Procedure Description
94760 Noninvasive ear or pulse oximetry for oxygen saturation, single determination
CPT Code Description
Codes with a Status Indicator of T
36598 Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report
94761 Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (e.g., during exercise)
96523 Irrigation of implanted venous access device for drug delivery systems
Coverage Indications, Limitations, and/or Medical Necessity
Pulse oximetry provides a simple, accurate, and noninvasive technique for the continuous or intermittent monitoring of arterial oxygen saturation. A small lightweight device attaches to the finger or toe and directs through the nailbed two wavelengths of light; a photodetector measures absorption. Arterial pulsation is used to gate the signal to the arterial component of blood contained within the nailbed.
Ear oximetry is a noninvasive method for evaluating arterial oxygenation. Ear oximeters are commonly used in sleep studies.
Single and Multiple Determinations (94760, 94761):
Ear or pulse oximetry for oxygen saturation (CPT Codes 94760, 94761) will be considered medically necessary when the patient has a condition resulting in hypoxemia and there is a need to assess the status of a chronic respiratory condition, supplemental oxygen requirements and/or a therapeutic regimen (see ICD-10 Codes That Support Medical Necessity).
Continuous Overnight Monitoring (94762):
Ear or pulse oximetry for oxygen saturation by continuous overnight monitoring (CPT code 94762) will be considered medically necessary in the following circumstances (see ICD-10 Codes That Support Medical Necessity):
The patient must have a condition for which intermittent arterial blood gas sampling is likely to miss important variations, and
The patient must have a condition resulting in hypoxemia and there is a need to assess supplemental oxygen requirements and/or a therapeutic regimen.
- Patient exhibits signs or symptoms of acute respiratory dysfunction such as:
- Tachypnea.
- Dyspnea.
- Cyanosis.
- Respiratory distress.
- Confusion.
- Hypoxia.
- Patient has chronic lung disease, severe cardiopulmonary disease or neuromuscular disease involving the muscles of respiration, and oximetry is needed for at least one of the following reasons:
- Initial evaluation to determine the severity of respiratory impairment.
- Evaluation of an acute change in condition.
- Evaluation of exercise tolerance in a patient with respiratory disease.
- Evaluation to establish medical necessity of oxygen therapeutic regimen.
- Patient has sustained severe multiple trauma or complains of acute severe chest pain.
- Patient is under treatment with a medication with known pulmonary toxicity, and oximetry is medically necessary to monitor for potential adverse effects of therapy.
- The patient has a condition for which intermittent arterial blood gas sampling is likely to miss important variations.
- The patient has a condition resulting in hypoxemia and there is a need to assess supplemental oxygen requirements and/or a therapeutic regimen.
- Safe and effective.
- Not experimental or investigational (exception: routine costs of qualifying clinical trial services with dates of service on or after September 19, 2000, which meet the requirements of the clinical trials NCD are considered reasonable and necessary).
- Appropriate, including the duration and frequency that is considered appropriate for the service, in terms of whether it is:
- Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member.
- Furnished in a setting appropriate to the patient’s medical needs and condition.
- Ordered and furnished by qualified personnel.
- One that meets, but does not exceed, the patient’s medical need.
- At least as beneficial as an existing and available medically appropriate alternative.
Note:
|
Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book. The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) require the use of short CPT descriptors in policies published on the Web.
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94760©
|
Measure blood oxygen level
|
94761©
|
Measure blood oxygen level
|
94762©
|
Measure blood oxygen level
|
REIMBURSEMENT GUIDELINES
All codes published on the NPFS Relative Value File are assigned a status code. The status code indicates whether the code is separately payable if the service is covered. Per the public use file that accompanies the NPFS Relative Value File, the following is stated for status indicator “T”:
“There are RVUs and payment amounts for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these services are bundled into the physician services for which payment is made.”
Consistent with CMS, Oxford considers Current Procedural Terminology (CPT®) and Healthcare Common Procedural Coding System (HCPCS) codes with a status indicator of “T” according to the CMS NPFS bundled into any other service assigned a status indicator of “A” or “R” provided, on the same date by the Same Individual Physician, Hospital, Ambulatory Surgical Center or Other Health Care Professional, for which payment is made. Modifier overrides will not prevent codes with a status indicator of “T” from bundling into other services.
Per the public use file that accompanies the NPFS Relative Value File, the following is stated for status indicator of “A”: “Active Code. These codes are paid separately under the physician fee schedule, if covered. There will be RVUs for
codes with this status. The presence of an ‘A’ indicator does not mean that Medicare has made a national coverage
determination regarding the service; carriers remain responsible for coverage decisions in the absence of a national Medicare policy.”
The following is stated for status indicator of “R”:
“Restricted Coverage. Special coverage instructions apply. If covered, the service is carrier priced.”
Note: The majority of codes to which this indicator will be assigned are the alpha-numeric dental codes, which begin with “D.” We are assigning the indicator to a limited number of CPT codes which represent services that are covered only in unusual circumstances.
QUESTIONS AND ANSWERS
1 Q: Why does this policy not address all codes that the NPFS identifies as T status?
A: Codes from the NPFS with a status of “T”, but otherwise addressed in other Oxford reimbursement policies, are not included in this policy.
2 Q: Will Oxford reimburse two codes with a status indicator of T when reported for the same patient by the Same Individual Physician, Hospital, Ambulatory Surgical Center or Other Health Care Professional on the same date of service?
A: No, Oxford will consider reimbursement for the code with a status indicator of T with the highest RVU and payment for the other as bundled and not separately reimbursed only when no other service reported with a status indicator of A or R. If reported with another service with a status indicator of A or R, Oxford will bundle both codes with a status indicator of T into the reimbursement for the payable service code and will not be separately reimbursed.
PULSE OXIMETER – Medicaid
Definition A pulse oximeter is a noninvasive device that measures arterial oxygen saturation levels and pulse rate. The device consists of a sensor attached to the patient’s finger or ear lobe that is linked to a processing unit that delivers a read-out.
Standards of Coverage
Pulse oximeter may be covered:
* For beneficiaries 21 or over as a diagnostic tool for short-term rental (one month) if ordered for oxygen or ventilator weaning in the home.
* For beneficiaries under 21:
* As a diagnostic tool for short-term rental (one month) when there are suspected desaturations during sleep, stress, or
feeding.
* Up to six months with a diagnosis requiring oxygen use.
* Up to six months for beneficiaries with a tracheostomy.
Documentation Documentation must be less than 90 days old and include the following:
* Diagnosis/medical condition related to the need for the unit.
* Treatment plan addressing what is to be done for abnormal readings.
* Current oxygen orders, if applicable.
* For coverage beyond the initial six-month period, an evaluation by an appropriate pediatric subspecialist (e.g., pediatric pulmonologist, pediatric cardiologist, neurologist, ENT, or pediatric internist) is required under the CSHCS program.
PA Requirements PA is not required when the Standards of Coverage are met, the beneficiary is under 21, and has one of the following diagnoses:
* Tracheostomy (Artificial Opening Status)
* Tracheostomy (Attention to Artificial Openings) PA is required:
* For all beneficiaries over the age of 21.
* When the Standards of Coverage are not met. Payment Rules A pulse oximeter is a capped rental item and is inclusive of the following:
* All accessories needed to use the unit (e.g., nondisposable infant or adult oximeter probes, cables, etc.).
* Education on the proper use and care of the equipment.
* Routine servicing and all necessary repairs or replacements to make the unit functional.
* Periodic downloading of recorded data.
If needed for continuous use beyond the 10 months of rental, the item is considered purchased and necessary repairs and/or replacements of accessories are separately reimbursable if not covered under the manufacturer warranty. Replacement of one non-disposable probe annually is separately reimbursable without prior authorization.
ICD-10 Codes that Support Medical Necessity
Single and Multiple Determinations (94760, 94761):
C34.00 Malignant neoplasm of unspecified main bronchus
C34.01 Malignant neoplasm of right main bronchus
C34.02 Malignant neoplasm of left main bronchus
C34.10 Malignant neoplasm of upper lobe, unspecified bronchus or lung
C34.11 Malignant neoplasm of upper lobe, right bronchus or lung
C34.12 Malignant neoplasm of upper lobe, left bronchus or lung
C34.2 Malignant neoplasm of middle lobe, bronchus or lung
C34.30 Malignant neoplasm of lower lobe, unspecified bronchus or lung
C34.31 Malignant neoplasm of lower lobe, right bronchus or lung
C34.32 Malignant neoplasm of lower lobe, left bronchus or lung
C34.80 Malignant neoplasm of overlapping sites of unspecified bronchus and lung
C34.81 Malignant neoplasm of overlapping sites of right bronchus and lung
C34.82 Malignant neoplasm of overlapping sites of left bronchus and lung
C34.90 Malignant neoplasm of unspecified part of unspecified bronchus or lung
C34.91 Malignant neoplasm of unspecified part of right bronchus or lung
C34.92 Malignant neoplasm of unspecified part of left bronchus or lung
I01.8 Other acute rheumatic heart disease
I09.81 Rheumatic heart failure
I11.0 Hypertensive heart disease with heart failure
I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I16.0 Hypertensive urgency
I16.1 Hypertensive emergency
I16.9 Hypertensive crisis, unspecified
I50.1 Left ventricular failure
I50.20 Unspecified systolic (congestive) heart failure
I50.21 Acute systolic (congestive) heart failure
I50.22 Chronic systolic (congestive) heart failure
I50.23 Acute on chronic systolic (congestive) heart failure
I50.30 Unspecified diastolic (congestive) heart failure
I50.31 Acute diastolic (congestive) heart failure
I50.32 Chronic diastolic (congestive) heart failure
I50.33 Acute on chronic diastolic (congestive) heart failure
I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.9 Heart failure, unspecified
J43.0 Unilateral pulmonary emphysema [MacLeod’s syndrome]
J43.1 Panlobular emphysema
J43.2 Centrilobular emphysema
J43.8 Other emphysema
J43.9 Emphysema, unspecified
J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection
J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
J44.9 Chronic obstructive pulmonary disease, unspecified
J45.20 Mild intermittent asthma, uncomplicated
J45.21 Mild intermittent asthma with (acute) exacerbation
J45.22 Mild intermittent asthma with status asthmaticus
J45.30 Mild persistent asthma, uncomplicated
J45.31 Mild persistent asthma with (acute) exacerbation
J45.32 Mild persistent asthma with status asthmaticus
J45.40 Moderate persistent asthma, uncomplicated
J45.41 Moderate persistent asthma with (acute) exacerbation
J45.42 Moderate persistent asthma with status asthmaticus
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbation
J45.52 Severe persistent asthma with status asthmaticus
J45.901 Unspecified asthma with (acute) exacerbation
J45.902 Unspecified asthma with status asthmaticus
J45.909 Unspecified asthma, uncomplicated
J45.990 Exercise induced bronchospasm
J45.991 Cough variant asthma
J45.998 Other asthma
J47.1 Bronchiectasis with (acute) exacerbation
J47.9 Bronchiectasis, uncomplicated
J80 Acute respiratory distress syndrome
J84.10 Pulmonary fibrosis, unspecified
J95.1 Acute pulmonary insufficiency following thoracic surgery
J95.2 Acute pulmonary insufficiency following nonthoracic surgery
J95.3 Chronic pulmonary insufficiency following surgery
J95.821 Acute postprocedural respiratory failure
J95.822 Acute and chronic postprocedural respiratory failure
J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.01 Acute respiratory failure with hypoxia
J96.02 Acute respiratory failure with hypercapnia
J96.10 Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.11 Chronic respiratory failure with hypoxia
J96.12 Chronic respiratory failure with hypercapnia
J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.21 Acute and chronic respiratory failure with hypoxia
J96.22 Acute and chronic respiratory failure with hypercapnia
J98.4 Other disorders of lung
R06.00 Dyspnea, unspecified
R06.02 Shortness of breath
R06.09 Other forms of dyspnea
R06.2 Wheezing
R06.3 Periodic breathing
R06.81 Apnea, not elsewhere classified
R06.82 Tachypnea, not elsewhere classified
R06.83 Snoring
R06.89 Other abnormalities of breathing
Group 2 Paragraph
Continuous Overnight Monitoring (94762):
Group 2 Codes
C34.00 Malignant neoplasm of unspecified main bronchus
C34.01 Malignant neoplasm of right main bronchus
C34.02 Malignant neoplasm of left main bronchus
C34.10 Malignant neoplasm of upper lobe, unspecified bronchus or lung
C34.11 Malignant neoplasm of upper lobe, right bronchus or lung
C34.12 Malignant neoplasm of upper lobe, left bronchus or lung
C34.2 Malignant neoplasm of middle lobe, bronchus or lung
C34.30 Malignant neoplasm of lower lobe, unspecified bronchus or lung
C34.31 Malignant neoplasm of lower lobe, right bronchus or lung
C34.32 Malignant neoplasm of lower lobe, left bronchus or lung
C34.80 Malignant neoplasm of overlapping sites of unspecified bronchus and lung
C34.81 Malignant neoplasm of overlapping sites of right bronchus and lung
C34.82 Malignant neoplasm of overlapping sites of left bronchus and lung
C34.90 Malignant neoplasm of unspecified part of unspecified bronchus or lung
C34.91 Malignant neoplasm of unspecified part of right bronchus or lung
C34.92 Malignant neoplasm of unspecified part of left bronchus or lung
G47.30 Sleep apnea, unspecified
I01.8 Other acute rheumatic heart disease
I09.81 Rheumatic heart failure
I11.0 Hypertensive heart disease with heart failure
I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I16.0 Hypertensive urgency
I16.1 Hypertensive emergency
I16.9 Hypertensive crisis, unspecified
I50.1 Left ventricular failure
I50.20 Unspecified systolic (congestive) heart failure
I50.21 Acute systolic (congestive) heart failure
I50.22 Chronic systolic (congestive) heart failure
I50.23 Acute on chronic systolic (congestive) heart failure
I50.30 Unspecified diastolic (congestive) heart failure
I50.31 Acute diastolic (congestive) heart failure
I50.32 Chronic diastolic (congestive) heart failure
I50.33 Acute on chronic diastolic (congestive) heart failure
I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.9 Heart failure, unspecified
J43.0 Unilateral pulmonary emphysema [MacLeod’s syndrome]
J43.1 Panlobular emphysema
J43.2 Centrilobular emphysema
J43.8 Other emphysema
J43.9 Emphysema, unspecified
J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection
J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
J44.9 Chronic obstructive pulmonary disease, unspecified
J45.20 Mild intermittent asthma, uncomplicated
J45.21 Mild intermittent asthma with (acute) exacerbation
J45.22 Mild intermittent asthma with status asthmaticus
J45.30 Mild persistent asthma, uncomplicated
J45.31 Mild persistent asthma with (acute) exacerbation
J45.32 Mild persistent asthma with status asthmaticus
J45.40 Moderate persistent asthma, uncomplicated
J45.41 Moderate persistent asthma with (acute) exacerbation
J45.42 Moderate persistent asthma with status asthmaticus
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbation
J45.52 Severe persistent asthma with status asthmaticus
J45.901 Unspecified asthma with (acute) exacerbation
J45.902 Unspecified asthma with status asthmaticus
J45.909 Unspecified asthma, uncomplicated
J45.990 Exercise induced bronchospasm
J45.991 Cough variant asthma
J45.998 Other asthma
J47.1 Bronchiectasis with (acute) exacerbation
J47.9 Bronchiectasis, uncomplicated
J80 Acute respiratory distress syndrome
J84.10 Pulmonary fibrosis, unspecified
J95.1 Acute pulmonary insufficiency following thoracic surgery
J95.2 Acute pulmonary insufficiency following nonthoracic surgery
J95.3 Chronic pulmonary insufficiency following surgery
J95.821 Acute postprocedural respiratory failure
J95.822 Acute and chronic postprocedural respiratory failure
J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.01 Acute respiratory failure with hypoxia
J96.02 Acute respiratory failure with hypercapnia
J96.10 Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.11 Chronic respiratory failure with hypoxia
J96.12 Chronic respiratory failure with hypercapnia
J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.21 Acute and chronic respiratory failure with hypoxia
J96.22 Acute and chronic respiratory failure with hypercapnia
J98.4 Other disorders of lung
R06.00 Dyspnea, unspecified
R06.02 Shortness of breath
R06.09 Other forms of dyspnea
R06.2 Wheezing
R06.3 Periodic breathing
R06.81 Apnea, not elsewhere classified
R06.82 Tachypnea, not elsewhere classified
R06.83 Snoring
R06.89 Other abnormalities of breathing
011.00–011.06
|
Tuberculosis of lung infiltrative
|
011.10–011.16
|
Tuberculosis of lung nodular
|
011.20–011.26
|
Tuberculosis of lung with cavitation
|
011.30–011.36
|
Tuberculosis of bronchus
|
011.40–011.46
|
Tuberculous fibrosis of lung
|
011.50–011.56
|
Tuberculous bronchiectasis
|
011.60–011.66
|
Tuberculous pneumonia (any form)
|
011.70–011.76
|
Tuberculous pneumothorax
|
011.80–011.86
|
Other specified pulmonary tuberculosis
|
011.90–011.96
|
Unspecified pulmonary tuberculosis
|
012.80–012.86
|
Other specified respiratory tuberculosis
|
020.3–020.5
|
Plague
|
021.2
|
Pulmonary tularemia
|
039.1
|
Pulmonary actinomycotic infection
|
052.1
|
Varicella (hemorrhagic) pneumonitis
|
073.0
|
Ornithosis with pneumonia
|
130.4
|
Pneumonitis due to toxoplasmosis
|
135
|
Sarcoidosis
|
136.3
|
Pneumocystosis
|
162.0
|
Malignant neoplasm of trachea
|
162.2–162.5
|
Malignant neoplasm of trachea, bronchus or lung
|
162.8–162.9
|
Malignant neoplasm of trachea, bronchus or lung
|
197.0
|
Secondary malignant neoplasm of lung
|
277.02
|
Cystic fibrosis with pulmonary manifestations
|
277.6
|
Other deficiencies of circulating enzymes
|
293.0
|
Delirium due to conditions classified elsewhere
|
298.9
|
Unspecified psychosis
|
335.20–335.21
|
Motor neuron disease
|
357.0
|
Acute infective polyneuritis
|
358.00–358.01
|
Myasthenia gravis
|
413.9
|
Other and unspecified angina pectoris
|
415.0
|
Acute cor pulmonale
|
415.11–415.12
|
Pulmonary embolism and infarction
|
415.19
|
Other pulmonary embolism and infarction
|
416.0–416.2
|
Chronic pulmonary heart disease
|
416.8–416.9
|
Chronic pulmonary heart disease
|
428.0–428.1
|
Heart failure
|
428.9
|
Heart failure
|
464.00–464.01
|
Acute laryngitis
|
464.10–464.11
|
Acute tracheitis
|
464.20–464.21
|
Acute laryngotracheitis
|
464.30–464.31
|
Acute epiglottitis
|
464.4
|
Croup
|
464.50–464.51
|
Supraglottitis unspecified
|
466.0
|
Acute bronchitis
|
466.11
|
Acute bronchiolitis due to respiratory syncytial virus (rsv)
|
466.19
|
Acute bronciolitis due to other infectious organisms
|
478.70–478.71
|
Other diseases of larynx, not else where classified
|
478.74–478.75
|
Other diseases of larynx, not else where classified
|
478.79
|
Other diseases of larynx
|
478.8–478.9
|
Other diseases of larynx, not else where classified
|
480.0–480.3
|
Viral pneumonia
|
480.8–480.9
|
Viral pneumonia
|
481
|
Pneumococcal pneumonia [streptococcus pneumoniae pneumonia]
|
482.1
|
Pneumonia due to pseudomonas
|
482.30–482.32
|
Pneumonia due to streptococcus
|
482.39
|
Pneumonia due to other streptococcus
|
482.40–482.42
|
Pneumonia due to staphylococcus unspecified
|
482.49
|
Other staphylococcus pneumonia
|
482.81–482.84
|
Pneumonia due to other specified bacteria
|
482.89
|
Pneumonia due to other specified bacteria
|
483.0–483.1
|
Pneumonia due to other specified organism
|
483.8
|
Pneumonia due to other specified organism
|
484.1
|
Pneumonia in cytomegalic inclusion disease
|
484.3
|
Pneumonia in whooping cough
|
484.5–484.8
|
Pneumonia in infectious diseases classified elsewhere
|
485
|
Bronchopneumonia organism unspecified
|
486
|
Pneumonia organism unspecified
|
487.0–487.1
|
Influenza
|
490
|
Bronchitis not specified as acute or chronic
|
491.1
|
Mucopurulent chronic bronchitis
|
491.20–491.21
|
Obstructive chronic bronchitis
|
492.0
|
Emphysematous bleb
|
492.8
|
Other emphysema
|
493.00–493.02
|
Extrinsic asthma
|
493.10–493.12
|
Intrinsic asthma
|
493.20–493.22
|
Chronic obstructive
|
493.81–493.82
|
Other forms of asthma
|
493.90–493.92
|
Asthma unspecified
|
494.0–494.1
|
Bronchiectasis
|
495.0–495.9
|
Extrinsic allergic alveolitis
|
496
|
Chronic airway obstruction not elsewhere classified
|
500
|
Coal workers’ pneumoconiosis
|
501
|
Asbestosis
|
502
|
Pneumoconiosis due to other silica or silicates
|
503
|
Pneumoconiosis due to other inorganic dust
|
504
|
Pneumonopathy due to inhalation of other dust
|
505
|
Pneumoconiosis unspecified
|
506.0–506.4
|
Respiratory conditions due to chemical fumes and vapors
|
506.9
|
Unspecified respiratory conditions due to fumes and vapors
|
507.0–507.1
|
Pneumonitis due to solids and liquids
|
507.8
|
Pneumonitis due to other solids and liquids
|
508.0–508.1
|
Respiratory conditions due to other and unspecified external agents
|
508.8–508.9
|
Respiratory conditions due to other and unspecified external agents
|
510.0
|
Empyema with fistula
|
510.9
|
Empyema without fistula
|
511.0–511.1
|
Pleurisy
|
511.81
|
Malignant pleural effusion
|
511.89
|
Other specified forms of effusion, except tuberculous
|
511.9
|
Unspecified pleural effusion
|
512.0–512.1
|
Pneumothorax
|
512.8
|
Other spontaneous pneumothorax
|
513.0–513.1
|
Abscess of lung and mediastinum
|
514
|
Pulmonary congestion and hypostasis
|
515
|
Postinflammatory pulmonary fibrosis
|
516.0–516.3
|
Other alveolar and parietoalveolar pneumonopathies
|
516.8–516.9
|
Other alveolar and parietoalveolar pneumonopathies
|
517.1–517.3
|
Lung involvement in conditions classified elsewhere
|
517.8
|
Lung involvement in other diseases classified elsewhere
|
518.0–518.7
|
Other diseases of lung
|
518.81–518.84
|
Other diseases of lung
|
518.89
|
Other diseases of lung not elsewhere classified
|
519.11
|
Acute bronchospasm
|
519.19
|
Other diseases of trachea and bronchus
|
519.4
|
Disorders of diaphragm
|
710.1
|
Systemic sclerosis
|
780.2
|
Syncope and collapse
|
780.31–780.33
|
Convulsions
|
780.39
|
Other convulsions
|
780.79
|
Other malaise and fatigue
|
782.5
|
Cyanosis
|
785.50–785.52
|
Shock without mention of trauma
|
785.59
|
Other shock without trauma
|
786.00–786.07
|
Dyspnea and respiratory abnormalities
|
786.09
|
Respiratory abnormality other
|
786.1
|
Stridor
|
786.30
|
Hemoptysis, unspecified
|
786.39
|
Other hemoptysis
|
786.50–786.52
|
Chest pain
|
786.59
|
Other chest pain
|
793.1–793.2
|
Nonspecific abnormal findings on radiological and other examinations of body structure
|
799.01–799.02
|
Asphyxia and hypoxemia
|
799.82
|
Apparent life threatening event in infant
|
805.00–805.08
|
Closed fracture of cervical vertebra unspecified level
|
805.10–805.18
|
Open fracture of cervical vertebra unspecified level
|
805.2–805.7
|
Fracture of vertebral column without mention of spinal cord injury
|
806.00–806.09
|
Cervical closed (fracture of vertebral column with spinal cord injury)
|
806.10–806.19
|
Cervical open (fracture of vertebral column with spinal cord injury )
|
806.20–806.29
|
Dorsal (thoracic) closed (fracture of vertebral column with spinal cord injury)
|
806.30–806.39
|
Dorsal (thoracic) open (fracture of vertebral column with spinal cord injury)
|
806.4–806.5
|
Fracture of vertebral column without mention of spinal cord injury
|
806.60–806.62
|
Sacrum and coccyx closed (fracture of vertebral column with spinal cord injury)
|
806.69
|
Closed fracture of sacrum and coccyx with other spinal cord injury
|
806.70–806.72
|
Sacrum and coccyx open (fracture of vertebral column with spinal cord injury)
|
806.79
|
Open fracture of sacrum and coccyx with other spinal cord injury
|
807.00–807.09
|
Rib(s) closed (fracture of rib(s), sternum, and treachea)
|
807.10–807.19
|
Rib(s) open (fracture of rib(s), sternum, and treachea)
|
807.2–807.6
|
Fracture of rib(s), sternum, and treachea
|
854.00–854.06
|
Intracranial injury of other and unspecified nature
|
854.09
|
Intracranial injury of other and unspecified nature
|
854.10–854.16
|
Intracranial injury of other and unspecified nature
|
854.19
|
Intracranial injury of other and unspecified
|
860.0–860.5
|
Traumatic pneumothorax and hemothorax
|
861.00–861.03
|
Heart without mention of open wound into thorax
|
861.10–861.13
|
Heart with open wound into thorax
|
861.20–861.22
|
Lung without mention of open wound into thorax
|
861.30–861.32
|
Lung with open wound into thorax
|
862.0–862.1
|
Injury to other and unspecified intrathoracic organs
|
862.21–862.22
|
Other specified intrathoracic organs, without mention of open wound into cavity
|
862.29
|
Injury to other specified intrathoracic organs without open wound into cavity
|
862.31–862.32
|
Other specified intrathoracic organs, with open wound into cavity
|
862.39
|
Injury to other specified intrathoracic organs with open wound into cavity
|
862.8–862.9
|
Injury to other and unspecified intrathoracic organs
|
863.1
|
Injury to stomach with open wound into cavity
|
863.20–863.21
|
Small intrestine without mention of open wound into cavity
|
863.29
|
Other injury to small intestine without open wound into cavity
|
863.30–863.31
|
Small intestine with open wound into cavity
|
863.39
|
Other injury to small intestine with open wound into cavity
|
863.40–863.46
|
|
863.49
|
Other injury to colon and rectum without open wound into cavity
|
863.50–863.56
|
|
863.59
|
Other injury to colon and rectum with open wound into cavity
|
863.80–863.85
|
Other and unspecified gastrointestinal sites without mention of open wound into cavity
|
863.89
|
Injury to other and unspecified gastrointestinal sites without open wound into cavity
|
863.90–863.95
|
Other and unspecified gastrointestinal sites with open wound into cavity
|
863.99
|
Injury to other and unspecified gastrointestinal sites with open wound into cavity
|
864.00–864.05
|
Injury to liver (without mention of open wound into cavity)
|
864.09
|
Other injury to liver without open wound into cavity
|
864.10–864.15
|
Injury to liver (with open wound into cavity)
|
864.19
|
Other injury to liver with open wound into cavity
|
865.00–865.04
|
Injury to spleen (without mention of open wound into cavity)
|
865.09
|
Other injury into spleen without open wound into cavity
|
865.10–865.14
|
Injury to spleen (with open wound into cavity)
|
865.19
|
Other injury to spleen with open wound into cavity
|
866.00–866.03
|
Injury to kidney without mention of open wound into cavity
|
866.10–866.13
|
Injury to kidney with open wound into cavity
|
867.0–867.9
|
Injury to pelvic organs
|
868.00–868.04
|
Injury to unspecified intra-abdominal organs
|
868.09
|
Injury to other and multiple intra-abdominal organs without open wound into cavity
|
868.10–868.14
|
Injury to other intra-abdominal organs without mention of open wound into cavity
|
868.19
|
Injury to other and multiple intra-abdominal organs with open wound into cavity
|
869.0–869.1
|
Internal injury to unspecified or ill-defined organs
|
933.1
|
Foreign body in larynx
|
934.0–934.1
|
Foreign body in trachea, bronchus and lung
|
934.8–934.9
|
Foreign body in trachea, bronchus and lung
|
941.20–941.29
|
Blisters with epidermal loss due to burn (second degree)
|
941.30–941.39
|
Full-thickness skin loss due to burn (third degree NOS)
|
941.40–941.49
|
Deep necrosis of underlying tissues due to burn (deep third degree) without mention of a body part
|
941.50–941.59
|
Deep necrosis of underlying tissues (deep third degree) with loss of body part
|
942.20–942.25
|
Blisters with epidermal loss (second degree)
|
942.29
|
Blisters with epidermal loss (second degree) other and multiple sites of trunk
|
942.30–942.35
|
Full-thickness skin loss (third degree NOS)
|
942.39
|
Full-thickness skin loss (third degree NOS) other and multiple sites of trunk
|
942.40–942.45
|
Deep necrosis of underlying tissues (deep third degree) without mention of loss of body part
|
942.49
|
Deep necrosis of underlying tissues (deep third degree) other and multiple sites of trunk
|
942.50–942.55
|
Deep necrosis of underlying tissues (deep third degree) with loss of body part
|
942.59
|
Deep necrosis of underlying tissues (deep third degree) other and multiple sites of trunk
|
943.20–943.26
|
Blisters with epidermal loss (second degree)
|
943.29
|
Blisters with epidermal loss (second degree) of multiple sites of upper limb except wrist and hand
|
943.30–943.36
|
Full-thickness skin loss (third degree NOS)
|
943.39
|
Full-thickness skin loss due to burn (third degree nos) of multiple sites of upper limb except wrist and hand
|
943.40–943.46
|
Deep necrosis of underlying tissues due to burn (deep third degree) without mention of loss of a body part
|
943.49
|
Deep necrosis of underlying tissues due to burn (deep third degree) of multiple sites of upper limb except wrist and hand without loss of upper limb
|
943.50–943.56
|
Deep necrosis of underlying tissues due to burn (deep third degree) with loss of a body part
|
943.59
|
Deep necrosis of underlying tissues due to burn (deep third degree) of multiple sites of upper limb except wrist and hand with loss of upper limb
|
944.20–944.28
|
Blisters with epidermal loss due to burn (second degree) – wrist(s) and hand(s)
|
944.30–944.38
|
Full-thickness skin loss due to burn (third degree nos) – wrist(s) and hand(s)
|
944.40–944.48
|
Deep necrosis of underlying tissues due to burn (deep third degree) without loss of a wrist(s) and hand(s)
|
944.50–944.58
|
Deep necrosis of underlying tissues due to burn (deep third degree) with loss of wrist(s) and hand(s)
|
945.20–945.26
|
Blisters epidermal loss (second degree) of lower limb (leg)
|
945.29
|
Blisters with epidermal loss due to burn (second degree) of multiple sites of lower limb(s)
|
945.30–945.36
|
Full-thickness skin loss due to burn (third degree nos) of lower limb
|
945.39
|
Full-thickness skin loss due to burn (third degree nos) of multiple sites of lower limb(s)
|
945.40–945.46
|
Deep necrosis of underlying tissues due to burn (deep third degree) without mention of loss of lower limb (leg)
|
945.49
|
Deep necrosis of underlying tissues due to burn (deep third degree) of multiple sites of lower limb(s) without loss of a body part
|
945.50–945.56
|
Deep necrosis of underlying tissues due to burn (deep third degree) with loss of lower limb (leg)
|
945.59
|
Deep necrosis of underlying tissues due to burn (deep third degree) of multiple sites of lower limb(s) with loss of a body part
|
946.2–946.5
|
Burns of multiple sites
|
947.0–947.4
|
Burn of internal organs
|
948.00
|
Burn (any degree) involving less than 10 percent of body surface
|
948.10–948.11
|
10–19 percent of body surface
|
948.20–948.22
|
20–29 percent of body surface
|
948.30–948.33
|
30–39 percent of body surface
|
948.40–948.44
|
40–49 percent of body surface
|
948.50–948.55
|
50–59 percent of body surface
|
948.60–948.66
|
60–69 percent of body surface
|
948.70–948.77
|
70–79 percent of body surface
|
948.80–948.88
|
80–89 percent of body surface
|
948.90–948.99
|
90 percent or more of body surface
|
949.2–949.5
|
Burn unspecified
|
959.8
|
Other and unspecified injury to other specified sites including multiple
|
960.0–960.9
|
Poisoning by antibiotics
|
961.0–961.9
|
Poisoning by other anti-infectives
|
962.0–962.9
|
Poisoning by hormones and synthetic substitutes
|
963.0–963.5
|
Poisoning by primarily systemic drugs
|
963.8–963.9
|
Poisoning by primarily systemic agents
|
964.0–964.9
|
Poisoning by agents primarily affecting blood constituents
|
965.00–965.02
|
Poisoning by opium (alkaloids) and related narcotics
|
965.09
|
Poisoning by other opiates and related narcotics
|
965.1
|
Poisoning by salicylates
|
965.4–965.5
|
Poisoning by analgesics, antipyretics and antirheumatics
|
965.61
|
Poisoning by propionic acid derivatives
|
965.69
|
Poisoning by other antirheumatics
|
965.7–965.9
|
Poisoning by analgesics, antipyretics and antirheumatics
|
966.0–966.4
|
Poisoning by anticonvulsants and anti-Parkinsonism drugs
|
967.0–967.6
|
Poisoning by sedatives and hypnotics
|
967.8–967.9
|
Poisoning by sedatives and hypnotics
|
968.0–968.7
|
Poisoning by other central nervous system depressants and anesthetics
|
968.9
|
Poisoning by other and unspecified local anesthetics
|
969.00–969.05
|
Poisoning by antidepressants
|
969.09
|
Poisoning by other antidepressants
|
969.1–969.6
|
Poisoning by psychotropic agents
|
969.70–969.73
|
Poisoning by psychostimulants
|
969.79
|
Poisoning by other psychostimulants
|
969.8–969.9
|
Poisoning by psychotropic agents
|
970.0–970.1
|
Poisoning by central nervous system stimulants
|
970.81
|
Poisoning by cocaine
|
970.89
|
Poisoning by other central nervous system stimulants
|
970.9
|
Unspecified central nervous system stimulant
|
971.0–971.3
|
Poisoning by drugs primarily affecting autonomic nervous system
|
971.9
|
Poisoning by unspecified drug primarily affecting autonomic nervous system
|
972.0–972.9
|
Poisoning by agents primarily affecting the cardiovascular system
|
973.0–973.9
|
Poisoning by agents primarily affecting the gastrointestinal system
|
974.0–974.7
|
Poisoning by water, mineral and uric acid metabolism drugs
|
975.0–975.8
|
Poisoning by agents primarily acting on the smooth and skeletal muscles and respiratory system
|
976.0–976.9
|
Poisoning by agents primarily affecting skin and mucous membrane
|
977.0–977.4
|
Poisoning by other and unspecified drugs and medicinal substances
|
977.8–977.9
|
Poisoning by other and unspecified drugs and medicinal substances
|
978.0–978.6
|
Poisoning by bacterial vaccines
|
978.8–978.9
|
Poisoning by bacterial vaccines
|
979.0–979.7
|
Poisoning by other vaccines and biological substances
|
979.9
|
Poisoning by other and unspecified vaccines and biological substances
|
980.0–980.3
|
Toxic effect of alcohol
|
980.8–980.9
|
Toxic effect of alcohol
|
981
|
Toxic effect of petroleum products
|
982.0–982.4
|
Toxic effect of solvents other than petroleum-based
|
982.8
|
Toxic effect of other nonpetroleum-based solvents
|
983.0–983.2
|
Toxic effect of corrosive aromatics, acids and caustic alkalis
|
983.9
|
Toxic effect of caustic unspecified
|
984.0–984.1
|
Toxic effect of lead and its compounds (including fumes)
|
984.8–984.9
|
Toxic effect of lead and its compounds (including fumes)
|
985.0–985.6
|
Toxic effect of other metals
|
985.8–985.9
|
Toxic effect of other metals
|
986
|
Toxic effect of carbon monoxide
|
987.0–987.9
|
Toxic effect of other gases, fumes or vapors
|
988.0–988.2
|
Toxic effect of noxious substances eaten as food
|
988.8–988.9
|
Toxic effect of noxious substances eaten as food
|
989.0–989.7
|
Toxic effect of other substances, chiefly nonmedical as to
|
989.81–989.84
|
Toxic effect of asbestos
|
989.89
|
Other substances chiefly nonmedicinal as to source
|
994.1
|
Drowning and nonfatal submersion
|
994.7
|
Asphyxiation and strangulation
|
997.31
|
Ventilator associated pneumonia
|
997.39
|
Other respiratory complications
|
V42.6
|
Lung replaced by transplant
|
V58.69
|
Long-term (current) use of other medications
|
V67.2
|
Follow-up examination following chemotherapy
|
V67.51
|
Follow-up examination following completed treatment with high-risk medication not elsewhere classified
|
|
|
|
|
327.21*–327.27*
|
Organic sleep apnea
|
415.12
|
Septic pulmonary embolism
|
416.0
|
Primary pulmonary hypertension
|
416.2
|
Chronic pulmonary embolism
|
416.8*–416.9*
|
Chronic pulmonary heart disease
|
428.0*–428.1*
|
Heart failure
|
428.20*–428.23*
|
Systolic heart failure
|
428.30*–428.33*
|
Diastolic heart failure
|
428.40*–428.43*
|
Combined systolic and diastolic heart failure
|
428.9*
|
Heart failure unspecified
|
492.8*
|
Other emphysema
|
496*
|
Chronic airway obstruction not elsewhere classified
|
780.09
|
Alteration of consciousness other
|
780.51
|
Insomnia with sleep apnea, unspecified
|
780.53
|
Hypersomnia with sleep apnea, unspecified
|
780.54*
|
Hypersomnia, unspecified
|
780.57
|
Unspecified sleep apnea
|
799.01*
|
Asphyxia
|
799.02*
|
Hypoxemia
|
799.82
|
Apparent life threatening event in infant
|
V12.53
|
Personal history of sudden cardiac arrest
|
|
Note: * These codes are to be used only for those patients who exhibit signs and symptoms of oxygen deprivation (supported by the patient’s medical record).
|
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