LIVER PROFILE HEPATIC FUNCTION PANEL
Test Code Test Name CPT
LIVER Hepatic Function Panel 80076 LIVER Liver Profile 80076 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 1 of 32
Narrative Description ICD9
Abdominal area, including retroperitoneum; nonspecific abnormal findings on 793.6 radiological and other examination of body structure Abdominal or pelvic swelling, mass or lump; Epigastric 789.36
Abdominal or pelvic swelling, mass or lump; Generalized 789.37
Abdominal or pelvic swelling, mass or lump; left lower quadrant 789.34
Abdominal or pelvic swelling, mass or lump; left upper quadrant 789.32
Abdominal or pelvic swelling, mass or lump; Other specified site 789.39
Abdominal or pelvic swelling, mass or lump; Periumbilic 789.35
Abdominal or pelvic swelling, mass or lump; right lower quadrant 789.33
Abdominal or pelvic swelling, mass or lump; right upper quadrant 789.31
Abdominal or pelvic swelling, mass or lump; unspecified site 789.30
Abdominal pain; Epigastric 789.06
Abdominal pain; Generalized 789.07
Abdominal pain; left lower quadrant 789.04
Abdominal pain; left upper quadrant 789.02
Abdominal pain; Other specified site 789.09
Abdominal pain; Periumbilic 789.05
Abdominal pain; right lower quadrant 789.03
Abdominal pain; right upper quadrant 789.01
Abdominal pain; unspecified site 789.00
Abdominal rigidity; Epigastric 789.46
Abdominal rigidity; Generalized 789.47
Abdominal rigidity; left lower quadrant 789.44
Abdominal rigidity; left upper quadrant 789.42
Abdominal rigidity; Other specified site 789.49
Abdominal rigidity; Periumbilic 789.45
Abdominal rigidity; right lower quadrant 789.43
Abdominal rigidity; right upper quadrant 789.41
Abdominal rigidity; unspecified site 789.40 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 2 of 32 Abdominal tenderness; Epigastric 789.66
Abdominal tenderness; Generalized 789.67
Abdominal tenderness; left lower quadrant 789.64
Abdominal tenderness; left upper quadrant 789.62
Abdominal tenderness; Other specified site 789.69
Abdominal tenderness; Periumbilic 789.65
Abdominal tenderness; right lower quadrant 789.63
Abdominal tenderness; right upper quadrant 789.61
Abdominal tenderness; unspecified site 789.60
Abnormal involuntary movements 781.0
Abnormal serum enzyme levels, other nonspecific 790.5
Abnormality of gait 781.2
Acquired coagulation factor deficiency 286.7
Actinomycotic infections; Abdominal 039.2
Alcohol amnestic syndrome 291.1
Alcohol dementia; other 291.2
Alcohol dependence, other and unspecified; continuous 303.91
Alcohol dependence, other and unspecified; episodic 303.92
Alcohol induced sleep disorders 291.82
Alcohol withdrawal delirium 291.0
Alcohol withdrawal hallucinosis 291.3
Alcohol, excessive blood level of 790.3
Alcoholic induced psychotic disorder with delusions 291.5
Alcoholic cirrhosis of liver 571.2
Alcoholic fatty liver 571.0
Alcoholic hepatitis, Acute 571.1
Alcoholic induced mental disorders 291.89
Alcoholic intoxication, Acute; continuous 303.01
Alcoholic intoxication, Acute; episodic 303.02
Alcoholic intoxication, Acute; unspecified 303.00 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 3 of 32 Alcoholic liver damage, unspecified 571.3
Alcoholic polyneuropathy 357.5
Alcoholic psychosis, other specified; Alcohol withdrawal 291.81
Alcoholic psychosis, unspecified 291.9
Alpha-1 antitrypsin deficiency 273.4
Amebiasis, unspecified 006.9
Amebic brain abscess 006.5
Amebic dysentery without mention of abscess, Acute 006.0
Amebic infection of other sites 006.8
Amebic liver abscess 006.3
Amebic lung abscess 006.4
Amebic nondysenteric colitis 006.2
Amebic skin ulceration 006.6
Amino-acid metabolism, unspecified disorder of 270.9
Amyloidosis, unspecified 277.30
Anaphylactic shock due to adverse food reaction; Due to crustaceans 995.62
Anaphylactic shock due to adverse food reaction; Due to eggs 995.68
Anaphylactic shock due to adverse food reaction; Due to fish 995.65
Anaphylactic shock due to adverse food reaction; Due to food additives 995.66
Anaphylactic shock due to adverse food reaction; Due to fruits and vegetables 995.63
Anaphylactic shock due to adverse food reaction; Due to milk products 995.67
Anaphylactic shock due to adverse food reaction; Due to other specified food 995.69
Anaphylactic shock due to adverse food reaction; Due to peanuts 995.61
Anaphylactic shock due to adverse food reaction; Due to tree nuts and seeds 995.64
Anaphylactic shock due to adverse food reaction; Due to unspecified food 995.60
Anomalies of gallbladder, bile ducts, and liver; Other 751.69
Anomaly of gallbladder, bile ducts, and liver; Unspecified 751.60
Anorexia 783.0
Anthrax septicemia 022.3
Aphasia 784.3 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 4 of 32 Appendicitis, Acute; with generalized peritonitis 540.0
Appendicitis, Acute; with peritoneal abscess 540.1
Appendicitis, Acute; without mention of peritonitis 540.9
Aromatic amino-acid metabolism, other disturbances of 270.2
Ascites 789.5
Autoimmune disease, not elsewhere classified 279.4
Bacteremia 790.7
Bile duct, Fistula of 576.4
Bile duct, Obstruction of 576.2
Bile duct, Perforation of 576.3
Biliary atresia 751.61
Biliary cirrhosis 571.6
Biliary tract, Other specified disorders of 576.8
Biliary tract, Unspecified disorder of 576.9
Biliary tract; nonspecific abnormal findings on radiological and other examination 793.3 of body structure Bilirubin excretion, disorders of 277.4
Biliuria 791.4
Blood chemistry, other abnormal 790.6
Blood vessels of abdomen and pelvis, injury to; Abdominal Aorta 902.0
Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.20 Celiac and mesenteric arteries, unspecified Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.21 Gastric artery Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.22 Hepatic artery Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.23 Splenic artery Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.24 Other specified branches of celiac axis Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.25 Superior mesenteric artery (trunk) Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.26 Primary branches of superior mesenteric artery Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.27 Inferior mesenteric artery Blood vessels of abdomen and pelvis, injury to; Celiac and mesenteric arteries, 902.29 Other Blood vessels of abdomen and pelvis, injury to; Inferior vena cava, Inferior vena 902.10 cava, unspecified HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 5 of 32 Blood vessels of abdomen and pelvis, injury to; Inferior vena cava, Hepatic veins 902.11
Blood vessels of abdomen and pelvis, injury to; Inferior vena cava, Other 902.19
Blood vessels of abdomen and pelvis, injury to; Other specified blood vessels of 902.87 abdomen and pelvis, Multiple blood vessels of abdomen and pelvis Blood vessels of abdomen and pelvis, injury to; Other specified blood vessels of 902.89 abdomen and pelvis, Other Blood vessels of abdomen and pelvis, injury to; Portal and splenic veins, Superior 902.31 mesenteric vein and primary subdivisions Blood vessels of abdomen and pelvis, injury to; Portal and splenic veins, Inferior 902.32 mesneteric vein Blood vessels of abdomen and pelvis, injury to; Portal and splenic veins, Portal vein 902.33
Blood vessels of abdomen and pelvis, injury to; Portal and splenic veins, Splenic 902.34 vein Blood vessels of abdomen and pelvis, injury to; Portal and splenic veins, Other 902.39
Blood vessels of abdomen and pelvis, injury to; Unspecified blood vessel of 902.9 abdomen and pelvis Bronchus, injury to, with open wound into cavity 862.31
Bronchus, injury to, without mention of open wound into cavity 862.21
Bubonic; Plague 020.0
Budd-Chiari syndrome 453.0
Cachexia 799.4
Calculus of bile duct with acute cholecystitis; with obstruction 574.31
Calculus of bile duct with acute cholecystitis; without mention of obstruction 574.30
Calculus of bile duct with other cholecystitis; with obstruction 574.41
Calculus of bile duct with other cholecystitis; without mention of obstruction 574.40
Calculus of bile duct without mention of cholecystitis; with obstruction 574.51
Calculus of bile duct without mention of cholecystitis; without mention of 574.50 obstruction Calculus of Gallbladder and bile duct with acute and chronic cholecystitis; without 574.80 mention of obstruction Calculus of Gallbladder and bile duct with acute and chronic cholecystitis; with 574.81 obstruction Calculus of Gallbladder and bile duct with acute cholecystitis; without mention of 574.60 obstruction Calculus of Gallbladder and bile duct with acute cholecystitis; with obstruction 574.61
Calculus of Gallbladder and bile duct with other cholecystitis; without mention of 574.70 obstruction Calculus of Gallbladder and bile duct with other cholecystitis; with obstruction 574.71
Calculus of Gallbladder and bile duct without cholecystitis; without mention of 574.90 obstruction HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 6 of 32 Calculus of Gallbladder and bile duct without cholecystitis; with obstruction 574.91
Calculus of Gallbladder with acute cholecystitis; with obstruction 574.01
Calculus of Gallbladder with acute cholecystitis; without mention of obstruction 574.00
Calculus of Gallbladder with other cholecystitis; with obstruction 574.11
Calculus of Gallbladder with other cholecystitis; without mention of obstruction 574.10
Calculus of Gallbladder without mention of cholecystitis; with obstruction 574.21
Calculus of Gallbladder without mention of cholecystitis; without mention of 574.20 obstruction Candidiasis, Disseminated 112.5
Carcinoma in situ of digestive organs; Liver and biliary system 230.8
Carrier or suspected carrier of infectious disease; Viral hepatitis; Viral hepatitis V02.60 carrier, unspecified Carrier or suspected carrier of infectious disease; Viral hepatitis; Hepatitis B carrier V02.61
Carrier or suspected carrier of infectious disease; Viral hepatitis; Hepatitis C carrier V02.62
Carrier or suspected carrier of infectious disease; Viral hepatitis; Other viral V02.69 hepatitis carrier Cellulocutaneous: Plague 020.1
Certain adverse effects not elsewhere classified; Angioneurotic edema 995.1
Certain adverse effects not elsewhere classified; Other anaphylactic shock 995.0
Certain adverse effects not elsewhere classified; Shock due to anesthesia 995.4
Chagas’ disease with other organ involvement 086.1
Child maltreatment syndrome; Child neglect [nutritional] 995.52
Child maltreatment syndrome; Shaken infant syndrome 995.55
Cholangitis 576.1
Cholecystitis, Acute 575.0
Cholecystitis, Acute and Chronic 575.12
Cholecystitis, Chronic 575.11
Cholecystitis, unspecified 575.10
Choleperitonitis 567.81
Chronic fatigue syndrome 780.71
Chronic kidney disease, stage III (Moderate) 585.3
Chronic kidney disease, stage IV (severe) 585.4
Chronic kidney disease, stage V 585.5 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 7 of 32 Circulating enzymes, other deficiencies of 277.6
Cirrhosis of liver without mention of alcohol 571.5
Clonorchiasis 121.1
Clubbing of fingers 781.5
Coagulation profile, abnormal 790.92
Complex febrile convulsions 780.32
Complications affecting specified body system, not elsewhere classified; Cardiac 997.1 complications Complications affecting specified body system, not elsewhere classified; Digestive 997.4 system complications Complications of medical care, not elsewhere classified; ABO incompatibility 999.6 reaction Complications of medical care, not elsewhere classified; Anaphylactic shock due to 999.4 serum Complications of medical care, not elsewhere classified; Other and unspecified 999.9 complications of medical care, not elsewhere classified Complications of medical care, not elsewhere classified; Other serum reactions 999.5
Complications of medical care, not elsewhere classified; Other transfusion reaction 999.8
Complications of medical care, not elsewhere classified; Rh incompatibility 999.7 reaction Complications of transplanted organ; Intestine 996.87
Complications of transplanted organ; Kidney 996.81
Complications of transplanted organ; Liver 996.82
Complications of transplanted organ; Other specified transplanted organs 996.89
Complications of transplanted organ; Pancreas 996.86
Contusion of Trunk; Abdominal wall 922.2
Contusion of Trunk; Back; Back 922.31
Contusion of Trunk; Back; Interscapular region 922.33
Contusion of Trunk; Chest wall 922.1
Contusion of Trunk; Multiple sides of trunk 922.8
Contusion of Trunk; Unspecified parts 922.9
Copper metabolism, disorder of 275.1
Crushing injury of Trunk; Multiple sites of trunk 926.8
Crushing injury of Trunk; Other specified parts, Back 926.11
Crushing injury of Trunk; Other specified parts, Other 926.19 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 8 of 32 Crushing injury of Trunk; Unspecified site 926.9
Cytomegaloviral disease 078.5
Defibrination syndrome 286.6
Delayed milestones 783.42
Dermatomyositis 710.3
Diabetes with ketoacidosis; type I [insulin dependent type] [IDDM] [juvenile type], 250.11 not stated as uncontrolled Diabetes with ketoacidosis; type I [insulin dependent type] [IDDM] [juvenile type], 250.13 uncontrolled Diabetes with ketoacidosis; type II [non-insulin dependent type] [NIDDM type] 250.10 [adult-onset type] or unspecified type, not stated as uncontrolled Diabetes with ketoacidosis; type II [non-insulin dependent type] [NIDDM type] 250.12 [adult-onset type] or unspecified type, uncontrolled Diabetes with other coma; type I [insulin dependent type] [IDDM] [juvenile type], 250.31 not stated as uncontrolled Diabetes with other coma; type I [insulin dependent type] [IDDM] [juvenile type], 250.33 uncontrolled Diabetes with other coma; type II [non-insulin dependent type] [NIDDM type] 250.30 [adult-onset type] or unspecified type, not stated as uncontrolled Diabetes with other coma; type II [non-insulin dependent type] [NIDDM type] 250.32 [adult-onset type] or unspecified type, uncontrolled Diabetes with other specified manifestations; type I [insulin dependent type] 250.81 [IDDM] [juvenile type], not stated as uncontrolled Diabetes with other specified manifestations; type I [insulin dependent type] 250.83 [IDDM] [juvenile type], uncontrolled Diabetes with other specified manifestations; type II [non-insulin dependent type] 250.80 [NIDDM type] [adult-onset type] or unspecified type, not stated as uncontrolled Diabetes with other specified manifestations; type II [non-insulin dependent type] 250.82 [NIDDM type] [adult-onset type] or unspecified type, uncontrolled Diaphragm, injury to, with open wound into cavity 862.1
Diaphragm, injury to, without mention of open wound into cavity 862.0
Dieulafoy lesion [hemorrhagic] of intestine 569.86
Diptheritic peritonitis 032.83
Disseminated intravascular coagulation in newborn 776.2
Disturbances of sensation of small and taste 781.1
Diverticulitis of colon (without mention of hemorrhage) 562.11
Diverticulitis of colon with hemorrhage 562.13
Diverticulitis of small intestine (without mention of hemorrhage) 562.01
Diverticulitis of small intestine with hemorrhage 562.03
Echinococcosis, unspecified, of liver 122.8 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 9 of 32 Echinococcus granulosus infection of liver 122.0
Echinococcus multilocularis infection of liver 122.5
Eclampsia; antepartum condition or complication 642.63
Eclampsia; delivered, with mention of postpartum complication 642.62
Eclampsia; delivered, with or without mention of antepartum condition 642.61
Eclampsia; postpartum condition or complication 642.64
Eclampsia; unspecified as to episode of care or not applicable 642.60
Eczema herpeticum 054.0
Effects of air pressure; Caisson disease 993.3
Effects of air pressure; Effects of air pressure caused by explosion 993.4
Effects of Heat and Light; Heat cramps 992.2
Effects of Heat and Light; Heat edema 992.7
Effects of Heat and Light; Heat exhaustion due to salt depletion 992.4
Effects of Heat and Light; Heat exhaustion due, unspecified 992.5
Effects of Heat and Light; Heat exhaustion, anhydrotic 992.3
Effects of Heat and Light; Heat fatigue, transient 992.6
Effects of Heat and Light; Heat stroke and sunstroke 992.0
Effects of Heat and Light; Heat syncope 992.1
Effects of Heat and Light; Other specified heat effects 992.8
Effects of other external causes; Effects of hunger 994.2
Effects of other external causes; Effects of thirst 994.3
Effects of Reduced temperature; Hypothermia 991.6
Effects of Reduced temperature; unspecified 990
Enchinococcosis, other and unspecified 122.9
Encounter for antineoplastic; Chemotherapy V58.11
Encounter for other and unspecified procedures and aftercare; Long-term [current] V58.61 drug use; Long-term [current] use of anticoagulants Encounter for other and unspecified procedures and aftercare; Long-term [current] V58.62 drug use; Long-term [current] use of antibiotics Encounter for other and unspecified procedures and aftercare; Long-term [current] V58.69 drug use; Long-term [current] use of other medications End stage renal disease 585.6
Enlargement of lymph nodes 785.6 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 10 of 32 Epistaxis 784.7
Erysipelothrix infection 027.1
Erythema nodosum 695.2
Escherichia coli [E. Coli] 038.42
Esophagus, injury to, with open wound into cavity 862.32
Esophagus, injury to, without mention of open wound into cavity 862.22
Failure to thrive 783.41
Fascioliasis 121.3
Febrile convulsions 780.31
Fever 780.6
Gallbladder, Cholesterolosis of 575.6
Gallbladder, Fistula of 575.5
Gallbladder, Hydrops of 575.3
Gallbladder, Obstruction of 575.2
Gallbladder, Other specified disorders of 575.8
Gallbladder, Perforation of 575.4
Gallbladder, Unspecified disorder of 575.9
Gallstone ileus 560.31
Gas gangrene 040.0
Gastroenteritis and colitis, Toxic 558.2
Gastrointestinal Tract, injury to; Colon or rectum, Ascending [right] colon, with 863.41 open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Ascending [right] colon, with 863.51 open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Colon unspecified, without 863.40 mention of open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Colon unspecified, with without 863.50 mention of open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Descending [left], with without 863.43 mention of open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Descending [left], with open 863.53 wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Multiple sites in colon and 863.46 rectum, with without mention of open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Multiple sites in colon and 863.56 rectum, with open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Other, with open wound into 863.49 cavity HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 11 of 32 Gastrointestinal Tract, injury to; Colon or rectum, Other, with open wound into 863.59 cavity Gastrointestinal Tract, injury to; Colon or rectum, Rectum, with without mention of 863.45 open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Rectum, with open wound into 863.55 cavity Gastrointestinal Tract, injury to; Colon or rectum, Sigmoid Colon, with without 863.44 mention of open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Sigmoid Colon, with open 863.54 wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Transverse colon, with without 863.42 mention of open wound into cavity Gastrointestinal Tract, injury to; Colon or rectum, Transverse colon, with open 863.52 wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.80 Gastrointestinal tract, unspecified; without mention of open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.81 Pancreas, head, without mention of open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.82 Pancreas, body, without mention of open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.83 Pancreas, tail, without mention of open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.84 Pancreas, multiple and unspecified sites, without mention of open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.85 Appendix, without mention of open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, Other, 863.89 without mention of open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.90 Gastrointestinal tract, unspecified site, with open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.91 Pancreas, head, with open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.92 Pancreas, body, with open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.93 Pancreas, tail, with open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.94 Pancreas, multiple and unspecified sites, with open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, 863.95 Appendix, with open wound into cavity Gastrointestinal Tract, injury to; Other and unspecified gastrointestinal sites, Other, 863.99 with open wound into cavity Gastrointestinal Tract, injury to; Small Intestine, Duodenum, without mention of 863.21 open wound into cavity Gastrointestinal Tract, injury to; Small Intestine, Duodenum, with open wound into 863.31 cavity Gastrointestinal Tract, injury to; Small Intestine, Other, with open wound into 863.39 cavity Gastrointestinal Tract, injury to; Small Intestine, Other, without mention of open 863.29 wound into cavity Gastrointestinal Tract, injury to; Small Intestine, unspecified site, without mention 863.20 of open wound into cavity HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 12 of 32 Gastrointestinal Tract, injury to; Small Intestine, unspecified site, with open wound 863.30 into cavity Gastrointestinal Tract, injury to; Stomach, with open wound into cavity 863.1
Gastrointestinal Tract, injury to; Stomach, without mention of open wound into 863.0 cavity Gastrointestinal tract; nonspecific abnormal findings on radiological and other 793.4 examination of body structure Glycogenosis 271.0
Gonococcal infection; other 098.89
Gram-negative organism, unspecified 038.40
Hb-S disease with mention of crisis 282.62
Hb-S disease without mention of crisis 282.61
Heart, injury to, with open wound into thorax; 861.10
Heart, injury to, with open wound into thorax; contusion 861.11
Heart, injury to, with open wound into thorax; laceration with penetration of heart 861.13 chambers Heart, injury to, with open wound into thorax; laceration without penetration of 861.12 heart chambers Heart, injury to, without mention of open wound into thorax; contusion 861.01
Heart, injury to, without mention of open wound into thorax; laceration without 861.02 penetration of heart chambers Heart, injury to, without mention of open wound into thorax; laceration with 861.03 penetration of heart chambers Heart, injury to, without mention of open wound into thorax; unspecified injury 861.00
Hemoglobinuria 791.2
Hemolytic disease due to ABO isoimmunization 773.1
Hemolytic disease due to other and unspecified isoimmunization 773.2
Hemolytic disease due to Rh isoimmunization 773.0
Hemophilus influenzae [H.influenzae] 038.41
Hemorrhage from throat 784.8
Hemothorax with open wound into thorax 860.3
Hemothorax without mention of open wound into thorax 860.2
Hepatic coma 572.2
Hepatic infarction 573.4
Hepatitis C, Acute or unspecified, with hepatic coma 070.41
Hepatitis C, Acute or unspecified, without mention of hepatic coma 070.51 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 13 of 32 Hepatitis C, Chronic, with hepatic coma 070.44
Hepatitis C, Chronic, without mention of hepatic coma 070.54
Hepatitis delta without mention of active hepatitis B disease with hepatic coma 070.42
Hepatitis delta without mention of active hepatitis B or hepatic coma 070.52
Hepatitis due to toxoplasmosis 130.5
Hepatitis E with hepatic coma 070.43
Hepatitis E without mention of hepatic coma 070.53
Hepatitis in other infectious diseases classified elsewhere 573.2
Hepatitis in viral diseases classified elsewhere 573.1
Hepatitis, Chronic persistent 571.41
Hepatitis, Chronic; other 571.49
Hepatitis, Chronic; unspecified 571.40
Hepatitis, unspecified 573.3
Hepatomegaly 789.1
Hepatorenal syndrome 572.4
Herpetic septicemia 054.5
Human immunodeficiency virus [HIV] disease 042
Human immunodeficiency virus [HIV], Nonspecific serologic evidence of 795.71
Hydrops fetalis due to isoimmunization 773.3
Hypercholesterolemia, pure 272.0
Hyperemesis gravidarum with metabolic disturbance; antepartum condition or 643.13 complication Hyperemesis gravidarum with metabolic disturbance; delivered, with or without 643.11 mention of antepartum condition Hyperemesis gravidarum with metabolic disturbance; unspecified as to episode of 643.10 care or not applicable Hyperglyceridemia, pure 272.1
Hyperlipidemia, other and unspecified 272.4
Hypersplenism 289.4
Idiosyncratic alcohol intoxication 291.4
Immune mechanism, other specified disorders involving the 279.8
Impaction of intestine, other 560.39
Impaction of intestine, unspecified 560.30 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 14 of 32 Infectious Mononucleosis 075
Intestinal amebiasis without mention of abscess, Chronic 006.1
Intestinal obstruction, other specified; other 560.89
Intestinal obstruction, unspecified 560.9
Intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection) 560.81
Intestine, perforation of 569.83
Intra-abdominal organs, other; with open wound into cavity; adrenal gland 868.11
Intra-abdominal organs, other; with open wound into cavity; bile duct and 868.12 gallbladder Intra-abdominal organs, other; with open wound into cavity; other and multiple 868.19 intra-abdominal organs Intra-abdominal organs, other; with open wound into cavity; peritoneum 868.13
Intra-abdominal organs, other; with open wound into cavity; retroperitoneum 868.14
Intra-abdominal organs, other; without mention of open wound into cavity; adrenal 868.01 gland Intra-abdominal organs, other; without mention of open wound into cavity; bile 868.02 duct and gallbladder Intra-abdominal organs, other; without mention of open wound into cavity; 868.03 peritoneum Intra-abdominal organs, other; without mention of open wound into cavity; 868.04 retroperitoneum Intra-abdominal organs, other; without mention of open wound into cavity; other 868.09 and multiple intra-abdominal organs Intrathoracic organs, multiple and unspecified, injury to, with open wound into 862.9 cavity Intrathoracic organs, multiple and unspecified, injury to, without mention of open 862.8 wound into cavity Intrathoracic, injury to; with open wound into cavity; Other 862.39
Intrathoracic, injury to; without mention of open wound into cavity; Other 862.29
Intussusception 560.0
Iron metabolism, disorders of 275.0
Jaundice, neonatal; associated with preterm delivery 774.2
Jaundice, neonatal; due to delayed conjugation in diseases classified elsewhere 774.31
Jaundice, neonatal; due to delayed conjugation, cause unspecified 774.30
Jaundice, neonatal; due to delayed conjugation; other 774.39
Jaundice, perinatal; due to hepatocellular damage 774.4
Jaundice, perinatal; from hereditary hemolytic anemias 774.0
Jaundice, perinatal; from other causes 774.5 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 15 of 32 Jaundice, perinatal; from other excessive hemolysis 774.1
Jaundice, unspecified fetal and neonatal 774.6
Jaundice, unspecified, not of newborn 782.4
Kernicterus due to isoimmunization 773.4
Kernicterus not due to isoimmunization 774.7
Kidney, injury to, with open wound into cavity; complete disruption of kidney 866.13 parenchyma Kidney, injury to, with open wound into cavity; hematoma without rupture of 866.11 capsule Kidney, injury to, with open wound into cavity; laceration 866.12
Kidney, injury to, without mention of open wound into cavity; complete disruption 866.03 of kidney parenchyma Kidney, injury to, without mention of open wound into cavity; hematoma without 866.01 rupture of capsule Kidney, injury to, without mention of open wound into cavity; laceration 866.02
Lack of coordination 781.3
Lack of normal physiological development, unspecified 783.40
Late effects of other and unspecified external causes; Late effect of poisoning due 909.0 to drug, medicinal or biological substance Late effects of other and unspecified external causes; Late effect of toxic effects of 909.1 nonmedical substances Late effects of other and unspecified external causes; late effect of radiation 909.2
Late effects of other and unspecified external causes; late effect of complications of 909.3 surgical and medical care Late effects of other and unspecified external causes; Late effect of certain other 909.4 external causes Late effects of other and unspecified external causes; Late effect of adverse effect 909.5 of drug, medical or biological substance. Late effects other and unspecified of injuries; Late effect of internal injury to intra- 908.1 abdominal organs Late effects other and unspecified of injuries; Late effect of injury to blood vessel 908.4 of thorax, abdomen, and pelvis Leptospirosis 100.0
Lipidoses 272.7
Lipoid metabolism, other disorders of 272.9
Listeriosis 027.0
Liver disease, Chronic; other sequelae of 572.8
Liver disease, other chronic nonalcoholic 571.8
Liver disease, unspecified chronic without mention of alcohol 571.9
Liver disorders in pregnancy; antepartum condition or complication 646.73 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 16 of 32 Liver disorders in pregnancy; delivered, with or without mention of antepartum 646.71 condition Liver disorders in pregnancy; unspecified as to episode of care or not applicable 646.70
Liver, Abcess of 572.0
Liver, Chronic passive congestion of 573.0
Liver, Congenital cystic disease of 751.62
Liver, injury to, with open wound into cavity; hematoma and contusion 864.11
Liver, injury to, with open wound into cavity; laceration unspecified 864.15
Liver, injury to, with open wound into cavity; laceration, major 864.14
Liver, injury to, with open wound into cavity; laceration, minor 864.12
Liver, injury to, with open wound into cavity; laceration, moderate 864.13
Liver, injury to, without mention of open wound into cavity; hematoma and 864.01 contusion Liver, injury to, without mention of open wound into cavity; laceration, minor 864.02
Liver, injury to, without mention of open wound into cavity; laceration, moderate 864.03
Liver, injury to, without mention of open wound into cavity; laceration, major 864.04
Liver, injury to, without mention of open wound into cavity; laceration unspecified 864.05
Liver, Other specified disorders of 573.8
Liver, Unspecified disorder of 573.9
Liver; Nonspecific abnormal results of function studies 794.8
Loss of weight 783.21
Lung, injury to, with open wound into thorax; contusion 861.31
Lung, injury to, with open wound into thorax; laceration 861.32
Lung, injury to, with open wound into thorax; unspecified injury 861.30
Lung, injury to, without mention of open wound into thorax; contusion 861.21
Lung, injury to, without mention of open wound into thorax; laceration 861.22
Lung, injury to, without mention of open wound into thorax; unspecified injury 861.20
Lymes disease 088.81
Malaise and fatigue, other 780.79
Malaria, other pernicious complications of 084.9
Malignant neoplasm, secondary; Liver, specified as secondary 197.7
Malignant neoplasm; intrahepatic bile ducts 155.1 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 17 of 32 Malignant neoplasm; Biliary tract, part unspecified 156.9
Malignant neoplasm; Extrahepatic bile ducts 156.1
Malignant neoplasm; Gallbladder 156.0
Malignant neoplasm; liver, not specified as primary or secondary 155.2
Malignant neoplasm; other specified sites of gallbladder and extrahepatic bile ducts 156.8
Malnutrition of mild degree 263.1
Meningismus 781.6
Meningococcemia 036.2
Metabolism, other and unspecified disorders of; with meconium ileus 277.01
Metabolism, other and unspecified disorders of; without mention of meconium ileus 277.00
Miliary tuberculosis, unspecified 018.90
Miliary tuberculosis, unspecified; bacteriological or histologically examination not 018.91 done Miliary tuberculosis, unspecified; bacteriological or histologically examination 018.92 unknown at present Miliary tuberculosis, unspecified; tubercle bacilli found (in sputum) by microscopy 018.93
Miliary tuberculosis, unspecified; tubercle bacilli not found (in sputum) by 018.94 microscopy, but found by bacterial culture Miliary tuberculosis, unspecified; tubercle bacilli not found by bacteriological 018.95 examination, but tuberculosis confirmed histologically Miliary tuberculosis, unspecified; tubercle bacilli not found by bacteriological or 018.96 histologically examination but tuberculosis confirmed by other methods(inoculation of animal Mumps hepatitis 072.71
Myotonic disorders 359.2
Necrosis of liver, Acute and Subacute 570
Nephrotic syndrome with lesion of membroanoproliferative glomerulonephritis 581.2
Nephrotic syndrome with lesion of membranous glomerulonephritis 581.1
Nephrotic syndrome with lesion of minimal change glomerulonephritis 581.3
Nephrotic syndrome with lesion of proliferative glomerulonephritis 581.0
Nephrotic syndrome with unspecified pathological lesion in kidney 581.9
Neurologic neglect syndrome 781.8
Nonspecific abnormal results of function studies; Other 794.9
Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [LDH] 790.4
Observation and evaluation for suspected exposure to anthrax V71.82
HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 18 of 32 Observation and evaluation for suspected exposure to other biological agent V71.83
Organ or tissue replaced by transplant; Liver V42.7
Ornithosis with pneumonia 073.0
Osteitis deformans without mention of bone tumor 731.0
Other amyloidosis 277.39
Other complications of procedures, not elsewhere classified; Accidental puncture or 998.2 laceration during a procedure Other complications of procedures, not elsewhere classified; Postoperative shock 998.0
Other retoperitoneal infections 567.39
Other retroperitonial abcess 567.38
Other sickle-cell disease without crisis 282.68
Other specific peritonitis 567.89
Other specified diseases due to Cosackie virus 074.8
Other suppurative Peritonitis 567.29
Pancreas, Cyst and pseudocyst of 577.2
Pancreas, Other specified diseases of 577.8
Pancreas, Unspecified disease of 577.9
Pancreatitis, Acute 577.0
Pancreatitis, Chronic 577.1
Paralytic ileus 560.1
Pathological lesion in kidney, Other specified 581.89
Peritoneal Abcess 567.22
Peritonitis, (Acute) Generalized 567.21
Peritonitis, Pneumococcal 567.1
Peritonitis, Unspecified 567.9
Persistent vegetative state 780.03
Personal history of certain other diseases; Diseases of blood and blood-forming V12.3 organs Personal history of certain other diseases; Endocrine, metabolic, and immunity V12.2 disorders Personal history of certain other diseases; Infectious and parasitic diseases; V12.01 Tuberculosis Personal history of certain other diseases; Infectious and parasitic diseases; V12.02 Poliomyelitis HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 19 of 32 Personal history of certain other diseases; Infectious and parasitic diseases; Malaria V12.03
Personal history of malignant neoplasm; Gastrointestinal tract; Liver V10.07
Pneumococcal septicemia [Streptococcus pheumoniae septicemia] 038.2
Pneumohemothorax with open wound into thorax 860.5
Pneumohemothorax without mention of open wound into thorax 860.4
Pneumothorax with open wound into thorax 860.1
Pneumothorax without mention to open wound into thorax 860.0
Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.0 respiratory system; Oxytocic agents Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.1 respiratory system; Smooth muscle relaxants Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.2 respiratory system; Skeletal muscle relaxants Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.3 respiratory system; Other and unspecified drugs acting on muscles Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.4 respiratory system; Antitussives Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.5 respiratory system; Expectorants Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.6 respiratory system; Anti-common cold drugs Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.7 respiratory system; Antiasthmatics Poisoning by agents primarily acting on the smooth and skeletal muscles and 975.8 respiratory system; Other and unspecified respiratory drugs Poisoning by agents primarily affecting blood constituents; Anticoagulants 964.2
Poisoning by agents primarily affecting blood constituents; Anticoagulant 964.5 antagonists and other coagulants Poisoning by agents primarily affecting blood constituents; Fibrinolysis-affecting 964.4 drugs Poisoning by agents primarily affecting blood constituents; Gamma globulin 964.6
Poisoning by agents primarily affecting blood constituents; Iron and its compounds 964.0
Poisoning by agents primarily affecting blood constituents; Liver preparations and 964.1 other antianemic agents Poisoning by agents primarily affecting blood constituents; Natural blood and blood 964.7 products Poisoning by agents primarily affecting blood constituents; Other specified agents 964.8 affecting blood constituents Poisoning by agents primarily affecting blood constituents; Unspecified agent 967.9 affecting blood constituents Poisoning by agents primarily affecting blood constituents; Vitamin K 964.3 [phytonadione] Poisoning by agents primarily affecting skin and mucous membrane, 976.0 ophthalmological, otorhinolaryngological, and dental drugs; Local anti-infectives and anti-inflammatory drugs HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 20 of 32 Poisoning by agents primarily affecting skin and mucous membrane, 976.1 ophthalmological, otorhinolaryngological, and dental drugs; Antipruritics Poisoning by agents primarily affecting skin and mucous membrane, 976.2 ophthalmological, otorhinolaryngological, and dental drugs; Local astringents and local detergents Poisoning by agents primarily affecting skin and mucous membrane, 976.3 ophthalmological, otorhinolaryngological, and dental drugs; Emollients, demulcents, and protectants Poisoning by agents primarily affecting skin and mucous membrane, 976.4 ophthalmological, otorhinolaryngological, and dental drugs; Keratolytics, keratoplastics, other hair treatment drugs and preparations Poisoning by agents primarily affecting skin and mucous membrane, 976.5 ophthalmological, otorhinolaryngological, and dental drugs; Eye anti-infectives and other eye drugs Poisoning by agents primarily affecting skin and mucous membrane, 976.6 ophthalmological, otorhinolaryngological, and dental drugs; Anti-infectives and other drugs and preparations for ear, nose and throat Poisoning by agents primarily affecting skin and mucous membrane, 976.7 ophthalmological, otorhinolaryngological, and dental drugs; Dental drugs topically applied Poisoning by agents primarily affecting skin and mucous membrane, 976.8 ophthalmological, otorhinolaryngological, and dental drugs; Other agents primarily affecting skin and mucous membrane Poisoning by agents primarily affecting skin and mucous membrane, 976.9 ophthalmological, otorhinolaryngological, and dental drugs; Unspecified agent primarily affecting skin and mucous membrane Poisoning by agents primarily affecting the cardiovascular system; Cardiac rhythm 972.0 regulators Poisoning by agents primarily affecting the cardiovascular system; Cardiotonic 972.1 glycosides and drugs of similar action Poisoning by agents primarily affecting the cardiovascular system; Antilipemic and 972.2 antiarteriosclerotic drugs Poisoning by agents primarily affecting the cardiovascular system; Ganglion- 972.3 blocking agents Poisoning by agents primarily affecting the cardiovascular system; Coronary 972.4 vasodilators Poisoning by agents primarily affecting the cardiovascular system; Other 972.5 vasodilators Poisoning by agents primarily affecting the cardiovascular system; Other 972.6 antihypertensive agents Poisoning by agents primarily affecting the cardiovascular system; Antivaricose 972.7 drugs, including sclerosing agents Poisoning by agents primarily affecting the cardiovascular system; Capillary-active 972.8 drugs Poisoning by agents primarily affecting the cardiovascular system; Other and 972.9 unspecified agents primarily affecting the cardiovascular system Poisoning by agents primarily affecting the gastrointestinal system; Antacids and 973.0 antigastric secretion drugs Poisoning by agents primarily affecting the gastrointestinal system; Irritant 973.1 cathartics Poisoning by agents primarily affecting the gastrointestinal system; Emollient 973.2 cathartics HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 21 of 32 Poisoning by agents primarily affecting the gastrointestinal system; Other 973.3 cathartics, including intestinal atonia drugs Poisoning by agents primarily affecting the gastrointestinal system; Digestants 973.4
Poisoning by agents primarily affecting the gastrointestinal system; Antidiarrheal 973.5 drugs Poisoning by agents primarily affecting the gastrointestinal system; Emetics 973.6
Poisoning by agents primarily affecting the gastrointestinal system; Other specified 973.8 agents primarily affecting the gastrointestinal system Poisoning by agents primarily affecting the gastrointestinal system; Unspecified 973.9 agent primarily affecting the gastrointestinal system Poisoning by analgesics, antipyretics, and antirheumatics; Antirheumatics 965.61 [antiphlogistics]; Propionic acid derivatives Poisoning by analgesics, antipyretics, and antirheumatics; Antirheumatics 965.69 [antiphlogistics]; Other antirheumatics Poisoning by analgesics, antipyretics, and antirheumatics; Antirheumatics 965.7 [antiphlogistics]; Other non-narcotic analgesics Poisoning by analgesics, antipyretics, and antirheumatics; Antirheumatics 965.8 [antiphlogistics]; Other specified analgesics and antipyretics Poisoning by analgesics, antipyretics, and antirheumatics; Antirheumatics 965.9 [antiphlogistics]; Unspecified analgesic and antipyretic Poisoning by analgesics, antipyretics, and antirheumatics; Aromatic analgesic, not 965.4 elsewhere classified Poisoning by analgesics, antipyretics, and antirheumatics; Opiates and related 965.00 narcotics; Opium[alkaloids], unspecified Poisoning by analgesics, antipyretics, and antirheumatics; Opiates and related 965.01 narcotics; Heroin Poisoning by analgesics, antipyretics, and antirheumatics; Opiates and related 965.02 narcotics; Methadone Poisoning by analgesics, antipyretics, and antirheumatics; Opiates and related 965.09 narcotics; Other Poisoning by analgesics, antipyretics, and antirheumatics; Pyrazole derivatives 965.5
Poisoning by analgesics, antipyretics, and antirheumatics; Salicylates 965.1
Poisoning by antibiotics; Antifungal antibiotics 960.1
Poisoning by antibiotics; Antimycobacterial antibiotics 960.6
Poisoning by antibiotics; Antineoplastic antibiotics 960.7
Poisoning by antibiotics; Cephalosporin group 960.5
Poisoning by antibiotics; Chloramphenicol group 960.2
Poisoning by antibiotics; Erythromycin and other macrolides 960.3
Poisoning by antibiotics; Other specified antibiotics 960.8
Poisoning by antibiotics; Penicillins 960.0
Poisoning by antibiotics; Tetracyline group 960.4
Poisoning by antibiotics; Unspecified antibiotics 960.9 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 22 of 32 Poisoning by anticonvulsant and anti Parkinsonism drugs; Anti-Parkinsonism drugs 966.4
Poisoning by anticonvulsant and anti Parkinsonism drugs; hydantoin derivatives 966.1
Poisoning by anticonvulsant and anti Parkinsonism drugs; Other and unspecified 966.3 anticonvulsants Poisoning by anticonvulsant and anti Parkinsonism drugs; Oxazolidine derivatives 966.0
Poisoning by anticonvulsant and anti Parkinsonism drugs; Succinimides 966.2
Poisoning by bacterial vaccines; BCG 978.0
Poisoning by bacterial vaccines; Cholera 978.2
Poisoning by bacterial vaccines; Diphtheria 978.5
Poisoning by bacterial vaccines; Mixed bacterial vaccines, except combinations 978.9 with a pertussis component Poisoning by bacterial vaccines; Other and unspecified bacterial vaccines 978.8
Poisoning by bacterial vaccines; Pertussis vaccine, including combinations with a 978.6 pertussis component Poisoning by bacterial vaccines; Plague 978.3
Poisoning by bacterial vaccines; Tetanus 978.4
Poisoning by bacterial vaccines; Typhoid and paratyphoid 978.1
Poisoning by central nervous system stimulants; Analeptics 970.0
Poisoning by central nervous system stimulants; Opiate antagonists 970.1
Poisoning by central nervous system stimulants; Other specified central nervous 970.8 system stimulants Poisoning by central nervous system stimulants; Unspecified central nervous 970.9 system stimulant Poisoning by drugs primarily affecting the autonomic nervous system; 971.0 Parasympathomimetics [cholinergics] Poisoning by drugs primarily affecting the autonomic nervous system; 971.1 Parasympatholytics [anticholinergics and antimuscarinics] Poisoning by drugs primarily affecting the autonomic nervous system; 971.2 Sypmathomimetics [adrenergics] Poisoning by drugs primarily affecting the autonomic nervous system; 971.3 Sympatholytis [antiadrenergis] Poisoning by drugs primarily affecting the autonomic nervous system; Unspecified 971.9 drug primarily affecting autonomic nervous system Poisoning by hormones and synthetic substitutes; Adrenal cortical steroids 962.0
Poisoning by hormones and synthetic substitutes; Androgens and anabolic 962.1 congeners Poisoning by hormones and synthetic substitutes; Anterior pituitary hormones 962.4
Poisoning by hormones and synthetic substitutes; Antithyroid agents 962.8
Poisoning by hormones and synthetic substitutes; Insulin's and antidiabetic agents 962.3 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 23 of 32 Poisoning by hormones and synthetic substitutes; Other and unspecified hormones 962.9 and synthetic substitutes Poisoning by hormones and synthetic substitutes; Ovarian hormones and synthetic 962.2 substitutes Poisoning by hormones and synthetic substitutes; Parathyroid and parathyroid 962.6 derivatives Poisoning by hormones and synthetic substitutes; Posterior pituitary hormones 962.5
Poisoning by hormones and synthetic substitutes; Thyroid and thyroid derivatives 962.7
Poisoning by other and unspecified drugs and medicinal substances; Dietetics 977.0
Poisoning by other and unspecified drugs and medicinal substances; Lipotropic 977.1 drugs Poisoning by other and unspecified drugs and medicinal substances; Antidotes and 977.2 chelating agents, not elsewhere classified Poisoning by other and unspecified drugs and medicinal substances; Alcohol 977.3 deterrents Poisoning by other and unspecified drugs and medicinal substances; Pharmaceutical 977.4 excipients Poisoning by other and unspecified drugs and medicinal substances; Other specified 977.8 drugs and medicinal substances Poisoning by other and unspecified drugs and medicinal substances; Unspecified 977.9 drug or medicinal substance Poisoning by other anti-infectives; Anthelmintics 961.6
Poisoning by other anti-infectives; Antimalarials and drugs acting on other blood 961.4 protozoa Poisoning by other anti-infectives; Antiviral drugs 961.7
Poisoning by other anti-infectives; Arsenical anti-infectives 961.1
Poisoning by other anti-infectives; Heavy metal anti-infectives 961.2
Poisoning by other anti-infectives; Other and unspecified anti-infectives 961.9
Poisoning by other anti-infectives; Other anti mycobacterial drugs 961.8
Poisoning by other anti-infectives; Other antiprotozoal drugs 961.5
Poisoning by other anti-infectives; Quinoline and Hydroxyquinoline derivatives 961.3
Poisoning by other anti-infectives; sulfonamides 961.0
Poisoning by other central nervous system depressants and anesthetics; Central 968.0 nervous system muscle-tone depressants Poisoning by other central nervous system depressants and anesthetics; Halothane 968.1
Poisoning by other central nervous system depressants and anesthetics; Other 968.2 gaseous anesthetics Poisoning by other central nervous system depressants and anesthetics; Intravenous 968.3 anesthetics Poisoning by other central nervous system depressants and anesthetics; Other and 968.4 unspecified anesthetics Poisoning by other central nervous system depressants and anesthetics; Surface 968.5 [topical] and infiltration anesthetics HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 24 of 32 Poisoning by other central nervous system depressants and anesthetics; Peripheral 968.6 nerve-and plexus- blocking anesthetics Poisoning by other central nervous system depressants and anesthetics; Spinal 968.7 anesthetics Poisoning by other central nervous system depressants and anesthetics; Other and 968.9 unspecified local anesthetics Poisoning by other vaccines and biological substances; Measles vaccine 979.4
Poisoning by other vaccines and biological substances; Mixed viral-rickettsial and 979.7 bacterial vaccines, except combinations with a pertussis component Poisoning by other vaccines and biological substances; Other and unspecified viral 979.6 and rickettsial vaccines Poisoning by other vaccines and biological substances; Other and unspecified 979.9 vaccines and biological substances Poisoning by other vaccines and biological substances; Poliomyelitis vaccine 979.5
Poisoning by other vaccines and biological substances; Rabies vaccine 979.1
Poisoning by other vaccines and biological substances; Smallpox vaccine 979.0
Poisoning by other vaccines and biological substances; Typhus vaccine 979.2
Poisoning by other vaccines and biological substances; Yellow fever vaccine 979.3
Poisoning by primarily systemic agents; Acidifying agents 963.2
Poisoning by primarily systemic agents; Alkalizing agents 963.3
Poisoning by primarily systemic agents; Antiallergic and antiemetic drugs 963.0
Poisoning by primarily systemic agents; Antineoplastic and immunosuppressive 963.1 drugs Poisoning by primarily systemic agents; Enzymes, not elsewhere classified 963.4
Poisoning by primarily systemic agents; Other specified systemic agents 963.8
Poisoning by primarily systemic agents; Unspecified systemic agents 963.9
Poisoning by primarily systemic agents; Vitamins, not elsewhere classified 963.5
Poisoning by psychotropic agents; Antidepressants 969.0
Poisoning by psychotropic agents; Benzodiazepine-based tranquilizers 969.4
Poisoning by psychotropic agents; Butyrophenone-based tranquilizers 969.2
Poisoning by psychotropic agents; Other antipsychotics, neuroleptics, and major 969.3 tranquilizers Poisoning by psychotropic agents; Other specified psychotropic agents 969.8
Poisoning by psychotropic agents; Other tranquilizers 969.5
Poisoning by psychotropic agents; Phenothiazine-based tranquilizers 969.1
Poisoning by psychotropic agents; Psychodysleptics {hallucinogens] 969.6
Poisoning by psychotropic agents; Psychostimulants 969.7 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 25 of 32 Poisoning by psychotropic agents; Unspecified psychotropic agent 969.9
Poisoning by sedatives and hypnotics; Barbiturates 967.0
Poisoning by sedatives and hypnotics; Bromine compounds 967.3
Poisoning by sedatives and hypnotics; Chloral hydrate group 967.1
Poisoning by sedatives and hypnotics; Glutethimide group 967.5
Poisoning by sedatives and hypnotics; Methaqualone compounds 967.4
Poisoning by sedatives and hypnotics; Mixed sedatives, not elsewhere classified 967.6
Poisoning by sedatives and hypnotics; Other sedatives and hypnotics 967.8
Poisoning by sedatives and hypnotics; Paraldehyde 967.2
Poisoning by sedatives and hypnotics; Unspecified sedative or hypnotic 967.9
Poisoning by water, mineral, and uric acid metabolism drugs; Carbonic acid 974.2 anhydrase inhibitors Poisoning by water, mineral, and uric acid metabolism drugs; Electrolytic, caloric, 974.5 and water-balance agents Poisoning by water, mineral, and uric acid metabolism drugs; Mercurial diuretics 974.0
Poisoning by water, mineral, and uric acid metabolism drugs; Other diuretics 974.4
Poisoning by water, mineral, and uric acid metabolism drugs; Other mineral salts, 974.6 not elsewhere classified Poisoning by water, mineral, and uric acid metabolism drugs; Purine derivative 974.1 diuretics Poisoning by water, mineral, and uric acid metabolism drugs; Saluretics 974.3
Poisoning by water, mineral, and uric acid metabolism drugs; Uric acid metabolism 974.7 drugs Polyarteritis nodosa 446.0
Porphyrin metabolism, disorders of 277.1
Portal hypertension 572.3
Portal pyemia 572.1
Portal vein thrombosis 452
Postcholecystectomy syndrome 576.0
Postoperative infection; Acute reaction to foreign substance accidentally left during 998.7 a procedure Postoperative infection; Infected postoperative seroma 998.51
Postoperative infection; Other postoperative infection 998.59
Precipitous drop in hematocrit 790.01
Pre-eclampsia or eclampsia superimposed on pre-existing hypertension; unspecified 642.70 as to episode of care or not applicable HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 26 of 32 Pre-eclampsia or eclampsia superimposed on pre-existing hypertension; delivered, 642.71 with or without mention of antepartum condition Pre-eclampsia or eclampsia superimposed on pre-existing hypertension; delivered, 642.72 with mention of postpartum complication Pre-eclampsia or eclampsia superimposed on pre-existing hypertension; antepartum 642.73 condition or complication Pre-eclampsia or eclampsia superimposed on pre-existing hypertension; postpartum 642.74 condition or complication Pre-Eclampsia, Severe; antepartum condition or complication 642.53
Pre-Eclampsia, Severe; delivered, with mention of postpartum complication 642.52
Pre-Eclampsia, Severe; delivered, with or without mention of antepartum condition 642.51
Pre-Eclampsia, Severe; postpartum condition or complication 642.54
Pre-Eclampsia, Severe; unspecified as to episode of care or not applicable 642.50
Primary pneumonic; Plague 020.3
Prostate specific antigen [PSA], elevated 790.93
Proteinuria 791.0
Pruritic disorder, Unspecified 698.9
Pseudomonas 038.43
Psoas Muscle Abscess 567.31
Pyoderma gangrenosum 686.01
Pyoderma, Other 686.09
Pyoderma, Unspecified 686.00
Red blood cells, other abnormality of 790.09
Respiratory arrest 799.1
Rheumatoid arthritis 714.0
Rib(s), fracture of, closed; eight or more ribs 807.08
Rib(s), fracture of, closed; five ribs 807.05
Rib(s), fracture of, closed; four ribs 807.04
Rib(s), fracture of, closed; multiple ribs, unspecified 807.09
Rib(s), fracture of, closed; one rib 807.01
Rib(s), fracture of, closed; seven ribs 807.07
Rib(s), fracture of, closed; six ribs 807.06
Rib(s), fracture of, closed; three ribs 807.03 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 27 of 32 Rib(s), fracture of, closed; two ribs 807.02
Rib(s), fracture of, open; eight or more ribs 807.18
Rib(s), fracture of, open; five ribs 807.15
Rib(s), fracture of, open; four ribs 807.14
Rib(s), fracture of, open; multiple ribs, unspecified 807.19
Rib(s), fracture of, open; one rib 807.11
Rib(s), fracture of, open; rib(s) unspecified 807.10
Rib(s), fracture of, open; seven ribs 807.17
Rib(s), fracture of, open; six ribs 807.16
Rib(s), fracture of, open; three ribs 807.13
Rib(s), fracture of, open; two ribs 807.12
Salmonella Septicemia 003.1
Sarcoidosis 135
Schistosomiasis, unspecified 120.9
Sclerosing mesenteritis 567.82
Secondary pneumonic; Plague 020.4
Sedimentation rate, elevated 790.1
Septic Shock 785.52
Septicemia due to anaerobes 038.3
Septicemia, Unspecified 038.9
Septicemia; other 038.49
Septicemic; Plague 020.2
Serratia 038.44
Shock without mention of trauma; other 785.59
Shock, unspecified 785.50
Short stature 783.43
Sickle-cell anemia, unspecified 282.60
Sickle-cell anemia; Other 282.69
Sickle-cell/Hb-C disease 282.63
Sickle-cell/Hb-C disease with crisis 282.64 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 28 of 32 Speech disturbance, Other 784.5
Sphincter of Oddi, spasm of 576.5
Spleen, injury to, with open wound into cavity; capsular tears, without major 865.12 disruption of parenchyma Spleen, injury to, with open wound into cavity; hematoma without rupture of 865.11 capsule Spleen, injury to, with open wound into cavity; laceration extending into 865.13 parenchyma Spleen, injury to, with open wound into cavity; massive parenchyma disruption 865.14
Spleen, injury to, without mention of open wound into cavity; capsular tears, 865.02 without major disruption of parenchyma Spleen, injury to, without mention of open wound into cavity; hematoma without 865.01 rupture of capsule Spleen, injury to, without mention of open wound into cavity; laceration extending 865.03 into parenchyma Spleen, injury to, without mention of open wound into cavity; massive parenchyma 865.04 disruption Splenomegaly 789.2
Spontaneous Bacterial Peritonitis 567.23
Spotted fevers 082.0
Staphylococcal septicemia, Other 038.19
Staphylococcal septicemia, unspecified 038.10
Staphylococcus aureus septicemia 038.11
Sternum, fracture of, closed 807.2
Sternum, fracture of, open 807.3
Stool contents; nonspecific abnormal findings in other body substances 792.1
Streptococcal septicemia 038.0
Sylvatic; Yellow Fever 060.0
Symbolic dsyfunction; other 784.69
Syphilis of liver 095.3
Syphilitic hepatitis, secondary 091.62
Systemic Lupus Erythematosus 710.0
Systemic Sclerosis 710.1
Tetany 781.7
Thrombophlebitis migrans 453.1
Thrombotic microangiopathy 446.6 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 29 of 32 Toxic effect of alcohol; Ethyl alcohol 980.0
Toxic effect of alcohol; Fusel oil 980.3
Toxic effect of alcohol; Isopropyl alcohol 980.2
Toxic effect of alcohol; Methyl alcohol 980.1
Toxic effect of alcohol; Other specified alcohols 980.8
Toxic effect of alcohol; Unspecified alcohols 980.9
Toxic effect of carbon monoxide 986
Toxic effect of corrosive aromatics, acids and caustic alkalis; Acids 983.1
Toxic effect of corrosive aromatics, acids and caustic alkalis; Corrosive aromatics 983.0
Toxic effect of corrosive aromatics, acids and caustic alkalis; Caustic alkalis 983.2
Toxic effect of corrosive aromatics, acids and caustic alkalis; Caustic, unspecified 983.9
Toxic effect of lead and its components (including fumes); Inorganic lead 984.0 compounds Toxic effect of lead and its components (including fumes); Organic lead 984.1 compounds Toxic effect of lead and its components (including fumes); Other lead compounds 984.8
Toxic effect of lead and its components (including fumes); Unspecified compound 984.9
Toxic effect of noxious substances eaten as food; Berries and other plants 988.2
Toxic effect of noxious substances eaten as food; Fish and shellfish 988.0
Toxic effect of noxious substances eaten as food; Mushrooms 988.1
Toxic effect of noxious substances eaten as food; Other specified noxious 988.8 substances eaten as food Toxic effect of noxious substances eaten as food; Unspecified noxious substances 988.9 eaten as food Toxic effect of other gases, fumes, or vapors; Chlorine gas 987.6
Toxic effect of other gases, fumes, or vapors; Freon 987.4
Toxic effect of other gases, fumes, or vapors; Hydrocyanic acid gas 987.7
Toxic effect of other gases, fumes, or vapors; Lacimogenic gas 987.5
Toxic effect of other gases, fumes, or vapors; Liquefied petroleum gases 987.0
Toxic effect of other gases, fumes, or vapors; Nitrogen oxides 987.2
Toxic effect of other gases, fumes, or vapors; Other hydrocarbon gas 987.1
Toxic effect of other gases, fumes, or vapors; Other specified gases, fumes, or 987.8 vapors Toxic effect of other gases, fumes, or vapors; Sulfur dioxide 987.3 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 30 of 32 Toxic effect of other gases, fumes, or vapors; Unspecified gas, fume, or vapor 987.9
Toxic effect of other metals; Antimony and its compounds 985.4
Toxic effect of other metals; Arsenic and its compounds 985.1
Toxic effect of other metals; Beryllium and its compounds 985.3
Toxic effect of other metals; Cadmium and its compounds 985.5
Toxic effect of other metals; Chromium 985.6
Toxic effect of other metals; Manganese and its compounds 985.2
Toxic effect of other metals; Mercury and its compounds 985.0
Toxic effect of other metals; Other specified metals 985.8
Toxic effect of other metals; Unspecified metal 985.9
Toxic effect of other substances, chiefly nonmedicinal as to source; Hydrocyanic 989.0 acid and cyanides Toxic effect of other substances, chiefly nonmedicinal as to source; Strychnine and 989.1 salts Toxic effect of other substances, chiefly nonmedicinal as to source; Chlorinated 989.2 hydrocarbons Toxic effect of other substances, chiefly nonmedicinal as to source; 989.3 Organophosphate and carbamate Toxic effect of other substances, chiefly nonmedicinal as to source; Other 989.4 pesticides, not elsewhere classified Toxic effect of other substances, chiefly nonmedicinal as to source; Venom 989.5
Toxic effect of other substances, chiefly nonmedicinal as to source; Soaps and 989.6 detergents Toxic effect of other substances, chiefly nonmedicinal as to source; Aflatoxin and 989.7 other mycotoxin [food contaminates] Toxic effect of petroleum products 981
Toxic effect of solvents other than petroleum-based; Benzene and homologues 982.0
Toxic effect of solvents other than petroleum-based; Carbon disulfide 982.2
Toxic effect of solvents other than petroleum-based; Carbon tetrachloride 982.1
Toxic effect of solvents other than petroleum-based; Nitroglycol 982.4
Toxic effect of solvents other than petroleum-based; Other Chlorinated 982.3 hydrocarbon solvents Toxic effect of solvents other than petroleum-based; Other nonpetroleum-based 982.8 solvents Transient alteration of awareness 780.02
Traumatic Shock; Certain early complications of trauma 958.4
Tuberculosis of intestines, peitoneum, and mesenteric glands; other unspecified 014.80
Tuberculosis of intestines, peitoneum, and mesenteric glands; other, bacteriological 014.81 or histological examination not done HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 31 of 32 Tuberculosis of intestines, peitoneum, and mesenteric glands; other, bacteriological 014.82 or histological examination unknown at present Tuberculosis of intestines, peitoneum, and mesenteric glands; other, tubercle bacilli 014.83 found (in sputum) by microscopy Tuberculosis of intestines, peitoneum, and mesenteric glands; other, tubercle bacilli 014.84 not found (in sputum) by microscopy, but found by bacterial culture Tuberculosis of intestines, peitoneum, and mesenteric glands; other, tubercle bacilli 014.85 not found by bacteriological examination, but tuberculosis confirmed histological Tuberculosis of intestines, peitoneum, and mesenteric glands; other, Tubercle 014.86 bacilli not found by bacteriological or histological examination but tuberculosis confirmed by other methods(inoculation of animal Tuberculosis of other organs; other specified organs; bacteriological or histological 017.91 examination not done Tuberculosis of other organs; other specified organs; bacteriological or 017.92 histologically examination unknown at present Tuberculosis of other organs; other specified organs; tubercle bacilli found (in 017.93 sputum) by microscopy Tuberculosis of other organs; other specified organs; tubercle bacilli not found (in 017.94 sputum) by microscopy, but found by bacterial culture Tuberculosis of other organs; other specified organs; tubercle bacilli not found by 017.95 bacteriological examination, but tuberculosis confirmed histologically Tuberculosis of other organs; other specified organs; tubercle bacilli not found by 017.96 bacteriological or histologically examination but tuberculosis confirmed by other methods(inoculation of animal Tuberculosis of other organs; other specified organs; unspecified 017.90
Turberculous peritonitis; bacteriological or histological examination not done 014.01
Turberculous peritonitis; bacteriological or histological examination unknown at 014.02 present Turberculous peritonitis; tubercle bacilli found (in sputum) by microscopy 014.03
Turberculous peritonitis; Tubercle bacilli not found (in sputum) by microscopy, but 014.04 found by bacterial culture Turberculous peritonitis; tubercle bacilli not found by bacteriological examination, 014.05 but tuberculosis confirmed histological Turberculous peritonitis; Tubercle bacilli not found by bacteriological or 014.06 histological examination but tuberculosis confirmed by other methods(inoculation of animal Turberculous peritonitis; unspecified 014.00
Unspecified adverse effect of other drug, medicinal and biological substance 995.29
Unspecified viral hepatitis C with hepatic coma 070.71
Unspecified viral hepatitis C without hepatic coma 070.70
Urban; Yellow Fever 060.1
Venous embolism and thrombosis, other; of other specified veins 453.8
Venous embolism and thrombosis, other; of vena cava 453.2
Venous embolism and thrombosis, other; off unspecified site 453.9 HEPATIC FUNCTION PANEL ICD9 CODES THAT SUPPORT MEDICAL NECESSITY [MEDICARE POLICY #98RI-7-1] Page 32 of 32 Viral Hepatitis A with hepatic coma 070.0
Viral Hepatitis A without mention of hepatic coma 070.1
Viral Hepatitis B with hepatic coma; acute or unspecified with hepatitis delta 070.21
Viral Hepatitis B with hepatic coma; acute or unspecified, without mention of 070.20 hepatitis delta Viral Hepatitis B with hepatic coma; chronic, with hepatitis delta 070.23
Viral Hepatitis B with hepatic coma; chronic, without mention of hepatitis delta 070.22
Viral Hepatitis B without mention of hepatic coma; acute or unspecified, without 070.30 mention of hepatitis delta Viral Hepatitis B without mention of hepatic coma; acute or unspecified with 070.31 hepatitis delta Viral Hepatitis B without mention of hepatic coma; chronic, with hepatitis delta 070.33
Viral Hepatitis B without mention of hepatic coma; chronic, without mention of 070.32 hepatitis delta Viral hepatitis with hepatic coma, Unspecified 070.6
Viral hepatitis without mention of hepatic coma, Unspecified 070.9
Viral hepatitis, other specified, with hepatic coma 070.49
Viremia, unspecified 790.8
Vitamin K, Deficiency of 269.0
Volvulus 560.2
Waterhouse-Friderichsen syndrome, meningococcal 036.3
LIVER / HEPATIC PANEL ICD Codes Numerical Order 003.1 017.96 038.44 006.0 018.90 038.49 006.1 018.91 038.9 006.2 018.92 039.2 006.3 018.93 040.0 006.4 018.94 042 006.5 018.95 054.0 006.6 018.96 054.5 006.8 020.0 060.0 006.9 020.1 060.1 014.00 020.2 070.0 014.01 020.3 070.1 014.02 020.4 070.20 014.03 022.3 070.21 014.04 027.0 070.22 014.05 027.1 070.23 014.06 032.83 070.30 014.80 036.2 070.31 014.81 036.3 070.32
014.82 070.33 038.0 014.83 070.41 038.10 014.84 070.42 038.11 014.85 070.43 038.19 014.86 070.44 038.2 017.90 070.49 038.3 017.91 070.51 038.40 017.92 070.52 038.41 017.93 070.53 038.42 017.94 070.54 038.43 017.95 070.6 LIVER / HEPATIC PANEL ICD Codes Numerical Order 070.70 156.8 277.01 070.71 156.9 277.1 070.9 197.7 277.30 072.71 230.8 277.39 073.0 250.10 277.4 074.8 250.11 277.6 075 250.12 279.4 078.5 250.13 279.8 082.0 250.30 282.60 084.9 250.31 282.61 086.1 250.32 282.62 088.81 250.33 282.63 091.62 250.80 282.64 095.3 250.81 282.68
098.89 250.82 282.69 100.0 250.83 286.6 112.5 263.1 286.7 120.9 269.0 289.4 121.1 270.2 291.0 121.3 270.9 291.1 122.0 271.0 291.2 122.5 272.0 291.3 122.8 272.1 291.4 122.9 272.4 291.5 130.5 272.7 291.81 135 272.9 291.82 155.1 273.4 291.89 155.2 275.0 291.9 156.0 275.1 303.00 156.1 277.00 LIVER / HEPATIC PANEL ICD Codes Numerical Order 303.01 562.13 572.3 303.02 567.1 572.4 303.91 567.21 572.8 303.92 567.22 573.0 357.5 567.23 573.1 359.2 567.29 573.2 446.0 567.31 573.3 446.6 567.38 573.4 452 567.39 573.8 453.0 567.81 573.9 453.1 567.82 574.00 453.2 567.89 574.01 453.8 567.9 574.10 453.9 569.83 574.11 540.0 569.86 574.20 540.1 570 574.21 540.9 571.0 574.30 558.2 571.1 574.31 560.0 571.2 574.40 560.1 571.3 574.41 560.2 571.40 574.50 560.30 571.41 574.51 560.31 571.49 574.60 560.39 571.5 574.61 560.81 571.6 574.70 560.89 571.8 574.71 560.9 571.9 574.80 562.01 572.0 574.81 562.03 572.1 574.90 562.11 572.2 574.91 LIVER / HEPATIC PANEL ICD Codes Numerical Order 575.0 585.3 710.0 575.10 585.4 710.1 575.11 585.5 710.3 575.12 585.6 714.0 575.2 642.50 731.0 575.3 642.51 751.60 575.4 642.52 751.61 575.5 642.53 751.62 575.6 642.54 751.69 575.8 642.60 773.0 575.9 642.61 773.1 576.0 642.62 773.2 576.1 642.63 773.3 576.2 642.64 773.4 576.3 642.70 774.0 576.4 642.71 774.1 576.5 642.72 774.2 576.8 642.73 774.30 576.9 642.74 774.31 577.0 643.10 774.39 577.1 643.11 774.4 577.2 643.13 774.5 577.8 646.70 774.6 577.9 646.71 774.7 581.0 646.73 776.2 581.1 686.00 780.02 581.2 686.01 780.03 581.3 686.09 780.31 581.89 695.2 780.32 581.9 698.9 780.6 LIVER / HEPATIC PANEL ICD Codes Numerical Order 780.71 789.04 789.64 780.79 789.05 789.65 781.0 789.06 789.66 781.1 789.07 789.67 781.2 789.09 789.69
781.3 789.1 790.01 781.5 789.2 790.09 781.6 789.30 790.1 781.7 789.31 790.3 781.8 789.32 790.4 782.4 789.33 790.5 783.0 789.34 790.6 783.21 789.35 790.7 783.40 789.36 790.8 783.41 789.37 790.92 783.42 789.39 790.93 783.43 789.40 791.0 784.3 789.41 791.2 784.5 789.42 791.4 784.69 789.43 792.1 784.7 789.44 793.3 784.8 789.45 793.4 785.50 789.46 793.6 785.52 789.47 794.8 785.59 789.49 794.9 785.6 789.5 795.71 789.00 789.60 799.1 789.01 789.61 799.4 789.02 789.62 807.01 789.03 789.63 LIVER / HEPATIC PANEL ICD Codes Numerical Order 807.02 861.10 863.42 807.03 861.11 863.43 807.04 861.12 863.44 807.05 861.13 863.45 807.06 861.20 863.46 807.07 861.21 863.49 807.08 861.22 863.50 807.09 861.30 863.51 807.10 861.31 863.52 807.11 861.32 863.53 807.12 862.0 863.54 807.13 862.1 863.55 807.14 862.21 863.56 807.15 862.22 863.59 807.16 862.29 863.80 807.17 862.31 863.81 807.18 862.32 863.82 807.19 862.39 863.83 807.2 862.8 863.84 807.3 862.9 863.85 860.0 863.0 863.89 860.1 863.1 863.90 860.2 863.20 863.91 860.3 863.21 863.92 860.4 863.29 863.93 860.5 863.30 863.94 861.00 863.31 863.95 861.01 863.39 863.99 861.02 863.40 864.01 861.03 863.41 864.02 LIVER / HEPATIC PANEL ICD Codes Numerical Order 864.03 868.14 909.5 864.04 868.19 922.1 864.05 902.0 922.2 864.11 902.10 922.31 864.12 902.11 922.33 864.13 902.19 922.8 864.14 902.20 922.9 864.15 902.21 926.11 865.01 902.22 926.19 865.02 902.23 926.8 865.03 902.24 926.9 865.04 902.25 958.4 865.11 902.26 960.0 865.12 902.27 960.1 865.13 902.29 960.2 865.14 902.31 960.3 866.01 902.32 960.4 866.02 902.33 960.5 866.03 902.34 960.6 866.11 902.39 960.7 866.12 902.87 960.8 866.13 902.89 960.9 868.01 902.9 961.0 868.02 908.1 961.1 868.03 908.4 961.2 868.04 909.0 961.3 868.09 909.1 961.4 868.11 909.2 961.5 868.12 909.3 961.6 868.13 909.4 961.7 LIVER / HEPATIC PANEL ICD Codes Numerical Order 961.8 965.01 968.4 961.9 965.02 968.5 962.0 965.09 968.6 962.1 965.1 968.7 962.2 965.4 968.9 962.3 965.5 969.0 962.4 965.61 969.1 962.5 965.69 969.2 962.6 965.7 969.3 962.7 965.8 969.4 962.8 965.9 969.5 962.9 966.0 969.6 963.0 966.1 969.7 963.1 966.2 969.8 963.2 966.3 969.9 963.3 966.4 970.0 963.4 967.0 970.1 963.5 967.1 970.8 963.8 967.2 970.9 963.9 967.3 971.0 964.0 967.4 971.1 964.1 967.5 971.2 964.2 967.6 971.3 964.3 967.8 971.9 964.4 967.9 972.0 964.5 967.9 972.1 964.6 968.0 972.2 964.7 968.1 972.3 964.8 968.2 972.4 965.00 968.3 972.5 LIVER / HEPATIC PANEL ICD Codes Numerical Order 972.6 976.0 979.4 972.7 976.1 979.5 972.8 976.2 979.6 972.9 976.3 979.7 973.0 976.4 979.9 973.1 976.5 980.0 973.2 976.6 980.1 973.3 976.7 980.2 973.4 976.8 980.3 973.5 976.9 980.8 973.6 977.0 980.9 973.8 977.1 981 973.9 977.2 982.0 974.0 977.3 982.1 974.1 977.4 982.2 974.2 977.8 982.3 974.3 977.9 982.4 974.4 978.0 982.8 974.5 978.1 983.0 974.6 978.2 983.1 974.7 978.3 983.2 975.0 978.4 983.9 975.1 978.5 984.0 975.2 978.6 984.1 975.3 978.8 984.8 975.4 978.9 984.9 975.5 979.0 985.0 975.6 979.1 985.1 975.7 979.2 985.2 975.8 979.3 985.3 LIVER / HEPATIC PANEL ICD Codes Numerical Order 985.4 991.6 996.81 985.5 992.0 996.82 985.6 992.1 996.86 985.8 992.2 996.87 985.9 992.3 996.89 986 992.4 997.1 987.0 992.5 997.4 987.1 992.6 998.0 987.2 992.7 998.2 987.3 992.8 998.51 987.4 993.3 998.59 987.5 993.4 998.7 987.6 994.2 999.4 987.7 994.3 999.5 987.8 995.0 999.6 987.9 995.1 999.7 988.0 995.29 999.8 988.1 995.4 999.9 988.2 995.52 V02.60 988.8 995.55 V02.61 988.9 995.60 V02.62 989.0 995.61 V02.69 989.1 995.62 V10.07 989.2 995.63 V12.01 989.3 995.64 V12.02 989.4 995.65 V12.03 989.5 995.66 V12.2 989.6 995.67 V12.3 989.7 995.68 V42.7 990 995.69 V58.11 LIVER / HEPATIC PANEL ICD Codes Numerical Order V58.61 V58.62 V58.69 V71.82
V71.83