failure with acute cortical necrosis N17.2 Acute kidney failure with medullary necrosis N18.6 End stage renal disease N73.3 Female acute pelvic peritonitis O03.2 Embolism following incomplete spontaneous abortion O03.31 Shock following incomplete spontaneous abortion O03.32 Renal failure following incomplete spontaneous abortion O03.81 Shock following complete or unspecified spontaneous abortion O03.82 Renal failure following complete or unspecified spontaneous abortion O04.7 Embolism following (induced) termination of pregnancy O04.81 Shock following (induced) termination of pregnancy O04.82 Renal failure following (induced) termination of pregnancy O07.2 Embolism following failed attempted termination of pregnancy O07.31 Shock following failed attempted termination of pregnancy O07.32 Renal failure following failed attempted termination of pregnancy O08.2 Embolism following ectopic and molar pregnancy Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 18 of 82

19 O08.3 Shock following ectopic and molar pregnancy O08.4 Renal failure following ectopic and molar pregnancy O10.42 Pre existing secondary hypertension complicating childbirth O11.1 Pre existing hypertension with pre eclampsia, first trimester O11.2 Pre existing hypertension with pre eclampsia, second trimester O11.3 Pre existing hypertension with pre eclampsia, third trimester O14.12 Severe pre eclampsia, second trimester O14.13 Severe pre eclampsia, third trimester O14.22 HELLP syndrome (HELLP), second trimester O14.23 HELLP syndrome (HELLP), third trimester O15.02 Eclampsia in pregnancy, second trimester O15.03 Eclampsia in pregnancy, third trimester O15.1 Eclampsia in labor O15.2 Eclampsia in the puerperium O22.31 Deep phlebothrombosis in pregnancy, first trimester O22.32 Deep phlebothrombosis in pregnancy, second trimester O22.33 Deep phlebothrombosis in pregnancy, third trimester O24.02 Pre existing diabetes mellitus, type 1, in childbirth O24.12 Pre existing diabetes mellitus, type 2, in childbirth O24.32 Unspecified pre existing diabetes mellitus in childbirth O24.82 Other pre existing diabetes mellitus in childbirth O34.31 Maternal care for cervical incompetence, first trimester O34.32 Maternal care for cervical incompetence, second trimester O34.33 Maternal care for cervical incompetence, third trimester O Infection of amniotic sac and membranes, unspecified, first trimester, not applicable or unspecified O Infection of amniotic sac and membranes, unspecified, first trimester, fetus 1 O Infection of amniotic sac and membranes, unspecified, first trimester, fetus 2 O Infection of amniotic sac and membranes, unspecified, first trimester, fetus 3 O Infection of amniotic sac and membranes, unspecified, first trimester, fetus 4 O Infection of amniotic sac and membranes, unspecified, first trimester, fetus 5 O Infection of amniotic sac and membranes, unspecified, first trimester, other fetus O Infection of amniotic sac and membranes, unspecified, second trimester, not applicable or unspecified O Infection of amniotic sac and membranes, unspecified, second trimester, fetus 1 O Infection of amniotic sac and membranes, unspecified, second trimester, fetus 2 O Infection of amniotic sac and membranes, unspecified, second trimester, fetus 3 O Infection of amniotic sac and membranes, unspecified, second trimester, fetus 4 O Infection of amniotic sac and membranes, unspecified, second trimester, fetus 5 O Infection of amniotic sac and membranes, unspecified, second trimester, other fetus O Infection of amniotic sac and membranes, unspecified, third trimester, not applicable or unspecified Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 19 of 82

20 O Infection of amniotic sac and membranes, unspecified, third trimester, fetus 1 O Infection of amniotic sac and membranes, unspecified, third trimester, fetus 2 O Infection of amniotic sac and membranes, unspecified, third trimester, fetus 3 O Infection of amniotic sac and membranes, unspecified, third trimester, fetus 4 O Infection of amniotic sac and membranes, unspecified, third trimester, fetus 5 O Infection of amniotic sac and membranes, unspecified, third trimester, other fetus O Chorioamnionitis, first trimester, not applicable or unspecified O Chorioamnionitis, first trimester, fetus 1 O Chorioamnionitis, first trimester, fetus 2 O Chorioamnionitis, first trimester, fetus 3 O Chorioamnionitis, first trimester, fetus 4 O Chorioamnionitis, first trimester, fetus 5 O Chorioamnionitis, first trimester, other fetus O Chorioamnionitis, second trimester, not applicable or unspecified O Chorioamnionitis, second trimester, fetus 1 O Chorioamnionitis, second trimester, fetus 2 O Chorioamnionitis, second trimester, fetus 3 O Chorioamnionitis, second trimester, fetus 4 O Chorioamnionitis, second trimester, fetus 5 O Chorioamnionitis, second trimester, other fetus O Chorioamnionitis, third trimester, not applicable or unspecified O Chorioamnionitis, third trimester, fetus 1 O Chorioamnionitis, third trimester, fetus 2 O Chorioamnionitis, third trimester, fetus 3 O Chorioamnionitis, third trimester, fetus 4 O Chorioamnionitis, third trimester, fetus 5 O Chorioamnionitis, third trimester, other fetus O Placentitis, first trimester, not applicable or unspecified O Placentitis, first trimester, fetus 1 O Placentitis, first trimester, fetus 2 O Placentitis, first trimester, fetus 3 O Placentitis, first trimester, fetus 4 O Placentitis, first trimester, fetus 5 O Placentitis, first trimester, other fetus O Placentitis, second trimester, not applicable or unspecified O Placentitis, second trimester, fetus 1 O Placentitis, second trimester, fetus 2 O Placentitis, second trimester, fetus 3 O Placentitis, second trimester, fetus 4 Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 20 of 82

21 O Placentitis, second trimester, fetus 5 O Placentitis, second trimester, other fetus O Placentitis, third trimester, not applicable or unspecified O Placentitis, third trimester, fetus 1 O Placentitis, third trimester, fetus 2 O Placentitis, third trimester, fetus 3 O Placentitis, third trimester, fetus 4 O Placentitis, third trimester, fetus 5 O Placentitis, third trimester, other fetus O44.11 Placenta previa with hemorrhage, first trimester O44.12 Placenta previa with hemorrhage, second trimester O44.13 Placenta previa with hemorrhage, third trimester O Premature separation of placenta with coagulation defect, unspecified, first trimester O Premature separation of placenta with coagulation defect, unspecified, second trimester O Premature separation of placenta with coagulation defect, unspecified, third trimester O Premature separation of placenta with afibrinogenemia, first trimester O Premature separation of placenta with afibrinogenemia, second trimester O Premature separation of placenta with afibrinogenemia, third trimester O Premature separation of placenta with disseminated intravascular coagulation, first trimester O Premature separation of placenta with disseminated intravascular coagulation, second trimester O Premature separation of placenta with disseminated intravascular coagulation, third trimester O Premature separation of placenta with other coagulation defect, first trimester O Premature separation of placenta with other coagulation defect, second trimester O Premature separation of placenta with other coagulation defect, third trimester O45.8X1 Other premature separation of placenta, first trimester O45.8X2 Other premature separation of placenta, second trimester O45.8X3 Other premature separation of placenta, third trimester O45.91 Premature separation of placenta, unspecified, first trimester O45.92 Premature separation of placenta, unspecified, second trimester O45.93 Premature separation of placenta, unspecified, third trimester O Antepartum hemorrhage with coagulation defect, unspecified, first trimester O Antepartum hemorrhage with coagulation defect, unspecified, second trimester O Antepartum hemorrhage with coagulation defect, unspecified, third trimester O Antepartum hemorrhage with afibrinogenemia, first trimester O Antepartum hemorrhage with afibrinogenemia, second trimester O Antepartum hemorrhage with afibrinogenemia, third trimester O Antepartum hemorrhage with disseminated intravascular coagulation, first trimester O Antepartum hemorrhage with disseminated intravascular coagulation, second trimester O Antepartum hemorrhage with disseminated intravascular coagulation, third trimester Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 21 of 82

22 O Antepartum hemorrhage with other coagulation defect, first trimester O Antepartum hemorrhage with other coagulation defect, second trimester O Antepartum hemorrhage with other coagulation defect, third trimester O60.02 Preterm labor without delivery, second trimester O60.03 Preterm labor without delivery, third trimester O60.12X0 Preterm labor second trimester with preterm delivery second trimester, not applicable or unspecified O60.12X1 Preterm labor second trimester with preterm delivery second trimester, fetus 1 O60.12X2 Preterm labor second trimester with preterm delivery second trimester, fetus 2 O60.12X3 Preterm labor second trimester with preterm delivery second trimester, fetus 3 O60.12X4 Preterm labor second trimester with preterm delivery second trimester, fetus 4 O60.12X5 Preterm labor second trimester with preterm delivery second trimester, fetus 5 O60.12X9 Preterm labor second trimester with preterm delivery second trimester, other fetus O60.13X0 Preterm labor second trimester with preterm delivery third trimester, not applicable or unspecified O60.13X1 Preterm labor second trimester with preterm delivery third trimester, fetus 1 O60.13X2 Preterm labor second trimester with preterm delivery third trimester, fetus 2 O60.13X3 Preterm labor second trimester with preterm delivery third trimester, fetus 3 O60.13X4 Preterm labor second trimester with preterm delivery third trimester, fetus 4 O60.13X5 Preterm labor second trimester with preterm delivery third trimester, fetus 5 O60.13X9 Preterm labor second trimester with preterm delivery third trimester, other fetus O60.14X0 Preterm labor third trimester with preterm delivery third trimester, not applicable or unspecified O60.14X1 Preterm labor third trimester with preterm delivery third trimester, fetus 1 O60.14X2 Preterm labor third trimester with preterm delivery third trimester, fetus 2 O60.14X3 Preterm labor third trimester with preterm delivery third trimester, fetus 3 O60.14X4 Preterm labor third trimester with preterm delivery third trimester, fetus 4 O60.14X5 Preterm labor third trimester with preterm delivery third trimester, fetus 5 O60.14X9 Preterm labor third trimester with preterm delivery third trimester, other fetus O60.22X0 Term delivery with preterm labor, second trimester, not applicable or unspecified O60.22X1 Term delivery with preterm labor, second trimester, fetus 1 O60.22X2 Term delivery with preterm labor, second trimester, fetus 2 O60.22X3 Term delivery with preterm labor, second trimester, fetus 3 O60.22X4 Term delivery with preterm labor, second trimester, fetus 4 O60.22X5 Term delivery with preterm labor, second trimester, fetus 5 O60.22X9 Term delivery with preterm labor, second trimester, other fetus O60.23X0 Term delivery with preterm labor, third trimester, not applicable or unspecified O60.23X1 Term delivery with preterm labor, third trimester, fetus 1 O60.23X2 Term delivery with preterm labor, third trimester, fetus 2 O60.23X3 Term delivery with preterm labor, third trimester, fetus 3 O60.23X4 Term delivery with preterm labor, third trimester, fetus 4 O60.23X5 Term delivery with preterm labor, third trimester, fetus 5 Table 6I Major Complications or Comorbidities (MCC) List FY 2016 Page 22 of 82