The 2012 Coding Manual Collection

Sample pages ICD-9-CM Manual, Volumes 1, 2 & 3 (Hospital Edition) ICD-9-CM Manual, Volume 1 & 2 (Professional Edition) HCPCS Level II Manual The following 10 sample pages are from HCPro’s 2011 ICD-9-CM Coding Manual, Volumes 1, 2 & 3

Sample pages ICD-9-CM Manual, Volumes 1, 2 & 3 (Hospital Edition) 2011 ICD-9-CM Conventions

HCPro’s ICD-9-CM manuals include all the symbols and conventions Please note: Certain categories of codes only consider a particular set of found in the government’s official version (see Preface and ICD-9-CM fifth digits to be a CC condition. Official Guidelines for Coding and Reporting). In addition, HCPro’s ICD- • For example: 9-CM manuals include the following icons and color-coded conventions: Category 403.9x. CC 1

✓4 TH Fourth digit required. In order to accurately assign a diagnosis This means that ICD-9 code 403.90 is not considered a CC condition, but from this category, it requires the assignment of a fourth digit. 403.91 is designated as a CC condition. • For example: Category 465.x requires a fourth digit of a 0, 8, or 9 to be assigned an accurate code. MCC Major Complication and Comorbidity. This diagnosis is considered a major complication and/comorbidity. Assignment of these ✓5 TH Fifth digit required. In order to accurately assign a diagnosis from diagnoses as an additional code may impact DRG assignment. this category, it requires the assignment of a fifth digit. • For example: 585.6 (End stage renal disease) is • For example: Category 642.0x requires a fifth digit of a 0, 1, 2, 3, or designated as an MCC. 4 to be assigned an accurate code. HIV HIV-related condition. This diagnosis code has been designated Unspecified This diagnosis code is designated as “unspecified.” It as an HIV-related condition. Based on the Official Guidelines, when is advisable to determine if a more specific code can be assigned to admission occurs for an HIV-related condition the principal diagnosis appropriately describe the condition. will be assigned code 042 (Human Immunodeficiency Virus Disease) • For example: followed by any HIV-related diagnoses. 585.9 (Chronic kidney disease, unspecified) • For example: Pneumocystis carinii pneumonia (PCP) due to HIV disease. Code 042 would be reported as the principal diagnosis and Manifestation Code This diagnosis is considered a manifestation of 136.3 would be reported as an additional diagnosis. an underlying disease and should not be assigned as a first listed or principal diagnosis. Codes designated as a manifestation code should H Hospital Aquired Condition. This condition has been identified always be assigned as an additional diagnosis only. In the Alphabetic as a hospital acquired condition (HAC). Per the Deficit Act of 2005, index, the manifestation code will be listed next to the underlying CMS designates certain conditions that when assigned with a present disease code in italicized slanted brackets. This convention indicates on admission (POA) indicator of “N” (which signifies not present on mandatory multiple coding in the order listed. In the Tabular index, the admission), will not yield the case into a higher-paying DRG if this is the code description will be written in italics. The instructional note “Code only condition identified as a CC/MCC. first underlying condition, cause or disease” will generally appear under • For example: the manifestation code. H 925.2 Crushing injury of neck CC • For example: 484.3 Pneumonia in whooping cough INCLUDES: An includes note identifies particular diagnoses considered to be classified to a particular code series. CC CC Condition. Codes are designated as CCs or MCCs if their • For example: presence would significantly increase hospital resources. These 598 (Urethral stricture) INCLUDES: pinhole meatus resources may include such services as intensive monitoring, complex stricture of urinary meatus services, or extensive care from multiple caregivers. A complication is a condition that develops that is not considered an expected outcome. ExCLUDES: An excludes note identifies particular diagnoses that would A comorbidity is a condition that co-exists with the primary condition not classify to a particular code series. For specific code assignment, during the specific encounter/admission. another series of codes may need to be referenced in lieu of or in • Complication example: addition to that code. PostoperativeTake hemorrhage a look (998.11) at our (CC Condition) CC • Comorbidity example: • For example: 598 (Urethral stricture) Atrial referenceflutter – 427.32 (CC guide condition) to the CC ExCLUDES: Congenital stricture of urethra and urinary conventions meatus (753.6) that appear in the ICD-9-CM Manual, Volumes 1, 2, & 3

ICD-9-CM MANUAL 2011 2011 ICD-9-CM CONVENTIONS vii

ICD9_2011_Preface.indd 7 8/16/10 10:09:16 PM 2011 ICD-9-CM Conventions

Valid OR Procedure This procedure has been designated as a valid OR New Code. This code is new for the current year. procedure that can affect DRG assignment. • For example : • For example: 237.73 Schwannomatosis 00.66 (Percutaneous transluminal coronary angioplasty [PTCA] or coronary atherectomy) Revised Code Title. This code title has been revised for the current year. • For example: Non OR Procedure This procedure has been designated as a non OR 307.0 Adult onset fluency disorder procedure and generally does not affect DRG assignment unless used in conjunction with a valid OR procedure. ♦ Revised Text ♦. Codes identified as having revised text have had • For example: additions or deletions to their inclusion notes, example conditions, or 36.06 (Insertion of non-drug-eluting coronary artery stent(s)) non-essential modifiers. • For example: Please note code 36.06 used in conjunction with 00.66 may affect DRG 564.0 Constipation assignment. ExCLUDES: ♦fecal impaction (560.32)♦

❖ New Line. This icon designates a new line in the Alphabetic index. • For example: ❖ Arcuate uterus 752.36

▲ Revised Text ▲. Revisions made to the alphabetic index in Volume 2 are also indicated. • For example: Arcuatus uterus ▲752.36 ▲

Appendix F provides a complete list of current CC Exclusions.

Take a look at our reference guide to the conventions that appear in the ICD-9-CM Manual, Volumes 1, 2, & 3

viii 2011 ICD-9-CM CONVENTIONS ICD-9-CM MANUAL 2011

ICD9_2011_Preface.indd 8 8/16/10 10:09:18 PM Index to Diseases and Injuries Fracture Fracture osteoporotic—see Fracture, pathologic multiple sites 813.07 Note—Use the following fifth-digit subclassification palate (closed) 802.8 open 813.17 with categories 800, 801, 803, and 804: open 802.9 neck 813.06 0 unspecified state of consciousness paratrooper—see Fracture, tibia, lower end open 813.16 1 with no loss of consciousness parietal bone—see Fracture, skull, vault open 813.17 2 with brief [less than one hour] loss of parry—see Fracture, Monteggia’s specified site NEC 813.07 patella (closed) 822.0 open 813.17 consciousness open 822.1 ramus 3 with moderate [1–24 hours] loss of pathologic (cause unknown) 733.10 inferior or superior (with visceral injury) consciousness ankle 733.16 (closed) 808.2 4 with prolonged [more than 24 hours] loss femur (neck) 733.14 open 808.3 of consciousness and return to pre-existing specified NEC 733.15 ischium—see Fracture, ischium conscious level fibula 733.16 mandible 802.24 5 with prolonged [more than 24 hours] loss of hip 733.14 open 802.34 consciousness, without return to pre-existing humerus 733.11 rib(s) (closed) 807.0 Yellow-shadedradius (distal) 733.12 conscious level specified site NEC 733.19 Use fifth-digit 5 to designate when a patient call-outtibia 733.16 boxes Note—Use the following fifth-digit subclassification is unconscious and dies before regaining ulna 733.12 with categories 807.0–807.1: consciousness, regardless of the duration of the vertebraedescribe (collapse) the 733.13 0 rib(s), unspecified loss of consciousness wristfifth-digit 733.12 1 one rib 6 with loss of consciousness of unspecified duration pedicle (of vertebral arch)—see Fracture, vertebra, by site 2 two ribs 9 with concussion, unspecified subclassifications.pelvis, pelvic (bone(s)) (with visceral injury) (closed) 808.8 3 three ribs multiple swith disruption of pelvic circles 808.43 4 four ribs with open 808.53 5 five ribs contusion, cerebral 804.1 open 808.9 6 six ribs epidural hemorrhage 804.2 rim (closed) 808.49 7 seven ribs extradural hemorrhage 804.2 open 808.59 hemorrhage (intracranial) NEC 804.3 peritrochanteric (closed) 820.20 8 eight or more ribs intracranial injury NEC 804.4 open 820.30 9 multiple ribs, unspecified laceration, cerebral 804.1 phalanx, phalanges, of one subarachnoid hemorrhage 804.2 foot (closed) 826.0 with flail chest (open) 807.4 subdural hemorrhage 804.2 with bone(s) of same lower limb 827.0 open 807.1 open 804.5 open 827.1 root, tooth 873.63 with open 826.1 complicated 873.73 contusion, cerebral 804.6 hand (closed) 816.00 sacrum—see Fracture, vertebra, sacrum epidural hemorrhage 804.7 with metacarpal bone(s) of same hand 817.0 scaphoid extradural hemorrhage 804.7 open 817.1 ankle (closed) 825.22 hemorrhage (intracranial) NEC 804.8 distal 816.02 open 825.32 intracranial injury NEC 804.9 open 816.12 wrist (closed) 814.01 laceration, cerebral 804.6 middle 816.01 open 814.11 subarachnoid hemorrhage 804.7 open 816.11 scapula (closed) 811.00 F subdural hemorrhage 804.7 multiple sites NEC 816.03 acromial, acromion (process) 811.01 vertebral column with other bones, except skull open 816.13 open 811.11 or face bones (sites classifiable to 805 or 806 open 816.10 body 811.09 proximal 816.01 with sites classifiable to 807–808 or 810–829) open 811.19 open 816.11 (closed) 809.0 coracoid process 811.02 pisiform (closed) 814.04 open 809.1 open 811.12 open 814.14 nasal (bone(s)) (closed) 802.0 glenoid (cavity) (fossa) 811.03 pond—see Fracture, skull, vault open 802.1 open 811.13 Pott’s (closed) 824.4 sinus—see Fracture, skull, base neck 811.03 open 824.5 navicular open 811.13 prosthetic device, internal—see Complications, carpal (wrist) (closed) 814.01 open 811.10 mechanical open 814.11 semilunar pubis (with visceral injury) (closed) 808.2 tarsal (ankle) (closed) 825.22 bone, wrist (closed) 814.02 open 808.3 open 825.32 open 814.12 Quervain’s (closed) 814.01 neck—see Fracture, vertebra, cervical cartilage (interior) (knee)—see Tear, meniscus open 814.11 neural arch—see Fracture, vertebra, by site sesamoid bone—see Fracture, by site radius (alone) (closed) 813.81 nonunion 733.82 shepherd’s (closed) 825.21 with ulna NEC 813.83 nose, nasal, (bone) (septum) (closed) 802.0 open 825.31 open 813.93 open 802.1 shoulder—see also Fracture, humerus, upper end distal end—see Fracture, radius, lower end occiput—see Fracture, skull, base blade—see Fracture, scapula Blue notes in theepiphysis odontoid process—see Fracture, vertebra, cervical silverfork—see Fracture, radius, lower end lower—see Fracture, radius, lower end olecranon (process) (ulna) (closed) 813.01 sinus (ethmoid) (frontal) (maxillary) (nasal) alphabetic index upper—see Fracture, radius, upper end open 813.11 (sphenoidal)—see Fracture, skull, base head—see Fracture, radius, upper end open 829.1 Skillern’s—see Fracture, radius, shaft help you easily spotlower end or extremity (distal end) (lower orbit, orbital (bone) (region) (closed) 802.8 skull (multiple NEC) (with face bones) (closed) 803.0 epiphysis) 813.42 floor (blow-out) 802.6 which descriptions with open 802.7 with ulna (lower end) 813.44 open 813.54 contusion, cerebral 803.1 open 802.9 require further epidural hemorrhage 803.2 roof—see Fracture, skull, base open 813.52 torus 813.45 extradural hemorrhage 803.2 specified part NEC 802.8 investigation. hemorrhage (intracranial) NEC 803.3 open 802.9 with ulna 813.47 neck—see Fracture, radius, upper end intracranial injury NEC 803.4 os laceration, cerebral 803.1 calcis (closed) 825.0 open NEC 813.91 pathologic 733.12 other bones—see Fracture, multiple, skull open 825.1 subarachnoid hemorrhage 803.2 magnum (closed) 814.07 proximal end—see Fracture, radius, upper end shaft (closed) 813.21 subdural hemorrhage 803.2 open 814.17 base (antrum) (ethmoid bone) (fossa) (internal pubis (with visceral injury) (closed) 808.2 with ulna (shaft) 813.23 open 813.33 ear) (nasal sinus) (occiput) (sphenoid) open 808.3 (temporal bone) (closed) 801.0 triquetrum (closed) 814.03 open 813.31 upper end 813.07 with open 814.13 contusion, cerebral 801.1 osseous with ulna (upper end) 813.08 open 813.18 epidural hemorrhage 801.2 auditory meatus—see Fracture, skull, base extradural hemorrhage 801.2 labyrinth—see Fracture, skull, base epiphysis 813.05 open 813.15 hemorrhage (intracranial) NEC 801.3 ossicles, auditory (incus) (malleus) (stapes)—see intracranial injury NEC 801.4 Fracture, skull, base head 813.05 open 813.15 laceration, cerebral 801.1

❖ New Line sReviseds

ICD-9-CM MANUAL 2011 VOLUME 2 141

ICD9_2011_vol2_sec1.indd 141 8/16/10 10:23:24 PM Hypertension, hypertensive Index to Diseases and Injuries

Malignant Benign Unspecified Malignant Benign Unspecified

Hypertension, hypertensive (arterial) (arteriolar) (crisis) Hypertension, hypertensive (continued) (degeneration) (disease) (essential) (fluctuating) (idiopathic) renal (artery) (intermittent) (labile) (low renin) (orthostatic) (paroxysmal) aneurysm ...... 405 .01 405 .11 405 .91 (primary) (systemic) (uncontrolled) (vascular) ...... 401 .0 401 .1 401 .9 anomaly ...... 405 .01 405 .11 405 .91 with embolism ...... 405 .01 405 .11 405 .91 chronic kidney disease fibromuscular hyperplasia ...... 405 .01 405 .11 405 .91 stage I through stage IV, or unspecified ...... 403 .00 403 .10 403 .90 occlusion ...... 405 .01 405 .11 405 .91 stage V or end stage renal disease ...... 403 .01 403 .11 403 .91 stenosis ...... 405 .01 405 .11 405 .91 heart involvement (conditions classifiable to 429 .0–429 .3, thrombosis ...... 405 .01 405 .11 405 .91 429 .8, 429 .9 due to hypertension) (see also encephalopathy ...... 437 .2 437 .2 437 .2 Hypertension, heart ) ...... 402 .00 402 .10 402 .90 gestationalShaded-colored (transient) NEC ...... - - 642 .3 with kidney involvement—see Hypertension, Goldblatt’s ...... 440 .1 440 .1 440 .1 cardiorenal heart (disease)columns (conditions classifiablemake to 429it .0–429a .3, 429 .8, srenal (kidney) involvements 429 .9 due to hypertension) ...... 402 .00 402 .10 402 .90 ❖ (only conditions classifiable to 585, 587) withsnap to find codes (excludes conditions classifiable to 584) (see also heartin failurethe .hypertensive ...... 402 .01 402 .11 402 .91 Hypertension, kidney ) ...... 403 .00 403 .10 403 .90 hypertensive kidney disease (conditions classifiable Hypertension, hypertensive Hypertension, with heart involvement—see Hypertension, table,to 403) (see alsoneoplasm Hypertension, cardiorenal ) . . . . 404 .00 404 .10 404 .90 cardiorenal renal sclerosis (see also Hypertension, cardiorenal ) . . . 404 .00 404 .10 404 .90 failure (and sclerosis) (see also Hypertension, kidney ) . . 403 .01 403 .11 403 .91 intracranial,table, benign . . and. . . . the...... - 348 .2 - sclerosis without failure (see also Hypertension, intraocular ...... - - 365 .04 kidney ) ...... 403 .00 403 .10 403 .90 kidney . Table. . . . . of. . .Drugs...... 403 .00 403 .10 403 .90 accelerated (see also Hypertension, by type, malignant ) . . . 401 .0 - - with antepartum—see Hypertension, complicating pregnancy, chronic kidney disease childbirth, or the puerperium stage I through stage IV, or unspecified ...... 403 .00 403 .10 403 .90 cardiorenal (disease) ...... 404 .00 404 .10 404 .90 stage V or end stage renal disease ...... 403 .01 403 .11 403 .91 with heart involvement (conditions classifiable to chronic kidney disease 429 .0–429 .3, 429 .8, 429 .9 due to hypertension) stage I through stage IV, or unspecified ...... 404 .00 404 .10 404 .90 (see also Hypertension, cardiorenal ) ...... 404 .00 404 .10 404 .90 and heart failure ...... 404 .01 404 .11 404 .91 hypertensive heart (disease) (conditions classifiable stage V or end stage renal disease ...... 404 .02 404 .12 404 .92 to 402) (see also Hypertension, cardiorenal ) . . . . 404 .00 404 .10 404 .90 and heart failure ...... 404 .03 404 .13 404 .93 lesser circulation ...... - - 416 .0 heart failure ...... 404 .01 404 .11 404 .91 necrotizing ...... 401 .0 - - and chronic kidney disease ...... 404 .01 404 .11 404 .91 ocular ...... - - 365 .04 stage I through stage IV or unspecified ...... 404 .01 404 .11 404 .91 pancreatic duct - code to underlying condition stage V or end stage renal disease ...... 404 .03 404 .13 404 .93 with cardiovascular disease (arteriosclerotic) (sclerotic) ...... 402 .00 402 .10 402 .90 chronic pancreatitis ...... - - 577 .1 with portal (due to chronic liver disease) ...... - - 572 .3 heart failure ...... 402 .01 402 .11 402 .91 postoperative ...... 997 .91 renal involvement (conditions classifiable to 403) psychogenic ...... - - 306 .2 (see also Hypertension, cardiorenal ) ...... 404 .00 404 .10 404 .90 puerperal, postpartum—see Hypertension, complicating H cardiovascular renal (disease) (sclerosis) (see also pregnancy, childbirth, or the puerperium Hypertension, cardiorenal ) ...... 404 .00 404 .10 404 .90 pulmonary (artery) s(secondary)s ...... - - 416 .8 cerebrovascular disease NEC ...... 437 .2 437 .2 437 .2 with cor pulmonale (chronic) ...... - - 416 .8 complicating pregnancy, childbirth, or the puerperium . . . . . 642 .2 642 .0 642 .9 acute ...... - - 415 .0 with idiopathic ...... 416 .0 albuminuria (and edema) (mild) ...... - - 642 .4 primary ...... 416 .0 severe ...... - - 642 .5 of newborn ...... 747 .83 chronic kidney disease ...... 642 .2 642 .2 642 .2 secondary ...... - - 416 .8 and heart disease ...... 642 .2 642 .2 642 .2 renal (disease) (see also Hypertension, kidney ) ...... 403 .00 403 .10 403 .90 edema (mild) ...... - - 642 .4 renovascular NEC ...... 405 .01 405 .11 405 .91 severe ...... - - 642 .5 secondary NEC ...... 405 .09 405 .19 405 .99 heart disease ...... 642 .2 642 .2 642 .2 due to and chronic kidney disease ...... 642 .2 642 .2 642 .2 aldosteronism, primary ...... 405 .09 405 .19 405 .99 renal disease ...... 642 .2 642 .2 642 .2 brain tumor ...... 405 .09 405 .19 405 .99 and heart disease ...... 642 .2 642 .2 642 .2 bulbar poliomyelitis ...... 405 .09 405 .19 405 .99 chronic ...... 642 .2 642 .0 642 .0 calculus with pre-eclampsia or eclampsia ...... 642 .7 642 .7 642 .7 kidney ...... 405 .09 405 .19 405 .99 fetus or newborn ...... 760 .0 760 .0 760 .0 ureter ...... 405 .09 405 .19 405 .99 essential ...... - 642 .0 642 .0 coarctation, aorta ...... 405 .09 405 .19 405 .99 with pre-eclampsia or eclampsia ...... - 642 .7 642 .7 Cushing’s disease ...... 405 .09 405 .19 405 .99 fetus or newborn ...... 760 .0 760 .0 760 .0 glomerulosclerosis (see also Hypertension, kidney ) . . . 403 .00 403 .10 403 .90 fetus or newborn ...... 760 .0 760 .0 760 .0 periarteritis nodosa ...... 405 .09 405 .19 405 .99 gestational ...... - - 642 .3 pheochromocytoma ...... 405 .09 405 .19 405 .99 pre-existing ...... 642 .2 642 .0 642 .0 polycystic kidney(s) ...... 405 .09 405 .19 405 .99 with pre-eclampsia or eclampsia ...... 642 .7 642 .7 642 .7 polycythemia ...... 405 .09 405 .19 405 .99 fetus or newborn ...... 760 .0 760 .0 760 .0 porphyria ...... 405 .09 405 .19 405 .99 secondary to renal disease ...... 642 .1 642 .1 642 .1 pyelonephritis ...... 405 .09 405 .19 405 .99 with pre-eclampsia or eclampsia ...... 642 .7 642 .7 642 .7 renal (artery) fetus or newborn ...... 760 .0 760 .0 760 .0 aneurysm ...... 405 .01 405 .11 405 .91 transient ...... - - 642 .3 anomaly ...... 405 .01 405 .11 405 .91 due to embolism ...... 405 .01 405 .11 405 .91 aldosteronism, primary ...... 405 .09 405 .19 405 .99 fibromuscular hyperplasia ...... 405 .01 405 .11 405 .91 brain tumor ...... 405 .09 405 .19 405 .99 occlusion ...... 405 .01 405 .11 405 .91 bulbar poliomyelitis ...... 405 .09 405 .19 405 .99 stenosis ...... 405 .01 405 .11 405 .91 calculus thrombosis ...... 405 .01 405 .11 405 .91 kidney ...... 405 .09 405 .19 405 .99 transient ...... - - 796 .2 ureter ...... Our. . . . icons. . . . . easily. . . 405 .09 405 .19 405 .99 of pregnancy ...... - - 642 .3 coarctation, aorta ...... 405 .09 405 .19 405 .99 venous, chronic (asymptomatic) (idiopathic) ...... - - 459 .30 Cushing’s disease ...... identify...... new . . . . and405 .09 405 .19 405 .99 with glomerulosclerosis (see also Hypertension, kidney ) . . . . 403 .00 403 .10 403 .90 complication, NEC ...... - - 459 .39 periarteritis nodosa ...... revised...... text.. . . 405 .09 405 .19 405 .99 inflammation ...... - - 459 .32 pheochromocytoma ...... 405 .09 405 .19 405 .99 with ulcer ...... - - 459 .33 polycystic kidney(s) ...... 405 .09 405 .19 405 .99 ulcer ...... - 459 .31 polycythemia ...... 405 .09 405 .19 405 .99 with inflammation ...... - - 459 .33 porphyria ...... 405 .09 405 .19 405 .99 due to pyelonephritis ...... 405 .09 405 .19 405 .99 deep vein thrombosis (see also Syndrome, postphlebitic) ...... - - 459 .10

❖ New Line sReviseds

164 VOLUME 2 ICD-9-CM MANUAL 2011

ICD9_2011_vol2_sec1.indd 164 8/16/10 10:23:35 PM Tabular List Diseases of the Circulatory System 414.2–421.1

excludes: acute coronary occlusion with myocardial infarction OTHER FORMS OF HEART DISEASE (420–429) (410.00-410.92) acute coronary occlusion without myocardial ✓4TH 420 Acute pericarditis infarction (411.81) Includes: acute: 414.3 Coronary atherosclerosis due to lipid rich plaque mediastinopericarditis Code first coronary atherosclerosis (414.00–414.07) myopericarditis 414.8 Other specified forms of chronic ischemic heart disease pericardial effusion Chronic coronary insufficiency pleuropericarditis Ischemia, myocardial (chronic) pneumopericarditis Any condition classifiable to 410 specified as chronic, or excludes: acute rheumatic pericarditis (391.0) presentingOur with 4 symptoms4 and after 4 58 weeks from date of postmyocardial infarction syndrome [Dressler’s] (411.0) infarction 420.0 Acute pericarditis in diseases classified excludes: coronarysymbols insufficiency identify (acute) (411.89) elsewhere CC 414.9 Chronic ischemic heart disease, unspecified Code first underlying disease, as: Ischemiccodes heart disease that NOS require actinomycosis (039.8) the assignment of amebiasis (006.8) DISEASES OF PULMONARY CIRCULATION (415–417) chronic uremia (585.9) ✓4TH 415 Acute pulmonaryadditional heart disease digits. nocardiosis (039.8) 415.0 Acute cor pulmonale MCC tuberculosis (017.9) excludes: cor pulmonale NOS (416.9) uremia NOS (586) 414–421 ✓5TH 415.1 Pulmonary embolism and infarction excludes: pericarditis (acute) (in): Pulmonary (artery) (vein): Coxsackie (virus) (074.21) apoplexy gonococcal (098.83) embolism histoplasmosis (115.0–115.9 with fifth-digit 3) infarction (hemorrhagic) meningococcal infection (036.41) thrombosis syphilitic (093.81) ✓TH excludes: that complicating: 5 420.9 Other and unspecified acute pericarditis abortion (634–638 with .6, 639.6) 420.90 Acute pericarditis, unspecified CC chronic pulmonary embolism (416.2) Pericarditis (acute): ectopic or molar pregnancy (639.6) NOS pregnancy, childbirth, or the puerperium infective NOS (673.0–673.8) sicca personal history of pulmonary embolism (V12.51) 420.91 Acute idiopathic pericarditis CC H 415.11 Iatrogenic pulmonary embolism Pericarditis, acute: and infarction MCC benign Use additional code for associated septic pulmonary nonspecific embolism, if applicable, 415.12 viral 415.12 Septic pulmonary embolism MCC 420.99 Other CC Septic embolism NOS Pericarditis (acute): Code first underlying infection, such as: pneumococcal septicemia (038.0-038.9) purulent excludes: septic arterial embolism (449) staphylococcal H 415.19 Other MCC streptococcal ✓4TH 416 Chronic pulmonary heart disease suppurative 416.0 Primary pulmonary hypertension CC Pneumopyopericardium Idiopathic pulmonary arteriosclerosis Pyopericardium Pulmonary hypertension (essential) (idiopathic) (primary) excludes: pericarditis in diseases classified elsewhere (420.0) excludes: ♦pulmonary hypertension NOS (416.8)♦ ✓4TH 421 Acute and subacute endocarditis ♦secondary pulmonary hypertension (416.8)♦ 421.0 Acute and subacute bacterial endocarditis MCC, HIV 416.1 Kyphoscoliotic heart disease CC Endocarditis (acute) (chronic) (subacute): 416.2 Chronic pulmonary embolism CC bacterial Use additional code, if applicable, for associated long-term (current) infective NOS use of anticoagulants (V58.61) lenta excludes: personal history of pulmonary embolism (V12.51) malignant 416.8 Other chronic pulmonary heart diseases purulent Pulmonary hypertension, secondary septic ♦Pulmonary hypertension NOS♦ ulcerative 416.9 Chronic pulmonary heart disease, unspecified vegetative Chronic cardiopulmonary disease Infective aneurysm Cor pulmonale (chronic) NOS Subacute bacterial endocarditis [SBE] ✓4TH 417 Other diseases of pulmonary circulation Use additional code, if desired, to identify infectious organism 417.0 Arteriovenous fistula of pulmonary vessels CC [e.g., Streptococcus 041.0, Staphylococcus 041.1] excludes: congenital arteriovenous fistula (747.3) 421.1 Acute and subacute infective endocarditis in diseases classified elsewhere MCC 417.1 Aneurysm of pulmonary artery CC Icons indicate Code first underlying disease, as: excludes: congenital aneurysm (747.3) blastomycosis (116.0) 417.8 Other specifiednew diseases codes, of pulmonary revised circulation Q fever (083.0) Pulmonary: typhoid (fever) (002.0) arteritiscodes, revised code excludes: endocarditis (in): endarteritis titles, CCS, MCCs, Coxsackie (virus) (074.22) Rupture of pulmonary vessel gonococcal (098.84) Stricture of pulmonaryHIV-related, vessel histoplasmosis (115.0–115.9 with fifth-digit 4) 417.9 Unspecified disease of pulmonary circulation and HACs. meningococcal infection (036.42) monilial (112.81)

✓4TH ✓5TH Additional Digit Required Unspecified Manifestation Code MCC Major CC Condition HIV HIV Related H Hospital Acquired Condition CC CC Condition For a list of CC Exclusions, please see Appendix F ♦Revised Text♦ ➜ New Code ✽ Revised Code Title CC CC Condition For a list of CC Exclusions, please see Appendix F ICD-9-CM MANUAL 2011 VOLUME 1 479

ICD9_2011_vol1_ch4_8.indd 479 8/16/10 10:14:27 PM Tabular List Diseases of the Circulatory System 429.7–434.9

Cerebrovascular Arteries 429.9 Heart disease, unspecified Heart disease (organic) NOS Posterior Morbus cordis NOS parietal Superficial excludes: that due to hypertension (402.0–402.9) temporal CEREBROVASCULAR DISEASE (430–438) Maxillary Includes: with mention of hypertension (conditions classifiable to 401–405) Use additionalOne of code dozens to identify presenceof of hypertension excludes: any condition classifiable to 430–434, 436, 437 occurring during helpful illustrationspregnancy, childbirth, or the puerperium, or specified as puerperal (674.0) throughoutiatrogenic cerebrovascular the infarction or hemorrhage (997.02) 430ICD-9-CM Subarachnoid manuals. hemorrhage MCC Meningeal hemorrhage Ruptured: berry aneurysm Facial (congenital) cerebral aneurysm NOS Occipital excludes: syphilitic ruptured cerebral aneurysm (094.87) 431 Intracerebral hemorrhage MCC External Hemorrhage (of): 429–434 carotid basilar bulbar Vertebral cerebellar cerebral cerebromeningeal Lingual cortical internal capsule Internal intrapontine carotid pontine Right subcortical common ventricular carotid Rupture of blood vesselIcons in brain indicate ✓4TH 432 Other and unspecifiedCCs intracranial and MCCs. hemorrhage Brachiocephalic 432.0 Nontraumatic extradural hemorrhage MCC Nontraumatic epidural hemorrhage 432.1 Subdural hemorrhage MCC Subdural hematoma, nontraumatic Thyrocervical 432.9 Unspecified intracranial hemorrhage CC trunk Intracranial hemorrhage NOS Internal ✓4TH 433 Occlusion and stenosis of precerebral arteries Costocervical thoracic Aortic Use additional code, if applicable, to identify status post trunk Right arch administration of tPA (rtPA) in a different facility within the last subclavian 24 hours prior to admission to current facility (V45.88)

excludes: congenital defects of heart (745, 746) The following fifth-digit subclassification is for use with category 433: coronary aneurysm (414.11) 0 without mention of cerebral infarction disorders of papillary muscle (429.6, 429.81) 1 with cerebral infarction postmyocardial infarction syndrome (411.0) rupture of chordae tendineae (429.5) Includes: embolism of basilar, carotid, and vertebral arteries 429.71 Acquired cardiac septal defect CC narrowing of basilar, carotid, and vertebral arteries excludes: acute septal infarction (410.00–410.92 obstruction of basilar, carotid, and vertebral arteries 429.79 Other CC thrombosis of basilar, carotid, and vertebral arteries Mural thrombus (atrial) (ventricular) acquired, excludes: insufficiency NOS of precerebral arteries (435.0–435.9) following myocardial infarction ✓5TH 433.0 Basilar artery MCC 1 ✓5TH 429.8 Other ill-defined heart diseases ✓5TH 433.1 Carotid artery MCC 1 429.81 Other disorders of papillary muscle CC ✓5TH 433.2 Vertebral artery MCC 1 Papillary muscle: ✓5TH 433.3 Multiple and bilateral MCC 1 atrophy ✓5TH 433.8 Other specified precerebral artery MCC 1 degeneration ✓5TH 433.9 Unspecified precerebral artery MCC 1 dysfunction Precerebral artery NOS incompetence ✓4TH 434 Occlusion of cerebral arteries incoordination Use additional code, if applicable, to identify status post scarring administration of tPA (rtPA) in a different facility within the last 429.82 Hyperkinetic heart disease CC 24 hours prior to admission to current facility (V45.88) 429.83 Takotsubo syndrome CC Broken heart syndrome The following fifth-digit subclassification is for use with category 434: Reversible left ventricular dysfunction following 0 without mention of cerebral infarction sudden emotional stress 1 with cerebral infarction Stress induced cardiomyopathy Transient left ventricular apical ballooning syndrome ✓5TH 434.0 Cerebral thrombosis MCC 1 429.89 Other Thrombosis of cerebral arteries Carditis ✓5TH 434.1 Cerebral embolism MCC 1 excludes: that due to hypertension (402.0–402.9) ✓5TH 434.9 Cerebral artery occlusion, unspecified MCC 1

✓4TH ✓5TH Additional Digit Required Unspecified Manifestation Code MCC Major CC Condition HIV HIV Related H Hospital Acquired Condition CC CC Condition For a list of CC Exclusions, please see Appendix F ♦Revised Text♦ ➜ New Code ✽ Revised Code Title CC CC Condition For a list of CC Exclusions, please see Appendix F ICD-9-CM MANUAL 2011 VOLUME 1 483

ICD9_2011_vol1_ch4_8.indd 483 8/16/10 10:14:43 PM Tabular List Diseases of the Musculoskeletal System and Connective Tissue

Muscular System - Anterior

Temporalis Frontalis Orbicularis oculi Masseter Orbicularis oris

Sternocleidomastoid Trapezius (SCM) Pectoralis major Coraco- brachialis Triceps brachii Biceps brachi Latissimus dorsi Brachialis Serratus anterior External oblique Extensor Rectus abdominis radialis longus Iliopsoas Pectineus Tensor faciae latae Adductor longus Gracilis Adductor magnus

You’ll find Rectus femoris Sartorius detailed full body Vastus lateralis illustrations and dozens of drawings Vastus medialis throughout the Peroneus ICD-9-CM manuals. longus Gastroc- nemius Tibialis ant. Soleus Tibialis Extensor anterior digitorum longus Tibialis posterior

✓4TH ✓5TH Additional Digit Required Unspecified Manifestation Code MCC Major CC Condition HIV HIV Related H Hospital Acquired Condition CC CC Condition For a list of CC Exclusions, please see Appendix F ♦Revised Text♦ ➜ New Code ✽ Revised Code Title CC CC Condition For a list of CC Exclusions, please see Appendix F ICD-9-CM MANUAL 2011 VOLUME 1 553

ICD9_2011_vol1_ch9_13.indd 553 8/16/10 10:17:27 PM Index to Procedures Repair

coronary artery 36.91 with nasal 21.89 Repair heart 37.32 patch graft 39.58 skull NEC 02.06 sinus of Valsalva 35.39 with excision or resection of vessel—see with thoracic aorta (dissecting), by Arteriectomy, with graft replacement, by site flap (bone) 02.03 fenestration 39.54 synthetic (Dacron) (Teflon) 39.57 graft (bone) 02.04 anomalous pulmonary venous connection (total) tissue (vein) (autogenous) (homograft) 39.56 bottle, hydrocele of tunica vaginalis 61.2 one-stage 35.82 suture 39.31 brain (trauma) NEC 02.92 partial—see specific procedure coronary NEC 36.99 breast (plastic)—see also Mammoplasty 85.89 total 35.82 by angioplasty—see Angioplasty, coronary broad ligament 69.29 anular disc 80.54 by atherectomy—see Angioplasty, coronary bronchus NEC 33.48 with graft or prosthesis 80.53 artificial opening—see Repair, stoma laceration (by suture) 33.41 anulus fibrosus 80.54 atrial septal defect 35.71 bunionette (with osteotomy) 77.54 with graft or prosthesis 80.53 with canaliculus, lacrimal 09.73 anus 49.79 prosthesis (open heart technique) 35.51 canthus (lateral) 08.59 laceration (by suture) 49.71 closed heart technique 35.52 cardiac pacemaker NEC 37.89 obstetric (current) 75.62 tissue graft 35.61 electrode(s) (lead) NEC 37.75 old 49.79 combined with repair of valvular and ventricular cardioverter/defibrillator (automatic) pocket, (skin) aorta 39.31 septal defects—see Repair, endocardial cushion (subcutaneous) 37.99 aorticopulmonary window 39.59 defect cerebral meninges 02.12 arteriovenous fistula 39.53 in total repair of total anomalous pulmonary cervix 67.69 by or with venous connection 35.82 internal os 67.59 clipping 39.53 atrioventricular canal defect (any type) 35.73 transabdominal 67.51 coagulation 39.53 with transvaginal 67.59 coil, NEC (endovascular approach) 39.79 prosthesis 35.54 aceration (by suture) 67.61 head and neck vessels tissue graft 35.63 obstetric (current) 75.51 bare coils 39.75 bifid digit (finger) 82.89 old 67.69 bioactive coils 39.76 bile duct NEC 51.79 chest wall (mesh) (silastic) NEC 34.79 division 39.53 laceration (by suture) NEC 51.79 chordae tendineae 35.32 excision or resection—see also Aneurysmectomy, The alphabeticcommon bile duct 51.71 index in choroid NEC 14.9 by site bladder NEC 57.89 with retinal repair—see Repair, retina with Volumeexstrophy 3 57.86 features blue cisterna chyli 40.69 anastomosis—see Aneurysmectomy, with notesfor to stress spot incontinence— descriptionssee Repair, stress claw toe 77.57 anastomosis, by site incontinence cleft graft replacement—see Aneurysmectomy, with thatlaceration require (by suture) further 57.81 hand 82.82 graft replacement, by site obstetric (current) 75.61 laryngotracheal 31.69 ligation 39.53 investigationold 57.89 and yellow lip 27.54 coronary artery 36.99 neck 57.85 palate 27.62 occlusion 39.53 highlightedblepharophimosis 08.59 call-out secondary or subsequent 27.63 endovascular approach 39.79 blepharoptosis 08.36 coarctation of aorta—see Excision, coarctation of aorta head and neck 39.72 boxesby for additional cochlear prosthetic device 20.99 suture 39.53 frontalis muscle technique (with) external components only 95.49 artery NEC 39.59 information.fascial sling 08.32 cockup toe 77.58 by suture 08.31 colostomy 46.43 R endovascular approach levator muscle technique 08.34 conjunctiva NEC 10.49 abdominal aorta 39.71 with resection or advancement 08.33 with scleral repair 12.81 head and neck (embolization or orbicularis oculi muscle sling 08.36 laceration 10.6 occlusion) 39.72 tarsal technique 08.35 with repair of sclera 12.81 other repair (of aneurysm) 39.79 blood vessel NEC 39.59 late effect of trachoma 10.49 percutaneous repair of intracranial vessel(s) with cornea NEC 11.59 (for stent insertion) 00.62 patch graft 39.58 with with excision or resection—see Angiectomy, with conjunctival flap 11.53 graft replacement transplant—see Keratoplasty Note—Also use 00.40, 00.41, 00.42, or 00.43 to synthetic (Dacron) (Teflon) 39.57 postoperative dehiscence 11.52 show the total number of vessels treated. Use tissue (vein) (autogenous) (homograft) 39.56 coronary artery NEC 36.99 code 00.44 once to show procedure on a bifurcated resection—see Angiectomy by angioplasty—see Angioplasty, coronary vessel. In addition, use 00.45, 00.46, 00.47, or 00.48 suture 39.30 by atherectomy—see Angioplasty, coronary to show the number of vascular stents inserted. coronary artery NEC 36.99 cranium NEC 02.06 by angioplasty—see Angioplasty, coronary with percutaneous repair of precerebral (extracranial) by atherectomy—see Angioplasty, coronary flap (bone) 02.03 vessel(s) (for stent insertion) 00.61 peripheral vessel NEC 39.59 graft (bone) 02.04 by angioplasty 39.50 cusp, valve—see Repair, heart, valve cystocele 70.51 Note—Also use 00.40, 00.41, 00.42, or 00.43 to with graft or prosthesis 70.54 show the total number of vessels treated. Use Note—Also use 00.40, 00.41, 00.42, or 00.43 to and rectocele 70.50 code 00.44 once to show procedure on a bifurcated show the total number of vessels treated. Use with graft or prosthesis 70.53 vessel. In addition, use 00.45, 00.46, 00.47, or 00.48 code 00.44 once to show procedure on a bifurcated dental arch 24.8 to show the number of vascular stents inserted. vessel. In addition, use 00.45, 00.46, 00.47, or 00.48 diaphragm NEC 34.84 to show the number of vascular stents inserted. diastasis recti 83.65 diastematomyelia 03.59 non-coronary percutaneous transluminal by atherectomy 39.50 ear (external) 18.79 angioplasty or atherectomy auditory canal or meatus 18.6 auricle NEC 18.79 Note—Also use 00.40, 00.41, 00.42, or 00.43 to Note—Also use 00.40, 00.41, 00.42, or 00.43 to cartilage NEC 18.79 show the total number of vessels treated. Use laceration (by suture) 18.4 show the total number of vessels treated. Use code 00.44 once to show procedure on a bifurcated code 00.44 once to show procedure on a bifurcated lop ear 18.79 vessel. In addition, use 00.45, 00.46, 00.47, or 00.48 middle NEC 19.9 vessel. In addition, use 00.45, 00.46, 00.47, or 00.48 to show the number of vascular stents inserted. to show the number of vascular stents inserted. prominent or protruding 18.5 ectropion 08.49 by endovascular approach 39.79 by or with basilar 00.61 bone NEC—see also Osteoplasty—see category 78.4 lid reconstruction 08.44 carotid 00.61 by synostosis technique—see Arthrodesis suture (technique) 08.42 femoropopliteal 39.50 accessory sinus 22.79 thermocauterization 08.41 iliac 39.50 cranium NEC 02.06 wedge resection 08.43 lower extremity NOS 39.50 with encephalocele (cerebral) 02.12 mesenteric 39.50 flap (bone) 02.03 endocardial cushion defect 35.73 renal 39.50 graft (bone) 02.04 with upper extremity NOS 39.50 for malunion, nonunion, or delayed union of fracture— prosthesis (grafted to septa) 35.54 vertebral 00.61 see Repair, fracture, malunion or nonunion tissue graft 35.63

❖ New Line sReviseds

ICD-9-CM MANUAL 2011 VOLUME 3 749

ICD9_2011_vol3_sec1.indd 749 8/16/10 10:29:02 PM Tabular List Procedures and Interventions, Not Elsewhere Classified 00.56–00.69

00.56 Insertion or replacement of implantable pressure Code also any: sensor (lead) for intracardiac or great vessel number of vascular stents inserted (00.45–00.48) hemodynamic monitoring number of vessels treated (00.40–00.43) Code also any associated implantation or replacement of percutaneous angioplasty or atherectomy of precerebral monitor (00.57) vessel(s) (00.61) ExcludEs: circulatory monitoring (blood gas, arterial or procedure on vessel bifurcation (00.44) venous pressure, cardiac output and coronary ExcludEs: angioplasty or atherectomy of other non-coronary 00 blood flow) (89.60–89.69) vessel(s)(39.50) 00.57 Implantation or replacement of subcutaneous insertion of drug-eluting peripheral vessel device for intracardiac or great vessel stent(s) (00.55) hemodynamic monitoring 00.64 Percutaneous insertion of other precerebral Implantation of monitoring device with formation (extracranial) artery stent(s) of subcutaneous pocket and connection to Includes the use of any embolic protection device, intracardiac pressure sensor (lead) distal protection device, filter device, or stent Code also any associated insertion or replacement of delivery system implanted pressure sensor (lead) (00.56) Basilar stent 00.58 Insertion of intra-aneurysm sac pressure Vertebral stent monitoring device (intraoperative) Code also any: Insertion of pressure sensor during endovascular number of vascular stents inserted (00.45–00.48) repair of abdominal or thoracic aortic number of vessels treated (00.40–00.43) aneurysm(s) percutaneous angioplasty or atherectomy of precerebral 00.59 Intravascular pressure measurement of coronary vessel(s) (00.61) arteries procedure on vessel bifurcation (00.44) IncludEs: fractional flow reserve (FFR) ExcludEs: angioplasty or atherectomy of other non–coronary Code also any synchronous diagnostic or therapeutic vessel(s)(39.50) procedures insertion of drug–eluting peripheral vessel ExcludEs: intravascular pressure measurement of stent(s) (00.55) intrathoracic arteries (00.67) 00.65 Percutaneous insertion of intracranial vascular ✓4TH 00.6 Procedures on blood vessels stent(s) ➜ 00.60 Insertion of drug-eluting stent(s) of superficial Includes the use of any embolic protection device, femoral artery distal protection device, filter device, or stent Code also any: delivery system angioplasty or atherectomy of other non-coronary vessel(s) Code also any: (39.50) number of vascular stents inserted (00.45–00.48) non-drug-eluting peripheral stents (39.90) number of vessels treated (00.40–00.43) number of vascular stents inserted (00.45–00.48) percutaneous angioplasty or atherectomy of intracranial number of vessels treated (00.40–00.43) vessel(s) (00.62) procedure on vessel bifurcation (00.44) procedure on vessel bifurcation (00.44) ExcludEs: insertion of drug-eluting stent(s) of other ExcludEs: angioplasty or atherectomy of other non-coronary peripheral vessel (00.55) vessel(s)(39.50) that for other endovascular procedure (39.71–39.79) insertion of drug-eluting peripheral vessel 00.61 Percutaneous angioplasty or atherectomy of stent(s) (00.55) precerebralPink (extracranial) and blue vessel(s) 00.66 Percutaneous transluminal coronary angioplasty Basilar [PTCA] or coronary atherectomy Carotid highlights in Balloon angioplasty of coronary artery Vertebral Coronary atherectomy Code also any: Volume 3 help Percutaneous coronary angioplasty NOS injection oridentify infusion of thrombolytic codes thatagent (99.10) PTCA NOS number of vascular stents inserted (00.45–00.48) Code also any: number ofare vessels non-OR treated (00.40–00.43) or valid injection or infusion of thrombolytic agent (99.10) percutaneous insertion of carotid artery stent(s) (00.63) insertion of coronary artery stent(s) (36.06–36.07) percutaneousOR insertion procedures. of other precerebral artery stent(s) intracoronary artery thrombolytic infusion (36.04) (00.64) number of vascular stents inserted (00.45–00.48) procedure on vessel bifurcation (00.44) number of vessels treated (00.40–00.43) ExcludEs: angioplasty or atherectomy of other non-coronary procedure on vessel bifurcation (00.44) vessel(s) (39.50) SuperSaturated oxygen therapy (00.49) removal of cerebrovascular obstruction of 00.67 Intravascular pressure measurement of vessel(s) by open approach (38.01–38.02, intrathoracic arteries 38.11–38.12, 38.31–38.32, 38.41–38.42) Assessment of: 00.62 Percutaneous angioplasty or atherectomy of aorta and aortic arch intracranial vessel(s) carotid Code also any: Code also any synchronous diagnostic or therapeutic injection or infusion of thrombolytic agent (99.10) procedures number of vascular stents inserted (00.45–00.48) 00.68 Intravascular pressure measurement of peripheral number of vessels treated (00.40–00.43) arteries percutaneous insertion of intracranial stent(s) (00.65) Assessment of: procedure on vessel bifurcation (00.44) other peripheral vessels ExcludEs: angioplasty or atherectomy of other non–coronary vessels of arm(s) vessel(s) (39.50) vessels of leg(s) removal of cerebrovascular obstruction of Code also any synchronous diagnostic or therapeutic vessel(s) by open approach (38.01–38.02, procedures 38.11–38.12, 38.31–38.32, 38.41–38.42) 00.69 Intravascular pressure measurement, other 00.63 Percutaneous insertion of carotid artery stent(s) specified and unspecified vessels Includes the use of any embolic protection device, iliac vessels distal protection device, filter device, or stent intra-abdominal vessels delivery system mesenteric vessels Non-drug-eluting stent renal vessels

✓3RD ✓4TH Additional Digit Required Valid OR Procedure Non-OR Procedure ♦Revised Text♦ ✽ Revised Code Title ➜ New Code

ICD-9-CM MANUAL 2011 VOLUME 3 771

ICD9_2011_vol3_sec2.indd 771 8/16/10 10:33:13 PM 36.99–37.49 Operations on the Cardiovascular System Tabular List

36.99 Other operations on vessels of heart 37.32 Excision of aneurysm of heart Exploration of coronary artery Repair of aneurysm of heart Incision of coronary artery 37.33 Excision or destruction of other lesion or tissue of Ligation of coronary artery heart, open approach Repair of arteriovenous fistula Ablation ♦or incision♦ of heart tissue (cryoablation) (electrocurrent) (laser) (microwave) ✓3RD 37 Other operations on heart and pericardium (radiofrequency) (resection) ♦(ultrasound)♦, Code also any injection or infusion of platelet inhibitor (99.20) open chest approach 37.0 Pericardiocentesis Cox-maze procedure ✓TH 4 37.1 Cardiotomy and pericardiotomy Maze procedure Code also cardiopulmonary bypass [extracorporeal circulation] ♦That by median sternotomy♦ [heart-lung machine] (39.61) ♦That by thoracotomy without use of thoracoscope♦ 37.10 Incision of heart, not otherwise specified ExcludEs: ablation,excision or destruction of lesion or tissue Cardiolysis NOS of heart: 37.11 Cardiotomy endovascular approach (37.34) Incision of: ♦thoracoscopic approach (37.37)♦ atrium excision or destruction of left atrial appendage endocardium (LAA) (37.36) myocardium ✽ 37.34 Excision or destruction of other lesion or tissue ventricle of heart, ♦endovascular♦ approach 37.12 Pericardiotomy Ablation of heart tissue (cryoablation) Pericardial window operation (electrocurrent)(laser) (microwave) Pericardiolysis (radiofrequency) (resection) ♦(ultrasound)♦, Pericardiotomy via peripherally inserted catheter ✓4TH 37.2 Diagnostic procedures on heart and pericardium Modified maze procedure, ♦percutaneous ♦ approach 37.20 Noninvasive programmed electrical ExcludEs: ♦ablation, excision or destruction of lesion of stimulation (NIPS) tissue of heart:♦ ExcludEs: that as part of intraoperative testing—omit code ♦open approach (37.33)♦ catheter based invasive electrophysiologic ♦thoracoscopic approach (37.37)♦ testing (37.26) 37.35 Partial ventriculectomy device interrogation only without arrhythmia Ventricular reduction surgery induction (bedside check) (89.45–89.49) Ventricular remodeling 37.21 Right heart cardiac catheterization Code also any synchronous: Cardiac catheterization NOS mitral valve repair (35.02, 35.12) ExcludEs: that with catheterization of left heart (37.23) mitral valve replacement (35.23–35.24) 37.22 Left heart cardiac catheterization Icons help you spot 37.36 Excision or destruction of left atrial appendage ExcludEs: that with catheterization of right heart (37.23) (LAA) 37.23 Combined right and left heart cardiac which codes are IncludEs: Thoracoscopic approach, minithoracotomy catheterization new or revised. approach 37.24 Biopsy of pericardium Clipping of left atrial appendage

36 –37 37.25 Biopsy of heart Exclusion of left atrial appendage 37.26 Catheter based invasive electrophysiologic testing Oversewing of left atrial appendage Electrophysiologic studies [EPS] Stapling of left atrial appendage Code also any concomitant procedure Code also any concomitant procedure performed ExcludEs: that as part of intraoperative testing—omit code ExcludEs: ablation, excision or destruction of lesion or tissue device interrogation only without arrhythmia of heart, endovascular approach (37.34) induction (bedside check) (89.45–89.49) ➜ 37.37 Excision or destruction of other lesion or tissue of His bundle recording (37.29) heart, thoracoscopic approach noninvasive programmed electrical stimulation Ablation or incision of heart tissue (cryoablation) (NIPS) (37.20) (electrocautery) (laser) (microwave) 37.27 Cardiac mapping (radiofrequency) (resection) (ultrasound), via Code also any concomitant procedure thoracoscope ExcludEs: electrocardiogram (89.52) Modified maze procedure, thoracoscopic approach His bundle recording (37.29) That via thoracoscopically-assisted approach 37.28 Intracardiac echocardiography (without thoracotomy) (with port access) Echocardiography of heart chambers (with sub-xiphoid incision) ICE ExcludEs: ablation, excision or destruction of lesion or tissue of heart: Code also any synchronous Doppler flow mapping (88.72) open approach (37.33) ExcludEs: intravascular imaging of coronary vessels (intravascular ultrasound)(IVUS) (00.24) endovascular approach (37.34) 37.29 Other diagnostic procedures on heart and thoracoscopic excision or destruction of left atrial pericardium appendage [LAA] (37.36) TH ExcludEs: angiocardiography (88.50–88.58) ✓4 37.4 Repair of heart and pericardium cardiac function tests (89.41–89.69) 37.41 Implantation of prosthetic cardiac support device cardiovascular radioisotopic scan and function around the heart study (92.05) Cardiac support device (CSD) coronary arteriography (88.55–88.57) Epicardial support device diagnostic pericardiocentesis (37.0) Fabric (textile) (mesh) device diagnostic ultrasound of heart (88.72) Ventricular support device on surface of heart x-ray of heart (87.49) Code also any: ✓4TH 37.3 Pericardiectomy and excision of lesion of heart cardiopulmonary bypass [extracorporeal circulation] Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] if performed (39.61) [heart-lung machine], ♦if performed♦ (39.61) mitral valve repair (35.02, 35.12) 37.31 Pericardiectomy mitral valve replacement (35.23–35.24) Excision of: transesophageal echocardiography (88.72) adhesions of pericardium constricting scar of: ExcludEs: circulatory assist systems (37.61–37.68) epicardium 37.49 Other repair of heart and pericardium pericardium

✓3RD ✓4TH Additional Digit Required Valid OR Procedure Non-OR Procedure ♦Revised Text♦ ✽ Revised Code Title ➜ New Code

798 VOLUME 3 ICD-9-CM MANUAL 2011

ICD9_2011_vol3_sec2.indd 798 8/16/10 10:33:20 PM The following 6 sample pages are from HCPro’s 2011 ICD-9-CM Coding Manual, Volumes 1 & 2

Sample pages ICD-9-CM Manual, Volumes 1 & 2 (Professional Edition) Periodontosis Index to Diseases and Injuries

Periodontosis 523.5 bacterial 567.29 cloaca 751.5 Periods—see also Menstruation spontaneous 567.23 communication—see Fistula, congenital heavy 626.2 bile, biliary 567.81 convolutions irregular 626.4 chemical 998.7 aortic arch 747.21 Perionychia (with lymphangitis) 681.9 chlamydial 099.56 fallopian tube 752.19 finger 681.02 chronic proliferative 567.89 oviduct 752.19 toe 681.11 congenital NEC 777.6 uterine tube 752.19 Perioophoritis (see also Salpingo-oophoritis ) 614.2 diaphragmatic 567.22 double aortic arch 747.21 Periorchitis (see also Orchitis ) 604.90 diffuse NEC 567.29 ductus Periosteum, periosteal—see condition diphtheritic 032.83 arteriosus 747.0 Periostitis (circumscribed) (diffuse) (infective) 730.3 disseminatedYellow NECshaded 567.29 Botalli 747.0 due to fetal call-outbile 567.81 boxes circulation 747.83 Note—Use the following fifth-digit subclassification foreign form of cervix (uteri) 752.49 with category 730: describebody or object accidentally the left during a hemoglobin (hereditary) (“Swiss variety”) 282.7 Periodontosis–Person 0 site unspecified procedure (instrument) (sponge) pulmonary hypertension 747.83 1 shoulder region fifth-digit(swab) 998.4 foramen 2 upper arm subclassifications.substance accidentally left during a procedure Botalli 745.5 3 forearm (chemical) (powder) (talc) 998.7 ovale 745.5 talc 998.7 Gartner’s duct 752.41 4 hand urine 567.89 hemoglobin, fetal (hereditary) (HPFH) 282.7 5 pelvic region and thigh fibrinopurulent 567.29 hyaloid 6 lower leg fibrinous 567.29 artery (generally incomplete) 743.51 7 ankle and foot fibrocaseous (see also Tuberculosis ) 014.0 system 743.51 8 other specified sites fibropurulent 567.29 hymen (tag) general, generalized (acute) 567.21 in pregnancy or childbirth 654.8 9 multiple sites gonococcal 098.86 causing obstructed labor 660.2 in infective disease NEC 136.9 [567.0] lanugo 757.4 with osteomyelitis (see also Osteomyelitis ) 730.2 meconium (newborn) 777.6 left acute or subacute 730.0 pancreatic 577.8 posterior cardinal vein 747.49 chronic or old 730.1 paroxysmal, benign 277.31 root with right arch of aorta 747.21 albuminosa, albuminosus 730.3 pelvic superior vena cava 747.49 alveolar 526.5 female (acute) 614.5 Meckel’s diverticulum 751.0 alveolodental 526.5 chronic NEC 614.7 mesonephric duct 752.89 dental 526.5 with adhesions 614.6 fallopian tube 752.11 gonorrheal 098.89 puerperal, postpartum, childbirth 670.8 mucosal disease (middle ear) (with posterior or hyperplastica, generalized 731.2 male (acute) 567.21 superior marginal perforation of ear drum) jaw (lower) (upper) 526.4 periodic (familial) 277.31 382.2 monomelic 733.99 phlegmonous 567.29 nail(s), anomalous 757.5 orbital 376.02 pneumococcal 567.1 occiput, anterior or posterior 660.3 syphilitic 095.5 postabortal 639.0 fetus or newborn 763.1 congenital 090.0 [730.8] proliferative, chronic 567.89 omphalomesenteric duct 751.0 P secondary 091.61 puerperal, postpartum, childbirth 670.8 organ or site NEC—see Anomaly, specified type NEC tuberculous (see also Tuberculosis, bone ) purulent 567.29 ostium 015.9 [730.8] septic 567.29 atrioventriculare commune 745.69 yaws (early) (hypertrophic) (late) 102.6 spontaneous bacterial 567.23 primum 745.61 Periostosis (see also Periostitis ) 730.3 staphylococcal 567.29 secundum 745.5 with osteomyelitis (see also Osteomyelitis ) 730.2 streptococcal 567.29 ovarian rests in fallopian tube 752.19 acute or subacute 730.0 subdiaphragmatic 567.29 pancreatic tissue in intestinal tract 751.5 chronic or old 730.1 subphrenic 567.29 primary (deciduous) hyperplastic 756.59 suppurative 567.29 teeth 520.6 Peripartum cardiomyopathy 674.5 syphilitic 095.2 vitreous hyperplasia 743.51 Periphlebitis (see also Phlebitis ) 451.9 congenital 090.0 [567.0] pulmonary hypertension 747.83 lower extremity 451.2 talc 998.7 pupillary membrane 743.46 deep (vessels) 451.19 tuberculous (see also Tuberculosis ) 014.0 iris 743.46 superficial (vessels) 451.0 urine 567.89 Rhesus (Rh) titer s(see also Complications, portal 572.1 Peritonsillar—see condition transfusion) 999.70s retina 362.18 Peritonsillitis 475 right aortic arch 747.21 superficial (vessels) 451.0 Perityphlitis (see also Appendicitis ) 541 sinus tuberculous (see also Tuberculosis ) 017.9 Periureteritis 593.89 urogenitalis 752.89 retina 017.3 [362.18] Periurethral—see condition venosus with imperfect incorporation in right Peripneumonia—see Pneumonia Periurethritis (gangrenous) 597.89 auricle 747.49 Periproctitis 569.49 Periuterine—see condition thymus (gland) 254.8 Periprostatitis (see also Prostatitis ) 601.9 Perivaginitis (see also Vaginitis ) 616.10 hyperplasia 254.0 Perirectal—see condition Perivasculitis, retinal 362.18 thyroglossal duct 759.2 Perirenal—see condition Perivasitis (chronic) 608.4 thyrolingual duct 759.2 Perisalpingitis (see also Salpingo-oophoritis ) 614.2 Periventricular leukomalacia 779.7 truncus arteriosus or communis 745.0 Perisigmoiditis 569.89 Perivesiculitis (seminal) (see also Vesiculitis ) 608.0 tunica vasculosa lentis 743.39 Perisplenitis (infectional) 289.59 Perlèche 686.8 umbilical sinus 753.7 Perispondylitis—see Spondylitis due to urachus 753.7 Peristalsis reversed or visible 787.4 moniliasis 112.0 vegetative state 780.03 Peritendinitis (see also Tenosynovitis ) 726.90 riboflavin deficiency 266.0 vitelline duct 751.0 adhesive (shoulder) 726.0 Pernicious—see condition wolffian duct 752.89 Perithelioma (M9150/1)—see Pericytoma Pernio, perniosis 991.5 Person (with) Peritoneum, peritoneal—see also condition Persecution admitted for clinical research, as participant or equilibration test V56.32 delusion 297.9 control subject V70.7 Peritonitis (acute) (adhesive) (fibrinous) (hemorrhagic) social V62.4 affected by (idiopathic) (localized) (perforative) (primary) Perseveration (tonic) 784.69 family member (with adhesions) (with effusion)Our 567.9icons easily Persistence, persistent (congenital) 759.89 currently on deployment (military) V61.01 with or following anal membrane 751.2 returned from deployment (military) (current or abortion—see Abortion, byidentify type, with sepsis new and arteria stapedia 744.04 past conflict) V61.02 abscess 567.21 atrioventricular canal 745.69 awaiting admission to adequate facility elsewhere V63.2 appendicitis 540.0 revised text. bloody ejaculate 792.2 undergoing social agency investigation V63.8 with peritoneal abscess 540.1 branchial cleft 744.41 concern (normal) about sick person in family V61.49 ectopic pregnancy (see also categories bulbus cordis in left ventricle 745.8 consulting on behalf of another V65.19 633.0–633.9 ) 639.0 canal of Cloquet 743.51 pediatric molar pregnancy (see also categories 630–632 ) 639.0 capsule (opaque) 743.51 pre-adoption visit for adoptive parents V65.11 aseptic 998.7 cilioretinal artery or vein 743.51 pre-birth visit for expectant parents V65.11

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ICD9_2011_vol2_sec1.indd 246 8/16/10 10:24:15 PM Disinfectant NEC Table of Drugs and Chemicals

oning oning

Substance Pois Accident TherapeuticUse SuicideAttempt Assault Undetermined Substance Pois Accident TherapeuticUse SuicideAttempt Assault Undetermined Disinfectant NEC ...... 983 .9 E861 .4 - E950 .7 E962 .1 E980 .6 8:28 treponemicides . . . . 961 .2 E857 E931 .2 E950 .4 E962 .0 E980 .4 alkaline ...... 983 .2 E861 .4 - E950 .7 E962 .1 E980 .6 8:32 trichomonacides . . . . 961 .5 E857 E931 .5 E950 .4 E962 .0 E980 .4 aromatic ...... 983 .0 E861 .4 - E950 .7 E962 .1 E980 .6 quinoline derivatives . . . 961 .3 E857 E931 .3 E950 .4 E962 .0 E980 .4 Disipal ...... 966 .4 E855 .0 E936 .4 E950 .4 E962 .0 E980 .4 nitrofuran derivatives . . . 961 .9 E857 E931 .9 E950 .4 E962 .0 E980 .4 Disodium edetate . . . . . 963 .8 E858 .1 E933 .8 E950 .4 E962 .0 E980 .4 8:36 urinary germicides . . . 961 .9 E857 E931 .9 E950 .4 E962 .0 E980 .4 Disulfamide ...... 974 .4 E858 .5 E944 .4 E950 .4 E962 .0 E980 .4 quinoline derivatives . . . 961 .3 E857 E931 .3 E950 .4 E962 .0 E980 .4 Disulfanilamide ...... 961 .0 E857 E931 .0 E950 .4 E962 .0 E980 .4 8:40 other anti-infectives . . 961 .9 E857 E931 .9 E950 .4 E962 .0 E980 .4 Disulfiram ...... 977 .3 E858 .8 E947 .3 E950 .4 E962 .0 E980 .4 10:00 antineoplastic Dithiazanine ...... 961 .6 E857 E931 .6 E950 .4 E962 .0 E980 .4 agents ...... 963 .1 E858 .1 E933 .1 E950 .4 E962 .0 E980 .4 Dithioglycerol ...... 963 .8 E858 .1 E933 .8 E950 .4 E962 .0 E980 .4 antibiotics ...... 960 .7 E856 E930 .7 E950 .4 E962 .0 E980 .4 Disinfectant NEC–Drug Disinfectant Dithranot ...... 976 .4 E858 .7 E946 .4 E950 .4 E962 .0 E980 .4 progestogens ...... 962 .2 E858 .0 E932 .2 E950 .4 E962 .0 E980 .4 Diucardin ...... 974 .3 E858 .5 E944 .3 E950 .4 E962 .0 E980 .4 12:04 parasympatho- Diupres ...... 974 .3 E858 .5 E944 .3 E950 .4 E962 .0 E980 .4 mimetic (cholinergic) Diuretics NEC ...... 974 .4 E858 .5 E944 .4 E950 .4 E962 .0 E980Shaded-colored .4 agents ...... 971 .0 E855 .3 E941 .0 E950 .4 E962 .0 E980 .4 carbonic acid anhydrase 12:08 parasympatholytic inhibitors ...... 974 .2 E858 .5 E944 .2 E950 .4 E962 .0 columnsE980 .4 in(cholinergic-blocking) Volumes mercurial ...... 974 .0 E858 .5 E944 .0 E950 .4 E962 .0 E980 .4 agents ...... 971 .1 E855 .4 E941 .1 E950 .4 E962 .0 E980 .4 osmotic ...... 974 .4 E858 .5 E944 .4 E950 .4 E962 .0 1 E980& 2.4 make12:12 Sympathomimeticit a snap purine derivatives . . . . . 974 .1 E858 .5 E944 .1 E950 .4 E962 .0 E980 .4 (adrenergic) agents . . . 971 .2 E855 .5 E941 .2 E950 .4 E962 .0 E980 .4 saluretic ...... 974 .3 E858 .5 E944 .3 E950 .4 E962 .0 toE980 find .4 12:16codes sympatholytic in the Diuril ...... 974 .3 E858 .5 E944 .3 E950 .4 E962 .0 hypertensiveE980 .4 (adrenergic-blocking) table, Divinyl ether ...... 968 .2 E855 .1 E938 .2 E950 .4 E962 .0 E980 .4 agents ...... 971 .3 E855 .6 E941 .3 E950 .4 E962 .0 E980 .4 D-lysergic acid neoplasm12:20 table, skeletal muscle and diethylamide . . . . . 969 .6 E854 .1 E939 .6 E950 .3 E962 .0 E980 .3 relaxants DMCT ...... 960 .4 E856 E930 .4 E950 .4 E962 .0 theE980 .4Tablecentral of nervousDrugs. system DMSO ...... 982 .8 E862 .4 - E950 .9 E962 .1 E980 .9 muscle-tone DMT ...... 969 .6 E854 .1 E939 .6 E950 .3 E962 .0 E980 .3 depressants . . . . . 968 .0 E855 .1 E938 .0 E950 .4 E962 .0 E980 .4 DNOC ...... 989 .4 E863 .5 - E950 .6 E962 .1 E980 .7 myoneural blocking DOCA ...... 962 .0 E858 .0 E932 .0 E950 .4 E962 .0 E980 .4 agents ...... 975 .2 E858 .6 E945 .2 E950 .4 E962 .0 E980 .4 Dolophine ...... 965 .02 E850 .1 E935 .1 E950 .0 E962 .0 E980 .0 16:00 blood derivatives . . . 964 .7 E858 .2 E934 .7 E950 .4 E962 .0 E980 .4 Doloxene ...... 965 .8 E850 .8 E935 .8 E950 .0 E962 .0 E980 .0 20:04 antianemia drugs . . . 964 .1 E858 .2 E934 .1 E950 .4 E962 .0 E980 .4 DOM ...... 969 .6 E854 .1 E939 .6 E950 .3 E962 .0 E980 .3 20:04 .04 iron preparations . . 964 .0 E858 .2 E934 .0 E950 .4 E962 .0 E980 .4 Domestic gas—see Gas, 20:04 .08 liver and utility stomach preparations . . 964 .1 E858 .2 E934 .1 E950 .4 E962 .0 E980 .4 Domiphen (bromide) 20:12 .04 anticoagulants . . . 964 .2 E858 .2 E934 .2 E950 .4 E962 .0 E980 .4 (lozenges) ...... 976 .6 E858 .7 E946 .6 E950 .4 E962 .0 E980 .4 20:12 .08 antiheparin Dopa (levo) ...... 966 .4 E855 .0 E936 .4 E950 .4 E962 .0 E980 .4 agents ...... 964 .5 E858 .2 E934 .5 E950 .4 E962 .0 E980 .4 D Dopamine ...... 971 .2 E855 .5 E941 .2 E950 .4 E962 .0 E980 .4 20:12 .12 coagulants . . . . 964 .5 E858 .2 E934 .5 E950 .4 E962 .0 E980 .4 Doriden ...... 967 .5 E852 .4 E937 .5 E950 .2 E962 .0 E980 .2 20:12 .16 hemostatics NEC . . 964 .5 E858 .2 E934 .5 E950 .4 E962 .0 E980 .4 Dormiral ...... 967 .0 E851 E937 .0 E950 .1 E962 .0 E980 .1 capillary active drugs . . . 972 .8 E858 .3 E942 .8 E950 .4 E962 .0 E980 .4 Dormison ...... 967 .8 E852 .8 E937 .8 E950 .2 E962 .0 E980 .2 24:04 cardiac drugs . . . . . 972 .9 E858 .3 E942 .9 E950 .4 E962 .0 E980 .4 Dornase ...... 963 .4 E858 .1 E933 .4 E950 .4 E962 .0 E980 .4 cardiotonic agents . . . . 972 .1 E858 .3 E942 .1 E950 .4 E962 .0 E980 .4 Dorsacaine ...... 968 .5 E855 .2 E938 .5 E950 .4 E962 .0 E980 .4 rhythm regulators . . . . 972 .0 E858 .3 E942 .0 E950 .4 E962 .0 E980 .4 Dothiepin hydrochloride . . s969 .05s E854 .0 E939 .0 E950 .3 E962 .0 E980 .3 24:06 antilipemic agents . . . 972 .2 E858 .3 E942 .2 E950 .4 E962 .0 E980 .4 Doxapram ...... 970 .0 E854 .3 E940 .0 E950 .4 E962 .0 E980 .4 thyroid derivatives . . . . 962 .7 E858 .0 E932 .7 E950 .4 E962 .0 E980 .4 Doxepin ...... s969 .05s E854 .0 E939 .0 E950 .3 E962 .0 E980 .3 24:08 hypotensive Doxorubicin ...... 960 .7 E856 E930 .7 E950 .4 E962 .0 E980 .4 agents ...... 972 .6 E858 .3 E942 .6 E950 .4 E962 .0 E980 .4 Doxycycline ...... 960 .4 E856 E930 .4 E950 .4 E962 .0 E980 .4 adrenergic blocking Doxylamine ...... 963 .0 E858 .1 E933 .0 E950 .4 E962 .0 E980 .4 agents ...... 971 .3 E855 .6 E941 .3 E950 .4 E962 .0 E980 .4 Dramamine ...... 963 .0 E858 .1 E933 .0 E950 .4 E962 .0 E980 .4 ganglion blocking Drano (drain cleaner) . . . . . 983 .2 E864 .2 - E950 .7 E962 .1 E980 .6 agents ...... 972 .3 E858 .3 E942 .3 E950 .4 E962 .0 E980 .4 Dromoran ...... 965 .09 E850 .2 E935 .2 E950 .0 E962 .0 E980 .0 vasodilators ...... 972 .5 E858 .3 E942 .5 E950 .4 E962 .0 E980 .4 Dromostanolone ...... 962 .1 E858 .0 E932 .1 E950 .4 E962 .0 E980 .4 24:12 vasodilating Droperidol ...... 969 .2 E853 .1 E939 .2 E950 .3 E962 .0 E980 .3 agents NEC ...... 972 .5 E858 .3 E942 .5 E950 .4 E962 .0 E980 .4 Drotrecogin alfa ...... 964 .2 E858 .2 E934 .2 E950 .4 E962 .0 E980 .4 coronary ...... 972 .4 E858 .3 E942 .4 E950 .4 E962 .0 E980 .4 Drug ...... 977 .9 E858 .9 E947 .9 E950 .5 E962 .0 E980 .5 nicotinic acid specified NEC ...... 977 .8 E858 .8 E947 .8 E950 .4 E962 .0 E980 .4 derivatives . . . . . 972 .2 E858 .3 E942 .2 E950 .4 E962 .0 E980 .4 AHFS List 24:16 sclerosing agents . . . 972 .7 E858 .3 E942 .7 E950 .4 E962 .0 E980 .4 4:00 antihistamine drugs . . . 963 .0 E858 .1 E933 .0 E950 .4 E962 .0 E980 .4 28:04 general anesthetics . . 968 .4 E855 .1 E938 .4 E950 .4 E962 .0 E980 .4 8:04 amebacides . . . . . 961 .5 E857 E931 .5 E950 .4 E962 .0 E980 .4 gaseous anesthetics . . . 968 .2 E855 .1 E938 .2 E950 .4 E962 .0 E980 .4 arsenical anti-infectives . . 961 .1 E857 E931 .1 E950 .4 E962 .0 E980 .4 halothane ...... 968 .1 E855 .1 E938 .1 E950 .4 E962 .0 E980 .4 quinoline derivatives . . . 961 .3 E857 E931 .3 E950 .4 E962 .0 E980 .4 intravenous anesthetics . . 968 .3 E855 .1 E938 .3 E950 .4 E962 .0 E980 .4 8:08 anthelmintics . . . . . 961 .6 E857 E931 .6 E950 .4 E962 .0 E980 .4 28:08 analgesics and quinoline derivatives . . . 961 .3 E857 E931 .3 E950 .4 E962 .0 E980 .4 antipyretics ...... 965 .9 E850 .9 E935 .9 E950 .0 E962 .0 E980 .0 8:12 .04 antifungal antirheumatics . . . . . 965 .69 E850 .6 E935 .6 E950 .0 E962 .0 E980 .0 antibiotics ...... 960 .1 E856 E930 .1 E950 .4 E962 .0 E980 .4 aromatic analgesics . . . . 965 .4 E850 .4 E935 .4 E950 .0 E962 .0 E980 .0 8:12 .06 cephalosporins . . . 960 .5 E856 E930 .5 E950 .4 E962 .0 E980 .4 non-narcotic NEC . . . . 965 .7 E850 .7 E935 .7 E950 .0 E962 .0 E980 .0 8:12 .08 chloramphenicol . . . 960 .2 E856 E930 .2 E950 .4 E962 .0 E980 .4 opium alkaloids . . . . . 965 .00 E850 .2 E935 .2 E950 .0 E962 .0 E980 .0 8:12 .12 erythromycins . . . . 960 .3 E856 E930 .3 E950 .4 E962 .0 E980 .4 heroin ...... 965 .01 E850 .0 E935 .0 E950 .0 E962 .0 E980 .0 8:12 .16 penicillins . . . . . 960 .0 E856 E930 .0 E950 .4 E962 .0 E980 .4 methadone ...... 965 .02 E850 .1 E935 .1 E950 .0 E962 .0 E980 .0 8:12 .20 streptomycins . . . . 960 .6 E856 E930 .6 E950 .4 E962 .0 E980 .4 specified type NEC . . . 965 .09 E850 .2 E935 .2 E950 .0 E962 .0 E980 .0 8:12 .24 tetracyclines . . . . 960 .4 E856 E930 .4 E950 .4 E962 .0 E980 .4 pyrazole derivatives ...... 965 .5 E850 .5 E935 .5 E950 .0 E962 .0 E980 .0 8:12 .28 other antibiotics . . . 960 .8 E856 E930 .8 E950 .4 E962 .0 E980 .4 salicylates ...... 965 .1 E850 .3 E935 .3 E950 .0 E962 .0 E980 .0 antimycobacterial . . . . Our960 .6 iconsE856 easilyE930 .6 E950 .4 E962 .0 E980 .4 specified NEC ...... 965 .8 E850 .8 E935 .8 E950 .0 E962 .0 E980 .0 macrolides ...... 960 .3 E856 E930 .3 E950 .4 E962 .0 E980 .4 28:10 narcotic antagonists . . 970 .1 E854 .3 E940 .1 E950 .4 E962 .0 E980 .4 8:16 antituberculars . . . . identify961 .8 E857 new E931 and .8 E950 .4 E962 .0 E980 .4 28:12 anticonvulsants . . . . 966 .3 E855 .0 E936 .3 E950 .4 E962 .0 E980 .4 antibiotics ...... 960 .6 E856 E930 .6 E950 .4 E962 .0 E980 .4 barbiturates ...... 967 .0 E851 E937 .0 E950 .1 E962 .0 E980 .1 8:18 antivirals ...... 961revised .7 E857 text.E931 .7 E950 .4 E962 .0 E980 .4 benzodiazepine-based 8:20 plasmodicides tranquilizers . . . . 969 .4 E853 .2 E939 .4 E950 .3 E962 .0 E980 .3 (antimalarials) . . . . . 961 .4 E857 E931 .4 E950 .4 E962 .0 E980 .4 bromides ...... 967 .3 E852 .2 E937 .3 E950 .2 E962 .0 E980 .2 8:24 sulfonamides . . . . . 961 .0 E857 E931 .0 E950 .4 E962 .0 E980 .4 hydantoin 8:26 sulfones ...... 961 .8 E857 E931 .8 E950 .4 E962 .0 E980 .4 derivatives . . . . 966 .1 E855 .0 E936 .1 E950 .4 E962 .0 E980 .4

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336 VOLUME 2 ICD-9-CM MANUAL 2010

NEW ICD-9 2010 Vol2 Section 2.indd 336 8/15/09 3:05:02 AM 189.2–194.6 Neoplasms Tabular List

189.2 Ureter Corpus striatum excludes: ureteric orifice of bladder (188.6) Globus pallidus 189.3 Urethra Hypothalamus excludes: urethral orifice of bladder (188.5) Thalamus 189.4 Paraurethral glands 191.1 Frontal lobe 189.8 Other specified sites of urinary organs 191.2 Temporal lobe Malignant neoplasm of contiguous or overlapping sites of Hippocampus kidney and other urinary organs whose point of origin Uncus cannot be determined 191.3 Parietal lobe 189.9 Urinary organ, site unspecified 191.4 Occipital lobe Urinary system NOS 4 4 191.5 Ventricles MALIGNANT NEOPLASMOur OF 4OTHER and AND 5 UNSPECIFIED SITES Choroid plexus (190–199) Floor of ventricle symbols identify 191.6 Cerebellum NOS excludes: carcinoma in situ (234.0–234.9) codes that require Cerebellopontine angle ✓4TH 190 Malignant neoplasm of eye 191.7 Brain stem excludes:the carcinoma assignment in situ (234.0) of Cerebral peduncle additionaldark area on retina digits. and choroid (239.81) Medulla oblongata eyelid (skin) (172.1, 173.1) Midbrain cartilage (171.0) Pons optic nerve (192.0) 191.8 Other parts of brain orbital bone (170.0) Corpus callosum retinal freckle (239.81) Tapetum 190.0 Eyeball, except conjunctiva, cornea, retina, and choroid Malignant neoplasm of contiguous or overlapping sites of

189–194 Ciliary body brain whose point of origin cannot be determined Crystalline lens 191.9 Brain, unspecified Iris Cranial fossa NOS Sclera ✓TH Uveal tract 4 192 Malignant neoplasm of other and unspecified parts of nervous system 190.1 Orbit Connective tissue of orbit excludes: peripheral, sympathetic, and parasympathetic nerves and ganglia (171.0–171.9) Extraocular muscle 192.0 Cranial nerves Retrobulbar Olfactory bulb excludes: bone of orbit (170.0) 190.2 Lacrimal gland 192.1 Cerebral meninges 190.3 Conjunctiva Dura (mater) 190.4 Cornea Falx (cerebelli) (cerebri) 190.5 Retina Meninges NOS 190.6 Choroid Tentorium 190.7 Lacrimal duct 192.2 Spinal cord Lacrimal sac Cauda equina Nasolacrimal duct 192.3 Spinal meninges 190.8 Other specified sites of eye 192.8 Other specified sites of nervous system Malignant neoplasm of contiguous or overlapping sites of eye Malignant neoplasm of contiguous or overlapping sites of whose point of origin cannot be determined other parts of nervous system whose point of origin 190.9 Eye, part unspecified cannot be determined 192.9 Nervous system, part unspecified ✓4TH 191 Malignant neoplasm of brain Nervous system (central) NOS excludes: cranial nerves (192.0) excludes: meninges NOS (192.1) retrobulbar area (190.1) 191.0 Cerebrum, except lobes and ventricles 193 Malignant neoplasm of thyroid gland Basal ganglia Thyroglossal duct Cerebral cortex Use additional code to identify any functional activity ✓4TH 194 Malignant neoplasm of other endocrine glands and 0HGLDQ6HFWLRQRI%UDLQ One of dozensrelated of structures helpful illustrationsexcludes: islets of Langerhans (157.4) &RUSXV 7KDODPXV neuroendocrine tumors (209.00–209.69) FDOORVXP throughout the ovary (183.0) 3DULHWDOOREH 3LQHDO testis (186.0–186.9) JODQGICD-9-CM manuals. thymus (164.0) )URQWDO HSLSK\VLV 194.0 Adrenal gland OREH Adrenal cortex Adrenal medulla Suprarenal gland 194.1 Parathyroid gland 194.3 Pituitary gland and craniopharyngeal duct Craniobuccal pouch Hypophysis Rathke’s pouch Sella turcica 194.4 Pineal gland 194.5 Carotid body )RUQL[ 194.6 Aortic body and other paraganglia 2SWLF Coccygeal body FKLDVP +\SRK\VLV 3RQV &HUHEHOOXP Glomus jugulare Para-aortic body

✓4TH ✓5TH Additional Digit Required Unspecified Manifestation Code ♦Revised Text♦ ➜ New Code ✽ Revised Code Title

410 VOLUME 1 ICD-9-CM MANUAL 2011

01_ICD92011vol1_Ch1_3_v2.indd 410 8/16/10 10:50:01 PM Tabular List Neoplasms 202.0–207

Lymphosarcoma: ✓5TH 204.8 Other lymphoid leukemia follicular (giant) Aleukemic leukemia: nodular lymphatic ✓5TH 202.1 Mycosis fungoides lymphocytic excludes: peripheral T-cell lymphoma (202.7) lymphoid ✓5TH 202.2 Sézary’s disease ✓5TH 204.9 Unspecified lymphoid leukemia ✓TH 5 202.3 Malignant histiocytosis TH ✓4 205 Myeloid leukemia Histiocytic medullary reticulosis Includes: leukemia: Malignant: granulocytic reticuloendotheliosis myeloblastic reticulosis myelocytic ✓TH 5 202.4 Leukemic reticuloendotheliosis myelogenous Hairy-cell leukemia myelomonocytic ✓TH 5 202.5 Letterer-Siwe disease myelosclerotic Acute: myelosis differentiated progressive histiocytosis histiocytosis X (progressive) The following fifth-digit subclassification is for use with category 205: infantile reticuloendotheliosis 0 without mention of having achieved remission reticulosis of infancy

failed remission 202–207 excludes: Hand-Schüller-Christian disease (277.89) 1 in remission histiocytosis (acute) (chronic) (277.89) Highlights2 in relapse easily histiocytosis X (chronic) (277.89) ✓5TH 202.6 Malignant mast cell tumors identify codes that are ✓TH Malignant: 5 205.0 Acute mastocytoma unspecified, suchAcute aspromyelocytic leukemia mastocytosis excludes: acute exacerbation of chronic myeloid leukemia (205.1) this one. You’ll✓TH also be Mast cell sarcoma 5 205.1 Chronic Systemic tissue mast cell disease able to immediatelyEosinophilic leukemia excludes: mast cell leukemia (207.8) Neutrophilic leukemia ✓TH TH spot highlighted ✓5 202.7 Peripheral T-cell lymphoma 5 205.2 Subacute TH TH ✓5 205.3 Myeloid sarcoma ✓5 202.8 Other lymphomas manifestation codes. Lymphoma (malignant): Chloroma NOS Granulocytic sarcoma ✓TH diffuse 5 205.8 Other myeloid leukemia excludes: benign lymphoma (229.0) Aleukemic leukemia: ✓5TH 202.9 Other and unspecified malignant neoplasms of lymphoid granulocytic and histiocytic tissue myelogenous Follicular dendritic cell sarcoma myeloid Interdigitating dendritic cell sarcoma Aleukemic myelosis TH Langerhans cell sarcoma ✓5 205.9 Unspecified myeloid leukemia Malignant neoplasm of bone marrow NOS ✓4TH 206 Monocytic leukemia ✓4TH 203 Multiple myeloma and immunoproliferative neoplasms Includes: leukemia: histiocytic monoblastic The following fifth-digit subclassification is for use with category 203: monocytoid 0 without mention of having achieved remission failed remission 1 in remission The following fifth-digit subclassification is for use with category 206: 2 in relapse 0 without mention of having achieved remission failed remission ✓5TH 203.0 Multiple myeloma 1 in remission Kahler’s disease 2 in relapse Myelomatosis TH excludes: solitary myeloma (238.6) ✓5 206.0 Acute ✓5TH 203.1 Plasma cell leukemia excludes: acute exacerbation of chronic monocytic Plasmacytic leukemia leukemia (206.1) Yellow shaded TH ✓5TH 203.8 Other immunoproliferative neoplasms ✓5 206.1 Chronic ✓5TH 206.2 Subacute ✓4TH 204 Lymphoid leukemia call-out boxes ✓5TH 206.8 Other monocytic leukemia Includes: leukemia: describe the Aleukemic: lymphatic monocytic leukemia lymphoblastic fifth-digit monocytoid leukemia lymphocytic ✓5TH 206.9 Unspecified monocytic leukemia lymphogenous subclassifications. ✓4TH 207 Other specified leukemia excludes: leukemic reticuloendotheliosis (202.4) The following fifth-digit subclassification is for use with category 204: plasma cell leukemia (203.1) 0 without mention of having achieved remission failed remission 1 in remission The following fifth-digit subclassification is for use with category 207: 2 in relapse 0 without mention of having achieved remission failed remission ✓5TH 204.0 Acute 1 in remission excludes: acute exacerbation of chronic lymphoid leukemia (204.1) 2 in relapse ✓5TH 204.1 Chronic ✓5TH 204.2 Subacute

✓4TH ✓5TH Additional Digit Required Unspecified Manifestation Code ♦Revised Text♦ ➜ New Code ✽ Revised Code Title

ICD-9-CM MANUAL 2011 VOLUME 1 413

01_ICD92011vol1_Ch1_3_v2.indd 413 8/16/10 10:50:04 PM Tabular List Diseases of the Musculoskeletal System and Connective Tissue 722.11–725

722.11 Thoracic intervertebral disc without myelopathy 723.1 Cervicalgia Any condition classifiable to 722.2 of thoracic Pain in neck intervertebral disc 723.2 Cervicocranial syndrome 722.2 Displacement of intervertebral disc, site unspecified, Barré-Liéou syndrome without myelopathy Posterior cervical sympathetic syndrome Discogenic syndrome NOS 723.3 Cervicobrachial syndrome (diffuse) Herniation of nucleus pulposus NOS 723.4 Brachia neuritis or radiculitis NOS Intervertebral disc NOS: Cervical radiculitis extrusion Radicular syndrome of upper limbs prolapse 723.5 Torticollis, unspecified protrusion Contracture of neck rupture ExcludEs: congenital (754.1) Neuritis or radiculitis due to displacement or rupture of due to birth injury (767.8) intervertebral disc hysterical (300.11) ✓TH 5 722.3 Schmorl’s nodes ocular torticollis (781.93) 722.30 Unspecified region psychogenic (306.0) 722.31 Thoracic region spasmodic (333.83) 722.32 Lumbar region traumatic, current (847.0) 722.39 Other 723.6 Panniculitis specified as affecting neck 722.4 Degeneration of cervical intervertebral disc 723.7 Ossification of posterior longitudinal ligament in Degeneration of cervicothoracic intervertebral disc cervical region ✓5TH 722.5 Degeneration of thoracic or lumbar intervertebral disc 723.8 Other syndromes affecting cervical region 722.51 Thoracic or thoracolumbar intervertebral disc Cervical syndrome NEC 722.52 Lumbar or lumbosacral intervertebral disc Klippel’s disease 722.6 Degeneration of intervertebral disc, site unspecified Occipital neuralgia Degenerative disc disease NOS 723.9 Unspecified musculoskeletal disorders and symptoms Narrowing of intervertebral disc or space NOS referable to neck ✓5TH 722.7 Intervertebral disc disorder with myelopathy Cervical (region) disorder NOS 722.70 Unspecified region ✓4TH 724 Other and unspecified disorders of back 722.71 Cervical region Icons help youExclud Es: collapsed vertebra (code to cause, e.g., osteoporosis, 722.72 Thoracic region spot which 733.00–733.09) 722.73 Lumbar region conditions due to: ✓TH 5 722.8 Postlaminectomy syndrome codes are new intervertebral disc disorders (722.0–722.9) 722.80 Unspecified region spondylosis (721.0–721.9) 722–725 722.81 Cervical region or revised.✓5TH 724.0 Spinal stenosis, other than cervical 722.82 Thoracic region 724.00 Spinal stenosis, unspecified region 722.83 Lumbar region 724.01 Thoracic region ✓TH 5 722.9 Other and unspecified disc disorder ✽ 724.02 Lumbar region♦, without neurogenic Calcification of intervertebral cartilage or disc Discitis claudication♦ 722.90 Unspecified region ♦Lumbar region NOS♦ 722.91 Cervical region ➜ 724.03 Lumbar region, with neurogenic claudication 722.92 Thoracic region 724.09 Other 722.93 Lumbar region 724.1 Pain in thoracic spine ✓4TH 723 Other disorders of cervical region 724.2 Lumbago ExcludEs: conditions due to: Low back pain intervertebral disc disorders (722.0–722.9) Low back syndrome spondylosis (721.0–721.9) Lumbalgia 723.0 Spinal stenosis of cervical region 724.3 Sciatia Neuralgia or neuritis of sciatic nerve ExcludEs: specified lesion of sciatic nerve (355.0) 724.4 Thoracic or lumbosacral neuritis or radiculitis, unspecified Radicular syndrome of lower limbs 6SLQDO6WHQRVLVLQ&HUYLFDO5HJLRQ 724.5 Backache, unspecified %RQH Vertebrogenic (pain) syndrome NOS FKLS 724.6 Disorders of sacrum Ankylosis, lumbosacral or sacroiliac (joint) Instability, lumbosacral or sacroiliac (joint) ✓5TH 724.7 Disorders of coccyx 'LVSODFHPHQWRI 724.70 Unspecified disorder of coccyx VSLQDOFRUGRU 724.71 Hypermobility of coccyx GLVORFDWLRQRI&RU& 724.79 Other Coccygodynia 6SLQDOFRUG 724.8 Other symptoms referable to back H[SDQGVLQWR Ossification of posterior longitudinal ligament NOS GXUDOVSDFH Panniculitis specified as sacral or affecting back 724.9 Other unspecified back disorders Ankylosis of spine NOS Compression of spinal nerve root NEC Spinal disorder NOS ExcludEs: sacroiliitis (720.2) RHEUMATISM, EXCLUDING THE BACK (725–729) IncludEs: disorders of muscles and tendons and their attachments, and of 7RUWLFROOLV other soft tissues

✓4TH ✓5TH Additional Digit Required Unspecified Manifestation Code ♦Revised Text♦ ➜ New Code ✽ Revised Code Title

ICD-9-CM MANUAL 2011 VOLUME 1 563

03_ICD92011vol1_Ch9_13_v2.indd 563 8/16/10 10:55:56 PM Diseases of the Circulatory System Tabular List

Venous Circulation

You’ll find detailed full body External jugular illustrations and Internal jugular dozens of drawings Subclavian throughout the Superior Axillary ICD-9-CM manuals. vena cava Cephalic Brachial Basilic Renal (kidney) Medial cubital Ovarian/ Inferior testicular vena cava Portal Common iliac Internal External iliac iliac Basilic

Portal Venous Circulation Deep femoral IVC Femoral Left Right hepatic hepatic

Spleen Greater saphenous Stomach Splenic Hepatic portal Popliteal Gastro- epiploic Pancreas Inferior mesenteric Right Small or external colic saphenous Left Superior colic Peroneal mesenteric Anterior tibial Ileocolic

Sigmoid Superior rectal Dorsal venous arch Right iliac

Digital

✓4TH ✓5TH Additional Digit Required Unspecified Manifestation Code ♦Revised Text♦ ➜ New Code ✽ Revised Code Title

474 VOLUME 1 ICD-9-CM MANUAL 2011

02_ICD92011vol1_Ch4_8_v2.indd 474 8/16/10 10:52:20 PM The following 7 sample pages are from HCPro’s 2011 HCPCS Level II Manual

Sample pages HCPCS Level II Manual 2011 HCPCS Level II Conventions

HCPro’s 2011 HCPCS Level II Manual includes the following icons and ● 00 – ● 99 Pricing Indicator Code The use of appropriate payment methodologies color-coded conventions: determines the Medicare reimbursement rate of a procedure or supply. The two-digit HCPCS pricing indicator codes indicated throughout Special Coverage Instructions Apply The codes indicate that CMS has the tabular section of this manual identify the appropriate payment published specific guidance regarding the coverage of the specific methodologies used to develop a particular procedure or supply’s unique procedure or supply code. You can find the instructions in the CMS pricing amount under Medicare Part B. Each procedure code may have Online Manual System. The online manual system is a compilation of one to four associated pricing indicators. CMS’ program guidance regarding coverage, operations, and procedures. The guidance is based on statutes, regulations, guidelines, and CMS HCPro has added the pricing indicators to help users determine directives. To obtain a procedure code’s specific coverage instructions, reimbursement rates and the appropriate claims processing contractor, access CMS’ Online Manual System at: www.cms.hhs.gov/Manuals?IOM/ as well as estimate the beneficiary’s financial responsibilities. list.asp. Pricing indicator codes To successfully navigate the CMS Online Manual System, you must 00 = Service not separately priced by Part B (e.g., services not covered; understand its organizational structure. The Online Manual System bundled; used by Part A only, etc.) consists of the following sections: • Internet-Only Manuals Pricing indicator codes linked to Physician Fee Schedule • Paper-Based Manuals 11 = Price established using national relative value units or RVU • Program Transmittals Take a look12 at = Pricethe established using national anesthesia base units • Program Memoranda conventions13 =you’ll Price established by carriers (e.g., not otherwise classified, find in the HCPCSindividual determination carrier discretion) The Internet-Only Manuals are further divided into 22 separate areas, known as publications. The publications are organized intoLevel II ManualPricing indicators linked to Clinical Lab Fee Schedule chapters, sections, and subsections. You can obtain specific coverage 21 = Price subject to national limitation amount instructions by performing a full text search using the search engine 22 = Price established by carriers (e.g., gap-fills) provided. CMS frequently updates the Online Manual System; therefore, exercise caution to ensure that you reference the most recent CMS Pricing indicators linked to durable medical equipment (DME), guidance. prosthetics, orthotics, supplies, and surgical dressings 31 = Frequently serviced DME (price subject to floors and ceilings) The Paper-Based Manuals are CMS manuals that were originally 32 = Inexpensive and routinely purchased DME (price subject to floors released in hardcopy. The majority of information found in these manuals and ceilings) was either transferred into the Internet-Only Manual or retired from the 33 = Oxygen and oxygen equipment (prices subject to floors and ceilings) manual; however, three sections—Pub 15-1, Pub 15-2 and Pub 45—are 34 = DME supplies (price subject to floors and ceilings) still active Paper-Based Manuals and used for guidance. The remaining 35 = Surgical dressings (price subject to floors and ceilings) paper-based manuals should be used for reference purposes only. 36 = Capped rental DME (price subject to floors and ceilings) 37 = Ostomy, tracheostomy, and urological supplies (price subject to floors and ceilings) Updates to the Internet-Only Manuals are made via Program 38 = Orthotics, prosthetics, prosthetic devices, and vision services Transmittals. The transmittals are used to communicate new (price subject to floors and ceilings) information, policy changes/procedures that are being incorporated 39 = Parenteral and enteral nutrition into a specific CMS program manual. The cover page of the transmittal 45 = Customized DME items summarizes the new changed material, provides the issue date, 46 = Carrier priced (e.g., not otherwise classified, individual effective date, and the change request number. Program Transmittals determination, carrier discretion gap-filled amounts) are catalogued by the year issued. You can sort the transmittals by transmittal number, issue date, subject, implementation date, or change Other pricing indicators request. In addition to the sort feature, CMS also provides a search 51 = Drugs engine allowing the user to narrow search by specific dates or key words. 52 = Reasonable charge 53 = Statute Prior to the implementation of Program Transmittals, CMS used 54 = Vaccinations Program Memoranda to convey information. Program Memoranda were 55 = Priced by carriers under Clinical Psychologist Fee Schedule (not used until October 2003. Program Memoranda for the years 2000–2003 applicable as of January 1, 1998) can be accessed via the CMS transmittal page. 56 = Priced by carriers under Clinical Social Worker Fee Schedule (not applicable as of January 1, 1998) 57 = Other carrier priced 99 = Value not established

vi 2011 HCPCS LEVEL II CONVENTIONS HCPCS LEVEL II MANUAL 2011

HCPCS4_2Preface.indd 6 11/19/10 4:01 PM 2011 HCPCS Level II Conventions

● 9 ● A – ● G Multiple Pricing Indicator Code The federal government may price Noncovered/Not Payable by Medicare Services reported with these codes are procedures using multiple pricing methodologies, depending upon the either not covered by Medicare or are invalid for Medicare purposes. circumstances surrounding the provision of a procedure. The multiple Consult The Internet-Only Manuals for an explanation regarding pricing indicators code is a single-digit code, which identifies the pricing noncoverage. methodologies used to determine the reimbursement amount. Carrier Judgment Coverage decisions of services reported by these codes Multiple pricing indicator codes are left to the Carrier’s judgment. Contact your local contractor regarding 9 = Not applicable as HCPCS, not priced separately by Part B (pricing specific coverage information. indicator is 00), or value is not established (pricing indicator is ‘99’) A = Not applicable as HCPCS, priced under one methodology ➜ New Code: This code is new for the current year. B = Professional component of HCPCS, priced using RVUs, while

technical component and global service priced by Medicare Part B ✧ Reinstated Code: This code has been reinstated. carriers C = Physician interpretation of clinical lab service is priced under ✽ Revised Code Title: This code title has been revised. Physician Fee Schedule using RVUs, while pricing of lab service is paid under Clinical Lab Fee Schedule D = Service performed by physician is priced under Physician Fee sR Revised Code: This code has been revised. Schedule using RVUs, while service performed by clinical psychologist is priced under Clinical Psychologist Fee Schedule (mm/dd/yyyy) Code Effective Date The month/day/year next to the code (not applicable as of January 1, 1998) description indicates the date the code took effect. E = Service performed by physician is priced under Physician Fee Schedule using RVUs, service performed by clinical psychologist is priced under Clinical Psychologist’s Fee Schedule and service performed by clinical social worker is priced under Clinical Social Worker Fee Schedule (not applicable as of January 1, 1998) F = Service performed by physician is priced under Physician Fee Schedule by carriers, service performed by clinical psychologist is priced under Clinical Psychologist’s Fee Schedule and service performed by clinical social worker is priced under Clinical Social Worker Fee Schedule (not applicable as of January 1, 1998) G = Clinical lab service priced under reasonable charge when service Take a look at the is submitted on claim with blood products, while service is priced conventions you’ll under Clinical Lab Fee Schedule when there are no blood products find in the HCPCS on claim. Level II Manual

HCPCS LEVEL II MANUAL 2011 2011 HCPCS LEVEL II CONVENTIONS vii

HCPCS4_2Preface.indd 7 11/19/10 4:01 PM Implant Alpha-Numeric Index

synthetic, urinary, L8606 Iodine I-123 sodium iodide, A9509, A9516 Knee-ankle-foot orthosis (KAFO) addition, vascular graft, L8670 Iodine I-125 serum albumin, A9532 high strength, lightweight material, Implantable radiation dosimeter, A4650 Iodine I-125 sodium iodide, A9527 L2755 Impregnated gauze dressing, A6222-A6230 Iodine I-125 sodium iothalamate, A9554 Kyphosis pad, L1020, L1025 Incontinence Iodine I-131 iodinated serum albumin, appliances and supplies, A4310, A4360, A9524 L A5071-A5075, A5102-A5114, K0280, Iodine I-131 sodium iodide capsule, A9517, Implant–LSO replace page K0281 A9528 Laboratory tests treatment system, E0740 Iodine I-131 sodium iodide solution, chemistry, P2028-P2038 Indium IN-111 carpromab pendetide, A9507 A9529-A9531 microbiology, P7001 Indium IN-111 ibritumomab tiuxetan, A9542 Iodine I-131 tositumomab, A9544-A9545 miscellaneous, P9010-P9615, Indium IN-111 labeled autologous white Iodine swabs/wipes, A4247 Q0111-Q0115 blood cells, A9570 IPD toxicology, P3000-P3001, Q0091 Indium IN-111 labeled autologous platelets, system, E1592 Lacrimal duct implant A9571 IPPB machine, E0500 permanent, A4263 Indium IN-111 oxyquinoline, A9547 Ipratropium bromide, inhalation solution, temporary, A4262 Indium IN-111 pentetate, A9548 unit dose, J7644, J7645 Lactated Ringer’s infusion, J7120 Indium IN-111 pentetreotide, A9572 Irinotecan, J9206 Laetrile, J3570 Indium IN-111 satumomab, A4642 Iron Dextran, J1750 Lancet, A4258, A4259 Infliximab injection, J1745 Iron sucrose, J1756 Lanreotide, J1930 Infusion Irrigation/evacuation system, bowel Laronidase, J1931 pump, ambulatory, with administrative control unit, E0350 Larynx, artificial, L8500 equipment, E0781 disposable supplies for, E0352 Laser blood collection device and accessory, pump, heparin, dialysis, E1520 Irrigation solution for bladder calculi, E0620, A4257 pump, implantable, E0782, E0783 Q2004 Lead investigation, T1029 pump, implantable, refill kit, A4220 Irrigation supplies, A4320-A4322, A4355, Lead wires, per pair, A4557 pump, insulin, E0784 A4397-A4400 Leg pump, mechanical, reusable, E0779, Isoetharine HCl, inhalation solution, bag, A4358, A5105, A5112 E0780 concentrated, J7647, J7648 extensions for walker, E0158 pump, uninterrupted infusion of Isoetharine HCl, inhalation solution, unit rest, elevating, K0195 Epiprostenol, K0455 The HCPCSdose, J7649, Level J7650 II rest, wheelchair, E0990 supplies, A4219, A4221, A4222, ManualIsolates, alphabetic B4150, B4152 strap, replacement, A5113-A5114 A4230-A4232 Isoproterenol HCl, inhalation solution, Legg Perthes orthosis, L1700-L1755 I therapy, other than chemotherapeutic indexconcentrated, breaks upJ7657, J7658 Lens drugs, Q0081 alphabeticIsoproterenol sections HCl, inhalation solution, unit aniseikonic, V2118, V2318 Inhalation solution (see also drug name), dose, J7659, J7660 contact, V2500-V2599 J7608-J7699, Q4074 withIsosulfan bold blue, headings Q9968 eye, V2100-V2615, V2700-V2799 Injections (see also drug name), soIV you pole, each,can E0776,easily K0105 intraocular, V2630-V2632 J0120-J7320 Ixabepilone, J9207 low vision, V2600-V2615 dental service, D9610, D9630 locate descriptions. progressive, V2781 supplies for self-administered, A4211 J Lepirudin, J1945 Inlay/onlay dental restoration, Leucovorin calcium, J0640 D2510-D2664 Jacket Leukocyte poor blood, each unit, P9016 Insertion tray, A4310-A4316 scoliosis, L1300, L1310 Leuprolide acetate, J9217, J9218, J9219, Insulin, J1815, J1817 Jenamicin, J1580 J1950 Interferon Levalbuterol, all formulations, inhalation Alpha, J9212-J9215 solution, concentrated, J7607, J7612 Beta-1 a, J1826, Q3025-Q3026 K Levalbuterol, all formulations, inhalation Beta- 1 b, J1830 Kanamycin sulfate, J1840, J1850 solution, unit dose, J7614, J7615 Gamma, J9216 Kartop patient lift, toilet or bathroom (see Levetiracetam, J1953 Intermittent also Lift), E0625 Levocarnitine, J1955 assist device with continuous positive Ketorolac thomethamine, J1885 Levofloxacin, J1956 airway pressure device, E0470-E0472 Kidney Levoleucovorin, J0641 limb compression device, E0676 ESRD supply, A4650-A4927 Levonorgestrel, (contraceptive), implants peritoneal dialysis system, E1592 system, E1510 and supplies, J7306 positive pressure breathing (IPPB) wearable artificial, E1632 Levorphanol tartrate, J1960 machine, E0500 Kits Lexidronam, A9604 Interphalangeal joint, prosthetic implant, enteral feeding supply (syringe) (pump) Lidocaine HCl, J2001 L8658, L8659 (gravity), B4034-B4036 Lift Interscapular thoracic prosthesis fistula cannulation (set), A4730 patient (includes seat lift), E0621-E0635 endoskeletal, L6570 parenteral nutrition, B4220-B4224 shoe, L3300-L3334 upper limb, L6350-L6370 surgical dressing (tray), A4550 Lincomycin HCl, J2010 Intraconazole, J1835 tracheostomy, A4625 Linezolid, J2020 Intraocular lenses, V2630-V2632 Knee Liquid barrier, ostomy, A4363 Intraoral radiographs, dental, D0210-D0240 disarticulation, prosthesis, L5150, L5160 Lodging, recipient, escort nonemergency Intrapulmonary percussive ventilation joint, miniature, L5826 transport, A0180, A0200 system, E0481 orthosis (KO), E1810, L1800-L1885 Lorazepam, J2060 Intrauterine copper contraceptive, J7300 Knee-ankle-foot orthosis (KAFO), Low osmolar contrast material, Iodine Iobenguane sulfate I-131, A9508 L2000-L2039, L2126-L2136 Q9965-Q9967 Iodine I-123 iobenguane, A9582 LSO, L0621-L0640

6 INDEX HCPCS LEVEL II MANUAL 2011

HCPCS4_3Index.indd 6 11/19/10 4:05 PM Tabular List Temporary Hospital OPPS Codes C1300–C1876

Temporary Hospital OPPS Codes C1759 Catheter, intracardiac echocardiography 01/01/2004 ●53 ●A

Hyberbaric oxygen Supplies, devices C1300 Hyperbaric oxygen under pressure, full body chamber, per C1760 Closure device, vascular (implantable/insertable) 30-minute interval 07/01/2003 ●53 ●A 01/01/2004 ●53 ●A C1762 Connective tissue, human (includes fascia lata) Anchor/screw 01/01/2004 ●53 ●A C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone C1763 Connective tissue, non-human (includes synthetic) (implantable) 01/01/2004 ●53 ●A 01/01/2004 ●53 ●A

C1764 Event recorder, cardiac (implantable) 01/01/2004 ●53 ●A Catheter, transluminal atherectomy C1765 Adhesion barrier 07/01/2001 ●53 ●A C1714 Catheter, transluminal atherectomy, directional C1766 Introducer/sheath, guiding, intracardiac electrophysiological, 01/01/2004 ●53 ●A steerable, other than peel-away 01/01/2004 ●53 ●A C1767 Generator, neurostimulator (implantable), Heading non-rechargeable 01/01/2006 ●53 ●A Brachytherapy C1768 Graft, vascular 01/01/2004 ●53 ●A C1715 Brachytherapy needle 01/01/2004descriptions ●53 ●A C1769 Guide wire 01/01/2004 ●53 ●A C1716 Brachytherapy source,categorize non-stranded, gold-198, and per source C1770 Imaging coil, magnetic resonance (insertable) 01/01/2004 ●53 ●A 04/01/2001 ●53 ●A break up code C1717 Brachytherapy source, non-stranded, high dose rate C1771 Repair device, urinary, incontinence, with sling graft 01/01/2004 ●53 ●A iridium-192, per source 04/01/2001sections. ●53 ●A C1719 Brachytherapy source, non-stranded, non-high dose rate C1772 Infusion pump, programmable (implantable) 01/01/2004 ●53 ●A iridium-192, per source 04/01/2001 ●53 ●A C1773 Retrieval device, insertable (used to retrieve fractured medical devices) 01/01/2004 ●53 ●A Cardioverter‑defibrillator C1776 Joint device (implantable) 01/01/2004 ●53 ●A C1777 Lead, cardioverter-defibrillator, endocardial single coil C1721 Cardioverter-defibrillator, dual chamber (implantable) (implantable) 01/01/2004 ●53 ●A

01/01/2004 ●53 ●A C1300–C1876 C1778 Lead, neurostimulator (implantable) 01/01/2004 ●53 ●A C1722 Cardioverter-defibrillator, single chamber (implantable) 01/01/2004 ●53 ●A C1779 Lead, pacemaker, transvenous VDD single pass 01/01/2004 ●53 ●A

C1780 Lens, intraocular (new technology) 01/01/2004 ●53 ●A

Catheter C1781 Mesh (implantable) 01/01/2004 ●53 ●A

C1724 Catheter, transluminal atherectomy, rotational 01/01/2004 ●53 ●A C1782 Morcellator 01/01/2004 ●53 ●A

C1725 Catheter, transluminal angioplasty, non-laser (may include C1783 Ocular implant, aqueous drainage assist device 07/01/2002 ●53 ●A guidance, infusion/perfusion capability) 01/01/2004 ●53 ●A C1784 Ocular device, intraoperative, detached retina 01/01/2004 ●53 ●A C1726 Catheter, balloon dilatation, non-vascular 01/01/2004 ●53 ●A C1785 Pacemaker, dual chamber, rate-responsive (implantable) C1727 Catheter, balloon tissue dissector, non-vascular (insertable) 01/01/2004 ●53 ●A ●53 ●A 01/01/2004 C1786 Pacemaker, single chamber, rate-responsive (implantable) C1728 Catheter, brachytherapy seed administration 01/01/2004 ●53 ●A 01/01/2004 ●53 ●A

C1729 Catheter, drainage 01/01/2004 ●53 ●A C1787 Patient programmer, neurostimulator 01/01/2004 ●53 ●A

C1730 Catheter, electrophysiology, diagnostic, other than 3D mapping C1788 Port, indwelling (implantable) 01/01/2004 ●53 ●A (19 or fewer electrodes) 01/01/2004 ●53 ●A Dates after the C1789 Prosthesis, breast (implantable) 01/01/2004 ●53 ●A C1731 Catheter, electrophysiology, diagnostic, other than 3D mapping code descriptions C1813 Prosthesis, penile, inflatable 01/01/2004 ●53 ●A (20 or more electrodes) 01/01/2004 ●53 ●A C1814 Retinalindicate tamponade device,when silicone the oil 04/01/2003 ●53 ●A C1732 Catheter, electrophysiology, diagnostic/ablation, 3D or vector mapping 01/01/2004 ●53 ●A C1815 Prosthesis,codes urinary took sphincter effect. (implantable) 01/01/2004 ●53 ●A C1733 Catheter, electrophysiology, diagnostic/ablation, other than 3D C1816 Receiver and/or transmitter, neurostimulator (implantable) or vector mapping, other than cool-tip 01/01/2004 ●53 ●A 01/01/2004 ●53 ●A

➜ C1749 Endoscope, retrograde imaging/illumination colonoscope C1817 Septal defect implant system, intracardiac 01/01/2004 ●53 ●A device (implantable) 10/01/2010 ●53 ●A C1818 Integrated keratoprosthesis 07/01/2003 ●53 ●A C1750 Catheter, hemodialysis/peritoneal, long-term 04/01/2001 ●53 ●A C1819 Surgical tissue localization and excision device C1751 Catheter, infusion, inserted peripherally, centrally or midline (implantable) 01/01/2004 ●53 ●A (other than hemodialysis) 01/01/2004 ●53 ●A C1820 Generator, neurostimulator (implantable), with rechargeable C1752 Catheter, hemodialysis/peritoneal, short-term 04/01/2001 ●53 ●A battery and charging system 01/01/2006 ●53 ●A

C1753 Catheter, intravascular ultrasound 01/01/2004 ●53 ●A C1821 Interspinous process distraction device (implantable) 01/01/2007 ●53 ●A C1754 Catheter, intradiscal 01/01/2004 ●53 ●A C1874 Stent, coated/covered, with delivery system 01/01/2004 ●53 ●A C1755 Catheter, intraspinal 01/01/2004 ●53 ●A C1875 Stent, coated/covered, without delivery system 01/01/2004 ●53 ●A C1756 Catheter, pacing, transesophageal 01/01/2004 ●53 ●A C1876 Stent, non-coated/non-covered, with delivery system C1757 Catheter, thrombectomy/embolectomy 01/01/2004 ●53 ●A 01/01/2004 ●53 ●A C1758 Catheter, ureteral 01/01/2004 ●53 ●A

Special Coverage Instructions Apply Noncovered/Not Payable by Medicare Carrier Judgment ●00 – ●99 Pricing Indicator Code ●9 ●A – ●G Multiple Pricing Indicator Code ➜ New Code ✧ Reinstated Code ✽ Revised Code Title sR Revised (mm/dd/yyyy) Code Effective Date HCPCS LEVEL II MANUAL 2011 C CODES 15

HCPCS4_4tabular_section.indd 15 11/19/10 4:03 PM Tabular List Durable Medical Equipment E1224–E1699

E1224 Wheelchair with detachable arms, elevating legrests E1356 Oxygen accessory, battery pack/cartridge for portable 01/01/1990 ●36 ●A concentrator, any type, replacement only, each 01/01/2009 ●00 ●9 E1225 Wheelchair accessory, manual semi-reclining back, (recline E1357 Oxygen accessory, battery charger for portable concentrator, greater than 15 degrees, but less than 80 degrees), each any type, replacement only, each 01/01/2009 ●00 ●9 01/01/2005 ●36 ●A E1358 Oxygen accessory, DC power adapter for portable concentrator, E1226 Wheelchair accessory, manual fully reclining back, (recline any type, replacement only, each 01/01/2009 ●00 ●9 greater than 80 degrees), each 01/01/2005 ●00 ●9 E1372 Immersion external heater for nebulizer 01/01/1996 ●32 ●A E1227 Special height arms for wheelchair 01/01/1990 ●32 ●A E1390 Oxygen concentrator, single delivery port, capable of E1228 Special back height for wheelchair 01/01/1990 ●36 ●A delivering 85 percent or greater oxygen concentration at the prescribed flow rate 01/01/2004 ●33 ●A E1229 Wheelchair, pediatric size, not otherwise specified 01/01/2005 ●32 ●A E1391 Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed E1230 Power operated vehicle (three or four wheel nonhighway) flow rate, each 01/01/2004 ●33 ●A specify brand name and model number 01/01/1991 ●32 ●A E1392 Portable oxygen concentrator, rental 01/01/2006 ●33 ●A E1231 Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system 01/01/2009 ●32 ●A E1399 Durable medical equipment, miscellaneous 01/01/1996 ●46 ●A E1232 Wheelchair, pediatric size, tilt-in-space, folding, adjustable, E1405 Oxygen and water vapor enriching system with heated with seating system 01/01/2009 ●32 ●A delivery 01/01/1990 ●33 ●A E1233 Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, E1406 Oxygen and water vapor enriching system without heated without seating system 01/01/2009 ●32 ●A delivery 01/01/1990 ●33 ●A E1234 Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system 01/01/2009 ●32 ●A Dialysis‑related equipment E1235 Wheelchair, pediatric size, rigid, adjustable, with seating system 01/01/2009 ●32 ●A E1500 Centrifuge, for dialysis 01/01/2002 ●52 ●A E1236 Wheelchair, pediatric size, folding, adjustable, with seating E1510 Kidney, dialysate delivery syst. kidney machine, pump system 01/01/2009 ●32 ●A recirculating, air removal syst, flowrate meter, power off, heater and temperature control with alarm, IV poles, pressure E1237 Wheelchair, pediatric size, rigid, adjustable, without seating gauge, concentrate container 01/01/2002 ●52 ●A system 01/01/2009 ●32 ●A E1520 Heparin infusion pump for hemodialysis 01/01/2002 ●52 ●A E1238 Wheelchair, pediatric size, folding, adjustable, without seating system 01/01/2009 ●32 ●A E1530 Air bubble detector for hemodialysis, each, replacement 01/01/2002 ●52 ●A E1239 Power wheelchair, pediatric size, not otherwise specified 01/01/2005 ●36 ●A Pink, blue, and yellow E1540 Pressure alarm for hemodialysis, each, replacement 01/01/2002 ●52 ●A E1240 Lightweight wheelchair,highlights detachable indicate arms, (desk which or full length) swing away detachable, elevating legrest 01/01/1989 ●36 ●A E1550 Bath conductivity meter for hemodialysis, each 01/01/2002 ●52 ●A E1250 Lightweight wheelchair,codes have fixed full special length arms, coverage swing away detachable footrestinstructions, 04/01/2001 ●00 ●9 which ones E1560 Blood leak detector for hemodialysis, each, replacement 01/01/2002 ●52 ●A E1260 Lightweight wheelchair, detachable arms (desk or full length) swing away detachablearen’t footrestcovered 04/01/2001 by ●00 Medicare, ●9 E1570 Adjustable chair, for ESRD patients 01/01/2002 ●52 ●A E1270 Lightweight wheelchair,and which fixed full oneslength arms, are swing up awayto E1575 Transducer protectors/fluid barriers, for hemodialysis, any detachable elevatingthe legrests carrier’s 01/01/1989 ●judgment.36 ●A size, per 10 01/01/2002 ●52 ●A E1280 Heavy duty wheelchair, detachable arms (desk or full length) E1580 Unipuncture control system for hemodialysis 01/01/2002 ●52 ●A elevating legrests 01/01/1989 ●36 ●A E1590 Hemodialysis machine 01/01/2002 ●52 ●A E1285 Heavy duty wheelchair, fixed full length arms, swing away E1592 Automatic intermittent peritioneal dialysis system detachable footrest 04/01/2001 ●00 ●9 01/01/2002 ●52 ●A E1290 Heavy duty wheelchair, detachable arms (desk or full length) E1594 Cycler dialysis machine for peritoneal dialysis 01/01/2002 ●52 ●A swing away detachable footrest 04/01/2001 ●00 ●9 E1600 Delivery and/or installation charges for hemodialysis E1295 Heavy duty wheelchair, fixed full length arms, elevating equipment 01/01/2002 ●52 ●A legrest 01/01/1989 ●36 ●A E1610 Reverse osmosis water purification system, for E1296 Special wheelchair seat height from floor 01/01/1989 ●32 ●A hemodialysis 01/01/2002 ●52 ●A E1297 Special wheelchair seat depth, by upholstery 01/01/1989 ●32 ●A E1615 Deionizer water purification system, for hemodialysis E1298 Special wheelchair seat depth and/or width, by 01/01/2002 ●52 ●A construction 01/01/1989 ●32 ●A E1620 Blood pump for hemodialysis, replacement 01/01/2002 ●52 ●A

E1625 Water softening system, for hemodialysis 01/01/2002 ●52 ●A Whirlpool, equipment E1630 Reciprocating peritoneal dialysis system 01/01/2002 ●52 ●A E1224–E1699 E1300 Whirlpool, portable (overtub type) 01/01/1996 ●00 ●9 E1632 Wearable artificial kidney, each 01/01/2002 ●52 ●A E1310 Whirlpool, non-portable (built-in type) 01/01/1996 ●32 ●A E1634 Peritoneal dialysis clamps, each 01/01/2004 ●52 ●A E1635 Compact (portable) travel hemodialyzer system Oxygen‑related equipment 01/01/2002 ●52 ●A ●52 ●A E1353 Regulator 01/01/2009 ●00 ●9 E1636 Sorbent cartridges, for hemodialysis, per 10 01/01/2002 E1354 Oxygen accessory, wheeled cart for portable cylinder E1637 Hemostats, each 01/01/2003 ●52 ●A or portable concentrator, any type, replacement only, E1639 Scale, each 01/01/2003 ●52 ●A each 01/01/2009 ●00 ●9 E1699 Dialysis equipment, not otherwise specified 01/01/2002 ●52 ●A E1355 Stand/rack 01/01/2009 ●00 ●9

Special Coverage Instructions Apply Noncovered/Not Payable by Medicare Carrier Judgment ●00 – ●99 Pricing Indicator Code ●9 ●A – ●G Multiple Pricing Indicator Code ➜ New Code ✧ Reinstated Code ✽ Revised Code Title sR Revised (mm/dd/yyyy) Code Effective Date HCPCS LEVEL II MANUAL 2011 E CODES 25

HCPCS4_4tabular_section.indd 25 11/19/10 4:03 PM Tabular List Drugs J3285–J7500

J3285 Injection, treprostinil, 1 mg 01/01/2006 ●51 ●A J7100 Infusion, dextran 40, 500 ml 01/01/1997 ●51 ●A

J3300 Injection, triamcinolone acetonide, preservative free, 1 mg J7110 Infusion, dextran 75, 500 ml 01/01/1997 ●51 ●A 01/01/2009 ●51 ●A J7120 Ringers lactate infusion, up to 1000 cc 01/01/1997 ●51 ●A J3301 Injection, triamcinolone acetonide, not otherwise specified, J7130 Hypertonic saline solution, 50 or 100 meq, 20 cc vial 10 mg 01/01/2009 ●51 ●A 01/01/1997 ●51 ●A J3302 Injection, triamcinolone diacetate, per 5 mg 01/01/1997 ●51 ●A ➜ J7184 Injection, von Willebrand factor complex (human), wilate, per J3303 Injection, triamcinolone hexacetonide, per 5 mg 01/01/1997 ●51 ●A 100 IU VWF:RCO 01/01/2011 ●51 ●A

J3305 Injection, trimetrexate glucuronate, per 25 mg 01/01/1997 ●51 ●A J7185 Injection, factor VIII (antihemophilic factor, recombinant) (xyntha), per IU 01/01/2010 ●51 ●A J3310 Injection, perphenazine, up to 5 mg 01/01/1997 ●51 ●A J7186 Injection, antihemophilic factor VIII/Von Willebrand factor J3315 Injection, triptorelin pamoate, 3.75 mg 01/01/2003 ●51 ●A complex (human), per factor VIII IU 01/01/2009 ●51 ●A J3320 Injection, spectinomycin dihydrochloride, up to 2 gm J7187 Injection, Von Willebrand factor complex (humate-P), per IU 01/01/1997 ●51 ●A VWF:RCO 01/01/2008 ●51 ●A J3350 Injection, urea, up to 40 gm 01/01/1997 ●51 ●A J7189 Factor VIIA (antihemophilic factor, recombinant), per 1 J3355 Injection, urofollitropin, 75 IU 01/01/2006 ●51 ●A microgram 01/01/2006 ●51 ●A

➜ J3357 Injection, ustekinumab, 1 mg 01/01/2011 ●51 ●A J7190 Factor VIII (antihemophilic factor, human) per IU 01/01/1999 ●51 ●A J3360 Injection, diazepam, up to 5 mg 01/01/1997 ●51 ●A J7191 Factor VIII (antihemophilic factor (porcine), per IU J3364 Injection, urokinase, 5000 IU vial 01/01/1997 ●51 ●A 01/01/1998 ●51 ●A ●51 ●A J3365 Injection, IV, urokinase, 250,000 IU vial 01/01/1997 ✽ J7192 Factor VIII (antihemophilic factor, recombinant) per IU, not J3370 Injection, vancomycin HCl, 500 mg 01/01/2000 ●51 ●A otherwise specified 01/01/2010 ●51 ●A

➜ J3385 Injection, velaglucerase alfa, 100 units 01/01/2011 ●51 ●A J7193 Factor IX (antihemophilic factor, purified, non-recombinant) per IU 01/01/2002 ●51 ●A J3396 Injection, verteporfin, 0.1 mg 01/01/2005 ●51 ●A J7194 Factor IX, complex, per IU 01/01/1998 ●51 ●A J3400 Injection, triflupromazine HCl, up to 20 mg 01/01/1997 ●51 ●A J7195 Factor IX (antihemophilic factor, recombinant) per IU 01/01/1997 ●51 ●A Our icons let you J3410 Injection, hydroxyzine HCl, up to 25 mg 01/01/2002 ●51 ●A Injection, thiamine HCl, 100 mg 01/01/2004 ●51 ●A J3411 ➜knowJ7196 Inection, immediately antithrombin recombinant, 50 IU 01/01/2011 ●51 ●A

J3415 Injection, pyridoxine HCl, 100 mg 01/01/2004 ●51 ●A J3285–J7500 J7197 whichAntithrombin codes IIIare (human), per IU 01/01/1997 ●51 ●A J3420 Injection, vitamin B-12 cyanocobalamin, up to 1000 mcg J7198 new,Anti-inhibitor, revised, per or IU 01/01/2000 ●51 ●A 01/01/1997 ●51 ●A J7199 Hemophilia clotting factor, not otherwise classified 01/01/1997 ●51 ●A reinstated J3430 Injection, phytonadione (vitamin K), per 1 mg 01/01/2000 ●51 ●A Injection, voriconazole, 10 mg 01/01/2004 ●51 ●A J3465 J7300 Intrauterine copper contraceptive 04/01/1995 ●00 ●9 J3470 Injection, hyaluronidase, up to 150 units 01/01/1997 ●51 ●A J7302 Levonorgestrel-releasing intrauterine contraceptive system, J3471 Injection, hyaluronidase, ovine, preservative free, per 1 USP 52 mg 01/01/2002 ●00 ●9 unit (up to 999 USP units) 01/01/2006 ●51 ●A J7303 Contraceptive supply, hormone containing vaginal ring, J3472 Injection, hyaluronidase, ovine, preservative free, per 1000 each 01/01/2004 ●00 ●9 USP units 01/01/2006 ●51 ●A J7304 Contraceptive supply, hormone containing patch, J3473 Injection, hyaluronidase, recombinant, 1 USP unit each 01/01/2005 ●00 ●9 01/01/2007 ●51 ●A J7306 Levonorgestrel (contraceptive) implant system, including J3475 Injection, magnesium sulfate, per 500 mg 01/01/1997 ●51 ●A implants and supplies 01/01/2006 ●00 ●9

J3480 Injection, potassium chloride, per 2 meq 01/01/1997 ●51 ●A J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 01/01/2008 ●00 ●9 J3485 Injection, zidovudine, 10 mg 01/01/2001 ●51 ●A J7308 Aminolevulinic acid HCl for topical administration, 20%, ●51 ●A J3486 Injection, ziprasidone mesylate, 10 mg 01/01/2004 single unit dosage form (354 mg) 01/01/2004 ●51 ●A J3487 Injection, zoledronic acid (Zometa), 1 mg 01/01/2008 ●51 ●A ➜ J7309 Methyl aminolevulinate (MAL) for topical administration, J3488 Injection, zoledronic acid (Reclast), 1 mg 01/01/2008 ●51 ●A 16.8%, 1 g 01/01/2011 ●51 ●A

J3490 Unclassified drugs 01/01/1997 ●51 ●A J7310 Ganciclovir, 4.5 mg, long-acting implant 01/01/1997 ●51 ●A

J3520 Edetate disodium, per 150 mg 01/01/1996 ●00 ●9 J7311 Fluocinolone acetonide, intravitreal implant 01/01/2007 ●51 ●A ➜ J3530 Nasal vaccine inhalation 01/01/1997 ●51 ●A J7312 Injection, dexamethasone intravitreal implant, 0.1 mg 01/01/2011 ●51 ●A J3535 Drug administered through a metered dose inhaler 01/01/1997 ●00 ●9 J7321 Hyaluronan or derivative, hyalgan or supartz, for intra- articular injection, per dose 01/01/2008 ●51 ●A J3570 Laetrile, amygdalin, vitamin B17 01/01/1996 ●00 ●9 J7323 Hyaluronan or derivative, euflexxa, for intra-articular J3590 Unclassified biologics 01/01/2003 ●51 ●A injection, per dose 01/01/2008 ●51 ●A J7030 Infusion, normal saline solution , 1000 cc 01/01/1997 ●51 ●A J7324 Hyaluronan or derivative, orthovisc, for intra-articular J7040 Infusion, normal saline solution, sterile (500 ml=1 unit) injection, per dose 01/01/2008 ●51 ●A 01/01/1997 ●51 ●A J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra- ●51 ●A J7042 5% dextrose/normal saline (500 ml = 1 unit) 01/01/1997 ●51 ●A articular injection, 1 mg 01/01/2010 ●57 ●A J7050 Infusion, normal saline solution , 250 cc 01/01/1997 ●51 ●A J7330 Autologous cultured chondrocytes, implant 07/01/2002 ➜ ●51 ●A J7060 5% dextrose/water (500 ml = 1 unit) 01/01/1997 ●51 ●A J7335 Capsaicin 8% patch, per 10 square centimeters 01/01/2011 ●51 ●A J7070 Infusion, D5W, 1000 cc 01/01/1997 ●51 ●A J7500 Azathioprine, oral, 50 mg 01/01/2000

Special Coverage Instructions Apply Noncovered/Not Payable by Medicare Carrier Judgment ●00 – ●99 Pricing Indicator Code ●9 ●A – ●G Multiple Pricing Indicator Code ➜ New Code ✧ Reinstated Code ✽ Revised Code Title sR Revised (mm/dd/yyyy) Code Effective Date HCPCS LEVEL II MANUAL 2011 J CODES 49

HCPCS4_4tabular_section.indd 49 11/19/10 4:03 PM Appendix A Table of Drugs

Appendix A: Table of Drugs

Intravenous administration includes all methods, such as gravity infusion, into joints, cavities, tissues, or topical applications, in addition to other injections, and timed pushes. The ‘VAR’ posting denotes various routes parenteral administrations. Listings posted with ‘OTH’ indicate other of administration and is used for drugs that are commonly administered administration methods, such as suppositories or catheter injections.

Unit Route Code Unit Route Code A Amphocin, see Amphotericin B Amphotericin B ...... 50 mg IV J0285 Abatacept ...... 10 mg J0129 Amphotericin B, lipid complex ...... 10 mg IV J0287-J0289 Abbokinase, see Urokinase Ampicillin sodium ...... up to 500 mg IM, IV J0290 Abbokinase, Open Cath, see Urokinase Ampicillin sodium/sulbactam sodium . . . . . per 1.5 gm IM, IV J0295 Abciximab ...... 10 mg IV J0130 Amygdalin, see Laetrile, Amygdalin, Abelcet, see Amphotericin B Lipid Complex vitamin B-17 ABLC, see Amphotericin B Amytal, see Amobarbital AbobotulinumtoxintypeA ...... 5 units J0586 Anabolin LA 100, see Nandrolone decanoate Acetazolamide sodium ...... up to 500 mg IM, IV J1120 Anadulafungin ...... 1 mg J0348 Acetylcysteine, injection ...... 100 mg J0132 Ancef, see Cefazolin sodium Acetylcysteine, unit dose form ...... per gram INH J7604,J7608 Andrest 90-4, see Testosterone enanthate and Achromycin, see Tetracycline estradiol valerate Actemra, see Tocilizumab Andro-Cyp, see Testosterone cypionate ACTH, see Corticotropin Andro-Cyp 200, see Testosterone cypionate Acthar, see Corticotropin Andro L .A . 200, see Testosterone enanthate Actimmune, see Interferon gamma 1-B Andro-Estro 90-4, see Testosterone enanthate Activase, see Alteplase recombinant and estradiol valerate Acyclovir ...... 5 mg J0133 Andro/Fem, see Testosterone cypionate and Adalimumab ...... 20 mg J0135 estradiol cypionate Adenocard, see Adenosine Androgyn L .A ., see Testosterone enanthate and Adenoscan, see Adenosine

estradiol valerate Abatacept–Atryn Adenosine ...... 6 mg IV J0150 Androlone-50, see Nandrolone phenpropionate Adenosine ...... 30 mg IV J0152 Androlone-D 100, see Nandrolone decanoate Adrenalin Chloride, see Adrenalin, epinephrine Andronaq-50, see Testosterone suspension Adrenalin, epinephrine ...... 0.1 mg SC, IM J0171 Andronaq-LA, see Testosterone cypionate Adriamycin PFS, see Doxorubicin HCl Andronate-200, see TestosteroneOur cypionate shaded-colored Adriamycin RDF, see Doxorubicin HCl Andronate-100, see Testosterone cypionate Adrucil, see Fluorouracil Andropository 100, see Testosteronecolumns enanthate help you Agalsidase beta ...... 1 mg J0180 Andryl 200, see Testosterone enanthate Aggrastat, see Tirofiban hydrochloride Anectine, see Succinylcholineimmediately chloride locate A-hydroCort, see Hydrocortisone sodium Anergan 25, see Promethazinedrugs, HCl units, routes, phosphate Anergan 50, see Promethazine HCl Akineton, see Biperiden Anistreplase ...... and . . . . codes...... in30 units the IV J0350 Alatrofloxacin mesylate, injection ...... 100 mg IV J0200 Anti-Inhibitor ...... per IU IV J7198 Albuterol ...... 0.5 mg INH J7620 Antispas, see Dicyclomine HCl Table of Drugs. Albuterol, concentrated form ...... 1 mg INH J7610, J7611 Antithrombin III (human) ...... per IU IV J7197 Albuterol, unit dose form ...... 1 mg INH J7609, J7613 Antithrombin recombinant ...... 50 IU J7196 Aldesleukin ...... per single IM, IV J9015 Anzemet, see Dolasetron mesylate injection use vial A .P .L ., see Chorionic gonadotropin Aldomet, see Methyldopate HCl Apomorphine Hydrochloride ...... 1 mg J0364 Alefacept ...... 0.5 mg J0215 Apresoline, see Hydralazine HCl Alemtuzumab ...... 10 mg J9010 Aprotinin ...... 10,000 kiu J0365 Alferon N, see Interferon alfa-n3 AquaMEPHYTON, see Vitamin K Alglucerase ...... per 10 units IV J0205 Aralen, see Chloroquine HCl Alglucosidase ...... 10 mg J0220 Aramine, see Metaraminol Alkaban-AQ, see Vinblastine sulfate Aranesp, see Darbepoetin Alfa Alkeran, see Melphalan, oral Arbutamine ...... 1 mg IV J0395 Alpha 1-proteinase inhibitor, human . . . . . 10 mg IV J0256 Arcalyst, see Rilanocept Alphanate ...... J7186 Aredia, see Pamidronate disodium Alprostadil, injection ...... 1.25 mcg OTH J0270 Arfonad, see Trimethaphan camsylate injection Arformoterol tartrate ...... 15 mcg J7605 Alprostadil, urethral suppository ...... OTH J0275 Aripiprazole ...... 0.25 mg J0400 Alteplase recombinant ...... 1 mg IV J2997 Aristocort Forte, see Triamcinolone diacetate Alupent, see Metaproterenol sulfate or Aristocort Intralesional, see Triamcinolone diacetate Metaproterenol, compounded Aristospan Intra-Articular, see Triamcinolone hexacetonide Amcort, see Triamcinolone diacetate Aristospan Intralesional, see Triamcinolone hexacetonide A-methaPred, see Methylprednisolone Arrestin, see Trimethobenzamide HCl sodium succinate Arsenic trioxide ...... 1 mg IV J9017 Amgen, see Interferon alphacon-1 Arzerra, see Ofatumumab Amifostine ...... 500 mg IV J0207 Asparaginase ...... 10,000 units IV, IM J9020 Amikacin sulfate ...... 100 mg J0278 Astramorph PF, see Morphine sulfate Aminolevalinic acid HCl ...... unit dose OTH J7308 Atgam, see Lymphocyte immune globulin (354 mg) Ativan, see Lorazepam Aminolevulinate ...... 1 gm OTH J7309 Atropine, concentrated form ...... per mg INH J7635 Aminophylline/Aminophyllin ...... up to 250 mg IV J0280 Atropine, unit dose form ...... per mg INH J7636 Amiodarone HCl ...... 30 mg IV J0282 Atropine sulfate ...... 0.01 mg IV, IM, SC J0461 Amitriptyline HCl ...... up to 20 mg IM J1320 Atrovent, see Ipratropium bromide Amobarbital ...... up to 125 mg IM, IV J0300 Atryn, see Antithrombin recombinant

IA –Intra-arterial administration IM –Intramuscular administration SC –Subcutaneous administration VAR –Various routes of administration ORAL –Administered orally IV –Intravenous administration IT –Intrathecal INH –Administration by inhaled solution OTH –Other routes of administration HCPCS LEVEL II MANUAL 2011 Appendix A A1

HCPCS4_5Appendices_A-F.indd 1 11/19/10 3:54 PM