ICD-10-CM/PCS MS-DRG v43.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v43.0 Definitions Manual |
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| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| O4102X4 | 14 | 817-819 | O43231 | 14 | 769 | O659 | 14 | 817-819 | ||
| O4102X4 | 14 | 831-833 | O43231 | 14 | 776 | O659 | 14 | 831-833 | ||
| O4102X5 | 14 | 817-819 | O43232 | 14 | 769 | O660 | 14 | 817-819 | ||
| O4102X5 | 14 | 831-833 | O43232 | 14 | 776 | O660 | 14 | 831-833 | ||
| O4102X9 | 14 | 817-819 | O43233 | 14 | 769 | O661 | 14 | 817-819 | ||
| O4102X9 | 14 | 831-833 | O43233 | 14 | 776 | O661 | 14 | 831-833 | ||
| O4103X0 | 14 | 817-819 | O43239 | 14 | 769 | O662 | 14 | 817-819 | ||
| O4103X0 | 14 | 831-833 | O43239 | 14 | 776 | O662 | 14 | 831-833 | ||
| O4103X1 | 14 | 817-819 | O43811 | 14 | 817-819 | O663 | 14 | 817-819 | ||
| O4103X1 | 14 | 831-833 | O43811 | 14 | 831-833 | O663 | 14 | 831-833 | ||
| O4103X2 | 14 | 817-819 | O43812 | 14 | 817-819 | O6640 | 14 | 817-819 | ||
| O4103X2 | 14 | 831-833 | O43812 | 14 | 831-833 | O6640 | 14 | 831-833 | ||
| O4103X3 | 14 | 817-819 | O43813 | 14 | 817-819 | O6641 | 14 | 998 | ||
| O4103X3 | 14 | 831-833 | O43813 | 14 | 831-833 | O665 | 14 | 817-819 | ||
| O4103X4 | 14 | 817-819 | O43819 | 14 | 817-819 | O665 | 14 | 831-833 | ||
| O4103X4 | 14 | 831-833 | O43819 | 14 | 831-833 | O666 | 14 | 817-819 | ||
| O4103X5 | 14 | 817-819 | O43891 | 14 | 817-819 | O666 | 14 | 831-833 | ||
| O4103X5 | 14 | 831-833 | O43891 | 14 | 831-833 | O668 | 14 | 817-819 | ||
| O4103X9 | 14 | 817-819 | O43892 | 14 | 817-819 | O668 | 14 | 831-833 | ||
| O4103X9 | 14 | 831-833 | O43892 | 14 | 831-833 | O669 | 14 | 817-819 | ||
| O411010 | 14 | 817-819 | O43893 | 14 | 817-819 | O669 | 14 | 831-833 | ||
| O411010 | 14 | 831-833 | O43893 | 14 | 831-833 | O670 | 14 | 998 | ||
| O411011 | 14 | 817-819 | O43899 | 14 | 817-819 | O678 | 14 | 998 | ||
| O411011 | 14 | 831-833 | O43899 | 14 | 831-833 | O679 | 14 | 998 | ||
| O411012 | 14 | 817-819 | O4390 | 14 | 817-819 | O68 | 14 | 998 | ||
| O411012 | 14 | 831-833 | O4390 | 14 | 831-833 | O690XX0 | 14 | 998 | ||
| O411013 | 14 | 817-819 | O4391 | 14 | 817-819 | O690XX1 | 14 | 998 | ||
| O411013 | 14 | 831-833 | O4391 | 14 | 831-833 | O690XX2 | 14 | 998 | ||
| O411014 | 14 | 817-819 | O4392 | 14 | 817-819 | O690XX3 | 14 | 998 | ||
| O411014 | 14 | 831-833 | O4392 | 14 | 831-833 | O690XX4 | 14 | 998 | ||
| O411015 | 14 | 817-819 | O4393 | 14 | 817-819 | O690XX5 | 14 | 998 | ||
| O411015 | 14 | 831-833 | O4393 | 14 | 831-833 | O690XX9 | 14 | 998 | ||
| O411019 | 14 | 817-819 | O4400 | 14 | 817-819 | O691XX0 | 14 | 998 | ||
| O411019 | 14 | 831-833 | O4400 | 14 | 831-833 | O691XX1 | 14 | 998 | ||
| O411020 | 14 | 817-819 | O4401 | 14 | 817-819 | O691XX2 | 14 | 998 | ||
| O411020 | 14 | 831-833 | O4401 | 14 | 831-833 | O691XX3 | 14 | 998 | ||
| O411021 | 14 | 817-819 | O4402 | 14 | 817-819 | O691XX4 | 14 | 998 | ||
| O411021 | 14 | 831-833 | O4402 | 14 | 831-833 | O691XX5 | 14 | 998 | ||
| O411022 | 14 | 817-819 | O4403 | 14 | 817-819 | O691XX9 | 14 | 998 | ||
| O411022 | 14 | 831-833 | O4403 | 14 | 831-833 | O692XX0 | 14 | 998 | ||
| O411023 | 14 | 817-819 | O4410 | 14 | 817-819 | O692XX1 | 14 | 998 | ||
| O411023 | 14 | 831-833 | O4410 | 14 | 831-833 | O692XX2 | 14 | 998 | ||
| O411024 | 14 | 817-819 | O4411 | 14 | 817-819 | O692XX3 | 14 | 998 | ||
| O411024 | 14 | 831-833 | O4411 | 14 | 831-833 | O692XX4 | 14 | 998 | ||
| O411025 | 14 | 817-819 | O4412 | 14 | 817-819 | O692XX5 | 14 | 998 | ||
| O411025 | 14 | 831-833 | O4412 | 14 | 831-833 | O692XX9 | 14 | 998 | ||
| O411029 | 14 | 817-819 | O4413 | 14 | 817-819 | O693XX0 | 14 | 998 | ||
| O411029 | 14 | 831-833 | O4413 | 14 | 831-833 | O693XX1 | 14 | 998 | ||
| O411030 | 14 | 817-819 | O4420 | 14 | 817-819 | O693XX2 | 14 | 998 | ||
| O411030 | 14 | 831-833 | O4420 | 14 | 831-833 | O693XX3 | 14 | 998 | ||
| O411031 | 14 | 817-819 | O4421 | 14 | 817-819 | O693XX4 | 14 | 998 | ||
| O411031 | 14 | 831-833 | O4421 | 14 | 831-833 | O693XX5 | 14 | 998 | ||
| O411032 | 14 | 817-819 | O4422 | 14 | 817-819 | O693XX9 | 14 | 998 | ||
| O411032 | 14 | 831-833 | O4422 | 14 | 831-833 | O694XX0 | 14 | 998 | ||
| O411033 | 14 | 817-819 | O4423 | 14 | 817-819 | O694XX1 | 14 | 998 | ||
| O411033 | 14 | 831-833 | O4423 | 14 | 831-833 | O694XX2 | 14 | 998 | ||
| O411034 | 14 | 817-819 | O4430 | 14 | 817-819 | O694XX3 | 14 | 998 | ||
| O411034 | 14 | 831-833 | O4430 | 14 | 831-833 | O694XX4 | 14 | 998 | ||
| O411035 | 14 | 817-819 | O4431 | 14 | 817-819 | O694XX5 | 14 | 998 | ||
| O411035 | 14 | 831-833 | O4431 | 14 | 831-833 | O694XX9 | 14 | 998 | ||
| O411039 | 14 | 817-819 | O4432 | 14 | 817-819 | O695XX0 | 14 | 998 | ||
| O411039 | 14 | 831-833 | O4432 | 14 | 831-833 | O695XX1 | 14 | 998 | ||
| O411090 | 14 | 817-819 | O4433 | 14 | 817-819 | O695XX2 | 14 | 998 | ||
| O411090 | 14 | 831-833 | O4433 | 14 | 831-833 | O695XX3 | 14 | 998 | ||
| O411091 | 14 | 817-819 | O4440 | 14 | 817-819 | O695XX4 | 14 | 998 | ||
| O411091 | 14 | 831-833 | O4440 | 14 | 831-833 | O695XX5 | 14 | 998 | ||
| O411092 | 14 | 817-819 | O4441 | 14 | 817-819 | O695XX9 | 14 | 998 | ||
| O411092 | 14 | 831-833 | O4441 | 14 | 831-833 | O6981X0 | 14 | 998 | ||
| O411093 | 14 | 817-819 | O4442 | 14 | 817-819 | O6981X1 | 14 | 998 | ||
| O411093 | 14 | 831-833 | O4442 | 14 | 831-833 | O6981X2 | 14 | 998 | ||
| O411094 | 14 | 817-819 | O4443 | 14 | 817-819 | O6981X3 | 14 | 998 | ||
| O411094 | 14 | 831-833 | O4443 | 14 | 831-833 | O6981X4 | 14 | 998 | ||
| O411095 | 14 | 817-819 | O4450 | 14 | 817-819 | O6981X5 | 14 | 998 | ||
| O411095 | 14 | 831-833 | O4450 | 14 | 831-833 | O6981X9 | 14 | 998 | ||
| O411099 | 14 | 817-819 | O4451 | 14 | 817-819 | O6982X0 | 14 | 998 | ||
| O411099 | 14 | 831-833 | O4451 | 14 | 831-833 | O6982X1 | 14 | 998 | ||
| O411210 | 14 | 817-819 | O4452 | 14 | 817-819 | O6982X2 | 14 | 998 | ||
| O411210 | 14 | 831-833 | O4452 | 14 | 831-833 | O6982X3 | 14 | 998 | ||
| O411211 | 14 | 817-819 | O4453 | 14 | 817-819 | O6982X4 | 14 | 998 | ||
| O411211 | 14 | 831-833 | O4453 | 14 | 831-833 | O6982X5 | 14 | 998 | ||
| O411212 | 14 | 817-819 | O45001 | 14 | 817-819 | O6982X9 | 14 | 998 | ||
| O411212 | 14 | 831-833 | O45001 | 14 | 831-833 | O6989X0 | 14 | 998 | ||
| O411213 | 14 | 817-819 | O45002 | 14 | 817-819 | O6989X1 | 14 | 998 | ||
| O411213 | 14 | 831-833 | O45002 | 14 | 831-833 | O6989X2 | 14 | 998 | ||
| O411214 | 14 | 817-819 | O45003 | 14 | 817-819 | O6989X3 | 14 | 998 | ||
| O411214 | 14 | 831-833 | O45003 | 14 | 831-833 | O6989X4 | 14 | 998 | ||
| O411215 | 14 | 817-819 | O45009 | 14 | 817-819 | O6989X5 | 14 | 998 | ||
| O411215 | 14 | 831-833 | O45009 | 14 | 831-833 | O6989X9 | 14 | 998 | ||
| O411219 | 14 | 817-819 | O45011 | 14 | 817-819 | O699XX0 | 14 | 998 | ||
| O411219 | 14 | 831-833 | O45011 | 14 | 831-833 | O699XX1 | 14 | 998 | ||
| O411220 | 14 | 817-819 | O45012 | 14 | 817-819 | O699XX2 | 14 | 998 | ||
| O411220 | 14 | 831-833 | O45012 | 14 | 831-833 | O699XX3 | 14 | 998 | ||
| O411221 | 14 | 817-819 | O45013 | 14 | 817-819 | O699XX4 | 14 | 998 | ||
| O411221 | 14 | 831-833 | O45013 | 14 | 831-833 | O699XX5 | 14 | 998 | ||
| O411222 | 14 | 817-819 | O45019 | 14 | 817-819 | O699XX9 | 14 | 998 | ||
| O411222 | 14 | 831-833 | O45019 | 14 | 831-833 | O700 | 14 | 769 | ||
| O411223 | 14 | 817-819 | O45021 | 14 | 817-819 | O700 | 14 | 776 | ||
| O411223 | 14 | 831-833 | O45021 | 14 | 831-833 | O701 | 14 | 769 | ||
| O411224 | 14 | 817-819 | O45022 | 14 | 817-819 | O701 | 14 | 776 | ||
| O411224 | 14 | 831-833 | O45022 | 14 | 831-833 | O7020 | 14 | 769 | ||
| O411225 | 14 | 817-819 | O45023 | 14 | 817-819 | O7020 | 14 | 776 | ||
| O411225 | 14 | 831-833 | O45023 | 14 | 831-833 | O7021 | 14 | 769 | ||
| O411229 | 14 | 817-819 | O45029 | 14 | 817-819 | O7021 | 14 | 776 | ||
| O411229 | 14 | 831-833 | O45029 | 14 | 831-833 | O7022 | 14 | 769 | ||
| O411230 | 14 | 817-819 | O45091 | 14 | 817-819 | O7022 | 14 | 776 | ||
| O411230 | 14 | 831-833 | O45091 | 14 | 831-833 | O7023 | 14 | 769 | ||
| O411231 | 14 | 817-819 | O45092 | 14 | 817-819 | O7023 | 14 | 776 | ||
| O411231 | 14 | 831-833 | O45092 | 14 | 831-833 | O703 | 14 | 769 | ||
| O411232 | 14 | 817-819 | O45093 | 14 | 817-819 | O703 | 14 | 776 | ||
| O411232 | 14 | 831-833 | O45093 | 14 | 831-833 | O704 | 14 | 769 | ||
| O411233 | 14 | 817-819 | O45099 | 14 | 817-819 | O704 | 14 | 776 | ||
| O411233 | 14 | 831-833 | O45099 | 14 | 831-833 | O709 | 14 | 769 | ||
| O411234 | 14 | 817-819 | O458X1 | 14 | 817-819 | O709 | 14 | 776 | ||
| O411234 | 14 | 831-833 | O458X1 | 14 | 831-833 | O7100 | 14 | 817-819 | ||
| O411235 | 14 | 817-819 | O458X2 | 14 | 817-819 | O7100 | 14 | 831-833 | ||
| O411235 | 14 | 831-833 | O458X2 | 14 | 831-833 | O7102 | 14 | 817-819 | ||
| O411239 | 14 | 817-819 | O458X3 | 14 | 817-819 | O7102 | 14 | 831-833 | ||
| O411239 | 14 | 831-833 | O458X3 | 14 | 831-833 | O7103 | 14 | 817-819 | ||
| O411290 | 14 | 817-819 | O458X9 | 14 | 817-819 | O7103 | 14 | 831-833 | ||
| O411290 | 14 | 831-833 | O458X9 | 14 | 831-833 | O711 | 14 | 817-819 | ||
| O411291 | 14 | 817-819 | O4590 | 14 | 817-819 | O711 | 14 | 831-833 | ||
| O411291 | 14 | 831-833 | O4590 | 14 | 831-833 | O712 | 14 | 769 | ||
| O411292 | 14 | 817-819 | O4591 | 14 | 817-819 | O712 | 14 | 776 | ||
| O411292 | 14 | 831-833 | O4591 | 14 | 831-833 | O713 | 14 | 769 | ||
| O411293 | 14 | 817-819 | O4592 | 14 | 817-819 | O713 | 14 | 776 | ||
| O411293 | 14 | 831-833 | O4592 | 14 | 831-833 | O714 | 14 | 769 | ||
| O411294 | 14 | 817-819 | O4593 | 14 | 817-819 | O714 | 14 | 776 | ||
| O411294 | 14 | 831-833 | O4593 | 14 | 831-833 | O715 | 14 | 769 | ||
| O411295 | 14 | 817-819 | O46001 | 14 | 817-819 | O715 | 14 | 776 | ||
| O411295 | 14 | 831-833 | O46001 | 14 | 831-833 | O716 | 14 | 769 | ||
| O411299 | 14 | 817-819 | O46002 | 14 | 817-819 | O716 | 14 | 776 | ||
| O411299 | 14 | 831-833 | O46002 | 14 | 831-833 | O717 | 14 | 769 | ||
| O411410 | 14 | 817-819 | O46003 | 14 | 817-819 | O717 | 14 | 776 | ||
| O411410 | 14 | 831-833 | O46003 | 14 | 831-833 | O7181 | 14 | 817-819 | ||
| O411411 | 14 | 817-819 | O46009 | 14 | 817-819 | O7181 | 14 | 831-833 | ||
| O411411 | 14 | 831-833 | O46009 | 14 | 831-833 | O7182 | 14 | 769 | ||
| O411412 | 14 | 817-819 | O46011 | 14 | 817-819 | O7182 | 14 | 776 | ||
| O411412 | 14 | 831-833 | O46011 | 14 | 831-833 | O7189 | 14 | 769 | ||
| O411413 | 14 | 817-819 | O46012 | 14 | 817-819 | O7189 | 14 | 776 | ||
| O411413 | 14 | 831-833 | O46012 | 14 | 831-833 | O719 | 14 | 769 | ||
| O411414 | 14 | 817-819 | O46013 | 14 | 817-819 | O719 | 14 | 776 | ||
| O411414 | 14 | 831-833 | O46013 | 14 | 831-833 | O720 | 14 | 769 | ||
| O411415 | 14 | 817-819 | O46019 | 14 | 817-819 | O720 | 14 | 776 | ||
| O411415 | 14 | 831-833 | O46019 | 14 | 831-833 | O721 | 14 | 769 | ||
| O411419 | 14 | 817-819 | O46021 | 14 | 817-819 | O721 | 14 | 776 | ||
| O411419 | 14 | 831-833 | O46021 | 14 | 831-833 | O722 | 14 | 769 | ||
| O411420 | 14 | 817-819 | O46022 | 14 | 817-819 | O722 | 14 | 776 | ||
| O411420 | 14 | 831-833 | O46022 | 14 | 831-833 | O723 | 14 | 769 | ||
| O411421 | 14 | 817-819 | O46023 | 14 | 817-819 | O723 | 14 | 776 | ||
| O411421 | 14 | 831-833 | O46023 | 14 | 831-833 | O730 | 14 | 769 | ||
| O411422 | 14 | 817-819 | O46029 | 14 | 817-819 | O730 | 14 | 776 | ||
| O411422 | 14 | 831-833 | O46029 | 14 | 831-833 | O731 | 14 | 769 | ||
| O411423 | 14 | 817-819 | O46091 | 14 | 817-819 | O731 | 14 | 776 | ||
| O411423 | 14 | 831-833 | O46091 | 14 | 831-833 | O740 | 14 | 998 | ||
| O411424 | 14 | 817-819 | O46092 | 14 | 817-819 | O741 | 14 | 998 | ||
| O411424 | 14 | 831-833 | O46092 | 14 | 831-833 | O742 | 14 | 998 | ||
| O411425 | 14 | 817-819 | O46093 | 14 | 817-819 | O743 | 14 | 998 | ||
| O411425 | 14 | 831-833 | O46093 | 14 | 831-833 | O744 | 14 | 998 | ||
| O411429 | 14 | 817-819 | O46099 | 14 | 817-819 | O745 | 14 | 998 | ||
| O411429 | 14 | 831-833 | O46099 | 14 | 831-833 | O746 | 14 | 998 | ||
| O411430 | 14 | 817-819 | O468X1 | 14 | 817-819 | O747 | 14 | 998 | ||
| O411430 | 14 | 831-833 | O468X1 | 14 | 831-833 | O748 | 14 | 998 | ||
| O411431 | 14 | 817-819 | O468X2 | 14 | 817-819 | O749 | 14 | 998 | ||
| O411431 | 14 | 831-833 | O468X2 | 14 | 831-833 | O750 | 14 | 998 | ||
| O411432 | 14 | 817-819 | O468X3 | 14 | 817-819 | O751 | 14 | 998 | ||
| O411432 | 14 | 831-833 | O468X3 | 14 | 831-833 | O752 | 14 | 817-819 | ||
| O411433 | 14 | 817-819 | O468X9 | 14 | 817-819 | O752 | 14 | 831-833 | ||
| O411433 | 14 | 831-833 | O468X9 | 14 | 831-833 | O753 | 14 | 817-819 | ||
| O411434 | 14 | 817-819 | O4690 | 14 | 817-819 | O753 | 14 | 831-833 | ||
| O411434 | 14 | 831-833 | O4690 | 14 | 831-833 | O754 | 14 | 769 | ||
| O411435 | 14 | 817-819 | O4691 | 14 | 817-819 | O754 | 14 | 776 | ||
| O411435 | 14 | 831-833 | O4691 | 14 | 831-833 | O755 | 14 | 998 | ||
| O411439 | 14 | 817-819 | O4692 | 14 | 817-819 | O7581 | 14 | 998 | ||
| O411439 | 14 | 831-833 | O4692 | 14 | 831-833 | O7582 | 14 | 998 | ||
| O411490 | 14 | 817-819 | O4693 | 14 | 817-819 | O7589 | 14 | 998 | ||
| O411490 | 14 | 831-833 | O4693 | 14 | 831-833 | O759 | 14 | 998 | ||
| O411491 | 14 | 817-819 | O4700 | 14 | 817-819 | O76 | 14 | 998 | ||
| O411491 | 14 | 831-833 | O4700 | 14 | 831-833 | O770 | 14 | 998 | ||
| O411492 | 14 | 817-819 | O4702 | 14 | 817-819 | O771 | 14 | 998 | ||
| O411492 | 14 | 831-833 | O4702 | 14 | 831-833 | O778 | 14 | 998 | ||
| O411493 | 14 | 817-819 | O4703 | 14 | 817-819 | O779 | 14 | 998 | ||
| O411493 | 14 | 831-833 | O4703 | 14 | 831-833 | O80 | 14 | 998 | ||
| O411494 | 14 | 817-819 | O471 | 14 | 817-819 | O82 | 14 | 998 | ||
| O411494 | 14 | 831-833 | O471 | 14 | 831-833 | O85 | 14 | 769 | ||
| O411495 | 14 | 817-819 | O479 | 14 | 817-819 | O85 | 14 | 776 | ||
| O411495 | 14 | 831-833 | O479 | 14 | 831-833 | O8600 | 14 | 769 | ||
| O411499 | 14 | 817-819 | O480 | 14 | 817-819 | O8600 | 14 | 776 | ||
| O411499 | 14 | 831-833 | O480 | 14 | 831-833 | O8601 | 14 | 769 | ||
| O418X10 | 14 | 817-819 | O481 | 14 | 817-819 | O8601 | 14 | 776 | ||
| O418X10 | 14 | 831-833 | O481 | 14 | 831-833 | O8602 | 14 | 769 | ||
| O418X11 | 14 | 817-819 | O6000 | 14 | 817-819 | O8602 | 14 | 776 | ||
| O418X11 | 14 | 831-833 | O6000 | 14 | 831-833 | O8603 | 14 | 769 | ||
| O418X12 | 14 | 817-819 | O6002 | 14 | 817-819 | O8603 | 14 | 776 | ||
| O418X12 | 14 | 831-833 | O6002 | 14 | 831-833 | O8604 | 14 | 769 | ||
| O418X13 | 14 | 817-819 | O6003 | 14 | 817-819 | O8604 | 14 | 776 | ||
| O418X13 | 14 | 831-833 | O6003 | 14 | 831-833 | O8609 | 14 | 769 | ||
| O418X14 | 14 | 817-819 | O6010X0 | 14 | 998 | O8609 | 14 | 776 | ||
| O418X14 | 14 | 831-833 | O6010X1 | 14 | 998 | O8611 | 14 | 769 | ||
| O418X15 | 14 | 817-819 | O6010X2 | 14 | 998 | O8611 | 14 | 776 | ||
| O418X15 | 14 | 831-833 | O6010X3 | 14 | 998 | O8612 | 14 | 769 | ||
| O418X19 | 14 | 817-819 | O6010X4 | 14 | 998 | O8612 | 14 | 776 | ||
| O418X19 | 14 | 831-833 | O6010X5 | 14 | 998 | O8613 | 14 | 769 | ||
| O418X20 | 14 | 817-819 | O6010X9 | 14 | 998 | O8613 | 14 | 776 | ||
| O418X20 | 14 | 831-833 | O6012X0 | 14 | 998 | O8619 | 14 | 769 | ||
| O418X21 | 14 | 817-819 | O6012X1 | 14 | 998 | O8619 | 14 | 776 | ||
| O418X21 | 14 | 831-833 | O6012X2 | 14 | 998 | O8620 | 14 | 769 | ||
| O418X22 | 14 | 817-819 | O6012X3 | 14 | 998 | O8620 | 14 | 776 | ||
| O418X22 | 14 | 831-833 | O6012X4 | 14 | 998 | O8621 | 14 | 769 | ||
| O418X23 | 14 | 817-819 | O6012X5 | 14 | 998 | O8621 | 14 | 776 | ||
| O418X23 | 14 | 831-833 | O6012X9 | 14 | 998 | O8622 | 14 | 769 | ||
| O418X24 | 14 | 817-819 | O6013X0 | 14 | 998 | O8622 | 14 | 776 | ||
| O418X24 | 14 | 831-833 | O6013X1 | 14 | 998 | O8629 | 14 | 769 | ||
| O418X25 | 14 | 817-819 | O6013X2 | 14 | 998 | O8629 | 14 | 776 | ||
| O418X25 | 14 | 831-833 | O6013X3 | 14 | 998 | O864 | 14 | 769 | ||
| O418X29 | 14 | 817-819 | O6013X4 | 14 | 998 | O864 | 14 | 776 | ||
| O418X29 | 14 | 831-833 | O6013X5 | 14 | 998 | O8681 | 14 | 769 | ||
| O418X30 | 14 | 817-819 | O6013X9 | 14 | 998 | O8681 | 14 | 776 | ||
| O418X30 | 14 | 831-833 | O6014X0 | 14 | 998 | O8689 | 14 | 769 | ||
| O418X31 | 14 | 817-819 | O6014X1 | 14 | 998 | O8689 | 14 | 776 | ||
| O418X31 | 14 | 831-833 | O6014X2 | 14 | 998 | O870 | 14 | 769 | ||
| O418X32 | 14 | 817-819 | O6014X3 | 14 | 998 | O870 | 14 | 776 | ||
| O418X32 | 14 | 831-833 | O6014X4 | 14 | 998 | O871 | 14 | 769 | ||
| O418X33 | 14 | 817-819 | O6014X5 | 14 | 998 | O871 | 14 | 776 | ||
| O418X33 | 14 | 831-833 | O6014X9 | 14 | 998 | O872 | 14 | 769 | ||
| O418X34 | 14 | 817-819 | O6020X0 | 14 | 998 | O872 | 14 | 776 | ||
| O418X34 | 14 | 831-833 | O6020X1 | 14 | 998 | O873 | 14 | 769 | ||
| O418X35 | 14 | 817-819 | O6020X2 | 14 | 998 | O873 | 14 | 776 | ||
| O418X35 | 14 | 831-833 | O6020X3 | 14 | 998 | O874 | 14 | 769 | ||
| O418X39 | 14 | 817-819 | O6020X4 | 14 | 998 | O874 | 14 | 776 | ||
| O418X39 | 14 | 831-833 | O6020X5 | 14 | 998 | O878 | 14 | 769 | ||
| O418X90 | 14 | 817-819 | O6020X9 | 14 | 998 | O878 | 14 | 776 | ||
| O418X90 | 14 | 831-833 | O6022X0 | 14 | 998 | O879 | 14 | 769 | ||
| O418X91 | 14 | 817-819 | O6022X1 | 14 | 998 | O879 | 14 | 776 | ||
| O418X91 | 14 | 831-833 | O6022X2 | 14 | 998 | O88011 | 14 | 817-819 | ||
| O418X92 | 14 | 817-819 | O6022X3 | 14 | 998 | O88011 | 14 | 831-833 | ||
| O418X92 | 14 | 831-833 | O6022X4 | 14 | 998 | O88012 | 14 | 817-819 | ||
| O418X93 | 14 | 817-819 | O6022X5 | 14 | 998 | O88012 | 14 | 831-833 | ||
| O418X93 | 14 | 831-833 | O6022X9 | 14 | 998 | O88013 | 14 | 817-819 | ||
| O418X94 | 14 | 817-819 | O6023X0 | 14 | 998 | O88013 | 14 | 831-833 | ||
| O418X94 | 14 | 831-833 | O6023X1 | 14 | 998 | O88019 | 14 | 817-819 | ||
| O418X95 | 14 | 817-819 | O6023X2 | 14 | 998 | O88019 | 14 | 831-833 | ||
| O418X95 | 14 | 831-833 | O6023X3 | 14 | 998 | O8802 | 14 | 998 | ||
| O418X99 | 14 | 817-819 | O6023X4 | 14 | 998 | O8803 | 14 | 769 | ||
| O418X99 | 14 | 831-833 | O6023X5 | 14 | 998 | O8803 | 14 | 776 | ||
| O4190X0 | 14 | 817-819 | O6023X9 | 14 | 998 | O88111 | 14 | 817-819 | ||
| O4190X0 | 14 | 831-833 | O610 | 14 | 817-819 | O88111 | 14 | 831-833 | ||
| O4190X1 | 14 | 817-819 | O610 | 14 | 831-833 | O88112 | 14 | 817-819 | ||
| O4190X1 | 14 | 831-833 | O611 | 14 | 817-819 | O88112 | 14 | 831-833 | ||
| O4190X2 | 14 | 817-819 | O611 | 14 | 831-833 | O88113 | 14 | 817-819 | ||
| O4190X2 | 14 | 831-833 | O618 | 14 | 817-819 | O88113 | 14 | 831-833 | ||
| O4190X3 | 14 | 817-819 | O618 | 14 | 831-833 | O88119 | 14 | 817-819 | ||
| O4190X3 | 14 | 831-833 | O619 | 14 | 817-819 | O88119 | 14 | 831-833 | ||
| O4190X4 | 14 | 817-819 | O619 | 14 | 831-833 | O8812 | 14 | 998 | ||
| O4190X4 | 14 | 831-833 | O620 | 14 | 817-819 | O8813 | 14 | 769 | ||
| O4190X5 | 14 | 817-819 | O620 | 14 | 831-833 | O8813 | 14 | 776 | ||
| O4190X5 | 14 | 831-833 | O621 | 14 | 817-819 | O88211 | 14 | 817-819 | ||
| O4190X9 | 14 | 817-819 | O621 | 14 | 831-833 | O88211 | 14 | 831-833 | ||
| O4190X9 | 14 | 831-833 | O622 | 14 | 817-819 | O88212 | 14 | 817-819 | ||
| O4191X0 | 14 | 817-819 | O622 | 14 | 831-833 | O88212 | 14 | 831-833 | ||
| O4191X0 | 14 | 831-833 | O623 | 14 | 817-819 | O88213 | 14 | 817-819 | ||
| O4191X1 | 14 | 817-819 | O623 | 14 | 831-833 | O88213 | 14 | 831-833 | ||
| O4191X1 | 14 | 831-833 | O624 | 14 | 817-819 | O88219 | 14 | 817-819 | ||
| O4191X2 | 14 | 817-819 | O624 | 14 | 831-833 | O88219 | 14 | 831-833 | ||
| O4191X2 | 14 | 831-833 | O628 | 14 | 817-819 | O8822 | 14 | 998 | ||
| O4191X3 | 14 | 817-819 | O628 | 14 | 831-833 | O8823 | 14 | 769 | ||
| O4191X3 | 14 | 831-833 | O629 | 14 | 817-819 | O8823 | 14 | 776 | ||
| O4191X4 | 14 | 817-819 | O629 | 14 | 831-833 | O88311 | 14 | 817-819 | ||
| O4191X4 | 14 | 831-833 | O630 | 14 | 817-819 | O88311 | 14 | 831-833 | ||
| O4191X5 | 14 | 817-819 | O630 | 14 | 831-833 | O88312 | 14 | 817-819 | ||
| O4191X5 | 14 | 831-833 | O631 | 14 | 817-819 | O88312 | 14 | 831-833 | ||
| O4191X9 | 14 | 817-819 | O631 | 14 | 831-833 | O88313 | 14 | 817-819 | ||
| O4191X9 | 14 | 831-833 | O632 | 14 | 998 | O88313 | 14 | 831-833 | ||
| O4192X0 | 14 | 817-819 | O639 | 14 | 817-819 | O88319 | 14 | 817-819 | ||
| O4192X0 | 14 | 831-833 | O639 | 14 | 831-833 | O88319 | 14 | 831-833 | ||
| O4192X1 | 14 | 817-819 | O640XX0 | 14 | 817-819 | O8832 | 14 | 998 | ||
| O4192X1 | 14 | 831-833 | O640XX0 | 14 | 831-833 | O8833 | 14 | 769 | ||
| O4192X2 | 14 | 817-819 | O640XX1 | 14 | 817-819 | O8833 | 14 | 776 | ||
| O4192X2 | 14 | 831-833 | O640XX1 | 14 | 831-833 | O88811 | 14 | 817-819 | ||
| O4192X3 | 14 | 817-819 | O640XX2 | 14 | 817-819 | O88811 | 14 | 831-833 | ||
| O4192X3 | 14 | 831-833 | O640XX2 | 14 | 831-833 | O88812 | 14 | 817-819 | ||
| O4192X4 | 14 | 817-819 | O640XX3 | 14 | 817-819 | O88812 | 14 | 831-833 | ||
| O4192X4 | 14 | 831-833 | O640XX3 | 14 | 831-833 | O88813 | 14 | 817-819 | ||
| O4192X5 | 14 | 817-819 | O640XX4 | 14 | 817-819 | O88813 | 14 | 831-833 | ||
| O4192X5 | 14 | 831-833 | O640XX4 | 14 | 831-833 | O88819 | 14 | 817-819 | ||
| O4192X9 | 14 | 817-819 | O640XX5 | 14 | 817-819 | O88819 | 14 | 831-833 | ||
| O4192X9 | 14 | 831-833 | O640XX5 | 14 | 831-833 | O8882 | 14 | 998 | ||
| O4193X0 | 14 | 817-819 | O640XX9 | 14 | 817-819 | O8883 | 14 | 769 | ||
| O4193X0 | 14 | 831-833 | O640XX9 | 14 | 831-833 | O8883 | 14 | 776 | ||
| O4193X1 | 14 | 817-819 | O641XX0 | 14 | 817-819 | O8901 | 14 | 769 | ||
| O4193X1 | 14 | 831-833 | O641XX0 | 14 | 831-833 | O8901 | 14 | 776 | ||
| O4193X2 | 14 | 817-819 | O641XX1 | 14 | 817-819 | O8909 | 14 | 769 | ||
| O4193X2 | 14 | 831-833 | O641XX1 | 14 | 831-833 | O8909 | 14 | 776 | ||
| O4193X3 | 14 | 817-819 | O641XX2 | 14 | 817-819 | O891 | 14 | 769 | ||
| O4193X3 | 14 | 831-833 | O641XX2 | 14 | 831-833 | O891 | 14 | 776 | ||
| O4193X4 | 14 | 817-819 | O641XX3 | 14 | 817-819 | O892 | 14 | 769 | ||
| O4193X4 | 14 | 831-833 | O641XX3 | 14 | 831-833 | O892 | 14 | 776 | ||
| O4193X5 | 14 | 817-819 | O641XX4 | 14 | 817-819 | O893 | 14 | 769 | ||
| O4193X5 | 14 | 831-833 | O641XX4 | 14 | 831-833 | O893 | 14 | 776 | ||
| O4193X9 | 14 | 817-819 | O641XX5 | 14 | 817-819 | O894 | 14 | 769 | ||
| O4193X9 | 14 | 831-833 | O641XX5 | 14 | 831-833 | O894 | 14 | 776 | ||
| O4200 | 14 | 817-819 | O641XX9 | 14 | 817-819 | O895 | 14 | 769 | ||
| O4200 | 14 | 831-833 | O641XX9 | 14 | 831-833 | O895 | 14 | 776 | ||
| O42011 | 14 | 817-819 | O642XX0 | 14 | 817-819 | O896 | 14 | 769 | ||
| O42011 | 14 | 831-833 | O642XX0 | 14 | 831-833 | O896 | 14 | 776 | ||
| O42012 | 14 | 817-819 | O642XX1 | 14 | 817-819 | O898 | 14 | 769 | ||
| O42012 | 14 | 831-833 | O642XX1 | 14 | 831-833 | O898 | 14 | 776 | ||
| O42013 | 14 | 817-819 | O642XX2 | 14 | 817-819 | O899 | 14 | 769 | ||
| O42013 | 14 | 831-833 | O642XX2 | 14 | 831-833 | O899 | 14 | 776 | ||
| O42019 | 14 | 817-819 | O642XX3 | 14 | 817-819 | O900 | 14 | 769 | ||
| O42019 | 14 | 831-833 | O642XX3 | 14 | 831-833 | O900 | 14 | 776 | ||
| O4202 | 14 | 817-819 | O642XX4 | 14 | 817-819 | O901 | 14 | 769 | ||
| O4202 | 14 | 831-833 | O642XX4 | 14 | 831-833 | O901 | 14 | 776 | ||
| O4210 | 14 | 817-819 | O642XX5 | 14 | 817-819 | O902 | 14 | 769 | ||
| O4210 | 14 | 831-833 | O642XX5 | 14 | 831-833 | O902 | 14 | 776 | ||
| O42111 | 14 | 817-819 | O642XX9 | 14 | 817-819 | O903 | 14 | 769 | ||
| O42111 | 14 | 831-833 | O642XX9 | 14 | 831-833 | O903 | 14 | 776 | ||
| O42112 | 14 | 817-819 | O643XX0 | 14 | 817-819 | O9041 | 14 | 769 | ||
| O42112 | 14 | 831-833 | O643XX0 | 14 | 831-833 | O9041 | 14 | 776 | ||
| O42113 | 14 | 817-819 | O643XX1 | 14 | 817-819 | O9049 | 14 | 769 | ||
| O42113 | 14 | 831-833 | O643XX1 | 14 | 831-833 | O9049 | 14 | 776 | ||
| O42119 | 14 | 817-819 | O643XX2 | 14 | 817-819 | O905 | 14 | 769 | ||
| O42119 | 14 | 831-833 | O643XX2 | 14 | 831-833 | O905 | 14 | 776 | ||
| O4212 | 14 | 817-819 | O643XX3 | 14 | 817-819 | O906 | 14 | 769 | ||
| O4212 | 14 | 831-833 | O643XX3 | 14 | 831-833 | O906 | 14 | 776 | ||
| O4290 | 14 | 817-819 | O643XX4 | 14 | 817-819 | O9081 | 14 | 769 | ||
| O4290 | 14 | 831-833 | O643XX4 | 14 | 831-833 | O9081 | 14 | 776 | ||
| O42911 | 14 | 817-819 | O643XX5 | 14 | 817-819 | O9089 | 14 | 769 | ||
| O42911 | 14 | 831-833 | O643XX5 | 14 | 831-833 | O9089 | 14 | 776 | ||
| O42912 | 14 | 817-819 | O643XX9 | 14 | 817-819 | O909 | 14 | 769 | ||
| O42912 | 14 | 831-833 | O643XX9 | 14 | 831-833 | O909 | 14 | 776 | ||
| O42913 | 14 | 817-819 | O644XX0 | 14 | 817-819 | O91011 | 14 | 817-819 | ||
| O42913 | 14 | 831-833 | O644XX0 | 14 | 831-833 | O91011 | 14 | 831-833 | ||
| O42919 | 14 | 817-819 | O644XX1 | 14 | 817-819 | O91012 | 14 | 817-819 | ||
| O42919 | 14 | 831-833 | O644XX1 | 14 | 831-833 | O91012 | 14 | 831-833 | ||
| O4292 | 14 | 817-819 | O644XX2 | 14 | 817-819 | O91013 | 14 | 817-819 | ||
| O4292 | 14 | 831-833 | O644XX2 | 14 | 831-833 | O91013 | 14 | 831-833 | ||
| O43011 | 14 | 817-819 | O644XX3 | 14 | 817-819 | O91019 | 14 | 817-819 | ||
| O43011 | 14 | 831-833 | O644XX3 | 14 | 831-833 | O91019 | 14 | 831-833 | ||
| O43012 | 14 | 817-819 | O644XX4 | 14 | 817-819 | O9102 | 14 | 769 | ||
| O43012 | 14 | 831-833 | O644XX4 | 14 | 831-833 | O9102 | 14 | 776 | ||
| O43013 | 14 | 817-819 | O644XX5 | 14 | 817-819 | O9103 | 14 | 769 | ||
| O43013 | 14 | 831-833 | O644XX5 | 14 | 831-833 | O9103 | 14 | 776 | ||
| O43019 | 14 | 817-819 | O644XX9 | 14 | 817-819 | O91111 | 14 | 817-819 | ||
| O43019 | 14 | 831-833 | O644XX9 | 14 | 831-833 | O91111 | 14 | 831-833 | ||
| O43021 | 14 | 817-819 | O645XX0 | 14 | 817-819 | O91112 | 14 | 817-819 | ||
| O43021 | 14 | 831-833 | O645XX0 | 14 | 831-833 | O91112 | 14 | 831-833 | ||
| O43022 | 14 | 817-819 | O645XX1 | 14 | 817-819 | O91113 | 14 | 817-819 | ||
| O43022 | 14 | 831-833 | O645XX1 | 14 | 831-833 | O91113 | 14 | 831-833 | ||
| O43023 | 14 | 817-819 | O645XX2 | 14 | 817-819 | O91119 | 14 | 817-819 | ||
| O43023 | 14 | 831-833 | O645XX2 | 14 | 831-833 | O91119 | 14 | 831-833 | ||
| O43029 | 14 | 817-819 | O645XX3 | 14 | 817-819 | O9112 | 14 | 769 | ||
| O43029 | 14 | 831-833 | O645XX3 | 14 | 831-833 | O9112 | 14 | 776 | ||
| O43101 | 14 | 817-819 | O645XX4 | 14 | 817-819 | O9113 | 14 | 769 | ||
| O43101 | 14 | 831-833 | O645XX4 | 14 | 831-833 | O9113 | 14 | 776 | ||
| O43102 | 14 | 817-819 | O645XX5 | 14 | 817-819 | O91211 | 14 | 817-819 | ||
| O43102 | 14 | 831-833 | O645XX5 | 14 | 831-833 | O91211 | 14 | 831-833 | ||
| O43103 | 14 | 817-819 | O645XX9 | 14 | 817-819 | O91212 | 14 | 817-819 | ||
| O43103 | 14 | 831-833 | O645XX9 | 14 | 831-833 | O91212 | 14 | 831-833 | ||
| O43109 | 14 | 817-819 | O648XX0 | 14 | 817-819 | O91213 | 14 | 817-819 | ||
| O43109 | 14 | 831-833 | O648XX0 | 14 | 831-833 | O91213 | 14 | 831-833 | ||
| O43111 | 14 | 817-819 | O648XX1 | 14 | 817-819 | O91219 | 14 | 817-819 | ||
| O43111 | 14 | 831-833 | O648XX1 | 14 | 831-833 | O91219 | 14 | 831-833 | ||
| O43112 | 14 | 817-819 | O648XX2 | 14 | 817-819 | O9122 | 14 | 769 | ||
| O43112 | 14 | 831-833 | O648XX2 | 14 | 831-833 | O9122 | 14 | 776 | ||
| O43113 | 14 | 817-819 | O648XX3 | 14 | 817-819 | O9123 | 14 | 769 | ||
| O43113 | 14 | 831-833 | O648XX3 | 14 | 831-833 | O9123 | 14 | 776 | ||
| O43119 | 14 | 817-819 | O648XX4 | 14 | 817-819 | O92011 | 14 | 817-819 | ||
| O43119 | 14 | 831-833 | O648XX4 | 14 | 831-833 | O92011 | 14 | 831-833 | ||
| O43121 | 14 | 817-819 | O648XX5 | 14 | 817-819 | O92012 | 14 | 817-819 | ||
| O43121 | 14 | 831-833 | O648XX5 | 14 | 831-833 | O92012 | 14 | 831-833 | ||
| O43122 | 14 | 817-819 | O648XX9 | 14 | 817-819 | O92013 | 14 | 817-819 | ||
| O43122 | 14 | 831-833 | O648XX9 | 14 | 831-833 | O92013 | 14 | 831-833 | ||
| O43123 | 14 | 817-819 | O649XX0 | 14 | 817-819 | O92019 | 14 | 817-819 | ||
| O43123 | 14 | 831-833 | O649XX0 | 14 | 831-833 | O92019 | 14 | 831-833 | ||
| O43129 | 14 | 817-819 | O649XX1 | 14 | 817-819 | O9202 | 14 | 769 | ||
| O43129 | 14 | 831-833 | O649XX1 | 14 | 831-833 | O9202 | 14 | 776 | ||
| O43191 | 14 | 817-819 | O649XX2 | 14 | 817-819 | O9203 | 14 | 769 | ||
| O43191 | 14 | 831-833 | O649XX2 | 14 | 831-833 | O9203 | 14 | 776 | ||
| O43192 | 14 | 817-819 | O649XX3 | 14 | 817-819 | O92111 | 14 | 817-819 | ||
| O43192 | 14 | 831-833 | O649XX3 | 14 | 831-833 | O92111 | 14 | 831-833 | ||
| O43193 | 14 | 817-819 | O649XX4 | 14 | 817-819 | O92112 | 14 | 817-819 | ||
| O43193 | 14 | 831-833 | O649XX4 | 14 | 831-833 | O92112 | 14 | 831-833 | ||
| O43199 | 14 | 817-819 | O649XX5 | 14 | 817-819 | O92113 | 14 | 817-819 | ||
| O43199 | 14 | 831-833 | O649XX5 | 14 | 831-833 | O92113 | 14 | 831-833 | ||
| O43211 | 14 | 769 | O649XX9 | 14 | 817-819 | O92119 | 14 | 817-819 | ||
| O43211 | 14 | 776 | O649XX9 | 14 | 831-833 | O92119 | 14 | 831-833 | ||
| O43212 | 14 | 769 | O650 | 14 | 817-819 | O9212 | 14 | 769 | ||
| O43212 | 14 | 776 | O650 | 14 | 831-833 | O9212 | 14 | 776 | ||
| O43213 | 14 | 769 | O651 | 14 | 817-819 | O9213 | 14 | 769 | ||
| O43213 | 14 | 776 | O651 | 14 | 831-833 | O9213 | 14 | 776 | ||
| O43219 | 14 | 769 | O652 | 14 | 817-819 | O9220 | 14 | 769 | ||
| O43219 | 14 | 776 | O652 | 14 | 831-833 | O9220 | 14 | 776 | ||
| O43221 | 14 | 769 | O653 | 14 | 817-819 | O9229 | 14 | 769 | ||
| O43221 | 14 | 776 | O653 | 14 | 831-833 | O9229 | 14 | 776 | ||
| O43222 | 14 | 769 | O654 | 14 | 817-819 | O923 | 14 | 769 | ||
| O43222 | 14 | 776 | O654 | 14 | 831-833 | O923 | 14 | 776 | ||
| O43223 | 14 | 769 | O655 | 14 | 817-819 | O924 | 14 | 769 | ||
| O43223 | 14 | 776 | O655 | 14 | 831-833 | O924 | 14 | 776 | ||
| O43229 | 14 | 769 | O658 | 14 | 817-819 | O925 | 14 | 769 | ||
| O43229 | 14 | 776 | O658 | 14 | 831-833 | O925 | 14 | 776 |
| | |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 12 Mar 2025 12:04:04 CMS, code-revision=373, description-revision=1431 |