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Vertical Perspective Medical Assistance Program Kansas Vertical Perspective Medical Assistance Program December 2006 Provider Bulletin Number 688 General Providers Emergent and Nonemergent Diagnosis Code List Attached is a list of diagnosis codes and whether the Kansas Medical Assistance Program (KMAP) considers the code to be emergent or nonemergent. Providers are responsible for validating whether a particular diagnosis code is covered by KMAP under the beneficiary’s benefit plan and that all program requirements are met. This list does not imply or guarantee payment for listed diagnosis codes. Information about the Kansas Medical Assistance Program as well as provider manuals and other publications are on the KMAP Web site at https://www.kmap-state-ks.us. If you have any questions, please contact the KMAP Customer Service Center at 1-800-933-6593 (in-state providers) or (785) 274-5990 between 7:30 a.m. and 5:30 p.m., Monday through Friday. EDS is the fiscal agent and administrator of the Kansas Medical Assistance Program for the Kansas Health Policy Authority. Page 1 of 347 Emergency Indicators as noted by KMAP: N – Never considered emergent S – Sometimes considered emergent (through supporting medical documentation) Y – Always considered emergent Diagnosis Emergency Diagnosis Code Description Code Indicator 0010 Cholera due to Vibrio Cholerae S 0011 Cholera due to Vibrio Cholerae El Tor S 0019 Unspecified Cholera S 019 Late Effects of Tuberculosis N 0020 Typhoid Fever S 0021 Paratyphoid Fever A S 0022 Paratyphoid Fever B S 0023 Paratyphoid Fever C S 024 Glanders Y 025 Melioidosis Y 0029 Unspecified Paratyphoid Fever S 0030 Salmonella Gastroenteritis S 0031 Salmonella Septicemia S 035 Erysipelas N 037 Tetanus Y 0038 Other Specified Salmonella Infections S 0039 Unspecified Salmonella Infection S 0040 Shigella Dysenteriae S 0041 Shigella Flexneri S 0042 Shigella Boydii S 042 Human Immunodeficiency Virus [HIV] N 0043 Shigella Sonnei S 043 Human Immunodeficiency Virus (HIV) Disease N 044 Human Immunodeficiency Virus (HIV) Disease N 0048 Other Specified Shigella Infections S 048 Other Enterovirus Diseases of Central Nervous System N 0049 Unspecified Shigellosis S 0050 Staphylococcal Food Poisoning S 0051 Botulism S 0052 Food Poisoning due to Clostridium Perfringens (C. Welchii) S 0053 Food Poisoning due to Other Clostridia S 0054 Food Poisoning due to Vibrio Parahaemolyticus S 0059 Unspecified Food Poisoning S 0060 Acute Amebic Dysentery Without Mention of Abscess S 0061 Chronic Intestinal Amebiasis Without Mention of Abscess S 061 Dengue Y 0062 Amebic Nondysenteric Colitis S 0063 Amebic Liver Abscess Y 0064 Amebic Lung Abscess Y 064 Viral Encephalitis Transmitted by Other and Unspecified Arthropods Y 0065 Amebic Brain Abscess Y EDS is the fiscal agent and administrator of the Kansas Medical Assistance Program for the Kansas Health Policy Authority. Page 2 of 347 Diagnosis Emergency Diagnosis Code Description Code Indicator 0066 Amebic Skin Ulceration N 067 Arthropod-Borne Hemorrhagic Fever Y 0068 Amebic Infection of Other Sites N 068 Other Arthropod-Borne Viral Diseases N 0069 Unspecified Amebiasis N 0070 Balantidiasis Y 0071 Giardiasis N 071 Rabies Y 0072 Coccidiosis N 0073 Intestinal Trichomoniasis N 0074 Cryptosporidiosis N 0075 Cyclosporiasis N 075 Infectious Mononucleosis N 0078 Other Specified Protozoal Intestinal Diseases N 0079 Unspecified Protozoal Intestinal Disease N 080 Louse-Borne (Epidemic) Typhus N 0081 Intestinal Infection due to Arizona Group of Paracolon Bacilli N 0082 Intestinal Infection due to Aerobacter Aerogenes N 0083 Intestinal Infections due to Proteus (Mirabilis) (Morganii) N 0085 Intestinal Infection due to Unspecified Bacterial Enteritis N 0088 Intestinal Infection due to Other Organism, Nec N 089 Other Arthropod-Borne Diseases N 0090 Infectious Colitis, Enteritis, and Gastroenteritis N 0091 Colitis, Enteritis, and Gastroenteritis of Presumed Infectious Origin N 0092 Infectious Diarrhea N 0093 Diarrhea of Presumed Infectious Origin N 096 Late Syphilis, Latent N 101 Vincent's Angina N 113 Actinomycosis Y 118 Opportunistic Mycoses N 124 Trichinosis N 129 Unspecified Intestinal Parasitism N 135 Sarcoidosis N 138 Late Effects of Acute Poliomyelitis N 179 Malignant Neoplasm of Uterus, Part Unspecified N 181 Malignant Neoplasm of Placenta N 185 Malignant Neoplasm of Prostate N 193 Malignant Neoplasm of Thyroid Gland N 0200 Bubonic Plague Y 0201 Cellulocutaneous Plague Y 0202 Septicemic Plague Y 0203 Primary Pneumonic Plague Y 0204 Secondary Pneumonic Plague Y 0205 Pneumonic Plague, Unspecified Y 0208 Other Specified Types of Plague Y 0209 Unspecified Plague Y EDS is the fiscal agent and administrator of the Kansas Medical Assistance Program for the Kansas Health Policy Authority. Page 3 of 347 Diagnosis Emergency Diagnosis Code Description Code Indicator 209 Myelofibrosis N 0210 Ulceroglandular Tularemia Y 0211 Enteric Tularemia Y 0212 Pulmonary Tularemia Y 0213 Oculoglandular Tularemia Y 217 Benign Neoplasm of Breast N 0218 Other Specified Tularemia Y 0219 Unspecified Tularemia Y 0220 Cutaneous Anthrax Y 220 Benign Neoplasm of Ovary N 0221 Pulmonary Anthrax Y 0222 Gastrointestinal Anthrax Y 0223 Anthrax Septicemia Y 226 Benign Neoplasm of Thyroid Glands N 0228 Other Specified Manifestations of Anthrax Y 0229 Unspecified Anthrax Y 0230 Brucella Melitensis Y 0231 Brucella Abortus Y 0232 Brucella Suis Y 0233 Brucella Canis Y 0238 Other Brucellosis Y 0239 Burcellosis, Unspecified Y 243 Congenital Hypothyroidism N 0260 Spirillary Fever Y 260 Kwashiorkor N 0261 Streptobacillary Fever Y 261 Nutritional Marasmus N 262 Other Severe Protein-Calorie Malnutrition N 267 Ascorbic Acid Deficiency N 0269 Unspecified Rat-Bite Fever Y 0270 Listeriosis N 0271 Erysipelothrix Infection N 0272 Pasteurellosis N 0278 Other Specified Zoonotic Bacterial Diseases N 0279 Unspecified Zoonotic Bacterial Disease N 0300 Lepromatous Leprosy (Type L) N 0301 Tuberculoid Leprosy (Type T) N 0302 Indeterminate Leprosy (Group I) N 0303 Borderline Leprosy (Group B) N 0308 Other Specified Leprosy N 0309 Unspecified Leprosy N 0310 Pulmonary Diseases due to Other Mycobacteria S 0311 Cutaneous Diseases due to Other Mycobacteria N 311 Depressive Disorder, Not Elsewhere Classified Y 0312 Disseminated Diseases due to Other Mycobacteria N 316 Psychic Factors Associated With Diseases Classified Elsewhere N EDS is the fiscal agent and administrator of the Kansas Medical Assistance Program for the Kansas Health Policy Authority. Page 4 of 347 Diagnosis Emergency Diagnosis Code Description Code Indicator 317 Mild Mental Retardation N 0318 Other Specified Diseases due to Other Mycobacteria N 0319 Unspecified Diseases due to Mycobacteria N 319 Unspecified Mental Retardation N 00320 Unspecified Localized Salmonella Infection S 0320 Faucial Diphtheria Y 00321 Salmonella Meningitis S 0321 Nasopharyngeal Diphtheria Y 00322 Salmonella Pneumonia S 0322 Anterior Nasal Diphtheria Y 00323 Salmonella Arthritis S 0323 Laryngeal Diphtheria Y 00324 Salmonella Osteomyelitis S 325 Phlebitis and Thrombophlebitis of Intracranial Venous Sinuses Y 326 Late Effects of Intracranial Abscess or Pyogenic Infection N 0328 Other Specified Diphtheria Y 00329 Other Localized Salmonella Infections S 0329 Unspecified Diphtheria Y 0330 Whooping Cough due to Bordetella Pertussis (P. Pertussis) Y 0331 Whooping Cough due to Bordetella Parapertussis (B. Parapertussis) Y 0338 Whooping Cough due to Other Specified Organism Y 0339 Whooping Cough, Unspecified Organism Y 0340 Streptococcal Sore Throat Y 340 Multiple Sclerosis S 0341 Scarlet Fever Y 347 Cataplexy and Narcolepsy N 0360 Meningococcal Meningitis Y 0361 Meningococcal Encephalitis Y 0362 Meningococcemia Y 0363 Waterhouse-Friderichsen Syndrome, Meningococcal Y 0368 Other Specified Meningococcal Infections Y 0369 Unspecified Meningococcal Infection Y 0380 Streptococcal Septicemia Y 0381 Staphylococcal Septicemia Y 0382 Pneumococcal Septicemia Y 0383 Septicemia due to Anaerobes Y 0388 Other Specified Septicemia Y 0389 Unspecified Septicemia Y 0390 Cutaneous Actinomycotic Infection Y 390 Rheumatic Fever Without Mention of Heart Involvement N 0391 Pulmonary Actinomycotic Infection Y 0392 Abdominal Actinomycotic Infection Y 0393 Cervicofacial Actinomycotic Infection Y 393 Chronic Rheumatic Pericarditis Y 0394 Madura Foot N 0398 Actinomycotic Infection of Other Specified Sites Y EDS is the fiscal agent and administrator of the Kansas Medical Assistance Program for the Kansas Health Policy Authority. Page 5 of 347 Diagnosis Emergency Diagnosis Code Description Code Indicator 0399 Actinomycotic Infection of Unspecified Site Y 0400 Gas Gangrene Y 400 Malignant Hypertension Y 0401 Rhinoscleroma N 0402 Whipple's Disease N 0403 Necrobacillosis N 0408 Other Specified Bacterial Diseases N 0412 Pneumococcus Infection in in Conditions Classified Elsewhere And of Unspecified Site N 412 Old Myocardial Infarction Y Friedlander's Bacillus Infection in Conditions Classified Elsewhere and of Unspecified 0413 Site N Escherichia Coli (E. Coli) Infection in Conditions Classified Elsewhere and of Unspecified 0414 Site N Hemophilus Influenzae (H. Influenzae) Infection in Conditions Classified Elsewhere and 0415 of Unspecified Site N Proteus (Mirabilis) (Morganii) Infection in Conditions Classified Elsewhere and of 0416 Unspecified Site N 0417 Pseudomonas Infection in Conditions Classified Elsewhere and of Unspecified Site N Bacterial Infection, Unspecified, in Conditions Classified Elsewhere and of Unspecified 0419 Site N 430 Subarachnoid Hemorrhage Y 431 Intracerebral Hemorrhage Y 436 Acute, but Ill-Defined,
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