Measure Name: Acute Bronchitis Treatment without Antibiotics Measure Code: BRN Lab Data: N

Measure Name: Acute Bronchitis Treatment without Antibiotics Owner: NCQA (AAB) Measure Code: BRN Lab Data: N Rule Description: Applicable Provider Specialty: General Criteria Summary The percentage of adults 18-64 years of age who had a diagnosis of acute bronchitis and were not dispensed an antibiotic prescription within three days of the encounter. Family Practice, Internal Medicine, Mixed Specialties Clinics, Allergy/Immunology, Pulmonary Diseases 1. Measurement period: 1 year prior to measurement period end date 2. Continuous enrollment: One year prior to the date of the acute bronchitis index encounter through 7 days following that date (373 days) 3. Index Episode based: Yes 4. Anchor date: Episode date 5. Gaps in enrollment: One 45-day gap allowed in the period of continuous enrollment 6. Medical coverage: Yes 7. Drug coverage: Yes 8. Attribution time frame: Episode date 9. Exclusions apply: None 10. Age range: 18-64 11. Intake period: All but the last 7 days of the measurement year Summary of changes for 2015 1. In the denominator the following codes were added: HCPCS codes G0463 and T1015. These are all outpatient visit types. 2. In the comorbid conditions and competing diagnosis code lists, diagnoses that required additional digit(s) are removed. 3. Update AAB-D drug list (258 NDCs added and 206 removed). ----------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------- Denominator Description: All patients, aged 18 years as of the beginning of the year prior to the measurement year to 64 years as of the end of the measurement year, who had an outpatient or emergency department encounter with a diagnosis of acute bronchitis Inclusion Criteria: Patients as above with no comorbid condition during the twelve month period prior to the encounter, no prescription for an antibiotic medication filled 30 days prior to the encounter, and no competing diagnosis during the period from 30 days prior to the encounter to 7 days after the encounter. The intake period is from the beginning of the measurement year to 7 days prior to the end of the measurement year. Eligibility Criteria Condition Description # Evnt Detailed Criteria Field Name Dimen Table Name Fact Table Name Timeframe Age is 18 years or older Age in Years >= 18 age_years demog eligibility As of the beginning of the year prior to the measurement year

AND Age is 64 years or less Age in Years <= 64 age_years demog eligibility As of the end of the measurement year AND Has medical coverage Coverage Indicator Medical = Y medical_co vg_ind AND Has drug coverage Coverage Indicator Drug = Y drug_covg_ ind plan eligibility From 365 days prior to the date of the index encounter through 7 days following the date of the index encounter plan eligibility From 365 days prior to the date of the index encounter through 7 days following the date of the index encounter Claim Criteria Condition Description # Evnt Detailed Criteria Field Name Dimen Table Name At least one observation, outpatient or emergency department visit with a principal diagnosis of acute bronchitis (Note: Identify all visits that meet the above criteria. Check each visit against the remaining denominator inclusion criteria.) AND No history of a comorbid condition during the year prior to the bronchitis encounter AND No antibiotic medication prescribed or refilled within 30 days prior to the acute bronchitis visit or still active on the date of the visit 1 CPT Procedure Code= Outpatient, Observation, or ED Value Set HCPCS Procedure Code= Outpatient Value Set Revenue Code UB= Outpatient or ED Value Set) And Any Diagnosis Code = Acute Bronchitis Value Set) 1 All Diagnosis Codes <> HIV, Emphysema, COPD, Cystic Fibrosis, or Comorbid Conditions, Malignant Neoplasms Value Set 1 No new, refilled, or active drug prescriptions where NDC Number Code = Table AAB-D: Antibiotic Medications, HEDIS 2015,Table AAB-D and NDC list are available at http://www.ncqa.org/hedisqualitymeasur Fact Table Name proc_cd proc fac_dtl prof_clm or proc_cd proc fac_dtl prof_clm or fac_revenue_cd proc fac_dtl dx_cd dx_cd dx any_dx dx any_dx fac_hdr prof_clm fac_hdr prof_clm Timeframe From the beginning of the measurement year to 7 days prior to the end of the measurement year From 12 months prior to the date of the acute bronchitis encounter through the date of the encounter ndc_nbr_cd drug drug_clm During the 90 day period prior to the acute bronchitis visit date (Note: 90 days is required to determine if there was a mail order prescription filled that is still active on the visit date.)

AND ement/hedismeasures/hedis2015/hedi S2015NDCLicense/HEDIS2015FinalNDCL ists.aspx A prescription is active if the prescription was filled more than 30 days prior to the bronchitis visit date and the Days Supply is greater than or equal to the number of days between the prescription fill date and the bronchitis visit date. No competing diagnosis from 30 days prior to the bronchitis encounter to 7 days after the encounter 1 All Diagnosis Codes <> Competing Diagnosis or Pharygitis Value Set dx_cd dx any_dx fac_hdr prof_clm From 30 days prior to the date of the acute bronchitis encounter through 7 days following the date of the encounter (Note: Identify all visits that meet the above criteria. Then select the visit with the earliest date and use that as the index encounter.) ----------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------- Numerator Description: For each patient who meets the denominator criteria, those who did not receive an antibiotic drug on or during the 3 day period following their acute bronchitis encounter Inclusion Criteria: Patients who did not have a prescription for an antibiotic drug on or up to three days following the date of their acute bronchitis index encounter Condition Description # Evnt Detailed Criteria Field Name Dimen Table Name No antibiotic medication dispensing events on or during the 3 day period following the date of the acute bronchitis index encounter 1 NDC Number Code <> Table AAB-D: Antibiotic Medications, HEDIS 2015,Table AAB-D and NDC list are available at http://www.ncqa.org/hedisqualitymeasur ement/hedismeasures/hedis2015/hedi S2015NDCLicense/HEDIS2015FinalNDCL ists.aspx Fact Table Name Timeframe ndc_nbr_cd drug drug_clm On or during the 3 day period following the date of the index encounter

Notes: 1. In the denominator criterion that looks for at least one outpatient or emergency department encounter, a Place of Service criterion is not needed for the procedure codes or revenue codes because they are setting-specific. 2. For all criteria based on facility header attributes, the Date of First Service from the facility claim is used to determine whether the criteria falls within the indicated timeframe, unless otherwise specified. For outpatient claims, this is the service date. For inpatient claims, this is the admission date. 3. When determining whether a prescription is still active on the date of a visit, the date the prescription was filled is counted as the first day in which the days supply was used. In other words, it is assumed that the patient started taking the drug the same day that they filled the prescription. 4. When counting medication dispensing events or drug supply days, the following rules are used: a. Drug claims with a zero value for days supply are discarded and not counted as a medication dispensing event or used in determining if a prescription is still active on a particular date. b. Any drug claim with a negative days supply value is assumed to be an adjustment record. With all adjustment claims, an attempt is made to match it to the original claim, using Person ID, service date, and NDC code: i. If no match is found, the adjustment claim is discarded. ii. If a match is found, the days supply on the adjustment claim is summed with the days supply on the original claim. If the sum <= 0, both are discarded. If the sum > 0, the adjusted value is used for the original claim and the adjustment record is discarded. c. Two drug claims with a positive days supply for the same patient on the same day for the same NDC code are combined and treated as a single claim: i. The days_supply_cnt fields from both claim rows are summed. ii. If only one of the claim rows has non-missing, non-null provider information (i.e., prov_key, ordering_prov_key values), the information from that claim is used. iii. If both claim rows have non-missing, non-null provider information, the provider information from the claim with the largest days_supply_cnt is used. iv. If both claim rows have non-missing, non-null provider information and the days_supply_cnt values are the same, the provider information from the claim with the smallest prov_key value is used. 5. The intake period is 7 days less than a full year. For example, if the measurement year starts on January 1, the intake period runs from January 1 through December 24. 6. In 2014, new Value Sets for codes were implemented. 7. In 2014, the following codes were added to the denominator: CPT 99341-99350, 99381-99384, 99387, 99391-99394, 99397, 99455, and 99456; and, HCPCS codes G0204, G0438, and G0439. These are all visit types. 8. In 2015, following codes were added to the denominator: HCPCS codes G0463 and T1015. These are all outpatient visit types. 9. In 2015, within the comorbid conditions and competing diagnosis code lists, many codes without a fourth digit (ie. 001) were dropped. Appendix AAB-D: Antibiotic Medications Description Prescription Aminoglycosides Amikacin Kanamycin Tobramycin

Gentamicin Streptomycin Aminopenicillins Amoxicillin Ampicillin Antipseudomonal penicillins Beta-lactamase inhibitors Piperacillin Amoxicillin-clavulanate Ampicillin-sulbactam Piperacillintazobactam Ticarcillin-clavulanate First generation cephalosporins Cefadroxil Cefazolin Cephalexin Fourth generation cephalosporins Ketolides Cefepime Telithromycin Lincomycin derivatives Clindamycin Lincomycin Macrolides Miscellaneous antibiotics Natural penicillins Azithromycin Clarithromycin Aztreonam Chloramphenicol Dalfopristinquinupristin Penicillin G benzathine-procaine Penicillin G potassium Erythromycin Erythromycin ethylsuccinate Daptomycin Erythromycin-sulfisoxazole Linezolid Penicillin G procaine Penicillin G sodium Penicillinase resistant penicillins Dicloxacillin Nafcillin Oxacillin Quinolones Rifamycin derivatives Second generation cephalosporin Ciprofloxacin Gemifloxacin Rifampin Cefaclor Cefotetan Levofloxacin Moxifloxacin Cefoxitin Cefprozil Sulfonamides Sulfadiazine Sulfamethoxazoletrimethoprim Erythromycin lactobionate Erythromycin stearate Metronidazole Vancomycin Penicillin V potassium Penicillin G benzathine Norfloxacin Ofloxacin Cefuroxime Tetracyclines Doxycycline Minocycline Tetracycline Third generation cephalosporins Urinary anti-infectives Cefdinir Cefditoren Cefixime Cefotaxime Cefpodoxime Ceftazidime Ceftibuten Ceftriaxone Fosfomycin Nitrofurantoin macrocrystals-monohydrate Nitrofurantoin Trimethoprim Nitrofurantoin macrocrystals

Observation Value Set Code Code Type Description 99217 CPT Observation Care Discharge 99218-99220 CPT Observation Care Outpatient Value Set Code Code Type Description 99201 CPT Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care 99202 CPT Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. 99203 CPT Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. 99204 CPT Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. 99205 CPT Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. 99211 CPT Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes 99212 CPT Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. 99213 CPT Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; 99214 CPT Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. 99215 CPT Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. 99217 CPT Observation care discharge day management (This code is to be utilized by the physician to report all services provided to a patient on discharge from "observation status" if the discharge is on other than the initial date of "observation status." 99218 CPT Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward 99219 CPT Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. 99220 CPT Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity.

99241 CPT Office consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. 99242 CPT Office consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Straightforward medical decision making. 99243 CPT Office consultation for a new or established patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies 99244 CPT Office consultation for a new or established patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers 99245 CPT Office consultation for a new or established patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers 99341-99345 CPT Home Visit - New Patient 99347-99350 CPT Home Visit - Est Patient 99381 CPT Init Pm E/M - New Pat - Inf 99382 CPT Init Pm E/M - New Pat 1-4 Yrs 99383 CPT Prev Visit - New - Age 5-11 99384 CPT Prev Visit - New - Age 12-17 99385 CPT Prev Visit - New - Age 18-39 99386 CPT Prev Visit - New - Age 40-64 99387 CPT Init Pm E/M - New Pat 65+ Yrs 99385 CPT New patient, 18-39 years, Initial comprehensive preventive medicine E&M including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunization 99386 CPT New patient, 40-64 years, Initial comprehensive preventive medicine E&M including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunization 99391 CPT Per Pm Reeval - Est Pat Inf 99392 CPT Prev Visit - Est - Age 1-4 99393 CPT Prev Visit - Est - Age 5-11 99394 CPT Prev Visit - Est - Age 12-17 99395 CPT Prev Visit - Est - Age 18-39 99396 CPT Prev Visit - Est - Age 40-64 99397 CPT Per Pm Reeval Est Pat 65+ Yr 99395 CPT Established patient, 18-39 years, Periodic comprehensive preventive medicine ree&m including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunization 99396 CPT Established patient, 40-64 years, Periodic comprehensive preventive medicine E&M including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunization 99401 CPT Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approx 15 minutes 99402 CPT Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approx 30 minutes 99403 CPT Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approx 45 minutes

99404 CPT Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approx 60 minutes 99411 CPT Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes 99412 CPT Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes 99420 CPT Administration and interpretation of health risk assessment instrument (eg, health hazard appraisal) 99429 CPT Unlisted preventive medicine service 99455 CPT Work Related Disability Exam 99456 CPT Disability Examination G0402 HCPCS Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0438 HCPCS Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0439 HCPCS Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0463 HCPCS Hospital outpatient clinic visit for assessment and management of a patient T1015 HCPCS Clinic visit/encounter, all-inclusive 0510 UB Revenue CLINIC 0511 UB Revenue CHRONIC PAIN CL 0512 UB Revenue DENTAL CLINIC 0513 UB Revenue PSYCH CLINIC 0514 UB Revenue OB-GYN CLINIC 0515 UB Revenue PEDS CLINIC 0516 UB Revenue URGENT CLINIC 0517 UB Revenue FAMILY CLINIC 0519 UB Revenue OTHER CLINIC 0520 UB Revenue FREESTAND CLINIC 0521 UB Revenue RURAL/CLINIC 0522 UB Revenue RURAL/HOME 0523 UB Revenue FR/STD 0526 UB Revenue FR/STD URGENT CLINIC 0527 UB Revenue FR/STD 0528 UB Revenue FR/STD 0529 UB Revenue OTHER FR/STD CLINIC 0981 UB Revenue PRO/ER 0982 UB Revenue PRO FEE/OUTPT 0983 UB Revenue PRO FEE/CLINIC

ED Value Set Code Code Type Description 99281 CPT ED visit for E&M, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care, self limited or minor problems 99282 CPT ED for E&M, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care, low to moderate severity 99283 CPT ED visit for E&M, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care, moderate severity 99284 CPT ED visit for E&M, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care, high severity 99285 CPT ED visit for E&M, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: A comprehensive history; high severity with threat to life 0450 UB Revenue EMERG ROOM 0451 UB Revenue ER/EMTALA 0452 UB Revenue ER/BEYOND EMTALA 0456 UB Revenue URGENT CARE 0459 UB Revenue OTHER EMER ROOM 0981 UB Revenue PRO FEE/ER Acute Bronchitis Value Set Description 466.0 Acute bronchitis Pharyngitis Value Set Description 034.0 Strep sore throat 462 Acute pharyngitis 463 Acute tonsillitis HIV Value Set Description 042 Human immuno virus dis V08 Asymp hiv infectn status

Cystic Fibrosis Value Set Description 2770.00-277.03, 277.09 Cystic fibrosis Malignant Neoplasms Value Set Description 140.0, 140.1-140.6, 140.8, 140.9 Malignant neoplasm of lip 141.0-141.6, 141.8, 141.9 Malignant neoplasm of tongue 142.0-142.2, 142.8, 142.9 Malignant neoplasm of major salivary glands 143.0, 143.1, 143.8, 143.9 Malignant neoplasm of gum 144.0, 144.1, 144.8, 144.9 Malignant neoplasm of floor of mouth 145.0-145.6, 145.8, 145.9 Malignant neoplasm of other and unspecified parts of mouth 146.0-146.9 Malignant neoplasm of oropharynx 147.0-147.3, 147.8, 147.9 Malignant neoplasm of nasopharynx 148.0-148.3, 148.8, 148.9 Malignant neoplasm of hypopharynx 149.0, 149.1, 149.8, 149.9 Malignant neoplasm of other and ill-defined sites with in the kip, oral cavity, and pharynx 150.0-150.5, 150.8, 150.9 Malignant neoplasm of esophagus 151.0-151.6, 151.8, 150.9 Malignant neoplasm of stomach 152.0-152.3, 152.8, 152.9 Malignant neoplasm of small intestine, including duodenum 153.0-153.9 Malignant neoplasm of colon 154.0-154.3, 154.8 Malignant neoplasm of rectum, rectosigmoid junction, and anus 155.0-155.2 Malignant neoplasm of liver and interhepatic bile ducts 156.0-156.2, 156.8, 156.9 Malignant neoplasm of gallbladder and extrahepatic bile ducts 157.0-157.4, 157.8, 157.9 Malignant neoplasm of pancreas 158.0, 158.8, 158.9 Malignant neoplasm of retroperitoneum and peritoneum 159.0, 159.1, 159.8, 159.9 Malignant neoplasm of other and ill-defined sites within the digestive organs and peritoneum 160.0-160.5, 160.8, 160.9 Malignant neoplasm of nasal cavities, middle ear, and accessory sinuses 161.0-161.3, 161.8, 161.9 Malignant neoplasm of larynx 162.0, 162.2-162.5, 162.8, 162.9 Malignant neoplasm of trachea, bronchus, and lung 163.0, 163.1, 163.8, 163.9 Malignant neoplasm of pleura 164.0-164.3, 164.8, 164.9 Malignant neoplasm of thymus, heart, and mediastinum 165.0, 165.8, 165.9 Malignant neoplasm of other ill-defined sites within the respiratory system and intrathoracic organs 170.0-170.9 Malignant neoplasm of bone and articular cartilage 171.0-171.9 Malignant neoplasm of connective and other soft tissue 172.0-174.9 Malignant melanoma of skin 173.00-173.02, 173.09-173.12, 179.19-173.22, 173.09-173.32, 173.39- Other and unspecified malignant neoplasm of the skin 173.42, 173.49-173.52, 173.59-173.62, 173.69-173.72, 173.79-173.82, 173.89-173.92, 173.99

174.0-174.6, 174.8, 174.9 Malignant neoplasm of female breast 175.0, 175.9 Malignant neoplasm of male breast 176.0-176.9 Kaposi's sarcoma 179 Malignant neoplasm of uterus-part unspecified 180.0, 180.1, 180.8, 180.9 Malignant neoplasm of cervix uteri 181 Malignant neoplasm of placenta 182.0, 182.1, 182.8 Malignant neoplasm of body of uterus 183.0, 183.2-183.5, 183.8, 183.9 Malignant neoplasm of ovary and other uterine adnexa 184.0-184.4, 184.8, 184.9 Malignant neoplasm of other and unspecified female genital organs 185 Malignant neoplasm of prostate 186.0, 186.9 Malignant neoplasm of testis 1871-187.9 Malignant neoplasm of penis and other male genital organs 188.0-188.9 Malignant neoplasm of bladder 189.0-189.9 Malignant neoplasm of kidney and other and unspecified urinary organs 190.0-190.9 Malignant neoplasm of eye 191.0-191.9 Malignant neoplasm of brain 192.0-192.3, 192.8, 192.9 Malignant neoplasm of other and unspecified parts of the nervous system 193 Malignant neoplasm of thyroid gland 194.0-194.6, 194.8, 194.9 Malignant neoplasm of other endocrine glands and related structures 195.0-195.5, 195.8 Malignant neoplasm of other and ill-defined sites 196.0-196.3, 196.5, 196.6, 196.8, 196.9 Secondary and unspecified malignant neoplasm of lymph nodes 197.0-197.8 Secondary malignant neoplasm of respiratory and digestive systems 198.0-198.7, 198.81, 198.82, 198.89 Secondary malignant neoplasm of other specified sites 199.0, 199.1, 199.2 Malignant neoplasm without specification of site 200.00-200.08, 200.10-200.18, 200.20-200.28, 200.30-200.38, 200.40- Lymphosarcoma and reticulosarcoma and other specified malignant tumors of lymphatic tissue 200.48, 200.50-200.58, 200.60-200.68, 200.70-200.78, 200.80-200.88 201.00-201.08, 201.10-201.18, 201.20-201.28, 201.40-201.48, 201.50- Hodgkin's disease 201.58, 201.60-201.68, 207.70-201.78, 201.90-201.98 202.00-202.08, 202.10-202.18, 202.20-202.28, 202.30-202.38, 202.40- Other malignant neoplasms of lymphoid and histiocytic tissue 202.48, 202.50-202.58, 202.60-202.68, 202.70-202.78, 202.80-202.88, 202.90-202.98 203.00-203.02, 203.10-203.12, 203.80-203.82 Multiple myeloma and immunoproliferative neoplasms 204.00-204.02, 204.10-204.12, 204.20-204.22, 204.80-204.82, 204.90- Lymphoid leukemia 204.92 205.00-205.02, 205.10-205.12, 205.20-205.22, 205.30-205.32, 205.80- Myeloid leukemia 205.82, 205.90-205.92 206.00-206.02, 206.10-206.12, 206.20-206.22, 206.80-206.82, 206.90- Monocytic leukemia 206.92 207.00-207.02, 207.10-207.12, 207.20-207.22, 207.80-207.82 Other specified leukemia

208.00-208.02, 208.10-208.12, 208.20-208.22, 208.80-208.82, 208.90-208.92 209.00-209.03, 209.10-209.17, 209.20-209.36, 209.40-209.43,209.50-209.57, 209.60-209.67, 209.69-209.75, 209.79 Leukemia of unspecified cell type Neuroendocrine tumors Emphysema Value Set Description 492.0, 492.8 Emphysema COPD Value Set Description 493.20-493.22 Chronic obstructive asthma 496 Chronic airway obstruction not elsewhere classified Comorbid Conditions Value Set Description 279.00-279.06, 279.09-279.13, 179.19, 279.2, 279.3, 279.41, 279.49- Disorders involving the immune mechanism 279.53, 279.8, 279.9 491.0, 491.1, 491.20-491.22, 491.8, 491.9 Chronic bronchitis 494.0, 494.1 Bronchiectasis 495.1-495.9 Extrinsic allergic alveolitis 500 Coal workers' pneumoconiosis 501 Asbestosis 502 Pneumoconiosis due to other silica or silicates 503 Pneumoconiosis due to other inorganic dust 504 Pneumonopathy due to inhalation of other dust 505 Pneumoconiosis unspecified 506.0-506.4, 506.9 Respiratory conditions due to chemical fumes and vapors 507.0, 507.1, 507.8 Pneumonitis due to solids and liquids 508.0-508.2, 508.8, 508.9 Respiratory conditions due to other and unspecified external agents 510.0, 510.9 Empyema 511.0, 511.1, 511.81, 511.89, 511.9 Pleurisy 512.0-512.2, 512.81-512.84, 512.89 Pneumothorax 513.0, 513.1 Abscess of lung and mediastinum 514 Pulmonary congestion and hypostasis 515 Postinflammatory pulmonary fibrosis 516.0-516.2, 516.30-516.37, 516.4, 516.5, 516.61-516.64, 516.69, Other alveolar and parietoalveolar pneumonopathy 516.8, 516.9

517.1-517.3, 517.8 Lung involvement in conditions classified elsewhere 518.0-518.4, 518.51-518.53, 518.6, 518.7, 518.81-518.84, 518.89 Other diseases of the lung 519.00-519.02, 519.09, 519.11, 519.19, 519.2-519.4, 519.8, 519.9 Other diseases of respiratory system 010.00-010.06, 010.10-010.16, 010.80-010.86, 010.90-010.96 Primary tuberculous infection 011.00-011.06, 011.10-011.16, 011.20-011.26, 011.30-011.36, 011.40- Pulmonary tuberculosis 011.46, 011.50 011.56, 011.60-011.66, 011.70-011.76, 011.80-011.86, 011.90-011.96 012.00-012.06, 012.10-012.16, 012.20-012.26, 012.30-012.36, 012.80- Other respiratory tuberculous 012.86 013.00-013.06, 013.10-013.16, 013.20-013.26, 013.30-013.396, 013.40- Tuberculous of meninges and central nervous system 013.46, 013.50-013.56, 013.60-013.66, 013.80-013.86, 013.90-013.96 014.00-014.06, 014.80-014.86 Tuberculous of intestines, peritoneum, and mesenteric glands 015.00-015.06, 015.10-015.16, 015.20-015.26, 015.50-015.56, 015.60- Tuberculosis of bones and joints 015.66, 015.70-015.76, 015.80-015.86, 015.90-015.96 016.00-016.06, 016.10-016.16, 016.20-016.26, 016.30-016.36, 016.40- Tuberculosis of genitourinary system 016.46, 016.50-016.56, 016.60-016.66, 016.70-016.76, 016.90-016.96 017.00-017.06, 017.10-017.16, 017.20-017.26, 017.30-071.36, 017.40- Tuberculosis of other organs 017.46, 017.50-017.56, 017.60-017.66, 017.70-017.76, 017.80-017.86, 017.90-017.96 018.00-018.06, 018.80-018.86, 018.90-018.96 Miliary tuberculosis Competing Diagnosis Value Set Description: Intestinal infections 001.0, 001.1, 001.9 Cholera 002.0-002.3, 002.9 Typhoid and paratyphoid fevers 003.0, 003.1, 003.20-003.24, 003.29, 003.8, 003.9 Other salmonella infections 004.0-004.3, 004.8, 004.9 Shigellosis 005.0-005.4, 005.81, 005.89, 005.9 Other food poisoning (bacterial) 006.0-006.6, 006.8, 006.9 Amebiasis 007.0-007.5, 007.8, 007.9 Other protozoal intestinal diseases 008.00-008.04, 008.09, 008.1-008.3, 008.41-008.47, 008.49, 008.5, Intestinal infection due to other organisms 008.61-008.67, 008.69, 008.8 009.0-009.3 Ill-defined intestinal infections Description: Pertussis 033.0, 003.1, 003.8, 003.9 Whooping cough Description: Bacterial infection unspecified 041.9 Bacterial infection unspecified in conditions classified elsewhere and of unspecified site

Description: Lyme disease and other arthropod-borne diseases 088.0, 088.81, 088.82, 088.89, 088.9 Other arthropod-borne diseases Description: Otitis media 382.00-382.02, 382.1-382.4, 382.9 Suppurative and unspecified otitis media Description: Acute sinusitis 461.0-461.3, 461.8, 461.9 Acute sinusitis Description: Acute pharyngitis 462 Acute pharyngitis 034.0 Streptococcal sore throat Description: Acute tonsillitis 463 Acute tonsillitis Description: Chronic sinusitis 473.0-473.3, 473.8, 473.9 Chronic sinusitis Description: Infections of the pharynx, larynx, tonsils, adenoids 464.10, 464.11 Acute tracheitis 464.20, 464.21 Acute laryngotracheitis 464.30, 464.31 Acute epiglottitis 474.00-474.02, 474.10-474.12, 474.2, 474.8, 474.9 Chronic disease of tonsils and adenoids 478.21 Cellulitis of pharynx or nasopharynx 478.22 Parapharyngeal abscess 478.24 Retropharyngeal abscess 478.29 Other diseases of pharynx or nasopharynx 478.71 Cellulitis and perichondritis of larynx 478.79 Other diseases of larynx 478.9 Other and unspecified diseases of upper respiratory tract Description: Prostatitis 601.0-601.4, 601.8, 601.9 Inflammatory diseases of prostate Description: Cellulitis, mastoiditis, other bone infections 383.00-383.02, 383.1, 383.20-383.22, 383.30-383.33, 383.81, 383.89, Mastoiditis and related conditions 383.9 681.00-681.02, 681.10, 681.11, 681.9 Cellulitis and abscess of finger and toe 682.0-682.9 Other cellulitis and abscess 730.00-730.39, 730.70-730.99 Osteomyelitis, periostitis, and other infections involving bone Description: Acute lymphadenitis 683 Acute lymphadenitis Description: Impetigo 684 Impetigo Description: Skin staph infections

686.00, 686.09, 686.1, 686.8, 686.9 Other local infections of skin and subcutaneous tissue Description: Pneumonia 481 Pneumococcal pneumonia 482.0, 482.1, 482.2, 182.30-482.32, 482.39-482.42, 482.49, 482.81- Other bacterial pneumonia 482.84, 485.89, 482.9 483.0, 483.1, 483.8 Pneumonia due to other specified organism 484.1, 484.3, 484.5, 484.8 Pneumonia in infectious diseases classified elsewhere 485 Bronchopneumonia organism unspecified 486 Pneumonia organism unspecified Description: Gonococcal infections and venereal diseases 098.0, 098.10-098.17, 098.19, 098.2, 098.30-098.37, 098.39-098.43, Gonococcal infections 098.49-098.53, 098.59, 098.6, 098.7, 098.81-098.86, 098.89 099.0-099.3, 099.40, 099.41, 099.49-099.56, 099.59, 099.8, 099.9 Other venereal diseases V01.6 Contact with or exposure to venereal diseases V02.7 Contact with or exposure to other viral diseases V02.8 Veneral disease carrier NEC Description: Syphilis 090.0-090.3, 090.40-090.42, 090.49. 090.5-090.7, 090.9 Congenital syphilis 091.0-091.4, 091.50-091.53, 091.61, 091.62, 091.69, 091.7, 091.81, Early syphilis, symptomatic 091.82, 091.89, 091.9 092.0, 092.9 Early syphilis, latent 093.0, 093.1, 093.20-093.24, 093.81, 093.82, 093.89, 093.9 Cardiovascular syphilis 094.0-094.3, 094.81-094.87, 094.89, 094.9 Neurosyphilis 095.0-095.9 Other forms of late syphilis, with symptoms 096 Late syphilis, latent 097.0, 097.1, 097.9 Other and unspecified syphilis 098.0, 098.10-098.17, 098.19, 098.2, 098.30-098.37, 098.39, 098.40- Gonococcal infections 098.43, 098.49-098.53, 098.59, 098.6, 098.7, 098.81-098.86, 098.89 099.0-099.3, 099.40, 099.41, 099.49-099.56, 099.59, 099.8, 099.9 Other venereal diseases Description: Chlamydia 078.88 Other specified diseases due to chlamydiae 079.88 Other specified chlamydial infection 079.98 Unspecified chlamydial infection Description: Inflammatory diseases (female reproductive organs) 131.00-131.03-131.09, 131.8, 131.9 Trichomoniasis 614.0-614.9 Inflammatory disease of ovary, fallopian tube, pelvic cellular tissue, and peritoneum 615.0, 615.1, 615.9 Inflammatory diseases of uterus, except cervix 616.0, 616.10, 616.11, 616.2-616.4, 616.50, 616.51, 616.81, 616.89, Inflammatory disease of cervix, vagina, and vulva 616.9

Description: Infections of the kidney 590.00, 590.01, 590.11, 590.11, 590.2, 590.3, 590.880, 590.81, 590.9 Infections of kidney Description: Cystitis or UTI 595.0-595.4, 595.81, 595.82, 595.89, 595.9 Cystitis 599.0 Urinary tract infection, site not specified Description: Acne 706.0 Acne varioliformis 706.1 Other acne