Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code V20.2 Routine infant or child health check V22.0 Supervision of normal first pregnancy V22.1 Supervision of other normal pregnancy V22.2 Pregnant state, incidental V23.0 Pregnancy with history of infertility V23.1 Pregnancy with history of trophoblastic disease V23.3 Grand multiparity V23.41 Pregnancy with history of pre-term labor V23.49 Pregnancy with other poor obstretric history V23.5 Pregnancy with other poor reproductive history V23.7 Insufficient prenatal care V23.81 Elderly primigravida V23.82 Elderly multigravida V23.83 Young primigravida V23.84 Young multigravida V23.89 Other high-risk pregnancy V23.9 Unspecified high-risk pregnancy V56.0 Encounter for extracorporeal dialysis V56.8 Encounter for other dialysis V58.0 Encounter for radiotherapy V58.11 Encounter for antineoplastic chemotherapy V58.61 Long-term (current) use of anticoagulants V72.6 Laboratory examination 042 HIV disease 054.40 Herpes simplex with unspecified ophthalmic complication 054.41 Herpes simplex dermatitis of eyelid 054.42 Dendritic keratitis 054.43 Herpes simplex disciform keratitis 054.44 Herpes simplex iridocyclitis 054.49 Herpes simplex with ophthalmic complications, other 070.0 Viral hepatitis A with hepatic coma 070.1 Viral hepatitis A without mention of hepatic coma 070.20 Viral hepatitis B with hepatic coma; acute or unspecified, without mention of hepatitis delta 070.21 Viral hepatitis B with hepatic coma; acute or unspecified with hepatitis delta 070.30 Viral hepatitis B without mention of hepatic coma; acute or unspecified, without mention of hepatitis delta
070.31 Viral hepatitis B without mention of hepatic coma; acute or unspecified with hepatitis delta 070.41 Acute hepatitis C with hepatic coma 070.42 Hepatitis delta without mention of active hepatitis B disease with hepatic coma 070.43 Hepatitis E with hepatic coma 070.44 Chronic hepatitis C with hepatic coma 070.49 Other specified viral hepatitis with hepatic coma 070.51 Acute hepatitis C without mention of hepatic coma 140.0 Malignant Neoplasms through 208.91 250.10 Diabetes with ketoacidosis; type II or unspecified type, not stated as uncontrolled 250.11 Diabetes with ketoacidosis; type I (juvenile type), not stated as uncontrolled 250.12 Diabetes with ketoacidosis; type II or unspecified type, uncontrolled 250.13 Diabetes with ketoacidosis; type I (juvenile type), uncontrolled 250.20 Diabetes with hyperosmolarity; type II or unspecified type, not stated as uncontrolled
250.21 Diabetes with hyperosmolarity; type I (juvenile type), not stated as uncontrolled
10/1/08 1 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 250.22 Diabetes with hyperosmolarity; type II or unspecified type, uncontrolled 250.23 Diabetes with hyperosmolarity; type I (juvenile type), uncontrolled 250.30 Diabetes with other coma; type II or unspecified type, not stated as uncontrolled 250.31 Diabetes with other coma; type I (juvenile type), not stated as uncontrolled 250.32 Diabetes with other coma; type II or unspecified type, uncontrolled 250.33 Diabetes with other coma; type I (juvenile type), uncontrolled 250.60 Diabetes with neurological manifestations; type II or unspecified type, not stated as uncontrolled 250.61 Diabetes with neurological manifestations; type I (juvenile type), not stated as uncontrolled 250.62 Diabetes with neurological manifestations; type II or unspecified type, uncontrolled 250.63 Diabetes with neurological manifestations; type I (juvenile type), uncontrolled 250.70 Diabetes with peripheral cirulatory disorders; type II or unspecified type, not stated as uncontrolled 250.71 Diabetes with peripheral cirulatory disorders; type I (juvenile type), not stated as uncontrolled 250.72 Diabetes with peripheral cirulatory disorders; type II or unspecified type, uncontrolled 250.73 Diabetes with peripheral cirulatory disorders; type I (juvenile type), uncontrolled 277.00 Cystic fibrosis without mention of meconium ileus 277.01 Cystic fibrosis with meconium ileus 277.02 Cystic fibrosis with pulmonary manifestations 277.03 Cystic fibrosis with gastrointestinal manifestations 282.41 Sickle-cell thalassemia without crisis 282.42 Sickle-cell thalassemia with crisis 282.49 Other thalassemia 282.60 Sickle-cell disease, unspecified 282.61 Hb-SS disease without crisis 282.62 Hb-SS disease with crisis 282.63 Sickle-cell/Hb-C disease without crisis 282.64 Sickle-cell/Hb-C disease with crisis 282.68 Other sickle-cell disease without crisis 282.69 Other sickle-cell disease with crisis 286.0 Congenital factor VIII disorder 286.1 Congenital factor IX disorder 286.2 Congenital factor XI deficiency 286.3 Congenital deficiency of other clotting factors 286.4 von Willebrand's disease 286.5 Hemorrhagic disease due to intrinsic circulating anticoagulants 286.6 Defibrination syndrome 286.7 Acquired coagulation factor deficiency 295.01 Schizophrenic disorders, simple type; subchronic 295.02 Schizophrenic disorders, simple type; chronic 295.03 Schizophrenic disorders, simple type; subchronic with acute exacerabation 295.04 Schizophrenic disorders, simple type; chronic with acute exacerbation 295.11 Schizophrenic disorders, disorganized type; subchronic 295.12 Schizophrenic disorders, disorganized type; chronic 295.13 Schizophrenic disorders, disorganized type subchronic with acute exacerbation 295.14 Schizophrenic disorders, disorganized type; chronic with acute exacerbation 295.21 Schizophrenic disorders, catatonic type; subchronic 295.22 Schizophrenic disorders, catatonic type; chronic 295.23 Schizophrenic disorders, catatonic type subchronic with acute exacerbation 295.24 Schizophrenic disorders, catatonic type; chronic with acute exacerbation 295.31 Schizophrenic disorders, paranoid type; subchronic 295.32 Schizophrenic disorders, paranoid type; chronic 295.33 Schizophrenic disorders, paranoid type subchronic with acute exacerbation 295.34 Schizophrenic disorders, paranoid type; chronic with acute exacerbation 295.41 Schizophreniform disorder; subchronic
10/1/08 2 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 295.42 Schizophreniform disorder; chronic 295.43 Schizophreniform disorder; subchronic with acute exacerbation 295.44 Schizophreniform disorder; chronic with acute exacerbation 295.51 Latent Schizophrenia; subchronic 295.52 Latent Schizophrenia; chronic 295.53 Latent Schizophrenia; subchronic with acute exacerbation 295.54 Latent Schizophrenia; chronic with acute exacerbation 295.61 Schizophrenic disorders, residual type; subchronic 295.62 Schizophrenic disorders, residual type; chronic 295.63 Schizophrenic disorders, residual type; subchronic with acute exacerbation 295.64 Schizophrenic disorders, residual type; chronic with acute exacerbation 295.71 Schizoaffective disorder; subchronic 295.72 Schizoaffective disorder; chronic 295.73 Schizoaffective disorder; subchronic with acute exacerbation 295.74 Schizoaffective disorder; chronic with acute exacerbation 295.81 Other specified types of schizophrenia; subchronic 295.82 Other specified types of schizophrenia; chronic 295.83 Other specified types of schizophrenia; subchronic with acute exacerbation 295.84 Other specified types of schizophrenia; chronic with acute exacerbation 295.91 Unspecified schizophrenia; subchronic 295.92 Unspecified schizophrenia; chronic 295.93 Unspecified schizophrenia; subchronic with acute exacerbation 295.94 Unspecified schizophrenia; chronic with acute exacerbation 296.03 Bipolar I disorder, single manic episode; severe, without mention of psychotic behavior 296.04 Bipolar I disorder, single manic episode; severe, specified as with psychotic behavior 296.13 Manic disorder, recurrent episode; severe, without mention of psychotic behavior 296.14 Manic disorder, recurrent episode; severe, specified as with psychotic behavior 296.23 Major depressive disorder, single episode; severe, without mention of psychotic behavior 296.24 Major depressive disorder, single episode; severe, specified as with psychotic behavior 296.33 Major depressive disorder, recurrent episode; severe, without mention of psychotic behavior 296.34 Major depressive disorder, recurrent episode; severe, specified as with psychotic behavior 296.43 Bipolar I disorder, most recent episode (or current) manic; severe, without mention of psychotic behavior
296.44 Bipolar I disorder, most recent episode (or current) manic; severe, specified as with psychotic behavior
296.53 Bipolar I disorder, most recent episode (or current) depressed; severe, without mention of psychotic behavior 296.54 Bipolar I disorder, most recent episode (or current) depressed; severe, specified as with psychotic behavior 296.63 Bipolar I disorder, most recent episode (or current) mixed; severe, without mention of psychotic behavior
296.64 Bipolar I disorder, most recent episode (or current) mixed; severe, specified as with psychotic behavior
356.1 Peroneal muscular atrophy 356.8 Other specified idiopathic peripheral neuropathy 357.2 Polyneuropathy in diabetes 361.00 Retinal detachment with retinal defect, unspecified 361.01 Retinal detachment with retinal defect, recent detachment, partial, with single defect 361.02 Retinal detachment with retinal defect, recent detachment, partial, with multiple defects 361.03 Retinal detachment with retinal defect, recent detachment, partial, with giant tear 361.04 Retinal detachment with retinal defect, recent detachment, partial, with retinal dialysis 361.05 Retinal detachment with retinal defect, recent detachment, total or subtotal 361.06 Retinal detachment with retinal defect, old detachment, partial
10/1/08 3 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 361.07 Retinal detachment with retinal defect, old detachment, total or subtotal 361.31 Round hole of retina without detachment 362.01 Background diabetic retinopathy 362.02 Proliferative diabetic retinopathy 362.03 Nonproliferative diabetic retinopathy NOS 362.04 Mild nonproliferative diabetic retinopathy 362.05 Moderate nonproliferative diabetic retinopathy 362.06 Severe nonproliferative diabetic retinopathy 362.07 Diabetic macular edema 362.11 Hypertensive retinopathy 362.32 Retinal vascular occlusion, arterial branch occlusion 362.35 Central retinal vein occlusion 362.41 Central serous retinopathy 362.50 Macular degeneration (senile), unspecified 362.51 Nonexudative senile macular degeneration 362.52 Exudative senile macular degeneration 362.53 Cystoid macular degeneration 362.54 Macular cyst, hole, or pseudohole 362.55 Toxic maculopathy 362.56 Macular puckering 364.10 Chronic iridocyclitis, unspecified 364.11 Chronic iridocyclitis in diseases classified elsewhere 364.21 Fuchs' heterochromic cyclitis 364.22 Glaucomatocyclitic crises 364.23 Lens-induced iridocyclitis 364.24 Vogt-Koyanagi syndrome 364.3 Unspecified iridocyclitis 364.41 Hyphema 365.10 Open-angle glaucoma, unspecified 365.11 Primary open angle glaucoma 365.12 Low tension glaucoma 365.13 Pigmentary glaucoma 365.14 Glaucoma of childhood 365.15 Residual stage of open angle glaucoma 365.20 Primary angle-closure glaucoma, unspecified 365.21 Intermittent angle-closure glaucoma 365.22 Acute angle-closure glaucoma 368.2 Diplopia 370.00 Corneal ulcer, unspecified 370.01 Marginal corneal ulcer 370.02 Ring corneal ulcer 370.03 Central corneal ulcer 370.04 Hypopyon ulcer 370.05 Mycotic corneal ulcer 370.06 Perforated corneal ulcer 370.07 Mooren's ulcer 371.02 Peripheral opacity of cornea 371.03 Central opacity of cornea 371.42 Recurrent erosion of cornea 371.62 Keratoconus, acute hydrops 374.00 Entropion, unspecified 374.01 Senile entropion 374.02 Mechanical entropion
10/1/08 4 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 374.03 Spastic entropion 374.04 Cicatrical entropion 374.05 Trichiasis without entropioin 377.00 Papilledema, unspecified 377.01 Papilledema associated with increased intracranial pressure 377.02 Papilledema associated with decreased ocular pressure 377.03 Papilledema associated with retinal disorder 377.04 Foster-Kennedy Syndrome 377.30 Optic neuritis, unspecified 377.31 Optic papillitis 377.32 Retrobulbar neuritis (acute) 379.01 Episcleritis periodica fugax 379.02 Nodular episcleritis 379.03 Anterior scleritis 379.04 Scleromalacia perforans 379.05 Scleritis with corneal involvement 379.06 Brawny scleritis 379.07 Posterior scleritis 379.21 Vitreous degeneration 379.23 Vitreous hemorrhage 401.0 Malignant hypertension 410.00 Acute myocardial infarction of anterolateral wall; episode of care unspecified 410.01 Acute myocardial infarction of anterolateral wall; initial episode of care 410.02 Acute myocardial infarction of anterolateral wall; subsequent episode of care 410.10 Acute myocardial infarction of other anterior wall; episode of care unspecified 410.11 Acute myocardial infarction of other anterior wall; initial episode of care 410.12 Acute myocardial infarction of other anterior wall; subsequent episode of care 410.20 Acute myocardial infarction of inferolateral wall; episode of care unspecified 410.21 Acute myocardial infarction of inferolateral wall; initial episode of care 410.22 Acute myocardial infarction of inferolateral wall; subsequent episode of care 410.30 Acute myocardial infarction of inferoposterior wall; episode of care unspecified 410.31 Acute myocardial infarction of inferoposterior wall; initial episode of care 410.32 Acute myocardial infarction of inferoposterior wall; subsequent episode of care 410.40 Acute myocardial infarction of other inferior wall; episode of care unspecified 410.41 Acute myocardial infarction of other inferior wall; initial episode of care 410.42 Acute myocardial infarction of other inferior wall; subsequent episode of care 410.50 Acute myocardial infarction of other lateral wall; episode of care unspecified 410.51 Acute myocardial infarction of other lateral wall; initial episode of care 410.52 Acute myocardial infarction of other lateral wall; subsequent episode of care 410.60 True posterior wall infarction; episode of care unspecified 410.61 True posterior wall infarction; initial episode of care 410.62 True posterior wall infarction; subsequent episode of care 410.70 Subendocardial infarction; episode of care unspecified 410.71 Subendocardial infarction; initial episode of care 410.72 Subendocardial infarction; subsequent episode of care 410.80 Acute myocardial infarction of other specified sites; episode of care unspecified 410.81 Acute myocardial infarction of other specified sites; initial episode of care 410.82 Acute myocardial infarction of other specified sites; subsequent episode of care 410.90 Acute myocardial infarction of unspecified site; episode of care unspecified 410.91 Acute myocardial infarction of unspecified site; initial episode of care 410.92 Acute myocardial infarction of unspecified site; subsequent episode of care 415.0 Acute cor pulmonale 415.11 Iatrogenic Pulmonary embolism and infarction
10/1/08 5 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 415.19 Other pulmonary embolism and infarction 428.0 Heart failure through 428.9 430 Subarachnoid hemorrhage 431 Intracerebral hemorrhage 432.0 Nontraumatic extradural hemorrhage 432.1 Subdural hemorrhage 432.9 Unspecified intracranial hemorrhage 454.0 Varicose veins of lower extremities with ulcer 454.2 Varicose veins of lower extremities with ulcer and inflammation 493.01 Extrinsic asthma with status asthmaticus 493.11 Intrinsic asthma with status asthmaticus 493.21 Chronic obstructive asthma with status asthmaticus 493.91 Asthma, unspecified with status asthmaticus 518.81 Acute respiratory failure 518.82 Other pulmonary insufficiency, not elsewhere classified 518.83 Chronic respiratory failure 518.84 Acute and chronic respiratory failure 570 Acute and subacute necrosis of liver 571.1 Acute alcoholic hepatitis 572.2 Hepatic coma 577.0 Acute pancreatitis 582.0 Chronic glomerulonephritis with lesion of proliferative glomerulonephritis 582.1 Chronic glomerulonephritis with lesion of membranous glomerulonephritis 582.2 Chronic glomerulonephritis with lesion of membranoproliferative glomerulonephritis 582.4 Chronic glomerulonephritis with lesion of rapidly progressive glomerulonephritis 582.81 Chronic glomerulonephritis in diseases classified elsewhere 582.89 Chronic glomerulonephritis with other specified pathological lesion in kidney, other 582.9 Chronic glomerulonephritis with unspecified pathological lesion in kidney 584.5 Acute renal failure with lesion of tubular necrosis 584.6 Acute renal failure with lesion of renal cortical necrosis 584.7 Acute renal failure with lesion of renal medullary [papillary] necrosis 584.8 Acute renal failure with other specified pathological lesion in kidney 584.9 Acute renal failure, unspecified 585.5 Chronic kidney disease, Stage IV (severe) 585.6 End stage renal disease 586 Renal failure, unspecified 642.00 Benign essential hypertension complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care or not applicable 642.01 Benign essential hypertension complicating pregnancy, childbirth, and the puerperium; delivered, with or without mention of antepartum conditions 642.02 Benign essential hypertension complicating pregnancy, childbirth, and the puerperium; delivered, with mention of postpartum complication 642.03 Benign essential hypertension complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication 642.04 Benign essential hypertension complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication 642.10 Hypertension secondary to renal disease, complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care or not applicable 642.11 Hypertension secondary to renal disease, complicating pregnancy, childbirth, and the puerperium; delivered, with or without mention of antepartum conditions
10/1/08 6 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 642.12 Hypertension secondary to renal disease, complicating pregnancy, childbirth, and the puerperium; delivered, with mention of postpartum complication 642.13 Hypertension secondary to renal disease, complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication 642.14 Hypertension secondary to renal disease, complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication 642.20 Other pre-existing hypertension complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care or not applicable 642.21 Other pre-existing hypertension complicating pregnancy, childbirth, and the puerperium; delivered, with or without mention of antepartum conditions 642.22 Other pre-existing hypertension complicating pregnancy, childbirth, and the puerperium; delivered, with mention of postpartum complication 642.23 Other pre-existing hypertension complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication 642.24 Other pre-existing hypertension complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication 642.30 Transient hypertension of pregnancy; unspecified as to episode of care or not applicable 642.31 Transient hypertension of pregnancy; delivered, with or without mention of antepartum conditions 642.32 Transient hypertension of pregnancy; delivered, with mention of postpartum complication 642.33 Transient hypertension of pregnancy; antepartum condition or complication 642.34 Transient hypertension of pregnancy; postpartum condition or complication 642.40 Mild or unspecified pre-eclampsia; unspecified as to episode of care or not applicable 642.41 Mild or unspecified pre-eclampsia; delivered, with or without mention of antepartum conditions 642.42 Mild or unspecified pre-eclampsia; delivered, with mention of postpartum complication 642.43 Mild or unspecified pre-eclampsia; antepartum condition or complication 642.44 Mild or unspecified pre-eclampsia; postpartum condition or complication 642.50 Severe pre-eclampsia; unspecified as to episode of care or not applicable 642.51 Severe pre-eclampsia; delivered, with or without mention of antepartum conditions 642.52 Severe pre-eclampsia; delivered, with mention of postpartum complication 642.53 Severe pre-eclampsia; antepartum condition or complication 642.54 Severe pre-eclampsia; postpartum condition or complication 642.60 Eclampsia; unspecified as to episode of care or not applicable 642.61 Eclampsia; delivered, with or without mention of antepartum conditions 642.62 Eclampsia; delivered, with mention of postpartum complication 642.63 Eclampsia; antepartum condition or complication 642.64 Eclampsia; postpartum condition or complication 642.70 Pre-eclampsia or eclampsia superimposed on pre-exisitng hypertension; unspecified as to episode of care or not applicable 642.71 Pre-eclampsia or eclampsia superimposed on pre-exisitng hypertension; delivered, with or without mention of antepartum conditions 642.72 Pre-eclampsia or eclampsia superimposed on pre-exisitng hypertension; delivered, with mention of postpartum complication 642.73 Pre-eclampsia or eclampsia superimposed on pre-exisitng hypertension; antepartum condition or complication 642.74 Pre-eclampsia or eclampsia superimposed on pre-exisitng hypertension; postpartum condition or complication 642.90 Unspecified hypertension complicating pregnancy, childbirth, or the puerperium; unspecified as to episode of care or not applicable 642.91 Unspecified hypertension complicating pregnancy, childbirth, or the puerperium; delivered, with or without mention of antepartum conditions 642.92 Unspecified hypertension complicating pregnancy, childbirth, or the puerperium; delivered, with mention of postpartum complication
10/1/08 7 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 642.93 Unspecified hypertension complicating pregnancy, childbirth, or the puerperium; antepartum condition or complication 642.94 Unspecified hypertension complicating pregnancy, childbirth, or the puerperium; postpartum condition or complication 643.00 Mild hyperemesis gravidarum; unspecified as to episode of care or not applicable 643.01 Mild hyperemesis gravidarum; delivered, with or without mention of antepartum conditions 643.03 Mild hyperemesis gravidarum; antepartum condition or complication 643.10 Hyperemesis gravidarum with metabolic disturbance; unspecified as to episode of care or not applicable
643.11 Hyperemesis gravidarum with metabolic disturbance; delivered, with or without mention of antepartum conditions 643.13 Hyperemesis gravidarum with metabolic disturbancem; antepartum condition or complication 643.20 Late vomiting of pregnancy; unspecified as to episode of care or not applicable 643.21 Late vomiting of pregnancy; delivered, with or without mention of antepartum conditions 643.23 Late vomiting of pregnancy; antepartum condition or complication 643.80 Other vomiting of pregnancy; unspecified as to episode of care or not applicable 643.81 Other vomiting of pregnancy; delivered, with or without mention of antepartum conditions 643.83 Other vomiting of pregnancy; antepartum condition or complication 643.90 Unspecified vomiting of pregnancy; unspecified as to episode of care or not applicable 643.91 Unspecified vomiting of pregnancy; delivered, with or without mention of antepartum conditions 643.93 Unspecified vomiting of pregnancy; antepartum condition or complication 644.00 Threatened premature labor; unspecified as to episode of care or not applicable 644.03 Threatened premature labor; antepartum condition or complication 644.10 Other threatened labor; unspecified as to episode of care or not applicable 644.13 Other threatened labor; antepartum condition or complication 644.20 Early onset of delivery; unspecified as to episode of care or not applicable 644.21 Early onset of delivery; delivered, with or without mention of antepartum conditions 645.10 Post term pregnancy; unspecified as to episode of care or not applicable 645.11 Post term pregnancy; delivered, with or without mention of antepartum conditions 645.13 Post term pregnancy; antepartum condition or complication 645.20 Prolonged pregnancy; unspecified as to episode of care or not applicable 645.21 Prolonged pregnancy; delivered, with or without mention of antepartum conditions 645.23 Prolonged pregnancy; antepartum condition or complication 646.00 Papyraceous fetus; unspecified as to episode of care or not applicable 646.01 Papyraceous fetus; delivered, with or without mention of antepartum conditions 646.03 Papyraceous fetus; antepartum condition or complication 646.10 Edema or excessive weight gain in pregnancy without mention of hypertension; unspecified as to episode of care or not applicable 646.11 Edema or excessive weight gain in pregnancy without mention of hypertension; delivered, with or without mention of antepartum conditions 646.12 Edema or excessive weight gain in pregnancy without mention of hypertension; delivered, with mention of postpartum complication 646.13 Edema or excessive weight gain in pregnancy without mention of hypertension; antepartum condition or complication 646.14 Edema or excessive weight gain in pregnancy without mention of hypertension; postpartum condition or complication 646.20 Unspecified renal disease in pregnancy, without mention of hypertension; unspecified as to episode of care or not applicable 646.21 Unspecified renal disease in pregnancy, without mention of hypertension; delivered, with or without mention of antepartum conditions 646.22 Unspecified renal disease in pregnancy, without mention of hypertension; delivered, with mention of postpartum complication
10/1/08 8 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 646.23 Unspecified renal disease in pregnancy, without mention of hypertension; antepartum condition or complication 646.24 Unspecified renal disease in pregnancy, without mention of hypertension; postpartum condition or complication 646.30 Habitual aborter; unspecified as to episode of care or not applicable 646.31 Habitual aborter; delivered, with or without mention of antepartum conditions 646.33 Habitual aborter; antepartum condition or complication 646.40 Peripheral neuritis in pregnancy; unspecified as to episode of care or not applicable 646.41 Peripheral neuritis in pregnancy; delivered, with or without mention of antepartum conditions 646.42 Peripheral neuritis in pregnancy; delivered, with mention of postpartum complication 646.43 Peripheral neuritis in pregnancy; antepartum condition or complication 646.44 Peripheral neuritis in pregnancy; postpartum condition or complication 646.50 Asymptomatic bacteriuria in pregnancy; unspecified as to episode of care or not applicable 646.51 Asymptomatic bacteriuria in pregnancy; delivered, with or without mention of antepartum conditions 646.52 Asymptomatic bacteriuria in pregnancy; delivered, with mention of postpartum complication 646.53 Asymptomatic bacteriuria in pregnancy; antepartum condition or complication 646.54 Asymptomatic bacteriuria in pregnancy; postpartum condition or complication 646.60 Infections of genitourinary tract in pregnancy; unspecified as to episode of care or not applicable 646.61 Infections of genitourinary tract in pregnancy; delivered, with or without mention of antepartum conditions
646.62 Infections of genitourinary tract in pregnancy; delivered, with mention of postpartum complication 646.63 Infections of genitourinary tract in pregnancy; antepartum condition or complication 646.64 Asymptomatic bacteriuria in pregnancy; postpartum condition or complication 646.70 Liver disorders in pregnancy; unspecified as to episode of care or not applicable 646.71 Liver disorders in pregnancy; delivered, with or without mention of antepartum conditions 646.73 Liver disorders in pregnancy; antepartum condition or complication 646.80 Other specified complications of pregnancy; unspecified as to episode of care or not applicable 646.81 Other specified complications of pregnancy; delivered, with or without mention of antepartum conditions
646.82 Other specified complications of pregnancy; delivered, with mention of postpartum complication 646.83 Other specified complications of pregnancy; antepartum condition or complication 646.84 Other specified complications of pregnancy; postpartum condition or complication 646.90 Unspecified complication of pregnancy; unspecified as to episode of care or not applicable 646.91 Unspecified complication of pregnancy; delivered, with or without mention of antepartum conditions 646.93 Unspecified complication of pregnancy; antepartum condition or complication 647.00 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - syphilis; unspecified as to episode of care or not applicable
647.01 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - syphilis; delivered, with or without mention of antepartum conditions
647.02 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - syphilis; delivered, with mention of postpartum complication
647.03 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - syphilis; antepartum condition or complication 647.04 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - syphilis; postpartum condition or complication 647.10 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - gonorrhea; unspecified as to episode of care or not applicable
10/1/08 9 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 647.11 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - gonorrhea; delivered, with or without mention of antepartum conditions
647.12 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - gonorrhea; delivered, with mention of postpartum complication
647.13 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - gonorrhea; antepartum condition or complication 647.14 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - gonorrhea; postpartum condition or complication 647.20 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other venereal diseases; unspecified as to episode of care or not applicable
647.21 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other venereal diseases; delivered, with or without mention of antepartum conditions 647.22 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other venereal diseases; delivered, with mention of postpartum complication
647.23 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other venereal diseases; antepartum condition or complication
647.24 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other venereal diseases; postpartum condition or complication
647.30 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - tuberculosis; unspecified as to episode of care or not applicable
647.31 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - tuberculosis; delivered, with or without mention of antepartum conditions
647.32 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - tuberculosis; delivered, with mention of postpartum complication
647.33 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - tuberculosis; antepartum condition or complication 647.34 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - tuberculosis; postpartum condition or complication 647.40 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - malaria; unspecified as to episode of care or not applicable
647.41 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - malaria; delivered, with or without mention of antepartum conditions
647.42 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - malaria; delivered, with mention of postpartum complication
647.43 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - malaria; antepartum condition or complication 647.44 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - malaria; postpartum condition or complication
10/1/08 10 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 647.50 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - rubella; unspecified as to episode of care or not applicable
647.51 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - rubella; delivered, with or without mention of antepartum conditions
647.52 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - rubella; delivered, with mention of postpartum complication
647.53 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - rubella; antepartum condition or complication 647.54 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - rubella; postpartum condition or complication 647.60 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other viral diseases; unspecified as to episode of care or not applicable
647.61 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other viral diseases; delivered, with or without mention of antepartum conditions 647.62 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other viral diseases; delivered, with mention of postpartum complication
647.63 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other viral diseases; antepartum condition or complication 647.64 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other viral diseases; postpartum condition or complication 647.80 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other specified infectionsand parasitic diseases; unspecified as to episode of care or not applicable 647.81 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other specified infectionsand parasitic diseases; delivered, with or without mention of antepartum conditions 647.82 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other specified infectionsand parasitic diseases; delivered, with mention of postpartum complication 647.83 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other specified infectionsand parasitic diseases; antepartum condition or complication 647.84 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other specified infectionsand parasitic diseases; postpartum condition or complication 647.90 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - unspecified infection or infestation; unspecified as to episode of care or not applicable 647.91 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - unspecified infection or infestation; delivered, with or without mention of antepartum conditions 647.92 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - unspecified infection or infestation; delivered, with mention of postpartum complication 647.93 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - unspecified infection or infestation; antepartum condition or complication
10/1/08 11 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 647.94 Infectious and parasitic conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - unspecified infection or infestation; postpartum condition or complication
648.00 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - diabetes mellitus; unspecified as to episode of care or not applicable 648.01 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - diabetes mellitus; delivered, with or without mention of antepartum conditions
648.02 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - diabetes mellitus; delivered, with mention of postpartum complication 648.03 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - diabetes mellitus; antepartum condition or complication 648.04 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - diabetes mellitus; postpartum condition or complication 648.10 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - thyroid dysfunction; unspecified as to episode of care or not applicable
648.11 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - thyroid dysfunction; delivered, with or without mention of antepartum conditions
648.12 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - thyroid dysfunction; delivered, with mention of postpartum complication
648.13 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - thyroid dysfunction; antepartum condition or complication 648.14 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - thyroid dysfunction; postpartum condition or complication 648.20 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - anemia; unspecified as to episode of care or not applicable 648.21 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - anemia; delivered, with or without mention of antepartum conditions 648.22 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - anemia; delivered, with mention of postpartum complication 648.23 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - anemia; antepartum condition or complication 648.24 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - anemia; postpartum condition or complication 648.30 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - drug dependence; unspecified as to episode of care or not applicable 648.31 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - drug dependence; delivered, with or without mention of antepartum conditions
648.32 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - drug dependence; delivered, with mention of postpartum complication 648.33 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - drug dependence; antepartum condition or complication 648.34 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - drug dependence; postpartum condition or complication 648.40 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - mental disorders; unspecified as to episode of care or not applicable 648.41 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - mental disorders; delivered, with or without mention of antepartum conditions
10/1/08 12 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 648.42 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - mental disorders; delivered, with mention of postpartum complication 648.43 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - mental disorders; antepartum condition or complication 648.44 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - mental disorders; postpartum condition or complication 648.50 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - congenital cardiovascular disorders; unspecified as to episode of care or not applicable
648.51 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - congenital cardiovascular disorders; delivered, with or without mention of antepartum conditions 648.52 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - congenital cardiovascular disorders; delivered, with mention of postpartum complication
648.53 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - congenital cardiovascular disorders; antepartum condition or complication
648.54 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - congenital cardiovascular disorders; postpartum condition or complication
648.60 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other cardiovascular diseases; unspecified as to episode of care or not applicable
648.61 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other cardiovascular diseases; delivered, with or without mention of antepartum conditions
648.62 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other cardiovascular diseases; delivered, with mention of postpartum complication
648.63 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other cardiovascular diseases; antepartum condition or complication 648.64 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - congenital cardiovascular disorders; postpartum condition or complication
648.70 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - bone and joint disorders of back, pelvis, and lower limbs; unspecified as to episode of care or not applicable 648.71 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - bone and joint disorders of back, pelvis, and lower limbs; delivered, with or without mention of antepartum conditions 648.72 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - bone and joint disorders of back, pelvis, and lower limbs; delivered, with mention of postpartum complication 648.73 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - bone and joint disorders of back, pelvis, and lower limbs; antepartum condition or complication 648.74 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - bone and joint disorders of back, pelvis, and lower limbs; postpartum condition or complication 648.80 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - abnormal glucose tolerance; unspecified as to episode of care or not applicable
10/1/08 13 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 648.81 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - abnormal glucose tolerance; delivered, with or without mention of antepartum conditions
648.82 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - abnormal glucose tolerance; delivered, with mention of postpartum complication
648.83 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - abnormal glucose tolerance; antepartum condition or complication 648.84 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - abnormal glucose tolerance; postpartum condition or complication 648.90 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other current conditions classifiable elsewhere; unspecified as to episode of care or not applicable 648.91 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other current conditions classifiable elsewhere; delivered, with or without mention of antepartum conditions 648.92 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other current conditions classifiable elsewhere; delivered, with mention of postpartum complication 648.93 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other current conditions classifiable elsewhere; antepartum condition or complication
648.94 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium - other current conditions classifiable elsewhere; postpartum condition or complication
649.00 Tobacco use disorder complicating pregnancy, childbirth, or the puerperium; unspecified as to episode of care or not applicable 649.01 Tobacco use disorder complicating pregnancy, childbirth, or the puerperium; delivered, with or without mention of antepartum conditions 649.02 Tobacco use disorder complicating pregnancy, childbirth, or the puerperium; delivered, with mention of postpartum complication 649.03 Tobacco use disorder complicating pregnancy, childbirth, or the puerperium; antepartum condition or complication 649.04 Tobacco use disorder complicating pregnancy, childbirth, or the puerperium; postpartum condition or complication 649.10 Obesity complicating pregnancy, childbirth, or the puerperium; unspecified as to episode of care or not applicable 649.11 Obesity complicating pregnancy, childbirth, or the puerperium; delivered, with or without mention of antepartum conditions 649.12 Obesity complicating pregnancy, childbirth, or the puerperium; delivered, with mention of postpartum complication 649.13 Obesity complicating pregnancy, childbirth, or the puerperium; antepartum condition or complication
649.14 Obesity complicating pregnancy, childbirth, or the puerperium; postpartum condition or complication
649.20 Bariatric surgery status complicating pregnancy, childbirth, or the puerperium; unspecified as to episode of care or not applicable 649.21 Bariatric surgery status complicating pregnancy, childbirth, or the puerperium; delivered, with or without mention of antepartum conditions 649.22 Bariatric surgery status complicating pregnancy, childbirth, or the puerperium; delivered, with mention of postpartum complication 649.23 Bariatric surgery status complicating pregnancy, childbirth, or the puerperium; antepartum condition or complication
10/1/08 14 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 649.24 Bariatric surgery status complicating pregnancy, childbirth, or the puerperium; postpartum condition or complication 649.30 Coagulation defects complicating pregnancy, childbirth, or the puerperium; unspecified as to episode of care or not applicable 649.31 Coagulation defects complicating pregnancy, childbirth, or the puerperium; delivered, with or without mention of antepartum conditions 649.32 Coagulation defects complicating pregnancy, childbirth, or the puerperium; delivered, with mention of postpartum complication 649.33 Coagulation defects complicating pregnancy, childbirth, or the puerperium; antepartum condition or complication 649.34 Coagulation defects complicating pregnancy, childbirth, or the puerperium; postpartum condition or complication 649.40 Epilepsy complicating pregnancy, childbirth, or the puerperium; unspecified as to episode of care or not applicable 649.41 Epilepsy complicating pregnancy, childbirth, or the puerperium; delivered, with or without mention of antepartum conditions 649.42 Epilepsy complicating pregnancy, childbirth, or the puerperium; delivered, with mention of postpartum complication 649.43 Epilepsy complicating pregnancy, childbirth, or the puerperium; antepartum condition or complication
649.44 Epilepsy complicating pregnancy, childbirth, or the puerperium; postpartum condition or complication
649.50 Spotting complicating pregnancy; unspecified as to episode of care or not applicable 649.51 Spotting complicating pregnancy; delivered, with or without mention of antepartum conditions 649.53 Spotting complicating pregnancy; antepartum condition or complication 649.60 Uterine size date discrepancy; unspecified as to episode of care or not applicable 649.61 Uterine size date discrepancy; delivered, with or without mention of antepartum conditions 649.62 Uterine size date discrepancy; delivered, with mention of postpartum complication 649.63 Uterine size date discrepancy; antepartum condition or complication 649.64 Uterine size date discrepancy; postpartum condition or complication 650 Normal delivery 651.00 Twin pregnancy; unspecified as to episode of care or not applicable 651.01 Twin pregnancy; delivered, with or without mention of antepartum conditions 651.03 Twin pregnancy; antepartum condition or complication 651.10 Triplet pregnancy; unspecified as to episode of care or not applicable 651.11 Triplet pregnancy; delivered, with or without mention of antepartum conditions 651.13 Triplet pregnancy; antepartum condition or complication 651.20 Quadruplet pregnancy; unspecified as to episode of care or not applicable 651.21 Quadruplet pregnancy; delivered, with or without mention of antepartum conditions 651.23 Quadruplet pregnancy; antepartum condition or complication 651.30 Twin pregnancy with fetal loss and retention of one fetus; unspecified as to episode of care or not applicable 651.31 Twin pregnancy with fetal loss and retention of one fetus; delivered, with or without mention of antepartum conditions 651.33 Twin pregnancy with fetal loss and retention of one fetus; antepartum condition or complication 651.40 Triplet pregnancy with fetal loss and retention of one or more fetus(es); unspecified as to episode of care or not applicable 651.41 Triplet pregnancy with fetal loss and retention of one or more fetus(es); delivered, with or without mention of antepartum conditions 651.43 Triplet pregnancy with fetal loss and retention of one or more fetus(es); antepartum condition or complication 651.50 Quadruplet pregnancy with fetal loss and retention of one or more fetus(es); unspecified as to episode of care or not applicable
10/1/08 15 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 651.51 Quadruplet pregnancy with fetal loss and retention of one or more fetus(es); delivered, with or without mention of antepartum conditions 651.53 Quadruplet pregnancy with fetal loss and retention of one or more fetus(es); antepartum condition or complication 651.60 Other multiple pregnancy with fetal loss and retention of one or more fetus(es); unspecified as to episode of care or not applicable 651.61 Other multiple pregnancy with fetal loss and retention of one or more fetus(es); delivered, with or without mention of antepartum conditions 651.63 Other multiple pregnancy with fetal loss and retention of one or more fetus(es); antepartum condition or complication 651.70 Multiple gestation following (elective) fetal reduction; unspecified as to episode of care or not applicable
651.71 Multiple gestation following (elective) fetal reduction; delivered, with or without mention of antepartum conditions 651.73 Multiple gestation following (elective) fetal reduction; antepartum condition or complication 651.80 Other specified multiple gestation; unspecified as to episode of care or not applicable 651.81 Other specified multiple gestation; delivered, with or without mention of antepartum conditions 651.83 Other specified multiple gestation; antepartum condition or complication 651.90 Unspecified multiple gestation; unspecified as to episode of care or not applicable 651.91 Unspecified multiple gestation; delivered, with or without mention of antepartum conditions 651.93 Unspecified multiple gestation; antepartum condition or complication 652.00 Unstable lie; unspecified as to episode of care or not applicable 652.01 Unstable lie; delivered, with or without mention of antepartum conditions 652.03 Unstable lie; antepartum condition or complication 652.10 Breech or other malpresentation successfully converted to cephalic presentation; unspecified as to episode of care or not applicable 652.11 Breech or other malpresentation successfully converted to cephalic presentation; delivered, with or without mention of antepartum conditions 652.13 Breech or other malpresentation successfully converted to cephalic presentation; antepartum condition or complication 652.20 Breech presentation without mention of version; unspecified as to episode of care or not applicable 652.21 Breech presentation without mention of version; delivered, with or without mention of antepartum conditions 652.23 Breech presentation without mention of version; antepartum condition or complication 652.30 Transverse or oblique presentation; unspecified as to episode of care or not applicable 652.31 Transverse or oblique presentation; delivered, with or without mention of antepartum conditions 652.33 Transverse or oblique presentation; antepartum condition or complication 652.40 Face or brow presentation; unspecified as to episode of care or not applicable 652.41 Face or brow presentation; delivered, with or without mention of antepartum conditions 652.43 Face or brow presentation; antepartum condition or complication 652.50 High head at term; unspecified as to episode of care or not applicable 652.51 High head at term; delivered, with or without mention of antepartum conditions 652.53 High head at term; delivered, with or without mention of antepartum conditions 652.60 Multiple gestation with malpresentation of one fetus or more; unspecified as to episode of care or not applicable 652.61 Multiple gestation with malpresentation of one fetus or more; delivered, with or without mention of antepartum conditions 652.63 Multiple gestation with malpresentation of one fetus or more; antepartum condition or complication 652.70 Prolapsed arm; unspecified as to episode of care or not applicable; unspecified as to episode of care or not applicable 652.71 Prolapsed arm; unspecified as to episode of care or not applicable; delivered, with or without mention of antepartum conditions
10/1/08 16 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 652.73 Prolapsed arm; unspecified as to episode of care or not applicable; antepartum condition or complication
652.80 Other specified malposition or malpresentation; unspecified as to episode of care or not applicable 652.81 Other specified malposition or malpresentation; delivered, with or without mention of antepartum conditions 652.83 Other specified malposition or malpresentation; antepartum condition or complication 652.90 Unspecified malposition or malpresentation; unspecified as to episode of care or not applicable 652.91 Unspecified malposition or malpresentation; delivered, with or without mention of antepartum conditions
652.93 Unspecified malposition or malpresentation; antepartum condition or complication 653.00 Major abnormality of bony pelvis, not further specified; unspecified as to episode of care or not applicable
653.01 Major abnormality of bony pelvis, not further specified; delivered, with or without mention of antepartum conditions 653.03 Major abnormality of bony pelvis, not further specified; antepartum condition or complication 653.10 Generally contracted pelvis; unspecified as to episode of care or not applicable 653.11 Generally contracted pelvis; delivered, with or without mention of antepartum conditions 653.13 Generally contracted pelvis; antepartum condition or complication 653.20 Inlet contraction of pelvis; unspecified as to episode of care or not applicable 653.21 Inlet contraction of pelvis; delivered, with or without mention of antepartum conditions 653.23 Inlet contraction of pelvis; antepartum condition or complication 653.30 Outlet contraction of pelvis; unspecified as to episode of care or not applicable 653.31 Outlet contraction of pelvis; delivered, with or without mention of antepartum conditions 653.33 Outlet contraction of pelvis; antepartum condition or complication 653.40 Fetopelvic disproportion; unspecified as to episode of care or not applicable 653.41 Fetopelvic disproportion; delivered, with or without mention of antepartum conditions 653.43 Fetopelvic disproportion; antepartum condition or complication 653.50 Unusually large fetus causing disproportion; unspecified as to episode of care or not applicable 653.51 Unusually large fetus causing disproportion; delivered, with or without mention of antepartum conditions
653.53 Unusually large fetus causing disproportion; antepartum condition or complication 653.60 Hydrocephalic fetus causing disproportion; unspecified as to episode of care or not applicable 653.61 Hydrocephalic fetus causing disproportion; delivered, with or without mention of antepartum conditions
653.63 Hydrocephalic fetus causing disproportion; antepartum condition or complication 653.70 Other fetal abnormality causing disproportion; unspecified as to episode of care or not applicable 653.71 Other fetal abnormality causing disproportion; delivered, with or without mention of antepartum conditions
653.73 Other fetal abnormality causing disproportion; antepartum condition or complication 653.80 Disproportion of other origin; unspecified as to episode of care or not applicable 653.81 Disproportion of other origin; delivered, with or without mention of antepartum conditions 653.83 Disproportion of other origin; antepartum condition or complication 653.90 Unspecified disproportion; unspecified as to episode of care or not applicable 653.91 Unspecified disproportion; delivered, with or without mention of antepartum conditions 653.93 Unspecified disproportion; antepartum condition or complication 654.00 Congenital abnormalities of uterus; unspecified as to episode of care or not applicable 654.01 Congenital abnormalities of uterus; delivered, with or without mention of antepartum conditions 654.02 Congenital abnormalities of uterus; delivered, with mention of postpartum complication 654.03 Congenital abnormalities of uterus; antepartum condition or complication 654.04 Congenital abnormalities of uterus; postpartum condition or complication 654.10 Tumors of body of uterus; unspecified as to episode of care or not applicable 654.11 Tumors of body of uterus; delivered, with or without mention of antepartum conditions 654.12 Tumors of body of uterus; delivered, with mention of postpartum complication
10/1/08 17 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 654.13 Tumors of body of uterus; antepartum condition or complication 654.14 Tumors of body of uterus; postpartum condition or complication 654.20 Previous cesarean section; unspecified as to episode of care or not applicable 654.21 Previous cesarean section; delivered, with or without mention of antepartum conditions 654.23 Previous cesarean section; antepartum condition or complication 654.30 Retroverted and incarcerated graid uterus; unspecified as to episode of care or not applicable 654.31 Retroverted and incarcerated graid uterus; delivered, with or without mention of antepartum conditions
654.32 Retroverted and incarcerated graid uterus; delivered, with mention of postpartum complication 654.33 Retroverted and incarcerated graid uterus; antepartum condition or complication 654.34 Retroverted and incarcerated graid uterus; postpartum condition or complication 654.40 Other abnormalities in shape or position of gravid uterus and of neighboring structures; unspecified as to episode of care or not applicable 654.41 Other abnormalities in shape or position of gravid uterus and of neighboring structures; delivered, with or without mention of antepartum conditions 654.42 Other abnormalities in shape or position of gravid uterus and of neighboring structures; delivered, with mention of postpartum complication 654.43 Other abnormalities in shape or position of gravid uterus and of neighboring structures; antepartum condition or complication 654.44 Other abnormalities in shape or position of gravid uterus and of neighboring structures; postpartum condition or complication 654.50 Cervical incompetence; unspecified as to episode of care or not applicable 654.51 Cervical incompetence; delivered, with or without mention of antepartum conditions 654.52 Cervical incompetence; delivered, with mention of postpartum complication 654.53 Cervical incompetence; antepartum condition or complication 654.54 Cervical incompetence; postpartum condition or complication 654.60 Other congenital or acquired abnormality of cervix; unspecified as to episode of care or not applicable
654.61 Other congenital or acquired abnormality of cervix; delivered, with or without mention of antepartum conditions 654.62 Other congenital or acquired abnormality of cervix; delivered, with mention of postpartum complication
654.63 Other congenital or acquired abnormality of cervix; antepartum condition or complication 654.64 Other congenital or acquired abnormality of cervix; postpartum condition or complication 654.70 Congenital or acquired abnormality of vagina; unspecified as to episode of care or not applicable 654.71 Congenital or acquired abnormality of vagina; delivered, with or without mention of antepartum conditions
654.72 Congenital or acquired abnormality of vagina; delivered, with mention of postpartum complication 654.73 Congenital or acquired abnormality of vagina; antepartum condition or complication 654.74 Congenital or acquired abnormality of vagina; postpartum condition or complication 654.80 Congenital or acquired abnormality of vulva; unspecified as to episode of care or not applicable 654.81 Congenital or acquired abnormality of vulva; delivered, with or without mention of antepartum conditions
654.82 Congenital or acquired abnormality of vulva; delivered, with mention of postpartum complication 654.83 Congenital or acquired abnormality of vulva; antepartum condition or complication 654.84 Congenital or acquired abnormality of vulva; postpartum condition or complication 654.90 Other and unspecified abnormality of organs and soft tissues; unspecified as to episode of care or not applicable 654.91 Other and unspecified abnormality of organs and soft tissues; delivered, with or without mention of antepartum conditions 654.92 Other and unspecified abnormality of organs and soft tissues; delivered, with mention of postpartum complication 654.93 Other and unspecified abnormality of organs and soft tissues; antepartum condition or complication
10/1/08 18 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 654.94 Other and unspecified abnormality of organs and soft tissues; postpartum condition or complication 655.00 Central nervous system malformation in fetus; unspecified as to episode of care or not applicable 655.01 Central nervous system malformation in fetus; delivered, with or without mention of antepartum conditions
655.03 Central nervous system malformation in fetus 655.10 Chromosomal abnormality in fetus; unspecified as to episode of care or not applicable 655.11 Chromosomal abnormality in fetus; delivered, with or without mention of antepartum conditions 655.13 Chromosomal abnormality in fetus; antepartum condition or complication 655.20 Hereditary disease in family possibly affecting fetus; unspecified as to episode of care or not applicable
655.21 Hereditary disease in family possibly affecting fetus; delivered, with or without mention of antepartum conditions 655.23 Hereditary disease in family possibly affecting fetus; antepartum condition or complication 655.30 Suspected damage to fetus from viral disease in the mother; unspecified as to episode of care or not applicable 655.31 Suspected damage to fetus from viral disease in the mother; delivered, with or without mention of antepartum conditions 655.33 Suspected damage to fetus from viral disease in the mother; antepartum condition or complication 655.40 Suspected damage to fetus from other disease in the mother; unspecified as to episode of care or not applicable 655.41 Suspected damage to fetus from other disease in the mother; delivered, with or without mention of antepartum conditions 655.43 Suspected damage to fetus from other disease in the mother; antepartum condition or complication 655.50 Suspected damage to fetus from drugs; unspecified as to episode of care or not applicable 655.51 Suspected damage to fetus from drugs; delivered, with or without mention of antepartum conditions 655.53 Suspected damage to fetus from drugs; antepartum condition or complication 655.60 Suspected damage to fetus from radiation; unspecified as to episode of care or not applicable 655.61 Suspected damage to fetus from radiation; delivered, with or without mention of antepartum conditions
655.63 Suspected damage to fetus from radiation; antepartum condition or complication 655.70 Decreased fetal movements; unspecified as to episode of care or not applicable 655.71 Decreased fetal movements; delivered, with or without mention of antepartum conditions 655.73 Decreased fetal movements; antepartum condition or complication 655.80 Other known or suspected fetal abnormality, not elsewhere classified; unspecified as to episode of care or not applicable 655.81 Other known or suspected fetal abnormality, not elsewhere classified; delivered, with or without mention of antepartum conditions 655.83 Other known or suspected fetal abnormality, not elsewhere classified; antepartum condition or complication 655.90 Unspecified known or suspected abnormality affecting management of mother; unspecified as to episode of care or not applicable 655.91 Unspecified known or suspected abnormality affecting management of mother; delivered, with or without mention of antepartum conditions 655.93 Unspecified known or suspected abnormality affecting management of mother; antepartum condition or complication] 656.00 Fetal-maternal hemorrhage; unspecified as to episode of care or not applicable 656.01 Fetal-maternal hemorrhage; delivered, with or without mention of antepartum conditions 656.03 Fetal-maternal hemorrhage; antepartum condition or complication 656.10 Rhesus isoimmunization; unspecified as to episode of care or not applicable 656.11 Rhesus isoimmunization; delivered, with or without mention of antepartum conditions 656.13 Rhesus isoimmunization; antepartum condition or complication 656.20 Isoimmunization from other and uspecified blood-group incompatiblity; unspecified as to episode of care or not applicable
10/1/08 19 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 656.21 Isoimmunization from other and uspecified blood-group incompatiblity; delivered, with or without mention of antepartum conditions 656.23 Isoimmunization from other and uspecified blood-group incompatiblity; antepartum condition or complication 656.30 Fetal distress; unspecified as to episode of care or not applicable 656.31 Fetal distress; delivered, with or without mention of antepartum conditions 656.33 Fetal distress; antepartum condition or complication 656.40 Intrauterine death; unspecified as to episode of care or not applicable 656.41 Intrauterine death; delivered, with or without mention of antepartum conditions 656.43 Intrauterine death; antepartum condition or complication 656.50 Poor fetal growth; unspecified as to episode of care or not applicable 656.51 Poor fetal growth; delivered, with or without mention of antepartum conditions 656.53 Poor fetal growth; antepartum condition or complication 656.60 Excessive fetal growth; unspecified as to episode of care or not applicable 656.61 Excessive fetal growth; delivered, with or without mention of antepartum conditions 656.63 Excessive fetal growth; antepartum condition or complication 656.70 Other placental conditions; unspecified as to episode of care or not applicable 656.71 Other placental conditions; delivered, with or without mention of antepartum conditions 656.73 Other placental conditions; antepartum condition or complication 656.80 Other specified fetal and placental problems; unspecified as to episode of care or not applicable 656.81 Other specified fetal and placental problems; delivered, with or without mention of antepartum conditions
656.83 Other specified fetal and placental problems; antepartum condition or complication 656.90 Unspecified fetal and placental problem; unspecified as to episode of care or not applicable 656.91 Unspecified fetal and placental problem; delivered, with or without mention of antepartum conditions 656.93 Unspecified fetal and placental problem; antepartum condition or complication 657.00 Polyhydramnios; unspecified as to episode of care or not applicable 657.01 Polyhydramnios; delivered, with or without mention of antepartum conditions 657.03 Polyhydramnios; antepartum condition or complication 658.00 Oligohydramnios; unspecified as to episode of care or not applicable 658.01 Oligohydramnios; delivered, with or without mention of antepartum conditions 658.03 Oligohydramnios; antepartum condition or complication 658.10 Premature rupture of membranes; unspecified as to episode of care or not applicable 658.11 Premature rupture of membranes; delivered, with or without mention of antepartum conditions 658.13 Premature rupture of membranes; antepartum condition or complication 658.20 Delayed delivery after spontaneous or unspecified rupture of membranes; unspecified as to episode of care or not applicable 658.21 Delayed delivery after spontaneous or unspecified rupture of membranes; delivered, with or without mention of antepartum conditions 658.23 Delayed delivery after spontaneous or unspecified rupture of membranes; antepartum condition or complication 658.30 Delayed delivery after artificial rupture of membranes; unspecified as to episode of care or not applicable
658.31 Delayed delivery after artificial rupture of membranes; delivered, with or without mention of antepartum conditions 658.33 Delayed delivery after artificial rupture of membranes; antepartum condition or complication 658.40 Infection of amniotic cavity; unspecified as to episode of care or not applicable 658.41 Infection of amniotic cavity; delivered, with or without mention of antepartum conditions 658.43 Infection of amniotic cavity; antepartum condition or complication 658.80 Other problems associated with amniotic cavity and membranes; unspecified as to episode of care or not applicable 658.81 Other problems associated with amniotic cavity and membranes; delivered, with or without mention of antepartum conditions
10/1/08 20 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 658.83 Other problems associated with amniotic cavity and membranes; antepartum condition or complication
658.90 Unspecified other problems associated with amniotic cavity and membranes; unspecified as to episode of care or not applicable 658.91 Unspecified other problems associated with amniotic cavity and membranes; delivered, with or without mention of antepartum conditions 658.93 Unspecified other problems associated with amniotic cavity and membranes; antepartum condition or complication 659.00 Failed mechanical induction; unspecified as to episode of care or not applicable 659.01 Failed mechanical induction; delivered, with or without mention of antepartum conditions 659.03 Failed mechanical induction; antepartum condition or complication 659.10 Failed medical or unspecified induction; unspecified as to episode of care or not applicable 659.11 Failed medical or unspecified induction; delivered, with or without mention of antepartum conditions 659.13 Failed medical or unspecified induction; antepartum condition or complication 659.20 Maternal pyrexia during labor, unspecified; unspecified as to episode of care or not applicable 659.21 Maternal pyrexia during labor, unspecified; delivered, with or without mention of antepartum conditions
659.23 Maternal pyrexia during labor, unspecified; antepartum condition or complication 659.30 Generalized infection during labor; unspecified as to episode of care or not applicable 659.31 Generalized infection during labor; delivered, with or without mention of antepartum conditions 659.33 Generalized infection during labor; antepartum condition or complication 659.40 Grand multiparity (affecting labor and delivery); unspecified as to episode of care or not applicable 659.41 Grand multiparity (affecting labor and delivery); delivered, with or without mention of antepartum conditions
659.43 Grand multiparity (affecting labor and delivery); antepartum condition or complication 659.50 Elderly primigravida (affecting labor and delivery); unspecified as to episode of care or not applicable 659.51 Elderly primigravida (affecting labor and delivery); delivered, with or without mention of antepartum conditions 659.53 Elderly primigravida (affecting labor and delivery); antepartum condition or complication 659.60 Elderly multigravida (affecting labor and delivery); unspecified as to episode of care or not applicable 659.61 Elderly multigravida (affecting labor and delivery); delivered, with or without mention of antepartum conditions 659.63 Elderly multigravida (affecting labor and delivery); antepartum condition or complication 659.70 Abnormality in fetal heart rate or rhythm (during labor and delivery); unspecified as to episode of care or not applicable 659.71 Abnormality in fetal heart rate or rhythm (during labor and delivery); delivered, with or without mention of antepartum conditions 659.73 Abnormality in fetal heart rate or rhythm (during labor and delivery); antepartum condition or complication
659.80 Other specified indications for care or intervention related to labor and delivery; unspecified as to episode of care or not applicable 659.81 Other specified indications for care or intervention related to labor and delivery; delivered, with or without mention of antepartum conditions 659.83 Other specified indications for care or intervention related to labor and delivery; antepartum condition or complication 659.90 Unspecified indication for care or intervention related to labor and delivery; unspecified as to episode of care or not applicable 659.91 Unspecified indication for care or intervention related to labor and delivery; delivered, with or without mention of antepartum conditions 659.93 Unspecified indication for care or intervention related to labor and delivery; antepartum condition or complication 660.00 Obstruction caused by malposition of fetus at onset of labor; unspecified as to episode of care or not applicable
10/1/08 21 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 660.01 Obstruction caused by malposition of fetus at onset of labor; delivered, with or without mention of antepartum conditions 660.03 Obstruction caused by malposition of fetus at onset of labor; antepartum condition or complication 660.10 Obstruction by bony pelvis (during L&D); unspecified as to episode of care or not applicable 660.11 Obstruction by bony pelvis (during L&D); delivered, with or without mention of antepartum conditions 660.13 Obstruction by bony pelvis (during L&D); antepartum condition or complication 660.20 Obstruction by abnormal pelvic soft tissues (during L&D); unspecified as to episode of care or not applicable 660.21 Obstruction by abnormal pelvic soft tissues (during L&D); delivered, with or without mention of antepartum conditions 660.23 Obstruction by abnormal pelvic soft tissues (during L&D); antepartum condition or complication 660.30 Deep transverse arrest and persistent occipitoposterior position; unspecified as to episode of care or not applicable 660.31 Deep transverse arrest and persistent occipitoposterior position; delivered, with or without mention of antepartum conditions 660.33 Deep transverse arrest and persistent occipitoposterior position; antepartum condition or complication
660.40 Shoulder (girdle) dystocia; unspecified as to episode of care or not applicable 660.41 Shoulder (girdle) dystocia; delivered, with or without mention of antepartum conditions 660.43 Shoulder (girdle) dystocia; antepartum condition or complication 660.50 Locked twins; unspecified as to episode of care or not applicable 660.51 Locked twins; delivered, with or without mention of antepartum conditions 660.53 Locked twins; antepartum condition or complication 660.60 Failed trial of labor, unspecified; unspecified as to episode of care or not applicable 660.61 Failed trial of labor, unspecified; delivered, with or without mention of antepartum conditions 660.63 Failed trial of labor, unspecified; antepartum condition or complication 660.70 Failed forceps or vacuum extractor, unspecified; unspecified as to episode of care or not applicable 660.71 Failed forceps or vacuum extractor, unspecified; delivered, with or without mention of antepartum conditions 660.73 Failed forceps or vacuum extractor, unspecified; antepartum condition or complication 660.80 Other causes of obstructed labor; unspecified as to episode of care or not applicable 660.81 Other causes of obstructed labor; delivered, with or without mention of antepartum conditions 660.83 Other causes of obstructed labor; antepartum condition or complication 660.90 Unspecified obstructed labor; unspecified as to episode of care or not applicable 660.91 Unspecified obstructed labor; delivered, with or without mention of antepartum conditions 660.93 Unspecified obstructed labor; antepartum condition or complication 661.00 Primary uterine inertia; unspecified as to episode of care or not applicable 661.01 Primary uterine inertia; delivered, with or without mention of antepartum conditions 661.03 Primary uterine inertia; antepartum condition or complication 661.10 Secondary uterine inertia; unspecified as to episode of care or not applicable 661.11 Secondary uterine inertia; delivered, with or without mention of antepartum conditions 661.13 Secondary uterine inertia; antepartum condition or complication 661.20 Other and unspecified uterine inertia; unspecified as to episode of care or not applicable 661.21 Other and unspecified uterine inertia; delivered, with or without mention of antepartum conditions 661.23 Other and unspecified uterine inertia; antepartum condition or complication 661.30 Precipitate labor; unspecified as to episode of care or not applicable 661.31 Precipitate labor; delivered, with or without mention of antepartum conditions 661.33 Precipitate labor; antepartum condition or complication 661.40 Hypertonic, incoordinate, or prolonged uterine contractions; unspecified as to episode of care or not applicable 661.41 Hypertonic, incoordinate, or prolonged uterine contractions; delivered, with or without mention of antepartum conditions 661.43 Hypertonic, incoordinate, or prolonged uterine contractions; antepartum condition or complication
10/1/08 22 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 661.90 Unspecified abnormality of labor; unspecified as to episode of care or not applicable 661.91 Unspecified abnormality of labor; delivered, with or without mention of antepartum conditions 661.93 Unspecified abnormality of labor; antepartum condition or complication 662.00 Prolonged first stage; unspecified as to episode of care or not applicable 662.01 Prolonged first stage; delivered, with or without mention of antepartum conditions 662.03 Prolonged first stage; antepartum condition or complication 662.10 Prolonged labor, unspecified; unspecified as to episode of care or not applicable 662.11 Prolonged labor, unspecified; delivered, with or without mention of antepartum conditions 662.13 Prolonged labor, unspecified; antepartum condition or complication 662.20 Prolonged second stage; unspecified as to episode of care or not applicable 662.21 Prolonged second stage; delivered, with or without mention of antepartum conditions 662.23 Prolonged second stage; antepartum condition or complication 662.30 Delayed delivery of second twin, triplet, etc.; unspecified as to episode of care or not applicable 662.31 Delayed delivery of second twin, triplet, etc.; delivered, with or without mention of antepartum conditions
662.33 Delayed delivery of second twin, triplet, etc.; antepartum condition or complication 663.00 Prolapse of cord; unspecified as to episode of care or not applicable 663.01 Prolapse of cord; delivered, with or without mention of antepartum conditions 663.03 Prolapse of cord; antepartum condition or complication 663.10 Cord around neck, with compression; unspecified as to episode of care or not applicable 663.11 Cord around neck, with compression; delivered, with or without mention of antepartum conditions 663.13 Cord around neck, with compression; antepartum condition or complication 663.20 Other and unspecified cord entanglement, with compression; unspecified as to episode of care or not applicable 663.21 Other and unspecified cord entanglement, with compression; delivered, with or without mention of antepartum conditions 663.23 Other and unspecified cord entanglement, with compression; antepartum condition or complication 663.30 Other and unspecified cord entanglement, without mention of compression; unspecified as to episode of care or not applicable 663.31 Other and unspecified cord entanglement, without mention of compression; delivered, with or without mention of antepartum conditions 663.33 Other and unspecified cord entanglement, without mention of compression; antepartum condition or complication 663.40 Short cord; unspecified as to episode of care or not applicable 663.41 Short cord; delivered, with or without mention of antepartum conditions 663.43 Short cord; antepartum condition or complication 663.50 Vasa previa; unspecified as to episode of care or not applicable 663.51 Vasa previa; delivered, with or without mention of antepartum conditions 663.53 Vasa previa; antepartum condition or complication 663.60 Vascular lesions of cord; unspecified as to episode of care or not applicable 663.61 Vascular lesions of cord; delivered, with or without mention of antepartum conditions 663.63 Vascular lesions of cord; antepartum condition or complication 663.80 Other umbilical cord complications; unspecified as to episode of care or not applicable 663.81 Other umbilical cord complications; delivered, with or without mention of antepartum conditions 663.83 Other umbilical cord complications; antepartum condition or complication 663.90 Unspecified umbilical cord complication; unspecified as to episode of care or not applicable 663.91 Unspecified umbilical cord complication; delivered, with or without mention of antepartum conditions 663.93 Unspecified umbilical cord complication; antepartum condition or complication 664.00 First-degree perineal laceration; unspecified as to episode of care or not applicable 664.01 First-degree perineal laceration; delivered, with or without mention of antepartum conditions 664.04 First-degree perineal laceration; postpartum condition or complication 664.10 Second-degree perineal laceration; unspecified as to episode of care or not applicable 664.11 Second-degree perineal laceration; delivered, with or without mention of antepartum conditions
10/1/08 23 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 664.14 Second-degree perineal laceration; postpartum condition or complication 664.20 Third-degree perineal laceration; unspecified as to episode of care or not applicable 664.21 Third-degree perineal laceration; delivered, with or without mention of antepartum conditions 664.24 Third-degree perineal laceration; postpartum condition or complication 664.30 Fourth-degree perineal laceration; unspecified as to episode of care or not applicable 664.31 Fourth-degree perineal laceration; delivered, with or without mention of antepartum conditions 664.34 Fourth-degree perineal laceration; postpartum condition or complication 664.40 Unspecified perineal laceration; unspecified as to episode of care or not applicable 664.41 Unspecified perineal laceration; delivered, with or without mention of antepartum conditions 664.44 Unspecified perineal laceration; postpartum condition or complication 664.50 Vulval and perineal hematoma; unspecified as to episode of care or not applicable 664.51 Vulval and perineal hematoma; delivered, with or without mention of antepartum conditions 664.54 Vulval and perineal hematoma; postpartum condition or complication 664.60 Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration, unspecified as to episode of care or not applicable 664.61 Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration, delivered, with or without mention of antepartum conditions 664.64 Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration, postpartum condition or complication 664.80 Other specified trauma to perineum and vulva; unspecified as to episode of care or not applicable 664.81 Other specified trauma to perineum and vulva; delivered, with or without mention of antepartum conditions
664.84 Other specified trauma to perineum and vulva; postpartum condition or complication 664.90 Unspecified trauma to perineum and vulva; unspecified as to episode of care or not applicable 664.91 Unspecified trauma to perineum and vulva; delivered, with or without mention of antepartum conditions
664.94 Unspecified trauma to perineum and vulva; postpartum condition or complication 665.00 Rupture of uterus before onset of labor; unspecified as to episode of care or not applicable 665.01 Rupture of uterus before onset of labor; delivered, with or without mention of antepartum conditions 665.03 Rupture of uterus before onset of labor; antepartum condition or complication 665.10 Rupture of uterus during labor 665.11 Rupture of uterus during labor; delivered, with or without mention of antepartum conditions 665.20 Inversion of uterus; unspecified as to episode of care or not applicable 665.22 Inversion of uterus; delivered, with or without mention of antepartum conditions 665.24 Inversion of uterus; postpartum condition or complication 665.30 Laceration of cervix; unspecified as to episode of care or not applicable 665.31 Laceration of cervix; delivered, with or without mention of antepartum conditions 665.34 Laceration of cervix; postpartum condition or complication 665.40 High vaginal laceration; unspecified as to episode of care or not applicable 665.41 High vaginal laceration; delivered, with or without mention of antepartum conditions 665.44 High vaginal laceration; postpartum condition or complication 665.50 Other injury to pelvic organs; unspecified as to episode of care or not applicable 665.51 Other injury to pelvic organs; delivered, with or without mention of antepartum conditions 665.54 Other injury to pelvic organs; postpartum condition or complication 665.60 Damage to pelvic joints and ligaments; unspecified as to episode of care or not applicable 665.61 Damage to pelvic joints and ligaments; delivered, with or without mention of antepartum conditions 665.64 Damage to pelvic joints and ligaments; postpartum condition or complication 665.70 Pelvic hematoma; unspecified as to episode of care or not applicable 665.71 Pelvic hematoma; delivered, with or without mention of antepartum conditions 665.72 IPelvic hematoma; delivered, with or without mention of antepartum conditions 665.74 Pelvic hematoma; postpartum condition or complication 665.80 Other specified obstetrical trauma; unspecified as to episode of care or not applicable 665.81 Other specified obstetrical trauma; delivered, with or without mention of antepartum conditions
10/1/08 24 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 665.82 Other specified obstetrical trauma; delivered, with mention of postpartum complication 665.83 Other specified obstetrical trauma; antepartum condition or complication 665.84 Other specified obstetrical trauma; postpartum condition or complication 665.90 Unspecified obstetrical trauma; unspecified as to episode of care or not applicable 665.91 Unspecified obstetrical trauma; delivered, with or without mention of antepartum conditions 665.92 Unspecified obstetrical trauma; delivered, with mention of postpartum complication 665.93 Unspecified obstetrical trauma; antepartum condition or complication 665.94 Unspecified obstetrical trauma; postpartum condition or complication 666.00 Third-stage hemorrhage; unspecified as to episode of care or not applicable 666.02 Third-stage hemorrhage; delivered, with mention of postpartum complication 666.04 Third-stage hemorrhage; postpartum condition or complication 666.10 Other immediate postpartum hemorrhage; unspecified as to episode of care or not applicable 666.12 Other immediate postpartum hemorrhage; delivered, with mention of postpartum complication 666.14 Other immediate postpartum hemorrhage; postpartum condition or complication 666.20 Delayed and secondary postpartum hemorrhage; unspecified as to episode of care or not applicable 666.22 Delayed and secondary postpartum hemorrhage; delivered, with mention of postpartum complication
666.24 Delayed and secondary postpartum hemorrhage; postpartum condition or complication 666.30 Postpartum coagulation defects; unspecified as to episode of care or not applicable 666.32 Postpartum coagulation defects; delivered, with mention of postpartum complication 666.34 Postpartum coagulation defects; postpartum condition or complication 667.00 Retained placenta without hemorrhage; unspecified as to episode of care or not applicable 667.02 Retained placenta without hemorrhage; delivered, with mention of postpartum complication 667.04 Retained placenta without hemorrhage; postpartum condition or complication 667.10 Retained portions of placenta or membranes, without hemorrhage; unspecified as to episode of care or not applicable 667.12 Retained portions of placenta or membranes, without hemorrhage; delivered, with mention of postpartum complication 667.14 Retained portions of placenta or membranes, without hemorrhage; postpartum condition or complication
668.00 Pulmonary complications (of anesthetic or other sedation); unspecified as to episode of care or not applicable 668.01 Pulmonary complications (of anesthetic or other sedation); delivered, with or without mention of antepartum conditions 668.02 Pulmonary complications (of anesthetic or other sedation); delivered, with mention of postpartum complication 668.03 Pulmonary complications (of anesthetic or other sedation); antepartum condition or complication 668.04 Pulmonary complications (of anesthetic or other sedation); postpartum condition or complication 668.10 Cardiac complications (of anesthetic or other sedation); unspecified as to episode of care or not applicable
668.11 Cardiac complications (of anesthetic or other sedation); delivered, with or without mention of antepartum conditions 668.12 Cardiac complications (of anesthetic or other sedation); delivered, with mention of postpartum complication
668.13 Cardiac complications (of anesthetic or other sedation); antepartum condition or complication 668.14 Cardiac complications (of anesthetic or other sedation); postpartum condition or complication 668.20 Central nervous system complications (of anesthetic or other sedation); unspecified as to episode of care or not applicable 668.21 Central nervous system complications (of anesthetic or other sedation); delivered, with or without mention of antepartum conditions 668.22 Central nervous system complications (of anesthetic or other sedation); delivered, with mention of postpartum complication
10/1/08 25 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 668.23 Central nervous system complications (of anesthetic or other sedation); antepartum condition or complication 668.24 Central nervous system complications (of anesthetic or other sedation); postpartum condition or complication 668.80 Other complications of anesthesia or other sedation in labor and delivery; unspecified as to episode of care or not applicable 668.81 Other complications of anesthesia or other sedation in labor and delivery; delivered, with or without mention of antepartum conditions 668.82 Other complications of anesthesia or other sedation in labor and delivery; delivered, with mention of postpartum complication 668.83 Other complications of anesthesia or other sedation in labor and delivery; antepartum condition or complication 668.84 Other complications of anesthesia or other sedation in labor and delivery; postpartum condition or complication 668.90 Unspecified complications of anesthesia and other sedation; unspecified as to episode of care or not applicable 668.91 Unspecified complications of anesthesia and other sedationa; delivered, with or without mention of antepartum conditions 668.92 Unspecified complications of anesthesia and other sedation; delivered, with mention of postpartum complication 668.93 Unspecified complications of anesthesia and other sedation; antepartum condition or complication 668.94 Unspecified complications of anesthesia and other sedation; postpartum condition or complication 669.00 Maternal distress; unspecified as to episode of care or not applicable 669.01 Maternal distress; delivered, with or without mention of antepartum conditions 669.02 Maternal distress; delivered, with mention of postpartum complication 669.03 Maternal distress; antepartum condition or complication 669.04 Maternal distress; postpartum condition or complication 669.10 Shock during or following labor and delivery; unspecified as to episode of care or not applicable 669.11 Shock during or following labor and delivery; delivered, with or without mention of antepartum conditions
669.12 Shock during or following labor and delivery; delivered, with mention of postpartum complication 669.13 Shock during or following labor and delivery; antepartum condition or complication 669.14 Shock during or following labor and delivery; postpartum condition or complication 669.20 Maternal hypotension syndrome; unspecified as to episode of care or not applicable 669.21 Maternal hypotension syndrome; delivered, with or without mention of antepartum conditions 669.22 Maternal hypotension syndrome; delivered, with mention of postpartum complication 669.23 Maternal hypotension syndrome; antepartum condition or complication 669.24 Maternal hypotension syndrome; postpartum condition or complication 669.30 Acute renal failure following labor and delivery; unspecified as to episode of care or not applicable 669.32 Acute renal failure following labor and delivery; delivered, with mention of postpartum complication 669.34 Acute renal failure following labor and delivery; postpartum condition or complication 669.40 Other complications of obstetrical surgery and procedures; unspecified as to episode of care or not applicable 669.41 Other complications of obstetrical surgery and procedures; delivered, with or without mention of antepartum conditions 669.42 Other complications of obstetrical surgery and procedures; delivered, with mention of postpartum complication 669.43 Other complications of obstetrical surgery and procedures; antepartum condition or complication 669.44 Other complications of obstetrical surgery and procedures; postpartum condition or complication 669.50 Forceps or vacuum extractor delivery without mention of indication; unspecified as to episode of care or not applicable 669.51 Forceps or vacuum extractor delivery without mention of indication; delivered, with or without mention of antepartum conditions
10/1/08 26 Exempt Diagnoses for Ambulatory Visit Limitation
Diagnosis Description Code 669.60 Breech extraction, without mention of indication; unspecified as to episode of care or not applicable 669.61 Breech extraction, without mention of indication; delivered, with or without mention of antepartum conditions 669.70 Cesarean delivery, without mention of indication; unspecified as to episode of care or not applicable 669.71 Cesarean delivery, without mention of indication; delivered, with or without mention of antepartum conditions 669.80 Other complications of labor and delivery; unspecified as to episode of care or not applicable 669.81 Other complications of labor and delivery; delivered, with or without mention of antepartum conditions
669.82 Other complications of labor and delivery; delivered, with mention of postpartum complication 669.83 Other complications of labor and delivery; antepartum condition or complication 669.84 Other complications of labor and delivery; postpartum condition or complication 669.90 Unspecified complication of labor and delivery; unspecified as to episode of care or not applicable 669.91 Unspecified complication of labor and delivery; delivered, with or without mention of antepartum conditions
669.92 Unspecified complication of labor and delivery; delivered, with mention of postpartum complication 669.93 Unspecified complication of labor and delivery; antepartum condition or complication 669.94 Unspecified complication of labor and delivery; postpartum condition or complication 682.7 Other cellulitis and abscess, foot, except toes 707.10 Ulcer of lower limb, unspecified 707.12 Ulcer of calf 707.13 Ulcer of ankle 707.14 Ulcer of heel and midfoot 707.15 Ulcer of other part of foot 713.5 Arthropathy associated with neurological disorders 714.0 Rheumatoid arthritis 730.06 Acute osteomyelitis, lower leg 730.07 Acute osteomyelitis, ankle and foot 730.16 Chronic osteomyelitis, lower leg 730.17 Chronic osteomyelitis, ankle and foot 730.26 Unspecified osteomyelitis, lower leg 730.27 Unspecified osteomyelitis, ankle and foot 730.96 Unspecified infection of bone, lower leg 730.97 Unspecified infection of bone, ankle and foot 891.1 Open wound of knee, leg (except thigh), and ankle, complicated 892.0 Open wound of foot except toes(s) alone, without mention of complication 892.1 Open wound of foot except toes(s) alone, complicated 918.1 Superficial injury of eye and adnexa, cornea 921.1 Contusion of eyelids and periocular area 921.2 Contusion of orbital tissues 930.0 Corneal foreign body 930.1 Foreign body in conjunctival sac 940.0 Chemical burn of eyelids and periocular area 940.1 Other burns of eyelids and periocular area 940.2 Alkaline chemical burn of cornea and conjunctival sac 940.3 Acid chemical burn of cornea and conjunctival sac 940.4 Other burn of cornea and conjunctival sac 997.62 Amputation stump complication, infection (chronic) 998.31 Disruption of internal operation wound 998.83 Non-healing surgical wound
10/1/08 27