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PT - 2020 Measure Value Set_AvoidableED

Numerator

  • Value Set Name Code
  • Definition
  • Code System

ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

  • A09
  • Infectious gastroenteritis and colitis, unspecified

Anogenital (venereal) warts Rubella without complication Plantar wart Other viral warts Viral wart, unspecified Acute viral hepatitis, unspecified Unspecified viral hepatitis without hepatic coma Viral conjunctivitis, unspecified Tinea corporis Tinea imbricata Tinea cruris Geotrichosis Unspecified mycosis Enterobiasis Pediculosis, unspecified Phthiriasis Infestation, unspecified Malignant neoplasm of prostate Hypothyroidism, unspecified Disorder of parathyroid gland, unspecified Pure hypercholesterolemia Lipoprotein deficiency Cystic fibrosis, unspecified Carpal tunnel syndrome, unspecified upper limb Carpal tunnel syndrome, right upper limb Carpal tunnel syndrome, left upper limb
A630 B069 B070 B078 B079 B179 B199 B309 B354 B355 B356 B483 B49 B80 B852 B853 B889 C61 E039 E215 E780 E786 E849 G5600 G5601 G5602 H00011 Hordeolum externum right upper eyelid H00012 Hordeolum externum right lower eyelid H00013 Hordeolum externum right eye, unspecified eyelid H00014 Hordeolum externum left upper eyelid H00015 Hordeolum externum left lower eyelid H00016 Hordeolum externum left eye, unspecified eyelid H00019 Hordeolum externum unspecified eye, unspecified eyelid H00031 Abscess of right upper eyelid H00032 Abscess of right lower eyelid H00033 Abscess of eyelid right eye, unspecified eyelid H00034 Abscess of left upper eyelid H00035 Abscess of left lower eyelid H00036 Abscess of eyelid left eye, unspecified eyelid H00039 Abscess of eyelid unspecified eye, unspecified eyelid H04121 Dry eye syndrome of right lacrimal gland H04122 Dry eye syndrome of left lacrimal gland H04123 Dry eye syndrome of bilateral lacrimal glands H04129 Dry eye syndrome of unspecified lacrimal gland H16211 Exposure keratoconjunctivitis, right eye H16212 Exposure keratoconjunctivitis, left eye

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  • January 2018

PT - 2020 Measure Value Set_AvoidableED

Numerator

  • Value Set Name Code
  • Definition
  • Code System

ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
H16213 Exposure keratoconjunctivitis, bilateral H16219 Exposure keratoconjunctivitis, unspecified eye H18821 Corneal disorder due to contact lens, right eye H18822 Corneal disorder due to contact lens, left eye H18823 Corneal disorder due to contact lens, bilateral H18829 Corneal disorder due to contact lens, unspecified eye H44811 Hemophthalmos, right eye H44812 Hemophthalmos, left eye H44813 Hemophthalmos, bilateral H44819 Hemophthalmos, unspecified eye

  • H5000
  • Unspecified esotropia

N/A

N/A N/A N/A N/A N/A N/A N/A
H66001 Acute suppurative otitis media without spontaneous rupture of ear drum, right ear ICD10CM H66002 Acute suppurative otitis media without spontaneous rupture of ear drum, left ear ICD10CM H66003 Acute suppurative otitis media without spontaneous rupture of ear drum, bilateral ICD10CM
Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent,
H66004

H66005 H66006 H66007 H66009
ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM right ear Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, left ear Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, bilateral Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, unspecified ear Acute suppurative otitis media without spontaneous rupture of ear drum, unspecified ear
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
H73891 Other specified disorders of tympanic membrane, right ear H73892 Other specified disorders of tympanic membrane, left ear H73893 Other specified disorders of tympanic membrane, bilateral H73899 Other specified disorders of tympanic membrane, unspecified ear
ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
H7390 H7391 H7392 H7393 H9190 H9191 H9192 H9193 H9210 H9211 H9212 H9213 I776
Unspecified disorder of tympanic membrane, unspecified ear Unspecified disorder of tympanic membrane, right ear Unspecified disorder of tympanic membrane, left ear Unspecified disorder of tympanic membrane, bilateral Unspecified hearing loss, unspecified ear Unspecified hearing loss, right ear Unspecified hearing loss, left ear Unspecified hearing loss, bilateral Otorrhea, unspecified ear Otorrhea, right ear Otorrhea, left ear Otorrhea, bilateral Arteritis, unspecified
J0100 J0101 J0190
Acute maxillary sinusitis, unspecified Acute recurrent maxillary sinusitis Acute sinusitis, unspecified

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  • January 2018

PT - 2020 Measure Value Set_AvoidableED

Numerator

  • Value Set Name Code
  • Definition

Acute recurrent sinusitis, unspecified Chronic rhinitis Unspecified chronic bronchitis Unilateral pulmonary emphysema [MacLeod's syndrome] Panlobular emphysema

Code System

ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
J0191 J310 J42 J430 J431 J432 J438 J82 K044 K088 K146 K311 K603 K604 K605
Centrilobular emphysema Other emphysema Pulmonary eosinophilia, not elsewhere classified Acute apical periodontitis of pulpal origin Other specified disorders of teeth and supporting structures Glossodynia Adult hypertrophic pyloric stenosis Anal fistula Rectal fistula Anorectal fistula
L02821 Furuncle of head [any part, except face] L02828 Furuncle of other sites L02831 Carbuncle of head [any part, except face] L02838 Carbuncle of other sites L080 L0881 L219 L270 L271 L272 L291 L292 L293 L298 L299 L400 L402 L403 L404 L408 L409 L503 L506 L508 L550 L559 L740 L741 L742 L743 L748 L750
Pyoderma Pyoderma vegetans Seborrheic dermatitis, unspecified Generalized skin eruption due to drugs and medicaments taken internally Localized skin eruption due to drugs and medicaments taken internally Dermatitis due to ingested food Pruritus scroti Pruritus vulvae Anogenital pruritus, unspecified Other pruritus Pruritus, unspecified Psoriasis vulgaris Acrodermatitis continua Pustulosis palmaris et plantaris Guttate psoriasis Other psoriasis Psoriasis, unspecified Dermatographic urticaria Contact urticaria Other urticaria Sunburn of first degree Sunburn, unspecified Miliaria rubra Miliaria crystallina Miliaria profunda Miliaria, unspecified Other eccrine sweat disorders Bromhidrosis

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PT - 2020 Measure Value Set_AvoidableED

Numerator

  • Value Set Name Code
  • Definition

Chromhidrosis

Code System

ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
L751 L758 L88 L905 L923
Other apocrine sweat disorders Pyoderma gangrenosum Scar conditions and fibrosis of skin Foreign body granuloma of the skin and subcutaneous tissue
M25471 Effusion, right ankle M25472 Effusion, left ankle M25473 Effusion, unspecified ankle M25474 Effusion, right foot M25475 Effusion, left foot M25476 Effusion, unspecified foot M25551 Pain in right hip M25552 Pain in left hip M25559 Pain in unspecified hip M2570 Osteophyte, unspecified joint M270 M279 M41112 Juvenile idiopathic scoliosis, cervical region M41113 Juvenile idiopathic scoliosis, cervicothoracic region M41114 Juvenile idiopathic scoliosis, thoracic region M41115 Juvenile idiopathic scoliosis, thoracolumbar region M41116 Juvenile idiopathic scoliosis, lumbar region M41117 Juvenile idiopathic scoliosis, lumbosacral region M41119 Juvenile idiopathic scoliosis, site unspecified M41122 Adolescent idiopathic scoliosis, cervical region M41123 Adolescent idiopathic scoliosis, cervicothoracic region M41124 Adolescent idiopathic scoliosis, thoracic region M41125 Adolescent idiopathic scoliosis, thoracolumbar region M41126 Adolescent idiopathic scoliosis, lumbar region M41127 Adolescent idiopathic scoliosis, lumbosacral region M41129 Adolescent idiopathic scoliosis, site unspecified M4120 Other idiopathic scoliosis, site unspecified M4122 Other idiopathic scoliosis, cervical region M4123 Other idiopathic scoliosis, cervicothoracic region M4124 Other idiopathic scoliosis, thoracic region M4125 Other idiopathic scoliosis, thoracolumbar region M4126 Other idiopathic scoliosis, lumbar region M4127 Other idiopathic scoliosis, lumbosacral region M5411 Radiculopathy, occipito-atlanto-axial region M5412 Radiculopathy, cervical region
Developmental disorders of jaws Disease of jaws, unspecified

M5413 Radiculopathy, cervicothoracic region M5414 Radiculopathy, thoracic region M5415 Radiculopathy, thoracolumbar region M5416 Radiculopathy, lumbar region M5417 Radiculopathy, lumbosacral region M6510 Other infective (teno)synovitis, unspecified site M65111 Other infective (teno)synovitis, right shoulder

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PT - 2020 Measure Value Set_AvoidableED

Numerator

  • Value Set Name Code
  • Definition
  • Code System

ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
M65112 Other infective (teno)synovitis, left shoulder M65119 Other infective (teno)synovitis, unspecified shoulder M65121 Other infective (teno)synovitis, right elbow M65122 Other infective (teno)synovitis, left elbow M65129 Other infective (teno)synovitis, unspecified elbow M65131 Other infective (teno)synovitis, right wrist M65132 Other infective (teno)synovitis, left wrist M65139 Other infective (teno)synovitis, unspecified wrist M65141 Other infective (teno)synovitis, right hand M65142 Other infective (teno)synovitis, left hand M65149 Other infective (teno)synovitis, unspecified hand M65151 Other infective (teno)synovitis, right hip M65152 Other infective (teno)synovitis, left hip M65159 Other infective (teno)synovitis, unspecified hip M65161 Other infective (teno)synovitis, right knee M65162 Other infective (teno)synovitis, left knee M65169 Other infective (teno)synovitis, unspecified knee M65171 Other infective (teno)synovitis, right ankle and foot M65172 Other infective (teno)synovitis, left ankle and foot M65179 Other infective (teno)synovitis, unspecified ankle and foot M6518 Other infective (teno)synovitis, other site M6519 Other infective (teno)synovitis, multiple sites M65811 Other synovitis and tenosynovitis, right shoulder M65812 Other synovitis and tenosynovitis, left shoulder M65819 Other synovitis and tenosynovitis, unspecified shoulder M65821 Other synovitis and tenosynovitis, right upper arm M65822 Other synovitis and tenosynovitis, left upper arm M65829 Other synovitis and tenosynovitis, unspecified upper arm M65831 Other synovitis and tenosynovitis, right forearm M65832 Other synovitis and tenosynovitis, left forearm M65839 Other synovitis and tenosynovitis, unspecified forearm M65841 Other synovitis and tenosynovitis, right hand M65842 Other synovitis and tenosynovitis, left hand M65849 Other synovitis and tenosynovitis, unspecified hand M65851 Other synovitis and tenosynovitis, right thigh M65852 Other synovitis and tenosynovitis, left thigh M65859 Other synovitis and tenosynovitis, unspecified thigh M65861 Other synovitis and tenosynovitis, right lower leg M65862 Other synovitis and tenosynovitis, left lower leg M65869 Other synovitis and tenosynovitis, unspecified lower leg M6588 Other synovitis and tenosynovitis, other site M6589 Other synovitis and tenosynovitis, multiple sites M6730 Transient synovitis, unspecified site M67311 Transient synovitis, right shoulder M67312 Transient synovitis, left shoulder M67319 Transient synovitis, unspecified shoulder M67321 Transient synovitis, right elbow

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PT - 2020 Measure Value Set_AvoidableED

Numerator

  • Value Set Name Code
  • Definition
  • Code System

ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
M67322 Transient synovitis, left elbow M67329 Transient synovitis, unspecified elbow M67331 Transient synovitis, right wrist M67332 Transient synovitis, left wrist M67339 Transient synovitis, unspecified wrist M67341 Transient synovitis, right hand M67342 Transient synovitis, left hand M67349 Transient synovitis, unspecified hand M67351 Transient synovitis, right hip M67352 Transient synovitis, left hip M67359 Transient synovitis, unspecified hip M67361 Transient synovitis, right knee M67362 Transient synovitis, left knee M67369 Transient synovitis, unspecified knee M67371 Transient synovitis, right ankle and foot M67372 Transient synovitis, left ankle and foot M67379 Transient synovitis, unspecified ankle and foot M6738 Transient synovitis, other site M6739 Transient synovitis, multiple sites M7670 Peroneal tendinitis, unspecified leg M7671 Peroneal tendinitis, right leg M7672 Peroneal tendinitis, left leg M7750 Other enthesopathy of unspecified foot M7751 Other enthesopathy of right foot M7752 Other enthesopathy of left foot M779 M795 M9240 Juvenile osteochondrosis of patella, unspecified knee M9241 Juvenile osteochondrosis of patella, right knee M9242 Juvenile osteochondrosis of patella, left knee M9250 Juvenile osteochondrosis of tibia and fibula, unspecified leg M9251 Juvenile osteochondrosis of tibia and fibula, right leg M9252 Juvenile osteochondrosis of tibia and fibula, left leg
Enthesopathy, unspecified Residual foreign body in soft tissue

N342 N430
Other urethritis Encysted hydrocele

  • N/A
  • N491
  • Inflammatory disorders of spermatic cord, tunica vaginalis and vas deferens
  • ICD10CM

N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
N492 N493 N498 N499 N509 N6081 N6082 N6089 N61
Inflammatory disorders of scrotum Fournier gangrene
ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
Inflammatory disorders of other specified male genital organs Inflammatory disorder of unspecified male genital organ Disorder of male genital organs, unspecified Other benign mammary dysplasias of right breast Other benign mammary dysplasias of left breast Other benign mammary dysplasias of unspecified breast Inflammatory disorders of breast

  • N62
  • Hypertrophy of breast

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PT - 2020 Measure Value Set_AvoidableED

Numerator

  • Value Set Name Code
  • Definition

Unspecified lump in breast Excessive and frequent menstruation with regular cycle Postmenopausal bleeding Omphalitis with mild hemorrhage Omphalitis without hemorrhage Neonatal jaundice from breast milk inhibitor Neurofibromatosis, unspecified Schwannomatosis Other neurofibromatosis Hepatomegaly, not elsewhere classified Change in bowel habit Anesthesia of skin Hypoesthesia of skin Paresthesia of skin

Code System

ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
N63 N920 N950 P381 P389 P593 Q8500 Q8503 Q8509 R160 R194 R200 R201 R202 R203 R208 R209 R233 R6884 R7611 Z005
Hyperesthesia Other disturbances of skin sensation Unspecified disturbances of skin sensation Spontaneous ecchymoses Jaw pain Nonspecific reaction to tuberculin skin test without active tuberculosis Encounter for examination of potential donor of organ and tissue Encounter for examination for period of delayed growth in childhood without abnormal findings Encounter for examination for period of delayed growth in childhood with abnormal findings
N/A N/A
Z0070 Z0071
ICD10CM ICD10CM
N/A N/A N/A N/A
Z0100 Z0101 Z0110
Encounter for examination of eyes and vision without abnormal findings Encounter for examination of eyes and vision with abnormal findings Encounter for examination of ears and hearing without abnormal findings
ICD10CM ICD10CM ICD10CM

  • ICD10CM
  • Z01110 Encounter for hearing examination following failed hearing screening

N/A N/A N/A

  • Z01118 Encounter for examination of ears and hearing with other abnormal findings
  • ICD10CM

ICD10CM ICD10CM
Z0112 Z0120
Encounter for hearing conservation and treatment Encounter for dental examination and cleaning without abnormal findings
N/A N/A N/A
Z0121 Z0130 Z0131
Encounter for dental examination and cleaning with abnormal findings Encounter for examination of blood pressure without abnormal findings Encounter for examination of blood pressure with abnormal findings
ICD10CM ICD10CM ICD10CM

N/A

N/A N/A
Z01411 Encounter for gynecological examination (general) (routine) with abnormal findings ICD10CM
Encounter for gynecological examination (general) (routine) without abnormal

  • Z01419
  • ICD10CM

findings

Encounter for cervical smear to confirm findings of recent normal smear following initial abnormal smear

  • Z0142
  • ICD10CM

N/A N/A N/A N/A
Z01810 Encounter for preprocedural cardiovascular examination Z01811 Encounter for preprocedural respiratory examination Z01812 Encounter for preprocedural laboratory examination Z01818 Encounter for other preprocedural examination
ICD10CM ICD10CM ICD10CM ICD10CM

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PT - 2020 Measure Value Set_AvoidableED

Numerator

  • Value Set Name Code
  • Definition

Encounter for allergy testing Encounter for blood typing

Code System

ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM ICD10CM
N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
Z0182 Z0183 Z0184 Z0189 Z049
Encounter for antibody response examination Encounter for other specified special examinations Encounter for examination and observation for unspecified reason Encounter for screening for respiratory tuberculosis Encounter for pregnancy test, result unknown Encounter for pregnancy test, result positive Encounter for pregnancy test, result negative Encounter for cosmetic surgery Cochlear implant status Myringotomy tube(s) status Presence of external hearing-aid Presence of other specified devices Post therapeutic collapse of lung status Peripheral vascular angioplasty status Other specified postprocedural states Malnutrition in pregnancy, first trimester Malnutrition in pregnancy, second trimester Malnutrition in pregnancy, third trimester
Z111 Z3200 Z3201 Z3202 Z411 Z9621 Z9622 Z974 Z978 Z983 Z9862 Z9889 O2511 O2512 O2513

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  • 190.18 - Serum Iron Studies

    190.18 - Serum Iron Studies

    Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) 190.18 - Serum Iron Studies HCPCS Codes (Alphanumeric, CPT AMA) Code Description 82728 Ferritin 83540 Iron 83550 Iron Binding capacity 84466 Transferrin ICD-10-CM Codes Covered by Medicare Program The ICD-10-CM codes in the table below can be viewed on CMS’ website as part of Downloads: Lab Code List, at http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/LabNCDsICD10.html Code Description A01.00 Typhoid fever, unspecified A01.01 Typhoid meningitis A01.02 Typhoid fever with heart involvement A01.03 Typhoid pneumonia A01.04 Typhoid arthritis A01.05 Typhoid osteomyelitis A01.09 Typhoid fever with other complications A01.1 Paratyphoid fever A A01.2 Paratyphoid fever B A01.3 Paratyphoid fever C A01.4 Paratyphoid fever, unspecified A02.0 Salmonella enteritis A02.1 Salmonella sepsis A02.20 Localized salmonella infection, unspecified NCD 190.18 January 2021 Changes ICD-10-CM Version – Red Fu Associates, Ltd. January 2021 1 Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) Code Description A02.21 Salmonella meningitis A02.22 Salmonella pneumonia A02.23 Salmonella arthritis A02.24 Salmonella osteomyelitis A02.25 Salmonella pyelonephritis A02.29 Salmonella with other localized infection A02.8 Other specified salmonella infections A02.9 Salmonella infection, unspecified A04.0 Enteropathogenic Escherichia coli infection A04.1 Enterotoxigenic Escherichia coli infection A04.2 Enteroinvasive Escherichia
  • The Clinical Conundrum of Pruritus Victoria Garcia-Albea, Karen Limaye

    The Clinical Conundrum of Pruritus Victoria Garcia-Albea, Karen Limaye

    FEATURE ARTICLE The Clinical Conundrum of Pruritus Victoria Garcia-Albea, Karen Limaye ABSTRACT: Pruritus is a common complaint for derma- Pruritus is also the most common symptom in derma- tology patients. Diagnosing the cause of pruritus can tological disease and can be a symptom of several sys- be difficult and is often frustrating for patients and pro- temic diseases (Bernhard, 1994). The overall incidence viders. Even after the diagnosis is made, it can be a chal- of pruritus is unknown because there are no epidemio- lenge to manage and relieve pruritus. This article reviews logical databases for pruritus (Norman, 2003). According common and uncommon causes of pruritus and makes to a 2003 study, pruritus and xerosis are the most com- recommendations for proper and thorough evaluation mon dermatological problems encountered in nursing and management. home patients (Norman, 2003). Key words: Itch, Pruritus INTRODUCTION ETIOLOGY Pruritus (itch) is the most frequent symptom in derma- The skin is equipped with a network of afferent sensory tology (Serling, Leslie, & Maurer, 2011). Itch is the pre- and efferent autonomic nerve branches that respond to dominant symptom associated with acute and chronic various chemical mediators found in the skin (Bernhard, cutaneous disease and is a major symptom in systemic dis- 1994). It is believed that maximal itch production is ease (Elmariah & Lerner, 2011; Steinhoff, Cevikbas, Ikoma, achieved at the basal layer of the epidermis, below which & Berger, 2011). It can be a frustration for both the patient pain is perceived (Bernhard, 1994). Autonomic nerves in- and the clinician. This article will attempt to provide an nervate hair follicles, pili erector muscles, blood vessels, overview of pruritus, a method for thorough and com- eccrine, apocrine, and sebaceous glands (Bernhard, 1994).
  • Blood Glucose Testing 2020.Pdf

    Blood Glucose Testing 2020.Pdf

    National Coverage Determination Procedure Code: 82947, 82948, 82962 Blood Glucose Testing CMS Policy Number: 190.20 See also: Medicare Preventive Services Back to NCD List Description: This policy is intended to apply to blood samples used to determine glucose levels. Blood glucose determination may be done using whole blood, serum or plasma. It may be sampled by capillary puncture, as in the fingerstick method, or by vein puncture or arterial sampling. The method for assay may be by color comparison of an indicator stick, by meter assay of whole blood or a filtrate of whole blood, using a device approved for home monitoring, or by using a laboratory assay system using serum or plasma. The convenience of the meter or stick color method allows a patient to have access to blood glucose values in less than a minute or so and has become a standard of care for control of blood glucose, even in the inpatient setting. Indications: Blood glucose values are often necessary for the management of patients with diabetes mellitus, where hyperglycemia and hypoglycemia are often present. They are also critical in the determination of control of blood glucose levels in patient with impaired fasting glucose (FPG 110-125 mg/dL), patient with insulin resistance syndrome and/or carbohydrate intolerance (excessive rise in glucose following ingestion of glucose/glucose sources of food), in patient with a hypoglycemia disorder such as nesidioblastosis or insulinoma, and in patients with a catabolic or malnutrition state. In addition to conditions listed, glucose testing may be medically necessary in patients with tuberculosis, unexplained chronic or recurrent infections, alcoholism, coronary artery disease (especially in women), or unexplained skin conditions (i.e.: pruritis, skin infections, ulceration and gangrene without cause).
  • Read Code Description 14L.. H/O: Drug Allergy 158.. H/O: Abnormal Uterine Bleeding 16C2

    Read Code Description 14L.. H/O: Drug Allergy 158.. H/O: Abnormal Uterine Bleeding 16C2

    Read Code Description 14L.. H/O: drug allergy 158.. H/O: abnormal uterine bleeding 16C2. Backache 191.. Tooth symptoms 191Z. Tooth symptom NOS 1927. Dry mouth 198.. Nausea 199.. Vomiting 19C.. Constipation 1A23. Incontinence of urine 1A32. Cannot pass urine - retention 1B1G. Headache 1B62. Syncope/vasovagal faint 1B75. Loss of vision 1BA2. Generalised headache 1BA3. Unilateral headache 1BA4. Bilateral headache 1BA5. Frontal headache 1BA6. Occipital headache 1BA7. Parietal headache 1BA8. Temporal headache 1C13. Deafness 1C131 Unilateral deafness 1C132 Partial deafness 1C133 Bilateral deafness 1C14. "Blocked ear" 1C15. Popping sensation in ear 1C1Z. Hearing symptom NOS 22J.. O/E - dead 22J4. O/E - dead - sudden death 22L4. O/E - Wound infected 2542. O/E - dental caries 2554. O/E - gums - blue line 2555. O/E - hypertrophy of gums 2FF.. O/E - skin ulcer 2I14. O/E - a rash 39C0. Pressure sore 39C1. Superficial pressure sore 39C2. Deep pressure sore 62... Patient pregnant 6332. Single stillbirth 66G4. Allergy drug side effect 72001 Enucleation of eyeball 7443. Exteriorisation of trachea 744D. Tracheo-oesophageal puncture 7511. Surgical removal of tooth 75141 Root canal therapy to tooth 7610. Total excision of stomach 7645. Creation of ileostomy 773C. Other operations on bowel 773Cz Other operation on bowel NOS 7826. Incision of bile duct 7840. Total excision of spleen 7B01. Total nephrectomy 7C032 Unilateral total orchidectomy - unspecified 7E117 Left salpingoophorectomy 7E118 Right salpingectomy 7E119 Left salpingectomy 7G321 Avulsion of nail 7H220 Exploratory laparotomy 7J174 Manipulation of mandible 8HG.. Died in hospital 94B.. Cause of death A.... Infectious and parasitic diseases A0... Intestinal infectious diseases A00.. Cholera A000.
  • Fee Schedule Instructions

    Fee Schedule Instructions

    Last Updated on: 9/3/2021 Fee Schedule Instructions Historical Behavioral Health Fee Schedules Fee Schedule Formats Format of CSV Fee Schedules Special Indicators on Fee Schedules Table Listing Fee Schedule Instructions Welcome to the Connecticut Medical Assistance Program enhanced fee schedule page. The fee schedules have been enhanced to provide different formats that can be easily viewed, downloaded and manipulated, and that have historical rate data. To reference provider bulletins with important fee schedule information, navigate to the Information page of this Web site by selecting Information > Publications and use the Publication Search feature to find provider bulletins for your provider type. Limited policy restriction information is only provided on the fee schedule. For a comprehensive set of policy information, please refer to Chapter 7 of the Provider Manual. To reference provider manuals, navigate to the Information page of this Web site by clicking on Information > Publications > Provider Manuals to find the provider manual for your provider type and click the “View Chapter 7” button. For enhanced pediatric and obstetrical services rate information, please review further down in the document the section titled Available Fee Schedules and the information provided under the “additional information column” for both the “Physician Office and Outpt Services” fee schedule. Historical Behavioral Health Fee Schedules This link contains Behavioral Health Partnership & Psychologist fee schedules produced prior to April 1, 2012. Fee Schedule Formats The most current fee schedules are now available in one of two formats as follows: o PDF –Portable Document Format - Fee schedules in this format (easily viewed and printed with free Adobe Acrobat Reader) contain footnoted information pertaining to some specific policies related to the procedure codes.

  • 2019 Texas FI PA Results Ready for Formatting 3-29-20

    2019 Texas Fully Insured Pharmacy Prior Authorization Requests Summary Prior Prior Total % Prior % Prior Appeal Appeal Total % Appeals % Appeals IRO Denials IRO Denials Total % IRO % IRO Authorization Authorization Prior Authorizations Authorizations Denials Denials Appeals Upheld Overturned Upheld Overturned IRO Upheld Overturned Approvals Denials Authorizations Approved Denied Upheld Overturned 23,211 7,514 30,725 76% 24% 235 293 528 45% 55% 7 1 8 88% 13% #Proprietary 1 of 83 2019 Texas Pharmacy Prior Authorization Report by Drug Name and 6-digit GPI Drug Name 1st 6 Prior Prior Total Prior % Prior % Prior Appeal Appeal Total Appeals % Appeals % Appeals IRO Denials IRO Denials Total IRO % IRO % IRO digits of Authorization Authorization Authorizations Authorizations Authorizations Denials Denials Upheld Overturned Upheld Overturned Upheld Overturned GPI Approval Denial Approved Denied Upheld Overturned 1STMEDX-PATC 908599 2 2 0% 100% ABILIFY 592500 6 4 10 60% 40% ABIRATERONE 214060 6 6 100% 0% ABSORICA 900500 47 26 73 64% 36% 1 1 2 50% 50% ACANYA 900599 1 1 2 50% 50% ACCU-CHEK 941000 3 2 5 60% 40% ACETAMINOPHEN CAFFEINE 659913 3 2 5 60% 40% ACETAMINOPHEN CODEINE 659910 192 16 208 92% 8% ACETAZOLAMIDE 371000 9 5 14 64% 36% 2 2 0% 100% ACETAZOLAMIDE 611000 2 2 100% 0% ACIPHEX 492700 6 4 10 60% 40% ACITRETIN 902505 1 1 100% 0% ACTEMRA 665000 17 9 26 65% 35% 2 2 0% 100% ACTICLATE 665000 1 1 100% 0% ACTONEL 300420 1 1 100% 0% ACTOPLUS 279980 1 1 100% 0% ACZONE 900510 248 11 259 96% 4% ADAPALENE 900500 11 2 13 85% 15% ADAPALENE 900599 13 5
  • Icd-10Causeofdeath.Pdf

    Icd-10Causeofdeath.Pdf

    A00 Cholera A00.0 Cholera due to Vibrio cholerae 01, biovar cholerae A00.1 Cholera due to Vibrio cholerae 01, biovar el tor A00.9 Cholera, unspecified A01 Typhoid and paratyphoid fevers A01.0 Typhoid fever A01.1 Paratyphoid fever A A01.2 Paratyphoid fever B A01.3 Paratyphoid fever C A01.4 Paratyphoid fever, unspecified A02 Other salmonella infections A02.0 Salmonella gastroenteritis A02.1 Salmonella septicemia A02.2 Localized salmonella infections A02.8 Other specified salmonella infections A02.9 Salmonella infection, unspecified A03 Shigellosis A03.0 Shigellosis due to Shigella dysenteriae A03.1 Shigellosis due to Shigella flexneri A03.2 Shigellosis due to Shigella boydii A03.3 Shigellosis due to Shigella sonnei A03.8 Other shigellosis A03.9 Shigellosis, unspecified A04 Other bacterial intestinal infections A04.0 Enteropathogenic Escherichia coli infection A04.1 Enterotoxigenic Escherichia coli infection A04.2 Enteroinvasive Escherichia coli infection A04.3 Enterohemorrhagic Escherichia coli infection A04.4 Other intestinal Escherichia coli infections A04.5 Campylobacter enteritis A04.6 Enteritis due to Yersinia enterocolitica A04.7 Enterocolitis due to Clostridium difficile A04.8 Other specified bacterial intestinal infections A04.9 Bacterial intestinal infection, unspecified A05 Other bacterial food-borne intoxications A05.0 Food-borne staphylococcal intoxication A05.1 Botulism A05.2 Food-borne Clostridium perfringens [Clostridium welchii] intoxication A05.3 Food-borne Vibrio parahemolyticus intoxication A05.4 Food-borne Bacillus cereus
  • WO 2009/040088 Al

    WO 2009/040088 Al

    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (43) International Publication Date PCT (10) International Publication Number 2 April 2009 (02.04.2009) WO 2009/040088 Al (51) International Patent Classification: (74) Agent: ARTH, Hans-Lothar; ABK Patent Attorneys, Jas- A61K 38/08 (2006.01) A61P 25/28 (2006.01) minweg 9, 14052 Berlin (DE). A61P 3/00 (2006.01) A61P 31/00 (2006.01) (81) Designated States (unless otherwise indicated, for every A61P 9/00 (2006.01) A61P 35/00 (2006.01) kind of national protection available): AE, AG, AL, AM, A61P 11/00 (2006.01) A61P 37/00 (2006.01) AO, AT,AU, AZ, BA, BB, BG, BH, BR, BW, BY,BZ, CA, CH, CN, CO, CR, CU, CZ, DE, DK, DM, DO, DZ, EC, EE, (21) International Application Number: EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, PCT/EP2008/008007 IL, IN, IS, JP, KE, KG, KM, KN, KP, KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY,MA, MD, ME, MG, MK, MN, MW, (22) International Filing Date: MX, MY,MZ, NA, NG, NI, NO, NZ, OM, PG, PH, PL, PT, 9 September 2008 (09.09.2008) RO, RS, RU, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY,TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (25) Filing Language: English ZW (84) Designated States (unless otherwise indicated, for every (26) Publication Language: English kind of regional protection available): ARIPO (BW, GH, GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, (30) Priority Data: ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), 07017747.2 11 September 2007 (11.09.2007) EP European (AT,BE, BG, CH, CY, CZ, DE, DK, EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT,LU, LV,MC, MT, NL, (71) Applicant (for all designated States except US): MONDO- NO, PL, PT, RO, SE, SI, SK, TR), OAPI (BF, BJ, CF, CG, BIOTECH LABORATORIES AG [UfLl]; Herrengasse CI, CM, GA, GN, GQ, GW, ML, MR, NE, SN, TD, TG).
  • Experimental Histamine Pruritus

    Experimental Histamine Pruritus

    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector EXPERIMENTAL HISTAMINE PRURITUS I. INFLUENCE OF PHYSICAL AND PsYcHoLOGIcAL FACTORS ON THRESHOLD REACTIVTTY* FRANK E. CORMIA, M.D. Itching is by far the most common symptom experienced by patients with skin diseases. It may occur in many clinically unrelated syndromes and is often severe when clinical evi- dence of inflammation is absent. The symptom is particularly common and severe in the various cutaneous manifestations of psychosomatic origin. It is especially important, therefore, that both the qualitative and quantitative aspects of itching be subjected to investigative studies. Pertinent data on the nature of itching has been assembled by Goldscheider (1), Lewis, Grant and Marvin (2), Bickford (3) and others. Much of the literature has been sum- marized by Rothman (4). Recently, Graham, Goodell and Wolff (5) have completed an im- portant re-evaluation of itching. There is now a fairly general agreement that itching is a modified form of pain, carried on afferent pain fibers, with subsequent discharge of impulses up the spinothalamic tracts to the sensory cortex. Cowhage does not produce a pure itch, but a severe itch which contains elements of burning and pricking pain (5). Moreover, the itch produced cannot be quantitatively evaluated. Pruritus produced by histamine ionto- phoresis is equally unreliable. Shelley (6) obtained inconstant results with an electrical stimulator. Rothman, in a personal communication, suggested the use of various dilutions of histamine, administered by the intradermal route. Shelley was able to produce a rather constant degree of itching in a majority of subjects tested by the intradermal injection of a controlled dilution of fresh histamine phosphate solution (7) and made valuable sug- gestions regarding the method (6).
  • Serum Iron ICD 10 Codes That Meet Medical Necessity Proprietary Information of Unitedhealthcare Community and State

    Serum Iron ICD 10 Codes That Meet Medical Necessity Proprietary Information of Unitedhealthcare Community and State

    Serum Iron ICD 10 Codes that Meet Medical Necessity Proprietary Information of UnitedHealthcare Community and State. Copyright 2018 United Healthcare Services, Inc. Unit Codes: CPT Codes: 16027 83540 36009 82728 36134 84446 37642 83550 IRON ICD-10 Codes Covered if selection criteria are met: A01.00 TYPHOID FEVER, UNSPECIFIED A01.01 TYPHOID MENINGITIS A01.02 TYPHOID FEVER WITH HEART INVOLVEMENT A01.03 TYPHOID PNEUMONIA A01.04 TYPHOID ARTHRITIS A01.05 TYPHOID OSTEOMYELITIS A01.09 TYPHOID FEVER WITH OTHER COMPLICATIONS A01.1 PARATYPHOID FEVER A A01.2 PARATYPHOID FEVER B A01.3 PARATYPHOID FEVER C A01.4 PARATYPHOID FEVER, UNSPECIFIED A02.0 SALMONELLA ENTERITIS A02.1 SALMONELLA SEPSIS A02.20 LOCALIZED SALMONELLA INFECTION, UNSPECIFIED A02.21 SALMONELLA MENINGITIS A02.22 SALMONELLA PNEUMONIA A02.23 SALMONELLA ARTHRITIS A02.24 SALMONELLA OSTEOMYELITIS A02.25 SALMONELLA PYELONEPHRITIS A02.29 SALMONELLA WITH OTHER LOCALIZED INFECTION A02.8 OTHER SPECIFIED SALMONELLA INFECTIONS A02.9 SALMONELLA INFECTION, UNSPECIFIED A04.0 ENTEROPATHOGENIC ESCHERICHIA COLI INFECTION A04.1 ENTEROTOXIGENIC ESCHERICHIA COLI INFECTION A04.2 ENTEROINVASIVE ESCHERICHIA COLI INFECTION A04.3 ENTEROHEMORRHAGIC ESCHERICHIA COLI INFECTION A04.4 OTHER INTESTINAL ESCHERICHIA COLI INFECTIONS A04.5 CAMPYLOBACTER ENTERITIS A04.6 ENTERITIS DUE TO YERSINIA ENTEROCOLITICA A04.8 OTHER SPECIFIED BACTERIAL INTESTINAL INFECTIONS A04.9 BACTERIAL INTESTINAL INFECTION, UNSPECIFIED A06.0 ACUTE AMEBIC DYSENTERY A06.1 CHRONIC INTESTINAL AMEBIASIS A06.2 AMEBIC NONDYSENTERIC COLITIS A06.3 AMEBOMA