Appendix I Hospital Acquired Conditions (Hacs) List Hac 01

APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST

HAC 01: FOREIGN OBJECT RETAINED AFTER SURGERY

SECONDARY DIAGNOSIS 9984 FB left during procedure (CC) 9987 Postop forgn subst react (CC)

HAC 02: AIR EMBOLISM

SECONDARY DIAGNOSIS 9991 Air embol comp med care (MCC)

HAC 03: BLOOD INCOMPATABILITY

SECONDARY DIAGNOSIS 99960 Abo incompat react NOS (CC) 99963 Abo incompat/delay HTR (CC) 99961 Abo incomp/HTR NEC (CC) 99969 Abo incompat reactn NEC (CC) 99962 Abo incompat/acute HTR (CC)

HAC 04: STAGE III & IV PRESSURE ULCERS

SECONDARY DIAGNOSIS 70723 Pressure ulcer,stage III (MCC) 70724 Pressure ulcer, stage IV (MCC)

HAC 05: FALLS AND TRAUMA

SECONDARY DIAGNOSIS 80000 Closed skull vault fx (CC) 80039 Cl skl vlt fx-concus NOS (MCC) 80001 Cl skull vlt fx w/o coma (CC) 80040 Cl skl vlt fx/br inj NEC (CC) 80002 Cl skull vlt fx-brf coma (CC) 80041 Cl skull vlt fx w/o coma (CC) 80003 Cl skull vlt fx-mod coma (MCC) 80042 Cl skull vlt fx-brf coma (CC) 80004 Cl skl vlt fx-proln coma (MCC) 80043 Cl skull vlt fx-mod coma (MCC) 80005 Cl skul vlt fx-deep coma (MCC) 80044 Cl skl vlt fx-proln coma (MCC) 80006 Cl skull vlt fx-coma NOS (CC) 80045 Cl skul vlt fx-deep coma (MCC) 80009 Cl skl vlt fx-concus NOS (CC) 80046 Cl skull vlt fx-coma NOS (CC) 80010 Cl skl vlt fx/cerebr lac (MCC) 80049 Cl skl vlt fx-concus NOS (CC) 80011 Cl skull vlt fx w/o coma (MCC) 80050 Opn skull vault fracture (MCC) 80012 Cl skull vlt fx-brf coma (MCC) 80051 Opn skul vlt fx w/o coma (MCC) 80013 Cl skull vlt fx-mod coma (MCC) 80052 Opn skul vlt fx-brf coma (MCC) 80014 Cl skl vlt fx-proln coma (MCC) 80053 Opn skul vlt fx-mod coma (MCC) 80015 Cl skul vlt fx-deep coma (MCC) 80054 Opn skl vlt fx-proln com (MCC) 80016 Cl skull vlt fx-coma NOS (MCC) 80055 Opn skl vlt fx-deep coma (MCC) 80019 Cl skl vlt fx-concus NOS (MCC) 80056 Opn skul vlt fx-coma NOS (MCC) 80020 Cl skl vlt fx/mening hem (MCC) 80059 Op skl vlt fx-concus NOS (MCC) 80021 Cl skull vlt fx w/o coma (MCC) 80060 Opn skl vlt fx/cereb lac (MCC) 80022 Cl skull vlt fx-brf coma (MCC) 80061 Opn skul vlt fx w/o coma (MCC) 80023 Cl skull vlt fx-mod coma (MCC) 80062 Opn skul vlt fx-brf coma (MCC) 80024 Cl skl vlt fx-proln coma (MCC) 80063 Opn skul vlt fx-mod coma (MCC) 80025 Cl skul vlt fx-deep coma (MCC) 80064 Opn skl vlt fx-proln com (MCC) 80026 Cl skull vlt fx-coma NOS (MCC) 80065 Opn skl vlt fx-deep coma (MCC) 80029 Cl skl vlt fx-concus NOS (MCC) 80066 Opn skul vlt fx-coma NOS (MCC) 80030 Cl skull vlt fx/hem NEC (MCC) 80069 Op skl vlt fx-concus NOS (MCC) 80031 Cl skull vlt fx w/o coma (MCC) 80070 Opn skl vlt fx/menin hem (MCC) 80032 Cl skull vlt fx-brf coma (MCC) 80071 Opn skul vlt fx w/o coma (MCC) 80033 Cl skull vlt fx-mod coma (MCC) 80072 Opn skul vlt fx-brf coma (MCC) 80034 Cl skl vlt fx-proln coma (MCC) 80073 Opn skul vlt fx-mod coma (MCC) 80035 Cl skul vlt fx-deep coma (MCC) 80074 Opn skl vlt fx-proln com (MCC) 80036 Cl skull vlt fx-coma NOS (MCC) 80075 Opn skl vlt fx-deep coma (MCC)

1107 APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST 80076 Opn skul vlt fx-coma NOS (MCC) 80164 Op skl base fx-prol coma (MCC) 80079 Op skl vlt fx-concus NOS (MCC) 80165 Op skl base fx-deep coma (MCC) 80080 Opn skull vlt fx/hem NEC (MCC) 80166 Opn skl base fx-coma NOS (MCC) 80081 Opn skul vlt fx w/o coma (MCC) 80169 Opn skul base fx-concuss (MCC) 80082 Opn skul vlt fx-brf coma (MCC) 80170 Op skl base fx/menin hem (MCC) 80083 Opn skul vlt fx-mod coma (MCC) 80171 Opn skl base fx w/o coma (MCC) 80084 Opn skl vlt fx-proln com (MCC) 80172 Opn skl base fx-brf coma (MCC) 80085 Opn skl vlt fx-deep coma (MCC) 80173 Opn skl base fx-mod coma (MCC) 80086 Opn skul vlt fx-coma NOS (MCC) 80174 Op skl base fx-prol coma (MCC) 80089 Op skl vlt fx-concus NOS (MCC) 80175 Op skl base fx-deep coma (MCC) 80090 Op skl vlt fx/br inj NEC (MCC) 80176 Opn skl base fx-coma NOS (MCC) 80091 Opn skul vlt fx w/o coma (MCC) 80179 Opn skul base fx-concuss (MCC) 80092 Opn skul vlt fx-brf coma (MCC) 80180 Opn skul base fx/hem NEC (MCC) 80093 Opn skul vlt fx-mod coma (MCC) 80181 Opn skl base fx w/o coma (MCC) 80094 Opn skl vlt fx-proln com (MCC) 80182 Opn skl base fx-brf coma (MCC) 80095 Op skul vlt fx-deep coma (MCC) 80183 Opn skl base fx-mod coma (MCC) 80096 Opn skul vlt fx-coma NOS (MCC) 80184 Op skl base fx-prol coma (MCC) 80099 Op skl vlt fx-concus NOS (MCC) 80185 Op skl base fx-deep coma (MCC) 80100 Clos skull base fracture (CC) 80186 Opn skl base fx-coma NOS (MCC) 80101 Cl skul base fx w/o coma (CC) 80189 Opn skul base fx-concuss (MCC) 80102 Cl skul base fx-brf coma (CC) 80190 Op sk base fx/br inj NEC (MCC) 80103 Cl skul base fx-mod coma (MCC) 80191 Op skul base fx w/o coma (MCC) 80104 Cl skl base fx-prol coma (MCC) 80192 Opn skl base fx-brf coma (MCC) 80105 Cl skl base fx-deep coma (MCC) 80193 Opn skl base fx-mod coma (MCC) 80106 Cl skul base fx-coma NOS (CC) 80194 Op skl base fx-prol coma (MCC) 80109 Cl skull base fx-concuss (CC) 80195 Op skl base fx-deep coma (MCC) 80110 Cl skl base fx/cereb lac (MCC) 80196 Opn skl base fx-coma NOS (MCC) 80111 Cl skul base fx w/o coma (MCC) 80199 Opn skul base fx-concuss (MCC) 80112 Cl skul base fx-brf coma (MCC) 8021 Nasal bone fx-open (CC) 80113 Cl skul base fx-mod coma (MCC) 80220 Mandible fx NOS-closed (CC) 80114 Cl skl base fx-prol coma (MCC) 80221 Fx condyl proc mandib-cl (CC) 80115 Cl skl base fx-deep coma (MCC) 80222 Subcondylar fx mandib-cl (CC) 80116 Cl skul base fx-coma NOS (MCC) 80223 Fx coron proc mandib-cl (CC) 80119 Cl skull base fx-concuss (MCC) 80224 Fx ramus NOS-closed (CC) 80120 Cl skl base fx/menin hem (MCC) 80225 Fx angle of jaw-closed (CC) 80121 Cl skul base fx w/o coma (MCC) 80226 Fx symphy mandib body-cl (CC) 80122 Cl skul base fx/brf coma (MCC) 80227 Fx alveolar bord mand-cl (CC) 80123 Cl skul base fx-mod coma (MCC) 80228 Fx mandible body NEC-cl (CC) 80124 Cl skl base fx-prol coma (MCC) 80229 Mult fx mandible-closed (CC) 80125 Cl skl base fx-deep coma (MCC) 80230 Mandible fx NOS-open (CC) 80126 Cl skul base fx-coma NOS (MCC) 80231 Fx condyl proc mand-open (CC) 80129 Cl skull base fx-concuss (MCC) 80232 Subcondyl fx mandib-open (CC) 80130 Cl skull base fx/hem NEC (MCC) 80233 Fx coron proc mandib-opn (CC) 80131 Cl skul base fx w/o coma (MCC) 80234 Fx ramus NOS-open (CC) 80132 Cl skul base fx-brf coma (MCC) 80235 Fx angle of jaw-open (CC) 80133 Cl skul base fx-mod coma (MCC) 80236 Fx symphy mandib bdy-opn (CC) 80134 Cl skl base fx-prol coma (MCC) 80237 Fx alv bord mand bdy-opn (CC) 80135 Cl skl base fx-deep coma (MCC) 80238 Fx mandible body NEC-opn (CC) 80136 Cl skul base fx-coma NOS (MCC) 80239 Mult fx mandible-open (CC) 80139 Cl skull base fx-concuss (MCC) 8024 Fx malar/maxillary-close (CC) 80140 Cl sk base fx/br inj NEC (CC) 8025 Fx malar/maxillary-open (CC) 80141 Cl skul base fx w/o coma (CC) 8026 Fx orbital floor-closed (CC) 80142 Cl skul base fx-brf coma (CC) 8027 Fx orbital floor-open (CC) 80143 Cl skul base fx-mod coma (MCC) 8028 Fx facial bone NEC-close (CC) 80144 Cl skl base fx-prol coma (MCC) 8029 Fx facial bone NEC-open (CC) 80145 Cl skl base fx-deep coma (MCC) 80300 Close skull fracture NEC (CC) 80146 Cl skul base fx-coma NOS (CC) 80301 Cl skull fx NEC w/o coma (CC) 80149 Cl skull base fx-concuss (CC) 80302 Cl skull fx NEC-brf coma (CC) 80150 Open skull base fracture (MCC) 80303 Cl skull fx NEC-mod coma (MCC) 80151 Opn skl base fx w/o coma (MCC) 80304 Cl skl fx NEC-proln coma (MCC) 80152 Opn skl base fx-brf coma (MCC) 80305 Cl skul fx NEC-deep coma (MCC) 80153 Opn skl base fx-mod coma (MCC) 80306 Cl skull fx NEC-coma NOS (CC) 80154 Op skl base fx-prol coma (MCC) 80309 Cl skull fx NEC-concuss (CC) 80155 Op skl base fx-deep coma (MCC) 80310 Cl skl fx NEC/cerebr lac (MCC) 80156 Opn skl base fx-coma NOS (MCC) 80311 Cl skull fx NEC w/o coma (MCC) 80159 Opn skul base fx-concuss (MCC) 80312 Cl skull fx NEC-brf coma (MCC) 80160 Op skl base fx/cereb lac (MCC) 80313 Cl skull fx NEC-mod coma (MCC) 80161 Opn skl base fx w/o coma (MCC) 80314 Cl skl fx NEC-proln coma (MCC) 80162 Opn skl base fx-brf coma (MCC) 80315 Cl skul fx NEC-deep coma (MCC) 80163 Opn skl base fx-mod coma (MCC) 80316 Cl skull fx NEC-coma NOS (MCC)

1108 APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST 80319 Cl skull fx NEC-concuss (MCC) 80405 Cl skul/oth fx-deep coma (MCC) 80320 Cl skl fx NEC/mening hem (MCC) 80406 Cl skl w oth fx-coma NOS (CC) 80321 Cl skull fx NEC w/o coma (MCC) 80409 Cl skul w oth fx-concuss (CC) 80322 Cl skull fx NEC-brf coma (MCC) 80410 Cl sk w oth fx/cereb lac (MCC) 80323 Cl skull fx NEC-mod coma (MCC) 80411 Cl skl w oth fx w/o coma (MCC) 80324 Cl skl fx NEC-proln coma (MCC) 80412 Cl skl w oth fx-brf coma (MCC) 80325 Cl skul fx NEC-deep coma (MCC) 80413 Cl skl w oth fx-mod coma (MCC) 80326 Cl skull fx NEC-coma NOS (MCC) 80414 Cl skl/oth fx-proln coma (MCC) 80329 Cl skull fx NEC-concuss (MCC) 80415 Cl skul/oth fx-deep coma (MCC) 80330 Cl skull fx NEC/hem NEC (MCC) 80416 Cl skl w oth fx-coma NOS (MCC) 80331 Cl skull fx NEC w/o coma (MCC) 80419 Cl skul w oth fx-concuss (MCC) 80332 Cl skull fx NEC-brf coma (MCC) 80420 Cl skl/oth fx/mening hem (MCC) 80333 Cl skull fx NEC-mod coma (MCC) 80421 Cl skl w oth fx w/o coma (MCC) 80334 Cl skl fx NEC-proln coma (MCC) 80422 Cl skl w oth fx-brf coma (MCC) 80335 Cl skul fx NEC-deep coma (MCC) 80423 Cl skl w oth fx-mod coma (MCC) 80336 Cl skull fx NEC-coma NOS (MCC) 80424 Cl skl/oth fx-proln coma (MCC) 80339 Cl skull fx NEC-concuss (MCC) 80425 Cl skul/oth fx-deep coma (MCC) 80340 Cl skl fx NEC/br inj NEC (CC) 80426 Cl skl w oth fx-coma NOS (MCC) 80341 Cl skull fx NEC w/o coma (CC) 80429 Cl skul w oth fx-concuss (MCC) 80342 Cl skull fx NEC-brf coma (CC) 80430 Cl skul w oth fx/hem NEC (MCC) 80343 Cl skull fx NEC-mod coma (MCC) 80431 Cl skl w oth fx w/o coma (MCC) 80344 Cl skl fx NEC-proln coma (MCC) 80432 Cl skl w oth fx-brf coma (MCC) 80345 Cl skul fx NEC-deep coma (MCC) 80433 Cl skl w oth fx-mod coma (MCC) 80346 Cl skull fx NEC-coma NOS (CC) 80434 Cl skl/oth fx-proln coma (MCC) 80349 Cl skull fx NEC-concuss (CC) 80435 Cl skul/oth fx-deep coma (MCC) 80350 Open skull fracture NEC (MCC) 80436 Cl skl w oth fx-coma NOS (MCC) 80351 Opn skul fx NEC w/o coma (MCC) 80439 Cl skul w oth fx-concuss (MCC) 80352 Opn skul fx NEC-brf coma (MCC) 80440 Cl skl/oth fx/br inj NEC (CC) 80353 Opn skul fx NEC-mod coma (MCC) 80441 Cl skl w oth fx w/o coma (CC) 80354 Opn skl fx NEC-prol coma (MCC) 80442 Cl skl w oth fx-brf coma (CC) 80355 Opn skl fx NEC-deep coma (MCC) 80443 Cl skl w oth fx-mod coma (MCC) 80356 Opn skul fx NEC-coma NOS (MCC) 80444 Cl skl/oth fx-proln coma (MCC) 80359 Opn skull fx NEC-concuss (MCC) 80445 Cl skul/oth fx-deep coma (MCC) 80360 Opn skl fx NEC/cereb lac (MCC) 80446 Cl skl w oth fx-coma NOS (CC) 80361 Opn skul fx NEC w/o coma (MCC) 80449 Cl skul w oth fx-concuss (CC) 80362 Opn skul fx NEC-brf coma (MCC) 80450 Opn skull fx/oth bone fx (CC) 80363 Opn skul fx NEC-mod coma (MCC) 80451 Opn skul/oth fx w/o coma (CC) 80364 Opn skl fx NEC-proln com (MCC) 80452 Opn skul/oth fx-brf coma (CC) 80365 Opn skl fx NEC-deep coma (MCC) 80453 Opn skul/oth fx-mod coma (MCC) 80366 Opn skul fx NEC-coma NOS (MCC) 80454 Opn skl/oth fx-prol coma (MCC) 80369 Opn skull fx NEC-concuss (MCC) 80455 Opn skl/oth fx-deep coma (MCC) 80370 Opn skl fx NEC/menin hem (MCC) 80456 Opn skul/oth fx-coma NOS (CC) 80371 Opn skul fx NEC w/o coma (MCC) 80459 Opn skull/oth fx-concuss (CC) 80372 Opn skul fx NEC-brf coma (MCC) 80460 Opn skl/oth fx/cereb lac (MCC) 80373 Opn skul fx NEC-mod coma (MCC) 80461 Opn skul/oth fx w/o coma (MCC) 80374 Opn skl fx NEC-prol coma (MCC) 80462 Opn skul/oth fx-brf coma (MCC) 80375 Opn skl fx NEC-deep coma (MCC) 80463 Opn skul/oth fx-mod coma (MCC) 80376 Opn skul fx NEC-coma NOS (MCC) 80464 Opn skl/oth fx-prol coma (MCC) 80379 Opn skull fx NEC-concuss (MCC) 80465 Opn skl/oth fx-deep coma (MCC) 80380 Opn skull fx NEC/hem NEC (MCC) 80466 Opn skul/oth fx-coma NOS (MCC) 80381 Opn skul fx NEC w/o coma (MCC) 80469 Opn skull/oth fx-concuss (MCC) 80382 Opn skul fx NEC-brf coma (MCC) 80470 Opn skl/oth fx/menin hem (MCC) 80383 Opn skul fx NEC-mod coma (MCC) 80471 Opn skul/oth fx w/o coma (MCC) 80384 Opn skl fx NEC-prol coma (MCC) 80472 Opn skul/oth fx-brf coma (MCC) 80385 Opn skl fx NEC-deep coma (MCC) 80473 Opn skul/oth fx-mod coma (MCC) 80386 Opn skul fx NEC-coma NOS (MCC) 80474 Opn skl/oth fx-prol coma (MCC) 80389 Opn skull fx NEC-concuss (MCC) 80475 Opn skl/oth fx-deep coma (MCC) 80390 Op skl fx NEC/br inj NEC (MCC) 80476 Opn skul/oth fx-coma NOS (MCC) 80391 Opn skul fx NEC w/o coma (MCC) 80479 Opn skull/oth fx-concuss (MCC) 80392 Opn skul fx NEC-brf coma (MCC) 80480 Opn skl w oth fx/hem NEC (MCC) 80393 Opn skul fx NEC-mod coma (MCC) 80481 Opn skul/oth fx w/o coma (MCC) 80394 Opn skl fx NEC-prol coma (MCC) 80482 Opn skul/oth fx-brf coma (MCC) 80395 Opn skl fx NEC-deep coma (MCC) 80483 Opn skul/oth fx-mod coma (MCC) 80396 Opn skul fx NEC-coma NOS (MCC) 80484 Opn skl/oth fx-prol coma (MCC) 80399 Opn skull fx NEC-concuss (MCC) 80485 Opn skl/oth fx-deep coma (MCC) 80400 Cl skul fx w oth bone fx (CC) 80486 Opn skul/oth fx-coma NOS (MCC) 80401 Cl skl w oth fx w/o coma (CC) 80489 Opn skull/oth fx-concuss (MCC) 80402 Cl skl w oth fx-brf coma (CC) 80490 Op skl/oth fx/br inj NEC (CC) 80403 Cl skl w oth fx-mod coma (MCC) 80491 Opn skul/oth fx w/o coma (CC) 80404 Cl skl/oth fx-proln coma (MCC) 80492 Opn skul/oth fx-brf coma (CC)

1109 APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST 80493 Opn skul/oth fx-mod coma (MCC) 80639 T7-t12 fx-op/crd inj NEC (MCC) 80494 Opn skl/oth fx-prol coma (MCC) 8064 Cl lumbar fx w cord inj (MCC) 80495 Opn skl/oth fx-deep coma (MCC) 8065 Opn lumbar fx w cord inj (MCC) 80496 Opn skul/oth fx-coma NOS (CC) 80660 Fx sacrum-cl/crd inj NOS (MCC) 80499 Opn skull/oth fx-concuss (CC) 80661 Fx sacr-cl/cauda equ les (MCC) 80500 Fx cervical vert NOS-cl (CC) 80662 Fx sacr-cl/cauda inj NEC (MCC) 80501 Fx c1 vertebra-closed (CC) 80669 Fx sacrum-cl/crd inj NEC (MCC) 80502 Fx c2 vertebra-closed (CC) 80670 Fx sacrum-op/crd inj NOS (MCC) 80503 Fx c3 vertebra-closed (CC) 80671 Fx sacr-op/cauda equ les (MCC) 80504 Fx c4 vertebra-closed (CC) 80672 Fx sacr-op/cauda inj NEC (MCC) 80505 Fx c5 vertebra-closed (CC) 80679 Fx sacrum-op/crd inj NEC (MCC) 80506 Fx c6 vertebra-closed (CC) 8068 Vert fx NOS-cl w crd inj (MCC) 80507 Fx c7 vertebra-closed (CC) 8069 Vert fx NOS-op w crd inj (MCC) 80508 Fx mult cervical vert-cl (CC) 80700 Fracture rib NOS-closed (CC) 80510 Fx cervical vert NOS-opn (MCC) 80701 Fracture one rib-closed (CC) 80511 Fx c1 vertebra-open (MCC) 80702 Fracture two ribs-closed (CC) 80512 Fx c2 vertebra-open (MCC) 80703 Fracture three ribs-clos (CC) 80513 Fx c3 vertebra-open (MCC) 80704 Fracture four ribs-close (CC) 80514 Fx c4 vertebra-open (MCC) 80705 Fracture five ribs-close (CC) 80515 Fx c5 vertebra-open (MCC) 80706 Fracture six ribs-closed (CC) 80516 Fx c6 vertebra-open (MCC) 80707 Fracture seven ribs-clos (CC) 80517 Fx c7 vertebra-open (MCC) 80708 Fx eight/more rib-closed (CC) 80518 Fx mlt cervical vert-opn (MCC) 80709 Fx mult ribs NOS-closed (CC) 8052 Fx dorsal vertebra-close (CC) 80710 Fracture rib NOS-open (MCC) 8053 Fx dorsal vertebra-open (MCC) 80711 Fracture one rib-open (MCC) 8054 Fx lumbar vertebra-close (CC) 80712 Fracture two ribs-open (MCC) 8055 Fx lumbar vertebra-open (MCC) 80713 Fracture three ribs-open (MCC) 8056 Fx sacrum/coccyx-closed (CC) 80714 Fracture four ribs-open (MCC) 8057 Fx sacrum/coccyx-open (MCC) 80715 Fracture five ribs-open (MCC) 8058 Vertebral fx NOS-closed (CC) 80716 Fracture six ribs-open (MCC) 8059 Vertebral fx NOS-open (MCC) 80717 Fracture seven ribs-open (MCC) 80600 C1-c4 fx-cl/cord inj NOS (MCC) 80718 Fx eight/more ribs-open (MCC) 80601 C1-c4 fx-cl/com cord les (MCC) 80719 Fx mult ribs NOS-open (MCC) 80602 C1-c4 fx-cl/ant cord syn (MCC) 8072 Fracture of sternum-clos (CC) 80603 C1-c4 fx-cl/cen cord syn (MCC) 8073 Fracture of sternum-open (MCC) 80604 C1-c4 fx-cl/cord inj NEC (MCC) 8074 Flail chest (MCC) 80605 C5-c7 fx-cl/cord inj NOS (MCC) 8075 Fx larynx/trachea-closed (MCC) 80606 C5-c7 fx-cl/com cord les (MCC) 8076 Fx larynx/trachea-open (MCC) 80607 C5-c7 fx-cl/ant cord syn (MCC) 8080 Fracture acetabulum-clos (MCC) 80608 C5-c7 fx-cl/cen cord syn (MCC) 8081 Fracture acetabulum-open (MCC) 80609 C5-c7 fx-cl/cord inj NEC (MCC) 8082 Fracture of pubis-closed (CC) 80610 C1-c4 fx-op/cord inj NOS (MCC) 8083 Fracture of pubis-open (MCC) 80611 C1-c4 fx-op/com cord les (MCC) 80841 Fracture of ilium-closed (CC) 80612 C1-c4 fx-op/ant cord syn (MCC) 80842 Fracture ischium-closed (CC) 80613 C1-c4 fx-op/cen cord syn (MCC) 80843 Pelv fx-clos/pelv disrup (CC) 80614 C1-c4 fx-op/cord inj NEC (MCC) 80844 Pelv fx-cl w/o plv disrp (CC) 80615 C5-c7 fx-op/cord inj NOS (MCC) 80849 Pelvic fracture NEC-clos (CC) 80616 C5-c7 fx-op/com cord les (MCC) 80851 Fracture of ilium-open (MCC) 80617 C5-c7 fx-op/ant cord syn (MCC) 80852 Fracture of ischium-open (MCC) 80618 C5-c7 fx-op/cen cord syn (MCC) 80853 Pelv fx-open/pelv disrup (MCC) 80619 C5-c7 fx-op/cord inj NEC (MCC) 80854 Pelv fx-opn w/o pelv dis (MCC) 80620 T1-t6 fx-cl/cord inj NOS (MCC) 80859 Pelvic fracture NEC-open (MCC) 80621 T1-t6 fx-cl/com cord les (MCC) 8088 Pelvic fracture NOS-clos (CC) 80622 T1-t6 fx-cl/ant cord syn (MCC) 8089 Pelvic fracture NOS-open (MCC) 80623 T1-t6 fx-cl/cen cord syn (MCC) 8090 Fracture trunk bone-clos (CC) 80624 T1-t6 fx-cl/cord inj NEC (MCC) 8091 Fracture trunk bone-open (MCC) 80625 T7-t12 fx-cl/crd inj NOS (MCC) 81010 Fx clavicle NOS-open (CC) 80626 T7-t12 fx-cl/com crd les (MCC) 81011 Fx clavic, stern end-opn (CC) 80627 T7-t12 fx-cl/ant crd syn (MCC) 81012 Fx clavicle shaft-open (CC) 80628 T7-t12 fx-cl/cen crd syn (MCC) 81013 Fx clavic, acrom end-opn (CC) 80629 T7-t12 fx-cl/crd inj NEC (MCC) 81110 Fx scapula NOS-open (CC) 80630 T1-t6 fx-op/cord inj NOS (MCC) 81111 Fx scapul, acrom proc-op (CC) 80631 T1-t6 fx-op/com cord les (MCC) 81112 Fx scapul, corac proc-op (CC) 80632 T1-t6 fx-op/ant cord syn (MCC) 81113 Fx scap, glen cav/nck-op (CC) 80633 T1-t6 fx-op/cen cord syn (MCC) 81119 Fx scapula NEC-open (CC) 80634 T1-t6 fx-op/cord inj NEC (MCC) 81200 Fx up end humerus NOS-cl (CC) 80635 T7-t12 fx-op/crd inj NOS (MCC) 81201 Fx surg nck humerus-clos (CC) 80636 T7-t12 fx-op/com crd les (MCC) 81202 Fx anatom nck humerus-cl (CC) 80637 T7-t12 fx-op/ant crd syn (MCC) 81203 Fx gr tuberos humerus-cl (CC) 80638 T7-t12 fx-op/cen crd syn (MCC) 81209 Fx upper humerus NEC-cl (CC)

1110 APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST 81210 Fx upper humerus NOS-opn (MCC) 81512 Fx metacarp base NEC-opn (CC) 81211 Fx surg neck humerus-opn (MCC) 81513 Fx metacarpal shaft-open (CC) 81212 Fx anat neck humerus-opn (MCC) 81514 Fx metacarpal neck-open (CC) 81213 Fx gr tuberos humer-open (MCC) 81519 Mult fx metacarpus-open (CC) 81219 Fx upper humerus NEC-opn (MCC) 81610 Fx phalanx, hand NOS-opn (CC) 81220 Fx humerus NOS-closed (CC) 81611 Fx mid/prx phal, hand-op (CC) 81221 Fx humerus shaft-closed (CC) 81612 Fx distal phal, hand-opn (CC) 81230 Fx humerus NOS-open (MCC) 81613 Fx mult phalan, hand-opn (CC) 81231 Fx humerus shaft-open (MCC) 8171 Multiple fx hand-open (CC) 81240 Fx lower humerus NOS-cl (CC) 8181 Fx arm mult/NOS-open (CC) 81241 Suprcondyl fx humerus-cl (CC) 8190 Fx arms w rib/sternum-cl (CC) 81242 Fx humer, lat condyl-cl (CC) 8191 Fx arms w rib/stern-open (CC) 81243 Fx humer, med condyl-cl (CC) 82000 Fx femur intrcaps NOS-cl (MCC) 81244 Fx humer, condyl NOS-cl (CC) 82001 Fx up femur epiphy-clos (MCC) 81249 Fx lower humerus NEC-cl (CC) 82002 Fx femur, midcervic-clos (MCC) 81250 Fx lower humer NOS-open (MCC) 82003 Fx base femoral nck-clos (MCC) 81251 Supracondyl fx humer-opn (MCC) 82009 Fx femur intrcaps NEC-cl (MCC) 81252 Fx humer, lat condyl-opn (MCC) 82010 Fx femur intrcap NOS-opn (MCC) 81253 Fx humer, med condyl-opn (MCC) 82011 Fx up femur epiphy-open (MCC) 81254 Fx humer, condyl NOS-opn (MCC) 82012 Fx femur, midcervic-open (MCC) 81259 Fx lower humer NEC-open (MCC) 82013 Fx base femoral nck-open (MCC) 81310 Fx upper forearm NOS-opn (MCC) 82019 Fx femur intrcap NEC-opn (MCC) 81311 Fx olecran proc ulna-opn (MCC) 82020 Trochanteric fx NOS-clos (MCC) 81312 Fx coronoid pro ulna-opn (MCC) 82021 Intertrochanteric fx-cl (MCC) 81313 Monteggia's fx-open (MCC) 82022 Subtrochanteric fx-close (MCC) 81314 Fx up ulna NEC/NOS-open (MCC) 82030 Trochanteric fx NOS-open (MCC) 81315 Fx radius head-open (MCC) 82031 Intertrochanteric fx-opn (MCC) 81316 Fx radius neck-open (MCC) 82032 Subtrochanteric fx-open (MCC) 81317 Fx up radius NEC/NOS-opn (MCC) 8208 Fx neck of femur NOS-cl (MCC) 81318 Fx up radius w ulna-open (MCC) 8209 Fx neck of femur NOS-opn (MCC) 81320 Fx shaft forearm NOS-cl (CC) 82100 Fx femur NOS-closed (MCC) 81321 Fx radius shaft-closed (CC) 82101 Fx femur shaft-closed (MCC) 81322 Fx ulna shaft-closed (CC) 82110 Fx femur NOS-open (MCC) 81323 Fx shaft rad w ulna-clos (CC) 82111 Fx femur shaft-open (MCC) 81330 Fx shaft forearm NOS-opn (MCC) 82120 Fx low end femur NOS-cl (CC) 81331 Fx radius shaft-open (MCC) 82121 Fx femoral condyle-close (CC) 81332 Fx ulna shaft-open (MCC) 82122 Fx low femur epiphy-clos (CC) 81333 Fx shaft rad w ulna-open (MCC) 82123 Supracondyl fx femur-cl (CC) 81340 Fx lower forearm NOS-cl (CC) 82129 Fx low end femur NEC-cl (CC) 81341 Colles' fracture-closed (CC) 82130 Fx low end femur NOS-opn (MCC) 81342 Fx distal radius NEC-cl (CC) 82131 Fx femoral condyle-open (MCC) 81343 Fx distal ulna-closed (CC) 82132 Fx low femur epiphy-open (MCC) 81344 Fx low radius w ulna-cl (CC) 82133 Supracondyl fx femur-opn (MCC) 81345 Torus fx radius-cl/alone (CC) 82139 Fx low end femur NEC-opn (MCC) 81346 Torus fx ulna-closed (CC) 8220 Fracture patella-closed (CC) 81347 Torus fx radius/ulna-clo (CC) 8221 Fracture patella-open (CC) 81350 Fx lower forearm NOS-opn (MCC) 82300 Fx upper end tibia-close (CC) 81351 Colles' fracture-open (MCC) 82302 Fx up tibia w fibula-cl (CC) 81352 Fx distal radius NEC-opn (MCC) 82310 Fx upper end tibia-open (MCC) 81353 Fx distal ulna-open (MCC) 82311 Fx upper end fibula-open (MCC) 81354 Fx low radius w ulna-opn (MCC) 82312 Fx up tibia w fibula-opn (MCC) 81380 Fx forearm NOS-closed (CC) 82320 Fx shaft tibia-closed (CC) 81382 Fracture ulna NOS-closed (CC) 82322 Fx shaft fib w tib-clos (CC) 81383 Fx radius w ulna NOS-cl (CC) 82330 Fx tibia shaft-open (MCC) 81390 Fx forearm NOS-open (MCC) 82331 Fx fibula shaft-open (MCC) 81391 Fracture radius NOS-open (MCC) 82332 Fx shaft tibia w fib-opn (MCC) 81392 Fracture ulna NOS-open (MCC) 82340 Torus fracture of tibia (CC) 81393 Fx radius w ulna NOS-opn (MCC) 82342 Torus fx tibia/fibula (CC) 81410 Fx carpal bone NOS-open (CC) 82380 Fx tibia NOS-closed (CC) 81411 Fx navicular, wrist-open (CC) 82382 Fx tibia w fibula NOS-cl (CC) 81412 Fx lunate, wrist-open (CC) 82390 Fx tibia NOS-open (MCC) 81413 Fx triquetral, wrist-opn (CC) 82391 Fx fibula NOS-open (MCC) 81414 Fx pisiform-open (CC) 82392 Fx tibia w fib NOS-open (MCC) 81415 Fx trapezium bone-open (CC) 8241 Fx medial malleolus-open (CC) 81416 Fx trapezoid bone-open (CC) 8243 Fx lateral malleolus-opn (CC) 81417 Fx capitate bone-open (CC) 8245 Fx bimalleolar-open (CC) 81418 Fx hamate bone-open (CC) 8247 Fx trimalleolar-open (CC) 81419 Fx carpal bone NEC-open (CC) 8249 Fx ankle NOS-open (CC) 81510 Fx metacarpal NOS-open (CC) 8251 Fracture calcaneus-open (CC) 81511 Fx 1st metacarp base-opn (CC) 82530 Fx foot bone NOS-open (CC)

1111 APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST 82531 Fx astragalus-open (CC) 83971 Dislocation sternum-open (MCC) 82532 Fx navicular, foot-open (CC) 83979 Dislocat site NEC-open (CC) 82533 Fx cuboid-open (CC) 8399 Dislocation NEC-open (CC) 82534 Fx cuneiform, foot-open (CC) 85011 Concus-brief coma <31 mn (CC) 82535 Fx metatarsal-open (CC) 85012 Concus-brf coma 31-59 mn (CC) 82539 Fx foot bone NEC-open (CC) 8502 Concussion-moderate coma (CC) 8271 Fx lower limb NEC-open (CC) 8503 Concussion-prolong coma (CC) 8280 Fx legs w arm/rib-closed (MCC) 8504 Concussion-deep coma (MCC) 8281 Fx legs w arm/rib-open (MCC) 8505 Concussion w coma NOS (CC) 8301 Dislocation jaw-open (CC) 85102 Cortex contus-brief coma (CC) 83110 Disloc shoulder NOS-open (CC) 85103 Cortex contus-mod coma (CC) 83111 Ant disloc humerus-open (CC) 85104 Cortx contus-prolng coma (CC) 83112 Post disloc humerus-open (CC) 85105 Cortex contus-deep coma (MCC) 83113 Infer disloc humerus-opn (CC) 85106 Cortex contus-coma NOS (CC) 83114 Disloc acromioclavic-opn (CC) 85110 Cortex contusion/opn wnd (MCC) 83119 Disloc shoulder NEC-open (CC) 85111 Opn cortx contus-no coma (MCC) 83210 Dislocat elbow NOS-open (CC) 85112 Opn cort contus-brf coma (MCC) 83211 Ant disloc elbow-open (CC) 85113 Opn cort contus-mod coma (MCC) 83212 Post disloc elbow-open (CC) 85114 Opn cort contu-prol coma (MCC) 83213 Med disloc elbow-open (CC) 85115 Opn cort contu-deep coma (MCC) 83214 Lat dislocat elbow-open (CC) 85116 Opn cort contus-coma NOS (MCC) 83219 Dislocat elbow NEC-open (CC) 85119 Opn cortx contus-concuss (MCC) 83310 Dislocat wrist NOS-open (CC) 85120 Cerebral cortex lacerat (MCC) 83311 Disloc dist radiouln-opn (CC) 85121 Cortex lacerat w/o coma (MCC) 83312 Disloc radiocarpal-open (CC) 85122 Cortex lacera-brief coma (MCC) 83313 Dislocat midcarpal-open (CC) 85123 Cortex lacerat-mod coma (MCC) 83314 Disloc carpometacarp-opn (CC) 85124 Cortex lacerat-prol coma (MCC) 83315 Dislocat metacarpal-open (CC) 85125 Cortex lacerat-deep coma (MCC) 83319 Dislocat wrist NEC-open (CC) 85126 Cortex lacerat-coma NOS (MCC) 83500 Dislocat hip NOS-closed (CC) 85129 Cortex lacerat-concuss (MCC) 83501 Posterior disloc hip-cl (CC) 85130 Cortex lacer w opn wound (MCC) 83502 Obturator disloc hip-cl (CC) 85131 Opn cortex lacer-no coma (MCC) 83503 Ant disloc hip NEC-clos (CC) 85132 Opn cortx lac-brief coma (MCC) 83510 Dislocation hip NOS-open (MCC) 85133 Opn cortx lacer-mod coma (MCC) 83511 Posterior disloc hip-opn (MCC) 85134 Opn cortx lac-proln coma (MCC) 83512 Obturator disloc hip-opn (MCC) 85135 Opn cortex lac-deep coma (MCC) 83513 Ant disloc hip NEC-open (MCC) 85136 Opn cortx lacer-coma NOS (MCC) 8364 Dislocation patella-open (CC) 85139 Opn cortx lacer-concuss (MCC) 83660 Dislocat knee NOS-open (CC) 85142 Cerebell contus-brf coma (CC) 83661 Ant disl prox tibia-open (CC) 85143 Cerebell contus-mod coma (CC) 83662 Post disl prox tibia-opn (CC) 85144 Cerebel contus-prol coma (CC) 83663 Med disl prox tibia-open (CC) 85145 Cerebel contus-deep coma (MCC) 83664 Lat disl prox tibia-open (CC) 85146 Cerebell contus-coma NOS (CC) 83669 Dislocat knee NEC-open (CC) 85150 Cerebel contus w opn wnd (MCC) 8371 Dislocation ankle-open (CC) 85151 Opn cerebe cont w/o coma (MCC) 83900 Disloc cerv vert NOS-cl (CC) 85152 Opn cerebe cont-brf coma (MCC) 83901 Disloc 1st cerv vert-cl (CC) 85153 Opn cerebe cont-mod coma (MCC) 83902 Disloc 2nd cerv vert-cl (CC) 85154 Opn cerebe cont-prol com (MCC) 83903 Disloc 3rd cerv vert-cl (CC) 85155 Opn cerebe cont-deep com (MCC) 83904 Disloc 4th cerv vert-cl (CC) 85156 Opn cerebe cont-coma NOS (MCC) 83905 Disloc 5th cerv vert-cl (CC) 85159 Opn cerebel cont-concuss (MCC) 83906 Disloc 6th cerv vert-cl (CC) 85160 Cerebel/brain stem lacer (MCC) 83907 Disloc 7th cerv vert-cl (CC) 85161 Cerebel lacerat w/o coma (MCC) 83908 Disloc mult cerv vert-cl (CC) 85162 Cerebel lacer-brief coma (MCC) 83910 Disloc cerv vert NOS-opn (MCC) 85163 Cerebel lacerat-mod coma (MCC) 83911 Disloc lst cerv vert-opn (MCC) 85164 Cerebel lacer-proln coma (MCC) 83912 Disloc 2nd cerv vert-opn (MCC) 85165 Cerebell lacer-deep coma (MCC) 83913 Disloc 3rd cerv vert-opn (MCC) 85166 Cerebel lacerat-coma NOS (MCC) 83914 Disloc 4th cerv vert-opn (MCC) 85169 Cerebel lacer-concussion (MCC) 83915 Disloc 5th cerv vert-opn (MCC) 85170 Cerebel lacer w open wnd (MCC) 83916 Disloc 6th cerv vert-opn (MCC) 85171 Opn cerebel lac w/o coma (MCC) 83917 Disloc 7th cerv vert-opn (MCC) 85172 Opn cerebel lac-brf coma (MCC) 83918 Disloc mlt cerv vert-opn (MCC) 85173 Opn cerebel lac-mod coma (MCC) 83930 Dislocat lumbar vert-opn (MCC) 85174 Opn cerebe lac-prol coma (MCC) 83931 Disloc thoracic vert-opn (MCC) 85175 Opn cerebe lac-deep coma (MCC) 83950 Disloc vertebra NOS-open (MCC) 85176 Opn cerebel lac-coma NOS (MCC) 83951 Dislocat coccyx-open (CC) 85179 Opn cerebell lac-concuss (MCC) 83952 Dislocat sacrum-open (CC) 85180 Brain laceration NEC (MCC) 83959 Disloc vertebra NEC-open (MCC) 85181 Brain lacer NEC w/o coma (MCC) 83961 Dislocat sternum-closed (CC) 85182 Brain lac NEC-brief coma (MCC)

1112 APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST 85183 Brain lacer NEC-mod coma (MCC) 85311 Brain hem opn w/o coma (MCC) 85184 Brain lac NEC-proln coma (MCC) 85312 Brain hem opn-brf coma (MCC) 85185 Brain lac NEC-deep coma (MCC) 85313 Brain hem open-mod coma (MCC) 85186 Brain lacer NEC-coma NOS (MCC) 85314 Brain hem opn-proln coma (MCC) 85189 Brain lacer NEC-concuss (MCC) 85315 Brain hem open-deep coma (MCC) 85190 Brain lac NEC w open wnd (MCC) 85316 Brain hem open-coma NOS (MCC) 85191 Opn brain lacer w/o coma (MCC) 85319 Brain hem opn-concussion (MCC) 85192 Opn brain lac-brief coma (MCC) 85402 Brain inj NEC-brief coma (CC) 85193 Opn brain lacer-mod coma (MCC) 85403 Brain inj NEC-mod coma (CC) 85194 Opn brain lac-proln coma (MCC) 85404 Brain inj NEC-proln coma (CC) 85195 Open brain lac-deep coma (MCC) 85405 Brain inj NEC-deep coma (MCC) 85196 Opn brain lacer-coma NOS (MCC) 85406 Brain inj NEC-coma NOS (CC) 85199 Open brain lacer-concuss (MCC) 85410 Brain injury w opn wnd (MCC) 85200 Traum subarachnoid hem (MCC) 85411 Opn brain inj w/o coma (MCC) 85201 Subarachnoid hem-no coma (MCC) 85412 Opn brain inj-brief coma (MCC) 85202 Subarach hem-brief coma (MCC) 85413 Opn brain inj-mod coma (MCC) 85203 Subarach hem-mod coma (MCC) 85414 Opn brain inj-proln coma (MCC) 85204 Subarach hem-prolng coma (MCC) 85415 Opn brain inj-deep coma (MCC) 85205 Subarach hem-deep coma (MCC) 85416 Open brain inj-coma NOS (MCC) 85206 Subarach hem-coma NOS (MCC) 85419 Opn brain inj-concussion (MCC) 85209 Subarach hem-concussion (MCC) 9251 Crush inj face scalp (CC) 85210 Subarach hem w opn wound (MCC) 9252 Crush inj neck (CC) 85211 Opn subarach hem-no coma (MCC) 92800 Crushing injury thigh (CC) 85212 Op subarach hem-brf coma (MCC) 92801 Crushing injury hip (CC) 85213 Op subarach hem-mod coma (MCC) 9405 Burn w eyeball destruct (CC) 85214 Op subarach hem-prol com (MCC) 94130 3rd deg burn head NOS (CC) 85215 Op subarach hem-deep com (MCC) 94131 3rd deg burn ear (CC) 85216 Op subarach hem-coma NOS (MCC) 94132 3rd deg burn eye (CC) 85219 Opn subarach hem-concuss (MCC) 94133 3rd deg burn lip (CC) 85220 Traumatic subdural hem (MCC) 94134 3rd deg burn chin (CC) 85221 Subdural hem w/o coma (MCC) 94135 3rd deg burn nose (CC) 85222 Subdural hem-brief coma (MCC) 94136 3rd deg burn scalp (CC) 85223 Subdural hemorr-mod coma (MCC) 94137 3rd deg burn face NEC (CC) 85224 Subdural hem-prolng coma (MCC) 94138 3rd deg burn neck (CC) 85225 Subdural hem-deep coma (MCC) 94139 3rd deg burn head-mult (CC) 85226 Subdural hemorr-coma NOS (MCC) 94140 Deep 3 deg burn head NOS (CC) 85229 Subdural hem-concussion (MCC) 94141 Deep 3rd deg burn ear (CC) 85230 Subdural hem w opn wound (MCC) 94142 Deep 3rd deg burn eye (CC) 85231 Open subdur hem w/o coma (MCC) 94143 Deep 3rd deg burn lip (CC) 85232 Opn subdur hem-brf coma (MCC) 94144 Deep 3rd deg burn chin (CC) 85233 Opn subdur hem-mod coma (MCC) 94145 Deep 3rd deg burn nose (CC) 85234 Opn subdur hem-prol coma (MCC) 94146 Deep 3rd deg burn scalp (CC) 85235 Opn subdur hem-deep coma (MCC) 94147 Deep 3rd burn face NEC (CC) 85236 Opn subdur hem-coma NOS (MCC) 94148 Deep 3rd deg burn neck (CC) 85239 Opn subdur hem-concuss (MCC) 94149 Deep 3 deg brn head-mult (CC) 85240 Traumatic extradural hem (MCC) 94150 3rd burn w loss-head NOS (CC) 85241 Extradural hem w/o coma (MCC) 94151 3rd deg burn w loss-ear (CC) 85242 Extradur hem-brief coma (MCC) 94152 3rd deg burn w loss-eye (CC) 85243 Extradural hem-mod coma (MCC) 94153 3rd deg burn w loss-lip (CC) 85244 Extradur hem-proln coma (MCC) 94154 3rd deg burn w loss-chin (CC) 85245 Extradural hem-deep coma (MCC) 94155 3rd deg burn w loss-nose (CC) 85246 Extradural hem-coma NOS (MCC) 94156 3rd deg brn w loss-scalp (CC) 85249 Extadural hem-concuss (MCC) 94157 3rd burn w loss-face NEC (CC) 85250 Extradural hem w opn wnd (MCC) 94158 3rd deg burn w loss-neck (CC) 85251 Extradural hemor-no coma (MCC) 94159 3rd brn w loss-head mult (CC) 85252 Extradur hem-brief coma (MCC) 94230 3rd deg burn trunk NOS (CC) 85253 Extradural hem-mod coma (MCC) 94231 3rd deg burn breast (CC) 85254 Extradur hem-proln coma (MCC) 94232 3rd deg burn chest wall (CC) 85255 Extradur hem-deep coma (MCC) 94233 3rd deg burn abdomn wall (CC) 85256 Extradural hem-coma NOS (MCC) 94234 3rd deg burn back (CC) 85259 Extradural hem-concuss (MCC) 94235 3rd deg burn genitalia (CC) 85300 Traumatic brain hem NEC (MCC) 94239 3rd deg burn trunk NEC (CC) 85301 Brain hem NEC w/o coma (MCC) 94240 Deep 3rd burn trunk NOS (CC) 85302 Brain hem NEC-brief coma (MCC) 94241 Deep 3rd deg burn breast (CC) 85303 Brain hem NEC-mod coma (MCC) 94242 Deep 3rd burn chest wall (CC) 85304 Brain hem NEC-proln coma (MCC) 94243 Deep 3rd burn abdom wall (CC) 85305 Brain hem NEC-deep coma (MCC) 94244 Deep 3rd deg burn back (CC) 85306 Brain hem NEC-coma NOS (MCC) 94245 Deep 3rd burn genitalia (CC) 85309 Brain hem NEC-concussion (MCC) 94249 Deep 3rd burn trunk NEC (CC) 85310 Brain hem NEC w opn wnd (MCC) 94250 3rd brn w loss-trunk NOS (CC)

1113 APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST 94251 3rd burn w loss-breast (CC) 94545 Deep 3rd deg burn knee (CC) 94252 3rd brn w loss-chest wll (CC) 94546 Deep 3rd deg burn thigh (CC) 94253 3rd brn w loss-abdom wll (CC) 94549 Deep 3 deg burn leg-mult (CC) 94254 3rd deg burn w loss-back (CC) 94550 3 deg brn w loss-leg NOS (CC) 94255 3rd brn w loss-genitalia (CC) 94551 3 deg burn w loss-toe (CC) 94259 3rd brn w loss-trunk NEC (CC) 94552 3 deg burn w loss-foot (CC) 94330 3rd deg burn arm NOS (CC) 94553 3 deg burn w loss-ankle (CC) 94331 3rd deg burn forearm (CC) 94554 3 deg brn w loss-low leg (CC) 94332 3rd deg burn elbow (CC) 94555 3 deg burn w loss-knee (CC) 94333 3rd deg burn upper arm (CC) 94556 3 deg burn w loss-thigh (CC) 94334 3rd deg burn axilla (CC) 94559 3 deg brn w loss leg-mlt (CC) 94335 3rd deg burn shoulder (CC) 9463 3rd deg burn mult site (CC) 94336 3rd deg burn scapula (CC) 9464 Deep 3 deg brn mult site (CC) 94339 3rd deg burn arm-mult (CC) 9465 3rd brn w loss-mult site (CC) 94340 Deep 3 deg burn arm NOS (CC) 9471 Burn larynx/trachea/lung (CC) 94341 Deep 3 deg burn forearm (CC) 9472 Burn of esophagus (CC) 94342 Deep 3 deg burn elbow (CC) 9473 Burn of GI tract (CC) 94343 Deep 3 deg brn upper arm (CC) 9474 Burn of vagina & uterus (CC) 94344 Deep 3 deg burn axilla (CC) 94810 10-19% bdy brn/3 deg NOS (CC) 94345 Deep 3 deg burn shoulder (CC) 94811 10-19% bdy brn/10-19% 3d (CC) 94346 Deep 3 deg burn scapula (CC) 94820 20-29% bdy brn/3 deg NOS (CC) 94349 Deep 3 deg burn arm-mult (CC) 94821 20-29% bdy brn/10-19% 3d (MCC) 94350 3rd burn w loss-arm NOS (CC) 94822 20-29% bdy brn/20-29% 3d (MCC) 94351 3rd burn w loss-forearm (CC) 94830 30-39% bdy brn/3 deg NOS (CC) 94352 3rd burn w loss-elbow (CC) 94831 30-39% bdy brn/10-19% 3d (MCC) 94353 3rd brn w loss-upper arm (CC) 94832 30-39% bdy brn/20-29% 3d (MCC) 94354 3rd burn w loss-axilla (CC) 94833 30-39% bdy brn/30-39% 3d (MCC) 94355 3rd burn w loss-shoulder (CC) 94840 40-49% bdy brn/3 deg NOS (CC) 94356 3rd burn w loss-scapula (CC) 94841 40-49% bdy brn/10-19% 3d (MCC) 94359 3rd burn w loss arm-mult (CC) 94842 40-49% bdy brn/20-29% 3d (MCC) 94430 3rd deg burn hand NOS (CC) 94843 40-49% bdy brn/30-39% 3d (MCC) 94431 3rd deg burn finger (CC) 94844 40-49% bdy brn/40-49% 3d (MCC) 94432 3rd deg burn thumb (CC) 94850 50-59% bdy brn/3 deg NOS (CC) 94433 3rd deg burn mult finger (CC) 94851 50-59% bdy brn/10-19% 3d (MCC) 94434 3 deg burn fingr w thumb (CC) 94852 50-59% bdy brn/20-29% 3d (MCC) 94435 3rd deg burn palm (CC) 94853 50-59% bdy brn/30-39% 3d (MCC) 94436 3 deg burn back of hand (CC) 94854 50-59% bdy brn/40-49% 3d (MCC) 94437 3rd deg burn wrist (CC) 94855 50-59% bdy brn/50-59% 3d (MCC) 94438 3rd deg burn hand-mult (CC) 94860 60-69% bdy brn/3 deg NOS (CC) 94440 Deep 3 deg brn hand NOS (CC) 94861 60-69% bdy brn/10-19% 3d (MCC) 94441 Deep 3 deg burn finger (CC) 94862 60-69% bdy brn/20-29% 3d (MCC) 94442 Deep 3 deg burn thumb (CC) 94863 60-69% bdy brn/30-39% 3d (MCC) 94443 Deep 3rd brn mult finger (CC) 94864 60-69% bdy brn/40-49% 3d (MCC) 94444 Deep 3rd brn fngr w thmb (CC) 94865 60-69% bdy brn/50-59% 3d (MCC) 94445 Deep 3 deg burn palm (CC) 94866 60-69% bdy brn/60-69% 3d (MCC) 94446 Deep 3rd brn back of hnd (CC) 94870 70-79% bdy brn/3 deg NOS (CC) 94447 Deep 3 deg burn wrist (CC) 94871 70-79% bdy brn/10-19% 3d (MCC) 94448 Deep 3 deg brn hand-mult (CC) 94872 70-79% bdy brn/20-29% 3d (MCC) 94450 3rd brn w loss-hand NOS (CC) 94873 70-79% bdy brn/30-39% 3d (MCC) 94451 3rd burn w loss-finger (CC) 94874 70-79% bdy brn/40-49% 3d (MCC) 94452 3rd burn w loss-thumb (CC) 94875 70-79% bdy brn/50-59% 3d (MCC) 94453 3rd brn w loss-mult fngr (CC) 94876 70-79% bdy brn/60-69% 3d (MCC) 94454 3rd brn w loss-fngr/thmb (CC) 94877 70-79% bdy brn/70-79% 3d (MCC) 94455 3rd burn w loss-palm (CC) 94880 80-89% bdy brn/3 deg NOS (CC) 94456 3rd brn w loss-bk of hnd (CC) 94881 80-89% bdy brn/10-19% 3d (MCC) 94457 3rd burn w loss-wrist (CC) 94882 80-89% bdy brn/20-29% 3d (MCC) 94458 3rd brn w loss hand-mult (CC) 94883 80-89% bdy brn/30-39% 3d (MCC) 94530 3rd deg burn leg NOS (CC) 94884 80-89% bdy brn/40-49% 3d (MCC) 94531 3rd deg burn toe (CC) 94885 80-89% bdy brn/50-59% 3d (MCC) 94532 3rd deg burn foot (CC) 94886 80-89% bdy brn/60-69% 3d (MCC) 94533 3rd deg burn ankle (CC) 94887 80-89% bdy brn/70-79% 3d (MCC) 94534 3rd deg burn low leg (CC) 94888 80-89% bdy brn/80-89% 3d (MCC) 94535 3rd deg burn knee (CC) 94890 90% + bdy brn/3d deg NOS (CC) 94536 3rd deg burn thigh (CC) 94891 90% + bdy brn/10-19% 3rd (MCC) 94539 3rd deg burn leg-mult (CC) 94892 90% + bdy brn/20-29% 3rd (MCC) 94540 Deep 3rd deg brn leg NOS (CC) 94893 90% + bdy brn/30-39% 3rd (MCC) 94541 Deep 3rd deg burn toe (CC) 94894 90% + bdy brn/40-49% 3rd (MCC) 94542 Deep 3rd deg burn foot (CC) 94895 90% + bdy brn/50-59% 3rd (MCC) 94543 Deep 3rd deg burn ankle (CC) 94896 90% + bdy brn/60-69% 3rd (MCC) 94544 Deep 3rd deg brn low leg (CC) 94897 90% + bdy brn/70-79% 3rd (MCC)

1114 APPENDIX I HOSPITAL ACQUIRED CONDITIONS (HACS) LIST 94898 90% + bdy brn/80-89% 3rd (MCC) 9912 Frostbite of foot (CC) 94899 90% + bdy brn/90% + 3rd (MCC) 9913 Frostbite NEC/NOS (CC) 9493 3rd degree burn NOS (CC) 9914 Immersion foot (CC) 9494 Deep 3rd deg burn NOS (CC) 9920 Heat stroke & sunstroke (CC) 9495 3rd burn w loss-site NOS (CC) 9933 Caisson disease (CC) 9910 Frostbite of face (CC) 9941 Drowning/nonfatal submer (CC) 9911 Frostbite of hand (CC) 9947 Asphyxiation/strangulat (CC)

HAC 06: CATHETER-ASSOCIATED URINARY TRACT INFECTION (UTI)

SECONDARY DIAGNOSIS 99664 React-indwell urin cath (CC) OR

SECONDARY DIAGNOSIS 99664 React-indwell urin cath (CC) AND

SECONDARY DIAGNOSIS 1122 Candidias urogenital NEC (CC) 59081 Pyelonephrit in oth dis (CC) 59010 Ac pyelonephritis NOS (CC) 5950 Acute cystitis (CC) 59011 Ac pyelonephr w med necr (MCC) 5970 Urethral abscess (CC) 5902 Renal/perirenal abscess (MCC) 5990 Urin tract infection NOS (CC) 5903 Pyeloureteritis cystica (CC) 99664 React-indwell urin cath (CC) 59080 Pyelonephritis NOS (CC)

HAC 07: VASCULAR CATHETER-ASSOCIATED INFECTION

SECONDARY DIAGNOSIS 99931 Oth/uns inf-cen ven cath (CC) 99933 Lcl inf dt cen ven cth (CC) 99932 Blood inf dt cen ven cth (CC)

HAC 08: SURGICAL SITE INFECTION-MEDIASTINITIS AFTER CORONARY BYPASS GRAFT (CABG)

PROCEDURES 3610 Aortocoronary bypass NOS 3615 1 int mam-cor art bypass 3611 Aortocor bypas-1 cor art 3616 2 int mam-cor art bypass 3612 Aortocor bypas-2 cor art 3617 Abd-coron artery bypass 3613 Aortocor bypas-3 cor art 3619 Hrt revas byps anas NEC 3614 Aortcor bypas-4+ cor art AND

SECONDARY DIAGNOSIS 5192 Mediastinitis (MCC)

HAC 09: MANIFESTATIONS OF POOR GLYCEMIC CONTROL

SECONDARY DIAGNOSIS 24910 Sec DM keto nt st uncntr (MCC) 25013 DMI ketoacd uncontrold (MCC) 24911 Sec DM ketoacd uncntrld (MCC) 25020 DMII hprsm nt st uncntrl (MCC) 24920 Sec DM hpros nt st uncnr (MCC) 25021 DMI hprsm nt st uncntrld (MCC) 24921 Sec DM hprosmlr uncntrld (MCC) 25022 DMII hprosmlr uncontrold (MCC) 25010 DMII keto nt st uncntrld (MCC) 25023 DMI hprosmlr uncontrold (MCC) 25011 DMI keto nt st uncntrld (MCC) 2510 Hypoglycemic coma (CC) 25012 DMII ketoacd uncontrold (MCC)

1115