Texas Medicaid & Healthcare Partnership

Transcription

1 October 1, 2006 Texas Medicaid & Healthcare Partnership Dear Texas Medicaid Provider: The enclosed information entitled 2007 ICD-9-CM GROUPER Version 24 provides GROUPER and Diagnosis Related Group () information based on the following publications: Federal Register Vol. 71, No. 160, August 18, International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) The enclosed document also provides information regarding Texas Medicaid relative weights, mean length of stay, and day thresholds, which is effective for admission dates occurring on and after October 1, Additional information concerning 2007 ICD 9-CM updates and information will be made available in the November/December 2006 edition of the Texas Medicaid Bulletin, the November 2006 edition of the Children with Special Health Care Needs (CSHCN) Bulletin, and on the Texas Medicaid & Healthcare Partnership (TMHP) website at. Please carefully review and distribute this information to the appropriate personnel at your facility. Thank you for your participation in the Texas Medicaid Program. If we can be of further assistance in this matter, you may call the TMHP Customer Service Provider Helpline, toll free, at Sincerely, Texas Medicaid & Healthcare Partnership

2 2007 ICD-9-CM GROUPER Version 24 CMS Changes Overview Each year, the Centers for Medicare & Medicaid Services (CMS) issue its changes to the hospital inpatient prospective payment system and new fiscal year rates. These changes result in new, revised, or invalid diagnosis codes, procedure codes, diagnosis related groups (s), and major diagnostic categories (MDCs), published annually in the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). In Federal Register Vol. 71, No. 160, August 18, 2006, CMS outlined changes to the current classifications for GROUPER Version 24. The changes outlined in this document are effective for Texas Medicaid admission dates on or after October 1, New s New s involving 13 different clinical areas were identified and found to improve the CMS system s recognition of severity of illness. Twelve of the new s are medical and eight are surgical. These s are constructed through a combination of approaches used in the proposed CMS s to refine the base s such as: Subdividing existing s through the use of diagnosis codes. Subdividing s based on specific surgical procedures. Selecting cases with specific diagnosis and/or procedure codes and assigning them to a new which better accounts for their resource use and severity. MDC Affiliation MDC 1 Nervous System) 560 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM MDC 1 Nervous System) MDC 1 Nervous System) MDC 1 Nervous System) MDC NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS 562 SEIZURE AGE > 17 W 563 SEIZURE AGE > 17 W/O 564 HEADACHES AGE > 17

3 MDC Affiliation Nervous System) MDC 4 Respiratory System): Respiratory System Diagnosis With Ventilator Support MDC 4 Respiratory System): Respiratory System Diagnosis With Ventilator Support MDC 6 Digestive System) MDC 6 Digestive System) MDC 6 (Diseases and Digestive System) MDC 6 Digestive System) MDC 6 Digestive System) MDC 6 Digestive System) MDC 11 Kidney and Urinary Tract): Major 565 RESPIRATORY STSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS 566 RESPIRATORY STSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96< HOURS 567 STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W W MAJOR GI DX 568 STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W/O W MAJOR GI DX 569 SURG MAJOR SMALL & LARGE BOWEL PROCEDURES W W MAJOR GI 570 SURG MAJOR SMALL & LARGE BOWEL PROCEDURES W W/O MAJOR GI DX 571 MED MAJOR ESOPHAGEAL DISORDERS 572 MED MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS 573 SURG MAJOR BLADDER PROCEDURES

4 MDC Affiliation Bladder Procedures MDC 16 Blood and Blood Forming Organs and Immunological Disorders): Major Hematological and Immunological Diagnoses MDC 18 (Infections and Parasitic Diseases (Systemic or Unspecified Sites)): O.R. Procedure for Patients With Infectious and Parasitic Diseases MDC 18 (Infections and Parasitic Diseases (Systemic or Unspecified Sites)): O.R. Procedure for Patients With Infectious and Parasitic Diseases MDC 1 Nervous System) MDC 18 (Infections and Parasitic Diseases (Systemic or Unspecified Sites)): O.R. Procedure for Patients With Infectious and Parasitic Diseases MDC 18 (Infections and Parasitic Diseases (Systemic or Unspecified Sites)): 574 MED MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL CMS also assigned the following new ICD-9-CM diagnosis codes to new 574: , , , , , , , and MED SEPTICEMIA W MV96+ HOURS AGE > MED SEPTICEMIA W/O MV96+ HOURS AGE > SURG CAROTID ARTERY STENT PROCEDURE 578 SURG INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE SURG POSTOPERATIVE OR POSTTRAUMATIC INFECTIONS W OR PROCEDURE

5 MDC Affiliation O.R. Procedure for Patients With Infectious and Parasitic Diseases Revised s The following existing s were modified to better capture differences in severity. MDC Affiliation Previous New LTC- 386 : EXTREME IMMATURITY CMS revised the s description: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE Pre-MDC 541 : TRACHEOSTOMY WITH MECHANICAL VENTILATION 96+ HOURS OR PRINCIPAL DIAGNOSIS EXEPT FACE, MOUTH AND NECK DIAGNOSES WITH MAJOR O.R. PROCEDURE CMS revised the s description: ECMO OR TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. MDC 1 Nervous System) Implantation of Intracranial Neurostimulator System for Deep Brain Stimulation (DBS) MDC 1 Nervous System) Carotid Artery Stents 543 : CRANIOTOMY WITH IMPLANTATION OF CHEMOTHERAPEUTIC AGENT OR ACUTE COMPLEX CENTRAL NERVOUS SYSTEM PRINCIPAL DIAGNOSIS 547 : PERCUTANEOUS CARDIOVASCULAR PROCEDURE WITH AMI WITH CMS revised the s description: CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX CMS revised the s description: CORONARY BYPASS W CARDIAC CATH W MAJOR CV DX LTC- 548 : PERCUTANEOUS CARDIOVASCULAR PROCEDURE WITH AMI WITHOUT CMS revised the s description: CORONARY BYPASS W CARDIAC CATH W/O MAJOR CV DX MDC 6 Digestive System) CMS created new 571 with the following ICD 9 CM diagnosis codes (removing them from s 174, 175, 182, 183, 184, 188, 189, and 190): , , , , , , , , 456.0, 456.1, , 530.4, 530.7, , ,

6 MDC Affiliation Previous New , 750.4, , and CMS also created new 572 with the following ICD 9 CM diagnosis codes (removing them from s 182, 183, 184, 188, 189, and 190): 001.0, 001.1, 001.9, 003.0, 004.0, 004.1, 004.2, 004.3, 004.8, 004.9, 005.0, 005.2, 005.3, 005.4, , , 006.0, 006.1, 006.2, 007.0, and MDC 11 Kidney and Urinary Tract): Major Bladder Procedures MDC 16 Blood and Blood Forming Organs and Immunological Disorders): Major Hematological and Immunological Diagnoses Pre-MDC Heart Transplant or Implant of Heart Assist System: Addition of Procedure to The implantation and removal of an external heart assist device in the same hospitalization was grouped to 103. CMS created new descriptions for the following s: Kidney and Ureter Procedures for Neoplasm Kidney and Ureter Procedures for Non-Neoplasm With Kidney and Ureter Procedures for Non-Neoplasm Without CMS also removed the following procedure codes from , 308, and 309 and assigned them to new 573: 57.6, 57.71, 57.79, 57.83, 57.84, 57.85, 57.86, 57.87, 57.88, and CMS created new 574 with the following ICD 9 CM diagnosis codes (removing them from s 395, 396, 398, and 399): , , , , 279.2, 283.0, , , 283.2, 2839, 284.8, 284.9, 288.1, 288.2, and CMS also assigned the following new ICD-9-CM diagnosis codes to new 574: , , , , , , , and CMS has reconfigured 103 in the following manner: Those patients who have both the replacement of an external heart assist system (code 37.63) and the explanation of that system (code 37.64) prior to the hospital discharge will be assigned to 103.

7 MDC Affiliation Previous New Pre-MDC Pancreas Transplants 513 The following ICD-9-CM diagnosis codes are currently required as a principal or secondary diagnosis for 513: , , , , , , , , 585.1, 585.2, 585.3, 585.4, 585.5, 585.6, 585.9, V42.0, and V Texas Medicaid & Healthcare Partnership CMS has modified the logic for principal and secondary diagnosis designations for 513. Therefore, the following ICD-9-CM diagnosis codes will no longer be required as a principal or secondary diagnosis for 513: , , , , , , , , 585.1, 585.2, 585.3, 585.4, 585.5, 585.6, 585.9, V42.0, and V MDC 5 Circulatory System) Insertion of Epicardial Leads for Defibrillator Devices CMS has added the following combinations of device and lead procedure codes to s 515, 535, and 536: code and code 00.54; code and code 37.96; and code and code Other Issues: Chronic Kidney Disease The following ICD-9-CM diagnosis codes were being classified to s 331, 332, and 333 in MDC 11 (Diseases and Kidney and Urinary Tract): , , and The three ICD-9-CM diagnosis codes (403.00, , and ) were modified to include the concept of chronic kidney disease. As such, CMS assigned these ICD-9-CM diagnosis codes to 315 (Other Kidney and Urinary Tract Procedures) and 316 (Renal Failure), and not to s 331 through 333. Discontinued s 8 existing s were deleted based on the additions and modifications to s. MDC Affiliation New MDC 1 Disorders of the Nervous System) 020 NERVOUS SYSTEM INFECTION EXCEPT VIRAL MENINGITIS 560 (new) 561 (new) MDC 1 Disorders of the Nervous System) MDC 1 Disorders of the Nervous System) MDC 6 Disorders of the Digestive System) 024 SEIZURE & HEADACHE AGE >17 W 025 SEIZURE & HEADACHE AGE >17 W/O 148 MAJOR SMALL & LARGE BOWEL PROCEDURES W 562 (new) 563 (new) 564 (new) 569 (new) 570 (new)

8 MDC Affiliation New MDC 6 Disorders of the Digestive System) 154 STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W Texas Medicaid & Healthcare Partnership 567 (new) 568 (new) MDC 18 (Infections and Parasitic Diseases (Systemic or Unspecified Sites)): O.R. Procedure for Patients With Infectious and Parasitic Diseases 415 O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES 578 (new) 579 (new) MDC 18 (Infections and Parasitic Diseases (Systemic or Unspecified Sites)): O.R. Procedure for Patients With Infectious and Parasitic Diseases Infectious and Parasitic Diseases 416 SEPTICEMIA AGE > (new) 576 (new) MDC 4 Disorders of the Respiratory System): Respiratory System Diagnosis With Ventilator Support 475 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 565 (new) 566 (new)

9 MDC Changes In addition, due to the 8 deleted s and 20 new s, CMS has reordered the following s in MDC 1 disorders of the Nervous System), MDC 6 Digestive System), MDC 11 Kidney and urinary Tract), and MDC 18 (Infectious and Parasitic Diseases (Systemic or Unspecified Sites)): In MDC 1, CMS has reordered 577 (Carotid Artery Stent Procedure) above 533 (Extracranial Procedures With ). In MDC 6, CMS has reordered s 567 and 568 (Stomach, Esophageal and Duodenal Procedures Age >17 With With and Without Major GI Diagnoses, respectively) above 155 (Stomach, Esophageal and Duodenal Procedures Age >17 Without ). In MDC 6, CMS has reordered s (Major Small and Large Bowel Procedures With With and Without Major GI Diagnoses, respectively) above 149 (Major Small and Large Bowel Procedures Without ). In MDC 11, CMS has reordered 573 (Major Bladder Procedures) above 303 (Kidney, Ureter and Major Bladder Procedures for Neoplasm). In MDC 18, CMS has reordered 578 (Infections and Parasite DiseasesWith O.R. Procedure) above 579 (Postoperative or Post-Traumatic Infections With O.R. Procedure). Additional CMS Reclassification for GROUPER Version 24 More information regarding the final rules of CMS reclassifications can be found in Federal Register Vol. 71, No. 160, August 18, 2006.

10 Texas Medicaid Information The following information is effective for Texas Medicaid inpatient admissions with date of service October 1, 2006 and after. 001 CRANIOTOMY AGE >17 W CRANIOTOMY AGE > 17 W/O CRANIOTOMY AGE INVALID INVALID CARPAL TUNNEL RELEASE PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W 008 PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O 009 SPINAL DISORDERS & INJURIES NERVOUS SYSTEM NEOPLASMS W NERVOUS SYSTEM NEOPLASMS W/O DEGENERATIVE NERVOUS SYSTEM DISORDERS MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION 015 NONSPECIFIC CVA & PRECEREBRAL OLUSION W/O INFARCT 016 NONSPECIFIC CEREBROVASCULAR DISORDERS W 017 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O 018 CRANIAL & PERIPHERAL NERVE DISORDERS W CRANIAL & PERIPHERAL NERVE DISORDERS W/O 020 INVALID VIRAL MENINGITIS HYPERTENSIVE ENCEPHALOPATHY NONTRAUMATIC STUPOR & COMA INVALID INVALID SEIZURE & HEADACHE AGE TRAUMATIC STUPOR & COMA, COMA >1 HR TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W 029 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O 030 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE CONCUSSION AGE >17 W

11 032 CONCUSSION AGE >17 W/O CONCUSSION AGE OTHER DISORDERS OF NERVOUS SYSTEM W OTHER DISORDERS OF NERVOUS SYSTEM W/O RETINAL PROCEDURES ORBITAL PROCEDURES PRIMARY IRIS PROCEDURES LENS PROCEDURES WITH OR WITHOUT VITRECTOMY 040 EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE > EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS 043 HYPHEMA ACUTE MAJOR EYE INFECTIONS NEUROLOGICAL EYE DISORDERS OTHER DISORDERS OF THE EYE AGE >17 W OTHER DISORDERS OF THE EYE AGE >17 W/O OTHER DISORDERS OF THE EYE AGE MAJOR HEAD & NECK PROCEDURES SIALOADENECTOMY SALIVARY GLAND PROCEDURES EXCEPT SIALOADENECTOMY 052 CLEFT LIP & PALATE REPAIR SINUS & MASTOID PROCEDURES AGE > SINUS & MASTOID PROCEDURES AGE MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES 056 RHINOPLASTY T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE > T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE > TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE MYRINGOTOMY W TUBE INSERTION AGE > MYRINGOTOMY W TUBE INSERTION AGE OTHER EAR, NOSE, MOUTH & THROAT O.R PROCEDURES 064 EAR, NOSE, MOUTH & THROAT MALIGNANCY

12 065 DYSEQUILIBRIUM EPISTAXIS EPIGLOTTITIS OTITIS MEDIA & URI AGE >17 W OTITIS MEDIA & URI AGE >17 W/O OTITIS MEDIA & URI AGE LARYNGOTRACHEITIS NASAL TRAUMA & DEFORMITY OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE > OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE MAJOR CHEST PROCEDURES OTHER RESP SYSTEM O.R. PROCEDURES W OTHER RESP SYSTEM O.R. PROCEDURES W/O PULMONARY EMBOLISM RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W 080 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O 081 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE RESPIRATORY NEOPLASMS MAJOR CHEST TRAUMA W MAJOR CHEST TRAUMA W/O PLEURAL EFFUSION W PLEURAL EFFUSION W/O PULMONARY EDEMA & RESPIRATORY FAILURE CHRONIC OBSTRUCTIVE PULMONARY DISEASE SIMPLE PNEUMONIA & PLEURISY AGE >17 W SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O SIMPLE PNEUMONIA & PLEURISY AGE INTERSTITIAL LUNG DISEASE W INTERSTITIAL LUNG DISEASE W/O PNEUMOTHORAX W PNEUMOTHORAX W/O BRONCHITIS & ASTHMA AGE >17 W BRONCHITIS & ASTHMA AGE >17 W/O BRONCHITIS & ASTHMA AGE RESPIRATORY SIGNS & SYMPTOMS W RESPIRATORY SIGNS & SYMPTOMS W/O OTHER RESPIRATORY SYSTEM DIAGNOSES W

13 102 OTHER RESPIRATORY SYSTEM DIAGNOSES W/O 103 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM 104 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH 105 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH 106 CORONARY BYPASS WITH PTCA INVALID OTHER CARDIOTHORACIC PROCEDURES INVALID MAJOR CARDIOVASCULAR PROCEDURES W MAJOR CARDIOVASCULAR PROCEDURES W/O INVALID AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE 114 UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS 115 INVALID INVALID CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT 118 CARDIAC PACEMAKER DEVICE REPLACEMENT VEIN LIGATION & STRIPPING OTHER CIRCULATORY SYSTEM O.R PROCEDURES 121 CIRCULATORY DISORDERS W AMI & MAJOR COMP DISCH ALIVE 122 CIRCULATORY DISORDERS W AMI W/O MAJOR COMP DISCH ALIVE 123 CIRCULATORY DISORDERS W AMI, EXPIRED CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG 125 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG 126 ACUTE & SUBACUTE ENDOCARDITIS HEART FAILURE & SHOCK DEEP VEIN THROMBOPHLEBITIS CARDIAC ARREST, UNEXPLAINED PERIPHERAL VASCULAR DISORDERS W PERIPHERAL VASCULAR DISORDERS W/O ATHEROSCLEROSIS W ATHEROSCLEROSIS W/O HYPERTENSION CARDIAC CONGENITAL & VALVULAR

14 DISORDERS AGE >17 W 136 CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W/O 137 CARDIAC CONGENITAL & VALVULAR DISORDERS AGE CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W 139 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O 140 ANGINA PECTORIS SYNCOPE & COLLAPSE W SYNCOPE & COLLAPSE W/O CHEST PAIN OTHER CIRCULATORY SYSTEM DIAGNOSES W OTHER CIRCULATORY SYSTEM DIAGNOSES W/O 146 RECTAL RESECTION W RECTAL RESECTION W/O INVALID MAJOR SMALL & LARGE BOWEL PROCEDURES W/O 150 PERITONEAL ADHESIOLYSIS W PERITONEAL ADHESIOLYSIS W/O MINOR SMALL & LARGE BOWEL PROCEDURES W 153 MINOR SMALL & LARGE BOWEL PROCEDURES W/O 154 INVALID STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O 156 STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE ANAL & STOMAL PROCEDURES W ANAL & STOMAL PROCEDURES W/O HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W 160 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O 161 INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W 162 INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W/O 163 HERNIA PROCEDURES AGE APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W 165 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O 166 APPENDECTOMY W/O COMPLICATED PRINCIPAL

15 DIAG W 167 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O 168 MOUTH PROCEDURES W MOUTH PROCEDURES W/O OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W 171 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O 172 DIGESTIVE MALIGNANCY W DIGESTIVE MALIGNANCY W/O G.I. HEMORRHAGE W G.I. HEMORRHAGE W/O COMPLICATED PEPTIC ULCER UNCOMPLICATED PEPTIC ULCER W UNCOMPLICATED PEPTIC ULCER W/O INFLAMMATORY BOWEL DISEASE G.I. OBSTRUCTION W G.I. OBSTRUCTION W/O ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W 183 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O 184 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE > DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE DENTAL EXTRACTIONS & RESTORATIONS OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W 189 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O 190 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE PANCREAS, LIVER & SHUNT PROCEDURES W PANCREAS, LIVER & SHUNT PROCEDURES W/O BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W 194 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O 195 CHOLECYSTECTOMY W C.D.E. W CHOLECYSTECTOMY W C.D.E. W/O CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W

16 198 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O 199 HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR MALIGNANCY 200 HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY 201 OTHER HEPATOBILIARY OR PANCREAS O.R PROCEDURES 202 CIRRHOSIS & ALCOHOLIC HEPATITIS MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS 204 DISORDERS OF PANCREAS EXCEPT MALIGNANCY 205 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W 206 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O 207 DISORDERS OF THE BILIARY TRACT W DISORDERS OF THE BILIARY TRACT W/O INVALID HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W 211 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O 212 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS 214 INVALID INVALID BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 217 WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS 218 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W 219 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O 220 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE INVALID INVALID MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W 224 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O 225 FOOT PROCEDURES SOFT TISSUE PROCEDURES W SOFT TISSUE PROCEDURES W/O

17 228 MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W 229 HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O 230 LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR 231 INVALID ARTHROSCOPY OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W 234 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O 235 FRACTURES OF FEMUR FRACTURES OF HIP & PELVIS SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH 238 OSTEOMYELITIS PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY 240 CONNECTIVE TISSUE DISORDERS W CONNECTIVE TISSUE DISORDERS W/O SEPTIC ARTHRITIS MEDICAL BACK PROBLEMS BONE DISEASES & SPECIFIC ARTHROPATHIES W 245 BONE DISEASES & SPECIFIC ARTHROPATHIES W/O 246 NON-SPECIFIC ARTHROPATHIES SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE 248 TENDONITIS, MYOSITIS & BURSITIS AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 250 FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W 251 FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O 252 FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W 254 FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O 255 FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES 257 TOTAL MASTECTOMY FOR MALIGNANCY W TOTAL MASTECTOMY FOR MALIGNANCY W/O

18 259 SUBTOTAL MASTECTOMY FOR MALIGNANCY W SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O 261 BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION 262 BREAST BIOPSY & LOCAL EXCISION FOR NON MALIGNANCY 263 SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W 264 SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O 265 SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W 266 SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O 267 PERIANAL & PILONIDAL PROCEDURES SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES 269 OTHER SKIN, SUBCUT TISS & BREAST PROC W OTHER SKIN, SUBCUT TISS & BREAST PROC W/O 271 SKIN ULCERS MAJOR SKIN DISORDERS W MAJOR SKIN DISORDERS W/O MALIGNANT BREAST DISORDERS W MALIGNANT BREAST DISORDERS W/O NON-MALIGANT BREAST DISORDERS CELLULITIS AGE >17 W CELLULITIS AGE >17 W/O CELLULITIS AGE TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W 281 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O 282 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE MINOR SKIN DISORDERS W MINOR SKIN DISORDERS W/O AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS 286 ADRENAL & PITUITARY PROCEDURES SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS 288 O.R. PROCEDURES FOR OBESITY PARATHYROID PROCEDURES

19 290 THYROID PROCEDURES THYROGLOSSAL PROCEDURES OTHER ENDOCRINE, NUTRIT & METAB O.R PROC W 293 OTHER ENDOCRINE, NUTRIT & METAB O.R PROC W/O 294 DIABETES AGE > DIABETES AGE NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W 297 NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O 298 NUTRITIONAL & MISC METABOLIC DISORDERS AGE INBORN ERRORS OF METABOLISM ENDOCRINE DISORDERS W ENDOCRINE DISORDERS W/O KIDNEY TRANSPLANT KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM 304 KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W 305 KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O 306 PROSTATECTOMY W PROSTATECTOMY W/O MINOR BLADDER PROCEDURES W MINOR BLADDER PROCEDURES W/O TRANSURETHRAL PROCEDURES W TRANSURETHRAL PROCEDURES W/O URETHRAL PROCEDURES, AGE >17 W URETHRAL PROCEDURES, AGE >17 W/O URETHRAL PROCEDURES, AGE OTHER KIDNEY & URINARY TRACT O.R PROCEDURES 316 RENAL FAILURE ADMIT FOR RENAL DIALYSIS KIDNEY & URINARY TRACT NEOPLASMS W KIDNEY & URINARY TRACT NEOPLASMS W/O KIDNEY & URINARY TRACT INFECTIONS AGE >17 W 321 KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O 322 KIDNEY & URINARY TRACT INFECTIONS AGE URINARY STONES W, &/OR ESW LITHOTRIPSY

20 Texas Medicaid & Healthcare Partnership 324 URINARY STONES W/O KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W 326 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O 327 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE URETHRAL STRICTURE AGE >17 W URETHRAL STRICTURE AGE >17 W/O URETHRAL STRICTURE AGE OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W 332 OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O 333 OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE MAJOR MALE PELVIC PROCEDURES W MAJOR MALE PELVIC PROCEDURES W/O TRANSURETHRAL PROSTATECTOMY W TRANSURETHRAL PROSTATECTOMY W/O TESTES PROCEDURES, FOR MALIGNANCY TESTES PROCEDURES, NON-MALIGNANCY AGE > TESTES PROCEDURES, NON-MALIGNANCY AGE PENIS PROCEDURES CIRCUMCISION AGE > CIRCUMCISION AGE OTHER MALE REPRODUCTIVE SYSTEM O.R PROCEDURES FOR MALIGNANCY 345 OTHER MALE REPRODUCTIVE SYSTEM O.R PROC EXCEPT FOR MALIGNANCY 346 MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W 347 MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W/O 348 BENIGN PROSTATIC HYPERTROPHY W BENIGN PROSTATIC HYPERTROPHY W/O INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM 351 STERILIZATION, MALE OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES 353 PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY 354 UTERINE,ADNEXA PROC FOR NON- OVARIAN/ADNEXAL MALIG W 355 UTERINE,ADNEXA PROC FOR NON- OVARIAN/ADNEXAL MALIG W/O

21 356 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES 357 UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY 358 UTERINE & ADNEXA PROC FOR NON MALIGNANCY W 359 UTERINE & ADNEXA PROC FOR NON MALIGNANCY W/O 360 VAGINA, CERVIX & VULVA PROCEDURES LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION 362 ENDOSCOPIC TUBAL INTERRUPTION D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY 364 D&C, CONIZATION EXCEPT FOR MALIGNANCY OTHER FEMALE REPRODUCTIVE SYSTEM O.R PROCEDURES 366 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W 367 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O 368 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS 370 CESAREAN SECTION W CESAREAN SECTION W/O VAGINAL DELIVERY W COMPLICATING DIAGNOSES 373 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES 374 VAGINAL DELIVERY W STERILIZATION &/OR D&C VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C 376 POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE 377 POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE 378 ECTOPIC PREGNANCY THREATENED ABORTION ABORTION W/O D&C ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY 382 FALSE LABOR OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS 384 OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS 385 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY

22 386 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE 387 PREMATURITY W MAJOR PROBLEMS PREMATURITY W/O MAJOR PROBLEMS FULL TERM NEONATE W MAJOR PROBLEMS NEONATE W OTHER SIGNIFICANT PROBLEMS NORMAL NEWBORN SPLENECTOMY AGE > SPLENECTOMY AGE OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS 395 RED BLOOD CELL DISORDERS AGE > RED BLOOD CELL DISORDERS AGE COAGULATION DISORDERS RETICULOENDOTHELIAL & IMMUNITY DISORDERS W 399 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O 400 INVALID LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W 402 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O 403 LYMPHOMA & NON-ACUTE LEUKEMIA W LYMPHOMA & NON-ACUTE LEUKEMIA W/O ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W 407 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W/O 408 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC 409 RADIOTHERAPY CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS 411 HISTORY OF MALIGNANCY W/O ENDOSCOPY HISTORY OF MALIGNANCY W ENDOSCOPY OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W 414 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O 415 INVALID INVALID SEPTICEMIA AGE POSTOPERATIVE & POST-TRAUMATIC INFECTIONS

23 419 FEVER OF UNKNOWN ORIGIN AGE >17 W FEVER OF UNKNOWN ORIGIN AGE >17 W/O VIRAL ILLNESS AGE > VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES 424 O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS 425 ACUTE ADJUST REACT & PSYCHOLOGICAL DYSFUNCTION OF MENTAL ILLNESS 426 DEPRESSIVE NEUROSES NEUROSES EXCEPT DEPRESSIVE DISORDERS OF PERSONALITY & IMPULSE CONTROL 429 ORGANIC DISTURBANCES & MENTAL RETARDATION 430 PSYCHOSES CHILDHOOD MENTAL DISORDERS OTHER MENTAL DISORDER DIAGNOSES ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA 434 INVALID INVALID INVALID INVALID INVALID SKIN GRAFTS FOR INJURIES WOUND DEBRIDEMENTS FOR INJURIES HAND PROCEDURES FOR INJURIES OTHER O.R. PROCEDURES FOR INJURIES W OTHER O.R. PROCEDURES FOR INJURIES W/O TRAUMATIC INJURY AGE >17 W TRAUMATIC INJURY AGE >17 W/O TRAUMATIC INJURY AGE ALLERGIC REACTIONS AGE > ALLERGIC REACTIONS AGE POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W 450 POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O 451 POISONING & TOXIC EFFECTS OF DRUGS AGE COMPLICATIONS OF TREATMENT W COMPLICATIONS OF TREATMENT W/O

24 454 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W 455 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O 456 INVALID INVALID INVALID INVALID INVALID O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES 462 REHABILITATION SIGNS & SYMPTOMS W SIGNS & SYMPTOMS W/O AFTERCARE W HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS 466 AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS 467 OTHER FACTORS INFLUENCING HEALTH STATUS 468 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 469 INVALID INVALID BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY 472 INVALID ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE > INVALID INVALID PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 477 NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 478 INVALID OTHER VASCULAR PROCEDURES W/O LIVER TRANSPLANT BONE MARROW TRANSPLANT TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES 483 INVALID CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA 485 LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TR 486 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

25 487 OTHER MULTIPLE SIGNIFICANT TRAUMA HIV W EXTENSIVE O.R. PROCEDURE HIV W MAJOR RELATED CONDITION HIV W OR W/O OTHER RELATED CONDITION MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY 492 CHEMOTHERAPY W ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS 493 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W 494 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O 495 LUNG TRANSPLANT COMBINED ANTERIOR/POSTERIOR SPINAL FUSION 497 SPINAL FUSION EXCEPT CERVICAL W SPINAL FUSION EXCEPT CERVICAL W/O BACK & NECK PROCS EXCEPT SPINAL FUSION W 500 BACK & NECK PROCS EXCEPT SPINAL FUSION W/O 501 KNEE PROC W PDX OF INFECTION W KNEE PROC W PDX OF INFECTION W/O KNEE PROCEDURES W/O PDX OF INFECTION EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MECHANICAL VENT 96+ W SKIN GRAFT 505 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MECHANICAL VENT 96+ W/O SKIN GRAFT 506 FULL THICK BURN W SK GRAFT OR INHAL INJ W OR SIG TR 507 FULL THICK BURN W SK GRAFT OR INHAL INJ W/O OR SIG TR 508 FULL THICK BURN W/O SK GRAFT OR INHAL INJ W OR SIG TR 509 FULL THICK BURN W/O SK GRAFT OR INHAL INJ W/O OR SIG TR 510 NON-EXTENSIVE BURNS W OR SIGNIFICANT TRAUMA 511 NON-EXTENSIVE BURNS W/O OR SIGNIFICANT TRAUMA 512 SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT 513 PANCREAS TRANSPLANT INVALID CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH 516 INVALID INVALID PERC CARDIO PROC W/O CORONARY ARTERY

26 Texas Medicaid & Healthcare Partnership STENT OR AMI 519 CERVICAL SPINAL FUSION W CERVICAL SPINAL FUSION W/O ALCOHOL/DRUG ABUSE OR DEPENDENCE W ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O 523 ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O 524 TRANSIENT ISCHEMIA OTHER HEART ASSIST SYSTEM IMPLANT INVALID INVALID INTRACRANIAL VASCULAR PROC W PDX HEMORRHAGE 529 VENTRICULAR SHUNT PROCEDURES W VENTRICULAR SHUNT PROCEDURE W/O SPINAL PROCEDURES W SPINAL PROCEDURES W/O EXTRACRANIAL PROCEDURES W EXTRACRANIAL PROCEDURES W/O CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK 536 CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK 537 LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W 538 LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W/O 539 LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W 540 LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W/O 541 TRACH W MV 96+HRS OR PDX EXC MTH, FACE & NECK DX W/MAJOR OR 542 TRACH W MV 96+HRS OR PDX EXC FACE, MTH, & NECK DX W/O MAJOR OR 543 CRANIOTOMY W/IMPLANT OF CHEMO AGENT OR ACT COMPLEX CNS PDX 544 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY. 545 REVISION OF HIP OR KNEE REPLACEMENT SPINAL FUSION EXC CERV WITH CURVATURE OF THE SPINE OR MALIG. 547 CORONARY BYPASS W CARDIAC CATH W MAJOR CV DX. 548 CORONARY BYPASS W CARDIAC CATH W/O MAJOR CV DX. 549 CORONARY BYPASS W/O CARDIAC CATH W MAJOR CV DX

27 550 CORONARY BYPASS W/O CARDIAC CATH W/O MAJOR CV DX. 551 PERMANENT CARDIAC PACEMAKER IMPL W MAJ CV DX OR AICD LEAD OR GNRTR. 552 OTHER PERMANENT CARDIAC PACEMAKER IMPLANT W/O MAJOR CV DX. 553 OTHER VASCULAR PROCEDURES W W MAJOR CV DX. 554 OTHER VASCULAR PROCEDURES W W/O MAJOR CV DX. 555 PERCUTANEOUS CARDIOVASCULAR PROC W MAJOR CV DX. 556 PERCUTANEOUS CARDIOVASCULAR PROC W NON-DRUG-ELUTING STENT W/O MAJ CV DX. 557 PERCUTANEOUS CARDIOVASCULAR PROC W DRUG-ELUTING STENT W MAJ CV DX. 558 PERCUTANEOUS CARDIOVASCULAR PROC W DRUG-ELUTING STENT W/O MAJ CV DX. 559 ACUTE ISCHEMIC STROKE WITH USE OF THROMBOLYTIC AGENT. 560 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM 561 NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS 562 SEIZURE AGE > 17 W SEIZURE AGE > 17 W/O HEADACHES AGE > RESPIRATORY STSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS 566 RESPIRATORY STSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96< HOURS 567 STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W W MAJOR GI DX 568 STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W/O W MAJOR GI DX 569 SURG MAJOR SMALL & LARGE BOWEL PROCEDURES W W MAJOR GI 570 SURG MAJOR SMALL & LARGE BOWEL PROCEDURES W W/O MAJOR GI DX 571 MED MAJOR ESOPHAGEAL DISORDERS MED MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS 573 SURG MAJOR BLADDER PROCEDURES MED MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL 575 MED SEPTICEMIA W MV96+ HOURS AGE > MED SEPTICEMIA W/O MV96+ HOURS AGE > SURG CAROTID ARTERY STENT PROCEDURE SURG INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE

28 SURG POSTOPERATIVE OR POSTTRAUMATIC INFECTIONS W OR PROCEDURE 999 NON-PAYABLE INFORMATIONAL 0 0 0